Mum refusing compression bandaging

Posted , 11 users are following.

This discussion has been locked due to a period of inactivity. Start a new discussion

I would really love some suggestions, if anybody has advice at all that they can offer. My mum is 84 and has 2 large painful leg ulgers on her ankles on both legs that have persisted for 2 years. She is adament that she does not want and cannot stand compression bandaging. She understands the theory of it and is very informed generally. My 87 year old father mainly changes the dressings (Melolin) and lightly bangages them for her. I also do it sometimes when I visit. The melolin dressings are not terribly absorbant nor comfortable. She pays for the dressings herslf and this is quite costly but the District nurse told her that, as she refused the compression bandaging there was nothing else to offer her. My brother was there at the time and asked if there was another dressing that could be recommended and she suggested one that we are unable to get in the size needed to cover the ulcer and my Mum explained that to her, but she just shrugged. Due to my mums lack of compliance she has become isolated from any medical care. She has become afraid to contact the GP because she says she is not doing what she has been told. My brother contacted the patient manager at the GP clinic and she sent the District nurse (again). And the cycle goes on. I want my mum to have the best care but I do not want to go against her wishes.

Does anyone know of any good absorbant dressing she could use? Does she have the right to insist on an alternative to the compression bandaging from her GP surgery? I would appreciate any help!

1 like, 11 replies

Report

11 Replies

Next
  • Posted

    Hello. My son returned from a week's respite with an enormous blister on his instep which had burst and looked very deep and ugly.

    The nurse I've been liaising with who has been dressing it seems pretty

    competent and has recommended METIPEL, swears by it, which is a

    silicone gauze which you cut to size. About £2.50 each.

    It doesn't stick to the wound, it allows any exudate to pass through into a padded absorbent dressing which you can change as frequently as you

    wish without disturbing the gauze which stays on for several days or evenup to a week or so.

    The dressing is MEPORE made by the same firm, comes in

    different sizes.

    We bought both these products at a big Tesco pharmacy.

    Hope this helps. Do wish the medics were more open minded!

    Report
    • Posted

      ruthio7, thank you so much for this. I am going to pick some up from Tesco for when I visit next week. I imagine leaving the gauze in place will allow healing to take place undisturbed and not a bad price either!

      Yes, It is a shame that the medical people haven't been more understanding, they have managed so well without help for so long.

      I really appreciate your input. I hope your son's blister has healed well,

      Many thanksconfused

       

      Report
  • Posted

    We delete content if it doesn’t meet the requirements in our Terms & Conditions.

  • Posted

    Yes! My son's horrific blister wound is now healing nicely, magic!

    I do hope the MEPITEL is good for your mum.

    There is also a MEPITEL ONE, don't get this as it's only coated on one

    side.

    I'm using it now on an ulcer on my leg which isn't healing no matter what I used, manuka honey, solcoseryl (recommended on this forum)

    Fingers crossed.

    Report
    • Posted

      That is great news!!

      Good luck wwith your healing too. I would be interested to know how you get on. I will post back on my Mum's progress.

      Fingers crossed all round :-)

      Report
  • Posted

    Hi there, I am a 51yr old lady that has been suffering from recurrent leg ulcers for 30 years.

    Your mums wounds will not heal without compression and you are wasting your money on expensive dressings without the compression.  Ask your mums GP to refer her to the tissue viability nurse at your local hospital, its important that the skin around the wound is kept moisterized and healthy.  Do not leave the silicone layer on the wound when you change the dressing as the edge of the wound is where all the dead skin and exhudite will accumulate and promote infection and you cannot remove this through the silicone layer.  The nurse can start the application of the compression at a light level that your mother can tolerate and will even benefit from some pain reduction.     The dressings should be changed at least twice a week. Make sure she is one the correct pain meds, ulcer pain is neural  (nerves, like a bad tooth) not muscular, over the counter meds will not address this issue, she could probably benefit from some Lyrica or Amitriptyline ask to see a pain nurse.  If the compression is complied with the ulcers could be healed within 2-3 months and a switch to compression hosiery could be used to prevent the recurrance.  Two-3 months of discomfort and/or inconvenience is much preferable to years of pain. 

    Report
    • Posted

      Dear ruthangel

      Thank you so much for your detailed reply. I know that this treatment is the gold standard and would indeed most likey be the most successful. I think my mum has a phobic reaction to the compression. She is of sound mind and very intelligent, but is adament that she will not have it and gets quite upset and pannicky. This is obviously a cause of frustration to the medical profession and we understand this, but still feel there is duty of care here.

      Thank you also for the advice on cleaning the periphery of the wound and also on the pain relief suggestions. 

      We will continue to persevere and hope that we can help her find a GP who will gain her confidence.

      Thank you again!

       

      Report
  • Posted

    Hi

    Sorry to hear your mum is suffering from painful leg ulcers I really feel for her.

    I have had a Non-Healing Chronic Leg Ulcer for nearly 6 years now and currently using Zetuvit Plus Dressing Pads. They are ideal for heavily exuding wounds and come in a variety of sizes (20x40cm is the biggest I think).   Also at every dressing change my leg is socked in Prontosan Wound Irrigation Solution for about 10-15 mins which helps cleans, moisturises and decontaminates the wound before the new dressings (inadine and N-A) and compression is applied.   

    Is it possible your mum could see a different GP or ask to be referred to the hospital vascular team, tissue viability nurse and if necessary the pain relief clinic.  

    Regardless if she refuses the compression bandaging or not they still have a duty of care to her and should be doing something even if its just changing dressings on a regular basis.

    Please tell her not to give up or be afraid to contact them as she is not receiving the care she is entitled to and needs, keep pestering them until she gets somewhere.  If she feels she still isnt getting anywhere with them, tell them you will be making an official complaint as you are not happy with the care she has received so far (even if you dont actually make the complaint) I was in a simular situation last year and it wasnt till I said about making an official complaint, that they actually did something.If its the pain your mum is worried about when using the compression bandaging ask the nurses if they can pad her legs out with K-Soft under the K-Two compression (some areas still use K-Soft and K-Lite bandaging which may be worth asking about), this may help with the pain aswell as helping to absorting exudate.  The compression shouldnt be uncomfortable or feel too tight, if it is it needs to be removed, it may however take a few days/weeks to get used to it.   Once in compression it is usually changed once or twice a week by the district nurses.  

    Please dont let anyone tell you the ulcers will be healed within 12 weeks or less if using compression as this is not always the case as it will depend on the underlying cause of the ulcer as well as other factors involved (ie mobility etc).  

    I really hope your mum gets all the care she is entitled to and she finds something that works for her.

     

    Report
  • Posted

    My mum died 10 years ago but she did clear up her ulcers herself before she went.  Claiming the nurses and contnued bandaging was doing more harm she just refused their treatment. Instead  she used Parafin Oil Wax gauze dressings with a light crepe bandage. Took some time but it worked 
    Report
  • Posted

    This is all interesting and some suggestions well worth trying.

    The question of compression or not continues to rage...

    I just want to add a post script to my original story on here.

    I went to my GP some weeks ago in despair and said that I'd tried everything and this wretched leg ulcer refused to heal and was getting bigger and uglier. She questioned whether or not it was a varicose ulcer at all, something the nurse never had nor the Dermatology dept. She sent me for a punch biopsy and the result came back almost immediately that it is a large BCC (basal cell carcinoma) and this will require a skin graft.

    All in hand now and I'm under an extremely competent plastic surgeon at Salisbury District Hospital

    So guys, always question everything! Thank god for a good GP!

    Report
  • Posted

    Hi Yoda5, i'm sorry to hear the issues you've had with your mum's district nurses. I work within a district nursing team myself, and we have many patients that will not, for various reasons, wear compression. This does not mean that we leave them to it! I am appalled. It may be that different trusts work in different ways, but I believe in duty of care. I don't know what your mum's ulcer looks like, so the advice I give is general. Melolin is barely absorbant at all. On the patients whose legs need dressing with alternatives, depending on their compliance levels I may dress with an absorbant adhesive (silicon based adhesive) such as mepilex border or allevyn gentle border. I may cover that with an activa liner - a non compression stocking that just gives a little support. Alternatively I would use something like atrauman/mepitel (mesh so gauze doesn't stick), gauze or dressing pad (xupad/kerramax care), yelowline/blueline stockinette, wadding bandage such as k-soft spiral toe-to-knee and a k-lite or crepe bandage to secure. These options aren't as good as compression as they aren't the 'gold standard' but I have had good results with them, albeit slower ones! Also, the district nurses or GP could arrange for these to be put on prescription so you don't have to pay for them. Good luck!
    Report
  • Posted

    We delete content if it doesn’t meet the requirements in our Terms & Conditions.

  • Posted

    My brother has 2 large painful leg ulcers, one on the front of his leg and one on the back. We use allevyn adhesive 12.5cm X 22.5cm which we get on prescription from our doctors surgery as he too cannot stand compression. The district nurse should be more helpful to you, i'm appalled as they are usually so good. Please take your mum to your GP explain the situation and ask for the above dressings, they are the best for leg ulcers and cannot be bought on line, well the smaller size can be found on eBay but at something stupid like £50 a box. Your mum may not need the 12 x 22's but my brother has been using these for over 2 years. 

    Hope me this helps you 

    claire X 

    Report

Join this discussion or start a new one?

New discussion

Report as inappropriate

Thanks for your help!

We want the forums to be a useful resource for our users but it is important to remember that the forums are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the forums is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.

newnav-down newnav-up