WOUND WISE: Basic wound cleaning step by step
Nursing Made Incredibly Easy!
September/October 2008 
Volume 6 Number 5
Pages 30 - 31

THE GOAL OF wound cleaning is to remove debris and contaminants from the wound without damaging healthy tissue. We'll walk you through the process step by step (see Picturing wound cleaning).



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Clean machine

As you follow these steps, be sure to observe standard precautions and follow your facility's protocols regarding the use of clean or sterile technique.

* Remove the soiled dressing. Roll or lift an edge of the dressing, then gently remove it while supporting the surrounding skin. When possible, remove the dressing in the direction of hair growth.
* Inspect the dressing and wound. Note the color, amount, and odor of drainage and necrotic debris.
* Clean the wound. Moisten gauze pads either by dipping the pads in wound cleaning solution and wringing out excess or by using a spray bottle to apply solution to the gauze. Move from the least contaminated area to the most contaminated area and use a clean gauze pad for each wipe. To clean a linear-shaped wound, such as an incision, gently wipe from top to bottom in one motion, starting directly over the wound and moving outward. For an open wound, such as a pressure ulcer, gently wipe in concentric circles, starting directly over the wound and moving outward (see Wound cleaning techniques).

The type of cleaning agent you'll use depends on the wound type and characteristics. Sterile 0.9% sodium chloride solution is the most commonly used cleaning agent. It provides a moist environment, promotes granulation tissue formation, and causes minimal fluid shifts in healthy adults. Antiseptic solutions, such as chlorhexidine, povidone-iodine, and hydrogen peroxide, are sometimes used to clean infected or newly contaminated wounds. Be aware that antiseptic solutions may damage healthy tissue and delay wound healing.

* Dry the wound. Using the same procedure as for cleaning a wound, dry the wound using dry gauze pads.
* Reassess the condition of the skin and wound. Note the character of the clean wound bed and surrounding skin.
* Pack or dress the wound as ordered. See Choosing a dressing for questions you can ask yourself to find the ideal dressing for your patient's wound.
Got the basics covered

Basic wound care centers on cleaning and dressing the wound. And now you have a better understanding of the fundamental wound cleaning techniques.

Picturing wound cleaning


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Figure. Removing the soiled dressing



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Figure. Inspecting the dressing and wound



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Figure. Cleaning the wound

Wound cleaning techniques


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Figure. Technique for a linear-shaped wound

To clean a linear-shaped wound (such as an incision), gently wipe from top to bottom in one motion, starting directly over the wound and moving outward, as shown above.



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Figure. Technique for an open wound

For an open wound (such as a pressure ulcer), gently wipe in concentric circles, starting directly over the wound and moving outward, as shown above.

Choosing a dressing

To confirm that you've chosen the proper dressing, answer these questions.

* Does the dressing protect the wound from secondary infection?
* Does it provide a moist wound-healing environment?
* Does it provide thermal insulation?
* Can it be removed without causing trauma to the wound?
* Does it remove drainage and debris?
* Is it free from particles and toxic products?
Learn more about it

Hess CT. Clinical Guide: Skin and Wound Care, 5th edition. Philadelphia, Pa., Lippincott Williams & Wilkins, 2005:102.

Wound Care Made Incredibly Easy! 2nd edition. Philadelphia, Pa., Lippincott Williams & Wilkins, 2007:55–59.

Wound Care Made Incredibly Visual! Philadelphia, Pa., Lippincott Williams & Wilkins, 2008:40–43.