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There is a cream on the market called Mederma that claims to reduce scars. I have no experience with it, so I can't recommend for or against it. There are many brands of silicone sheets out too. Those do work. More aggressively, a physician can inject Kenalog, a steroid, into the lesion to help.

Renee C., MSPT, MPH, CWS

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silicin gel sheet

unsigned

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Hi Donna, here in New Zealand we use compression garments to prevent the formation of keloid tissue in burns patients.
Liz Francis, registered nurse

unsigned (JunctionalEB)

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I have never heard that Mepitel can be reused nor have I reused it. I have left it in place for up to seven days, pulled it away from the wound bed to make my observations and then replaced it over the wound. What I like about Mepitel is that it does not adhere to the wound bed, it lets drainage come through it and also allows wet-to-moist dressings or wound gels keep the wound bed moist without causing them to adhere to the wound bed. If you have any questions about reusing it, I would contact the rep or look it up on the Internet. I think Molyncke makes it.

Nancy B., RN, CWCN

Jan LPN, Wound Care Director

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Janelle
Please concentrate on how the blisters or other ecchymotic marks got on the body A, protect the blisters as long as you can,ie (if the blisters are on the heels keep the heels free-floating and identify the causative factor) With skin protectant you are drying out the skin over a period of time and you know that you must keep the skin hydrated so it won't dry out and crack, causing a break in the skin. Keep in mind, usually, if you take away the causative factor, and nutrition is OK the body will usually heel itself With Stage 1 wounds, it usually tells you that the patient needs to be repositioned more frequently, check bony prominence and use the appropriate modalities to remove pressure, shear, friction. I know you asked about how long you should use skin prep over blisters but you need to see and understand the whole picture

Janet G
Board Certified RN/ ET for 25 years

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Hi Janelle,
If the protectant wipes dry the skin apply a lotion a
bit before applying the skin protectant wipe. While
allowing the skin to dry from the lotion just protect
the affected areas. Try using the protectant barriers
during the night while the patient is sleeping and
still. Later on when you check the pt apply the
barrier wipe. 3M also makes a barrier cream which
protects the skin and provides moisture to the skin.
Otherwise check which brand name your company uses and
ask a representative for advise.

Theresa RN

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I used to apply skin protectant because I was told it toughens the skin, but it always caused the skin to dry and crack. I currently use Xenaderm on intact skin on heels, usually stage 1 or stage 2 blisters because it is covered by Medicaid, but almost any petroleum based ointment will do. I got great results from Smith and Nephew's Unisalve before Xenaderm was on the market. Make sure the heels are off-loaded.

unsigned

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Dear Janelle:

Anything that causes drying should not be used on necrotic skin or open wound. However, more importantly, when you say ". . . purple or brown spots that show up on heels" you are indicating too many patients in your institution are suffering from prolonged pressure on their heels (one is too many). Forgive me if I sound critical, but, the real problem for your staff to resolve is alleviating heel pressure. Your patients need anti-pressure boots, which must be removed and reapplied every eight hours without fail. Please avoid floating the heels off the beds with pillows because that merely shifts the pressurized area from the heels to the calf area and behind the knee.

Thomas A. Sharon, R.N., M.P.H.

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Hydrogen peroxide is cytotoxic. Soaking in it for a half hour per day will make it difficult to heal.
Sheryl CWS

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Janet-
Full strength H2O2 soaks are used to debride necrotic tissue and prevent infection. Personally I only use them to a point; when the necrotic tissue starts to lift and you can grab it with teasers, look into sharp debridement.
Tina (LVN, wound care nurse)

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Hi,

I would clarify with the MD to ensure he just didn't
misorder this. I have never heard of such an order.
H2O2 works much better with H2O. However, it also eats
away healing tissue as well as necrotic tissue. I
would question using a different type of treatment
altogether.

Theresa RN