HHC Health & Home Care Clinical Policy And

HHC HEALTH & HOME CARE Section: 7-14
Skin Care: Transparent Film Application __RN
PURPOSE:
To illustrate application techniques and selection of
candidates for this specialized dressing.
CONSIDERATIONS:
1. There are several transparent, semipermeable
membrane adhesive dressings on the market.
2. This type of dressing is valuable for second-degree
burns, abrasions, intravenous therapy sites, and
pressure ulcer care.
3. The advantages for this type of dressing are:
a. The dressing reduces the need for frequent
changes and may remain in place until the
wound is completely healed in many instances.
b. The wound can be inspected through the
transparent dressing.
c. The dressing retains the serous exudate, keeps
the wound moist, and hastens healing.
d. The dressing does not adhere to the wound's
surface.
e. The dressing may be applied over a joint
without reducing mobility.
f. Bathing and showering is permitted without
removing the dressing.
h. The dressing may be used on bony
prominences and other areas, prophylactically,
to prevent skin breakdown.
4. The disadvantages of this dressing are:
a. May not be recommended for infected wounds.
b. Not recommended for wounds with moderate to
heavy drainage.
c. Not recommended for use on fragile skin.
d. May be difficult to apply and handle.
e. May dislodge from high-function areas.
f. Requires a margin of intact skin to adhere.
5. This dressing may be used as a secondary dressing
with largely exudating wounds.
EQUIPMENT:
Gloves
Skin protectant (optional)
Transparent film
Hypoallergenic tape (optional)
Scissors
g. The dressing affords pain relief.
Impervious trash bag
Normal saline
PROCEDURE:
1. Adhere to Universal Precautions.
2. Explain procedure to patient.
3. Assemble necessary equipment at the bedside.
4. Thoroughly cleanse area and clip the hair (optional)
within 2 inches (5 cm) of the site. Apply skin
protectant, if desired, e.g., Skin Prep®, and allow to
dry.
5. Measure the burn/wound and choose the correct
dressing size. Apply the transparent film, leaving
1.5 to 2 inches (3.8 to 5 cm) around the burn/wound
site to ensure total coverage. Do not stretch the
dressing, because a stretched dressing restricts
mobility and may cause discomfort.
6. Follow manufacturers guidelines for use and
application of dressing.
7. As you apply the dressing, explain its advantages to
the patient and explain why the patient should not
remove it.
8. To apply dressing on a contoured area on the body.
The dressing can be overlapped up to three times
and still remain semi-permeable.
9. Care should be exercised when applying the semipermeable
dressing on the coccyx or other area to
consider whether feces or urine can contaminate
the wound. The dressing can, even if properly
applied, become loosened and subsequently
become contaminated.
10. If fluid accumulates under dressing consider using
absorptive dressing (e.g. Alginate) under film to
allow dressing to remain in place longer.
11. Replace dressing when it leaks or every 3-7 days.
12. Discard soiled supplies in appropriate containers.
AFTER CARE:
1. Document in patient's record:
a. Patient's response to the procedure.
b. Temperature and vital signs.
c. Wound appearance including size, drainage,
and odor.
d. Response of the wound to the prescribed
regimen.
2. Instruct patient/caregiver in wound care, including:
a. Reporting signs or symptoms of infection
including pain, change in color, amount or
character of drainage, or elevated temperature.
b. Exercising caution to not remove or disturb
dressing.
c. Leaking of dressing.
d. Diet to promote healing.
e. Dressing on an open wound will produce thick,
sometimes foul-smelling drainage and this is
not necessarily a sign of infection.
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