Wound dressing is usually done to optimally improve and promote wound healing and prevent infection. When a wound is secured it could have mild to worst complications if not dressed properly. Wound dressing is one of the basic techniques in nursing practice that predisposes one to different kinds of wound. Dressing which could involve removing dead tissues (mild or little dead tissues) as well removal or cleansing of excess bleeding in wound site, removal of sloughs and scars are predominantly done to prevent more contamination, sepsis or endogenous infection and to promote wound healing either by primary or secondary wound healing. It consists of caring for wounds such as contaminated wounds, abrasions, diabetic ulcers, decubitous ulcers and surgical wounds.
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Most times wound dressing results into faster healing but sometimes may not produce a significant change if the condition of wound was already worst when the dressing began. The things to watch out for during dressing includes
How sterile is the dressing environment or field?
The environment has to be sterile. The nurses must maintain a sterile field to prevent contamination.
Are the equipments sterilized?
No wound dressing should commence if the equipment have not been sterilized. This is to prevent infection that could complicate to sepsis.
Are all my items needed for the surgery ready?
If any item is missing on the trolley the dressing shouldn’t start until there is certainty of all items ready then dressing can begin.
Do I have an assistant?
Ideal wound dressing is a two nurses’ procedure and thereby should be taken into cognizance. For standard ethics and infection control always ensure you have an assistant when dressing.
Do I have the patient’s consent?
It is very necessary to seek the patient’s consent about the procedure and if possible do well to explain the procedure to the patient for right decision making because every patient has autonomy.
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Having sorted the patient’s consent, you must know that there are several kinds of dressing liquids or solutions for different kinds of wounds. These solutions are categorized or classified into three based on the kind of wound acquired, the depth and the etiology of the wound. There are three types of wounds basically and they include clean wound, clean contaminated wound and contaminated wound. Clean wound requires primary healing process e.g. surgically incised wound but contaminated wound involves wounds secured from road traffic accident (RTA), a high fall injury, wounds from insurgency attacks, violent abuse etc. the different kinds of solutions generally that are used for dressing includes hydrogen peroxide, Edinburgh university solution (EUSOL), povidone iodine, tincture of benzoic compound (TBC), Metronidazole (flagyl), honey, and normal saline. Sloughed wounds such as diabetic ulcers, late hoot water burns are cleansed with Metronidazole in some places as a prophylaxis for infection and then dressed properly with Povidone iodine, TBC or honey. In wound dressing generally the solutions are divided into disinfectants, antiseptics and antibiotics. The antibiotics could sometimes be used in place of disinfectants when improvising. Disinfectants include hydrogen peroxide, and eusol. Antiseptics include povidone iodine and TBC, while antibiotics include metronidazole and honey.
Proper wound dressing should consist of wound cleaning from the inner to the outer surface of the wound and accurate aseptic technique should be maintained. Binding items includes gauze, gauze bandage, and krep’s bandage which are used consistently for different wounds. Always ensure to bind the wound but not to tight to reduce pain, fast soiling and increase good perfusion and vascularisation.
Finally, in the world of wound dressing never you forget your face mask and your protective latex or surgical gloves depending on which is available.
Written By Nr Danladi Aminu
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