WOUND CARE
DEFINITION
It is the sterile protective surgical covering,applied to a wound incision
with aseptic techniques,with or without medication.
TYPES OF DRESSING
DEPENDS ON : 1.The location,size and type of wound.
2.Type and amount of exudates.
3.Whether it is infected or has sinus tracts.
4.Frequency of changing dressings.
GAUZE: These are most commonly used dressings. They do not interact with wound area and cause
little wound irritation.
TYPES OF DRESSINGS
WET DRESSING : Prefered in debridment wounds. T
his moistens the dressing increasing
gauze’s ability to collect exudate and wound debris.
NON ADHERENT DRESSING : These dressings have a shiny non-adherent surface that does
not stick to incision or wound opening but allows drainage to pass through
the softened gauze above.
SELF ADHESIVE DRESSING : Ideal for small superficial wounds that do not require
debridment.
HYDROCOLLOID [HCD] AND HYDROGEL DRESSING.
PRESSURE DRESSING : Promotes hemostasis.
PURPOSE OF DRESSING
To prevent wound granulation and healing.
To decrease micro-organisms from entering the wound.
To decrease the presence of purulent wound drainage.
To absorb fluid and support the medication.
ARTICLES RATIONALE
A STERILE TRAY CONTAINING RATIONALE
Artery forceps -1 To clean the wound
Dissecting forceps -2 To clean the wound
Scizzors -1 (surgical) For debridment of wound
Sinus forceps -1 To open or pack the sinus tract , if necessary.
Small bowl -1 To take the cleaning lotions.
Gloves , mask , gown. To provide proper aspsis.
Cotton balls , gauze pieces , cotton pads. To clean and dress the wound.
Dressing towels. To create a sterile field around the wound.
Towel clips -4 To fix the sterile towel.
AN UNSTERILE TRAY CONTAINING
Cleaning solutions To clean the wound and surrounding areas.
Ointments and powders. To apply on wound.
Bandages , binders , pins , adhesives plaster and To fix the dressing in place.
scizzors.
A large bowl with a disinfectant solution. To discard the used instruments.
A kidney tray and a paper bag. To collect the waste.
To immobilize and support the wound.
PREPATORY PHASE
Wash hands thoroughly and put on mask , gown and gloves.
Place dressing , supplies or articles on a clean flat surface. [overhead table]
Place disposable bags nearby to collect soiled dressings.
Determine what type of dressing is necessary.
Open the dressing tray by pealing apart the edges of the package.
Wash hands thoroughly before and after the procedure.
GENERAL INSTRUCTIONS
Maintain a strict aseptic technique to prevent cross – infection , to and from the wound. All
materials touching the wound should be sterile.
All articles should be disinfected thoroughly.
Wash hands thoroughly before and after the procedure.
One set of instruments should be used for one dressing.
Use mask , sterile gown and gloves to minimize wound contamination.
Dressing should not be done immediately after sweeping and dusting ; wait atlest for 15-20
minutes.
Use individually wrapped sterile dressing and equipment for the wound.
Maintain a sterile field around the wound by spreading sterile towels.
Avoid sneezing , coughing , talking when the wound is open.
If the dressing is adherent to the wound due to dry secreations or blood , wet it with sterile saline
before it is removed.
Observe the discharge from the wound accurately for color , odour , amount and consistency.
Shortening and removal of dressing tube is done only after doctors order.
Avoid meal timing for doing dressing. It should be done either half an hour before or after the
meals.
PREPARATION OF THE PATIENT AND ENVIRONMENT
Identify the patient and position him comfortably.
Explain the procedure and provide privacy.
Drape the patient.
Offer a bedpan or urinal prior to dressing.
Close the doors and windows. Put off the fan to prevent draughts.
Keep one assistant for dressinf of the lerge wounds.
Protect the bed with a mackintosh and a treatment towel.
Expose the part as necessary.
Untie the bandage or adhesive and remove only after hand washing.
Turn the patients head to one side to prevent anxiety.
REMOVAL OF SUTURES
To remove the sutures or drai nage tube there should be doctors instruction.
It is always done after the wound is thoroughly cleaned.
Extra sterile articles needed are:
Suture cutting scizzors – 1
Toothed discecting forceps -1
Grasp the knot of the suture with the toothed forceps and pull it gently to expose the portion of
the stitch under the skin.
Cut the suture with the suture cutting scizzors between the knot and the skin
Pull the thread out as one piece.
The suture which is aldeary above the skin should not be drawn under the skin.
Every suture e should be examined for its completion.
Total no. of sutures removed should be counted.
AFTER CARE OF THE PATIENT AND ARTICLES
Remove the makintosh and the treatment towel.
Take all articles to the treatment room.
Discard the soiled articles in the covered container and send it for autoclaving.
Replace the articles at the proper place.
Help the patient to dress up and make him comfortable.
Replace the bed linen.
Wash hands.
Record
