Need information about gauze/drain sponges combine pad

nurseprnRN, BSN, RN · Feb 13, 2014

Take a look at what's on there now, and bring new ones to the bedside. If it looks like the old one didn't need all that much on it, use less. Unless dressing materials are specifically prescribed (medicated, for example), it's pretty much the nurse's choice of how to dress a wound.

Drain sponges are gauze or other material square pads with a slit in one side to the middle, so they can be placed around a drain without needing to cut the pad. 4x4s are the basic workhorses of dressings, but may not be the best because they can stick to a wound. Combine pads are the overnight diapers of the dressing world-- they are thick and absorbent. Telfa pads are just like the ones your mom used to put on your skinned knee-- they are absorbent but have a sort of cellophaney outside so they don't stick to the wound.

You can also google all of these and more and see photos by the manufacturers to get a better idea.

NurseNightOwl, BSN, RN · Feb 13, 2014

At the LTC/rehab facility I worked in, our wound care nurse wrote out very meticulous wound care... orders? (not sure if that's technically what it's called, bec I think she came up with it rather than the dr) or directions on the TAR for each patient's every wound, down the exact type of dressing product and how many to use and what type of tape to secure everything with. Not sure if that was facility policy or if that's just how she liked things.

HappyWife77, BSN, RN · Feb 13, 2014

Where I work, all dressings are specific to how the orders are written. The orders come from the wound center and we follow them to the letter. Sometimes if it's a routine skin issue, we will have standing orders from the physician who has that patient. It depends on the skin issue as to what type of drsg will be used.

Cuticerin with hydrogel is a popular drsg...followed with 4x4's and gauze wrap if needed.

Duoderms, mepilex, mepilex Ag are all different drsgs you will have orders for them though. Go into the supply room and get familiar with the different names, types and sizes.

Look at the order, it will tell you what you should use. Beware of always following the same dressing of what is on there....As not everyone dresses them properly.

Check the order for yourself.

loriangel14, RN · Feb 13, 2014

Our doctors don't write dressing orders very often but our wound care nurse does for the complicated wounds.Usually it's just up to us.

mugs · Feb 13, 2014

Thanks you all. Thanks for all suggestions. I will definitely look for all the available dressings in the storage

nurseprnRN, BSN, RN · Feb 14, 2014

At the LTC/rehab facility I worked in, our wound care nurse wrote out very meticulous wound care... orders? (not sure if that's technically what it's called, bec I think she came up with it rather than the dr) or directions on the TAR for each patient's every wound, down the exact type of dressing product and how many to use and what type of tape to secure everything with. Not sure if that was facility policy or if that's just how she liked things.

We don't call anyone's prescriptions "orders" in the enlightened world. No "technically" about it. That is ancient terminology left over from when nurses worked promarily in war areas and the military model of superiority and orders and obeying were the way things were thought of.

Nowadays, fortunately, we have a better way of looking at the responsibilities and abilities of registered nurses. There are things that are parts of a medical plan of care, and there are things that are parts of the nursing plan of care. Nurses are legally obligated to implement some parts of the medical plan of care (not all, obviously-- a nurse isn't the lab, the dietary department, PT...) That doesn't mean they are following orders, because at any time a nurse can (and legally, must) delay or prevent implementation of part of a medical plan of care that would be harmful to the patient.

Nurses can prescribe as RNs, as APRNs, and as NPs. Your wound care nurse prescribes dressing care directions as part of her responsibility. RNs prescribe nursing plans of care in the, well, nursing care plans. They are as full of force as medical prescriptions.

nurseprnRN, BSN, RN · Feb 14, 2014

Where I work, all dressings are specific to how the orders are written. The orders come from the wound center and we follow them to the letter. Sometimes if it's a routine skin issue, we will have standing orders from the physician who has that patient. It depends on the skin issue as to what type of drsg will be used.
Cuticerin with hydrogel is a popular drsg...followed with 4x4's and gauze wrap if needed.
Duoderms, mepilex, mepilex Ag are all different drsgs you will have orders for them though. Go into the supply room and get familiar with the different names, types and sizes.
Look at the order, it will tell you what you should use. Beware of always following the same dressing of what is on there....As not everyone dresses them properly.
Check the order for yourself.

You are quite correct. I was thinking she was asking more along the lines of a simple postop dressing with 4x4s, combipad, and tube drain dressings. For more complex or chronic wounds, definitely check to see if more complex dressings/protocols are prescribed.

NurseNightOwl, BSN, RN · Feb 14, 2014

Consider me enlightened GrnTea