What is the worst wound you have ever treated?

Please take a moment to share with the group your experience and how the wound was treated.

Replies to This Discussion

Permalink Reply by Judy Hammond on August 10, 2010 at 11:20pm

I have treated several patient with squamous cell carcinoma of the head and neck. I think those are the worst wounds ever. I had a patient that had a tumor start on her chin, small, about 1cm X 1cm. It continued to spread all across the chin from ear to ear, and down the chin to her throat, and up over her bottom lip. by the time she died it was 17cm by 11cm and about 5 cm thick. It had copious drainage and would bleed every time it was exposed to air. The smell was so bad that conventional treatment were totally ineffective and you were hit with the smell the moment you entered the house. The thing that I took away from this experience was that it was her daughter who came up with an ingenious way to dress it. after cleansing and treating with flagyl powder and applying telpha and guaze, we used a face mask to support it. put it over her ears and pulled it down over her chin. then small piece of tape on a few places. It held the dressing well, and covered her chin so that she was not mortified to have visitors. It is hard to see a horific wound like that and know that there is nothing you can do to stop it from spreading.

Judy Hammond

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Permalink Reply by Judy Hammond on August 10, 2010 at 11:25pm

Sorry guys, forgot I posted the wound story earlier. so you got it twice.
Judy Hammond

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Permalink Reply by Michelle Shannon RN, BSN on May 18, 2011 at 6:27pm

I treated a patient who had a history of DM and was receiving dialysis and had Venous Stasis Ulcers. Patient went into skin failure. This was the most impressive experience-- while performing a treatment on this patient the digits fell off of the body. This was simply amazing. Furthermore, the patient did not express any concern nor did the patient show any visible signs of distress. However, I will never forget the odors associated with true skin failure.

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Permalink Reply by Sherri Barris on May 20, 2011 at 2:22pm

I have also had a similar patient his big toe fell off in my hand, I was fairly new home health nurse and boy did it take me by surprise.

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Permalink Reply by Laurie Swezey RN, BSN, CWS,CWOCN on June 7, 2011 at 1:43pm

I had the same thing happen to me my first year in home care. I was working in NYC and in a small apartment up a narrow staircase. I was scared as it was, but when I took off my patient's bandage and there was a black toe in it....I almost went out the window. The other experience I had in NY was when an aide told me my patient seemed very tired. I went to examine her and she was stone cold. She had probably died several hours earlier, but the aide didn't pick up on it. Home care can be crazy!!

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Permalink Reply by Anna Annes LPN on May 20, 2011 at 11:28am

woman with breast cancer who was in denial. Her entire breast rotted off and was filled with foul smelling necrotic tissue. This was one case where Dakins was indicated to help control the bioburden (obviously she had no healing potential).

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Permalink Reply by Sherri Barris on May 20, 2011 at 2:30pm

The worst one that I have ever seen was when I was a new grad and got my first job at the city jail as an intake nurse. They brought me a homeless man and asked to examine him because the smell was so bad. We had him undress and start to get in the shower, The smell was worse than anything I had ever smelt. Anyway when he turn his back towards me he had maggots crawling all over his buttocks, and so much dried feces, he finally stated he sat on a beer bottle three weeks earlier and it hurt to bad to clean his self. The maggots actually helped the wound but it was nasty.

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Permalink Reply by Laurie Swezey RN, BSN, CWS,CWOCN on June 7, 2011 at 1:43pm

wow, that is horrible!

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Permalink Reply by mowaffaq suliman badawi abueisha on June 7, 2011 at 4:33am

the most dificalt wound to treat was that which is associated with arterial insufitioncy

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Permalink Reply by Leticia Magana on January 13, 2012 at 4:21am

i new pt with large extensive surgical wound dehisces stalled for almost 4 months. 35% slough and some parts ischemic scattered,using Santyl mixed hydrogel packed w/ gauze daily. Because i want to use NPWT when wound will be clean. to help this pt's recovery please advice .