Wound Cleansing and Irrigation


  Review physician's order for wound irrigation and type of solution.
Getting Started

   1. Assess wound characteristics and patient's level of pain and anxiety.
   2. Administer prescribed analgesic 30 to 45 minutes before irrigation.
   3. Position patient so wound is vertical to basin. Provide privacy, and expose wound.
   4. Perform hand hygiene.
   5. Apply gown, goggles, and clean gloves. Remove soiled dressing, and discard in waterproof biohazard bag with cuff near bed. Discard gloves.
   6. Prepare equipment; open sterile supplies. Apply sterile gloves.

To irrigate wound with wide opening:

   1. Fill 35-ml syringe with irrigation solution, and attach 19-gauge angiocatheter.
   2. Hold syringe tip 2.5 cm above upper end of wound over area being cleansed.
   3. Using continuous pressure, flush wound; repeat steps a through c until solution runs clear.

To irrigate deep wound with very small opening:

   1. Attach soft angiocatheter to filled irrigating syringe.
   2. Lubricate catheter tip with irrigating solution; then gently insert catheter tip, and pull out about 1 cm.
   3. Using slow, continuous pressure, flush wound. Then pinch off catheter just below syringe while keeping catheter in place.
   4. Remove and refill syringe. Reconnect to catheter, and repeat until solution runs clear.

To cleanse wound with handheld shower:

   1. With patient seated in shower chair, adjust spray to warm, gentle flow. Cover showerhead with clean washcloth, if needed.
   2. Shower for 5 to 10 minutes with showerhead 30 cm from wound.

To cleanse wound with whirlpool:

   1. Adjust water level and temperature; add prescribed cleansing agent.
   2. Assist patient into whirlpool, or place extremity into whirlpool.
   3. Allow patient to remain in whirlpool for prescribed interval.
   4. When indicated, obtain cultures after cleansing with nonbacteriostatic saline solution.
   5. Dry wound edges with gauze; dry patient if shower or whirlpool has been used.
   6. Apply appropriate dressing.
   7. Remove gloves, mask, goggles, and gown. Dispose of used equipment. Perform hand hygiene.
   8. Assist patient to comfortable position.