Dressings for burns

August 12, 2017 17:50 | First Aid

In the complex treatment of patients with burns, and prepare them for the early recovery of the skin integrity of the dressing occupy a leading position, so the dressing nurse has an essential role.The burn dressing must work two sisters.The first of these provides a strict sterility of all kinds of work dressing, the second dressing room preparing to work and participate directly in the dressings.During the dressings in patients with burns dressing first sister in the sterile sheets and gloves should be sterile at the table, to give the necessary tools and bandage doctor performing ligation.The second dressing sister controls the sequence of dressings and participates in them.Primarily produce dressings in patients with a smooth operational flow (after autodermoplasty), then in patients with uncomplicated superficial burns, granulating wounds and the least - in patients with abundant suppuration burn wound, which will necrectomy-stage.

All dressings, except for urgent, performed four times a week.In th

e days-free dressings, the staff prepares and sterilizes instruments restocking medicines, covers table with sterile instruments.

The burn dressing must be a sufficient number of tools to ensure the smooth rhythm of work.For 20 daily dressings in the tool table must be the following set of tools:

• forceps - 25 pcs .;

• anatomical tweezers - 10 pcs .;

• Scissors Cooper - 15 pcs .;

• pointed scissors - 5 pcs .;

• scissors for cutting bandages - 25 pcs .;

• scalpels bryushistye and pointed - 3 pcs .;

• Hemostatic Clips - 10 pcs .;

• needle holders - 2 pcs .;

• Surgical cutting needle - 5 pcs .;

• serrated sharp hooks - 4 pcs .;

• lamellar hooks - 2 pcs .;

• grooved probe - 2 pcs .;

• bellied probe - 1 pc .;

• forceps - 3 pcs .;

• reniform basins - 15 pcs .;

• 10 ml syringe with needles - 2 pcs .;

• 20 ml syringe with needles - 2 pcs .;

• Janet syringe - 1 pc .;

• cups for solutions - 5 pcs.

increase in the number of surgical tweezers and scissors in the toolbox is necessary because in the dressing every patient with extensive burns, usually attended by at least two doctors.In addition to these tools, you must have a plaster dressing scissors, nail files, plaster forceps, metal spatula, sutures (sterile silk with number 3 on the G), chromic catgut (from number 2 to 4).

The dressing burn patients should be a large number of different groups of medicines:

• furatsilin 1:5000 in solution, is used as a prophylactic and therapeutic agent for antiseptic wet adhering dressings for burn wounds and toilet blending gauze bandages wet-drying;

• rivanol in a solution of 1: 1000 is used for the same purposes and in the case of allergy to furatsilina;

• hydrogen peroxide in the form of a 1 to 2% solution is used for soaking and less painful removal of dead dressings, cleanse burn wounds from the wound and purulent discharge;

• Novocaine 1.2% solution used to rapidly reach an analgesic effect in the removal of dressings in patients with increased pain sensitivity.To this solution, novocaine is impregnated with a two-layer gauze and applied to the wound for 2-3 minutes;

• silver nitrate as a 0.5% solution is used to overlay it bilayer wetted gauze wound granulation tissue on in preparation for autodermoplasty.In the form of a 30% solution is used for granulation with cautery overgrowth;

• potassium permanganate in a 5% solution of dried and used as a deodorizing agent in the treatment of dry necrosis, as well as soaking bandages in patients with burns of hands and feet;

• hypertonic solution of sodium chloride, 5-10% solution is used to enhance drainage of the wound and purulent discharge in a bandage during the demarcation of inflammation and the appearance of copious suppuration in burn wound;

• Methyluracilum as a 0.8% solution is used to restore the disturbed metabolism of tissues and stimulation of regenerative processes in the burn wound, in preparing patients for surgery;

• furatsilinovoy, streptocidal ointment Vishnevsky ointment sintomitsinovoy emulsion 5% is used in the topical treatment of superficial and deep burns;

• salicylic ointment 30% is used to accelerate the rejection necrosis as a keratolytic agent after the completion of the demarcation process, 7-9 days after the burn;

• enzymatic means trypsin or chymotrypsin, iruksol enzymatic ointment cause rejection of necrosis;

• ointments containing steroids (hydrocortisone, prednisolone, ftorokort, etc.), and the spray emulsion containing corticosteroids and antibiotics (such as "Oksikort"), is used to reduce swelling and inflammation of granulation in the wound in preparation for their operation;

• 2-3% solution of boric acid - to inhibit the growth of Pseudomonas aeruginosa;

• sterile vaseline oil is used to impregnate bandages on the wounds of the donor on the eve of their removal;

• for fixing dressings used kleol;

• camphor alcohol intended for treatment of the skin around the bedsore;

• 96% ethyl alcohol solution of brilliant green and iodine.