Dry goods? Small wound, University asked: wound dressing paste can do this!

There are many kinds of medical adhesive tape, which can be used to fix and avoid falling off.

However, adhesive tape is a kind of foreign body to human skin. Long time contact, friction and stimulation can cause different reactions of skin. Improper selection or use may cause skin damage and other problems.

At the same time, due to the particularity of some parts of the body, it is difficult to fix the wound dressing. Although bandage or elastic net can be used for external fixation, the wound dressing is easy to fall off due to the patient's restlessness or activity, which increases the patient's treatment cost and nursing hours.

In addition, patients are afraid to turn over or get out of bed for fear that the wound dressing will fall off, which will affect the recovery of the wound and the disease. Especially when the new dressing is used to treat the wound, the unit price of the new dressing is higher. If the wound dressing does not fall off, leak or pollute, it can be replaced every 5-7 days. This can maintain the constant temperature and humidity of the wound, effectively promote the wound healing, and shorten the healing time. If it is replaced frequently, it will not only fail to achieve effective therapeutic effect, but also increase the economic burden of patients.

Therefore, how to choose the appropriate medical tape and use it correctly, avoid skin damage, and how to paste the wound dressing of special parts, so that the wound dressing paste is stable, firm and lasting, which is not only convenient for patients to move, but also makes them feel comfortable, and is conducive to wound healing.

Common problems and nursing care of adhesive tape

one

Mechanical damage due to tension

Tension mechanical damage is the most common problem in the use of rubber cloth.

1. reasons

It is usually caused by the tension of the adhesive tape, the first end, then the swelling and swelling of the other end or the paste part.

2. clinical manifestations

The typical cases are tension blisters at both ends of the rubber cloth.

3. nursing measures

(1) To evaluate the skin and the whole body of the patients, and select the appropriate medical tape;

(2) Avoid sticking the adhesive cloth on the swelling part as far as possible, and if swelling occurs in the local area, it should be pasted again;

(3) Paste the adhesive correctly to avoid physical friction or pulling. When pasting, one side shall not be pasted, and then the other side shall be applied with tension to cause skin tension or traction, causing skin damage; the adhesive cloth shall be placed flat at the place where it is pasted so that it is properly pasted with the skin, and then the rubber cloth shall be applied with fingers from the center of the adhesive cloth to both sides to ensure that there is no tension between the adhesive and the skin.

two

Non tension mechanical damage

1. Reasons

Skin is damaged by improper selection of the tape (too viscous) or improper removal.

2. clinical manifestations

Skin is swollen, damaged and tingling.

3. preventive measures

(1) To understand the skin and systemic condition of patients, choose the appropriate medical tape.

(2) When removing the adhesive cloth, one hand gently press the skin, and the other hand slowly tear the wound in 180 ° horizontal direction to avoid physical damage.

(3) When the adhesive is sticky with hair, tear it off along the direction of hair growth.

(4) Tear the cloth on both sides of the dressing first, then remove the whole cloth to avoid physical skin damage caused by the hard removal of the tape from one side.

(5) When the adhesive cloth is not able to be removed, do not remove it by force. If the patient's condition allows, the adhesive can be soaked with disinfectant or normal saline or water to make it easy to fall off and then removed; or wipe the adhesive (such as peeling agent) with a special liquid that dissolves the adhesive.

(6) if the adhesive tape and skin paste are too tight, use alcohol or emulsion to smear on the back of the adhesive tape to reduce its viscosity.

three

Epidermis exfoliation

1. Reasons

The main reason is that the skin cells are damaged by the glue because of the repeated use of the adhesive in the same part.

2. clinical manifestations

The degree of injury is related to the skin condition of the patient, which can be manifested as skin congestion, swelling, damage and pain.

3. preventive measures

Skin peeling shall use low sensitive adhesive with good permeability and moderate viscosity; or apply or spray the skin protective film on local skin before pasting; pay attention to replacing the adhesive tape and removing the adhesive cloth correctly.

four

Chemical damage

1. Reasons

There is a residual of irritating chemicals between the skin surface and the adhesive cloth. It can directly act on the skin by the chemicals of the adhesive, but there are chemical irritants (such as alcohol or other disinfectants) on the skin, and the non permeable rubber cloth is added to cause the skin to produce chemical stimulation reaction.

2. clinical manifestations

The red, swollen and papules appear in the adhesive tape, and pustules can be produced in severe cases.

3. preventive measures

Before pasting the adhesive cloth, clean the skin around the wound with normal saline or clear water, and wipe it clean to avoid using disinfectant; the adhesive cloth shall be pasted on the skin which is dry, clean, without chemical agent or grease (chemical substances or grease will affect the adhesive property of the adhesive cloth), and the rubber cloth with good air permeability shall be selected.

five

Skin immersion

1. Reasons

Because the skin of the adhesive is in wet environment or the air property of the adhesive is poor for a long time, immersion can weaken the skin strength, and make it more susceptible to irritation and damage.

2. clinical manifestations

The skin is white and soft, and swelling and wrinkles appear.

3. preventive measures

In order to avoid skin immersion, it is important to choose a low sensitive adhesive which does not prevent the skin from sweating and breathing. In addition, the adhesive cloth with certain fixed force and adhesive force should be selected according to the purpose and position of use. Local skin can also be applied or sprayed with skin protective film to paste the adhesive cloth; timely change the wet wound dressing to avoid the skin from the stimulation of wound infiltration; pay attention to changing the adhesive tape and remove the adhesive cloth correctly.

six

Allergic reaction

1. Reasons

Sensitive to adhesive or material of the adhesive.

2. clinical manifestations

Red, swollen, papules and itching, the involved parts are not limited to the edge or the bottom of the tape, but can involve a wide range of parts around the rubber cloth. The longer the adhesive is, the more serious the reaction is.

3. preventive measures

Remove the current adhesive, use good permeability and low sensitization adhesive; use non adhesive bandages, such as 3M self adhesive bandages; conduct spot patch test on patients to understand the allergy history of patients and avoid contacting with sensitization sources; observe the skin on the edge of the tape frequently, and pay attention to itching or redness.

seven

Residual glue

1. Reasons

It is the adhesive of the adhesive and backing is not firmly combined, resulting in adhesive residue. Zinc oxide adhesive is more common.

2. clinical manifestations

Adhesive remains on the skin or fixings when the tape is removed.

3. preventive measures

When the adhesive on the adhesive is left on the skin surface, the residual adhesive can be removed by repeatedly sticking the adhesive with the adhesive cloth; or the gauze or cotton swab stained with alcohol, gasoline or turpentine can be used to remove the residual adhesive. But after use, the solvent shall be cleaned with soap and water.

Notes for adhesive tape

1. peel off the required length and paste it to avoid the adhesive tape after it is fixed before tearing off the film.

2. avoid sticking the adhesive cloth to the joint and skin lesions. The adhesive tape should be perpendicular to the longitudinal axis of the body or the right direction opposite to the body action. If it is pasted, it should cross the joint surface to avoid direct adhesion. Because the adhesive cloth will loose with the joint movement during the straight sticking. If the wound is in a difficult position, it is advisable to use a tubular mesh or self-adhesive bandage.

3. avoid overlapping and pasting adhesive tape.

4. the length of the adhesive cloth on both sides of the dressing shall be half of the width of the dressing, and the fixation shall be stable.

5. the rubber cloth end shall be folded back for easy tearing.

6. for wounds that need to be replaced frequently and the skin conditions are poor, the skin on the left and right sides of the wound can be cleaned and dried, and then the skin protective skin or water gel dressing can be pasted.

After the wound covering dressing, the adhesive cloth is first set on the dressing, and then the adhesive cloth is applied to the skin protection skin or water gel dressing on both sides of the wound to avoid the adhesive cloth directly sticking to the skin.

Each time the dressing is replaced, the skin protective skin or colloid dressing does not need to be replaced, unless it becomes wet, dirty, loose or has skin problems.

Dressing fixing skills

The closed or semi closed wet dressing can maintain the constant temperature and humidity of the wound, and is conducive to the wound healing. If the dressing does not fall off or leak, it can generally be maintained for 5-7 days. Although the closed or semi closed wet dressing generally has self-adhesive function, the adhesive on the edge of dressing will stick to the clothes and easily be lifted up during the use of the patient. Especially when the patient is not cooperative or upset, and the parts easy to be frictionable are easy to loose and affect the use time.

In addition, in sacrum and other parts of the site is easy to be contaminated by stool and shorten the use time, affecting the treatment effect. Therefore, in order to prolong the use time of self-adhesive dressing and ensure the dressing to achieve the proper treatment effect, the self-adhesive dressing needs to be fixed externally.

[method]

Rinse and dry the wound and surrounding skin, paste hydrocolloid or foam dressing from the wound center, then smoothen the dressing with hand, try to avoid leaving gaps or creases, and the dressing should be at least 2~3cm above the outer edge of the wound.

In order to avoid the shift of dressing when the patient moves, the edge of the dressing should be fixed with wide air permeable tape or transparent thin desert as the edge of the dressing.

Paste on the place where the size is easy to pollute, can be covered with transparent film to avoid pollution. Mark the date on the outer dressing, and can clearly understand the use time of the dressing.

When changing dressing, you can first press and hold the skin in one hand, and tear it off slowly from one corner of the dressing to avoid damaging the skin.

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