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I ask my nurses to leave the discarded dressings on top of the trashcan so that I can have a look at them. There’s a lot you can learn from used dressings. I am worried about the fact that drainage can be copious despite compression, that patients on oral anticoagulants ooze blood continuously, and that it’s still a challenge to control bacterial colonization, even with all the tools at our disposal. I think these days I collect more pictures of used dressings than of wounds, and I’m trying to figure out better ways to use this information in patient care.

Completely saturated dressings and neon green drainage. Clearly, the wound colonization is not controlled, and I haven’t figured out how to turn off the faucet of his edema.
This patient with a diabetic foot ulcer has worn a “hole” in his dressing (which is also bloody.) Do you think this dressing tells us something about whether he’s offloading?
More bloody dressings. Coumadin didn’t cause constant oozing, but the newer coagulants do. I am willing to bet this constant oozing impacts healing. What should we do about it?

Dr. Fife sees patients at the CHI St. Luke's Hospital Wound Clinic in The Woodlands, Texas. For an appointment call (936) 266-2150.



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