Wounds range from minor irritation with unbroken skin to severe tissue damage extending below the skin to deep into the muscle or bone. Cleaning wounds requires using sterile or aseptic technique. Methods of cleansing wounds vary according to the size of wound and the type of drainage.
Gather Supplies
Supplies needed for wound cleaning include saline, Betadine, hydrogen peroxide or chlorhexidine, gauze dressings, barrier drapes or sterile fields to place supplies on, sterile containers to hold cleaning fluid, and sterile non-latex gloves in sizes for the wound cleaner. Local pharmacies or drug stores carry ready-made kits for dressing changes. Individuals may assemble supplies for their own kit.
Preparation
Prior to cleaning any wound site, the hands must be washed with soap and tap water for at least 15 seconds followed by rubbing the hands together with alcohol hand sanitizer until the alcohol dries. If pain medication is required, medication needs to be administered at least 30 minutes prior to cleaning a wound.
Redness with Unbroken Skin
A reddened skin site with no open areas may be cleaned with soap and tap water. No dressing is required on a site with unbroken skin.
Preparation for an Open Wound
After proper hand washing, preparation is made to clean the skin broken with exposed tissue. According to "Schwartz's Principle of Surgery," a drape barrier is spread out next to the site of the wound. The sterile containers are placed on the sterile barrier and one is filled with Betadine and one is filled with saline. The sterile gauze for cleaning is placed on the sterile barrier. The person cleaning the wound puts on sterile gloves. A sterile barrier with an opening is then placed over the wound location. Sterile procedure is maintained throughout the cleansing process until after a sterile dressing is placed on the wound.
Simple Open wounds
"Fundamental and Advanced Nursing Skills" advises dipping the gauze in Betadine to add the cleaning solution. The person cleaning the wound places the gauze in the center of the wound and using a circular motion wipes with the Betadine-soaked gauze to the edges of the wound. Discarding the used gauze into the trash puts the waste in one place for disposal. The circular motion may be repeated until removing all wound debris. Next, the person uses saline soaked gauze and employs the same circular motion from the center of the wound to the edge. Saline gauze is used only once and then discarded in the trash. An appropriate wound covering completes the cleaning procedure.
Complex Deep Wound
The same method is used to treat a deeper wound, but extra gauze may be required for more drainage or debris in the wound. Deeper wounds exhibit more wound exudate and sometimes show infection with purulent or pus filled drainage. Hydrogen peroxide or chlorhexidine may be substituted for Betadine to clean purulent matter or bacteria from the wound. The trash can requires emptying at the end of the procedure to prevent spread of infection.
References
- "World Wide Wounds"; Acute Wounds, Chronic Wounds and Wounds in the Aged; S. Enoch, Ph.D. & P. Price, Ph.D.; 2004
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