SURGICAL FOMENTATION – Purpose, Preliminary Assessment, Physiologic Effects, Indications, Contraindications and Cautions, Equipment, Preparation of the Patient, Procedure and After Care
NURSING PROCEDURES LIST CLICK HERE
Application of moist heal or medication using sterile gauze, to a surgical incision or wound
Surgical fomentation is the application of a hot moist fomentation pad over an open wound under strict aseptic conditions
DEFINITION
A fomentation consists of a local application of moist heat to the body surface. A fomentation is usually made of blanket material: 50% wool to retain heat and 50% cotton to retain moisture and be more durable.
PURPOSE
- To soften extrenuates
- To hasten suppurative process
- To promote healing
- To reduce swelling
- To reduce pain
- To provide a soothing effect
- To reduce inflammation
PRELIMINARY ASSESSMENT
- Assess the general condition of the patient
- Check the physicians order
- Check the specific precautions, if any
- Check the available articles in the patients unit
- Check the consciousness and ability to follow the instructions
PHYSIOLOGIC EFFECTS
- Promotes increase in circulating white blood cells
- Increases blood flow to the skin, thereby relieving internal congestion
- Relieves muscle spasm by increasing circulation and releasing muscle tension
- Relieves pain in muscles and joints by counter-irritation and decongestion
- Reflex relieves pain from internal organs
- Increases elimination by promoting sweating
- Stimulates or sedates according to the temperature of the application
INDICATIONS
- Joint pain
- Neuralgia and neuritis pain
- Muscle tension
- Insomnia
- To warm the tissues in preparation for massage
- To prepare for cold procedures
- Active chest congestion in colds, influenza, bronchitis, pleurisy (no cold used for pleurisy)
- Nervous tension – sedative to spine
- To produce sweating
CONTRAINDICATIONS AND CAUTIONS
- Loss of skin sensation due to:
Unconsciousness
Paralysis of the part
Legs and feet of diabetic
- Leg or feet edema, varicose veins, advanced vascular disease
- Malignancy
- Tendency to bleed (hemorrhage)
- Stomach or bowel ulcers
- Omit cold in extreme pain such as pleurisy, renal colic and dysmenorrhea
EQUIPMENT
- Small dressing pack
- Kettle with water heated to 105 – 115 degree F (42-46 degree celcius)
- Solution needed for compress magnesium sulfate, normal saline
- Mackintosh
- Plastic bag
- Dressing drum
- Pad drum
- Adhesive and scissors, if required
- Lotion thermometer
PREPARATION OF THE PATIENT
- Explain the procedure to the patient
- The dressing change is scheduled for a suitable time
- If the patient is an open unit the curtains are drawn to ensure the privacy
PROCEDURE
- Collect equipment
- Explain procedure and purpose to patient
- Provide privacy and drape patient
- Put-off fan
- Wash hands
- Open dressing pack
- Pour solution into cup and cover pack with one corner of wrapper
- Check the temperature of water after pouring into bowl, using lotion thermometer
- Wash hands again
- Open sterile dressing pack
- Using artery clamp, well and remove remaining adrenal gauze
- Remove used clamp from sterile field
- Place cup with solution into steel bowl of warm water using artery clamp
- Take sterile gauze and soak in solution using thumb forceps and artery clamp squeeze excess solution form gauze pieces into cup and place in wound, after checking patients heat tolerance repeat this procedure for about 15 minutes using fresh gauze, each time allow the next gauze to soak in solution until first one or provides gauze is removed from wound and is disposed into plastic bag. Press wound if needed
- Keep the patient comfortable
- Replace the equipment
AFTER CARE
- Keep patient comfortable
- Replace the articles
- Record procedure, wound condition solution used and patient response
