Surgical Asepsis and Wound Care Fundamentals Unit 8

Surgical Asepsis and Wound Care Fundamentals Unit 8

Surgical Asepsis and Wound Care n Terms n n n Preoperative Intraoperative Postoperative Skin prep Shave prep What is surgical asepsis? n n n Free from all microorganisms Only as good as the most careful person If sterility is doubt, consider contaminated!

Surgical Asepsis and Wound Care n n n Pathogen evolution and antibiotic resistance Sterile technique is used for… Use sterile technique when entering sterile interior of the body n n n Bladder Wounds Veins Lower airways Rules for sterile technique…

Surgical Asepsis and Wound Care n The surgical scrub… n n n n The stroke method The timed method Up the arm to 2 inches above elbow Keep hands above the elbows Rinse in one direction only, fingers first Dry each hand with a separate sterile towel Sterile gloving Let’s do it!

Surgical Asepsis and Wound Care n The 3 types of wound healing are… n n n First intention – skin edges close together Second intention – adhesion of two granulated surfaces Third intention – left open and closed later

Surgical Asepsis and Wound Care n Factors which affect wound healing… n n n Age Nutrition Metabolism Medication Edema Foreign bodies Radiation Dressing technique Drains Stressors Closures

Surgical Asepsis and Wound Care n n n Purposes for a dressing… Purposes for leaving wounds open to air… Some dressing change guidelines are… Removing the dressing Some safety factors in wound care

Surgical Asepsis and Wound Care n n n Sterile dressing changes Nursing actions Types of drains n n n Penrose drain Jackson Pratt wound suction Hemovac or Porta-Vac T-tubes Wound VAC

Surgical Asepsis and Wound Care n n How do I care for a patient with a suction device? Discontinuing the drainage device n n n n Check the order! Do with dressing change Relieve the suction! Cut suture prn Pull firmly and place in towel. Inspect! Proceed with dressing change Document

Surgical Asepsis and Wound Care n What are the types of drainage? n n n n Serous Sanguineous Serosanguineous Purulent Mucopurulent Bile Fecal

Surgical Asepsis and Wound Care n Wound infections n n n S and Sx Interventions Wound cultures Dehiscence Evisceration

Surgical Asepsis and Wound Care n n Removal of sutures Removal of staples Wound irrigation Care of the deep wound, with review Let’s practice!

Surgical Asepsis and Wound Care Bandages and Binders n Purposes for bandages and binders are… n n n To apply pressure to control bleeding or edema To immobilize a part To serve as a support To hold splints in place To hold surgical dressings in place

Surgical Asepsis and Wound Care n Types of binders n n Classifications of bandages according to shape n n n Abdominal binder – application may take two people T-binder – suspending bandage Double T-binder – used for the male Triangular – used as a sling Roller – gauze or ace wraps Types of roller bandages n n n Circular Oblique Spiral reverse Figure of eight Recurrent

Surgical Asepsis and Wound Care n Applying bandages n n n n n Position patient Clean part to be bandaged Use pillows prn to elevate Wrap distal to proximal Never let two skin surfaces touch under bandage Never apply a wet or damp bandage tightly Overlap ½ the previous bandage turn width Apply with even tension Note edema present before application Secure the bandage ends

Surgical Asepsis and Wound Care n n Circulatory and neurovascular checks are… Documentation is important n n Type of bandage Area applied to Neurovascular assessments How tolerated

Surgical Asepsis and Wound Care n Removal n n Wash hands, use clean scissors Untape or cut bandage to the side of the wound Unroll bandage, do not allow to fall to floor Special types n n n Mitten Clavicle strap TEDS Now we’ll practice bandaging.

Surgical Asepsis and Wound Care Hot and Cold Applications Terms- Compress Ischemia Maceration Suppuration Tepid Vasodilation Vasoconstriction

Surgical Asepsis and Wound Care n Heat is used for n n n Tissue healing Reduce edema Relieve pain Increases the inflammatory response Cold is used for n n n Prevent edema Control bleeding Relieve pain

Surgical Asepsis and Wound Care Hot and Cold Applications n n n Effects of hot and cold Effects of moist and dry Patients at risk for hot and cold tx n n n n Children Elderly Unconsciousness Peripheral vascular disease Damage to the nervous system Broken areas of skin Fragile areas of skin

Surgical Asepsis and Wound Care n Safety guidelines to follow n n n Equipment Amount of time Adaptation Skin Types of heat applications n n Aquathermia pad Warm, wet compress Whirlpool or soak Sitz bath

Surgical Asepsis and Wound Care n Types of cold applications n n n Ice pack Chemical cold pack Cold, moist compress Tepid sponge bath Temperature ranges Done with unit 8!