Introduction
A surgical soak is a therapeutic procedure involving the immersion of a body part—typically an arm, leg, or wound site—into a sterile solution to promote healing, reduce discomfort, and prepare the area for further treatment. It is often used in wound care, especially for infected or ulcerated areas, and must be performed using strict aseptic technique.
Definition
Surgical soak is the therapeutic submersion or direct immersion of a body part or wound in a warm medicated solution using sterile technique.
Purposes for Surgical Soak
- To promote wound healing by increased circulation.
- To relieve discomfort, pain, and edema.
- To relieve congestion and crust formation.
- To aid in cleaning of slough from wounds.
- To apply medication to a locally infected area.
- As a pre-preparation for surgery, for example, diabetic ulcer foot for skin grafting.
Principles for Surgical Soak
- Bacteria travel through the dust particles.
- Nutrition and oxygen are carried to the wound via blood and are essential for collagen formation, which is essential for wound healing.
- Soaking increases blood circulation and minimizes the spread of organisms.
Indications
- For proper drainage of the wound, which includes removal of dead cells or tissues.
- For removal of the existing fluid or gas and prevent accumulation of fluid or gas.
Contraindications
- GI tract diseases-esophagitis, peptic ulcer, etc.
- Severe cardiovascular insufficiency.
- Alcohol or drug abuse.
- Mental disorders.
Articles
| Articles | Purposes | |
| 1. | Sterile basin or bucket, sterile pint measure | To soak the surgical site. |
| 2. | Boiled water | To maintain asepsis and provide warm soak. |
| 3. | Sterile pint measure and ounce glass/measuring cup | To measure the required quantity of water and solution. |
| 4. | Lotion thermometer | To check the temperature of the solution. |
| 5. | Solutions used: Water (105°F-110°F or 40°C-45°C).Concentrated normal saline. Potassium permanganate. Dakin’s Na-hypochlorite solution. Other solutions, for example, povidone-iodine: 30 mL in 500 mL of water | To soak and disinfect the surgical site. |
| 6. | Normal saline | To soak adherent dressing for easy removal. |
| 7. | Clean gloves | To remove old dressing. |
| 8. | Sterile gloves | To handle the sterile items. |
| 9. | Sterile gauze pieces, cotton pads | To cover the wound after the soak. |
| 10. | Small Mackintosh/waterproof sheet | To protect the bed linen. |
| 11. | K-basin | To receive the waste materials. |
Procedure for Surgical Soak
| Nursing Action | Rationale | |
| 1. | Explain the procedure to the patient. | Relieves anxiety and promotes understanding of the healing process. |
| 2. | Assemble equipment at the bedside. | Prevents waste of time and promotes easy usage of articles. |
| 3. | Provide privacy and switch off fan. | Reduces air currents that may transfer the microorganisms to the wound and also to prevent chillness. |
| 4. | Position the patient comfortably and drape him or her. | Ensures comfort. |
| 5. | Perform hand hygiene in an aseptic manner. | Prevents infection. |
| 6. | Wear clean gloves; spread Mackintosh under the part to be soaked. | Prevents transmission of microorganisms and protects the bed linen. |
| 7. | Remove old dressings; pour sterile saline over the wound dressing if the adhering gauge piece needs to be removed. | Prevents pain and bleeding from the healing tissues. |
| 8. | Remove gloves and wash hands. | To prevent transmission of microorganisms. |
| 9. | Check the temperature of water using the lotion thermometer; open the sterile basin; measure and pour the required quantity of water into it. | To prevent scalds due to moist heat. |
| 10. | Add the prescribed medication (as per prescription) with a sterile ounce glass/measuring cup. | To promote healing. |
| 11. | Keep the basin on Mackintosh. | Prevents spilling of water on the bed. |
| 12. | After checking the patient’s tolerance (temperature of water), ask him or her to immerse an affected part into the basin. | To prevent scalding from hot water. |
| 13. | Instruct the patient to soak the area for 15-20 minutes. | Disinfects the surgical site and promotes healing. |
| 14. | Remove the basin and drape the wound with sterile gauze pad. | To prevent contamination of the wound until surgical dressing is done. |
| 15. | Do surgical dressing if advised. | To protect the wound and promote healing. |
| 16. | Dispose of the gloves and contaminated dressing materials in the K-basin, replace the articles, and wash hands/perform hand rub. | To prevent spread of microorganisms. |
| 17. | Make the patient comfortable and instruct him or her to report any discomfort at the soaked surgical site. | Ensures comfort and early identification of complications. |
| 18. | Document the procedure accurately. Note the time, type, amount and temperature of the solution and duration of soak, and condition of the wound and patient. | Helps in monitoring the progress of wound healing process. |
Special Considerations
- Maintain aseptic technique throughout to prevent infection
- Avoid extreme temperatures that may damage tissue
- Monitor for signs of allergic reaction or intolerance to solution
- Do not refer to incisions as “scars” during explanation—some patients may find the term distressing
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwers, ISBN-13:978-9388313285
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884.
- Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/
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