The ABC of dressings: When “kissing the boo-boo” is no longer enough

We all remember running to mom crying after a terrible fall that had us understand the abrasive power of asphalt. Under her good care, we had to courageously survive the peroxide cleansing, and wait patiently for the mercurochrome to dry or for the ointment to be absorbed to finally get a dressing… and a kiss. We would then go right back to play, forgetting all our troubles.

Unfortunately, as we grow old, things tend to get more complicated: accidents, surgeries, life events threatening the well being of our loved ones and instantly turning us into caregivers or improvised nurses. When confronted to a more serious wound, the simple act of applying the right dressing can be worrisome, especially when we don’t always have access to a healthcare professional to guide us. How do we make sure that the wound is cleaned properly and that there are no risks of infection? Which type of dressing to choose? Should we let it air out, or apply a tight bandage to keep dirt away? Here are a few basic tips to answer several of these questions.

What is the real purpose of a dressing?

There are several reasons why a dressing should be used:

• Protect the wound from infection or friction by isolating it from the external environment;
• Promote healing by preserving its humidity;
• Compress blood vessels to encourage coagulation in cases of light bleeding;
• Close up the wound to reduce healing time and minimize scarring.

Which dressing for which type of wound?

The choice of a dressing is generally made according to the stage of the wound and whether or not there is oozing. Note that beyond simple scratches and non-infected wounds, it is always best to consult a physician or healthcare professional to know which type of dressing to use. Ideally, you should not choose a dressing with specific properties without a medical prescription.
Here are the most common dressings on the market at this time:

Plastic dressings

They are the most popular dressings, the famous band-aids, which are thin compresses held in place by adhesive sides. We typically use this type of dressing to treat clean, non-inflammatory wounds, such as scratches and small cuts. The size of the dressing must suit that of the wound.
Easy to find, ready to use, more water and soil resistant than fabric dressings, plastic dressings however peel easily and must therefore be replaced often.

Product code: 19154

Fabric dressings

Fabric dressings resemble plastic dressings, but are more elastic, which make them ideal to protect joints. However, because they are not waterproof, they must be kept away from water.

Product code: 19157

Moist dressings or compresses

These dressings are made of several layers of gauze held in place by plaster strips. We use them to treat oozing or bleeding wounds. Compresses absorb secretions and gently stop haemorrhaging, thereby reducing the risk of secondary infection. They are also used on burns.

Products codes: 3044-45, 3059, 3060, 3062-63-64, 3072-73-74, 3085-86-88

Other dressings with specific properties

There are several other types of dressings with specific properties. For instance, some are made to be completely waterproof, while others promote fast healing through an integrated silver ion gel. There are also liquid dressings, which are very useful for wounds in hard-to-reach areas, such as between fingers and toes. Finally, there are dressings specifically made to treat blisters and burns.

Products codes: 19142-43

Note: Beware of side effects

• Some dressing components (plastic, gel, adhesives) can cause allergic reactions in some people.
• An excessively adhesive dressing can be painful to remove.
• Opaque dressings can interfere with the monitoring of the wound.

5-step dressing

For a dressing worthy of its name and to avoid complications, you must follow four very important preliminary steps:
1. Clean the wound
2. Rinse the wound
3. Dry the wound
4. Sanitize the wound

Step 1: Cleaning the wound

• You must first wash your hands and decontaminate them with a liquid or gel antiseptic. Dry them with a clean towel.
• Then clean the wound using a white face cloth or clean compresses and an ordinary, perfume-free soap. Your movement should go from the center of the wound outwards.
• Make sure to remove all dirt particles. The skin around the wound should be very clean, and free of crusts, clots and dead cells.
• Note that we never apply cotton to a wound. We instead use compresses.

Step 2: Rinsing the wound

• Once the wound has been thoroughly cleaned, it must be rinsed with water.
• If the wound is bleeding, use a gauze compress and gently tap it to stop the haemorrhaging.

Step 3: Drying the wound

• Dry the wound with a clean towel, i.e., a towel that has not been used.
• Try to use white towels.

Step 4: Sanitizing the wound

• Once the wound is clean and dry, before using a dressing, apply an antiseptic medication that will reduce the risk of infection and speed up the heeling process.
• There is a variety of antiseptic medication with different properties. Never mix antiseptic creams because the interaction of some medicated properties can cause side effects.
• In cases of more severe wounds, such as an open wound, your physician will probably prescribe a specific antiseptic. If you are not sure which product to choose, do not hesitate to ask a healthcare professional for advice.

Note: Even if we commonly say ‘disinfect a wound’, in reality you do not disinfect it; you sanitize it. Disinfecting refers to what must be done to the objects around the room where care is given in order to avoid risks of contamination.

Final step: Applying the dressing

• First, it is important to preserve the sterility of the dressing by avoiding any direct contact.
• Follow the product label instructions and your physician’s recommendations to the letter to know which type of dressing to use and the frequency at which it must be changed.
• The dressing must cover the wound and not leave any openings that could allow dirt and germs to come in. Its sides should exceed the size of the wound by at least two centimetres.
• The dressing must be clean and changed regularly. Generally, for a simple wound, it is best to change it every two days. In cases of oozing, bleeding or dirty wounds, the dressing must be changed every day, even several times a day if the wound is infected.
• Never apply a circular or compression dressing, especially around the fingers. Blood must be able to flow freely.

Finally, at the slightest doubt, for instance if the wound is dirty, continues bleeding, shows signs of infections or refuses to heal, consult a physician. Never neglect a wound.

Sources
http://www.reseaumain.fr/impression.php?rubrique=237
http://savoir.fr/comment-faire-un-pansement
http://www.uniprix.com/en/health/advice/choosing-the-right-bandage/