Application & Instructions

PLEASE READ EVERYTHING BELOW & Please Follow These Time Tested Suggestions – use the video as a supplement to written instructions:


DermaWound – Application, Dressing Changes & More
Video by Dr. David Dixon, MD – 11:03

VENOUS STASIS & BURN INSTRUCTIONS are below at the end of the primary instructions.

ALL You Will Need Is:

aOne of Three DermaWound Brand Products for your specific condition;
b. Tongue Depressor or similar tool to apply product directly onto a gauze pad and/or directly into the wound or ulcer;
c. Cotton Gauze Pads/Sponges
(i.e. 4×4’s, 2×2’s, etc. wound-size dependent);
d. Tape of your choice – please use whatever you find to be less irritating;
e. If ankle or leg involvement – a Kerlix-type bandage (gauze webbing that resembles an “Ace” bandage) depending on the type of wound;
(C, D & E, can all be found in our Discount Gauze & Tape section: Click Here)
f. A clean water source for rinsing the wound site.

Obviously the gauze needs to be new and packaged, but does not need to come in sterile individual packing. In general, Wound Care at home is not a sterile procedure; so why should anyone at home be forced to spend money for sterile and individually wrapped supplies they don’t need? (We do not recommend using Bulk Packing in an Institutional setting, unless it stays at the patients bedside and hand-washing protocol is strictly enforced.) Talc-free disposable gloves should be worn with each dressing change, but they also do not need to come in sterile packaging (like in an operating room) – which also reduces overall cost.

1. Prior to application of DermaWound (any one of 3 types), evaluate the wound or ulcer. Insure that no active pulsing of blood from an artery or vein is present. As the DermaWound quickly works, new capillaries will form and break as new vasculature is established, so spotting is normal and is to be expected with each dressing change.
2. Gently rinse with clean water or normal saline. Use a shower head, squirt bottle or syringe. *Do NOT actively clean out the wound bed – never, ever, ever*. Very Important!!!
The wound itself does not need to be thoroughly cleaned and residue free.
This can not be overemphasized. Whatever does not come off with normal irrigation (water or saline in a squirt bottle; shower or bath) or on the gauze pads during a dressing change, will come off at a later date when it’s ready.
3. Gently dry around the wound or ulcer using a clean gauze pad, absorbent towel or cloth. Then take the gauze pad, absorbent towel or cloth and set it on top of the wound itself. Apply pressure ONCE using the palm or fingers, to the material on top of the area being treated – then lift it off. That’s it!
Let entire area air dry for 3-5 minutes before re-dressing.
It is important to let the area that holds the tape get a chance to breathe and dry out a bit, to help prevent maceration (moist skin breakdown) of the surrounding healthy tissue. After the surrounding area has dried is when pictures should be taken – prior to step 4.
4. Spread DermaWound on a 4×4 or 2×2 or size appropriate Cotton Gauze Pad, or apply directly to the affected area, to a height of approximately 1/8 inch – like a thin layer of creamy (slightly granular) peanut butter – covering the entire wound area, overlapping the border edges 1/8 inch.
NOTE: a)At first it may seem a bit difficult to work with because the product is “tacky”, but after a couple of dressing changes you will be a pro! b)And don’t worry about the sheets or clothing as it will rinse clean with washing
5. Apply the DermaWound side of the gauze to the wound or ulcerated area(s).
6. Tunneling wounds or Fistulas should be packed to the surface with DermaWound. If necessary use your finger to pack or to dilate the opening; then make a plug/cork out of gauze to hold it in.  At the next dressing change most, if not all, of the product will be gone – which is normal. Occasionally, if a tunneling wound appears to be closing at the surface faster than the tunnel is healing on the inside; simply use your finger to dilate the opening at every dressing change to insure product can be adequately packed in. Having said that, in 21 years we have never seen an opening close before the fistula or tunnel has healed from the bottom up completely.
7. Apply 3-4 discontinuous layers of additional 4×4 or 2×2 gauze over the wound, ulcer or fistula for additional padding and to soak up the exudates that will be quickly pulled out (if wound is draining, swollen or edematous). Use less gauze if it is not draining.
If necessary apply an ABD pad over the pile of gauze to ensure a tight, even seal when edges are secured. The bandage should be occlusive. In some instances you can just not get a tight seal (perineal region/between sex organs & anus), just do the best you can.
On the sacrum, hip, or relatively flat areas, make sure the edges of the gauze are secured (with paper tape or Medipore tape) to help prevent leakage.
If the wound or ulcer is on a leg or foot, use a Kerlix gauze or J&J No.1 rolled gauze as an “Ace” bandage to hold it in place.
A comfortable Pressure Stocking may be used in conjunction with any bandage or by itself (no more than 15-18mmHg).
Any adhesive tape is OK, as long as the person does not have a sensitivity to it.
8. Dressing changes, on average, should be done twice a day (every 12 hours). If once a day is all you can manage, that will suffice and you will still have better results than if you use any other wound care product.
9. If the wound or ulcer is Very Infected, Purulent and Draining, it should be changed three times a day (every 8 hours) initially.
Brown Recluse bites should also be changed 3x day (every 8 hours first 3 days, then every 8-12 hours thereafter).
10. If infected and draining – major amounts of pus, exudates or discharge on the gauze is good and normal in the beginning (first few days). Old Venous Stasis ulcers (>6 or 9 mo.+) can drain up to 12+ weeks.
11. During treatment, sometimes a wound or ulcer will flash over with black eschar – this is normal.  Do NOT Remove the Eschar, simply keep putting DermaWound over the blackened area until the eschar becomes friable and starts to break up, exposing healthy granulation tissue underneath.
12. When changing the dressing every 8-12 hours, re-dress the wound or ulcer following the instructions in #’s 2, 3, 4, 5, 6, and 7 above.
13. Again…do not actively clean out the wound bed – the whitish, yellowish slough is basically a soft scab that is very important as it protects the primordial epithelium in the granulation tissue and should not be wiped off or removed.
Please re-read for emphasis.
14. On occasion, after periods of rapid healing (or an “accidental” or unwanted debriding), a large wound or ulcer may appear to “slow down” – this is normal. After rapid tissue generation sometimes a wound needs a resting period to gather its strength before beginning another rapid growth or healing phase. This period of “rest” usually last between 7-14 days. Keep using the DermaWound during this time and expect the wound to once again begin a rapid healing phase after a brief pause – while tissues under the wound/ulcer remodel and become stronger and more stable.
15. Continue to use DermaWound to cover the affected area as it closes, until you literally need just a small amount to cover the small remaining wound area.

Continue to use until the defect has resolved completely.
That’s it! Please follow the time tested and proven instructions/algorithm and do not be creative!

VENOUS STASIS INSTRUCTIONS:
DO NOT use the Original Formula for any Venous Stasis Ulcers – as it will be too strong and is not the right tool for this type of job.

If the wound/ulcer is on the bottom or side of the toe, foot, ankle or leg and is weight bearing during the day (as are ALL Venous Stasis Ulcers), DermaWound should be applied only at night when “down” for the evening (covered with a Regular Gauze Pad/Sponge) and removed in the morning to avoid unnecessary agitation while active or working. The wound site should then be covered during the day or while active, with a Bacitracin, Polysporin, Vaseline or Triple Antibiotic type of product (avoid Neosporin or Silvadene) and a Non-Stick Gauze Pad/Sponge to maintain a moist environment until the DermaWound is reapplied at night or when not active.  Believe it or not, after following this algorithm for over 22 years, we know from experience that if you are active and your wound is on the bottom or side of the toe, foot, ankle or leg – you will heal faster if you only use it at night or when down, rather than trying to use it 24/7!

Note: Venous Stasis Ulcers of long standing duration will take considerably longer to heal than any other chronic non-healing wound – the older the Venous Stasis Ulcer and the heavier the client, the longer it will take.  Also, the wound may get larger before it starts to heal from the outside in; but will become shallower at the same time.  DermaWound has to first remove all non-viable tissue and reduce edema to begin the healing process – and in Venous Stasis wounds, that usually includes some infected surrounding tissue. This is unfortunately the nature of the hardest wound in the world to heal.  If a Venous Stasis Rash or a great deal of leg edema and weeping are present, one must consider use of our Venous Stasis Relief Spray initially. Please consult our website or call if you have any questions.

BURN INSTRUCTIONS:
ONLY USE: 1.) DermaWound Venous Stasis (VS) or 2.) Hypo Allergenic Formula AFTER The Acute Stages of a Burn (thermal or radiation injury).
DO NOT use the Original Formula for any burn ulcers – as it will be too strong and is not the right tool for this type of job.

1. If you are burned, you need to let the area calm down first – before the application of DermaWound VS or Hypo.
2. If there are blisters, apply DermaWound VS or Hypo AFTER the blisters break.
3. We suggest using Xeroform Petrolatum impregnated gauze in the acute phase of any burn until the area starts to dry and eschar/scabs start to form.
Again, only start application of DermaWound VS or Hypo after the acute phase of any burn.
4. The area may become “goopy” with exudates – do not wipe that off. Whatever needs to come off will come off by sticking to the gauze pad during the course of a normal dressing change.
5. Keep putting DermaWound VS or Hypo on the affected area twice a day (BID) using an occlusive dressing.
6. If application of DermaWound VS or Hypo is painful, stop using it until it’s not.
7. If the bandage sticks, and it most likely will, apply water to the gauze for 5 minutes to allow it to loosen (you may shower – and again, do not actively clean the burned area).
8. Dead skin will slough off attached to the gauze as it is auto-debriding.
9. Natural areas of skin “islands” will start to develop even over large areas of tissue loss; thereby eliminating the need for skin grafts. VERY large areas of tissue loss will require temporary coverage of a skin substitute to prevent dehydration and shock.
10. Rinse affected area(s) with cool water; pat dry. Let area air dry for 5 minutes (take pictures at the end of 5 minutes) and redress.
11. Try to keep the affected area out of direct sunlight until your natural color starts to return (it may take several months to one year depending on the severity and extent of the burn injury).

Wound Care Support “Hotline” – please email email us at: pdcustomerservice@hotmail.com Attn: Doctor – telling us of the situation (include a name and return phone number to reach you); and one of our medical professionals will contact you at our earliest convenience for a free consult / opinion of your situation.

Side Effects / Precautions:

1. 33% – transient smarting or stinging sensation, fades after 15 minutes.
Every product on Earth has the potential for an allergic reaction except water.
2. 1-3% Local Allergy – Persons who are allergic or sensitive to Iodine should avoid DermaWound Original and DermaWound Venous Stasis (VS).
3. 1-2% Local Allergy – Persons allergic or sensitive to “-caine” based products (Novocaine, Benzocaine, etc.), should avoid DermaWound VS. We have DermaWound Hypo Allergenic Formula formula for these instances.

So… Allergic to Iodine, but need DermaWound Original Formula ?
Use DermaWound Hypo Allergenic.

Allergic to Iodine, but need DermaWound Venous Stasis ?
Use DermaWound Hypo Allergenic Formula.

Allergic to Benzocaine, but need DermaWound Venous Stasis Formula ?
Use DermaWound Hypo Allergenic Formula.

4. If a local allergic/sensitivity reaction does occur, it simply requires removal of product, followed with clean water irrigation. Local symptoms (a burning sensation) will subside within 1/2 to one hour. Do not hesitate to email us if you think you are sensitive – just because the product keeps working and you are happy to find something that really works well for the 1st time – if you think you are becoming sensitive, email us (Attn: Dr. Dixon) and stop using immediately.
5. No continuous/pulsatile bleeding (i.e. after a sharp debridement – which is usually not necessary due to the natural debriding properties of these products) should be present for 24 hours before the use of DermaWound.
One of the many ways DermaWound works is by naturally increasing circulation to the damaged area, which promotes new vessel formation. With that in mind, spotting of blood is normal and expected during dressing changes.
6. If you are using DermaWound on your feet or legs and need to walk around during the day, use DermaWound overnight after an evening bath or shower. During the day use a broad spectrum Triple Antibiotic Ointment like a Bacitracin or Polysporin to keep the wound from drying out. If you will not be ambulating (walking) a lot during the day or night, you can try DermaWound 24/7 to see if it will be comfortable or not. Please be conservative in your approach.

Getting up and going to the bathroom or kitchen is always OK;
walking the dog is not.

Please avoid: a)Neosporin (it seems to irritate these types of larger, chronic wounds – we believe it’s the type of Neomycin used in the name brand); and b)Silvadene (it will keep the wound clean, but it stops the healing – we have no idea why) as a daytime or activity salve/ointment.

In regards to the legs, feet, ankles or toes – even if it does feel comfortable and you are finally out of pain, we still strongly suggest DermaWound be removed while active or working.

If active or sitting for extended periods of time with Venous Stasis Ulcers, Men & Women, please wear a mild knee-high compression stocking (15-18 mmHg) during the day or working hours – ALWAYS (even after you are completely healed to help avoid future breakdown). They should be comfortable… make sure they are not so tight that they actually restrict blood flow or are so uncomfortable and tight you do not want to wear them.

The higher pressure stockings are simply not as comfortable, more restrictive and cost a whole lot more; therefore in our opinion, we do not see a difference in effectiveness to justify their use and recommend a pressure gradient of 15-18mmhg in every situation.

As everyone knows in this situation and has been told by every doctor and nurse in the world, ideally one should be non-weight bearing (crutches or scooter) if they have wounds on their feet. However,  many people still have to work or are alone; so you have to do what you have to do and we realize that.

 

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