Thus, bacterial transmission can be kept to a minimum during wound treatment if a wound dressing is removed initially using a sterile bag and non-touch technique. The idea initially penned by Lister is that bacteria are the causative agents of infection. The authors concluded that the use of clean technique for acute wound care is a clinically effective intervention and does not affect the incidence of infection, and that there is no recommendation regarding the ideal dressing technique for chronic wounds due to lack of evidence in the literature ( Kent et al, 2018).Īseptic technique aims to produce an environment that is free of microbial contamination to protect patients from developing infections ( Marcovitch, 2005). Therefore, the findings were not generalisable or conclusive. However, the studies varied greatly in size, and the wounds were found not to be representative of those clinically encountered. These four studies reported no significant difference in the rate of wound infection between the clean or aseptic technique with dressing application ( Kent et al, 2018). Some 473 articles were examined, and four research studies met the inclusion criteria as identified via a systemic approach. They looked into all wounds, chronic and acute. Kent et al (2018) performed a literature search to examine the evidence and provide recommendations on whether the clean or aseptic technique is most effective in preventing wound infection when changing wound dressings. Sterile packing should still be applied, as well as a sterile dressing, but clean technique would generally apply in this case, which is more appropriate for the cleansing of a heavily exuding wound Thus, it is appropriate, for example, for patients who are not at high risk for infection and for patients who require routine dressings for chronic wounds such as venous ulcers, or wounds healing by secondary intention with granulation tissue ( Wooten and Hawkins, 2001 Kent et al, 2018). This is especially true in the case of large wounds that require many dressings, including packing of the wound for heavy exudate. Clean technique is considered most appropriate for long-term and home care, and so is applicable most commonly as the most aseptic way of changing a dressing in community nursing practice. Wound dressings would be opened onto the sterile field in a sterile-to-sterile technique. Minimal transference is used in both cases, where gloves do not repeatedly go from the wound or patient, back to a sterile pack and then back again to the wound. The sterile-to-sterile policy means that only sterile gloves that are clean and new out of their packet can be used before touching any sterile surface. Clean technique would involve clean hands and clean-but not necessarily sterile-latex gloves. This means that sterile technique requirements, such as wearing clean sterile gloves before touching any sterile surface, for example, a dressing field, do not apply. The main difference between the two is that, unlike aseptic technique, clean technique does not require ‘sterile-to-sterile’ ( Rowley et al, 2010). The technique involves care delivery using methods that prevent the transmission of microorganisms, such as by meticulous handwashing maintaining a clean environment by preparing a clean field using personal protective equipment, such as clean gloves and sterile instruments and preventing direct contamination of materials and supplies. On the other hand, clean technique is a slightly less sterile technique, but the term still indicates free of dirt, marks or stains. The term ‘aseptic technique’ means free from pathogenic microorganisms and is the deliberate prevention of the transfer of organisms from one individual to another by keeping the microbial count to an irreducible minimum ( Rowley et al, 2010).
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