Help with the steps of wound care

[oxyjen]

Hi, can someone help me remember the steps to the following procedure, changing a wet to dry dressing with wound measurement using a cotton tip applicator, irrigation with a Toomy syringe, and packing a tract? I need to write a plan of care and it has been awhile.

Specifically, I can't remember when to take off the non sterile gloves and go with the sterile ones? Is it after removing the old dressing and before measurement, or after measurenment?

Or, is it after measuring and after irrigating. (since you have to dry the surrounding skin before the sterile packing and new dressing begins)

Or do you measure, then sterile gloves, then irrigate, pack, apply wet to dry, then, being done with the sterile part, dry the skin which would contaminate your gloves but it wouldn't matter at this point.

Briefly, I have:

position patient with basin and padding

open and position supplies

apply non sterile gloves

remove old dressing

measure wound

irrigate

dry skin with 4x4's

apply sterile gloves

pack wound

abd then sucure

Rearrange these steps if you think they are out of order, maybe add your rational so I understand the reason. Thank you!

[cantwait4sunshine]

what you have looks right to me

[TheCommuter, BSN, RN]

Have you visited this site's Wound Nurse forum? If not, I have posted the link below. Good luck in finding what you are seeking.

https://allnurses.com/forums/f66/

[Jay-Jay, RN]

I work in the community. We don't DO sterile dressings, and certainly would NOT put on sterile gloves for doing one! The rational is the skin cannot be sterilized, so complete sterility is not necessary, unless you're dealing with something that goes right into the inner body (e.g., a drain or central line.)

I think I'd opt for after measuring, though, because the measurement scale and the pen you use to mark the scale aren't sterile, whereas the syringe and packing are. Or, as an alternative, you could have on one sterile glove to do the measuring, and another unsterile one for doing the marking.

[Amber_student_nurse]

Weve been taught gloves for removing dressing and cleaning. Then removing our gloves to dress wounds. No sterile gloves are used for simple dressings. Can understand the rational for deep open wounds.