Integrative review of the clean and sterile technique: agreement and disagreement in the execution of dressing

Abstract

Objective: This study aimed to describe, analyze, and categorize the evidence associated to the use of the clean and sterile technique in wounds. Methods: It is an integrative literature review using Lilacs, Medline and Cinahl databases. Results: Seven publications were found,, of which four compare the clean and sterile technique, regarding the occurrence of infection; two evaluate the microbiological safety of gloves, and one analyzed the cleansing solution. Conclusion: There is consensus that the clean technique reduces costs. Considering the scarcity of studies, we stress the need to perform more level I and II research, according to the evidence hierarchy. Keywords: Asepsis; Bandages/utilization; Surgical wound infection/nursing , Sterilization/methods RESUMOObjetivo: Analisar a literatura que descreve aspectos que envolvem a técnica limpa e estéril no cuidado de feridas. Métodos: Trata-se de uma revisão integrativa da literatura, nas bases de dados Lilacs, Medline e Cinahl. Resultados: Dentre as sete publicações identificadas, quatro compararam a técnica limpa e estéril do ponto de vista da ocorrência ou não de infecção; duas avaliaram a segurança microbiológica das luvas e uma analisou a solução de limpeza. Conclusão: É consenso que a técnica limpa reduz custos. Considerando a escassez de estudos, ressaltase a necessidade de mais pesquisas de níveis I e II, segundo a hierarquia de evidências. Descritores: Assepsia; Bandagens/utilização; Infecção da ferida operatória/enfermagem; Esterilização/métodos RESUMEN Objetivo: Este estudio tiene como objetivo describir, analizar y categorizar las evidencias asociadas al uso de la técnica limpia y estéril en curaciones. Métodos: Se trata de una revisión integrada de la literatura en las bases de datos Lilacs, Medline y Cinahl. Resultados: Se tuvo un total de 7 publicaciones de las cuales 4 compararon la técnica limpia y estéril desde el punto de vista de la ocurrencia o no de infección; 2 evaluaron la seguridad microbiológica de los guantes y 1 analizó la solución de la limpieza. Conclusión: Es consenso que la técnica limpia reduce costos. Considerando la escasez de estudios se resalta la necesidad de más investigaciones de nivel I y II según la jerarquía de evidencias.

Validity of instruments used in nursing care for people with skin lesions

“…In the constitution of care guidelines for people with skin lesions, the identification of risk factors appears as a separate item of the patient history (8) Includes directed physical exam (5) No Authors refer to the performance of a complete and detailed physical examination of the person with skin lesion (8.9) When evaluating the lesion, specifies the volume, depth and width measurements (3) Yes The measurements will be specified and standardized to facilitate the implementation of the instrument Care of the wound and surrounding skin Does not describe the saline jet stream technique to clean the lesion (1) No Technique described in literature (10,11) When applying the dressing, divides the item into clean and sterile techniques (3) No We opted for the sterile technique, since the instrument will be collected in hospitals and health care units. In the environment of health care services, sterile technique should be used (10) Follow-up and guidance to people with skin lesions and their relative/caregiver Includes nutrition guidance in health education actions for people with skin lesions (1) …”

Instrument for evaluating care given by undergraduate nursing students to people with wounds

“…However, the technique described in the checklist, involving these procedures, is supported in the literature, principally in books and protocols for care of wounds (16)(17)(18)(19) . The shortage of standardized valid and reliable conducts favors use of different, divergent or conflicting practices in care of wounds by an interdisciplinary team.…”

Fundamental aspects of the local approach to cutaneous ulcers

“…The sterile technique is considered most appropriate in acute care hospital sectors for patients at risk of infection and for performing certain procedures such as mechanical and surgical debridement. 9 , 10 …”

“…These practices are most appropriate for chronic care, home care, patients with low risk of infection and patients with chronic wounds. 9 , 10 …”