Chang ing wound dressing Renata Vytejčková, Jana Heřmanová

Wound The impairment of integrity of the skin or mucous membranes Wound classification Acute – surgical wounds Chronic – bedsore, leg ulcer

Phase of wound healing Granulating wound – red, well perfused wound, prone to injury Epithelisation wound – red with white places, skin cells migratin g to the middle

Wound healing Per primam – primary intention (no complications, as expected) Per secundam – secondary intention (complications, wound infection, dehiscence, evisceration)

Phase of wound healing infected wound - secretion, odor, redness around Necrotic wound – dry or wet, black crust

Indication for dressing change Wound control Sterile Dressing Application Medicament application, ointments, powders remove the drain suture removal Wound cleaning Etc.

Preparing for the dressing change Analgetic application Patient position ing Room preparing – treatment room, patient‘s room ensure private environment Equipment preparing

Basic surgical instruments Plain Forceps - without teeth Kocher – with teeth Surgical tweezers – teeth (tissue tweezers) Anatomic tweezers – without teeth (plain tweezers) Scissors

Dressing cart, table, trolley Upper surface – sterile equipment, solutions Lower surface – d i sinfection bath, glowes, The kidney bowl etc. Plastic basket for waste

Equipment Personal protective equipment (PPE) Sterile or cle a n glo ve s Face m ask Sterilization packaging Paper with foil metal container + Cylinder and sterile forceps

Procedure of dressing chang e Explain the procedure to the patient Position the dressing set on the table Wash your hands with antiseptic solution Open the dressing set without touching the contents Loosen the tape on the patient's existing dressing

Patient positio n Waterproof drape to protect the linen The kidney bowel Only the material that can be decontaminated can be placed in bed

Procedure of dressing chang e Put on c le a n gloves Remov e the existing dressing sterile water, benzin Remove the gloves Put on sterile gloves or work in cle a n gloves and with an instrument Don‘t touch cle a n surface of the dressing table

Wound d i sinfection Aerosol alcohol desinfection + sterile swab Iodine disinfection (Betadine) + sterile swab Sterile napkin with d i sinfectin g solutio n Chlorhexidine, Peroxide

Equipment for wound cleaning

Instruments

D i sinfection procedure Linear wound, puncture wound

Wound cleaning

Applying the new dressing With sterile gloves With sterile instrument Grab the gauze around the corner Do not touch the central area Secure with tape or use adhesive dressing

Changing dressing of a wound with a tube drain Cut the gauze with s terile scissors attach to both sides of the drain

Inadine dressing paraffin gauze with iodine between two sterile foil s Cut over sterile surface Use s terile scissors and forceps (tweezers)

Suture removal Sterile scissors and forceps (tweezers) nothing should remain under the skin Use gentle movements to release the suture under the skin Cut the stitch under the knot Using tweezers, remove the stitch

Finishing the dressing change remov e gloves in side the room Hand d i sinfection adjust the position of the patient Educate the p atient about pain, secretion Cle an the equipment in cleaning room