1. Chang ing wound dressing Renata Vytejčková, Jana Heřmanová

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

3. 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

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

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

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

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

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

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

10. 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

11. 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

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

13. 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

15. 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

16. Equipment for wound cleaning

17. Instruments

18. D i sinfection procedure Linear wound, puncture wound

19. Wound cleaning

20. 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

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

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

23. 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

24. 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