Wound dressing contact layer

So after a little motorbike incident in Chiang Mai, I'm sitting in a hotel room in Thailand right now recovering from some wounds. Road rash hurts, but what hurts even more is changing the dressings everyday because the gauze get stuck to the wound, and peeling it off just causes it to be exposed again.

However, right after the incident I was in one of their pharmacies (basically a really, really tiny drugstore) and they gave me this thing I've never seen before. It's called URGO Techology Lipido-Colloid, and it's feels like this 4x4 teflon like patch that you apply under the dressings. It prevents the gauze from sticking when you undo the dressing. If anyone knows where to get this stuff in the US, I highly recommend to keep it in a first aid kit. Unfortunately I only bought a few pieces, but I'm thinking I might buy a couple boxes of this stuff to bring back.

Anyway, one thing I learned (aside from being more careful on a motorbike) is that I really need to carry a lot more gauze and first aid tape. Luckily I was carrying two first aid kits (my normal, and my hiking one), so between those two and all the bandages I was mostly able to patch myself up on the side of the road

and after you debride it, you sprinkle some salt on it to make it heal faster.

There are some gel pads on the market, telfa pads, vaseline gauze and plain gauze smeared with bacitracin work okay, tho the latter keep the wound kind of damp. The old standby approach, serving both anti-pain and debridement functions, is to soak the wound, old dressings and all, in warm salt water. softens the adherent secretions, improves circulation to the area, and permits relatively painless removal of the dressing. Cheap, easy, simple...much like myself...

It's been mentioned here before, but honey would be a good option. I keep a vial in my first aid kit, a small vial anyways. Easy to find in any city, improves healing, reduces rate of infection.

Eric

I was going to ask about hydrocolloid bandages in general. I think the 3M name is tegaderm, and J&J sells some too with names like "advanced healing" or some such.

They're not just meant to be a contact layer, but rather the entire covering. They're meant to function like an artificial scab, so the wound can stay wet and heal underneath. They stay on for upwards of a week at a time but can't be used on infected wounds.

Does anyone have experiences with this type of dressing/bandage they could share?

Tegaderm probably isn't what you are looking for. It is similar to just a piece of clear, square, flexible plastic that has adhesive on one side, usually used to cover IV sites. There isn't any hydrocolloid on it. I've seen what you are thinking about though, in the pharmacies.

Eric

right on. tegaderm and clones are a semi-permeable membrane like goretex-allows vapor to pass, but not water droplets. Put it on a wet wound-road rash or similar abrasions, you get a layer of serous drainage, blood, pus.], that collects under the teg and stays wet and eerily squishy for a long time (experimented on myself, and one of my kids). put a piece of gauze on a dryish wound, add a teg to cover it, and you have a pretty cool dressing, protects the wound from water penetration and permits it to breathe.

The hydrocolloid dressings are an outgrowth of burn center technology, but they are heavy and bulky and offer little first aid advantage over gauze squares, as nearly as i can tell.
On the other hand, if you are using maggots for wound debridement , colloids might work fine:
"What is the role of hydrocolloid dressings in maggot therapy?
Despite decades of experience in Maggot therapy, selecting appropriate dressing materials continues to be a problem. The dressing has to (1) prevent the maggots from escaping, (2) permit oxygen to reach the maggots, (3) facilitate drainage, (4) allow inspection of the wound, (5) require minimal maintenance, and (6) be of low cost.

One centre developed a two-layered cagelike dressing, the bottom layer of which comprised a hydrocolloid pad, applied to the surrounding healthy skin and covered by a fine chiffon or nylon mesh. Liquefied necrotic tissue drained through the mesh and was absorbed in a top layer of gauze, which was replaced periodically. Thus it was possible to contain the maggots within the wound by means of readily available materials.

Reference: Sherman R. A., A new dressing design for use with maggot therapy. Plast Reconstr Surg 1997 Aug;100(2):451-456"

Nursemike, is tergaderm the equivilent of this product?

http://www.urgouk.com/products/urgotul_ssd.php

This is what I was talking about, though it doesn't sound like the same thing as what you're describing. It's just a real thin sheet, you peel off the plastic layers on each side and apply it directly to the wound, under the gauze pad. There's no adhesive on it that I can tell. The wound stays moist, I'm not sure if that's good or bad, but most of the discarge is absorbed by the gauze above it. If anything, the biggest advantage was not having to peel off a fresh layer of skin when you change bandages.

I think I'll skip the maggot therapy.

Silver is good stuff, my nurses swear by it for wound care.

And I recall an old nurse that would use honey for bed sores- they healed, but nothing scientific in her methods.....

Interesting that you would mention "Honey". A friend of mine is recuperating from a bad bout of MRSA and the wound is being treated with honey along with IV antibiotics.

Back in the old days, we treated non-healing wounds by packing them with sugar, or strapping an oxygen mask on the wound and giving it an enriched atmosphere. Folks have tried hyperbaric oxygen therapy, and all the colloids and stuff already described. These approaches are regaining some status as we run out of effective antibiotics.

One of the tattoo shops where I've had some work uses a meat packing thing.

You when you open a package of ground beef, in between the bottom of the meat and the foam tray there is a liner of sorts?

They use those, but clean, unused ones of course.

They work pretty good for tattoos at least. I have one on my thigh where I was having problems with denim rubbing when I walked. I got some of those meat packing pads and used an ace bandage.

Seems to me they would work fairly well for RR too. You can get a few from the butcher or likely buy them (probably in bulk) as well. Don't know what they are called exactly.

Ditto me - the FDA just approved "Medical Honey" - I'm suffering with MRSA, but they are trying to keep me out of the hospital, and use Zyvox

2 drugs are going through the FDA approval process that in clinical trials, killed the MRSA virus in 95% of the patients treated!!!!

Hang on for about a year and it should be on the market!!!!!!

Hang on another year? Sigh - MRSA HURTS - when my wound starts to really hurt, that's when I know I'm seriously infected - again.
I have a feeling they are going to put me in the doc shop tomorrow - the stupid insurance company wants pre-approval for the Zyvox, and have been dragging their feet for 5 days now - and my leg keeps getting worse. MD said if my leg wasn't better by tomorrow WITH the zyvox, I was going into the hospital - well, the insurance company hasn't approved the prescription - they don't want to pay the $2800 - so they are going to end up paying 30K+ for me to go in-patient, and have it given IV

See if you can get home infusion- have you checked into that?

Call a company like Coram, ask them to work with your doc to either come to the home or go to one of their infusion suites.

Sometimes insurance companies will pay for home infusion as a less costly alternative to admitting you. Or the home infusion company will work something out with you and the drug maker that costs less if out of pocket.

Hope you feel better,kc.....

I was on the oral Zyvox before (Feb if I remember right) - they will probably get around to approving me, but if it's not soon, they are going to be too late

The last time I priced it, it was $2800 for the 28 pills