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My patient has a healed wrist wound, but because the arm is contracted the wrist rubs against the chest and causes skin breaks. Any suggestions?

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I had great luck with the Liquid Bandage products.
It would seal the skin but also provide a more durable covering that would protect while the skin healed.
If there is a way to cushion the hand/wrist or the chest that might be helpful as well. Prevention is better than trying to provide "a band-aid cure"
An extra lap blanket maybe or "lambs wool" protector might help. Kinda like that "Sherpa" material
A bit off topic but when I had to start giving my Husband Morphine (very small doses) I was actually able to move his hand and arm out of the contracted position for the first time in a while. And he was able to maintain a more relaxed position for a while after medication. For the fact that he was able to relax for the first time in a very long time I was thankful for the Morphine.

As far as moisturizer I would "slather" him after shower or bed bath with a lotion that I would combine with a heavier barrier cream with zinc in it. The one with zinc was very heavy and the lotion seemed not to last long by mixing the 2 I had a creamy lotion that would last most of the day. I would do hands and feet again during the day.
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Reply to Grandma1954
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FIL was covered in these skin tears before he died. I did learn to dress the wounds and one thing I learned was that you have to keep the skin moist with antibacterial ointment and gauze and use those stretchy 'tube socks' to hold the gauze in place. Absolutely NO adhesive strips--you pull those off and have MORE tears.

We did dressing changes 2-3xs a day---and sadly, I was never able to keep up with the new ones, nor did the old ones ever heal. It was a losing battle, but I kept him comfortable, which is all I could hope for.
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Reply to Midkid58
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JoAnn29 Jul 1, 2021
Thats why I suggested Steri Strips. With these the tear will heal because they help to bring the tear together. My daughter is a wound care Nurse.
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Things to consider that will help with skin integrity:

1 - Only use a soap that is pH balanced. If your patient is older, try a cleansing lotion - one with moisturizers - rather than straight soap which can strip skin oils.

2 - Make sure to dry his/her skin well before applying lotion.

3 - I like lotions that contain jojoba or shea, but baby lotion can work well too. Use them after cleansing the skin and a couple of times during the day is skin is dry.

4 - If the person tends to get sweaty, crumbly skin, then moisture is a problem. Try to get the "sweaty areas" opened up a couple of times a day. Use passive range of motion exercises. Sometimes it helps to put a clean dry washrag into areas where skin meets skin.

5 - Sounds like part of the problem is also "friction." Try to reduce friction by covering the areas that rub with clothing. The wrist might do better with a wrist band, something like a smooth knit sock, that keeps the skin on the wrist from rubbing against anything.
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OkieGranny Jul 5, 2021
Just a heads up - some people are allergic to jojoba. My daughter is, but she's a redhead, so she's got a lot of sensitive skin issues.
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Skin breakdown is caused by pressure and moisture. Eliminate the moisture with Calmoseptine. It can be ordered through Amazon. This oinntment has Zinc Oxide and is excellent for helping heal pressure sores and wounds on bed bound patients.
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Reply to Robtw44
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If this question is about wounds, then a Wound Care consult is preferred since most care with breakdown is more about not just the skin, but nutrition, hydration and pressure. Unless you are a wound care expert which is a specialized nurse, or physician, I would not ask this question and get replies to follow, you can do more damage not knowing what type of wound is really there and risk of infection to point of growing more bacteria. Would advise to seek medical attention for this wound, and requesting Dressing Changes. Once you have the reason why this is likely the case of will it heal or not, then you can be taught how to care for it, otherwise you can accelerate a problem putting wrong creams or ointments on skin that might be breaking down due to poor nutrition. Skin breakdown is more than placing a covering.
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Reply to Allye1
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Not much you can do about skin tears. The skin just becomes too thin. My daughter gave me Steri strips for my Mom. They help to bring the sides of the wounds together so they can heal better. As said maybe a Telfa pad over where Mom gets the tears all the time. Lotions may help with dryness but will not cure the problem.
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Reply to JoAnn29
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I didn’t see this coming but logically it makes sense. Thanks for the questions and replies. I‘ ll be more diligent with my Mom as time passes. The last time she was in the ER I saw how painful pulling the bandages and adhesives had become. I’ll know to ask for alternatives now to head off the issue.
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Reply to sparkielyle
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I've been using Virgin Coconut Oil on my 97 yr old Dad for 2 yrs and it works awesome.
I use Butt Paste on his butt and he's never had a bed sore.
But my Dad's skin is Super thin so if he had an area like your talking about, I would let him wear 100% Cotton long sleeve T Shirts to help protect his skin.
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Reply to bevthegreat
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There's nothing to be done for fragile, thin skin, I'm afraid. My mother is having gruesome skin tears on an almost daily basis now.

Protecting the spot from getting hit or rubbed is about all you can do.
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Reply to MJ1929
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When my mom's skin tears were healing I would moisturize, and cover with a non-adherent dressing (like a telfa pad) and seal the edges (only) with silicone tape. There's probably something pre-made available, but I liked how this let me cut to shape and add an extra bit of padding if it was in an area that rubbed. The silicone tape has a secure hold, but won't pull on skin when removing.
Moisturizing: Sad but true, I use a lot of Asian beauty products and also use them on my gardening scratches and abrasions. Decided to try them on Mom to keep the 'new' skin supple. I did a moisturizing serum (or one of my heavier overnight 'face pack' lotions) as they seal in moisture like nobody's business. They are geared to be gentle. Not shilling for anyone, but this is what I used if you're interested-These are supposed to be tapped in lightly and a very little goes a long way. The Japanese products tend to be very minimalistic in terms of additives.
https://smile.amazon.com/Rohto-Gokujyn-Hyaluronic-Lotion-170ml/dp/B07DMZ76GF/ref=sr_1_18?crid=1OVRJO082TKY1&dchild=1&keywords=hada+labo+hyaluronic+acid&qid=1625150693&sprefix=had%2Caps%2C180&sr=8-18
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