Practical Issues in Wound, Skin and Ostomy Management
I am a new nurse working in an urgent care center. This feature article would be of great help in my practice. Thanks!
there is a controversey at work if you need to change gloves and wash hands prior to applying clean treatment/dressing
Here is a quick description of glove changing according to infection control guidelines:
1-Wash hands, apply gloves
2- Remove soiled dressing
3- Remove gloves, wash hands, apply new gloves.
4- Clean wound with prescribed cleanser
Pat the tissue surrounding the wound dry
5- Remove gloves, wash hands, apply new gloves.
6-Apply wound dressing
7-Discard gloves and all used supplies in trash bag
8- Wash hands
Also, Here is a link to a detailed step by step procedure of non-sterile dressing change. http://woundcareadvisor.com/apple-bites-vol1-no4/
Thank you for your post regarding washing hands and donning new gloves. It just seems wrong to be advised not to change gloves after cleansing a wound thereby potentially infecting a wound.
You are correct. Gloves should be removed and hands washed after cleaning a wound.
4- Clean wound with prescribed cleanser. Pat the tissue surrounding the wound dry.
5- Remove gloves, wash hands, apply new gloves
Can I change the ratio of the saline solution? Will it make any difference?
Thank you for the technique
Please I have observed a wound dressing in which savlon and Hydrogen Peroxide used. Why should they be used?
What cleanser do I use on a beefy red wound? Thanks
Normal saline, a commercial wound cleanser, or even clean tap water can be used.
I’m currently undergoing treatment after a bike accident. The nurses clean the wound very hard and have use a scalpel once to scrap some wounds after a few days if healing!
I feel that the wounds are taking to long to heal because of the hard cleaning! They told me they want to scrap my knee ( after 10 days already ) today which will be very painful. I feel like the hospital is prolonging the treatment which I’m paying for PLEASE ADVISE thank you!
Without seeing your wound, I cannot tell you if your treatment is correct. However, cleaning a wound is important to make sure it heals correctly. Cleaning can also involve a method called debridement. Debridement is the removal of dead, dry or infected tissue from the wound bed. Scrubbing and scalpel use are both considered forms of debridement. There are other methods of debridment that can be used, some of which take longer for healing to occur, but are less painful. Here is a link to an article that discusses wound debridement http://woundcareadvisor.com/debridement-options-beams-made-easy_vol2-no/
Hope this helps
l’m an infection control nurse and just back from post basic in infection control l was taught not to use Normal saline solution for wound cleaning as it will enhance the growth of microorganism. Could you please advice.
Rafizah, I am not familiar with any studies or practices that state normal saline will enhance growth of microorganisms in a wound. However, commercial normal saline generally does not contain a preservative to prevent bacteria from growing in the container. Therefore, one opened, saline bottles should be discarded within 24 hours of opening.
My mom is bedridden and is paralyzed. We turn her every 2-3 hours so that she doesn’t get sores. A few days ago, I noticed the side of the right buttock looking irritated so I cleaned it and put duoderm and covered it with tegaderm. However it turned into a blister. When it popped I continued to clean and put dressing on it. A couple of days later, the wound continued to saturate the bandage with a liquid that had a bad smell. Last night I pressed on the wound to try to see if there is more liquid underneath, and since it had a bad smell I worried about infection. Once I pressed on it, more liquid did come out, and the skin gave way, and I could see a deep wound underneath that I couldn’t tell was there when the skin was still over it. What do I do? Should I take her to the emergency room, or is this something I can take care of at home? I will talk to my cousin who is a physician’s assistant to get advice, but help from someone who specializes in wound care would be so very much appreciated. I hesitate to take my mom to the emergency only because last time it took them hours before they took a look at her and I would hate to have her sit in her wheelchair uncomfortable. Thanks for any advice you can give!
Yes, your moms wound does need to be seen by either a physician, nurse practitioner, or wound specialist. Infection in wounds can spread into the bloodstream easily causing serious problems and even death if not treated promptly.
I am doing research on wound irrigation. We are a rural hospital and rely upon irrigating wounds with a 35 ml syringe and 18g catherer, using normal saline. Or we have tips that can be applied directly to saline bottles. Can you direct me to articles for EBP guidelines and what are your thoughts on irrigating tunnels?
Can you explain the implications of wound healing when saline from the fridge is used? Is it okay to put NS in fridge? Thank you
Are normal saline bullets really adequate for therapeutic wound cleansing? I am concerned that the size of saline bullets are insufficient to properly cleanse a wound/ulcer and question if they have a PSI appropriate for wound cleansing. Please elaborate…Thank you Donna
Am wondering if in after cleaning an open wound, it is better to pack with equal a n b or iodine
Thanks a lot for refreshing my memory
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We use a dermal wound cleanser in a spray bottle in office. I cannot find a set time to discard unused portion of wound cleanser (ie saline is 24 hrs) after opening. Is there a time limit or is it just manufacturer’s date?
I had surgery in jan 2016, my wound is still opened, bleeding and constantly infected. Should the district nurse use tap water to clean the open wound before applying a iodine solution
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