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How To Cleanse, Irrigate, Debride, and Dress Wounds
Equipment for Wound Care
Wound hygiene and closure techniques need not be sterile procedures. Although instruments that touch the wound (eg, forceps, needles, suture) must be sterile, clean nonsterile gloves as well as clean but not sterile water may be used in immunocompetent patients. Some operators prefer the better fit and better barrier protection of sterile gloves. Clean procedure, barrier protection Face mask and safety glasses (or a face shield), head cap, gown, gloves (sterile if preferred, but these are nonsterile procedures) Sterile drapes, towels (for wound debridement and suturing) Wound cleansing, inspection, debridement(not all items are required for simple repairs) Overhead procedure light Antiseptic solution (eg,chlorhexidine,povidone-iodine) Sterile gauze squares (eg, 10 cm×10 cm [4 inch×4 inch]) Pneumatic tourniquet (or blood pressure cuff), commercial hemostatic agent, as needed to assist hemostasis in extremities affected by peripheral vascular disease, in digits, the penis, or tip of the nose, or at distal sites when a compression tourniquet is also being used. Local anesthetics are discussed in Lacerations . For certain patients (eg, children), topical anesthetic (eg, proprietary emulsions of 2.5%lidocaineplus 2.5%prilocaine) Sterile saline for irrigation (sterile water or clean, potable water are permissible substitutes) 35-mL and/or 60-mL syringes Irrigation shield (syringe attachment to block splashing) Plastic catheter (eg, 18- or 19-gauge standard catheter) or commercially available splash guard device Basin Fine-pore sponge (eg, 90 pores per inch) Tissue forceps (eg, Adson forceps), tissue hook, probe, hemostat, splinter forceps (fine-tipped), and suture scissors (single blunt-tip, double sharp edge) Scalpel (#10 for large incisions, #15 for precise incisions, #11 for small stab incisions), iris scissors, or curette Wound dressing Antibiotic ointment: Topical antibiotic ointments continue to be recommended for sutured wounds because they help keep wound edges moist and prevent dressings from sticking. However, they have not been proven to reduce infection or enhance healing. Sterile nonadherent, absorbent, and/or occlusive dressing Gauze roll and tape or gauze sleeve Sometimes splints or other materials to restrict motion or skin tension that may pull on the wound 