Bandaging
To bandage or not to bandage. there is much controversy about how much to bandage. Bandaging for protection only is a personal choice with many pros and cons.
A blister/erosion/wound should be bandaged if any of the following are present:
- The wound requires protection from further trauma or contact/friction with clothes
- The wound is draining or bleeding
- The wound requires topical treatment for infection
- The wound is painful and a dressing will improve comfort
It would be ideal for all involved if one dressing would work on every wound at all times but unfortunately, various wounds will be at different stages of healing at any given time. To optimize healing, each wound should be assessed during the dressing change and product selection should be made based on the following features:
- The dressing must be non-adhesive. No tape or adhesives should be applied to EB skin.
- Moisture balance is essential for healing.
- A dry wound will need moisture added with a dressing that hydrates or adds moisture to the wound
- A heavily draining, wet wound will need the drainage removed from the wound bed by an absorbent dressing
- An excessively draining wound may benefit from an alginate or a specialty absorptive dressing
- An infected wound may benefit from a silver dressing (treatment is necessary for infected wounds. (See section on Infection)
- Personal preference is among the most important factors to consider. If you do not find a particular dressing comfortable, then it is not the right dressing to use.
Once you have determined the condition of the wound, choosing the proper dressing becomes easier. There are literally thousands of exceptional wound care products available and many are suitable for the treatment of EB wounds. Below is a list of some of the dressings, click on the Product Name for a detailed description of when they are most useful.
Mepitac: (Molnlycke Health Care) soft silicone tape
Mepitac is a soft silicone tape designed for securing medical devices such as EKG electrodes, IVs and dressings. Mepitac is highly conformable and easy to apply and remove. The Safetac layer assures secure fixation and easy removal from the skin.
(http://www.molnlycke.com/safetac/index.html)
How to apply:
Apply on a clean skin surface and avoid the use of ointments, lotions and creams.
Infants and those with especially fragile skin may not be able to tolerate Mepitac. In such situations, it has been reported to cause damage upon removal. If in doubt, soak off with water or allow to loosen by covering with Vaseline or Aquaphor
Rolled Gauze
There are literally dozens of brands of conforming stretch rolled gauze. Rolled gauze is used to secure bandages in place, absorb drainage and to add padding and protection to the EB dressing. It is important to look for a product that is comfortable, stays in place and isn't too warm. Rolled gauzes come in various weaves, some being tighter and others looser. They come in various widths (i.e., 2 inches, 3 inches, 4 inches, etc.). Selection depends on personal preference. Some brands to consider are:
- Conform Stretch Bandage (Kendall)
- Kerlix Lite (Dumex)
- Conform Roll (Conco)
- Elastomull (Biersdorf)
Tubular Dressing Retainers
There are several brands of tubular dressing retainers to choose from. Selection depends on personal preference. Some popular choices are:
- Surgilast Tubular Elastic Bandage Retainer (Western Medical)
- Tubifast Dressing Retention Bandage
- Bandnet Tubular Dressing Retainer (Western Medical)
- XX-Span Tubular Dressing Retainer (Allegiance)
Coban: 3M Healthcare dressing retainer
Coban is a flesh colored, permeable, elastic fabric. The fabric is coated with a self-adherent substance that gives the bandage the ability to stick to itself but not to skin or clothing. It is sometimes used as the outer component of a multi-layer bandaging system as a dressing retainer.
Vet Wrap is a similar product made for animals by 3M Healthcare. It comes in various colors (pink, red, yellow, etc.) and is preferred by some children.
