Dressing. Elastic bandage. Napkins sterile gauze

Dressing is the first aid. The history of its origin can be traced from very ancient times. Around 460-377 years. BC. E. (In the time of Hippocrates), in order to firmly fix the dressing, used adhesive adhesive, various resins and canvas. And in 130-200 years. BC. E. Roman physician Galen created a special guide. In it, he described the various techniques of imposing bandages.

History of development

The use of dressings received the first wide resonance thanks to the decree of the Roman Senate. It said that every soldier should be given a strip of cloth, with which he could, if necessary, provide first aid to himself or his colleague. It is likely that the imposition of various materials on the affected area of the body was used even in prehistoric times. For this purpose, leaves and grass could be used, since they possess qualities such as flexibility, softness, elasticity and smoothness of the cover. Some of the plants have healing properties and even pharmacological effect, for example, have astringent and analgesic effect.

It is also worth noting that certain plants are used in folk medicine to apply bandages to this day. Among them: baked onions, plantain and many others. The dressing in its development reached its peak in the time of capitalist production. In the period from 1476 to 1492 in Europe, a wide-ranging publicity was given to a band-aid bandage. In the XVIII century and until the first half of the XIX century, special importance was given to the absorbing effect of funds. The dressing material was made using raw materials with high capillarity. For example, linseed and hemp hemp, as well as lint (cotton-weaved rags threaded on the thread). Since the second half of the XIX century. Instead of them, gauze, hygroscopic cotton wool and lignin were used.

General classification

Not so long ago, the types of dressings were limited to only a few points:

• Adhesive plasters in coils, as well as bactericidal in the form of plates.
• Medical bandages.
• Pillows of medical purpose.
• Gauze wipes are medical.

Compared with the past years, the modern choice of dressings has become significantly richer. This was greatly facilitated by the large development of pharmacological production in the territory of our country, as well as mass imports of foreign products to the domestic market.

Classification according to purpose

Conditionally, all dressings can be divided into four groups: sterile and non-sterile, simple and complex. However, their main distinctive quality is the purpose of the application. By this principle, we can distinguish the following series of functions performed by bandages:

• To close the wounded surface. To do this, we use napkins, bactericidal plaster, wound coatings and so on.
• For compression of limbs or fixation of joints.
• To fasten the dressing.
• Compression coatings.

A mandatory requirement for any kind of dressing material for wound closure is sterility.

Product Features

The production of the dressing material has stepped on a new stage of development due to the appearance of modern technologies. As a result of their use, highly elastic, perforated webs with a non-woven structure were obtained, based on the use of polymer compositions and metallized coatings. The use of modern materials in medicine allows us to solve the following problems:

• Achieving a high rate of antimicrobial activity.
• Long term.
• High absorptive capacity in combination with good air permeability, optimum wetting speed and capillarity.
• Atraumatism.
• Stability of antimicrobial treatment of agents in conditions of radiation and steam sterilization.

What to choose: traditional or modern dressings and products?

In fact, this issue is only rhetorical. The use of modern materials in medicine creates favorable conditions for more rapid healing of wounds. This, in turn, insures against the appearance of scarring on the wounded surface. The reason for their occurrence is often the long closure of the wound with traditional dressings.

As for the price issue, the difference in value between modern and former materials is quite noticeable. This argument is sometimes cited in favor of the latter. However, when the question is about human health, the cost is far from always the decisive factor for the implementation of the choice. In addition, as practice shows, the use of modern medical materials is economically more profitable compared to traditional ones. Because of their lower efficiency, they have to be used for a very long time. This statement can be considered in more detail using the example of the use of cotton-gauze bandages:

• Fleecy structure causes the particles of the material to enter the wound. They cause irritation of the tissue and interfere with its speedy healing.
• Gauze is a fine-mesh material with increased mass capacity. These structural features cause an increase in the number of microorganisms in the wound. In addition, they lead to a decrease in air and vapor permeability under the bandage. This is especially true when several layers are applied. At the same time, the process of epithelialization and granulation of the wound is delayed, and as a consequence, the period of its healing becomes longer.
• Adhesion, or simply sticking, is another disadvantage of using gauze dressings. The fact is that, impregnated with wound excreta, they harden when hardened. Granulation of the wound occurs through the dressing material, resulting in a new injury to the surface and painful sensations when removed. At the same time, the surrounding skin also suffers. Its damage also causes pain and slows down the overall healing process.
• Cuttings and napkins are usually completed in several pieces in a package. When it is opened without germs, only the first remains. While the rest of this quality is lost.
• To increase the absorbency and give the right size, gauze has to be cut and then folded into several layers. This procedure disrupts the antimicrobial activity and causes certain inconveniences in the patient.
• In order to fix the cotton-gauze dressing on the wound, it is necessary to use an auxiliary fastening. This leads to extra money spending and requires additional manipulation.

Thus, the use of conventional, traditional materials causes a long process of wound healing. A good alternative are modern devices that lack all the disadvantages described above. Improved bandages are atraumatic coatings with high absorption capacity. Their fixation occurs independently with the help of hypoallergenic adhesive composition.

Advantages of modern products

• Bandages have a non-woven or transparent, film base, which allows you to monitor the progress of wound healing.
• Water resistance is another plus. The patient has the opportunity to take water procedures without the risk of water entering the wound.
• Reliable fixation.
• Modern bandages do not stick to the wound surface and do not injure it.
• Removal is painless for the patient.
• The self-adhesive side of the dressing is fixed independently and does not require the use of additional tools.
• There is a sorbing atraumatic swab that collects wound exudate.
• The superimposed dressing reliably protects the wound from getting secondary infection and mechanical irritations.
• Hypoallergenic composition.
• High values of air and vapor permeability prevent the occurrence of maceration.
• Modern dressings are ready for use and do not require preparation.
• Antibacterial.
• The packaging is easily opened.

Medical tissue

The gauze is a canvas with a rare, mesh-like structure. There are two types: severe and bleached hygroscopic. They, in turn, are divided into two different types: pure cotton and with the addition of viscose staple cloth (in a ratio of 50% cotton to 50% viscose or 70% cotton to 30% viscose). Their main difference is as follows: cotton absorbs liquid for 10 seconds, while gauze with viscose admixture does the same for 60 seconds, that is 6 times slower.

Advantages of viscose are high moisture capacity, increased ability to absorb wound exudate and higher blood absorption rates. However, in comparison with cotton gauze, the viscose analogue retains medicines inferior. And also after carrying out of repeated washing the suction ability decreases. According to the strength criterion, the cotton dressing material is 25% higher than the tissue with a viscose admixture. But the capillarity in both species is approximately the same, it is from 10-12 cm / h. By neutrality, medical requirements are the same as for cotton wool. The fabric is produced with standard canvas dimensions: width - 69-73 cm, length from 50 to 150 m in a piece.

For non-standard surgical dressings, cuts of 3 pieces are produced. In a pack. The length of each is 10 m, and the width is 90 cm. Like cotton wool, gauze is tested for wettability (absorbency), neutrality and capillarity.

The course of tissue testing for suitability

• In order to check the wettability, the immersion method is used. To do this, a sample of hygroscopic gauze measuring 5 x 5 cm descends to the surface of the water. According to the prescribed norms, he must immerse himself in water without touching the walls of the vessel for 10 seconds. The designer of severe gauze needs to do this for 60 seconds.
• To check the dressing for capillarity, a strip of cloth about 5 cm wide is lowered one end into a special Petri dish filled with a solution of eosin. The sample considers that the test is completed if within 60 minutes the solution rises from the liquid level by at least 10 cm.

Special types of fabric

There are two categories of gauze, which have a specific specificity of the action. It is a hardening and haemostatic.

• Hemostatic dressing is obtained during the treatment of ordinary gauze with nitrogen oxides. The resulting tissue not only stops blood, but also completely resolves in the wound for a month. It has the form of napkins measuring 13x13 cm.
• Hemostatic tissue. It contains a calcium salt of acrylic acid. It also stops blood (on average no more than 5 minutes), but does not resolve. Can be used in the form of tampons, balls and napkins. Using this type creates up to 15% savings.

Gauze bandage with your own hands

First of all, before you start making, you need to decide on its future dimensions. The standard dressing that is sold in pharmacies has a length of not more than 15 cm and a height of 5 cm. If the product is intended for a child, then its size depends on the age of the patient. For example, for babies up to 6 years old a bandage of 10 x 4 cm is suitable, but for a 10-year-old child one can already use an adult version. In order to independently sew a product on your face, you will need:

• Cut off absorbent fabric size 17 x 7 cm - 4 pcs.
• Band of narrow bandage in the amount of 2 pcs. The length should be of the order of 60-70 cm, width 5 cm.

After all the necessary elements of the future product have been prepared, you can start making gauze bandages. The following is the progress of the work.

• It is necessary to take a strip of bandage and roll it into 3 layers.
• Then sew along the edges with a sewing machine or manually with a small seam.
• Repeat the procedure with the second bandage.
• After this, the workpiece should be temporarily laid aside and gauze cuts. Four flaps must be joined together and sewed along the entire length.
• Then, the edges of the resulting rectangle should be turned inward by a centimeter and stitched again.
• Now that all three parts have been prepared, they need to be assembled into a single bandage. To do this, along the fabric rectangle, you must sew both strings: one - from above, and the other from the lower side. So the gauze bandage is made by own hands.

Tensile fastening products

• Elastic bandage is used for fixation. It is made of cotton yarn. Strict requirements are imposed on stretching the bandage - it should be at least 50%. A bandage of standard sizes is produced: length - 3 m, width - 5 or 10 cm. Elastic bandage of this category has high strength indexes. A single flap 5 cm wide can withstand a load of at least 30 kgf. The package contains 18 wrapped in a separate label products with a width of 10 cm or 36 pieces of 5 cm.
• Elastic bandage (tubular) performs the same task as its knitted analog. However, the extensibility of the former is higher up to 800%. This type of bandage belongs to the category "tepermat", which means "knitted elastic dressing". It is made of elastomeric thread, which is braided with cotton yarn and synthetic fibers. Thanks to the mesh structure, the fixation from the elastic bandage does not interfere with air circulation and observation of the affected area. They can have 7 different widths of the sleeve: 75, 40, 35, 30, 25, 20 and 10 mm. Weight 1 square. M is 280 g. The use of tubular products significantly saves dressings and time spent. Their washing is carried out at a temperature of no more than 40 ° C without the use of synthetic agents. After it is done rinsing in warm water. To wring out excess moisture, towels are used. Unscrewing of bandages is unacceptable.

Other products

Gauze Napkin is a rectangular flap made of two layers of absorbent fabric. The edges of the product are wrapped in the inside so that the threads do not come into contact with the wound. There are such products of three sizes: small - 14 x 16 cm, medium - 33 x 45 cm, large - 70 x 68 cm.

Small non-sterile products are packed in 100 and 200 pieces. In one pack. Napkins sterile gauze folded on 40 pcs. Non-sterile medium products are packed in 100 pieces. In a pack. Sterile - stacked on 10 pcs. Non-sterile large wipes are contained in an amount of 50 pcs. In one package. Sterile products of this group - 5 pcs. Each napkin is packed in parchment paper. On the wrapper, the size, quantity, name of the manufacturer and the date of manufacture are mandatory.

Treatment

Sterilization of dressings is carried out at specialized factories. After that, in bacteriological laboratories, they are tested for antibacterial activity. Preparation of dressings for further use is carried out for 45 minutes in a special steam boiler. The internal temperature is 120 ° C. After this, the dressing is put into the beads. In these metal boxes they continue to be kept. If a filter is installed in the bix, the purity of the materials remains for a longer period of time. In this case - not less than 8-10 days.

Content requirements

Storage of dressings can also be carried out in wooden boxes located in dry, normally ventilated rooms, protected from rodents and dust. Non-sterile products may be kept in an unheated room. However, the temperature should be stable, without hesitation. Also, it should avoid dampness and the formation of fungi, mold. To organize the correct content of sterile dressings in a warehouse, they must be laid out by the years of the last procedure. Since 5 years later, if the integrity of the package is not violated, the material should be selectively tested for antibacterial activity. If the package is opened or moistened, the products inside it are no longer clean.