M.S RAMAIAH INSTITUTE OF NURSING EDUCATION AND RESEARCHBANGALORE - ’54

COMMUNITY HEALTH NURSING

WOUND DRESSING

BY; o RASSAL RAJ 4TH YEAR BSC (N)

INTRODUCTION The procedure applies to dressings

that are done in the school , homes , centers or in an industrial health office. It is frequently necessary for the nurse to dress traumatic wounds and other lesions particularly in rural areas where other medical services are not available .

DEFINITION“Cleansing a wound or incision and

apply sterile protective covering using aseptic technique” .

PURPOSESTo remove and dispose of soiled

dressings to prevent spread of infection .

To cleanse area around the wound to prevent additional infection .

To apply sterile dressing to prevent other infections and to promote healing.

PRINCIPLES Practice strict aseptic technique to prevent

infection. All articles should be disinfected thoroughly

to make sure that they are free from pathogens.

Wash hands before and after the procedure. Instruments used for one dressing can not be

used for another until they have been re-sterilized.

Use mask , sterile gloves and gowns for large dressing to minimise the wound contamination.

Use individually wrapped sterile dressing and equipments for greatest safety of wound.

Create a sterile field around the wound by spreading sterile towel.

Avoid talking ,coughing and sneezing when the wound is opened.

Cleaning of the wound should be done from the cleanest area to the less clean area.

When dressing the wound keep the wound edges as near as possible to promote healing.

Before doing the dressing inspect the wound for any complications such as dehiscence and evisceration.

Avoid meal timings. Give an analgesic prior to the painful dressings.

ARTICLES NEEDED

2 paper bags or two large leaves;one for soiled dressings and one for dressings to be washed for re –use .

Instuments ; scissors , artery forceps , dissecting forceps .

Sterile dressings – packaged dressings that have been autoclaved in the centre or local hospital or cold clean absorbent clothes that have been boiled, and “well” ironed in the home .

Other supplies such as cotton swabs or pieces of old absorbent cloth, applicator .

A bowl , kidney tray or substitute for use as container to sterile irrigating solution if needed .

Spirits , antiseptic bowl of soap and water as indicated .

ARTICLES NEEDED

scissors Artery forceps

GAUZE PIECESCOTTON BALLS

LIST 0F SOLUTIONS USED.

PROCEDURE Assemble supplied and equipment at bedside

either on box, extra charpoy, chair or table. Explain the procedure to the patient or to the

home nurse. Remove bandages and other dressing with

fingers or with forceps. Stress on washing of hands thoroughly with

soap and water. Demonstrate surgical dressing to the home

nurse. Apply medication as directed in standing

order.

PROCEDURE CONT…Apply sterile dressing and fasten

it with a bandage , or a strip of clean rag preferably white.

Record the services, the condition of the wound and medication used.

Take the person’s temperature and pulse and refer to the doctor as indicated.

AFTER CARE OF EQUIPMENT

Wrap the soiled dressing and burn. Do this yourself with the help of home nurse.

Wash used instruments and bowls with soap and water, rinse and boil for 5 minutes.

Return clean boiled instruments to the nursing bag. Stress on importance of hand washing after the procedure.

CONCLUSIONIt is cleanse area around the wound to prevent

additional infection. The procedure applies to dressings that are done in the school , homes , centers or in an industrial health office. The challenges of wound management have been highlighted suggesting that clinical governance, pain management from wounds and improving quality of life through effective wound care are intricately related.

BIBLIOGRAPHY A community health nursing manual,

TNAI ,3rd edition,Pg no:155- 158. Annamma Jacob , clinical nursing

procedure 2nd edition, Pg no:356- 358. Principles and practices of nursing,

Sr. Nancy,4th edition, Pg no:39-40.