Cleaning the bed sore has to be done from?

RUHS, Jaipur, M.Sc Nursing Entrance Exam-2018

Fundamental of Nursing

Easy

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2018

Explanation

The correct procedure for cleaning a bed sore is from the inner aspect to the outer aspect.
This method follows the core principle of asepsis: cleaning from the least contaminated area (the wound bed) to the most contaminated area (the surrounding skin).
This action prevents the introduction of microorganisms from the skin into the wound, which could cause infection and delay healing.
Each cleaning stroke should be done with a new piece of sterile gauze to avoid re-contaminating the wound.

Option B: Cleaning from outer to inner would drag bacteria and debris from the surrounding skin directly into the wound bed.
Option C: The position of the caregiver is irrelevant to the principles of infection control. Cleaning should always follow the 'clean to dirty' rule, regardless of where the caregiver is standing or sitting.
Option D: Cleaning the entire surface at once is an unsystematic approach that would spread contaminants all over the wound and surrounding skin, significantly increasing the risk of infection.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Aseptic technique for wound care, specifically for pressure ulcers (bed sores) as background academic context rather than a clinical decision trigger.
Proper wound cleaning technique is a critical nursing skill to prevent healthcare-associated infections (HAIs), which can lead to complications like delayed healing, sepsis, and increased hospital stays.
Failure to follow aseptic principles during wound care can introduce harmful bacteria, leading to local infection or systemic illness, which is particularly dangerous for immunocompromised or debilitated patients.
What if? If the wound had a drain, the principle would still be 'clean to dirty'. You would clean the incision line first (inner to outer), and then clean around the drain site with separate swabs, moving in circles from the point of insertion outwards.

How to Approach the Question

Identify the core task in the question: 'Cleaning the bed sore'.
Recall the fundamental principle of medical asepsis for cleaning procedures: move from the least contaminated area to the most contaminated area.
Apply this principle to a wound. The wound bed itself is considered less contaminated than the surrounding skin, which hosts a variety of resident microorganisms.
Therefore, the correct motion is to start at the center (inner) and move away from it (outer).
Evaluate the options to find the one that matches this principle: 'Inner to outer'.

Concept Tested & Keywords

Concept Tested: Aseptic technique for wound care, specifically for pressure ulcers (bed sores).
Stem keywords: Cleaning, bed sore
Lead-in keywords: has to be done from

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