5.3 Wound cleaning and dressing application

Wound cleaning and dressing application are crucial skills in first aid. Proper cleaning prevents infection, while correct dressing protects the wound and promotes healing. These techniques are essential for effective wound care and management.

Mastering antiseptic use, irrigation, and debridement is key to wound cleaning. For dressing, understanding non-adherent materials, antibiotic ointments, and secure application methods ensures optimal wound protection and healing. These skills are fundamental in bleeding control and bandaging.

Wound Cleaning

Antiseptic Solutions and Wound Irrigation

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• Antiseptic solutions help prevent infection by killing bacteria and other microorganisms on the skin and in wounds
• Common antiseptic solutions include hydrogen peroxide, iodine, and chlorhexidine gluconate
• Wound irrigation involves flushing the wound with sterile saline or water to remove debris, foreign material, and bacteria
• Irrigation should be performed using a syringe or squeeze bottle with enough pressure to effectively clean the wound without causing further damage
• Sterile gauze can be used to gently clean around the wound edges and remove any remaining debris

Debridement Techniques

• Debridement is the removal of dead, damaged, or infected tissue from a wound to promote healing and prevent infection
• Mechanical debridement involves using sterile instruments (forceps, scissors) or wound dressings to physically remove debris and necrotic tissue
• Enzymatic debridement uses topical medications containing enzymes (collagenase, papain) to break down and dissolve necrotic tissue
• Autolytic debridement relies on the body's natural ability to break down necrotic tissue through the use of moisture-retaining dressings (hydrogels, hydrocolloids)
• The choice of debridement method depends on factors such as the type and size of the wound, the presence of infection, and the patient's overall health status

Dressing Application

Non-Adherent Dressings and Antibiotic Ointments

• Non-adherent dressings are designed to prevent sticking to the wound surface, reducing pain and trauma during dressing changes
• Examples of non-adherent dressings include silicone-coated gauze, petrolatum gauze, and polyurethane foam dressings
• Antibiotic ointments, such as bacitracin or mupirocin, can be applied to the wound before applying the non-adherent dressing to help prevent infection
• When applying antibiotic ointment, use a sterile cotton swab or gloved finger to apply a thin layer to the wound surface, avoiding excessive application that may macerate the surrounding skin

Securing Dressings with Adhesive Tape and Sterile Gauze

• After applying the non-adherent dressing and antibiotic ointment (if indicated), the dressing should be secured in place using adhesive tape or a secondary dressing
• Adhesive tape, such as paper or silk tape, should be applied around the edges of the dressing, leaving a small border of exposed skin to prevent maceration
• Alternatively, sterile gauze can be used as a secondary dressing to hold the primary dressing in place
• When using sterile gauze, wrap it gently around the affected area, ensuring that it is snug but not too tight to restrict blood flow or cause discomfort
• Secure the sterile gauze in place with adhesive tape or a flexible bandage, such as a self-adherent wrap (Coban)