The dressing change to treat burns

2021-01-30 12:00 AM

After changing the dressing for a patient, hands must be soaked and washed, each patient must use a separate bandage change diet to avoid cross-contamination.

Purpose

Eliminate purulent fluid deposited in the burn, remove necrotic tissue, clean the burn wound, apply the drug to local treatment, additionally diagnose the area and depth.

Request

Ensure sterile, prevent cross-contamination.

Changing the dressing must be gentle and meticulous.

Do not cause more pain to the patient, limit bleeding or peel the skin graft.

Dressing only

Change the dressing regularly

Depending on the condition of the wound, if the wound is large, a lot of pus fluid, change the bandage every day, if the area is narrow, with little pus, change the bandage every two days 2. dressing technique.

Regulations on sterility in dressing changes:

After changing the dressing for a patient, hands must be soaked and washed, each patient must use a separate bandage change diet to avoid cross-contamination.

The ration of changing ice includes: 2 pea trays, 2 diapers (1 felt with no claw), 1 curved scissors, cotton bandage, gauze, just enough medicine, all are autoclaved and sterile.

Order of patients to change the dressing:

Priority is given to patients who need initial treatment, post-skin transplant patients, followed by patients with a narrow area of ​​burn, less pus, then patients with extensive burns, and finally infected patients. severe bacteria.

If there is no patient after skin grafts, the patient will be hospitalized to change the bandage first, the old patient will change the back bandage. The youngest child is given priority to change the dressing first.

Patients with an infectious disease must have the back dressing changed with its own kit.

Patients should be taken to the dressing room to change the dressing, except for patients with severe burns who have to change the dressing at the hospital bed (need to have a table and a mobile dressing team).

The duties of dressing change staff: must have sterile and bacteriostatic people

Bacteriophage: transfer patient to dressing room, and transfer patient to ward, use felt, pull out bandage and outer gauze. pour 0.9% physiological saline or dilute purple medicine to moist gauze, help sterile people, bandage the wound properly.

Dressing technique:

(performed by a sterile operator).

A sterile person must wash his / her hands according to hospital procedures, wear sterile clothes, and wear steamed gloves.

Use 2 felt to gently peel off the inner layer of gauze, so that the gauze pad is parallel to the skin surface. use a felt with a squeeze of water-squeezed sphere so that the area of ​​the cotton when dipping the wound is much exposed but the nose does not touch the wound.

When washing the burn wound, it must be in the following order:

Wash from clean area to dirty area (head area, face wash first, foot area, perineal area wash at the end of dressing change).

On a wound: wash first, wash after dirt. the healing area of ​​the wound edge can be disinfected with 70 degrees alcohol or a red medicine solution.

Pay attention not to cause bleeding, affecting the grafted skin piece, if the grafted skin piece is removed, it must be replaced.

Use gauze to gently absorb the wound, remove the pseudo membrane, cut the necrosis, wash the wound clean.

Place a medicated gauze or apply medication directly to the burn (as directed by your doctor). then apply dry gauze to absorb water (if the skin grafting area add a layer of Vaseline gauze) .. the gauze layer after the gauze layer before 1cm. The thickness of the gauze depends on the secretion of the wound.

For seed tissue prepared for skin grafting, do not apply grease directly to seed surgery from 3-5 days before surgery.

Dressing change in some special cases for burns that have been applied film forming agents

If the film is dry, let it go away.

If the infection is under the drug membrane, use scissors to remove the infected drug film, wash it with 0.9% physiological saline and apply medicated gauze to the cut-off area for the burn to semi-open gauze:

If it is dry, do not treat it to expose itself.

If wet, use scissors to remove the wet gauze, wash it and apply a semi-open medicated gauze, and dry for facial and perineal burns.

If the burn is superficial: wash, pat dry, apply red medicine, leave it open.

If deep burns: wash, apply medicine and bandage, change bandages as directed.

Change the bandage after thin skin grafting yourself

Point:

With stamp skin grafts: 72 hours after surgery or later if the patient has no fever, the burn is dry and clean.

With large self-skin graft: change the first bandage after 24 hours. in the following days, change the dressing every day if the burn is very fluid. If dry, change the dressing every two days.

Where to get skin: change the first dressing after 24 hours.

Skill:

The bacteriostatic person took the patient after skin grafting surgery to the first dressing room, removing the bandage.

A sterile man uses a felt to remove the sponge gauze, remove the oil gauze layer (Vaseline).

Use absorbent cotton, soak water in the inner layer of medicated gauze to support sticking. use a non-clawed felt to peel off the innermost layer of gauze, when peeling gently, the gauze is tangent to the skin surface. use felt to make the squeezed ball of water to squeeze the juice. remove hematoma bands or pus colonies (if any), put back flakes of skin. use sterile gauze or cotton to absorb, press to remove any fluid or pus in the skin graft.

Place a layer of medicated gauze (as directed by your doctor) in the innermost layer.

Place another layer of oil gauze on top of the medicated gauze.

Place a wet absorbent gauze (thickness depends on the level of wound exudate). layers of gauze stacked like "roof tiles".

The compression bandage is just right.

The skin grafted area should be placed high, not to contact the bed surface because it is prone to secretions and infection, the skin will die.

For the skin area: after the patient has received good pain relief, the sterile person peels off each layer of the foam gauze outside and leaves a layer of oil gauze inside. Dry the area with a dryer. If this happens, after 5-7 days, the skin will heal and the membrane will peel off.

The drugs are often used in the dressing chamber

Form of solution

Physiological saline solution 0.9%. 

Berberine solution 0.1%.

3% boric acid solution.

Silver nitrate solution 0.25%, 0.5%.

Copper sulfate solution 5% /

Red medicine solution.

10% betadine solution or 10% povidone.

Turmeric juice, 5% salt water, ...

Ointment form

High yellow fat, Vaseline fat, antibiotic grease, chitosan ...

Madhuxin fat.

Madecasol ointment ...

Powder form

B76 powder, a.boric powder ...

Cream form

Preparations of silver sulfadiazine 1% (cream sulfadiazine-silver 1%, sivirin 1%.

Cream biaffine.

Turmeric Cream ...