[Fundamentals] Wound irrigation

Wound irrigation is performed to flush out debris and bacteria to ensure proper wound healing. This is important for wounds obtained in an outdoor environment (eg. playground) because contamination with soil or dirt greatly increases the risk for infection.

 

To perform wound irrigation, the nurse should:

* Administer analgesia 30-60mins before the procedure to decrease client discomfort during the procedure

* Fill a 30- to 60-mL sterile irrigation syringe with the prescribed irrigation solution.

* Attach an 18- or 19-gauge needle to the syringe and hold it 1 inch (2.5cm) above the wound.

* Use continuous pressure to flush the wound, repeating until the drainage is clear.

* Dry the surrounding wound area to prevent skin breakdown and irritation.

 

1. Perform hand hygiene, and apply clean gloves. Remove the old dressing. Remove and discard gloves.

2. Perform hand hygiene, and apply sterile gloves. Assess the wound bed. Cleanse the wound bed and surrounding skin with normal saline (eg. flushing, swabbing with gauze) to remove drainage and debris). Remove and discard gloves.

3. Perform hand hygiene, and apply clean gloves. Gently swab the wound bed with a sterile swab, from the wound center toward the outer margin. Avoid contact with skin at the wound edge as it can contaminate the specimen with skin flora.

4. Place the swab in a sterile specimen container; avoid touching the swab to the outside of the container.

5. Apply prescribed topical medication (eg. bacitracin) after obtaining cultures to prevent interference with microorganism identification. Apply new dressing.

6. Remove and discard gloves, and perform hand hygiene. Label the specimen, and document the procedure.