Wound Care: Evaluating the Safety of Clean Dressing Technique for Surgical Wounds

This article evaluates the safety of clean dressing technique for surgical wounds and compares it with sterile dressing technique. It discusses the effectiveness, cost, and risk of infection associated with clean dressing technique.

Running head: WOUND CARE
Name of the student:
Name of the university
Author note:

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Introduction:
The wound dressing is a dynamic and complex technique process which requires a
suitable environment to promote the healing process (George 2017). A research question helps
researchers to focus on specific issues by providing a direction of working towards supporting an
arguable thesis. In order to formulate a research question, in-depth evidence-based research has
been conducted focusing on specific issues. It was often observed that in the surgical setting,
while a considerate number of nurses use the sterile method of dressing, few nurses’ use cleaning
dressing technique. Hence, to evaluate whether the clean dressing technique is safe for dressing
surgical wound or not, in-depth systematic review has been conducted. To gain the answer of
the research question: is cleaning wound dressing a safe option for dressing surgical wound??
The electronic databases such as CINAHL, Medline and PubMed have been used since
provided the opportunity to investigate the safety of clean dressing fir dressing surgical wounds.
The key terms used for searching include, “ Clean wound dressing “, “ safety of clean wound
dressing and “ comparison between sterile and clean dressing technique in surgical wound
dressing “.
The rationale behind choosing journals:
Journals Level of evidence Reliability Research design
1. Ding et al.
(2017)
Level 2 Provided gap in
clinical practice for
dressing wound.
Cross sectional
prospective study
2. Huang et al.
(2016)
Level 2 Compared sterile and
clean dressing
Prospective cohort
study

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technique which is
appropriate for
addressing the
research question.
3. Kent et al.
(2018),
Level 3 Study provided the
in-depth
understanding of
whether this kind of
infection would be
appropriate or not
Systematic review
4. Lin et al.
(2019)
Level 3 semi‐structured
individual interviews
was conducted
Ethnographic study
5. Khudhair,
A.S., 2018.
Level 4 Descriptive study Descriptive study
Discussion:
Ding et al. (2017) conducted a cross-sectional descriptive study where researchers
recruited 60 nurses from four surgical units from different hospitals in order to gain the
understanding that whether clean wound dressing is effective or not in the wound care process of
the surgical wound. The result suggested that the standard practice guideline recommend the
sterile dressing technique, especially for surgical wound. The clean wound dressing is especially
for dry wounds. It was observed that majority of the nurses are unable to adhere to the standard

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guideline of wound care and consequently, they did not use proper sterile gloves or aseptic
technique which further promoted the surgical site infection. In order to reduce the infections, the
nurses are required to adhere to the sterile techniques. However, on the other hand, Another
Prospective cohort study conducted by Huang et al. (2016) suggested that there is no significant
difference between the sterile wound dressing technique and clean dressing techniques. The
findings highlighted that the cost of sterile dressing technique is higher compared to the cleaning
dressing technique. However, a study also highlighted that the safety of the technique heavily
relies on the immunity of patients. Researchers stated that while there is no significant difference
between the technique in term of safety for adult patients, patient safety may be affected by
pediatric patients. Kent et al. (2018 ) conducted a systematic review of the study 4 studies using
john Hopkins nursing evidence-based practice nursing research appraisal tool. The research
suggested that although there is no relation between occurrence wound infections and cleaning
dressing techniques, sterile dressing technique is proved to be a better technique for reducing the
risk of wound infection during the dressing. Lin et al. (2019) conducted an ethnographic study
where researchers conducted a semi-structured interview on 20 participants and analyzed
existing policy for gaining the understanding of the efficacy of the clean dressing technique. The
researcher highlighted that a considerate number of nurses lack the education of evidence-based
practice which further increases the risk of surgical site infection and accounts for 30 % of
surgical site infection. The process does not follow “sterile to sterile” rules; rather use vigorous
hand washing, maintaining a clean environment for the study. Hence in order to produce
although a significant number of nurses use sterile techniques, clean dressing technique used by
surgical nurses along with not follow proper hand hygiene regimen increases the bacterial
transmission which further increases the risk of surgical site infection. Khudhair, (2018)

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conducted a descriptive study where researchers highlighted that for post-operative wound care,
using clean dressing technique increases the risk of infection since it does not follow “sterile to
sterile” rules and it increases the contamination from debris, and pus. The researchers suggested
that the main aim of wound dressing is to promote tissue repair as well as regeneration of tissues
of skin for recovering skin integrity. Clean wound dressing remove debrides from the wound and
places a protective cover to prevent laceration. Hence, in order to improve quality of wound care
and reduce the risk of surgical site wound infection, it is crucial to use sterile dressing technique
for surgical wound using different sterile instruments and using sterile to sterile rule. Appropriate
education and adherence to the standard practice is required in this case.
Conclusion:
In a concluding note, it can be said that clean dressing techniques mainly focused on
strategies used in patient care to reduce the overall number of microbes in order to prevent the
infection. Cleaning technique is cheap and effective for long term home care or in some clinical
setting for patients who are not at higher risk of infection. Although many researchers
documented that there is no significant difference between techniques and occurrence of
infection depend on the immunity of patient, clean washing techniques use hand washing and
clean environment without application of sterile to the sterile rule which is applied in the sterile
techniques. Clean dressing technique increases bacterial contamination and associated infection.
Hence in order to provide safe and responsive care to the patient, it is crucial to use sterile
techniques using sterile instruments or equipment’s and sterile to sterile rule. The proper
education of standard practices is required to provide to the nurses for improving quality of care.

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References:
Ding, S., Lin, F., Marshall, A.P. and Gillespie, B.M., 2017. Nurses' practice in preventing
postoperative wound infections: an observational study. Journal of wound care, 26(1),
pp.28-37.
George, M.D., 2017. Improving wound dressing techniques and infection control through
support from International Non-Governmental Organizations in Sub-Sahara
Africa. Asian Journal of Research in Medical and Pharmaceutical Sciences, pp.1-8.
Huang, X.L., Zhang, J.Q., Guan, S.T. and Liang, W.J., 2016. Comparison of sterile and clean
dressing techniques in post-operative surgical wound infection in a chinese healthcare
facility. Tropical Journal of Pharmaceutical Research, 15(2), pp.415-419.
Kent, D.J., Scardillo, J.N., Dale, B. and Pike, C., 2018. Does the Use of Clean or Sterile Dressing
Technique Affect the Incidence of Wound Infection?. Journal of Wound, Ostomy and
Continence Nursing, 45(3), pp.265-269.
Khudhair, A.S., 2018. Nurses Practice Concerning Postoperative Clean Wound Dressing. Indian
Journal of Public Health, 9(6), p.252.
Lin, F., Gillespie, B.M., Chaboyer, W., Li, Y., Whitelock, K., Morley, N., Morrissey, S.,
O’Callaghan, F. and Marshall, A.P., 2019. Preventing surgical site infections: Facilitators
and barriers to nurses’ adherence to clinical practice guidelines—A qualitative
study. Journal of clinical nursing, 28(9-10), pp.1643-1652.

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