1. Practical lesson № 3 Wounds

2. Learning Objectives
• Differentiate types of wounds. • Explain the purpose of wound care. • List important equipment needed to provide wound care. • Perform dressing of clean and septic wounds. • Provide care for the patient with draining wound. • Demonstrate skill of wound suturing and irrigation. • Apply clip and remove it when indicated.

3. Toilet of the wound
Toilet:  In medicine, cleansing of a wound and the skin around it.

4. Toilet of the wound includes the following steps Туалет раны включает выполнение следующих этапов
1. Cleansing of the skin around the wound:
cleaning the skin around the wound;
remove loose epidermis; disinfection of the skin around the wound with an alcoholic solution of an antiseptic.
Очищение кожи вокруг раны:
удаление грязной повязки;
очистка кожи вокруг раны; удаление отслоившегося эпидермиса;
дезинфекция кожи вокруг раны спиртовым раствором антисептика.

5. SKILL 1. Toilet of the wound includes the following steps
Equipment. From first aid kits!
•Sterile gauze napkins
• Gloves
• Gauze
• Аlcohol skin antiseptic
Non-alcoholic skin antiseptic
• Bandages
• Scissors
Procedure:
1. Cleansing of the skin around the wound:
cleaning the skin around the wound;
remove loose epidermis; disinfection of the skin around the wound with an alcoholic solution of an antiseptic.
2. Cleansing of the wound surface:
cleansing the wound with aqueous antiseptic;
removal of the necrotic tissue with forceps; removal of foreign bodies.
3. The imposition of aseptic dressings.

6. SKILL 2. Dressing of a Clean (postoperative) Wound
Purpose • To keep wound clean • To prevent the wound from injury and contamination • To keep in position drugs applied locally • To keep edges of the wound together by immobilization • To apply pressure
Equipment. Pick up forceps in a container
• Sterile bowl or kidney dish
•Sterile gauze napkins
• Three sterile forceps
• Gloves
Unsterile:
• Gauze
• Rubber sheet with its cover
• Antiseptic solution as ordered
• Bandages
• Scissors
• Kidney dish

7. Procedure:
Explain procedure to the patient
Prepare the equipment on clean trolley or tray.
Put patient in comfortable position.
Place rubber sheet under the affected side.
Wear gloves.
Remove the outer layer of the dressing.
Remove the inner layer of the dressing using the first sterile forceps and discard both the soiled dressing and the forceps.
Take the second sterile forceps. Clean wound with cotton balls soaked in antiseptic solution, starting from inside to the outside.
Again use the second forceps to clean the skin.
Cover the wound sterile gauze using third forceps.
Fix dressing in place using adhesive tape or bandage.
Leave patient comfortable position.
Conduct disinfection used material. Take the gloves off and put them in the container for disinfection.
Wash hands.
Record the type of enema. Record result.

8. SKILL 3. Dressing of a Clean (postoperative) Wound. Medicinal bandage.
Purpose • To keep wound clean • To prevent the wound from injury and contamination • To keep in position drugs applied locally • To keep edges of the wound together by immobilization • To apply pressure
Equipment. Pick up forceps in a container
• Sterile bowl or kidney dish
•Sterile gauze napkins
• Three sterile forceps
• Spatula
• Gloves
Unsterile:
• Gauze
• Rubber sheet with its cover
• Antiseptic solution as ordered
• Adhesive tape or bandages
•Scissors
• Ointment or other types of drugs as needed
• Kidney dish

9. Procedure
Explain procedure to the patient
Prepare the equipment on clean trolley or tray.
Put patient in comfortable position.
Place rubber sheet under the affected side.
Wear gloves.
Remove the outer layer of the dressing.
Remove the inner layer of the dressing using the first sterile forceps and discard both the soiled dressing and the forceps.
Take the second sterile forceps. Clean wound with cotton balls soaked in antiseptic solution, starting from inside to the outside.
Again use the second forceps to clean the skin around.
Ointment and paste must be smeared with spatula on gauze and then applied on the wound.
Cover the wound sterile gauze using third forceps.
Fix dressing in place using adhesive tape or bandage.
Leave patient comfortable position.
Conduct disinfection used material. Take the gloves off and put them in the container for disinfection.
Wash hands.
Record the type of enema. Record result.