[cherilee]

When is a dressing supposed to be clean as opposed to sterile? I know that central line dressings are sterile, but are all wound dressings sterile? I would think they would be, but I have heard people say certain ones dont need to be. Can anyone clear this up for me??
Thanks

[Daytonite]

You know, that's a good question. I know that for some home care, dressings only have to be clean. However, for my own peace of mind, in the hospital or nursing home setting, I would insist on using sterile technique for all dressings that I did for the simple reason that there are bugs everywhere in the hospital. I don't want to be responsible for contaminating anyone's wound.

I've had two surgical wounds where the sutures opened up and the wounds took months to heal with lots of drainage. With the first one I was told to only use clean technique at home. I had to pack the wound every 4 hours with alternating gauze infiltrated with hydrogen peroxide or saline. The doctor just instructed me to pour the liquids onto the gauze and then just wring out the excess liquid with my hands (after I had washed them). I never had a problem with the wound becoming infected. But I was also on Keflex for the entire time.

The last surgical wound was a different story. It was a strict sterile dressing change and it still went septic from bacteria in the bowel (had a hemicolectomy). When I was in the hospital on IV antibiotics for this, it was interesting watching the different nurses who changed the dressing (BID dressing changes). Some did it strictly sterile. Some fudged a little. I was on 3 IV antibiotics, however.

I think your decision as to whether to do clean or sterile has to be as to where the wound is and whether or not the patient has antibiotic coverage.

[fatoma]

when it comes to wounds, I use sterile tecnique...those patients are at high risk for infection...we don't want to give those vulnrable patients another hit..our rule is to minimize this risk!!!

[mcknis]

HOw about wet-to-dry or not wet-to-dry? Tell me if I am thinking on the right path here...if its a mucous membrane, then wet-to-dry, but if its a closed wound, then dry dressing. Is this right?

[Lady_Bing]

I have observed that most RNs on our floor do clean drsng when packing wounds or doing WD drsng. I asked about that and the thought was - well, when the pt goes home they will not be doing strerile drsngs anyway. However, I still use a sterile technique, because even if the pt will be utilizing a clean technique at home, they are HOME, not at a hospital. When they are at a hospital, we should be going an extra step to protect their immune system.

[TigerGalLE]

I use sterile technique for all PICC line, Central line, and Perm-cath dressing. I also use sterile technique for any surgical wound. The only time I only use clean technique is when they have a sacral decub that is being changed daily or every time it is soaked with stool... For almost all other wounds I use sterile technique... or at least clean as possible... It depends on what it is really.