Wound dressing change procedure

This is an automatically translated article.

This article is professionally consulted by resident Doctor Le Thanh Tuan - Gastroenterologist - General Surgery Department - Vinmec Nha Trang International General Hospital.
Changing the dressing, washing the wound properly will help the wound to be clean, prevent infection and speed up recovery. Depending on the type of wound, there will be certain rules and procedures for changing the wound dressing.

1. Classification of wounds

There are many types of wounds with different characteristics and properties. Based on the classification of clean wounds or infected wounds, there will be different dressing and wound washing techniques.
With a clean wound (not infected):
A clean wound is a wound that is not infected with bacteria, has no fluid or inflammatory pus; With wounds that do not need to be sutured: The wound is not swollen, has no pus, has young skin, and is progressing well. Sutured wound : The edge of the suture is flat, no swelling of the suture feet, no fluid, no burning, redness, irritation, Infected wound:
Wound that does not require sutures: Around the wound is inflamed red, in the wound exudate fluid, pus, many regional organizations are necrotic. With deep wounds, the extent of the damage is high, and the risk of infection is high. Stitched wounds: The stitches are inflamed, red, swollen, and around the wound, the wound area feels pain and burning. In addition to wound pain, infected wounds can also cause the patient to have a high fever.

2. Procedure for changing wound dressings

2.1 Before changing dressings, washing the wound Inform the patient before changing the dressing, washing the wound; Observe and evaluate the condition of the wound; Medical staff need to wash their hands and disinfect, use medical gloves; Prepare necessary tools to change and wash the wound. 2.2 Technical practice Procedures for changing dressings, washing wounds are not infected:
Let the patient sit/lying in a favorable position; Nurses wear gloves to perform, put arm/foot pillows if the injury is extremities, spread pads or plastic sheets under the wound; Remove the old dressing gently to avoid causing pain to the patient or causing the wound to bleed. If there is fluid or dried blood in the old bandage, use a cotton ball to soak it in water, wash the wound until it is moist and easy to peel, and then slowly remove the bandage; Throw the old gauze in the right place; Assess the condition of the wound; Use gauze to absorb the solution to wash the wound, wash from the inside of the wound to the outside of the healed skin. Absorb gently, do not rub vigorously; Use a small gauze or dry cotton pad to gently pat the wound to dry; Use a new sterile gauze pad to cover the wound surface and then cover it; With sutured wounds, after a period of time change the dressing, wash the wound regularly, the wound is caustic, the surface is dry, there is no discharge or pus; After 5 days, it is possible to cut the wound on the head and face. After about 7 days, suture the wound in other areas of the body; How to cut thread: Using a Kocher clamp, thread the scissors close to the skin, cut the exposed thread, withdraw the thread on the opposite side of the thread that was cut. Procedure for changing infected wound dressings:
Wound with sutures:
Preparatory steps before proceeding to change and wash the wound and remove the old gauze bandage similar to that of a non-infected wound; Observe the wound if there are signs of infection such as swelling, redness, the leg is only very tight, ... it is necessary to use an antiseptic solution to wash the outside of the wound; Using Kocher forceps and sharp scissors: Cut a small nodule, leaving an infected nodule, and gently separate the edge of the wound with the Kocher forceps; Pick up the gauze, gently press along the wound to let the fluid inside the wound drain out; Apply the solution to the wound until it is clean; Use another gauze pad to dry the wound; Apply fresh gauze to the wound. Use bandages or bandages depending on the location of the wound. Wounds without sutures:
After removing the old bandages and gauze, use gauze to clean and absorb fluid and pus in the wound. Use an antiseptic solution or hydrogen peroxide solution to clean the wound; Use scissors to cut out the necrotic and crushed areas. If the wound is complicated, in a difficult-to-see position, it is necessary to remove pus and foreign objects; Large infected wounds take a long time to heal, so continuous wet irrigation (Carrel method) is required. The solution for irrigation is dakin solution, 3% boric water, 0.2% silver nitrate; Wash the wound gently, when the surface is no longer pus, the fluid is okay. With deep wounds can put meche to drain fluid, pus out; Use a new cotton pad, small gauze to dry the wound; Apply gauze to the wound and then use a bandage or bandage to cover the wound.

3. Notes during dressing change, wound washing

Disinfection, sterility during dressing change or thread trimming; The dressing of sterile wounds should be changed before changing other wounds; Pay attention to always observe the condition of the wound when changing the dressing. In case the wound is infected, the patient has a high fever, it is necessary to immediately go to a reputable medical facility to be examined by a specialist. Currently, Vinmec International General Hospital is one of the leading prestigious hospitals in the country, trusted by a large number of patients for medical examination and treatment. Not only the physical system, modern equipment: 6 ultrasound rooms, 4 DR X-ray rooms (1 full-axis machine, 1 light machine, 1 general machine and 1 mammography machine) , 2 DR portable X-ray machines, 2 multi-row CT scanner rooms (1 128 rows and 1 16 arrays), 2 Magnetic resonance imaging rooms (1 3 Tesla and 1 1.5 Tesla), 1 room for 2 levels of interventional angiography and 1 room to measure bone mineral density.... Vinmec is also the place to gather a team of experienced doctors and nurses who will greatly assist in diagnosis and detection. early signs of abnormality in the patient's body. In particular, with a space designed according to 5-star hotel standards, Vinmec ensures to bring the patient the most comfort, friendliness and peace of mind.

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