Dressings

Dressing material - a material used in operations and dressings for drying of surgical field, wounds, for tamponade and bandages. Dressings should not change during sterilization, good suck discharge from the wound (to be hygroscopic), not to irritate tissue wounds. The main dressing materials - gauze (see), wool (see), lignin (wood wool). Substitutes: moss, peat, sawdust (in gauze bags).
Gauze is prepared for operations and dressings in the form of cloths (8X8 cm, 50X10 cm, 50X30 cm). From the piece of gauze cut the appropriate size napkins, edge trim bent inwards and the napkin folded four times. Napkins are used in dry or moistened in warm sterile isotonic sodium chloride for protection against drying peritoneum, intestinal loops at laparotomy (see). For large chrevosechenie often field operations fenced off from other parts of the abdomen and set the dropdown intestinal loops using a large gauze napkins. To the ends of the big napkins sometimes sew long (40 cm) of the ribbon to the napkins were not forgotten in the wound.
Long strips of gauze - tampons (width of 5-10 cm, length 20 - 30 cm). Edge trimming bend inwards and tampons put first in length, then four. Napkins for plugging in the way of Mikulich prepared as follows. In the middle of a large gauze napkins strengthen durable node thick silk thread. Napkin folded, sterilized and then, capturing the heart of a tampon forceps, enter it in the wound in the form of semi-opened umbrella; the cavity formed bag perform regular tampons, easily replaceable. Remove the tampon, pulling at the thread. Small tampons (10X10 cm) are used for drainage of wounds; they roll in the form of a ball (envelope) so that he could not get into the wound separate falling thread. Apply and atomaria balls, wrapped in gauze absorbent cotton ball. Clean wound close labels, which prepare from strips of cotton wrapped in gauze, or the same size strips of gauze. They strengthened clervoy or Kolodina bandage (see Desmurgy). Preparation of bandages - see the Screw.
Lignin - wood wool of the cellular elements of wood, well sucks. It is put on top of gauze and a small layer of cotton wool for wounds with excessive discharge of pus. To the bandages are substitutes (see above). They cleaned and sterilized in sacks from a gauze or better cotton. Use them over gauze dressings to replace the wool.
Sterilization dressing materials is carried out, as a rule, in autoclaves (see Sterilization surgery). Along with aseptic dressing material used antiseptic dressing material, i.e. the gauze and cotton wool impregnated with an antiseptic solution (corrosive sublimate, iodoform, malachite and brilliant green, the furatsilina) or antibiotics (the syntomycin, biomitsin) with the purpose of influence on the microbial flora of the wound or to best maintain sterility of the material. For bandaging of surface wounds and abrasions is the patch (see Desmurgy) and bactericidal paper, impregnated with salts of silver, which after wetting sterile water place of healing. Bandages soaked hemostatic means, and biological dressings - fibrinnaya film and hemostatic sponge (see) is applied to stop bleeding.
For rendering of first aid use ready sterile dressing packets with cotton-gauze pad, with a bandage, bandage and a pin (see Individual bandage), pads of cotton-gauze size 25X25 cm, 15X15 cm, 10X10 cm, sterile wipes in packs of 10 pieces 33X45 cm, 14x16 cm and sterile bandages. In the field for easy storage and transportation of used sterile ready dressings in bundles containing large and small bandages, bandages, cotton wool and kerchiefs. On the package indicates the way to showdown, which is not disturbed sterility of the material. When using prepared at the factory sterile bandages to check violated the integrity of the shell package, and hence the sterility of the contents.
In order to save, you can apply a gauze again, after washing, though her suction capacity decreases. Re can be used only cloth, bandages and tampons that were in effect when aseptic operations or bandaging.
Used bandages soaked in cold water, or 0.5% solution of liquid ammonia is not yet dried blood, then washed, boiled, rinsed, dried, sterilized and used exclusively with dressings.

Dressing material - a material used in the operations, dressings for protection of wounds from secondary pollution, drying it, stop the bleeding and remove the pus.
Requirements for dressing material: good absorption (absorption), capillarity, fast drying, the ability to sterilize without compromising the quality, flexibility, no annoying tissue properties.
To the bandages are: gauze, cotton wool and lignin (lignin), jute (Utah), granules, canvas, moss, peat, lint, hemp, charcoal, glass wool, and so on, the most common being the gauze and cotton wool.
Gauze - cotton fabric different varieties of rare or more dense grid. White gauze has a high hygroscopicity. In the surgical Department comes gauze pieces-rolls. From it is prepared napkins, tampons, bandages of different sizes, gauze balls. Gauze well sucks out of the wound, blood, pus.
Napkins, swabs of gauze prepare so that the ends of the threads had been bent inwards, to prevent and leaving the individual threads in the wound. Pads and bandages after the clean operations can be re-used after appropriate processing. If they soaked in blood, they are lowered into a bowl and pour a 0.5% water solution of ammonia for 2-3 hours, then ammonia drained and again fill in 0,5% a solution of soda for 30-40 minutes, then wash, boil in a soap solution, rinsed, dried and sterilized in the usual way. Bandages and wipes saturated with blood, can be washed and then sterilized. For reuse dressings may be used for dressing.
Wool is made from cotton; applies or chemically treated, whether (absorbent) or not defatted, brown - gray or simple. Absorbent cotton has a good absorption and dries quickly, it increases suction properties bandages, as is imposed on the wound covered with a gauze. Grey wool is used only when applying hot compresses and as bedding under plaster bandage and Longuet.
Of absorbent cotton is harvested cotton swab for lubrication of iodine and other drugs, the skin of the patient, and the nail spaces at the hands of the participants of the operation.


Lignin (lignin), or wood wool - thin slices of wood of coniferous trees, mechanically and chemically treated; being folded, they form a loose, well absorbent cloth. Lignin has exclusive hygroscopicity, suck better than gauze. It is not put directly on the wound and covered with a gauze and a small layer of cotton wool, as it crumbles easily and can clog up the wound. Apply lignin with wounds with a large purulent discharge.
Surgical departments are mainly used aseptic dressing material, made from cotton and gauze. Antiseptic dressing material impregnated with antiseptic substances (iodoform, kseroforma, mercuric chloride, carbolic acid and others), currently almost not used, as it is not indifferent to the tissues; it can cause irritation, cell death, and even the General intoxication of an organism, with the exception of iodapromonet gauze, sometimes used for the treatment of purulent wounds in bone tuberculosis. Some authors recommend also antiseptic dressing materials, impregnated 1% aqueous solution of aniline paints (crystal violet, green and brilliant green), or preparations FBS (furatsilina, bigumal, syntomycin), or silver salts (in the form of porous bactericidal paper), or antibiotics for the treatment of purulent wounds.
The purpose of the local stop bleeding apply haemostatic products derived from blood and tissues of humans and animals (see the Blood, drugs). The greatest application have found hemostatic sponge, fibrinnaya film, biological antiseptic swab, dry thrombin, hemostatic synthetic gauze, etc.
Hemostatic sponge is made from human blood plasma with the addition of brain thromboplastin and calcium salts.
It is a dry porous mass of well-absorbing moisture; absorbing blood, it turns into a thick film and closes the defect in the tissues. It is used in powder form or separate massive pieces. The sponge is left in the tissues, completely absorbed, so it can be used for bleeding during cavitary operations. Application technique: sterile forceps sponge transferred from the opened package in sterile vessel or sterile gauze. Put the sponge on the bleeding surface, slightly press (over three minutes), after which sponge, turning into a thick film, stops the bleeding.
Vibronnye film, derived from the plasma of human blood put on a plastic lining in a sealed tube. Before use, the tube with the film opened in compliance with the rules upgrades. After opening the test tube fibrinous film remove the sterile forceps, release from cellophane, washed with antiseptic solution (5% solution of sodium-sulfatiazola, 5% solution of sodium sulfatsila, the solution of penicillin or rivanol) and placed on the wound surface (for example, burn after pre-treatment is the removal of bubbles and processing antiseptic solution). On film impose antiseptic dressing for 3-6 days.
Biological antiseptic swab (BAT) is active hemostatic and yet antibacterial drug, designed to stop bleeding during neurosurgical operations, in the nose, on the uterus, etc. it is Prepared from plasma and serum person with add gelatin, hemostatic and antimicrobial agents. Dry thrombin is prepared from plasma of human blood; apply (subject to the minor) at the capillary bleeding from wounds, nasal, dental bleeding. On the bleeding place make sterile gauze balls, abundantly moistened with a solution of thrombin. After 5-10 minutes gauze balls gently remove the bleeding stops.
Hemostatic gauze COLIC obtained by oxidation of pulp (normal Marley) nitrogen dioxide. Available as a sterile napkin size 13 x 13 cm in sealed penicillin bottles. Used as hemostatic means at bleedings from parenchymatous organs, as well as the capillary and venous bleeding. The advantage of hemostatic Marley is that it is completely absorbed, without causing side effects, and stops the bleeding.