How to Treat a Wound

In modern hospitals a room is set aside for the treatment of wounds, but in older hospitals and in the home this is not possible. However, according to a wound care doctor certain precautions should always be taken whenever a wound is dressed, to avoid contamination by micro­organisms. Avoid disturbing the air, either by draughts or excessive movement, as if dust and micro-organisms are moved they may settle on the wound. If the room needs cleaning, do this at least one hour before attending to a dressing, to allow time for the air to settle: use a vacuum cleaner if possible. Clean any trays or trolleys to be used with soap and water and check that the sterile packets are undamaged.

Avoid unnecessary talking throughout the procedure, to keep the number of micro-organisms breathed out from the nose and mouth to a minimum. Wash your hands before you start.

Which method you use to apply a dressing and how you secure it to the part will depend on the size and position of the wound and on what equipment is available.

In the home, you are likely to be attending to a small graze, cut or burn, in which case the minimum of equipment is necessary. Occasionally, you may assist the doctor or community nurse with a larger dressing but in these circumstances they will provide the necessary sterile equipment for wound care. Volunteers who are helping in the Accident and Emergency Department of a hospital or in a hospital ward will have sterile packs provided, which someone will show you how to use.

There are two methods of applying a dressing to a wound: one is just a clean method, while the other involves a “non-touch” technique. There are several ways of securing the dressing, depending on the size and position of the wound.

Treating a small graze

The vast majority of dressings done in the home are to cover small or shallow grazes. The people most likely to suffer such grazes are children.

To dress a small graze, seat the patient and wash your hands thoroughly. Grazes often have dirt and grit embedded in them, so wash the area gently with soap and water until it is really clean. Then apply a self-adhesive dressing. Most dressings of this sort come off of on their own accord a few days later. If you want to remove it, pull it off quickly rather than picking at it; the bath is a good place to remove old plasters. If you notice any redness around the dressing, take it off and examine the graze, for redness is a sign of infection.

Grazes are often more painful than deeper wounds, because they expose an area of raw, tender skin full of sensitive nerve endings. A child who has grazed his skin needs a cuddle, plenty of attention and perhaps a sweet for bravery.

Treating a larger wound you will need:

  • a tray
  • cotton wool swabs and mild antiseptic
  • a paper towel or square of kitchen roll
  • the appropriate dressing
  • a bandage or adhesive plaster
  • a paper bag for soiled dressings
  • a pair of scissors.

Before you begin, make the patient comfortable: seat him, or if he is in bed turn back the bedclothes, exposing him as little as possible. (If the injury is on the foot or leg, turn the bedclothes up from the foot of the bed.) If the cut or wound is too deep, it’s better to bring the patient to a hospital for professional laceration repair and treatment.

Expose the wound, removing any bandage, dressing or plaster already in place. Wash your hands thoroughly, then begin gently cleaning the wound: use cotton wool swabs dipped in antiseptic and wipe from the centre of the wound out­wards. Use each swab once only, discarding them immediately after use into the paper bag. Cover the wound with a clean dressing and secure it in position with a bandage o plaster­