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Fold and Mold Dressing Packing

Excelsior   (301 Views 16 Comments)
by Feral.Cat.Herder Feral.Cat.Herder (Member) Member Nurse

Feral.Cat.Herder has 22 years experience and specializes in Peds, MS, DIDD, Corrections, HH, LTC.

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For some reason I am having a difficult time getting my wound dressing to look right. Either it's not "fluffy" enough or I feel it doesn't cover enough of the wound. As a LPN I was taught to use an sterile cotton tip applicator but with the CPNE we can't use them.  I've been using the technique shown on the Excelsior video. Recently I saw a post on FB talking about using the "fold and mold" method. I've tried to look for videos on youtube but didn't find any. 

Is anyone familiar with this method or has any tips to packing the wound?

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Pixie.RN has 18 years experience as a MSN, RN, EMT-P and specializes in EMS, ED, Trauma, CNE, CEN, CPEN, TCRN.

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Try looking for the parachute method, I think that is what you are describing. 

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simplybam has 5 years experience.

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The fold & mold method is basically when you soak the gauze (while in the boat/sterile container) and then you pick one out, squeeze the sterile water out, open it up laid flat in your palm (but not completely to a single thin ply) , start by folding the corners in to form like a triangle or shape it like the wound itself (basically the shape of the wound you're looking at), then u mold it on the sides with no strings hanging, you then bunch it up loosely for placement in the center of the wound without disrupting the shape you just made. Without touching the wound/ edges open it up and adjust the gauze, then place your abd pad &tape.

The parachute method is different from the above.

I passed CPNE June 2nd 2019. Attached image is mine using the folding method on several attempts during my practice. 

I hope this helps. Good luck! 

20190517_160615.jpg

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Feral.Cat.Herder has 22 years experience and specializes in Peds, MS, DIDD, Corrections, HH, LTC.

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@simplybam thank you so much for your reply. I've tried the parachute method over and over and I don't feel I get it fluffy enough.  I will try the fold and mold tonight when I get home.  Just so I have it straight in my head, I do all the folding and molding and fluffing in my hand BEFORE putting it in the wound, correct? 

Thank you!

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Pixie.RN has 18 years experience as a MSN, RN, EMT-P and specializes in EMS, ED, Trauma, CNE, CEN, CPEN, TCRN.

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9 hours ago, simplybam said:

The parachute method is different from the above

When I tested in 2008, those terms were used interchangeably. Thank you for clarifying! 

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Feral.Cat.Herder has 22 years experience and specializes in Peds, MS, DIDD, Corrections, HH, LTC.

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I am thinking the parachute method is where you make like a rope, kind of wind it up in your hand and then feed it into the wound, like the video for the NSL wound.  I may be incorrect. 

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Pixie.RN has 18 years experience as a MSN, RN, EMT-P and specializes in EMS, ED, Trauma, CNE, CEN, CPEN, TCRN.

7 Followers; 32 Articles; 13,155 Posts; 127,726 Profile Views

Just now, Feral.Cat.Herder said:

I am thinking the parachute method is where you make like a rope, kind of wind it up in your hand and then feed it into the wound, like the video for the NSL wound.  I may be incorrect. 

No, it is molded in the hand after you gather corners like a parachute. What you describe is what we called the ribbon method. But it doesn't really matter! 

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Feral.Cat.Herder has 22 years experience and specializes in Peds, MS, DIDD, Corrections, HH, LTC.

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39 minutes ago, Pixie.RN said:

No, it is molded in the hand after you gather corners like a parachute. What you describe is what we called the ribbon method. But it doesn't really matter! 

YES! you are exactly right, I remember it being called that. I just need to find a method that I can feel comfortable with. 🙄

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simplybam has 5 years experience.

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@Feral.Cat.Herder "Just so I have it straight in my head, I do all the folding and molding and fluffing in my hand BEFORE putting it in the wound, correct?"

Yes. And when its placed in the wound you can then pull/adjust the gauze to cover the areas you want as much as possible without contamination. Let me know how it goes after you try it out. If I can insert a video of me doing it here I'll try to.

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Feral.Cat.Herder has 22 years experience and specializes in Peds, MS, DIDD, Corrections, HH, LTC.

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8 minutes ago, simplybam said:

Let me know how it goes after you try it out. If I can insert a video of me doing it here I'll try to.

That would be awesome if you were able to post a video.  It seems silly to me but it's like this wound dsg is driving me crazy. LOL

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simplybam has 5 years experience.

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I'll try to and I know how you feel! I spent so much time on getting it right as well including the PICC & CATH, I even took my wound model to NY with me because it's the easiest to fly with but I ended up with a PiCC during my test lol, thank God I'd them all down packed! so I'm saying this to you, not to stay "stressed" over just the wound ok? But focus on the "time" to complete it and the "notes" that you will write after its done and also the next 2 days of POC which is THE MOST CRITICAL OF ALL...You already know lol! You've got this! 

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Feral.Cat.Herder has 22 years experience and specializes in Peds, MS, DIDD, Corrections, HH, LTC.

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Thank you @simplybam.  I have been so focused on the labs....  wound and counting those dang IV drops that I've not even started on the POC practice. I'm going to take your advice and switch gears and maybe when I come back to the labs I will feel more confident. 

Thank you again for your advice and encouragement! 

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