Wound dressing

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Wound dressing

• Prepared by Miss Aisha Al-hofaian
• Supervised by Dr.Gehan

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Purpose

• 1- To promote wound healing by primary intention
  .
• 2- To prevent infection .
• 3- To assess the healing process
• 4- To protect the wound from mechanical trauma .
• 5- To absorb drainage.
• 6- To prevent contamination from bodily discharge.

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Types of dressings

• Dry - to dry
• Used primarily for wounds closing by primary
  intention.
• Layer of wide mesh cotton gauze lies next to the
  wound surface , second layer of dry absorbent
  cotton to protect the wound

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Types of dressings

• Wet to dry
• These are particularly useful for untidy or
  infected wounds that must be debrided and closed
  by secondary intention
• Layer of wide mesh cotton gauze saturated with
  saline next to wound surface ,second layer of
  moist absorbent with same solution to debride the
  wound

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Cont..

• Wet to damp
• Variation of wet to dry dressing .
• Wet to wet
• Used in clean open wounds.
• Layer of wide mesh gauze saturated with
  antibacterial solution next to the wound surface,
  second layer of absorbent material saturated with
  the same solution to dilutes viscous exudates .

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Assessment

• 1- Client allergies to wound cleaning agents.
• 2- The appearance and size of the wound .
• 3- The amount and character of exudates.
• 4- Client complaints of discomfort.
• 5- The time of last pain medication .
• 6- Signs of systemic infection ( e.g. .elevated
  in body temp , diaphoresis, malaise ) .

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Equipment

• -Moisture proof bag .
• -Mask .
• -Acetone solution to loosen adhesive .
• -Clean gloves.
• -Sterile gloves .
• -Sterile dressing set .
• -Additional supplies ( extra gauze dressing , and
  ointment if ordered .
• -Tie tapes, tape or binder .
• - Normal saline or antiseptic solution .

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Implementation

• Before changing a dressing , determine any
  specific order about dressing or wound.
• Preparation
• - Acquire assistance for changing a dressing on
  restless or confused client .
• - Put the client to comfortable position in which
  the wound can be readily exposed ( expose only
  wound area ).
• - Make cuff on the moisture proof bag for
  disposal of the soiled dressings and place the
  bag within reach .
• - Put on face mask .

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Performance

• 1- Explain procedure to the client .
• 2- wash hands.
• 3- provide for client privacy .

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4- Remove binder and tape -remove binder if used
and place them aside . - If adhesive tape used ,
remove it by holding down the skin and pulling
the tape toward the wound . - Use solvent to
loose the tape if required .
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5- Remove and dispose of soiled dressing . - Put
on clean gloves to remove outer dressing or
surgipad . - Place outer dressing away from
client . - Place the soiled dressing in moisture
proof bag without touch the outside the bag . -
Remove the under dressing , taking care not to
dislodge any drains , if the gauze sticks to the
drains , support the drain with one hand and
remove the gauze with other.
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• Assess the location , type and odor of the wound
  drainage and number of gauzes saturated .
• Discard the soiled dressing in the bag as before
  .
• Remove clean gloves .
• - Wash hands or clean with antiseptic solution .

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6- Setup sterile supplies . - Open the sterile
dressing set using aseptic technique . - Place
the sterile drape beside the wound . - Open the
sterile cleaning solution pour it over the gauze
sponges . - Put on sterile gloves .
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7- Irrigate the wound -Instill a steady stream
of irrigating solution into the wound . -
Position the basin below the wound to receive the
irrigating -Use either a syringe with a catheter
attached or with irrigating tip to flush the
wound -Continue irrigating until the solution
becomes clear. -Dry the area around the wound.
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• 8- Clean the wound .
• - Clean the wound using your gloved hands or
  forceps and gauze swabs moisture with cleaning
  solutions.
• Use the cleaning method .
• Use a separate swab for each stroke and discard
  each swab after use .

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-If drain is present , clean the skin around the
drain site by swabbing it half or circle .
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• Cont
• Support and hold the drain erect while cleaning
  around .
• Dry the surrounding skin with gauze swab as
  required .do not dry wound or incision itself .

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9- Apply dressing to the drain site and
incision. -Place a precut 4 in 4 gauze around
drain . -Apply the sterile dressing one at a
time over the drain and incision . -Apply
surgipad , remove gloves and dispose of them
. -Secure the dressing with tape or tie. - Wash
your hands. -Document the procedure and all
nursing assessment .