Miller

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Panafil is used primarily for it's healing properties as the constituent properties of hydrophyllic copper complex and chlorophil support the growth of healthy tissue. There is a debriding component, but this is weak in comparison to Accuzyme or other enzymatic type debriding agents. Wound gels (hydrogels) would maintain a moist environment - but with chronic wounds or stalled wounds - the dynamics of normal healing are impaired. If the person is a diabetic - both wounds are subject to the impaired healing factors of being a diabetic. Best to offweight the areas as much as possible, support healthy tissue formation and promote moist wound healing with a viable wound edge. Keep the diabetes well managed !!! Proper nutrition !!!!

Gregory J. Redmond, PT, MSPT, CWS
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There are many people out there that believe the same as you. I was even one of them. Panafil can heal, debride, and deodorize wounds. Papain, the proteolytic enzyme derived from the fruit of carica papaya, is a potent digestant of nonviable protein matter, but harmless to viable tissue. I has the the unique advantage of being active over a wide ph range. Papain alone is ineffective for debridement. When combined with Urea, it can denature the nonviable tissue, or debris of lesions. The Chlorophyllin Copper Complex Sodium is what adds the healing action. It promotes healthy granulation, controls inflammation, and reduces wound odors. Adding this last component to Panafil is what permits its continuous use for as long as desired to help produce and then maintain a clean wound base and to promote healing. Panafil can be used for acute & chronic lesions like varicose, diabetic and decubitus ulcers, burns, post-op wounds, pilonidal cyst wounds, carbuncles and miscellaneous traumatic or infected wounds. There are no know contraindications for use & Panafil is generally well tolerated and nonirritating. Go to www.healthpoint.com for more information.

unsigned

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Hello,
It's my understanding that while Panafil has a debriding agent in it, it is a low concentation of papain urea. We are using Panafil as a healing ointment because the papain urea retards the formation of slough while the chlorophyl acts as a healing agent. I have used it until the wound is completely healed without problems. The only problem is that it can be a costly treatment for patients that must purchase it themselves. In that case we usually recommend a hydrogel.
Hope it helps.
Kelly RN WCC

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Yes Panafil is indicated for these wounds, the debriding agent in it helps keep the wound clean and the copper in it will help strengthen the wound bed. The debriding agent in Panafil is not a high enough concentration to be indicate Panafil as an enzymatic debrider.
Tina (L.V.N./ wound care nurse)

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 Hello,

Best way to find out why its being used is to ask who ordered or who asked the Doc to order.
Though panafil is used to debride, it alkso can be used to soften up a "tough" area to promote
the formulation of granulation tissue. This doesn't mean that is specifically why its being used on "your" wound, but it is one reason panafil is used despite any presence of necrotic tissue.

Respectfully,

Chuck DiTullio R.N.

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Panafil does have debriding properties, but it is also very beneficial in promoting healing by promotion of new tissue growth. Often used in clean wounds for this reason. Panafil helps control any odor that may be present, will debride any sloughing tissue, a promote granulation for faster healing.

unsigned

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Hello, Panafil has only about half the debriding agent of something like its sister product Accuzyme. Panafil is used when you are trying to keep the bio-bed clean, free from bacteria, etc. Many studies have been shown to use Panafil from start to finish on a wound with good success.
Cheryl Nichols LVN Treatment Nurse

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Panafil assists in increasing blood flow to wound and promotes granulation. It will also help prevent the build up of slough. It is an appropriate treatment for the wounds you describe.

Monica Miller RN,C

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I would recommend contacting Healthpoint, they will come by your facility and give you information regarding thier products. According to their brochure Panafil's primary goal is to promote healthy granulation, and is for granulating wounds. I recommend this product often for many types of wounds. Hope this helps.
DeLaney, CWS

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Technically in order to be a stage II ulcer the skin must be broken, you can cover yourself with documentation if you chart "closed blister located on xxx unable to determine extent of underlying tissue damage", then after the blister opens stage appropriately.
Tina (L.V.N./wound care nurse)

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The aetiogenesis of 'pressure sores' has been accepted / doucmented to be pressure or friction (shearing forces). This is a purely academic question as your management does not really change with the 'label'.
kumkum

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 Desiree,

Your co-worker could be right. A wound should be staged IF it is a pressure ulcer and in that case a blister that is caused from pressure is stage II. If it is a blister caused by something other than pressure, friction and shear forces, then it is not a pressure ulcer and would more correctly be classified in other terms... maybe just a blister, which is a partial-thickness wound not a full-thickness wound. Classifying wounds can be confusing. Just keep in mind that only pressure ulcers/sores are given the term "stage I/II/III/IV." There are lots of wound websites that you can learn from.

Amy, RN, BSN - Cambodia
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A stage 2 is a partial thickness wound and so a blister would be classified as a Stage 2 wound. The real question would be- is it pressure or another cause?

Annie Bresnahan, R.N.A.D.O.N.skilled nursing facility

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you were correct at staging it as a 2...if it is a blood filled blister it is a non stageable...

jo..WCC

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 Hello,

Once the blister pops it may be called a "stage 2" although superficial. Stage 2 sores are "open" areas of the integumentary system.

Respectfully,

Chuck DiTullio R.N.

Barbara

AN ALGINATE ON THE WOUND BED (SUCH AS KALTOSTAT, MAXSORB, ETC) AND COVER WITH A FOAM DRESSING, SUCH AS ALLEVYN OR OPTIFOAM.

Amparo (Amy) Pastor
RN, CWS, Manager of Clinical Practice

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I have a few thoughts. You could use absorbent dressings, like foams,
hydrofibers, and alginates. Another option would be the VAC. However,
I have to ask if the wound goes into the joint. If so, synovial fluid
could be draining heavily. That would require surgical intervention.
Renee Cordrey, PT, PhD(c), MSPT, MPH, CWS
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There are several you can try... alginates, foams, powders... change the dressing more then once daily... with out knowing more about what you have tried it is hard to help.
Tina (L.V.N./ wound care nurse)

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sanitary pad to absorb the discharge and ZnO paste to protect the skin
kumkum

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one method is to soak the dressing in tap water
or savalon + H2O2, give it some time and allow the innermost layer to separate under flowing water(tap).
kumkum

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Soak the wound in clean preferbly warm saling although clean water will do.

Respectfully,

Chuck DiTullio R.N.

HHC

The best way to treat a stage I is to keep the pressure off it.
Renee Cordrey, PT, PhD(c), MSPT, MPH, CWS

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Good nutrition and frequent repositioning. Keep well hydrated. Keep off of the site as much as possible.

Monica Miller RN,C

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I presented an inservice to my homecare agency last year. I did a search on google for images and asked for "pressure ulcers" and got many pictures that were helpful. If you're looking for a specific stage you can also search for "stage ? pressure ulcers" which narrows the search. Hope this helps.
Kelly RN WCC

Undermining is like a lip on an edge of a wound. Tunneling is a hole.

Joan Sullivan,MAS,RN,CNA,CWOCN