Dressing material and its sterilization

The material used during operations and dressings to drain wounds and the surgical field, tamponade wounds and the application of various dressings is called dressing. Dressings should have a good water absorption, dry quickly, be elastic nym, easily sterilized. From a variety of different dressings on the great- est widely used gauze, cotton wool, lignin. 

Gauze – Cotton cloth rarely intertwined GOVERNMENTAL strands having an ability to absorb a good blood, pus and other liquids. Gauze is elastic, soft, does not clog the wound and therefore is the material from which bandages, napkins, tampons, turundas are made. 

Vata – fibers of the cotton seed box. In medicine use absorbent (defatted hydrochloric) wool, which has a large suction spo lities. Cotton wool applied to the gauze over the wound, which increases the suction capacity of the dressing and protecting a wound from external influences. 

Lignin – corrugated sheets of the thinnest paper – is used instead of absorbent cotton. 

The dressing is made as a not sterile nym in large rolls or packages (Preparation re vyazochnogo material desired size and sterilized tion performed medical personnel on site) and sterilized in small hermetically sealed with GOVERNMENTAL packages of parchment.
For first aid outside the facility (on pro duction, in the field, the home environment) is most suitable sterile packages. The sterile dressings produced in the form of bandages or napkin different times mers or individual packages, special bandages and packages impregnated with antiseptic solutions iodoform, brilliant green, synthomycin et al. And drugs that increase blood clotting (e.g. hemostatic gauze).

First aid in enterprises and institutions providing health care workers health post or sleigh container post, t. E. The employees of enterprises, trained in first aid, having in its disposing SRI first aid kit, stretcher tires. Health centers and sanitary posts should be provided with the necessary supply of sterile dressings. Nai more convenient for storage and application are ready standard packages with sterile bandages napkins wool. An individual dressing bag is required, the use of which allows you to quickly and reliably protect the wound from contamination.

In the absence of a sterile dressing, it is prepared from non-sterile large pieces of gauze.
Napkins, tampons in packs of 10 pieces way vayut in Bix and autoclaved. Sterile perevyazoch ny material kept in closed Bix. Instead, the camp -standard of individual packages can be prepared to improvise. To do this, take a piece of gauze 6X9 cm in size, in the center of it, almost to the edges, lay an even layer of cotton wool, fold it in half with gauze and wrap it out in parchment paper 16X16 cm in size. Individual packets are placed in bixes and sterilized.

Sterilization of linen, dressings is most often carried out under pressure in autoclaves.
Underwear and the dressing usually sterilized form a store, and a metal iCal drums (bik sah). On the side walls Bix has openings for the steam inside, after which ste sterilization is closed, ne remeschaya metal rim. If the holes of the slut covered, not sterile material. The dressing can be sterilized in mesh kah from dense tissue.   

The sterility of the material after autoclaving pin roliruyut using special tests. Together with the mother scarlet in Bix laying tube with powder sulfur litipirina, amidopirina or other substance whose melting point is about 120 ° C. At high tempera round (120-134 ° C) material is melted. If melting does not occur, then the contents can not be considered Bix ste -sterile. Sometimes they use the Mikulich method. On the filter paper strip pencil write “sterile” smeared strip starch paste, and then loaded into aqueous iodine solution – yn strip becomes intensively and blue lettering ceases to be visible. Strips are also laid in bixes with material. Under the influence of temperature above 110 ° С, starch passes into dextrin, which leads to the disappearance of blue paint and the word “sterile” becomes visible.

Sometimes sterilization control performed by the power of a biological sample. A piece of silk thread about pityvayut solution to which is added a certain amount of spore-forming bacteria, and packaged in ste -sterile paper. After autoclaving, silk threads are placed in culture media and grown. The absence of bacterial growth indicates the effectiveness of Steri tion of. Sterilized laundry must be dry; otherwise its sterility is doubtful.  

In emergency cases, when there is no sterile March whether or bandage as the dressing can be used either pure matter pieces. However, before putting the washed matter on the wound, it must be ironed well with a hot iron.

If not possible, and thus sterilize the dressing, the non-sterile gauze or other hydrophilic material (web) must smo chit solution of ethacridine lactate (rivanol), a weak solution of potassium permanganate, sodium tetraborate (borax) (2 teaspoons per cup of boiling water) or sol boric acid rum 1/3 teaspoon per cup of boiling price tag of water). Dressings impregnated with one of these solutions, in exceptional cases, can be applied to the wound.

Surgical instruments and its sterilization.

Modern surgical instruments are very diverse.
The tissue lesion when changing knives, scalpels, scissors, for gripping and holding the soft tissue – tweezers, a variety of hooks, to stop the bleeding – various blood -stopping clips. They connect the tissues, stitching them using different needles or brackets.

When dressings are used tweezers (anatomic and surgical), scissors, probes (circumvallate and bellied), hooks for expansion wounds variety kro voostanavlivayuschie clamps, forceps.
Dressings ocv fected sterile instruments, regardless of the first, clean the wound or pus – instrumental ligation. After each dressing, the instrument must be washed and sterilized again. After dressing purulent wounds, instruments are sterilized separately. 

Metal tools ste rilizuyut by calcination and Su chemical heat in special ovens. The most common cases with electrical heating tion, which after 10-15 minutes, the temperature reaches 140-180 ° C. Complete sterility of the instrument at this temperature occurs in 20-30 minutes.  

The easiest sterilization method is boiling. Sterilization by boiling can impl stvlyat in any bowl, over any heat source. There are special sterilizers – boilers sa Mykh various sizes, from handhelds to large stationary.  

Can be sterilized by boiling metal Institute strumentary and other glass products, lane Kamchatka, rubber catheters and tubes, some plastmas cial instruments, in special cases – dressing. Sterilize tools by boiling in the sterile -water. Sterility is readily achieved by two-fold water nym boiling for 30 minutes with an interval of 6 hours: in such fractional die even the boiling spores resistant microbes. The water added alkali (hydrogen tension dence) to obtain 2% solution. Alkaline water accelerates sterilization, prevents oxidation and rust on the instruments. Plated the Tools trans- formations should be lowered into the boiling water and cool it dale wives on a table covered with a sterile oilcloth. Glass products (syringes, flasks, jars, glasses) should not be immersed in boiling water to avoid damage.

In extreme cases the metal yn strumentary can be decontaminated in an accelerated manner – by burning . Burning is carried out with burning alcohol. A tool is placed in a basin, drained with alcohol and set on fire. Flame, a relatively satisfactory disinfection, one to this way of “reliable sterilization does not.

Hand treatment and disinfection of gloves.

To prevent getting an infection in the wound, the hand produces any surgical manipulation Dolj us to be carefully handled and nails short sharp wife.

Hand treatment includes: thorough mechanical cleaning of the skin, washing in an antiseptic solution and tanning of the skin. Tanning often carry alcohol, which, condensing the skin, closes the pores and thereby pre discourages “samoinfitsirovaniyu ‘hands. There are many ways to handle your hands.

Method Spasokukotskogo – Kochergin.
Contaminated hands (hand and forearm), thoroughly washed with soap under a stream of her running water – remove “household” dirt. The main processing is carried out in two hands enamelle bathroom basins warm solution of ammonia (Sol. Ammonii caustici). In each basin for 2 l of boiled water add 10 ml of ammonia. Hand washing is done with sterile gauze napkins. Motion Nia should be energetic, and hands most of the time immersed in the solution. In the first pelvis, the forearms, nail beds, palms are especially thoroughly washed, in the second – mainly the hands and the area of ​​the wrist joints. The duration of the treatment of hands in each pelvis is 3 minutes. Then hands are thoroughly wiped with a sterile towel or napkin. Dry hands (brush and the region radiocarpal joints) twice for 2 min 1/2 treating dissolved with 96% ethanol.

Fürbringer’s way. Hands are washed with soap and two sterile horsehair brushes 10 min under a stream tep loi running water. Then hands sterile wipe cloth treated with 70% ethanol in Techa of 3 min and a solution of mercuric chloride 1: 1000. nail bed mazyvayut alcoholic solution of iodine. 

Method for hand disinfection with formic acid.
Hands are washed with soap in running water, wiped dry with a sterile cloth, then washed in this solution for a minute and dried with a sterile cloth. The disinfecting solution is prepared for 1 1/2 hr -1 to approx neniya. Use a 2.4% solution of the formulation of C-4. To prepare 1 liter of solution, 17 ml of a 33% solution of hydrogen peroxide and 7 ml of a 100% solution of formic acid are taken, mixed and kept in the refrigerator for an hour. Then distilled or boiled water is added to the resulting solution to 1 L.       

A method of disinfecting hands with zerigel. Zerigel is a colorless viscous liquid that has a significant bactericidal effect; it quickly freezes in air. When processing the hands with zerigel, a film forms on them and the hands are in sterile “gloves.” Dosing: palm poured into dry 5 mL tserigelya and for 8-10 triturated vigorously with it to that kim calculation that the solution covered the surface of the fingers, hand and wrist region of the joints. Hands dried in those chenie 2-3 minutes in a position such that the fingers do not touch each other. The film (“glove”) can be easily washed off with a swab moistened with alcohol. Surgical gloves in significantly increased vayut reliable disinfection, but their use is not for changing the compulsory treatment of hands. Sterilization is performed by autoclaving gloves or ki pyacheniem. 

Faster hand treatment in emergency cases.
When providing first aid on hand possibility Nosta must be decontaminated by one of these methods, especially if the victim has a wound or other injury to the skin and mucous membranes (PAS Dina, burns, frostbite).
In extreme cases of rabotka hands it can be carried out more easily spo sobom. Hands are washed with soap under running water, dried with a clean towel. Then, taking up a small como check wool or the bandage, it is poured into 5-7 ml tanning or sanitizing solution and carefully wipe them for 1-2 minutes fingers and hands.

Ethyl alcohol, 5% alcoholic solution of iodine, 5% solution of tannin can be used for tanning the skin; Disinfection – 5% solution of phenol (carbolic kis lot), mercury dichloride solution (mercuric chloride) 1: 1000, diotsida solution (1: 5000), 0.5% solution of chloramine B, 1% stretch thief degmina. If sterile gloves are available, they can be worn on non-sterile hands. In the process of providing Pomo soup with their hands dirty, you can wipe it again with the same disinfectant solution.

local_offerevent_note March 7, 2020

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