Wound Dressings for the Frail Aged

I personally use, and recommend, ONLY silicone dressings i.e.Mepilex Border™ by Mölnlycke, and Allevyn Gentle Border™ by Smith & Nephew. Both dressings have a wonderful silicone adherent that holds the dressing in place very well but will not damage skin on removal.

The silicone dressings can be left on for a week (depending on the exudates) and I have used it on skin tears, lower limb ulcers and pressure ulcers in nursing home residents.

But how many times have I heard nurses, managers and even wound care colleagues say those dreaded words…Oh! That’s too expensive…when I tell them about the wonderful properties of these, and other, second and third generation wound dressings?

So to help you understand the actual cost of [doing] dressings, I have prepared a spreadsheet. Click here to see it. (you will need Excel on your computer to open it).

The left hand column shows the cost of a traditional daily wound-dressing regime using a dressing pack, impregnated gauze and a secondary dressing held in place with tape.

The right hand column shows the cost of a weekly dressing like Mepilex Border ™ applied immediately after a shower.

Click here for a Step by Step ‘How to Incorporate Your Wound Management into the Residents Shower Regime” (This chart can be printed out and used in your health care facility).

The objective of showering is to clean the wound and surrounding skin. Showering offers a cheap and easy option of copious amounts of water to clean the wound, far more than you would use with a dressing pack and a little pack of normal saline.

Often dressings that are ‘low adherent’ do STICK like glue to wounds! They are painful to remove, can tear the epidermis away from the dermis and create a much larger wound.

Tape used to secure dressings is often contaminated with microorganisms, including methicillin resistant Staphylococcus aureus (MRSA). Tape goes from patient to patient and lives in the fluffy pockets of nurses, around their necks with a bunch of keys and / or it gets thrown back into the cupboard to contaminate all the clean rolls of tape! Scissors used to cut tape may be contaminated with bacteria as well.

These are big infection control issues that are simple to address by just using an ‘all-in-one’ dressing….no tape, no scissors!

In particular for the elderly with their frail tissue paper skin, please think about silicone dressings, it will save their skin at the same time saving you money.