Which procedure should be used to remove a dressing that is sticking to a wound?
A dressing is used to protect a wound and prevent infection, but also to allow healing. A dressing should be large enough to totally cover the wound, with a safety margin of about 2.5 cm on all sides beyond the wound. A sterile dressing may be used to control bleeding from a major wound or to absorb any discharge from a minor wound. Dressings vary greatly in nature and size, so it is important to select the correct dressing for use on a specific
wound. A sterile dressing which is past its expiry date should NOT be used. A bandage is used in combination with a dressing where a wound is present. A roller bandage is used to secure a dressing in place. A triangular bandage is used as an arm sling or as a pad to control bleeding. It may also be used to support or immobilise an injury to a bone or joint or as improvised padding over a painful injury. A tubular gauze bandage is used to retain a dressing on a finger or toe. Wound dressings will be in a sterile packet, which should be opened carefully by a person with clean or gloved hands. Then, to avoid contamination of the sterile dressing, it is not removed from the opened packet until the wound is ready to be covered. Dressings used to control bleeding must be bulky to ensure that adequate pressure is applied over the injured area. The most common dressing is made of combined wool or cellulose, covered in a light cotton
woven fabric, and these are generally known as ‘combine dressings’. Some major wound dressings are labelled as BPC or BP (because they are listed in the British Pharmacopoeia) and consist of a sterile combine dressing with attached bandage. They are ideal to fill crater wounds or to control severe bleeding. Sterile gauze squares are used mainly for cleaning a wound. Cotton wool should NOT be used because of loose cotton fibres that might stick to the wound during healing. Very light dressings are used on a minor wound to aid healing and most have a non-adherent surface. A non-adherent dressing is often covered on one or both sides with a plastic film containing many perforations. If only one side has a plastic film, that is the side to be placed against the wound. This allows fluids to pass through into an absorbent layer, to keep the wound dry. Other types of non-adherent dressing have a special synthetic coating on one or both sides to prevent adhesion to the wound surface. The non-adherent layer is always placed against the wound. To reduce confusion and incorrect use, some manufacturers make both sides onadherent. Non-adherent dressings are used for extensive surface wounds such as an abrasion (graze) or burn. Improvised dressingsIn an emergency a dressing may be improvised from a range of materials. To control bleeding a bulky pad may be made from a bundle of several facial tissues or from any clean, non-fluffy material. For a minor burn or scald, a piece of clean plastic kitchen wrap may be used initially. However, if the burn is serious, it is vital to use only sterile coverings to avoid the risk of infection. Cooling should be continued until a sterile dressing is available. BandagesRoller bandagesRoller bandages vary greatly depending on how they are to be used. A roller bandage is used to: Roller bandages are made from lightweight cotton, crepe or elasticised crepe, depending on the pressure to be achieved. A lightweight cotton bandage is used to hold a dressing in place, whereas a crepe or elasticised crepe bandage is used for applying support or firm pressure to a soft tissue injury. Applying roller bandagesA roller bandage needs to be chosen carefully to ensure that it is the correct width for the body part involved. As a general guide, the following widths are recommended: Basic steps to successful use of a roller bandage:
Applying a roller bandage to the lower arm or leg:
Applying a roller bandage to the elbow or knee:
Applying a roller bandage to the hand or foot:
Triangular bandagesTriangular bandages are usually made from a metre square of cotton or calico that is cut in half diagonally. The bandage can be used in various ways as a sling or for immobilisation of broken bones and soft tissue injuries. Sling
Broad-fold bandage
Narrow-fold bandage
Pad
Tying a reef knot with a triangular bandage
It is easy to untie a reef knot without jarring or hurting the patient. Simply choose two paired ends as they come out of the knot at one side. Then pull the ends apart steadily until two loops form and can be slipped off one end. Arm sling
Elevation sling
Collar-and-cuff sling
Have the information on hand when you need it the most. Learn the practical skills to help save a life. What can be done to remove an old dressing that is sticking to the wound?Removing the old dressing
If the dressing is stuck, soak with water or saline and wait for the dressing to loosen – allow a bit of time and avoid pulling as this will be painful and will damage the wound. If the dressing is adhesive or has an adhesive border, avoid peeling it off.
What can be used to remove a dressing that sticks to the patient's skin?Medicated tape or adhesive bandage can readily and painlessly be removed from the patient by moistening the bandage with a little pure ethyl acetate held in absorbent cotton, by sopping lightly over the entire surface of the bandage or tape.
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