The first rule in any treatment modality for wounds is cleanliness. Prevention of infection is the only assurance that a wound will heal well.
• In wounds caused by accidents where dirt and dust is spread around, e.g. road accidents, earthquakes, train collisions etc., there are greater chances of infection.
• Wounds caused by metal, burns or neat incised cuts acquired through glass injuries are generally clean wounds.
• Open wounds always carry the risk of infection.
A dressing is a material or fabric piece applied to a wound or to an injured part and is primarily used for three purposes :
• To control bleeding.
• To protect a wound from further infection.
• To prevent or lessen infection.
TYPE OF DRESSINGS
1. Prepared sterile dressing
This is the ideal dressing for all wounds and consists of a sterilised (germ-free) piece of gauze or lint to which sometimes a pad or roller bandage is stitched. This dressing is enclosed and sealed in a protective covering. Before using a sterile dressing, hands must be thoroughly washed with a disinfectant preferably chlorhexidine 7.5% or with soap and water. Loosen the protective covering and remove the dressing. Expose the dressing as little as possible to the air. Do not breath or cough over it. Avoid fingering the surface of the dressing which is to be applied to the wound.
2. Gauze or lint
If a sterile dressing is not available, cover the wound with a piece of clean gauze or lint. Do not use cotton wool or a fluffy fabric directly on an open wound as it will stick to the surface.
3. Emergency dressing
If a prepared sterile dressing or gauze or lint is not immediately available, soft old sari material, cotton bed sheets, table cover, sanitary pads, the inside fold of a clean handkerchief or freshly laundered towel, a piece of linen or even clean paper tissue can be used, but their use is only temporary until a prepared sterile dressing or gauze or lint is procured.
The greatest care that must be taken in handling and applying dressing is to avoid touching with the naked fingers any part of the wound or any part of the dressing which will be in contact with the wound. The object is to prevent further contamination by germs. Dressings must be covered with an adequate pad of cotton wool which must extend well beyond the dressing and be kept in place with a bandage.
4. Cold compress or wet dressing
It can help to limit swelling and bleeding under the skin.
Making a cold compress : Take a thin towel, piece of lint, flannel, cotton wool or handkerchief and soak it in cold water. Squeeze out the water so that the material does not drip but do not wring it dry. Keep the compress moist by dripping on more water from time to time or by replacing it with another freshly prepared cold compress. Do not apply a wet dressing where there is an open wound.
Note : A bleeding wound needs a pressure pad dressing.