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WOUND DRESSING INTRODUCTION Any cut & abrasion or operated area should be dressed & referred if needed. Dressing can be done is home, schools & health center. DEFINITION According To I Clement, Wound dressing defined as cleaning monitoring & promoting healing in a wound that is closed with sutures, clips or staples. OR According To B T.Basavanthappa, cleansing a wound or incision & applying sterile protective covering using aseptic technique. PURPOSES 1. To protect the wound from contamination with microorganisms. 2. To promote wound granulation & healing. 3. To support or splint the wound site. 4. To promote thermal insulation to the wound surface. 5. To provide for maintenance of high humidity between the wound & dressing. 6. To promote physical, psychological & aesthetic comfort. ARTICLES REQUIRED Artery forceps -1 ( 2, for extensive or infected wound) Thumb forceps -1 Bowl with sterile cotton swabs Gauze pieces Kidney tray Sterile scissor Clean gloves sterile gloves cleaning solution (normal saline) Medication Adhesive plaster Bandage Culture tubes ( optional) News paper Mackintosh Plastic cover cardboard Match box Dairy Pen Paper bag Soap with soap dish Towel Nail brush Extra carry bag to carry need articles PROCEDURE Upon reaching the home select work area which is well and dry where the bag can be set up away from the children and domestic animals. Spread newspaper on a flat clean surface and place the bag in one of the corner of the newspaper. Inform patient of dressing change explain procedure and have patient lie in bed. Open the back outer pocket the bag, remove the hand washing articles. Open the flap and keep it half closed. Assist patient to comfortable position that provides easy access to wound area. Loosen tapes on dressing ( if tape is soiled, don clean gloves before loosening the tape). Wash hands. Touch the inner part of cover to open the inner pocket of bag & keep the folds a side on both sides. Remove necessary supplies & equipment & place it on the clean area on the mackintosh. Don clean disposable gloves & remove soiled dressing carefully from more clean to less clean area ( if dressing is adherent to the skin moisten ,if by pouring small amount of normal saline) Keep soiled side of dressing away from patients view. Assess the amount, colour & odour of drainage. Discard dressing in paper bag pull off gloves inside out & discard in appropriate receptacle. Open cleaning solution & pour into the sterile cotton swab. Don sterile gloves. Pick up soaked cotton using artery forceps. 18. 1). For a surgical wound, clean from top to bottom or from centres outward. In contaminated wound clean from periphery to center (circular motion for cleaning circulate wound). 2). use one cotton swab/gauze sponge for each wipe, discarding each by dropping in the paper bag after wiping. do not touch the paper bag with forceps. 3).If a drain is present clean around it, moving from center outward in a circular motion. 4.) Dry the wound using sponge in same motion. Apply medication ordered (ointment) to the wound on a dry sterile gauze, apply a layer of sterile dressing over wound. Place sterile gauze slit on side under & around the drain. (Use per cut gauze or cut one using sterile scissors). Apply a second layer of gauze to wound site & a bandage the outer most layers. Remove gloves from inside out & discard in paper bag. Apply adhesive tape to secure the dressing. Discard the paper bag by burning or by disposing off into dustbin. Wash the used articles such as Artery forceps, thumb forceps, bowl, kidney tray, and scissors with running water & keep it in extra carry bag in back outer pocket. Wash hand again. Open inner pocket & return the articles such as cleaning solution, medication adhesive plaster and bandage. Close the inner pocket. Replace the soap with place soap dish, nailbrush & towel in the outer pocket. Close the bag & take the bag. 30.Fold the used paper & mackintosh & replace it in over pocket. Lecture cum discussion Lecture cum discussion Lecture cum discussion


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