Actions	Justifications
1. Wear rubber gloves.	Ensuring personal safety.
2. Explain to the patient the meaning of the manipulation and reassure.	Psychological preparation sick.
3. Position the patient so that you are facing him (if possible).	Ensuring the ability to monitor the patient's condition.
4. Treat the wound with a skin antiseptic with two different balls at a distance of 3-4 cm, moving from the wound to the periphery in a spiral.	Reduced infection rates.
5. Place a sterile napkin on the wound and secure it with circular bandages so that the knot is not located above the wound.	Prevention of further infection.
6.Prevention of tetanus.

End of work -

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Disaster medicine. Emergency medical care

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Ascertainment of biological death
The fact of the presence of biological, i.e. irreversible brain death can be established by the presence of reliable signs, and before their formation - by a combination of signs. The time must be indicated

Actions of a nurse in case of thermal burns
Actions Justification 1. Remove (remove) from the fire zone. Stop contact with high temperature.

Actions of a nurse in case of chemical burns
Actions Rationale 1. Call ambulance. The victim urgently needs the help of a doctor 2. By

Electric shock
Electrical injury is a pathological condition caused by exposure of the victim to electric current. It accounts for more than 2.5% of all injuries and is accompanied by significant (up to 20%)

Action of a nurse in case of electrical injury
Actions Justification 1. Observe personal safety rules (do not touch the power source bare hands, do not approach the victim, e

Causes of cold injuries
General cooling occurs when long-term exposure on the body at low temperatures (cold environment - air, water), especially at high wind speeds, as well as hypo- or adynamia

Clinical picture of cold injuries
General cooling may occur suddenly (for example, when falling into ice water) or develop slowly (for example, in those lost in the forest, in elderly people living in a village

Action of a nurse in case of frostbite
Actions justification 1. Lay down. 2. Warm it up, put a heating pad on the places where blood vessels accumulate (with

Action of a nurse during general cooling
actions justification 1. Take off wet clothes, put them on, wrap them in dry ones. 2.Call an ambulance

Drowning
Drowning is one of the common reasons death of young people. This indicates the relevance of the problem of providing assistance in case of drowning. By type and reasons

Nurse's actions
Actions Rationale 1. Ask others to call an ambulance. The victim needs help

Strangulation asphyxia
Strangulation asphyxia (suffocation) is one of the varieties acute disorder obstruction of the airways and occurs with direct compression of the trachea, sucking

Nurse's actions
action Rationale 1. Ask others to call an ambulance. The victim needs urgent medical attention.

Angina pectoris
Angina pectoris is one of the forms of coronary artery disease, the causes of which can be - spasm - atherosclerosis - transient thrombosis of the coronary vessels.

Acute myocardial infarction
Myocardial infarction is ischemic necrosis of the heart muscle, which develops as a result of disruption of coronary blood flow. Characterized by chest pain of unusual intensity

Acute vascular insufficiency
Acute vascular insufficiency is a condition in which there is sharp drop blood pressure. There are 3 types vascular insufficiency: fainting, collapse,

Acute left ventricular failure
(CARDIAC ASTHMA, PULMONARY EDEMA) Cardiac asthma is an attack of suffocation, accompanied by a feeling of lack of air, shortness of breath, inspiratory

Criteria for relief of OA and patient transportability
1. Decrease in shortness of breath to less than 22 breaths per minute. 2. Disappearance of foamy sputum. 3. Disappearance of moist rales along the anterior surface of the lungs. 4. Reduction of cyanosis. 5

Bronchial asthma
Bronchial asthma is a chronic inflammatory process in the bronchi, predominantly of an allergic nature, the main clinical symptom which is the

Emergency conditions for diabetes mellitus
Diabetes mellitus- a disease characterized by metabolic disorders associated with insufficient insulin production. There are two main types of sugar

Currently, prehospital insulin therapy without determining blood sugar levels is prohibited!
Prepare: 1. System for intravenous infusion, syringes, saline. solution, Ringer's solution, simple insulin - actrapid.

Anaphylactic shock
Anaphylactic shock- this is the most dangerous clinical variant of an allergic reaction that occurs when administered various substances. Anaphylactic shock can

Urticaria, angioedema
Urticaria: localized skin rash with blistering and erythema. As a result of their fusion, extensive lesions may appear, accompanied by characteristic itching. Allergic with

Emergency care for poisoning
1. Poisoning caused by poisons entering through the mouth. Under acute poisoning refers to sudden health problems caused by foreign substances entering the body

External, arterial bleeding
Information allowing nurse suspect emergency: 1. There is damage skin or mucous membranes - a wound. 2. It comes from the wound

Technique for applying a rubber tourniquet for arterial bleeding
Stages of Justification 1. Manipulation is performed with gloves. Ensuring personal protection. 2.Make sure

Applying a pressure bandage for venous bleeding
Actions Justifications 1. Manipulation is performed with gloves. Ensuring personal safety.

Concussion Clinic
A concussion is characterized mainly by general cerebral and autonomic disorders– short-term (several seconds and minutes) loss or disturbance of consciousness

Brain contusion clinic
Clinical picture brain contusion is characterized acute development symptom complex at the time of injury. Over the next few hours and days, a further increase in clinical symptoms is often observed.

Chest injury
Damage chest are divided into closed (bruises, compression, rib fractures) and open (wounds). Wounds can be penetrating (the parietal pleura is damaged) and

Application of an occlusive dressing
Steps Rationale 1. Ensure that there is an open pneumothorax. Determination of indications for manipulation.

Spinal injury
Among spinal injuries, the most dangerous are injuries to the vertebrae themselves. Early diagnosis spinal injury is extremely important for providing correct and timely assistance to victims

Technique for applying a Shants collar to the cervical spine
spine: Action Rationale 1. Make sure there is an injury. Definition n

Abdominal injuries
Damage to the abdominal organs is severe and extremely life-threatening. If a patient with damage to the abdominal organs is not provided with adequate medical treatment in a timely manner

Pelvic injuries
Pelvic injuries are classified as severe injuries. They may be accompanied by painful shock and massive bleeding. Damage to the pelvic bones is divided into the following groups: 1) cr

Traumatic shock
Traumatic shock– this is special serious condition, associated with an extreme degree of damage to the body as a result of extreme factors. The reasons for the development of shock vary

Closed fractures
At closed fracture the skin is not damaged and bone fragments do not communicate with the external environment. TO reliable signs fractures include: pain that increases with dosed load

Open fractures
At open fracture there is a wound, bleeding, bone fragments may be visible, pain, deformation, swelling at the site of injury. The function of the limb is impaired. Medical tactics

Prevention of tetanus
Emergency prevention tetanus involves primary surgical treatment of the wound with removal foreign bodies and necrotic tissues and creation (if necessary) of specific immunity

Immobilization for injured limbs
Immobilization is one of the main components medical care victims with mechanical damage, the adequacy of immobilization largely depends on

Rules for applying transport tires
1. Transport immobilization should be carried out as soon as possible from the moment of injury. 2. Transport tires must provide immobilization, in addition to the damaged se

Cramer splint application
Steps Rationale 1. Make sure there is a fracture. Determination of indications for immobilization. 2.

Long-term compartment syndrome
(crash syndrome, traumatic toxicosis, myorenal syndrome, positional syndrome, Bywaters syndrome) is a severe injury that develops with prolonged compression of the limbs during

If the victim was released from compression by rescuers before the ambulance arrived, a tourniquet is not applied when providing assistance.
Prepare tools and preparations: 1. Syringes, needles, tourniquet, oxygen, Ambu bag. Assessment of achievements: 1. Condition has stabilized, blood pressure and pulse are stable

Means and methods of transport immobilization
Body part Joints Application and position during transport Available means Shoulder

Asepsis– a set of measures taken to prevent microbes from entering the wound during surgery and therapeutic procedures. Everything that comes into contact with the wound, even a puncture wound (when the skin is pierced with a thin needle), must be sterile.

Asepsis begins with hygiene: wet cleaning of premises, clean clothes, bed linen. Hand care is of particular importance.

Antiseptics is a set of measures to limit and destroy infection that has entered a wound. There are mechanical, chemical and bacteriological methods antiseptics. TO mechanical methods refers to the removal of germs by excision of wounds and washing them. Physical methods include drying of wounds with hygroscopic dressings, bandages, as well as irradiation (for example, ultraviolet) for bactericidal purposes. Biological antiseptics include antibiotics, bacteriophages, vaccines and serums.

Of particular importance in practice is the chemical disinfection of instruments, care items, as well as hands, wounds, and infected cavities. For disinfection, use a triple solution (formalin, phenol, sodium bicarbonate), alcohol, chlorhexidine.

Chloramine B is used to disinfect hands and non-metallic instruments (0.25 - 0.5% solutions). Hydrogen peroxide (3% solution) is used to treat wounds and cavities, potassium permanganate is used for washing wounds, baths (0.1-0.5% solutions), for lubricating burn and ulcer surfaces (2-5% solutions), for douching (0.02-0.1% solutions). An alcohol solution of iodine (5-10%) is used to disinfect the skin around wounds, cauterize abrasions and small wounds. Very effective antimicrobial drug is furacillin, which is used in the form of aqueous (1:5000), alcohol (1:1500) solutions and 0.2% ointment. Aqueous solution wash cavities, irrigate wounds and burn surfaces. An alcohol solution of methylene blue (1-2%) is used for cauterization, lubrication of abrasions and pustules.

Bandages (desmurgy)

Desmurgy is the study of bandages and methods of applying them. Comes from two Greek words: desmos - bandage and ergos - business.

By bandage one should understand everything that therapeutic purpose applied to a wound, burn, fracture or other lesion. A bandage consists of a dressing material applied to the injured area. This material is usually impregnated medicinal substances: antiseptic solutions or ointments. The third component of the dressing is the fixing means that secure the dressing material to the surface of the body (glue, bandage, scarf, adhesive plaster, etc.).

Purpose of bandages:

· to hold dressing material on the surface of the body;

To protect affected areas from exposure external factors;

· to stop bleeding;

· to hold the damaged part of the body in a stationary position during a fracture, dislocation, etc.

The dressing material applied to the wound or burn surface must be sterile. The dressing is called aseptic.

Purpose aseptic dressing:

prevents secondary microbial infection of the wound,

stops bleeding

creates rest for the damaged organ,

· reduces pain,

· has a psychologically beneficial effect on the victim.

Protecting a wound from infection is best achieved by applying a bandage and following following rules:

· Do not touch the wound with your hands, as there are especially many microbes on the skin of the hands;

· the dressing material used to close the wound must be sterile.

Before applying a bandage, if the situation allows, you need to wash your hands with soap and wipe them with alcohol. If possible, the skin around the wound is lubricated with iodine, thereby destroying the microbes on the skin. Then take a sterile gauze pad, touching only one side of it with your hands, and apply it to the wound with the side that the hand did not touch.

Types of dressings. Depending on the application of the material for applying dressings, there are soft(kerchief, cleol, bandage, retelast, adhesive plaster) and hard(splints, plaster, plastic).

BANDAGES- a means for the treatment of injuries and diseases, consisting of applying a dressing to the affected area and fixing it in the affected area or immobilizing the affected area itself.

There are several types of antiseptic P.: dry (dry antiseptic is poured onto the wound, and dry aseptic P. is applied on top); wet-drying (gauze napkins soaked in antiseptic solution are applied to the wound and covered with dry aseptic P.); P. using aerosols, P. using napkins, the tissue molecules of which include antiseptic drugs; P. with the longest bactericidal effect (for example, “Livian”, “Legrazol”, etc.); P., which have anti-inflammatory, analgesic and antiseptic effects.

A hypertonic dressing promotes the drainage of wound exudate from the wound. Its suction effect is due to solutions impregnating tampons, the osmotic pressure of which is higher than the pressure in body tissue fluids and wound discharge. Hypertensive P. is one of the methods of physical antiseptics; used for treatment purulent wounds with a copious amount of discharge, as well as with sluggish epithelization of the wound. After 6-12 hours. after application (depending on the amount of wound discharge), P. practically ceases to act. According to the technique of application, hypertonic P. does not differ from wet-drying antiseptic P. As hypertonic solution most often used 5 - 10% chloride solution sodium

Hemostatic dressing is used in two versions. For venous and capillary bleeding, the so-called pressing P., which is a dry aseptic P., a lump of cotton wool is tightly bandaged on top of the cut. This P. was widely used in the 19th century; At that time, special pads were made to compress blood vessels. If hemostatic P. is used to stop cough, small arterial, venous or mixed bleeding, then biol, an antiseptic tampon, hemostatic sponge or dry thrombin.

An oil-balsamic dressing is a medicinal dressing with an ointment proposed by A.V. Vishnevsky and called it an oil-balsamic antiseptic. It can be used to treat inflammatory processes, burns, and frostbite.

An occlusive (sealing) bandage isolates the affected area of ​​the body from water and air. The idea of ​​these P. was implemented for the first time in Lister's isolating bandage. In modern surgery, the term “occlusive bandage” is understood as a method of separating the pleural cavity and external environment for chest injuries complicated by open pneumothorax (see). To ensure occlusion, water- and air-tight material (large gauze pads soaked in Vaseline oil, a wrapper from an individual dressing bag, sterile plastic film, etc.), which is tightly fixed with a gauze bandage. Occlusion can also be achieved by covering the wound with wide strips of adhesive tape, applied like tiles; for greater reliability, especially with wet skin, dry aseptic P is applied on top.

Fixed bandages are used to ensure complete or partial immobility of the affected part of the body (see Immobilization) or immobility with traction (see). These include splints (see Splints, splinting) and hardening P. Of the hardening P., the most common are gypsum (see Gypsum equipment). P. is included in surgical practice using synthetic materials (polyvik, foamed polyurethane, etc.), which become plastic when heated in hot water and harden after application to the limb. Other hardening products (using starch, glue, celluloid, liquid glass etc.) have historical significance; orthopedists sometimes resort to them in pediatric practice.

Seten's starch bandage is applied over a cotton lining, using bandages soaked in starch paste; bandage the limb from the periphery to the center. To increase the strength of the bandages, strips of cardboard are placed between the layers of bandages. Starch powder dries slowly, and therefore there is a risk of secondary displacement during the hardening process; it is less durable than gypsum.

An adhesive bandage is prepared from cloth bandages coated with wood glue. Before applying P., bandages are immersed in hot water and applied to the limb over a gauze pad. It takes approx. for the dressing to dry. 8 o'clock

A celluloid bandage is made by applying a solution of celluloid in acetone over the passages of a gauze bandage.

A Shrout liquid glass bandage is applied to the limb on a layer of cotton wool (batting, flannel), securing it with a bandage (3-5 layers) soaked in liquid glass (saturated water solution sodium sulfite). P. hardens after 4 hours.

The elastic bandage is designed to provide uniform pressure on the tissues of the limb in order to prevent swelling due to stagnation of blood and lymph (see Lymphostasis). It is used for varicose veins (see), postthrombophlebitic syndrome (see Phlebothrombosis), etc. Elastic P. can be made on a zinc-gelatin basis using Unna paste. Unna's paste contains zinc oxide and gelatin (1 part each), glycerin (6 parts) and distilled water (2 parts). The paste has a dense elastic consistency. Before use, it is heated in a water bath (without boiling) and applied with a wide brush to each layer of gauze bandage applied to the limb. Usually P. is made of 4-5 layers. P. drying lasts 3-4 hours. Another type of elastic bandage is the application of a knitted elastic or mesh elastic bandage. Bandaging with an elastic bandage is performed from the periphery to the center like a spiral bandage. Ready-made products such as elastic stockings, elastic knee pads, etc. are also used.

Complications associated with the use of P. are most often caused by the irritating effect of some of them on the skin and technical errors when applying them. Thus, adhesive plaster and colloidal P. irritate the skin; adhesive plaster sticks to the hair so tightly that removing it is usually associated with painful sensations; tight application of a bandage to a limb causes pain, blueness and swelling below the p. Incorrect application of hardening and hard p., which usually remain on the patient’s body for a long time, can cause problems with mobility in the joints, bedsores in the area bony protrusions, displacement of bone fragments during a fracture, etc.

Bibliography: Atyasov N. I. and Reut N. I. Desmurgy technique for soft tissue injuries and bone fractures (Medical Atlas), Saransk, 1977; Billroth T. General surgical pathology and therapy in 50 lectures, trans. from German, St. Petersburg, 1884; Boyko N. I. Influence different concentrations and combinations of dimexide (dimethyl sulfoxide) solutions on the course of the wound process, Klin, hir., No. 1, p. 64, 1979; Tauber A. S. Modern schools of surgery in the main countries of Europe, book. 1, St. Petersburg, 1889; F r i d l a n d M. O. Guide to orthopedics and traumatology. M., 1967; Biological actions of dimethyl sulfoxide, ed. by S. W. Jacob a. R. Herschler, N.Y., 1975; Lister J. On the antiseptic principle in the practice of surgery, Lancet, v. 2, p. 353, 1867.

F. X. Kutushev, A. S. Libov.

Bandages are applied to treat wounds and protect them from external influences, for the purpose of immobilization (see), stopping bleeding ( pressure bandages), to combat the expansion of the saphenous veins and venous, etc. There are soft and hard, or fixed bandages.

Soft bandage, scarf, plaster, cleol and other dressings are applied to hold on the wound, as well as for other purposes. Application methods - see.

Aseptic dry dressing consists of several layers of sterile gauze covered with a wider layer of absorbent cotton wool or lignin. Apply it directly to the wound or over tampons or drains inserted into it for the purpose of drying: the outflow of fluid (pus, lymph) into the bandage promotes drying surface layers wounds. At the same time, due to the removal of microbes from the wound, conditions favorable to healing are created. A dry aseptic dressing also protects the wound from new infection. If the bandage gets wet through and through (the entire bandage or just the top layers) must be changed; in some cases, bandaging is done - cotton wool is added and bandaged again.

Antiseptic dry dressing the method of application does not differ from dry aseptic, but is prepared from materials pre-impregnated antiseptics(solution of sublimate, iodoform, etc.) and then dried or sprinkled with powdered antiseptics (for example,) before applying the bandage. A dry antiseptic dressing is used mainly when applied to influence the microbial flora of the wound with the substances contained in them. More often used wet dry bandage from gauze soaked in an antiseptic solution. The antiseptic solution can be injected into the bandage fractionally or continuously by drip through special drains, the ends of which are brought out through the bandage.

Hypertonic wet dry dressing prepared from materials (tampons, gauze covering the wound) soaked immediately before applying a bandage with a 5-10% solution of sodium chloride, 10-25% solution of magnesium sulfate, 10-15% solution of sugar and other substances. Such dressings cause increased drainage of lymph from the tissues into the wound and into the dressing. Their application is indicated for infected wounds with scanty discharge, and for wounds containing a lot of necrotic tissue.

Protective bandage consists of gauze thickly lubricated with sterile petroleum jelly, petroleum jelly, 0.5% synthomycin or other oily substances. It is used to treat granulating wounds that have cleared necrotic tissue.

Pressure bandage used for the purpose temporary stop bleeding (see). Over tampons inserted into the wound, and gauze napkins Place a tight ball of cotton wool and bandage it tightly.

Occlusive dressing used when open (see). Its main purpose is to prevent air from entering through the chest wound into pleural cavity. After generously lubricating the skin around the wound with Vaseline, apply a piece of torn rubber, oilcloth or other air-impermeable fabric to it. The bandage should cover not only the wound, but also the skin around it. Place on top of this fabric large number cotton wool and bandage tightly. When you inhale, the airtight fabric is suctioned to the wound and seals it. It is also possible to tighten the edges of the wound with strips of adhesive and apply gauze, cotton wool and a bandage on top.

Zinc-gelatin dressing - see Desmurgy.

Fixed (immobilizing) bandages are applied to limit movement and provide rest to any part of the body. Indicated for bruises, dislocations, fractures, wounds, inflammatory processes, tuberculosis of bones and joints. Fixed dressings are divided into splint (see) and hardening. The latter include plaster bandages (see), as well as a starch bandage, which is rarely used nowadays. To make hardening dressings, it is possible to use other substances: a syrupy solution of gelatin, liquid glass (sodium silicate solution) and a solution of celluloid in acetone. These slowly hardening dressings are used (mainly the latter) for the production of corsets and splint-sleeve devices made from a plaster model.

Starch dressing. Starch gauze bandages, after being immersed in boiling water and wrung out, are placed on top of a cotton pad, often with cardboard splints. This bandage hardens within 24 hours. A starch bandage can also be applied using a regular bandage, each layer of which is smeared with starch glue. It is prepared by mixing starch with a small amount of water to the consistency of thick sour cream, and brewing with boiling water while stirring.

See also Oil-balsamic dressings.

According to their mechanical properties, they are distinguished soft bandages, used to treat wounds; rigid, or motionless, - for immobilization (see); elastic - to combat the expansion of saphenous veins and venous stasis; bandages with traction (see Traction). Soft dressings are most widely used for wounds and other defects of the integument (burns, frostbite, various ulcers, etc.). They protect wounds from bacterial contamination and other environmental influences, serve to stop bleeding, influence the microflora already present in the wound, and the biophysical and chemical processes occurring in it. When treating wounds, dry aseptic dressings, antiseptic (bactericidal), hypertonic, oil-balsamic, protective, and hemostatic are used.

Methods of holding dressings on a wound - see Desmurgy.

A dry aseptic dressing consists of 2-3 layers of sterile gauze (applied directly to the wound or on tampons inserted into the wound) and a layer of sterile absorbent cotton covering the gauze of varying thickness (depending on the amount of discharge). The area of ​​the bandage should cover the wound and surrounding skin at a distance of at least 4-5 cm from the edge of the wound in any direction. The cotton layer of the bandage should be 2-3 cm wider and longer than the gauze. Absorbent cotton can be completely or partially (upper layers) replaced with another highly absorbent sterile material (for example, lignin). To increase the strength of the bandage and ease of bandaging, a layer of gray (non-absorbent) cotton wool is often placed on top of it. On surgical wounds that are tightly sutured, an aseptic bandage is applied from one gauze in 5-6 layers without cotton wool. A dry aseptic dressing is applied to dry the wound. For wounds that heal by primary intention, drying promotes the rapid formation of a dry scab. In infected wounds, a significant portion of microorganisms and toxic substances enter the dressings along with pus. About 50% of the radioactive isotopes contained in it pass into a dry cotton-gauze bandage applied to a fresh radioactively contaminated wound (V.I. Muravyov). A dry dressing reliably protects the wound from contamination until it gets wet. A completely wet bandage must either be changed immediately or bandaged, that is, after smearing the wet area of ​​the bandage with tincture of iodine, fix another layer of sterile material, preferably non-hygroscopic, over the bandage.

An antiseptic (bactericidal) dry dressing does not differ in design from a dry aseptic one, but is prepared from materials impregnated with antiseptic agents, or is a dry aseptic dressing, the gauze layer of which is sprinkled with a powdered antiseptic (for example, streptocide).

The use of dry dressings made from antiseptic dressing material is most justified in military field conditions, since they, even when soaked in blood, continue to protect the wound to a certain extent from microbial invasion. Therefore, for the manufacture of individual dressing bags, antiseptic dressing material is preferable.

A wet-to-dry antiseptic dressing consists of sterile gauze pads moistened ex tempore with an antiseptic solution; they are applied to the wound in a lump and covered with a dry aseptic dressing. The latter immediately absorbs the liquid from the napkins and gets wet; in order to prevent the patient’s linen and bed from getting wet, the bandage is usually covered on top with a layer of sterile non-absorbent cotton wool that does not interfere with ventilation. If you cover a wet bandage with an airtight material (for example, oilcloth), you will get a warming compress from an antiseptic solution, which can cause dermatitis and even skin burns, and sometimes tissue necrosis in the wound. At one time, bactericidal dressings almost completely fell out of use and only with the advent of modern antiseptics began to be widely used again. Currently, a wide variety of chemical and biological antibacterial drugs are used, introduced into the dressing ex tempore.

Hypertensive patch makes a difference in osmotic pressure tissue fluid and fluid contained in the wound and in the dressing, and thereby causes increased lymph flow from the tissues into the wound cavity. A dry hypertonic dressing is prepared from a dry aseptic dressing, dusting 2-3 layers of gauze and the wound with powdered sugar. This type of dressing is rarely used; usually a wet drying hypertonic dressing is made, which, instead of an antiseptic solution, is impregnated with a hypertonic (5-10%) salt solution, usually table salt. A solution of magnesium sulfate, which has analgesic properties, can also be used. Sometimes they use a 10-15% sugar (beet) solution, but salt hypertonic solution more profitable, as it promotes favorable changes in the electrolyte balance of tissues, pH of the environment and other indicators, therefore, it is a method pathogenetic therapy wounds.

Oil-balsamic dressings have an even greater influence on the pathogenesis of the wound process (see).

A protective bandage is used at the wound granulation stage. She protects the tender granulation tissue from drying out and from irritation by fibers and loops of gauze. This dressing is devoid of suction ability, but is used in that phase of the wound when the pus accumulating under the dressing is rich in antibodies and phagocytic cells and serves as a good environment for young connective tissue.

It is advisable to widely use a Vaseline protective dressing (an ordinary dry aseptic dressing, thickly lubricated on the gauze side with sterile Vaseline ointment). It's simple and effective. With a protective bandage, the introduction of drains, tampons and highly active antiseptics into the wound is usually excluded. Ointments with a weak antiseptic effect that do not irritate granulations (for example, A. V. Vishnevsky’s oil-balsamic ointment, 0.5% synthomycin ointment, etc.) can be used for a protective dressing, but do not have significant advantages over pure petroleum jelly. A protective bandage is often applied to long term, in these cases it should be covered on top with a layer of non-absorbent cotton wool.

An occlusive (hermetic) bandage is necessarily used for external open pneumothorax. It is based on a piece of sealed fabric (oilcloth, rubber, leukoplast), applied directly to the wound and widely covering the skin around it. When you inhale, the oilcloth adheres to the wound and reliably seals it. When you exhale, air from the pleural cavity freely comes out from under the bandage. Complex occlusive dressings, equipped with valves of various designs, do not provide significant benefits.

Fixed bandages are divided into splints (see Splints, splinting) and hardening. The latter can be made using various substances. Plaster cast- see Gypsum technique.

A starch bandage is made from factory-produced starch bandages up to 4 m long. Before bandaging, the bandage is immersed in boiling water. After light squeezing, the bandages are cooled on plates. The limb is wrapped in a thin layer of gray cotton wool and bandaged with a warm starch bandage in a spiral manner (see Desmurgy). When ironed by hand, the bandages are glued and aligned. Having applied three layers of starch bandage, place cardboard splints longitudinally and secure them with another 2-3 layers of starch bandage.

After about a day, the bandage hardens. The disadvantage of starch dressings and previously used liquid glass dressings is slow hardening. The use of bandages moistened with quickly hardening glue of the BF-2 type seems promising.

Elastic and gelatin (zinc-gelatin) dressings - see. Varicose veins veins

Radioactive dressings - see Alpha therapy.

Any type of burn leads to damage to the skin or tissue. The wound surface must be anesthetized and properly treated to prevent microorganisms from entering it. Bandages for burns with medicines will help protect the wound and speed up regeneration.

In modern treatment burn wounds the use of special dressings is provided that disinfect, moisturize, and anesthetize the wound. Such dressings can have a different base: cotton fabric, plaster, hydroactive polymer and others. They may contain an antiseptic, analgesic, a regenerating drug or gel-forming substances that help maintain the required level of moisture in the damaged area.

All types of wound dressings have two sides. One of them is intended for contact with damaged skin and tissue, and therefore must be sterile. The other, the outer one, is devoid of a medicinal layer and serves for convenient fixation of the dressing material.

There is a certain algorithm that must be followed when using medicinal dressings:

1. First, it is necessary to stop the action of the etiological or pathological factor. If there is clothing on the damaged surface, it is removed or cut, freeing the burned arm, leg, shoulder, shin, thigh from further exposure to boiling water, hot oil or chemical substance. The stuck part of the fabric must not be torn off. It is cut off as much as possible with scissors, and the rest is left in the wound to avoid further injury.
2. Now you need to cool the damaged area to relieve pain, relieve swelling and prevent further tissue damage. Such an event makes sense for the first half hour after an injury. For cooling, the affected part of the body is placed under a flow cold water or immerse for 20 minutes. The water temperature should not be lower than 15 o C. At the same time, you can use a painkiller.
3. The bandage is applied to the damaged area in such a way that the burn surface is completely covered, but does not extend beyond the wound more than 2 cm around the perimeter.

After the dressing has been cut out according to the area of ​​the burn, the protective layer of the bandage is removed and applied to the body. For fixation, you can use a bandage or plaster.

When localizing, a bandage is applied to each finger separately, and then the hand and forearm are suspended on a piece of fabric.

A bandage is not applied to the face, and the wound is treated in open form chlorhexidine solution and covered with ointment preparations.

Dressing of the burned area is carried out according to the instructions of the dressing used. As a rule, for burn wounds, the bandage must be replaced every 2-3 days. When providing first aid to a victim, it is not recommended to use anti-burn ointments, as they may affect the correct determination of the degree of injury.

Types of dressings

There are several types of dressings. Let's look at some of them with detailed descriptions.

View	Characteristic
Aseptic	An aseptic dressing is used when providing emergency care for burns. The dressing material used is a sterile bandage, an ironed diaper or cotton cloth, or a clean bag. The material can be dry or moistened with an antiseptic ( alcohol tincture calendula or propolis, vodka, potassium permanganate solution). The main goal is to close the wound surface from infection before sending the victim to a medical facility.
Mazevaya	You can make it yourself or buy it ready-made at the pharmacy. For cooking at home remedy applied to gauze or bandage, and then applied to the wound and secured. Most often, and are used for these purposes. Store-bought ointment dressings are a layer of medication on a mesh base with protection from external influences. The most famous and widespread is the Voskopran series of ointment dressings. Levomekol, Dioxidin, Methyluracil ointment, Povidone-iodine can be used as medicine.
Wet	Wet-dry dressings are intended for protection, pain relief and treatment of 2nd and 3rd degree burns. For wounds with purulent inflammatory process a base is applied with antiseptic solutions of furatsilin, boric acid or chlorhexidine. If there is a scab in a grade 3 wound, a wet-dry type of dressing with an antiseptic is also used to ensure a drying effect on the wound surface. Ready-made gel dressings for burns, Gelepran with miramistin and lidocaine, have moisturizing, antiseptic and analgesic properties.
Hydrogel	Hydrogel bandages for burns are modern remedy for the treatment and protection of the wound surface. One of three forms of this dressing can be purchased at the pharmacy: amorphous hydrogel (gel in a tube, syringe, foil bag or aerosol); impregnated hydrogel (gel applied to a fabric base, napkin or); gel plate on a mesh base. The advantage of this method is the removal pain syndrome, support required level moisture in the wound, protection against infection, providing cooling and cleansing the burned area from necrosis products. Contraindication: do not use this remedy on wounds with strong discharge exudate.

Banolind dressings

Branolind burn dressing is a modern remedy for the treatment of burns and other wounds. It has a cotton mesh base. Branolind is an ointment dressing, the active ingredient of which is peruvian balsam. Therapeutic impregnation has the following ingredients:

• Branolind ointment;
• glycerol;
• petrolatum;
• cetomacrogol;
• purified fat.

At the pharmacy you can purchase a package of Branolind with 10 or 30 pcs. mesh bandages. It is also possible to buy the mesh individually. This tool showed itself to be great way to protect against infection, accelerate regeneration, relieve inflammation. Branolind is widely used in surgery after skin grafting for accelerated growth cells and trouble-free tissue engraftment.

The advantage is that it is hypoallergenic. The wound-healing components of the ointment do not irritate even sensitive skin.

Based on consumer reviews, Branolind does an excellent job of non-healing wounds of any nature. Pregnancy and lactation are not contraindications for use. It can also be used by children and adolescents.

How to avoid complications and further care

The main complication of burns is the development of burn disease. It occurs when more than 5-10% of the area of ​​all skin is affected. The complication is caused by a complex of dysfunctions various systems and organs. These include hypovolemia, intoxication, circulatory disorders, tachycardia, etc.

It is important to timely admit a patient with an extensive burn to a specialized burn department. In a state of shock, specialists carry out a number of therapeutic measures to the patient to eliminate pain, normalize breathing, and prevent cardiovascular and renal failure.

Another complication of a burn can be sepsis. To avoid wound infection, regularly treat the affected area with antiseptic agents, perform dressings and monitor the healing process.

To avoid burns, you should follow safety rules and also protect children from possible sources of burn injuries.