1. Dressing
Wound Irrigation
Bandaging
Prepared by: Geeta Rai, Lecturer

2. Content
● Dressing: Definition, purpose, types, principles
and procedure
● Wound irrigation: Definition, purposes, principles
and procedures

3. Definition
A piece of material used to cover and protect a
wound to aid in healing.

4. Principles of dressing
● Use sterile or very clean materials as dressings. ...
● Cover the entire wound and its immediate
surrounding areas.
● Control bleeding. ...
● Do not remove dressing once it has been applied
to a wound
● However, if bleeding persists despite bulky
dressing, the bulky blood-soaked dressings may
be removed to allow reestablishing of pressure.

5. Purposes
● To protect the wound from mechanical injury
● To protect the wound from microbial
contamination
● To provide or maintain moist wound healing
● To provide thermal insulation

6. Contd…
● To absorb drainage or debride a wound or both
● To prevent hemorrhage (when applied as a
pressure dressing or with elastic bandages)
● To splint or immobilize the wound site and
thereby facilitate healing and prevent injury

7. Types of Dressings
Various dressing materials are available to cover
wounds. The type of dressing used depends on
(a) the location, size, and type of the wound;
(b) the amount of exudate;

8. Contd…
(c) whether the wound requires debridement or is
infected; and
(d) such considerations as frequency of dressing
change, ease or difficulty of dressing application,
and cost

13. Transparent Dressings
Transparent dressings are often applied to wounds
including ulcerated or burned skin areas.

14. Hydrocolloid Dressings
Hydrocolloid dressings are frequently used over
pressure ulcers.

15. Securing Dressings
The nurse tapes the dressing over the wound,
ensuring that the dressing covers the entire wound
and does not become dislodged. The correct type of
tape must be selected for the purpose.

16. Dressing Technique

19. Wound irrigation
Definition: An irrigation (lavage) is the washing or
flushing out of an area. Sterile technique is required
for a wound irrigation because there is a break in the
skin integrity.

20. Purposes
● To clean the area
● To apply heat and hasten the healing process
● To apply an antimicrobial solution

21. Principles of wound irrigation
1. Provide easy access to the wound. Move the
patient in order to gain better access if
necessary.
2. Remove dressing.
3. Irrigate the wound with the right equipment and
pressure.
4. Let the liquid flow from the cleanest to the
dirtiest area.
5. Cover open areas with a sterile bandage or
towels.

22. Contd…
Equipment
● Sterile dressing equipment and dressing
materials
● Sterile irrigation set or individual supplies,
including:
○ Sterile syringe (e.g., a 30- to 60-mL syringe)
with a catheter of an appropriate size (e.g.,
#18 or #19) or an irrigating (catheter) tip
syringe

23. Contd…
○ Basin for collecting the used irrigating solution
○ Sterile graduated container for irrigating solution
○ Moisture-proof sterile drape
○ Moisture-proof bag

24. Contd…
○ Irrigating solution, usually 200 mL (6.5 oz) of
solution warmed to body temperature, according
to the agency’s or primary care provider’s choice
• Goggles, gown, and mask
○ Clean gloves
○ Sterile gloves

25. Procedures
● Preparation Check that the irrigating fluid is at the
proper temperature.
1. Prior to performing the procedure, introduce self
and verify the client’s identity using agency
protocol. Explain to the client what you are going
to do, why it is necessary, and how he or she can
participate. Discuss how the results will be used
in planning further care or treatments.

26. Contd…
2. Perform hand hygiene and observe other
appropriate infection prevention procedures.
3. Provide for client privacy.
4. Prepare the client.
○ Assist the client to a position in which the
irrigating solution will flow by gravity from the
upper end of the wound to the lower end and
then into the basin.

28. Contd…
○ Place the waterproof drape under the wound
and over the bed.
○ Apply clean gloves and remove and discard
the old dressing.
○ If indicated, clean the wound from the cleanest
area toward the least clean. If the wound is
circular, this would be from the center of the
wound outward. For a linear wound, cleanse
from top to bottom, beginning in the middle
and moving progressively laterally.

30. Contd…
○ Use a separate swab for each stroke, and discard
each swab after use. Rationale: This prevents the
introduction of microorganisms to other wound
areas.Assess the wound and drainage.
○ Remove and discard clean gloves.
○ Perform hand hygiene.

31. Contd…
5. Prepare the equipment.
● Open the sterile dressing set and supplies.
● Pour the ordered solution into the solution
container.
● Position the basin below the wound to receive the
irrigating fluid

32. Contd…
6. Irrigate the wound.
● Apply clean gloves.
● Instill a steady stream of irrigating solution into
the wound. Make sure all areas of the wound are
irrigated.
● Use either a syringe with a catheter attached or
with an irrigating tip to flush the wound.

34. Contd…
● If you are using a catheter to reach tracks or
crevices, insert the catheter into the wound until
resistance is met. Do not force the catheter.
Rationale: Forcing the catheter can cause tissue
damage.
● Continue irrigating until the solution becomes
clear (no exudate is present).

35. Contd…
● Dry the area around the wound. Rationale:
Moisture left on the skin promotes the growth of
microorganisms and can cause skin irritation and
breakdown.
● Remove and discard clean gloves.
● Perform hand hygiene.

36. Contd…
7. Assess and dress the wound.
● Assess the appearance of the wound again,
noting in particular the type and amount of
exudate still present and the presence and extent
of granulation tissue.
● Using sterile technique, apply a dressing to the
wound based on the amount of drainage
expected

37. Contd…
● Remove and discard gloves.
● Perform hand hygiene.

38. Contd…
8. Document the irrigation and the client’s response
in the client record using forms or checklists
supplemented by narrative notes when
appropriate.

39. BANDAGING

40. Bandage
Bandage is a strip of material used mainly to support
and immobilize a part of the body.

41. Contd…
Bandage is a strip or roll of cloth or other materials
that may be bound around a part of the body in
variety of ways to secure a dressing maintain
pressure over a body part or immobilize a limb or
other part of the body.

42. Contd…
Bandage are available in rolls of various widths and
materials, including gauze, elasticized knit, elastic
webbing, flannel, and muslin.

43. Bandaging
Bandaging is the process of covering a wound or
injured part using various materials such as gauze,
cotton, elasticized knit, flannel.

44. Contd…
A simple gauze dressing is often not enough to
immobilize or provide support to a wound so that
binder and bandages applied over around dressing
provide extra protection and therapeutic benefits by
creating pressure, supporting wound, and
immobilizing a body part.

45. Purposes
● To support wound
● To immobilize a fracture or dislocation and an
injured part so as to relieve pain
● To maintain direct pressure over a body part or
dressing to control bleeding
● To secure dressing
● To maintain splints in position

46. Contd…
● To retain warmth e.g., a flannel bandage on a
rheumatoid joint
● To prevent or reduce swelling
● To assist the patient in lifting and moving
● To prevent contamination of a wound
● To improve venous blood flow from lower
extremities by applying pressure

47. Principles
➔Always inspect the skin for abrasions, edema,
discoloration or exposed wound edges
➔Use a tightly rolled bandage of the correct width
➔Support the part to be bandage throughout the
procedure
➔Cover exposed wounds with a sterile dressing
➔Hold the end of the bandage in the right hand
when bandaging a left limb and vice versa

48. Contd…
➔Apply the bandage from the inner side to the
outer side, from below to upwards, maintaining
even pressure throughout
➔Held the bandage with the head of roll uppermost
and apply the outer surface of the bandage to the
part. Unroll the bandage just a length at a time.
➔Do not cover the tips of the fingers or toes. These
must be observable.

49. Contd…
➔Bandage should not be too tight or too loose
➔Generally each turn should cover two thirds of the
previous one
➔Assess the condition of underlying dressings and
change if soiled
➔Pad the axilla or groin when bandaging these
parts so that two surfaces of the skin do not touch
each other beneath the bandage

50. Contd….
➔Finish off with a straight turn above the part. Hold
the end and fasten with the safety pin
➔Always stand in front of the patient, except when
applying a capeline bandage
➔Finish off with a strait turn above the part, hold
the end and fasten with the safety pin or tape.

51. Types of bandage
● Roller bandage
● Triangular bandage
● T bandage
● Many tailed bandage
● Abdominal binder/ Large rectangular

54. Articles
● Bandages
● Padding
● Scissors
● Safety pins/ adhesive tape

55. Techniques of bandaging
● Roller bandage
○ Circular turn
○ Simple spiral turn
○ Reverse spiral
○ Figure of eight (Spica)

64. END

65. REFERENCE
● Berman, Audrey T., Synder, S. and Frandsen,
G. 2016. Kozier and Erb’s Fundamentals for
Nursing: concepts and practice 10th
Edition.USA: Pearson
● Potter , P., Perry, A. Stockert P. and Hall, A.
2013. Fundamentals of Nursing . 8th edition.
Canada : Mosby Elsevier
● Devkota R., Pathak S., A textbook of
fundamentals of nursing; 2018, Page: 403-413