DRESSING OF COMPLICATED WOUND (WITH ASSISTANT)

REQUIREMENTS #

A trolley containing the following:

1. Top shelf ( a Sterile field with the following sterile items)
   • Two (2) or three (3) gallipots for lotions
   • Two (2) kidney dish
   • Two (2) pairs of dressing forceps
   • Two (2) pairs of dissecting forceps
   • Sinus forceps
   • Probe
2. Bottom shelf with the following:
   1. Dressing lotion
   2. Sterile cotton and gauze swab in a drum/pack
   3. Mackintosh and dressing towel
   4. Adhesive tape/strip
   5. Bandage
   6. Scissors
   7. Apron
   8. Disposable gloves
   9. Sterile gloves
   10. Receiver for used dressings

STEPS #

1. Establish rapport (Refer to steps)
2. Explain procedure to patient (Refer to steps)
3. Ensure privacy
4. Put on mask and perform hand hygiene
5. Prepare and send trolley aseptically to the patient’s bedside
6. Protect the bed with mackintosh and dressing towel
7. Ask assistant to:
   1. Put patient into desired position
   2. Protect bed clothes and exposes wound
8. Ask assistant to:
   1. Pour out lotions into gallipots
   2. Wear gloves and remove plaster or bandage and discard
9. Remove soiled dressing with dissecting forceps or disposable gloves, assess for the type of exudate and discard
10. Assess the state of the wound for exudates, granulation and depth
11. Perform hand hygiene
12. Dab or clean wound with sterile forceps/gloves using prescribed lotion from within outwards
13. Where necessary gently irrigates wound with syringe and saline
14. Clean or dab wound with series of swabs until wound is clean
15. Clean the surrounding skin
16. Apply sterile dressing using prescribed dressing lotion
17. Add enough sterile dressing and secures into position or leaves exposed where necessary
18. Ask assistant to help apply the adhesive tape or bandage to the site where necessary
19. Remove mackintosh and dressing towel
20. Reposition patient in bed with the help of the assistants
21. Inform patient about the state of the wound
22. Dispose off used items, decontaminate used instruments and trolley
23. Perform hand hygiene
24. Document and report state of the wound in the nurse notes (manually or electronically)  
25. Report findings to the appropriate officer