Lecture Notes: Wound Care and Diabetic Foot Care

Introduction

• Presenter: Maris
• Focus: Wound care and diabetic foot care
• Materials: Fundamentals of Nursing flashcards (starting at card #85)

Wound Culture and Irrigation

Wound Culture

• Perform before starting antibiotic treatment to avoid false readings.
• Swab viable tissue, not eschar or slough.

Wound Irrigation

• Wear gown, gloves, and eye protection due to splash risk.
• Use a 35ml piston syringe and 19-gauge catheter or needle.
• Purpose: To clean debris without damaging skin.

Sterile Dressing Change

• Initial Dressing Removal: Use clean gloves (not sterile) from the wall.
• Setting Up: Use sterile gloves and a sterile field for cleaning.
• Cleaning Technique:
  • Start from the top or center, moving outward, using new gauze each time.
  • Avoid introducing new bacteria by not cleaning towards the wound.
• Glove Use: Sometimes sterile gloves are not indicated for chronic wounds - follow facility policy.

Removing Sutures and Staples

• Provider Order: Required before removal.
• Technique: Remove every other suture/staple to check for wound separation before complete removal.
  • Sutures: Use sterile removal kit, cut below the knot, and avoid dragging dirty suture through tissue.
  • Staples: Use a staple remover, press the center to release.

Caring for Drains

• Types of Drains:
  • Open: Penrose drain (drains freely)
  • Closed: Jackson Pratt (JP) drain, Hemovac (uses negative pressure)
• Closed Drain Care:
  • Create negative pressure by emptying and compressing before closing the drain.
  • Change dressing daily and assess site for infection.

Diabetic Foot Care

• Shoe Fit: Wear professionally fitted shoes to avoid pressure and injury.
• Foot Inspection: Daily inspection using a mirror.
• Moisturizer: Apply to feet (not between toes).
• Socks: Wear cotton, not synthetic.
• Toenails: Cut straight across; file sharp edges.
• Avoid:
  • OTC products for corns/calluses.
  • Heating pads on feet (risk of burns).
  • Soaking feet (prolonged moisture is bad).
• Water Temperature: Check with wrist/elbow to prevent burns.

Conclusion

• Wound care and diabetic foot care are essential topics in nursing.
• Encourage further study on fluid and electrolytes (upcoming topic).

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