DRESSING MATERIAL — the material used at operations and bandagings for drainage of a surgery field and a wound, a tamponade of a wound for the purpose of a stop of bleeding and drainage for imposing of bandages, and also for protection of a wound and the burned surface against secondary infection and damages. The bandage made of P. by m, packages, bandages, napkins, balls and other products, ready to use, are called dressing means.
The item of m is applied in medicine long ago, before everything bandage, images appeared to-rykh reached us in ancient drawings. In the subsequent along with bandage began to make napkins and a lint from linen and cotton, the Crimea at the end of 19 century the gauze succeeded.
For the first time scientific justification to lay down. properties P. of m M. Ya. Preobrazhensky in the doctrine about physical antiseptics gave (see. Antiseptics ). To them it was shown that P. the m thanks to hygroscopicity actively sucks away a wound secret from wounds, evaporates water, detains microbes and toxins, reducing intoxication of an organism.
The main requirements to P. of m are: harmlessness for an organism, the sufficient durability and elasticity, high hygroscopicity, ability it is good to evaporate water, to maintain sterilization and not to collapse at contact with wound separated and the pharmaceuticals used at treatment of wounds, low cost and simplicity of production.
Modern surgeons apply many P. the m made of natural and synthetic materials. Are most widespread gauze (see) and cotton wool (see). Make of a gauze various sizes bandage (see), and also dressing means for use during operations and bandagings (napkins, tampons, turundas, balls). Napkins represent the rectangular or square pieces of a gauze curtailed so that the cut edges of fabric formed during the cutting were removed in a napkin. Small napkins use for drainage of wounds, average and big — for protection of a surgery field against an external infection, against flowing of blood and the infected contents during the opening of phlegmons, abscesses, noly bodies, etc. The sizes of napkins can vary depending on width of a piece of a gauze. Tampons — strips of a gauze up to 10 cm wide, up to 50 cm long — are applied to a stop of bleeding by method of a tamponade, and also to drainage of purulent cavities, etc. Are made as well as napkins. Turundas — long narrow tampons (width of 2 — 3 cm, length of 10 — 15 cm) — do of bandage, and sprain edges of bandage inside, and bandage is put on length by 4 times; are applied to drainage of narrow deep wounds. Balls — the pieces of a gauze (.priblizitelno 10x10 cm) curtailed into 3 layers put by a corner; • The remained ends are sprained in a ball. Balls apply to drainage of wounds, processing of skin.
Vatu together with a gauze use in the form of wadded and gauze balls (the lumps of a purified cotton wrapped in a gauze) for carrying out a toilet of skin around a wound; in the form of the prepared in advance wadded and gauze compresses (strips of a gauze, between to-rymi the layer of cotton wool is laid) for closing of the sewn-up wound and as a part of the bandages applied with protective and the warming purposes when between strips of a gauze the layer of compresseal cotton wool is laid. The industrial enterprises sterile wadded and gauze small pillows the sizes 25x25, 15x15, 10x10 cm, a medical wadded and gauze tape of 200x29 cm in size, a wadded tape from compresseal cotton wool of 200 X 32 cm in size, etc. are issued.
Along with cotton wool for the same purposes use a lignin (artificial cotton, wood cotton wool), the bleached viscose rayon and some other materials. Lignin — the sheets of thin, friable paper with a crumpled surface made of wood fibers; possesses a high capillarity and a sufficient absorbing capacity. A lack of a lignin is that at a namokaniye it loses durability and creeps away, and in a dry form maloprochen, very withdrawal pains.
The bleached viscose rayon — substitute of cotton fibers — in medical practice is used in mix with cotton wool from cotton. On hygroscopicity and thermal characteristics this material concedes to cotton wool from cotton a little, has smaller firmness to a nek-eye to the pharmaceuticals applied during the bandagings, higher inflammability, and also bad portability by nek-ry patients (isolated cases of irritation of skin are registered).
In a particularly complex situation of wartime at P.'s lack of m for bandagings incidental materials in the form of the small pillows sheathed by a gauze filled granulezy (the black crumbling weight made of crude cotton), by a lint, a moss, peat, wood charcoal, asbestos, jute, etc. can be used.
P. is widely applied by m from synthetics, to-ry in addition to necessary physical properties possesses medical. So, P. is issued the m from the smooth polymeric threads covered with the soaking-up layer to-ry does not stick to a wound and well influences the current of a wound process; self-adhesive bandages, napr, cling operational films. Nek-ry films contain pharmaceuticals — antiseptic agents, haemo statics, the immobilized enzymes, etc.
M receive antiseptic P. by impregnation of a gauze Furacilin, synthomycin, biomycin, an iodoform, corrosive sublimate, Dermatolum, etc. Apply to treatment of superficial wounds, grazes adhesive plaster (see), bactericidal adhesive plaster, and also bactericidal paper (see).
Of m the gauze and cotton wool, impregnirovanny iron or polutorakhloristy trichloride, a gauze from an oxycellulose, a fibrinny film belong to haemo static P. (see. Fibrinnaya sponge, film ), etc.
Apply a first-aid dressing kit to rendering the first medical aid (see. Package dressing individual ), packaging to-rogo allows is long to keep sterility of the prisoner of P. of m in it.
For P.'s fixing m on a wound use gauze bandage and bandage from wet-strength krepirovanny paper, a kerchief, an adhesive plaster, kleol, and also knitted tubular bandage, bandage from a nonwoven glued cloth, elastic tubular rollers, bandage from a severe cotton and latex thread, an obkruchenny cotton, etc.
These bandage are produced the different sizes, each of to-rykh is intended for the corresponding part of a body (see. Desmurgy ).
In medical practice the ready sterile dressing means released by the industrial enterprises are eurysynusic: sterile small bandages with a vatnomarlevy small pillow of 29 X 56 pieces in size and big with a small pillow of 43 X 67 cm in size, primary burn bandages from the metallized material, sterile bandages from a nonwoven glued cloth, the facilitated bandages for bandaging of patients with burns, sterile gauze napkins with the sizes of 16 X 14 cm and 45 X 33 cm, the bandage, cotton wool and other P. of m imprisoned in the close packing ensuring safety of sterility a long time, and also unsterile P. of m to-ry before the use it has to be sterilized (see. Sterilization ).
P.'s sterility of m in the steam sterilizer remains to 3 days; P.'s sterility of the m which underwent autoclaving in fabric multilayer packagings — to 4 days. The gauze and cotton wool can maintain sterilization in the autoclave to 3 — 4 times. For a rational and economical expenditure the repeated use of P. of the m after pure operations (bandagings) which underwent the corresponding processing by disinfecting solutions and washing is recommended; The Item of m used at purulent operation (bandaging) is subject to burning. M will sterilize synthetic P., as a rule, industrially. At safety of hermetic packaging these materials can be stored a long time.
Bibliography: Daurova T. T., etc. Influence of structure of dressing materials on regeneration of wounds, Surgery, No. 5, page 100, 1980; To and with with and V. Yu. N, etc. Experience of use of a new dressing material at treatment burned, Owls. medical, No. 3, page 109, 1978; The Reference book of the instrument and dressing nurse, under the editorship of B. D. Komarov, page 77, etc., M., 1976; V. I Pods. General surgery, page of t 61, M., 1978; Fedosova A. F. and Vashkov V. I. Research of new (antiseptic) drugs for treatment of a dressing material, the Works Center. nauch; - issled. disinfection in-that, century 9, page 59, M., 1956; H u e b n e r G. D. a. Older-m a n G. M. Wood fiber contamination of reusable cotton laparotomy pads, Surg. Gynec. Obstet., v. 148, p. 887, 1979.
V. A. Sakharov.