Dressing material is a first aid tool . The history of its occurrence can be traced from a very long time. Around 460-377 BC e. (during the time of Hippocrates), in order to firmly fix the dressing, an adhesive patch, various resins and canvas were used. And in 130-200. BC e. the Roman physician Galen created a special guide. In it, he described a variety of dressing techniques.
History of development
The use of dressings received the first wide resonance thanks to the decree of the Roman Senate. It said that each soldier needs to give a strip of canvas, with which he could, if necessary, provide first aid to himself or his colleague. It is likely that the application of various materials to the affected area of the body was used in prehistoric times. Leaves and grass could be used for this purpose, since they possess such qualities as flexibility, softness, elasticity and smoothness of the cover. Some of the plants have healing properties and even a pharmacological effect, for example, have an astringent and analgesic effect.
It is also worth noting that certain plants are used in folk medicine to apply dressings to this day. Among them: baked onions, plantain and many others. Dressing material reached its peak in the days of capitalist production. In the period from 1476 to 1492, a band-aid bandage was widely publicized in Europe. In the 18th century and until the 1st half of the 19th century, special importance was given to the absorbent effect of the means. The dressing was made using raw materials with high capillarity. For example, flaxseed and hemp hemp, as well as lint (cotton cloth ragged on a thread). Since the second half of the XIX century. instead, gauze, absorbent cotton 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.
- Bandages are medical.
- Medical pads.
- Medical gauze napkins.
Compared with the past years, the modern choice of dressings has become much richer. This was largely favored by the large development of pharmacological production in our country, as well as the massive import of foreign products into the domestic market.
Intended classification
Conventionally, all dressings can be divided into four groups: sterile and non-sterile, simple and complex. However, their main distinguishing quality is the purpose - the purpose of the application. According to this principle, the following series of functions performed by dressings can be distinguished:
- To close the wounded surface. To do this, use napkins, a bactericidal patch, wound dressings and more.
- For compressing limbs or fixing joints.
- For fixing dressings.
- Compression coatings.
A mandatory requirement for any type of dressing to close the wound is sterility.
Product Features
The production of dressings has moved to a new stage of development thanks to the advent of modern technology. As a result of their use, highly elastic, perforated fabrics with a non-woven structure were obtained, which were based on the use of polymer compositions and metallized coatings. The use of modern materials in medicine allows us to solve the following series of problems:
- Achieving a high rate of antimicrobial activity.
- Long term validity.
- High absorption capacity combined with good breathability, optimal wetting speed and capillarity.
- Atraumatic.
- Sustainability of antimicrobial treatment of agents in conditions of radiation and steam sterilization.
What to choose: traditional or modern dressings and products?
In fact, this question is only a rhetorical one. The use of modern materials in medicine creates favorable conditions for faster healing of wounds. This, in turn, insures against the appearance of scarring on the wounded surface. The reason for their occurrence is often a prolonged closure of the wound with traditional dressings.
As for the price issue, the difference in cost between modern and old materials is quite noticeable. This argument is sometimes given in favor of the latter. However, when it comes to human health, cost is far from always the decisive factor for making a choice. In addition, as practice shows, the use of modern medical materials is economically more profitable than traditional ones. Due to 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 cotton-gauze dressings:
- The fleecy structure causes particles of material to enter the wound. They cause tissue irritation and interfere with its speedy healing.
- Gauze is a fine-meshed 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 dressing. This is especially true when several layers are applied. At the same time, the process of epithelization and granulation of the wound is delayed, and as a result, the healing time becomes longer.
- Adhesion, or more simply sticking, is another minus of using gauze dressings. The fact is that, saturated with wound secretions, they harden upon drying. Granulation of the wound occurs through the dressing, resulting in a new surface injury and pain during removal. The surrounding skin also suffers. Its damage also causes pain and slows down the overall healing process.
- Cuts and napkins are usually completed with several pieces per pack. At its opening, only the first remains without germs. While the rest lose this quality.
- To increase absorbency and give the right size, gauze has to be cut and then folded in several layers. This procedure violates antimicrobiality and causes certain inconvenience to the patient.
- In order to fix the cotton-gauze dressing on the wound, it is necessary to use auxiliary fixation. This leads to extra cash spending and requires additional manipulation.
Thus, the use of conventional, traditional materials becomes the reason for the long healing process. A good alternative are modern devices that are devoid of all those disadvantages that are described above. Advanced dressings are atraumatic coatings with high absorption capacity. Their fixation occurs independently using a hypoallergenic adhesive composition.
The advantages of modern products
- Dressings 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 is able to take water procedures without the risk of water entering the wound.
- Reliable fixation.
- Modern dressings do not stick to the wound surface and do not injure it.
- Withdrawal is painless for the patient.
- The self-adhesive side of the dressing is fixed independently and does not require the use of additional funds.
- There is a sorbing atraumatic swab that collects wound exudate.
- The applied dressing reliably protects the wound from getting a secondary infection and mechanical irritations.
- Hypoallergenic composition.
- High rates of air and vapor permeability prevent maceration.
- Modern dressings are ready to use and do not require preparation.
- Antibacterial.
- The packaging is easy to open.
Medical tissue
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: purely cotton and with the addition of viscose staple fabric (in the ratio of 50% cotton to 50% viscose or 70% cotton to 30% viscose). Their main difference is as follows: cotton absorbs liquid for 10 s, while gauze with a viscose admixture does the same for 60 s, that is, 6 times slower.
The advantages of viscose are high moisture capacity, increased ability to absorb wound exudate and higher rates of blood absorption. However, compared with cotton gauze, the viscose counterpart holds pharmaceuticals worse. And also after repeated washing, the absorption capacity decreases. According to the strength criterion, the cotton dressing is 25% higher than the indicator of fabric with an admixture of viscose. But the capillarity in both species is approximately the same, it ranges from 10-12 cm / h. In terms of neutrality, medical gauze has the same requirements as cotton wool. The fabric is available in standard canvas sizes: width - 69–73 cm, length from 50 to 150 m in a piece.
For non-standard surgical dressings, 3 pieces are produced. in a pack. Each is 10 m long and 90 cm wide. Like cotton wool, gauze is tested for wettability (absorption capacity), neutrality and capillarity.
Suitability test
- In order to check the wettability, the immersion method is used. For this, a sample of hygroscopic gauze measuring 5 x 5 cm is lowered to the surface of the water. According to the prescribed standards, it must be immersed in water for 10 seconds without touching the walls of the vessel. Sample gauze must be done in 60 seconds.
- To check the dressing for capillarity, a strip of tissue about 5 cm wide is lowered at one end into a special Petri dish filled with an eosin solution. The sample is considered to have passed the test 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 action. Ethocostatic and hemostatic.
- Hemostatic dressing is obtained during the processing of ordinary gauze with nitrogen oxides. The resulting tissue not only stops the blood, but also completely absorbed in the wound within a month. It has the appearance of napkins measuring 13x13 cm.
- Hemostatic tissue. Its composition includes the calcium salt of acrylic acid. It also stops the blood (on average in no more than 5 minutes), but does not resolve. It can be used in the form of tampons, balls and napkins. Using this type creates up to 15% savings.
DIY gauze dressing
First of all, before proceeding with manufacturing, you need to decide on its future dimensions. The standard dressing, which 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 with a size of 10 x 4 cm is suitable, but for a ten-year-old child you can use an adult version. In order to stitch the product on your own, you will need:
- A section of absorbent tissue measuring 17 x 7 cm - 4 pcs.
- Band of narrow bandage in the amount of 2 pcs. The length should be about 60-70 cm, width 5 cm.
After all the necessary elements of the future product have been prepared, you can start manufacturing gauze dressings. The following is the progress of work.
- You need 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 with the second bandage.
- After this, the blanks need to be temporarily set aside and engaged in gauze cuts. Four flaps must be joined together and sheathed along the entire length.
- Then the edges of the resulting rectangle need to be turned inwards by a centimeter and again stitched.
- Now that you have prepared all three parts, they need to be assembled into a single dressing. To do this, you need to sew both ties along the fabric rectangle: one on the top and the other on the bottom. This is how a gauze bandage is made with your own hands.
Stretch fixation products
- An elastic bandage is used for fixation. It is made from harsh cotton yarn. Strict requirements are imposed on the stretching of the bandage - it must be at least 50%. The bandage is available in standard sizes: length - 3 m, width - 5 or 10 cm. The elastic bandage in this category has high strength indicators. A single flap 5 cm wide withstands a load of at least 30 kgf. The package contains 18 items wrapped in a separate label with a width of 10 cm or 36 pieces of 5 cm.
- An elastic bandage (tubular) performs the same task as its knitted counterpart. However, the elongation of the former is up to 800%. This type of bandage belongs to the category of “thermal”, which means “knitted elastic dressing”. It is made of elastomeric thread, which is braided with cotton yarn and synthetic fibers. Due to the mesh structure, fixation from an elastic bandage does not interfere with air circulation and observation of the affected area. They can have 7 different sleeve width numbers: 75, 40, 35, 30, 25, 20 and 10 mm. Weight 1 sq. m is 280 g. The use of tubular products significantly saves dressings and time spent. Their washing is carried out at a temperature of not more than 40 ° C without the use of synthetic products. Following it, rinsing in warm water is performed. Towels are used to squeeze out excess moisture. Unscrewing bandages is unacceptable.
Other products
The gauze napkin is a rectangular flap of absorbent tissue folded in two layers. The edges of the product are wrapped inward so that the threads do not come into contact with the wound. There are such products in 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. 40 gauze sterile napkins Non-sterile medium products are packed in 100 pieces. in a pack. Sterile - stacked in 10 pieces. Large non-sterile wipes are contained in an amount of 50 pcs. in one package. Sterile products of this group - 5 each. Each napkin is packed in parchment paper. The wrapper must indicate the size, quantity, name of the manufacturer and the date of manufacture.
Treatment
Sterilization of dressings is carried out at specialized factories. After that, in bacteriological laboratories they are tested for antibacteriality. The preparation of dressing material for further use is carried out for 45 minutes in a special steam boiler. Furthermore, internal temperature is 120 ° C. After that, dressing is placed in the bixes. In these metal boxes they continue to be contained. If a filter is installed in the lens, the purity of the materials is maintained for a longer period of time. In this case, at least 8-10 days.
Content Requirements
Dressings can also be stored in wooden crates 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 maintenance of sterile dressings in the warehouse, they must be laid out according to the years of the last procedure. Since after 5 years, if the integrity of the package is not broken, the material should be selectively checked for antibacteriality. If the packaging is opened or moistened, the products inside it are no longer clean.