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Rules for applying an aseptic bandage to a wound. Applying an aseptic bandage: technique and safety rules

In preparation for the procedure for applying an aseptic dressing to a wound, the following steps should be performed:

1. Explain to the patient the course of the upcoming manipulation

2. Wash your hands hygienically.

3. Put on sterile gloves

4. Take sterile tweezers, put 3 gauze pads, a bandage and 2 gauze balls on the tray with tweezers.

The procedure for applying an aseptic dressing to a wound should be performed in the following sequence:

1. Moisten a gauze ball in a beaker with 1% iodonate solution.

2. Treat the edges of the wound in one direction

3. Get a napkin from the tray with tweezers and apply to the wound. Put the second and third napkins on top of the first.

4. Fix the napkin on the wound with a bandage or glue bandage.

At the end of the procedure, you should:

1. Dispose of used instruments in a container with a disinfectant solution.

2. Remove gloves. Wash the hands.

3. Make an entry in the "Medical record" about the procedure and the patient's reaction to it.

Injury is a violation of the integrity and function of tissues (organ) as a result of external influence. Damaging external factors can be mechanical, thermal, electrical, chemical.

Injuries are classified:

1. By the nature of the damage:

– closed

– open

2. By the nature of penetration into the cavity:

– non-penetrating

– penetrating

3. By complexity:

– monotrauma

– polytrauma

The actions of a nurse in providing first aid to victims depend on the type of injury: bruise, sprain and rupture, dislocation, fracture.

A bruise is damage to soft tissues and organs without violating their integrity. A bruise occurs from a blow with a blunt object or from a blow of the body against a blunt object. It is characterized by local pain, swelling, hemorrhage (hematoma), impaired function of the damaged organ.

the procedure for providing first aid for bruises.

1. Conduct anesthesia (give an analgin tablet, inject a 50% solution of analgin 2 ml / m).

2. Apply a pressure bandage.

3. Apply an ice pack to the damaged joint (local hypothermia).

4. Hospitalize in a medical institution.

Stretching and rupture - closed tissue damage without violation (stretching) and with violation (rupture) of anatomical continuity as a result of the action of two forces in opposite directions. Occur when running, jumping, falling, lifting weights, etc.

There is pain, swelling in the joint area, restriction of movement.

The nurse should do the following the procedure for providing first aid for sprains and ruptures.

1. Perform anesthesia (give an analgin tablet, inject a 50% solution of analgin 2 ml intramuscularly or local anesthesia with chlorethyl).

2. Apply a pressure bandage.

3. Apply transport bar.

4. Apply an ice pack to the damaged joint (local hypothermia).

5. Hospitalize in a medical institution.

Dislocation is a persistent displacement of the articular ends of the bones, accompanied by a rupture of the articular capsule and damage to the ligaments of the joint. Pain, dysfunction of the limb, deformity in the area of damage, forced position, spring resistance in the joint when trying to change the position of the limb, a change in the relative length of the limb (more often shortening) are noted.

The articular end, which came out of the articular cavity during dislocation, is not palpated in its usual place or is not defined at all. The diagnosis is confirmed radiographically.

The nurse should do the following procedure for providing first aid in case of dislocation.

1. If there is a wound and bleeding, apply an aseptic bandage after stopping the bleeding (temporary stop of bleeding by any available means).

2. Perform anesthesia (inject a 50% solution of analgin 2 ml / m or baralgin to local anesthesia with chlorethyl).

3. Carry out the simplest anti-shock measures (warm, give warm tea, soda-salt solution).

4. Apply a transport splint or fixing bandage.

6. Hospitalize in a medical institution.

In a medical institution, surgical care consists in reducing the dislocation (introducing the articular end through the torn capsule into the joint cavity) and fixing the limb with a bandage for 5-10 days. After the fixation period, active movements, muscle massage, therapeutic exercises, physiotherapy procedures are prescribed.

A fracture is a complete or partial violation of the integrity of a bone as a result of external violence or a pathological process. Fractures can be closed or open. During the examination, absolute and relative signs of fractures are distinguished.

The nurse must assess the patient's condition, take into account the risk of possible complications (traumatic shock, acute blood loss, infection) and adhere to the following sequence of actions:

1. Stop bleeding with available means (tourniquet, twist, pressure bandage, etc.)

2. Introduce painkillers - narcotic analgesics (50% solution of analgin, promedol 2% - 1.0 ml, morphine 1%), carry out the simplest anti-shock measures (warm, give warm tea, soda-salt solution).

3. Treat the skin around the wound with an antiseptic (1% iodonate solution, alcohol solution of iodine, alcohol) and apply an aseptic dressing. Bone fragments protruding into the wound should be covered with an aseptic dressing.

Remember! It is unacceptable to set bone fragments protruding into the wound!

4. Apply a transport splint to the injured limb.

5. Apply an ice pack to the damaged joint (local hypothermia).

6. Transport the victim to a medical facility.

With closed fractures, there is no need to stop bleeding and apply an aseptic dressing.

Providing first aid to victims with injuries, fractures, dislocations, ligament injuries, bruises, burns, and others becomes almost impossible without the timely and correct application of a bandage. Indeed, due to the dressing, additional infection of the wound is prevented, and bleeding stops, fractures are fixed, and even a therapeutic effect on the wound begins.

Medical dressings and their types

The branch of medicine that studies the rules for applying bandages and tourniquets, their types and methods of application, is called desmurgy (from the Greek desmos - leash, bandage and ergon - performance, business).

By definition, a bandage is a way to treat injuries and wounds, which consists in using:

dressing material, which is applied directly to the wound;
the outer part of the dressing, which fixes the dressing.

The role of dressing material, for various reasons, can be:

special dressing packages;
napkins;
cotton swabs;
gauze balls.

Types of dressings according to the method of application

Description

Varieties

Protective or soft

Consist of a material that is applied to the wound and a fixing bandage

Used in most cases: for burns, bruises, open wounds

bandage;
elastic;
colloidal;
kerchief;
mesh-tubular

Immobilization or solid

Consist of dressing material and splint

They are used to transport the victim, in the treatment of injuries to bones and their elastic joints.

tire (surgical, mesh, pins);
plaster;
adhesive;
transport

Primary care for injuries

The process of applying a bandage is called dressing. Its purpose is to close the wound:

to prevent its further infection;
to stop bleeding;
to have a healing effect.

General rules for dressing wounds and injuries:

Wash your hands thoroughly with soap, if this is not possible, then you should at least treat them with special antiseptic agents.
If the site of damage is an open wound, then gently treat the skin around it with an alcohol solution, hydrogen peroxide or iodine.
Place the victim (patient) in a position convenient for him (sitting, lying), while providing free access to the damaged area.
Stand in front of the patient's face to observe his reaction.
Start bandaging with an “open” bandage from left to right, from the periphery of the limbs towards the body, that is, from the bottom up, using two hands.
The arm must be bandaged in a bent at the elbow state, and the leg in a straightened state.
The first two or three turns (tours) should be fixing, for this the bandage is tightly wrapped around the narrowest undamaged place.
Next, bandage should be with uniform tension, without folds.
Each turn of the bundle covers the previous one by about a third of the width.
When the injured area is large, one bandage may not be enough, then at the end of the first, the beginning of the second is laid, strengthening this moment with a circular coil.
Finish the dressing by making two or three fixing turns of the bandage.
As an additional fixation, you can cut the end of the bandage into two parts, cross them together, circle around the bandage and tie with a strong knot.

The main types of bandages

Before studying the rules for applying bandage dressings, you should familiarize yourself with the types of tourniquets and options for their use.

Bandage classification:

1. By type:

aseptic dry;
antiseptic dry;
hypertonic wet drying;
pressing;
occlusal.

2. According to the overlay method:

circular or spiral;
eight-shaped or cruciform;
serpentine or creeping;
spike-shaped;
tortoiseshell bandage: divergent and convergent.

3. By localization:

on the head;
on the upper limb;
on the lower limb;
on the stomach and pelvis;
on the chest;
on the neck.

Rules for applying soft bandages

Bandage dressings are relevant in most cases of injuries. They prevent secondary infection of the wound and minimize the adverse effects of the environment.

The rules for applying a soft bandage bandage are as follows:

1. The patient is placed in a comfortable position:

with injuries to the head, neck, chest, upper limbs - sedentary;
with injuries of the abdomen, pelvic region, upper thighs - recumbent.

2. Choose a bandage, according to the type of damage.

3. The bandaging process is carried out using the basic rules for bandaging.

If you made a dressing, following the rules for applying sterile dressings, then the compress will meet the following criteria:

completely cover the damaged area;
do not interfere with normal blood and lymph circulation;
be comfortable for the patient.

Rules for applying bandage dressings by type of overlay.

	Bandage Rule
circular bandage	Superimposed on the wrist, lower leg, forehead and so on. The bandage is applied spirally, both with and without kinks. Dressing with kinks is best done on which they have a canonical shape
creeping bandage	Superimposed for the purpose of preliminary fixation of the dressing on the injured area
cruciform bandage	Superimposed in difficult configuration places In the course of dressing, the bandage should describe the figure eight. For example, a cruciform chest bandage is performed as follows: move 1 - make several circular turns through the chest; move 2 - a bandage through the chest is carried out obliquely from the right axillary region to the left forearm; move 3 - make a turn through the back on the right forearm across, from where the bandage is again carried out along the chest towards the left armpit, while the previous layer is crossed; move 4 and 5 - the bandage is again carried out through the back towards the right armpit, making an eight-shaped step; fixing move - the bandage is wrapped around the chest and fixed
spike bandage	It is a kind of eight-shaped. Its imposition, for example, on the shoulder joint is performed according to the following scheme: move 1 - the bandage is carried out through the chest from the side of a healthy armpit to the opposite shoulder; move 2 - with a bandage they go around the shoulder in front, along the outside, behind, through the armpit and raise it obliquely to the shoulder, so as to cross the previous layer; move 3 - the bandage is carried out through the back back to a healthy armpit; moves 4 and 5 - repetition of moves from the first to the third, observing that each new layer of the bandage is applied slightly higher than the previous one, forming a “spikelet” pattern at the intersection
Turtle headband	Used to bandage the area of the joints one turn of the bandage is made in the center of the joint; repeat circular revolutions above and below the previous layer several times, gradually closing the entire injured area; each new layer intersects with the previous one in the popliteal cavity; a fixing turn is done around the thigh Descending Turtle Bandage: make peripheral tours above and below the injured joint, while crossing the bandage in the popliteal cavity; all the following turns of the bandage are done in the same way, moving towards the center of the joint; fixing turn is performed at the level of the middle of the joint

head bandaging

There are several types of headbands:

1. "bonnet";

2. simple;

3. "bridle";

4. "hat of Hippocrates";

5. one eye;

6. on both eyes;

7. Neapolitan (in the ear).

Dressing situations according to their type

Name	When superimposed
	For injuries to the frontal and occipital part of the head
	With mild injuries of the occipital, parietal, frontal part of the head
"Bridle"	In case of injuries of the frontal part of the skull, face and lower jaw
"Hippocratic Hat"	There is damage to the parietal part
One eye	Injury to one eye
For both eyes	When both eyes are injured
Neapolitan	For ear injury

The rule of bandaging the head is based on the fact that, regardless of the type, the dressing is carried out with bandages of medium width - 10 cm.

Since in case of any injury it is very important to provide it in time, in case of general head damage, it is recommended to apply the simplest version of the bandage - the “cap”.

Rules for applying a bandage "bonnet":

1. A piece about a meter long is cut off from the bandage, which will be used as a tie.

2. Its middle part is applied to the crown.

3. The ends of the tie are held with both hands, this can be done either by an assistant or by the patient himself, if he is in a conscious state.

4. Apply a fixing layer of bandage around the head, reaching the tie.

5. They begin to wrap the bandage around the tie and further, over the head.

6. Having reached the opposite end of the tie, the bandage is again wrapped and carried around the skull a little above the first layer.

7. Repeated actions completely cover the scalp with a bandage.

8. Making the last round, the end of the bandage is tied to one of the straps.

9. Straps tie under the chin.

Examples of applying some other dressings

	Bandage Rule
	Spend a bandage twice around the head. The next step in front is a bend and the bandage begins to be applied obliquely (from the forehead to the back of the head), slightly higher from the circular layer. At the back of the head, another bend is made and the bandage is led from the other side of the head. The moves are fixed, after which the procedure is repeated, changing the direction of the bandage. The technique is repeated until the top of the head is completely covered, while not forgetting to fix every two oblique strokes of the bandage
"Bridle"	Make two turns around the head. Next, the bandage is lowered under the lower jaw, passing it under the right ear. Raise it back to the crown through the left ear, respectively. Three such vertical turns are made, after which a bandage from under the right ear is carried out on the front of the neck, obliquely through the back of the head and around the head, thus fixing the previous layers. The next step is again lowered on the right side under the lower jaw, trying to completely cover it horizontally. Then the bandage is carried out to the back of the head, repeating this step. Once again repeat the move through the neck, and then finally fixing the bandage around the head
One eye	The bandage begins with two reinforcing layers of the bandage, which is carried out in case of injury to the right eye from left to right, the left eye - from right to left. After that, the bandage is lowered from the side of the injury along the back of the head, wound under the ear, covers the eye obliquely through the cheek and is fixed in a circular motion. The step is repeated several times, covering each new layer of bandage with the previous one by about half.

Dressings for bleeding

Bleeding is the loss of blood in violation of the integrity of the blood vessels.

Rules for applying bandages for bleeding of various types

Type of bleeding	Description	Bandage Rule
Arterial	Blood has a bright red color and beats with a strong pulsating jet	Tightly squeeze the place above the wound with your hand, tourniquet or tissue twist. Bandage type - pressure
Venous	Blood turns dark cherry color and flows evenly	Raise the damaged part of the body higher, apply sterile gauze to the wound and bandage it tightly, that is, make a pressure bandage The tourniquet is applied from below the wound!
capillary	Blood is released evenly from the entire wound	Apply a sterile bandage, after which the bleeding should stop quickly
mixed	Combines the features of the previous types	Apply pressure bandage
Parenchymal (internal)	Capillary bleeding from internal organs	Bandaging using a plastic bag with ice

General rules for applying bandages for bleeding from a limb:

Place a bandage under the limb, slightly above the wound site.
Attach an ice pack (ideally).
Stretch the tourniquet strongly.
Tie the ends.

The main rule for applying a bandage is to place the tourniquet over clothing or a specially lined fabric (gauze, towel, scarf, and so on).

With the right actions, the bleeding should stop, and the place under the tourniquet should turn pale. Be sure to put a note under the bandage with the date and time (hours and minutes) of the dressing. After first aid, no more than 1.5-2 hours should pass before the victim is taken to the hospital, otherwise the injured limb cannot be saved.

Rules for applying a pressure bandage

Pressure bandages should be applied to reduce all types of external bleeding at bruises, as well as to reduce the size of the edema.

Rules for applying a pressure bandage:

The skin adjacent to the wound (about two to four cm) is treated with an antiseptic.
If there are foreign objects in the wound, they should be carefully removed immediately.
As a dressing material, a ready-made dressing bag or a sterile cotton-gauze roller is used, if there is none, then a bandage, a clean handkerchief, and napkins will do.
The dressing is fixed on the wound with a bandage, scarf, scarf.
Try to make the bandage tight, but not pulling the damaged area.

A well-applied pressure bandage should stop bleeding. But if she still managed to soak in blood, then it is not necessary to remove it before arriving at the hospital. It should simply be bandaged tightly from above, after placing another gauze bag under the new bandage.

Features of the occlusive dressing

An occlusive dressing is applied to seal off the damaged area to prevent contact with water and air. Used for penetrating wounds.

Rules for applying an occlusive dressing:

Place the victim in a sitting position.
Treat the skin adjacent to the wound with an antiseptic (hydrogen peroxide, chlorhexidine, alcohol).
An antiseptic wipe is applied to the wound and the adjacent area of the body with a radius of five to ten cm.
The next layer is applied with a water- and air-tight material (necessarily with a sterile side), for example, a plastic bag, cling film, rubberized fabric, oilcloth.
The third layer consists of a cotton-gauze pad, which plays the role of constipation.
All layers are tightly fixed with a wide bandage.

When applying a bandage, it should be remembered that each new layer of dressing should be 5-10 cm larger than the previous one.

Of course, if possible, it is best to use the PPI - which is a bandage with two cotton-gauze pads attached. One of them is fixed, and the other moves freely along it.

Applying an aseptic dressing

An aseptic dressing is used in cases where there is an open wound and it is required to prevent contamination and foreign particles from entering it. This requires not only correctly applying the dressing, which must be sterile, but also securely fixing it.

Rules for applying an aseptic dressing:

Treat wounds with special antiseptic agents, but in no case use water for this purpose.
Attach gauze directly to the injury, 5 cm larger than the wound, previously folded in several layers.
From above, apply a layer (easily exfoliated), which is two to three centimeters larger than gauze.
Tightly fix the dressing with a bandage or medical adhesive tape.

Ideally, it is better to use special dry aseptic dressings. They consist of a layer of hygroscopic material that absorbs blood very well and dries the wound.

To better protect the wound from dirt and infection, additionally glue the cotton-gauze bandage on all sides to the skin with adhesive tape. And then fix everything with a bandage.

When the bandage is completely saturated with blood, it must be carefully replaced with a new one: completely or only the top layer. If this is not possible, for example, due to the lack of another set of sterile dressings, then the wound can be bandaged by first lubricating the soaked bandage with iodine tincture.

Splint dressing

When providing first aid for fractures, the main thing is to ensure the immobility of the injury site, as a result, pain sensations decrease and displacement of bone fragments is prevented in the future.

The main signs of a fracture:

Severe pain at the site of injury that does not stop for several hours.
Pain shock.
With a closed fracture - swelling, edema, deformation of tissues at the site of injury.
With an open fracture - a wound from which bone fragments protrude.
Limited movement or their complete absence.

Basic rules for applying bandages for fractures of the limbs:

The dressing must be of the immobilization type.
In the absence of special tires, you can use improvised things: a stick, a cane, small boards, a ruler, and so on.
Keep the victim immobile.
To fix the fracture, use two splints wrapped in soft cloth or cotton.
Apply tires on the sides of the fracture, they should capture the joints below and above the damage.
If the fracture is accompanied by an open wound and profuse bleeding, then:

a tourniquet is applied above the fracture and wound;
a bandage is applied to the wound;
two splints are placed on the sides of the injured limb.

If you apply any type of bandage incorrectly, then instead of providing first aid, you can cause irreparable harm to the health of the victim, which can lead to death.

Often, any wound that was received, not during the period of surgical intervention, is considered infected, since microbes may be present there anyway.

To prevent subsequent infection in the wound obtained in one way or another, it is recommended to apply a sterile or, in other words, aseptic dressing. At the same time, in order to gain access to a person’s wound, it is often necessary to cut rather than remove existing clothing. In no case should you wash the wound with ordinary water, since as a result of these actions, microorganisms located on the surface of the wound, together with water, can penetrate deeper. Immediately before such a procedure as the application of an aseptic dressing, it is necessary to carefully lubricate the skin near the wound with ordinary tincture of iodine. In addition, in a situation where it is an aseptic dressing that is applied, it is also recommended to use other medications instead of iodine, such as brilliant green, cologne, or ordinary alcohol. Next, the wound is covered with a special bandage that has sterile characteristics in several layers. Otherwise, in the absence of such a bandage, you can use a piece of cotton naturally in a clean version. After these actions, the tissue applied to the wound is recommended to be well fixed. Here you can use both a scarf and a regular bandage.

Dry antiseptic dressings today are actually made under the guise of layers of ordinary sterile gauze, which are covered in the upper part with hygroscopic cotton wool or lignin, which have a wider diameter. Today it is customary to apply modern aseptic dressings either on the human wound itself, or on top of the applied tampons, or on special drainage. In order to rid the wound of infections and toxins as effectively as possible to ensure rapid healing, it is in any case necessary to use a sterile dressing in order to prevent subsequent infection.

To date, there are a number of mandatory steps that must always be followed when applying sterile dressings. So, any aseptic dressing on the wound is applied taking into account the following recommendations. First of all, the specialist must thoroughly wash his own hands and put on special sterile rubber gloves. The patient should be in a comfortable position for him. The very same procedure regarding the imposition of a dressing of a sterile version is often carried out using a pair of tweezers. The skin must be lubricated with cleol. Good fixation of a sterile dressing is of great importance, since this product is primarily intended to cover the affected parts of the human body. No less important here is the procedure for disinfecting the instrument used.

It is also worth clarifying here that there are also differences between antiseptic and aseptic dressings. Therefore, in no case should you consider that this is the same product. After all, for example, an aseptic dressing is considered just a sterile dressing, but an antiseptic dressing is additionally also intended to protect against various infections entering the wound.

Protective bandages are used today to protect the wound from re-infection and the adverse effects of the external environment. Protective is considered to be an ordinary aseptic bandage, which in certain situations can be made with the presence of an additional cover under the guise of a waterproof polyethylene film. This type of dressing also includes dressings for wounds with the presence of a film-forming aerosol or a conventional bactericidal plaster. In addition, occlusive dressings are also considered to be protective, which are designed to hermetically seal the affected areas of the human body in order to prevent the penetration of air and, accordingly, water to the wound. Most often, such a dressing is used in the presence of a penetrating wound to such a part of the human body as the chest. In this situation, the application of a material that does not allow air or water to pass through is recommended first of all. Often such a product is impregnated with vaseline oil or other similar substances. Any such bandage should be well fixed, for example, with a simple bandage. In addition, in this situation, the use of a wide adhesive plaster is also allowed, which is applied under the guise of a tile for the purpose of subsequent maximum fixation of the product.

Thus, when applying an aseptic bandage in any situation, it is necessary not only to strictly observe the rules for implementing this procedure, but also to use additional medications.

Antiseptic (bactericidal) dressing designed for antibacterial (bactericidal or bacteriostatic) effect of the substances contained in it. There are bactericidal dressings dry and wet drying.

Dry bactericidal dressing in design it does not differ from dry aseptic dressings, but is prepared from dressings impregnated with any antiseptic agents, or is a dry aseptic dressing, the gauze layer of which is sprinkled with a powdered antiseptic (for example, streptocide).

wet drying bactericidal bandage consists of one or more sterile gauze wipes moistened ex tempore with an antiseptic solution; they are applied to the wound in a lump and covered with a dry aseptic bandage on top. The latter immediately absorbs the liquid from the wipes and gets wet. Microorganisms cannot penetrate through a wet antiseptic dressing; in order to prevent the patient's linen and bed from getting wet, the bandage is usually covered with a layer of sterile, non-hygroscopic cotton wool on top, which does not interfere with ventilation. This is very important, because if you cover a wet dressing with an airtight material (for example, oilcloth), you get a kind of warming compress from an antiseptic solution, which can cause dermatitis and even skin burns, and sometimes tissue necrosis in the wound (for example, a compress from a sublimate solution). ). The first antiseptic used for dressings was carbolic acid (Lister), followed by salicylic and boric acids. In the 80s of the XIX century. a bandage with a sublimate solution was widely used, replacing all other types of antiseptic dressings. With the transition from antiseptic methods to asepsis, bactericidal dressings almost completely fell out of use. It was only with the advent of modern antiseptics that this type of dressing began to be widely used again. Currently, they use a wide variety of chemical and biological antibacterial drugs introduced into the bandage ex tempore.

The use of dry dressings made of antiseptic dressing material is most justified in military field conditions, since even a bactericidal dressing soaked with blood continues to a certain extent protect the wound from microbial invasion. Therefore, for the manufacture of individual dressing bags, an antiseptic dressing is preferred.

Dressings are used to treat burn injuries of varying severity and localization. Consider their types, rules and methods of application, medicinal properties.

Damage to the skin and mucous membranes by chemicals, high or low temperatures, radiation energy or electricity is a burn. The specificity of this kind of injury depends on the properties of the agent that caused it, and the individual characteristics of the patient's body (type of skin structure, age, extent of the lesion). The main types of burns:

Thermal - arise due to contact with boiling water, hot air or steam, hot objects. The depth of damage depends on the duration of the agent's action.
Electrical - most often occur when working with electrical equipment or due to lightning strikes. Skin injuries are accompanied by disorders of the cardiovascular and respiratory systems. Even a small wound causes headaches, dizziness, loss of consciousness. The last stages provoke respiratory arrest, clinical death.
Radiation - exposure to ultraviolet radiation. Occurs due to prolonged exposure to the sun.
Chemical - develop in contact with chemically aggressive substances. The severity and depth of injury depend on the concentration and time of exposure of the reagent to living tissues.

Dressings are applied for all types of burns. For them, special therapeutic ointments, antiseptics, disinfecting solutions and other drugs are used that accelerate the healing process.

A burn is an injury from which no one is immune. The effectiveness of recovery depends on the correct and timely treatment. In order to help the victim, you need to know the algorithm for applying bandages. With burns and frostbite, it is worth considering the localization and extent of the lesion.

First of all, it is necessary to ensure sterility. If there is no bandage on hand, and a tissue flap is used, then it must be clean, as there is a risk of infection. You can apply a bandage on your own with 1-2 degrees of burns, that is, with redness and blisters on the skin.
For more serious grade 3-4 injuries, when muscle tissue is visible, dressings are not recommended, emergency medical care is needed. Since the bandage can stick to the tissues, and changing it will cause severe pain and increase the risk of infection.
The bandage is applied after the frostbitten or burned area is cleaned of contamination and treated with a special antibacterial or antiseptic ointment. Wound care promotes normal tissue repair and reduces pain.

Before applying a bandage to the wound area, you need to restore normal blood circulation. In case of frostbite, it is recommended to rub and warm the skin, and in case of a burn, stop exposure to temperature and cool the injury site. After that, anesthetize and prevent infection.

Consider the basic rules for applying a bandage:

Wash your hands thoroughly and prepare sterile materials (bandage, tissue flap, gauze) for dressing. The use of dirty dressings is dangerous, as it can provoke an infectious infection of the wound.
Carefully inspect the burnt area, it is necessary to determine the degree of the burn. Only then can you make a decision about self-administration of first aid or going to the hospital. Do not forget that a burn wound, regardless of its size and location, is very serious, and without proper treatment can lead to serious complications.
If there is any anti-burn, antiseptic or anesthetic ointment, then it must be applied to the skin before applying the bandage. This will reduce pain and help you recover faster from an injury by providing protection from germs.
Gently bandage the injured area, trying not to cause pain to the victim.

The main difficulty encountered when applying dressings is determining the degree of burn. If the epidermis is reddened and there are blisters on it, then this indicates a 1-2 degree. More serious wounds require medical attention. If the injury is serious and the skin has turned black, then without emergency hospitalization, amputation of the injured limbs is possible.

The effectiveness of the treatment of burns depends not only on timely medical care, but also on the drugs used. Antiseptic dressings for burns are necessary to prevent infection and destroy putrefactive bacteria. The drug has a disinfectant, bacteriostatic, bactericidal and antiseptic effect.

To date, the pharmaceutical market has many antiseptics in various forms of release that can be used for dressings and wound treatment. Their use is explained by the fact that even under conditions of complete sterility, a small amount of bacteria enters the wound. For the occasional treatment of minor burns, preparations based on iodine or silver, but without alcohol, are best.

Consider the most effective antiseptics for the treatment of burns of varying severity:

Argacol is a hydrogel with active ingredients: poviargol, catapol, dioxidin. It has an antimicrobial effect. It is used to treat burns, cuts, abrasions and other skin lesions. After application to the skin, it forms an elastic, air- and water-permeable film.
Amprovizol is a combined agent with anesthesin, vitamin D, menthol and propolis. It has anti-burn, antiseptic, anti-inflammatory, cooling and analgesic properties. Effective in the treatment of thermal and sunburns of the 1st degree.
Acerbin is an antiseptic for external use. It comes in the form of a spray, which makes it easier to apply on wounds. Active ingredients: benzoic, malic acid and salicylic acid, propylene glycol. The spray is used to treat burns, ulcers and open wounds on the skin. Accelerates regeneration, reduces the formation of exudate, promotes the formation of a crust.
Betadine is a drug with a wide range of uses. It has several forms of release: ointment, solution, suppositories. The active substance is iodine. It has bactericidal properties, and its mechanism of action is based on the destruction of proteins and enzymes of harmful microorganisms. It is used for antiseptic treatment of burn surfaces and wounds, disinfection. It can be used as a means for the primary treatment of the skin and mucous membranes from infected materials.
Miramistin is a drug with a hydrophobic effect on harmful microorganisms. Active against gram-positive and gram-negative microorganisms, has an antifungal effect. It is used to treat burns, wounds, trophic ulcers, suppuration, frostbite and other infected lesions. Miramistin is used in dermatology, gynecology, venereology, and dentistry.
Cigerol is an antiseptic solution with disinfecting and wound healing properties. It is used to treat burns, necrotic and granulating wounds, trophic ulcers.
Chlorhexidine is a local antiseptic solution with bactericidal properties. Its mechanism of action is based on changes in the cell membranes of harmful microorganisms. It is used to treat the skin with burns, deep wounds, abrasions, as well as during surgery.

All of the above preparations are suitable for the treatment of damaged skin. Before applying a bandage, the wound can be treated with medicine or a bandage already moistened with the preparation can be applied to the skin. There are also ready-made anti-burn antiseptic dressings:

VitaVallis is used to treat burns of 1-4 degrees, thermal and granulating wounds, in the postoperative period and to protect transplanted skin from secondary infection. Accelerates the regeneration process at the cellular level, minimizes scarring. Good pain reliever. The dressing material is made of antimicrobial sorption fiber with colloidal silver and aluminum particles, designed for single use.
Activetex - special textile wipes impregnated with medicinal substances (antiseptics, anesthetics, antioxidants, hemostatics). For burns with a pronounced inflammatory process, dressings with an antiseptic (miramistin) and painkillers (chlorhexidine, lidocaine, furagin) are suitable.
Voskopran is a dressing material in the form of a polyamide mesh, which is impregnated with an antiseptic and beeswax. Does not adhere to the wound site, provides exudate outflow, accelerates healing and minimizes scarring.
Biodespol is a drug coating with an antiseptic (chlorhexidine, miramistin) and anesthetic (lidocaine). Cleanses the wound from a thin scab and fibrin, activates epithelialization.

To care for a burn wound, you can treat the tissues with chlorhexidine, then with any antiseptic spray, apply a bandage (VitaValis, Branolid) and an ointment containing silver. It is in this sequence that the drugs are applied to the burn under a sterile dressing.

The leading place in the treatment of burns is occupied by dressings, the action of which is aimed at restoring the integrity of the skin and protecting against infection. Before applying them, the wound areas are treated with special antiseptic solutions and other disinfecting and anti-inflammatory drugs.

How often to change dressings for burns depends on the area and depth of the lesion. As a rule, dressings are carried out 1-2 times a day. If possible, the wound is best left open (provided there is no infection) in order to form a crust. Most often, the dressing is applied not only to the burn surface, but also to the surrounding healthy tissues, to protect them from injury.

The leader among domestic injuries are thermal burns of the 2nd degree. The main signs of damage: swelling and redness of the skin, soreness, the appearance of large blisters with liquid. Such wounds are especially dangerous, since if they are not properly treated, there is a risk of an inflammatory process. As a result, post-burn recovery is delayed for a couple of months instead of 2-3 weeks.

It is strictly contraindicated to touch the burn with your hands or open the blisters. If any contamination has got on the skin, then you should consult a doctor who will clean the wound and prevent microbial infection. If a small area of the skin is affected, treatment can be carried out at home. The therapy consists of:

Daily dressings.
Treatment of the wound surface with antiseptic agents.
Treatment of the wound with a special anti-burn ointment.

Sterile dressings for burns of the 2nd degree must be applied with medical gloves. If the burn begins to suppurate, then treatment of the wound with antiseptic solutions and ointments is indicated. For healing, drugs are used that accelerate tissue regeneration: ointments with chloramphenicol, vitamin E, sea buckthorn oil and other substances.

The most commonly used tools are:

Panthenol is a drug with the active substance dexpanthenol. It is used to accelerate the healing of the skin and mucous membranes in case of damage of various origins. It is effective for burns, aseptic wounds in the postoperative period, as well as for skin grafts. It has several forms of release, which facilitates its application to damaged areas.
Dermazin is a sulfadiazine derivative of silver with a wide spectrum of antimicrobial activity. It is used to treat burn injuries of different localization and severity. It acts as an excellent prevention of infection of wound surfaces. Helps with trophic ulcers and other injuries.
Synthomycin emulsion is an antibacterial agent, similar in its action to chloramphenicol. It affects the protein metabolism of pathogenic bacteria, destroying them. Accelerates the process of regeneration of damaged tissues at the cellular level, minimizes the formation of scars.
Olazol - an aerosol with sea buckthorn oil, chloramphenicol, boric acid and anesthesin. Anesthetizes and has an antibacterial effect, reduces exudation, accelerates the process of epithelization. It is used for burns, wounds, trophic ulcers, inflammatory lesions of the epidermis.
Solcoseryl is a biogenic stimulant, the action of which is aimed at the destruction of harmful microorganisms and the restoration of damaged tissues. Effective for burns 2-3 degrees.

Medicines must be applied to the wound site before dressing. For the fastest healing, it is desirable to carry out the procedure 2 times a day.

Ointment dressings are used to anesthetize, accelerate the process of epithelialization and restore the skin. For burns, the following drugs are most often used:

Levomekol

A drug with a combined composition. Contains an immunostimulant (methyluracil) and an antibiotic (chloramphenicol). It is active against most harmful microorganisms, while the presence of pus does not reduce the effect of the antibiotic. Improves the process of tissue regeneration, has an anti-inflammatory effect, reduces the formation of exudate. It is used for burns of 2-3 degrees, purulent-inflammatory wounds, boils. The ointment is applied to sterile wipes and loosely filled with wounds. The dressing is carried out every day until the skin is completely cleansed. The main contraindication is intolerance to the active components. Side effects are manifested in the form of allergic reactions.

Ebermin

External agent with bactericidal properties, stimulates wound healing. Contains silver sulfadiazine, that is, a substance that causes the death of harmful microorganisms. It is used to treat deep and superficial burns of varying severity and localization. The ointment normalizes the growth of collagen fibers, prevents pathological scarring of tissues. The agent is applied to the skin with a layer of 1-2 mm, and a bandage or other dressing with a mesh structure is applied on top. Dressings are carried out 1-2 times in 48 hours, the course of treatment is from 10 to 20 days. Side effects are manifested in the form of local allergic reactions.

Argosulfan

A drug with antimicrobial and wound healing properties. It has a pronounced analgesic effect, reduces pain and the severity of the inflammatory process. The active substance is sulfathiazole. It is used for burns of varying severity and origin, frostbite, as well as for trophic ulcers, cuts, infections. The ointment can be applied both under a sterile dressing and on open skin 1-3 times a day. Side effects are manifested as local allergic reactions. The drug is not recommended for patients with intolerance to its components, for children under 2 months of age and with congenital deficiency of glucose-6-phosphate dehydrogenase.

eplan

An external preparation with pronounced wound healing, bactericidal and regenerating properties. It has several forms of release: liniment in dropper bottles, cream and medical gauze ointment dressings. It is used for all types of burns, cuts, abrasions, allergic reactions and to prevent infection of wounds. The only contraindication is intolerance to the active components. The medicine is applied to the skin until the defect is completely healed.

Rescuer-forte

A complex drug with a synergistic effect. Softens, nourishes and accelerates tissue regeneration. It has an antibacterial, sedative, analgesic and detoxifying effect. After application to the skin, it forms a film that does not allow damaged tissues to dry out. It is used for thermal and chemical burns, bruises, sprains, wounds, abrasions, diaper rash. Helps with secondary infection and acute inflammatory diseases of the skin and mucous membranes. Before applying the product, the skin must be washed with an antiseptic and dried. First, an ointment is applied, and a bandage is applied on top as an insulating layer.

In case of thermal, chemical or radiation damage to the skin of mild or moderate severity, a closed method of treatment is recommended. Wet dressings for burns are necessary to protect the wound site from infection, minimize the inflammatory process, relieve pain and accelerate regeneration.

Before bandaging, the wound surface must be washed with an antiseptic solution or a bandage with Furacilin, Iodopyrine, Chlorhexidine or Miramistin should be applied to the wound. After that, dry the skin and apply the ointment. Dressings can be soaked in medicated ointments and applied to the wound, or medicine can be applied directly to the injury. The procedure is carried out as the bandage dries, usually 2-3 times a day until complete healing.

For the treatment of burn injuries of varying severity, drugs of various effectiveness are used. Gel dressings for burns are a special dressing material that includes an aqueous dispersion medium (formed from microheterogeneous colloidal solutions). A hydrogel is a porous material that swells strongly in water or an aqueous solution. Such dressings are impregnated with biologically active compounds, the action of which is aimed at disinfecting the wound and accelerating the process of epithelization.

Gel dressings have several advantages over ointments:

The aqueous environment of the gel stimulates the penetration of antiseptic and anti-inflammatory components into the wound site. This speeds up the healing process and minimizes the risk of infection.
The active substances in the gel base are gradually released from the carrier, providing a prolonged therapeutic effect. The polymer matrix of the gel controls the rate of release of drug components, which ensures their delivery to the areas that need them.

Consider the popular gel-based anti-burn dressings:

OpikUn - gel bandages and wipes for the treatment of wounds and burn injuries. They have anti-inflammatory and antimicrobial effects. They speed up the process of epithelialization, prevent the appearance of blisters (provided that the bandage was applied immediately after the burn), cool the wound and relieve pain. Do not stick to the wound surface, breathable. The dressings are hypoallergenic and have a transparent base, which allows you to monitor the condition of the burn. They are recommended to be used as first aid for burns of 1-3 degrees and to prevent purulent complications of wounds of any origin.
Appolo - dressings with hydrogel, anesthetic and anesthetic. The mechanism of action of this dressing promotes rapid cooling of the injury, minimizes pain, fights pathogens. Appolo has an anti-inflammatory effect, eliminates an unpleasant odor from the wound. Bandages adhere well to the wound surface and are easily removed. They need to be changed every 24-48 hours and can be combined with other dressings or drugs.
Granuflex is a hydrocolloid dressing with silver. Effective in the treatment of 2nd degree burns. They absorb wound exudate, forming a gel that provides a moist environment and promotes the removal of dead tissue from the wound. Silver ions have a bactericidal effect, reduce the risk of infection and are active against a wide range of harmful microorganisms.

But, despite all the useful properties, gel dressings have a number of contraindications. The dressing material is not used for wounds with profuse discharge, with purulent-necrotic lesions. Also not suitable for patients with individual intolerance to their active ingredients.

One of the most popular drugs used to treat epidermal damage of various etiologies is Branolind. The drug is a gauze bandage, which is impregnated with a healing ointment (balsam of Peru). Most often bandages are used for burns. Branolind is made of a mesh cotton base with high air and secretion permeability. One package contains 30 dressings, each with a protective wrap.

The cotton base is impregnated with Peruvian balsam, petroleum jelly, hydrogenated fat and other substances. This composition has a complex therapeutic effect on damage, provides antibacterial, antiseptic and anti-inflammatory activity. Branolind accelerates the process of tissue regeneration and minimizes the risk of scarring.

Indications for use: treatment and care of superficial wounds (thermal and chemical burns, abrasions, bruises), frostbite, purulent abscesses. The tool is used in skin transplantation, phimosis operations and in the treatment of infected wounds.
How to use: open the package with a bandage of a suitable size (depending on the amount of damage), remove the protective paper layer and apply to the wound. After that, remove another protective layer and cover with a bandage. The bandage should be changed every 2-3 days or at each dressing. Thanks to the ointment base, such a compress does not stick to the skin, which makes it possible to remove it painlessly.
Contraindications: not used in case of intolerance to the active ingredients and for the treatment of lesions with a necrotic process. Branolind can cause local allergic reactions of varying severity. To eliminate them, you must stop using the tool.

Dressings for burns of varying severity simplify the treatment process. They can be used with various antiseptic, anti-inflammatory or analgesic ointments and solutions. They protect the wound from infection and accelerate the process of regeneration of damage.

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Bandages are applied to treat wounds and protect them from external influences, to immobilize (see), stop bleeding (pressure bandages), to combat saphenous veins and venous stasis, etc. There are soft and hard bandages, or fixed .

Soft bandage, kerchief, plaster, glue and other dressings are applied to hold the dressing on the wound, as well as for other purposes. Overlay methods - see Desmurgy.

Aseptic dry dressing consists of several layers of sterile gauze, covered with a wider layer of hygroscopic cotton wool or lignin. It is applied directly to the wound or over the tampons or drains introduced into it in order to drain the wound: the outflow of fluid (pus, lymph) into the bandage contributes to the drying of the surface layers of the wound. At the same time, due to the removal of microbes and toxins from the wound, conditions conducive to healing are created. A dry aseptic bandage also protects the wound from new infection. If the bandage gets wet through (all of it or only the upper layers) must be changed; in some cases, bandaging is performed - cotton wool is added and bandaged again.

Antiseptic dry dressing according to the method of application, it does not differ from dry aseptic, but is prepared from materials previously impregnated with antiseptic agents (mercuric chloride solution, iodoform, etc.) and then dried or sprinkled with powdered antiseptics (for example, streptocide) before applying the dressing. A dry antiseptic dressing is used mainly in first aid in order to influence the substances contained in them on the microbial flora of the wound. More commonly used wet drying dressing from gauze soaked in an antiseptic solution. An antiseptic solution can be injected into the bandage fractionally with a syringe or continuously drip through special drains, the ends of which are brought out through the bandage.

Hypertonic wet drying dressing is prepared from materials (tampons, gauze covering the wound) soaked immediately before bandaging with 5-10% sodium chloride solution, 10-25% magnesium sulfate solution, 10-15% sugar solution and other substances. Such dressings cause an increased outflow of lymph from the tissues into the wound and into the dressing. Their imposition is indicated for infected wounds with poor discharge, for wounds containing many necrotic tissues.

Protective bandage consists of gauze thickly lubricated with sterile vaseline, vaseline oil, 0.5% synthomycin emulsion or other oily substances. It is used to treat granulating wounds cleared of necrotic tissues.

pressure bandage it is applied for the purpose of a temporary stop of bleeding (see). A tight ball of cotton wool is placed over the tampons inserted into the wound and gauze napkins and bandaged tightly.

Occlusive dressing used for open pneumothorax (see). Its main purpose is to prevent air from entering the pleural cavity through the chest wound. After abundant lubrication of the skin with vaseline around the wound, a piece of a torn rubber glove, oilcloth or other air-tight fabric is applied to it. The bandage should cover not only the wound, but also the skin around it. A large amount of cotton wool is applied over this fabric and bandaged tightly. When inhaled, the air-tight tissue sticks to the wound and seals it. It is also possible to tighten the edges of the wound with strips of a sticky plaster with the application of gauze, cotton wool and a bandage on top.

Elastic bandage - see Varicose veins.

Zinc-gelatin bandage - see Desmurgy.

Fixed (immobilizing) dressings superimposed to limit movement and ensure rest of any part of the body. Indicated for bruises, dislocations, fractures, wounds, inflammatory processes, tuberculosis of bones and joints. Fixed dressings are divided into tire (see Tires, splinting) and hardening. The latter include plaster casts (see Plaster technique), as well as the starch dressing, which is rarely used at the present time. For the manufacture of hardening dressings, other substances can also be used: a syrupy solution of gelatin, liquid glass (sodium silicate solution) and a solution of celluloid in acetone. These slowly hardening dressings are used (mainly the latter) for the production of corsets and splint-sleeve devices made from a plaster model.

starch dressing. Starched gauze bandages, after being immersed in boiling water and squeezed out, are applied over a cotton lining, often with cardboard splints. Such a bandage hardens within a day. A starch dressing can also be applied with a regular bandage, each layer of which is smeared with starch glue. It is prepared by mixing starch with a small amount of water to the consistency of thick sour cream, and brewed with boiling water while stirring.

See also Balsamic dressings.

According to the mechanical properties, soft bandages used to treat wounds are distinguished; rigid, or motionless, - for an immobilization (see); elastic - to combat the expansion of the saphenous veins and venous stasis; bandages with traction (see Traction). Soft dressings are most widely used for wounds and other defects of the integument (burns, frostbite, various ulcers, etc.). They protect wounds from bacterial contamination and other environmental influences, serve to stop bleeding, influence the microflora already present in the wound, and the biophysical and chemical processes occurring in it. In the treatment of wounds, dry aseptic dressings, antiseptic (bactericidal), hypertonic, oil-balsamic, protective, hemostatic dressings are used.

Ways to keep dressings on the wound - see Desmurgy.

A dry aseptic bandage consists of 2-3 layers of sterile gauze (applied directly to the wound or to tampons inserted into the wound) and a layer of sterile absorbent cotton covering the gauze of various thicknesses (depending on the amount of discharge). In terms of area, the dressing should cover the wound and the surrounding skin at a distance of at least 4-5 cm from the edge of the wound in any direction. The cotton layer of the dressing should be 2-3 cm wider and longer than the gauze. Absorbent cotton can be completely or partially (top layers) replaced with another highly absorbent sterile material (eg lignin). To increase the strength of the bandage and the convenience of bandaging, a layer of gray (non-hygroscopic) cotton wool is often applied over it. On operating wounds sewn tightly, an aseptic bandage is applied from one gauze in 5-6 layers without cotton wool. A dry aseptic bandage is applied to dry the wound. With wounds that heal by primary intention, drying promotes the rapid formation of a dry scab. With infected wounds, along with pus, a significant part of microorganisms and toxic substances enter the dressings. About 50% of the radioactive isotopes contained in it pass into a dry cotton-gauze bandage applied to a fresh radioactively infected wound (V. I. Muravyov). A dry bandage reliably protects the wound from contamination until it gets wet. A soaked bandage must either be immediately changed or bandaged, i.e., having lubricated the soaked area of the bandage with iodine tincture, fix another layer of sterile material over the bandage, preferably non-hygroscopic.

An antiseptic (bactericidal) dry dressing does not differ in design from a dry aseptic one, but is prepared from materials impregnated with antiseptic agents, or is a dry aseptic dressing, the gauze layer of which is sprinkled with a powdered antiseptic (for example, streptocide).

The use of dry dressings made of antiseptic dressings is most justified in military field conditions, since they, even soaked in blood, continue to protect the wound from microbial invasion to a certain extent. Therefore, for the manufacture of individual dressing bags, an antiseptic dressing is preferred.

Wet drying antiseptic dressing consists of sterile gauze wipes moistened ex tempore with an antiseptic solution; they are applied to the wound in a lump and covered with a dry aseptic bandage on top. The latter immediately absorbs the liquid from the napkins and gets wet; in order to prevent the patient's linen and bed from getting wet, the bandage is usually covered on top with a layer of sterile non-hygroscopic cotton wool that does not interfere with ventilation. If you cover a wet dressing with an airtight material (such as oilcloth), you get a warming compress from an antiseptic solution, which can cause dermatitis and even skin burns, and sometimes tissue necrosis in the wound. At one time, bactericidal dressings almost completely went out of use and only with the advent of modern antiseptic agents began to be widely used again. Currently, a wide variety of chemical and biological antibacterial drugs are used, introduced into the bandage ex tempore.

The hypertonic bandage creates a difference in the osmotic pressure of the tissue fluid and the fluid contained in the wound and in the dressing, and thereby causes an increased flow of lymph from the tissues into the wound cavity. A dry hypertonic dressing is prepared from a dry aseptic dressing, powdering 2-3 layers of gauze and the wound with powdered sugar. This type of bandage is rarely used, usually a wet drying hypertonic bandage is made, which is impregnated with a hypertonic (5-10%) solution of salt, usually table salt, instead of an antiseptic solution. A solution of magnesium sulphate, which has analgesic properties, can also be used. Sometimes a 10-15% solution of sugar (beet) is also used, however, saline hypertonic solution is more beneficial, as it contributes to favorable changes in the electrolyte balance of tissues, pH of the environment and other indicators, therefore, it is a method of pathogenetic wound therapy.

Oil-balsamic dressings have an even greater influence on the pathogenesis of the wound process (see).

A protective bandage is used at the stage of wound granulation. It protects the delicate granulation tissue from drying out and from being irritated by gauze fibers and loops. This bandage is devoid of suction capacity, but is used in that phase of the wound, when the pus that accumulates under the bandage is rich in antibodies and phagocytic cells and serves as a good environment for young connective tissue.

It is advisable to widely use a vaseline protective bandage (usual dry aseptic bandage, thickly lubricated from the gauze side with sterile vaseline ointment). It is simple and effective. With a protective bandage, the introduction of drains, tampons and highly active antiseptics into the wound is usually excluded. Ointments of weak antiseptic action that do not irritate granulations (for example, A. V. Vishnevsky's oil-balsamic ointment, 0.5% synthomycin ointment, etc.) can be used for a protective dressing, but they do not have significant advantages over pure petroleum jelly. A protective bandage is often applied for a long time, in these cases it should be covered with a layer of non-absorbent cotton wool on top.

An occlusive (hermetic) bandage is necessarily used for external open pneumothorax. It is based on a piece of hermetic tissue (oilcloth, rubber, leukoplast), applied directly to the wound and widely covering the skin around it. When inhaled, the oilcloth sticks to the wound and reliably seals it. When exhaling, the air from the pleural cavity freely exits from under the bandage. Complex occlusive dressings, equipped with a valve of various designs, do not represent significant benefits.

Fixed dressings are divided into tire (see Tires, splinting) and hardening. The latter can be made using various substances. Plaster cast - see Plaster technique.

A starch bandage is made from factory-made starch bandages up to 4 m long. Before bandaging, the bandage is immersed in boiling water. After light squeezing, the bandages are cooled on plates. The limb is wrapped with a thin layer of gray cotton wool and bandaged with a warm starch bandage spirally (see Desmurgy). When ironing by hand, the tours of the bandage are glued and aligned. After applying three layers of starch bandage, cardboard tires are laid longitudinally and fixed with another 2-3 layers of starch bandage.

After about a day, the bandage hardens. The disadvantage of the starch dressing and previously used liquid glass dressings is the slow hardening. It seems promising to use bandages moistened with a fast-curing adhesive such as BF-2.

Elastic and gelatin (zinc-gelatin) dressings - see Varicose veins.

Radioactive dressings - see Alpha therapy.

Correct and promptly provided first aid will alleviate the condition of the victim. A well-applied aseptic dressing will protect the wound from contamination and infection, which means it will speed up the wound healing process.

The occurrence of a wound on the human body immediately requires first aid. Any wound to some extent damages the integument of the body, violates the integrity of muscles, blood vessels, and internal organs. But most importantly, it is a direct channel for infection to enter the body. Therefore, any wound should be immediately covered with a bandage. And it is better if it is a sterile bandage, in a different way, aseptic.

Aseptic and antiseptic dressings should be distinguished. "Asepsis" means preventing the entry of infectious pathogens into the wound, while antiseptic, with solutions already contained in its composition, affects the microbial flora of the wound, disinfecting and preventing further spread of the infection.

Properly treated wounds after aseptic operations contain a small number of microorganisms. At the same time, there are no conditions for their reproduction. Such wounds heal quickly and without suppuration.

Bleeding should be stopped before bandaging. This will help to make a pressure bandage. It is applied to the bleeding area, squeezing it. For these purposes, a bandage, gauze, cotton wool, and even a handkerchief or a clean cloth are used. Compression of the vessel can be digital. Moreover, pressure is applied to the area of the vessel located above the wound. For the same purposes, with heavy bleeding, a tourniquet or twist is used. Here you can use any material at hand (scarf, belt, rubber tube). But it should be remembered that an unskilledly applied tourniquet can pose a great danger to the victim.

After stopping the bleeding, the edges of the wound are treated with a disinfectant solution (alcohol, brilliant green, a solution of iodine or potassium permanganate). And the next stage is the application of an aseptic bandage.

It consists of two parts. This is the inner part that is in direct contact with the wound. And the outer part that holds the bandage on the damaged area of the body.

An aseptic dressing can be applied using an individual dressing bag, a sterile bandage, cotton wool or lignin.

Bandaging should be accompanied by mandatory security measures. It is necessary to treat the wound with disinfected clean hands. You do not need to touch with your fingers the layer of gauze that will be applied directly to the affected area.

The wound should not be washed with water. Before applying an aseptic dressing, the skin around the wound should be treated with an antiseptic solution (furatsilina, hydrogen peroxide, iodine). This removes dirt and other foreign matter from the skin that can lead to infection of the wound. On the other hand, cauterizing agents, such as alcohol or an alcoholic solution of iodine, should not get into the wound area, as they cause cell death, which will lead to purulent processes. Also, do not independently remove blood clots, dirt and other foreign substances from the deep layers of the wound. Such actions can cause bleeding, infection, or damage to internal organs. Wounds should not be lubricated with ointment, covered with powder. Do not apply a layer of cotton wool directly to the damaged area.

Bandaging should not cause severe pain. Therefore, during the procedure, you should stand facing the victim in order to observe his condition. If necessary, the bandage must be loosened.

What is an aseptic wound dressing? It is necessary, first of all, for draining the wound. Therefore, it should consist of a highly absorbent capillary material. 2-3 layers of sterile gauze or swabs are applied directly to the wound, which are inserted into the wound. Hygroscopic cotton wool is placed on top of the gauze. The layer of cotton wool is made longer and wider than gauze by about 2-3 cm. Cotton wool can be replaced with lignin. The bandage itself should cover the entire surface of the wound, capturing the surrounding skin 4-5 cm in all directions from the edge of the injury. The final stage of bandaging is bandaging.

Also, special attention should be paid to the following fact. The bandage protects the wound from bacterial infection only if it is dry. As soon as it gets wet through, an unobstructed corridor to the wound opens for the microflora. Therefore, when the dressing gets wet, it should be changed immediately. If it is impossible to change the bandage, bandaging is allowed. To do this, the wet layer is smeared with iodine tincture and another layer of sterile material is applied.

First aid for the victim is important. But it is by no means a substitute for qualified medical assistance. Therefore, after carrying out actions to alleviate the condition of the victim, he should be taken to a medical facility.

The article "Aseptic wound dressing: safety rules" and other medical articles on the topic "Surgery" on the YOD website.

Any type of burn leads to damage to the skin or tissues. The wound surface must be anesthetized and properly treated to prevent the entry of microorganisms into it. Medicated burn dressings can help protect the wound and speed up healing.

Modern treatment of burn wounds involves the use of special dressings that disinfect, moisturize, and anesthetize the wound. Such dressings can have a different base: cotton fabric, plaster, hydroactive polymer, and others. They may contain an antiseptic, analgesic, regenerating drug or gelling agents to maintain the required level of moisture in the damaged area.

All types of wound dressings have two sides. One of them is intended for contact with damaged skin and tissues, therefore it must be sterile. The other - the outer one - is devoid of a medicinal layer and serves for convenient fixation of the dressing material.

There is a certain algorithm that must be followed when using medical dressings:

First, it is necessary to stop the action of the etiological or pathological factor. If there is clothing on the damaged surface, it is removed or cut, freeing the burned arm, leg, shoulder, shin, thigh from further exposure to boiling water, hot oil or a chemical. The adhering part of the fabric must not be torn off. It is cut with scissors as far as possible, and the rest is left in the wound to avoid further injury.
Now you need to cool the damaged area in order to anesthetize, relieve swelling and prevent further tissue damage. Such an event makes sense the first half hour after the injury. For cooling, the affected part of the body is placed under running cold water or immersed for 20 minutes. The water temperature should not be below 15 ° C. In parallel, you can use an anesthetic pharmacy.
The bandage is applied to the damaged area in such a way that the burn surface is completely closed, but does not go beyond the wound by more than 2 cm along the perimeter.

After the dressing has been cut according to the area of the burn, the protective layer of the dressing is removed and applied to the body. For fixing, you can use a bandage or plaster.

When the burn is localized on the fingers of the hand, a bandage is applied to each finger separately, and then the hand with the forearm is suspended on a tissue section.

A bandage is not applied to the face, and the wound is treated openly with a solution of chlorhexidine and covered with ointment preparations.

The bandaging of the burnt area is carried out according to the instructions of the dressing used. As a rule, with burn wounds, the bandage must be replaced every 2-3 days. When providing first aid to the victim, it is not recommended to use anti-burn ointments, as they may affect the correct determination of the degree of injury.

There are several types of bandages. Let's consider some of them with a detailed description.

View	Characteristic
aseptic	Aseptic dressing is used in the provision of emergency care for burns. A sterile bandage, an ironed diaper or cotton cloth, a clean bag is used as a dressing. The material can be dry or moistened with an antiseptic (alcohol tincture of calendula or propolis, vodka, potassium permanganate solution). The main goal is to close the wound surface from infection before sending the victim to a medical facility.
Mazeva	You can make it yourself or buy ready-made in a pharmacy. For home preparation, the remedy is applied to gauze or a bandage, and then applied to the wound and fixed. Most often, Levomekol and Panthenol are used for these purposes. Purchased ointment dressings are a mesh-based drug layer with protection from external influences. The most famous and widespread is a series of Voskopran ointment dressings. As a medicine, Levomekol, Dioxidin, Methyluracil ointment, Povidone-iodine can be used.
Wet	Wet-drying dressings are designed to protect, anesthetize and treat 2nd and 3rd degree burns. In case of wounds with a purulent inflammatory process, a base is applied with antiseptic solutions of furacilin, boric acid or chlorhexidine. In the presence of a scab in the wound of the 3rd degree, a wet-drying type of dressing with an antiseptic is also used to ensure the drying effect of the wound surface. Moisturizing, antiseptic and analgesic properties have ready-made gel dressings for burns Gelepran with miramistin and lidocaine.
Hydrogel	Hydrogel dressings for burns are a modern tool for the treatment and protection of the wound surface. One of three forms of this dressing can be purchased at a pharmacy: amorphous hydrogel (gel in a tube, syringe, foil bag or aerosol); impregnated hydrogel (the gel is applied to a fabric base, napkin or patch); grid-based gel plate. The advantage of such a remedy is the removal of pain, maintaining the required level of moisture in the wound, protection against infection, providing cooling and cleansing the burnt area from necrosis products. Contraindication: do not use this remedy for wounds with a strong release of exudate.

Branolind burn dressing is a modern remedy for the treatment of burns and other wounds. It has a mesh cotton base. Branolind is an ointment dressing material, the active ingredient of which is Peruvian balsam. Therapeutic impregnation has the following ingredients:

ointment Branolind;
glycerol;
petrolatum;
cetomacrogol;
refined fat.

In the pharmacy you can buy a package of Branolind with 10 or 30 pcs. mesh bandages. It is also possible to buy the mesh by the piece. This remedy has shown itself to be an excellent way to protect against infection, accelerate regeneration, and relieve inflammation. Branolind is widely used in surgery after skin grafting for accelerated cell growth and trouble-free tissue engraftment.

The advantage is hypoallergenicity. Wound healing components of the ointment do not irritate even sensitive skin.

Based on consumer reviews, Branolind does an excellent job with non-healing wounds of any nature. Pregnancy and lactation are not contraindications for use. It can also be used for children and teenagers.

The main complication of burns is the development of burn disease. It occurs when more than 5-10% of the area of all skin is affected. The complication is caused by a complex of violations in the functioning of various systems and organs. These include hypovolemia, intoxication, circulatory disorders, tachycardia, etc.

It is important to timely place a patient with an extensive burn in a specialized burn department. In a state of shock, the patient is given a number of therapeutic measures by specialists to eliminate pain, normalize breathing, and prevent median vascular and renal insufficiency.

Another complication of a burn can be sepsis. In order to avoid infection of the wound, the affected area is regularly treated with antiseptic agents, bandaged and the healing process is monitored.

To avoid burns, you should follow the safety rules, as well as protect children from possible sources of burn injuries.

Often, any wound that was received, not during the period of surgical intervention, is considered infected, since microbes may be present there anyway.

Thus, when applying an aseptic bandage in any situation, it is necessary not only to strictly observe the rules for implementing this procedure, but also to use additional medications.

Bandages are applied to treat wounds and protect them from external influences, to immobilize (see), stop bleeding (pressure bandages), to combat the expansion of the saphenous veins and venous, etc. There are soft and hard bandages, or motionless.

Soft bandages, kerchiefs, plasters, glue and other dressings are applied to hold on the wound, as well as for other purposes. Overlay methods - see.

Aseptic dry dressing consists of several layers of sterile gauze, covered with a wider layer of hygroscopic cotton wool or lignin. It is applied directly to the wound or over the tampons or drains introduced into it for the purpose of draining: the outflow of fluid (pus, lymph) into the dressing contributes to the drying of the surface layers of the wound. At the same time, due to the removal of microbes from the wound, conditions conducive to healing are created. A dry aseptic bandage also protects the wound from new infection. If the bandage gets wet through (all of it or only the upper layers) must be changed; in some cases, bandaging is performed - cotton wool is added and bandaged again.

Antiseptic dry dressing according to the method of application, it does not differ from dry aseptic, but is prepared from materials previously impregnated with antiseptic agents (mercuric chloride solution, iodoform, etc.) and then dried or sprinkled with powdered antiseptics before applying the bandage (for example,). A dry antiseptic dressing is used mainly when rendering with the aim of influencing the substances contained in them on the microbial flora of the wound. More commonly used wet drying dressing from gauze soaked in an antiseptic solution. An antiseptic solution can be introduced into the bandage fractionally or continuously drip through special drains, the ends of which are brought out through the bandage.

Protective bandage consists of gauze, thickly lubricated with sterile vaseline, vaseline oil, 0.5% synthomycin or other oily substances. It is used to treat granulating wounds cleared of necrotic tissues.

Occlusive dressing applied when open (see). Its main purpose is to prevent air from entering the pleural cavity through the chest wound. After abundant lubrication of the skin with vaseline around the wound, a piece of torn rubber, oilcloth or other air-tight tissue is applied to it. The bandage should cover not only the wound, but also the skin around it. A large amount of cotton wool is applied over this fabric and bandaged tightly. When inhaled, the air-tight tissue sticks to the wound and seals it. It is also possible to tighten the edges of the wound with sticky strips with the imposition of gauze napkins, cotton wool and a bandage on top.

Zinc-gelatin bandage - see Desmurgy.

Fixed (immobilizing) dressings superimposed to limit movement and ensure rest of any part of the body. Indicated for bruises, dislocations, fractures, wounds, inflammatory processes, tuberculosis of bones and joints. Fixed dressings are divided into tire (see) and hardening. The latter include plaster bandages (see), as well as a starch bandage, which is rarely used at present. For the manufacture of hardening dressings, other substances can also be used: a syrupy solution of gelatin, liquid glass (sodium silicate solution) and a solution of celluloid in acetone. These slowly hardening dressings are used (mainly the latter) for the production of corsets and splint-sleeve devices made from a plaster model.