It is a clean procedure where we must observe basic elements of hygiene.
It is not necessary to have sterile gloves, but GAUZES are to be sterile.
We must pick them from the container with sterile forceps.
The trolley for the dressing must be clean to avoid contamination of wounds.
Containers, creams and betadine should be closed after usage.
FREQUENCY OF DRESSING
After an operation do dressing at alternate days.
Dressing is very important to remove the dirt on the wound, to check if there can be any problem with the operation site (pus under the stitches), serum, blood clots, and gaping.
Not dressing an operation wound for many days will allow the germs contained in the sweat to multiply in the cut, thus facilitating suppuration.
When an operation is in a dirty area (for instance hydrocoele) where there can be leakage of urine on the wound, the dressing is better done every day.
Bed sores are normally dressed every day to release pressure on the sore, to remove the germs contained in the sweat and human fluids (stool, urine) and to remove the necrotic material.
When there is a dry black necrotic tissue on the bed sore, this should be removed as soon as possible because under the dry necrosis there is proliferation of germs.
H202 is not used on clean granulating sores.
It is used only on dirty necrotic material which we want to remove from the sore.
When dressing after incision and drainage (I&D), gauze soaked in betadine is to be inserted up to when there is nothing coming out (no pus, no serum).
Normally we do not have modern creams. Apart from the wounds where H202 is indicated, our normal procedure is the following:
washing with normal saline, disinfection with betadine, application of honey or sugar + betadine, covering with sterile gauzes.
For surgical wounds we apply only betadine and we cover with gauzes.
For burns we either use honey or silver sulphadiazine.
Dr Bro Joseph Gaido
Dr James Ogembo
Clinical Officers
Nursing Officers
Cottolengo Mission Hospital
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