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Care must be taken to change sterile gloves after removing old bandages prior to handling the new bandage. A Penrose drain may be inserted where drainage is necessary ((Taylor, Lillis, & LeMone, 2005; 1071).
Infected Wound Care:
Open, infected wounds, particularly those involving deep tissue layers require more attention to sterile procedure. A gown and mask should be worn and care taken not to breathe into the wound. Additional care must be taken not to contaminate healthy tissue with infected or necrotic tissue (Taylor, Lillis, & LeMone, 2005; 1076). Great care should be taken to change sterile gloves in-between removal of the old bandage and cleaning the wound. Red tissue is healthy must be protected from contamination by yellow tissue that is infected or by black necrotic tissue during its removal during wound debridement (Taylor, Lillis, & LeMone, 2005; 1076).
Treatment steps for open infected wounds varies in relation to each type of tissue involved. Necrotic, black tissue must be removed through debridement via the sharp method using a scalpel or scissors; the mechanical method via scrubbing; the chemical method; or the autolytic method using medicated moist dressings designed to encourage natural enzymatic breakdown processes. Yellow,...
A non-adherent hydrogel or other absorbent dressing is applied, often after application of topical antimicrobial medication to the wound (Taylor, Lillis, & LeMone, 2005; 1076). Red tissue already in the process of healing and forming granulation tissue should be gently cleansed and covered with transparent or hydrocolloid film and the dressing changed only when necessary (Taylor,
Lillis, & LeMone, 2005; 1076).
Conclusion:
In principle, open wound care requires attention to the same fundamental elements for most types of open wounds. However chronic wounds also require appropriate porous dressings, and open infected wounds require different intervention techniques for each type of tissue involved. By applying the right techniques and materials to every type of wound, the nurse practitioner can ensure optimal healing.
References
Taylor, C., Lillis, C., LeMone, P. (2005). Fundamentals of Nursing: The Art and Science
of Nursing Care. Philadelphia: Lippincott, Williams, and Wilkins.
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