Follow-up evaluations have revealed that some postoperative patients develop wound infections after surgery or medical procedures. These infections are often caused by a lack of knowledge or experience in wound care, especially in managing foot wounds—whether by patients themselves or their caregivers. Improper wound cleansing can lead to severe complications, prolonged recovery, increased anxiety, and in severe cases, limb loss due to uncontrolled infections.
To minimize the risk of infection and prevent further complications, proper wound cleaning is essential.
Types of Wound Cleaning
- Dry Wound Cleaning
Used for clean, closed, non-inflamed wounds or small superficial wounds. - Wet Wound Cleaning
Applied to open or infected wounds. The initial dressing typically involves moist materials such as saline-soaked gauze (0.9% normal saline), followed by dry gauze for secondary coverage.
Objectives of Wound Cleaning
- To create an optimal environment for tissue regeneration
- To absorb wound exudate, such as blood, lymphatic fluid, or pus
- To limit movement and stabilize the wound area
- To maintain moisture on the wound surface
- To prevent the dressing from sticking and damaging newly formed tissue
- To protect the wound from external trauma
- To prevent contamination from urine, feces, or other impurities
- To aid in hemostasis (bleeding control)
Wound Cleaning Equipment
Sterile wound care kits typically include:
- Non-toothed and toothed forceps
- Sterile cups or containers
- Cotton balls, gauze pads
- Antiseptic solutions such as povidone-iodine or other physician-recommended disinfectants
- Normal saline (0.9% sodium chloride) for cleaning
- 70% alcohol for cleansing the skin around the wound and dressing (not always required for all wound types)
Dry Wound Cleaning Procedure
- Remove the dressing by folding the side that contacts the wound inward and discard it in a disposal container.
- Open the sterile dressing kit and use proper technique to handle the forceps—one pair with your hand, the other passed using the first pair of forceps (or use sterile gloves if available).
- Using the non-toothed forceps, pick up alcohol-soaked cotton (about two-thirds damp) and hand it to the toothed forceps.
- Clean the skin around the wound by wiping outward in a circular motion, about 2–3 inches from the edge. Discard used cotton without allowing the forceps to touch the container.
- Cover the wound with sterile gauze and secure it with adhesive tape across the body contour.
Wet Wound Cleaning Procedure
- Remove the top dressing by hand and discard. Use toothed forceps to remove any dressing stuck directly to the wound.
- If gauze is dry and adhered to the wound, soften it with saline-soaked cotton to ease removal and protect healing tissue.
- Clean the wound edges using the same method as dry wound care.
- Use saline- or antiseptic-soaked cotton to clean inside the wound until thoroughly cleansed.
- Insert antiseptic-soaked gauze into the wound to control infection, absorb discharge, and maintain moisture.
- Apply sterile gauze and cotton padding according to wound size, then secure with tape across the body.
Special Consideration for Diabetic Foot Wounds
Wound care for diabetic patients depends on wound classification. Post-surgical wounds are typically considered clean wounds. However, wounds with pus, inflammation, redness, swelling, or necrotic tissue must first be medically debrided and cleaned. If no signs of infection remain, these are also classified as clean wounds.
General Wound Care Guidelines
- Avoid getting the wound wet. If the dressing becomes soaked, replace it immediately.
- Consume a balanced diet with all five food groups, providing adequate fluids, protein, vitamins (A, C, E), and minerals to promote tissue repair and wound healing.
- If you experience itching or allergic reactions to adhesive tape, switch to a different type. Do not scratch the area, as this may cause skin damage, infection, or wound enlargement.
- Seek medical attention if the wound becomes swollen, red, or increasingly painful.
Proper wound care is a vital part of recovery. When done correctly, it reduces complications, promotes faster healing, and prevents infection-related consequences. Always follow medical advice and consult healthcare providers for any unusual symptoms or concerns.
