Dressing material is a first aid tool. The history of its origin can be traced back to very ancient times. Approximately in 460-377. BC e. (at the time of Hippocrates), in order to firmly fix the dressing, they used an adhesive plaster, various resins and canvas. And in 130-200 years. BC e. Roman physician Galen created a special manual. In it, he described various bandaging techniques.
Development history
The use of dressings received the first wide resonance thanks to the decision of the Roman Senate. It said that each soldier should be given a strip of linen, 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 in prehistoric times. For this purpose, one could useleaves and grass, because they have such qualities as flexibility, softness, elasticity and smoothness of the cover. Some of the plants have healing properties and even pharmacological effects, such as astringent and analgesic effects.
It is also worth noting that certain plants are used in traditional medicine for dressing to this day. Among them: baked onions, plantain and many others. The dressing material reached its peak in its development during the times of capitalist production. In the period from 1476 to 1492, the adhesive bandage received wide publicity in Europe. In the 18th century and until the first half of the 19th century, the absorbent action of the products was of particular importance. The production of dressing material was carried out using raw materials with high capillarity. For example, linen and hemp hemp, as well as lint (cotton rags torn on a thread). From the second half of the XIX century. gauze, absorbent cotton and lignin were used instead.
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.
- Medical pads.
- Medical gauze wipes.
Compared to past years, the modern choice of dressings has become noticeably richer. This was largely facilitated by the large-scale development of pharmacological production on the territory of our country.countries, as well as mass imports of foreign products to the domestic market.
Classification by purpose
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 bandages can be distinguished:
- To close the wounded surface. For this, napkins, a bactericidal plaster, wound dressings, etc. are used.
- For limb compression or joint fixation.
- For fixing the dressing.
- Compression coatings.
A mandatory requirement for any type of dressing to close a wound is sterility.
Product Features
The production of dressings has stepped to a new stage of development thanks to the emergence of modern technologies. As a result of their application, 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 problems:
- Achieve high antimicrobial activity.
- Long duration.
- High absorbency combined with good breathability, optimal wetting rate and capillarity.
- Atraumatic.
- Antimicrobial resistancetreatment of funds under conditions of radiation and steam sterilization.
What to choose: traditional or modern dressings and products?
In fact, this question is only rhetorical. The use of modern materials in medicine creates favorable conditions for faster wound healing. This, in turn, insures against the appearance of scarring on the wounded surface. The reason for their occurrence is often the long-term closure of the wound with traditional dressings.
As for the price issue, the difference in cost between modern and old materials is quite noticeable. It is this argument that is sometimes advanced in favor of the latter. However, when it comes to human he alth, cost is not always the decisive factor for making a choice. In addition, as practice shows, the use of modern medical materials is more cost-effective compared to 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 using cotton-gauze dressings:
- The fuzzy structure causes material particles to enter the wound. They cause tissue irritation and prevent its speedy healing.
- Gauze is a fine-mesh material with high 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 andvapor permeability under the bandage. This is especially true when applying several layers. At the same time, the process of epithelialization and granulation of the wound is delayed, and as a result, the period of its healing becomes longer.
- Adhesion, or more simply sticking, is another disadvantage of using gauze bandages. The fact is that, impregnated with wound secretions, they harden when dried. Granulation of the wound occurs through the dressing, resulting in a new injury to the surface and pain during removal. At the same time, the surrounding skin also suffers. Damage to it also causes pain and slows down the overall healing process.
- Cuts and napkins are usually supplied in several pieces per pack. When it is opened, only the first remains without microbes. While others lose this quality.
- To increase absorbency and give the desired size, gauze has to be cut and then folded into several layers. This procedure violates antimicrobial properties and causes some inconvenience to the patient.
- In order to fix the cotton-gauze bandage on the wound, it is necessary to use an auxiliary fastening. This leads to unnecessary spending and requires additional manipulations.
Thus, the use of conventional, traditional materials causes a long wound healing process. A good alternative is modern devices that are devoid of all the shortcomings that are described above. Advanced dressings are atraumatic, highly absorbent coatings. Their fixation occurs independently with the help of a hypoallergenic adhesive composition.
The advantages of modern products
- The dressings have a non-woven or transparent film backing that allows you to monitor the progress of wound healing.
- Water resistant is another plus. The patient has the opportunity to take water treatments without the risk of water entering the wound.
- Secure hold.
- Modern dressings 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 on its own and does not require the use of additional tools.
- There is a sorbent atraumatic swab that collects wound exudate.
- The applied dressing reliably protects the wound from secondary infection and mechanical irritation.
- Hypoallergenic composition.
- High air and vapor permeability prevents maceration.
- Modern dressings are ready to use and require no preparation.
- Antibacterial.
- The package is easy to open.
Medical fabric
Gauze is a canvas with a rare, grid-like structure. There are two types: harsh and bleached hygroscopic. They, in turn, are further divided into two different types: pure cotton and with the addition of viscose staple fabric (inratio of 50% cotton to 50% viscose or 70% cotton to 30% viscose). Their main difference is as follows: cotton gauze absorbs liquid within 10 seconds, while gauze with viscose impurities does the same in 60 seconds, 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 to cotton gauze, the viscose analogue retains drugs worse. Also, after repeated washes, the suction capacity decreases. According to the criterion of strength, cotton dressing material 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 is subject to the same requirements as cotton wool. The fabric is produced in standard sizes of the canvas: 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. Each is 10 m long and 90 cm wide. Like cotton, the gauze is tested for wettability (absorbency), neutrality and capillarity.
Progress of fabric suitability tests
- In order to test wettability, the immersion method is used. To do this, a sample of hygroscopic gauze measuring 5 x 5 cm is lowered onto the surface of the water. According to the prescribed norms, it must be immersed in water for 10 s without contact with the walls of the vessel. A sample of hard gauze needs to do this in 60 seconds.
- To check the dressing for capillarity, a strip of cloth about 5 cm wide is lowered at one end into a special Petri dish filled with eosin solution. The sample is considered to have passed the test if the solution rises from the liquid level by at least 10 cm within 60 minutes.
Special fabrics
There are two categories of gauze that have a specific action. It is hemostatic and hemostatic.
- Hemostatic dressing is obtained by processing ordinary gauze with nitric oxides. The resulting tissue not only stops the blood, but is completely absorbed in the wound within a month. Looks like 13x13 cm napkins.
- Hemostatic tissue. It contains the calcium s alt of acrylic acid. It also stops the blood (on average, 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.
Do-it-yourself gauze bandage
First of all, before you start manufacturing, you need to decide on its future size. A standard bandage, which is sold in pharmacies, has a length of no more than 15 cm and a height of 5 cm. If the product is intended for a child, then its dimensions depend on the age of the patient. For example, for babies under 6 years old, a 10 x 4 cm bandage is suitable, but for a ten-year-old child, you canuse the adult version. In order to sew the product on your face yourself, you will need:
- A piece of absorbent fabric measuring 17 x 7 cm - 4 pieces
- Strip 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 are prepared, you can start making a gauze bandage. The following is a progress report.
- You need to take a strip of bandage and roll it into 3 layers.
- Then sew along the edges with a sewing machine or by hand with a fine stitch.
- Repeat with the second bandage.
- After this, the workpiece should be put aside for a while and deal with gauze cuts. Four flaps must be joined together and sheathed along the entire length.
- Then the edges of the resulting rectangle must be tucked inward by a centimeter and stitched again.
- Now that you have prepared all three parts, they need to be assembled into a single bandage. To do this, along the fabric rectangle, you need to sew both ties: one on top and the other on the bottom side. This is how a do-it-yourself gauze bandage is made.
Stretch fixing products
- Elastic bandage used for fixation. It is made from coarse cotton yarn. Strict requirements are imposed on the stretching of the bandage - it must be at least 50%. A bandage is produced in standard sizes: length - 3 m, width - 5 or 10 cm. An elastic bandage of this category has high strength indicators. A single flap 5 cm wide withstands a load of at least30 kgs. The package contains 18 individually labeled pieces 10 cm wide or 36 pieces of 5 cm.
- Elastic bandage (tubular) performs the same task as its knitted counterpart. 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 from an elastomeric thread, which is braided with cotton yarn and synthetic fibers. Thanks to the mesh structure, the fixation of the elastic bandage does not interfere with air circulation and observation of the affected area. Available in 7 different sleeve widths: 75, 40, 35, 30, 25, 20 and 10mm. 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 not exceeding 40 ° C without the use of synthetic products. It is followed by a rinse in warm water. To squeeze out excess moisture, towels are used. Twisting bandages is not allowed.
Other products
Gauze pad is a rectangular piece of absorbent fabric folded into two layers. The edges of the product are wrapped to the inside 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 pcs. in one pack. Sterile gauze wipes are folded in 40 pieces. Non-sterile medium products are packed in 100 pcs. in a pack. Sterile - stacked in 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. The wrapper must indicate the size, quantity, manufacturer's name and date of manufacture.
Processing
Sterilization of dressings is carried out at specialized factories. After that, in bacteriological laboratories, they are tested for antibacteriality. Preparation of the dressing for further use is carried out within 45 minutes in a special steam boiler. The internal temperature is 120°C. After that, the dressing material is laid in the bix. They continue to be contained in these metal boxes. If a filter is installed in the bix, the purity of the materials is maintained for a longer period of time. In this case - at least 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 are allowed to be kept in an unheated room. However, the temperature must be stable, without fluctuations. Also, dampness and the formation of fungi and mold should be avoided in it. 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 packaging is notbroken, the material should be selectively tested for antibacterial properties. If the packaging is opened or wetted, the items inside are no longer clean.
