The proper application of a wound dressing is a foundational step in managing minor injuries, creating a controlled environment that supports the body’s natural healing processes. This barrier is placed directly over a wound bed to promote healing and prevent external contamination. Its primary functions are to stop bleeding, absorb fluid drainage (exudate), prevent infection, and maintain a beneficial level of moisture at the site of injury. Correct technique ensures the wound is protected from further trauma, allowing skin cells to regenerate effectively and reducing the likelihood of complications and scarring.
Preparing the Wound and Supplies
Before the dressing is even handled, meticulous preparation of the site and the materials is necessary to prevent infection. Begin by washing hands thoroughly with soap and water for at least 20 seconds, or use an alcohol-based hand sanitizer, and then put on disposable, non-sterile gloves. Next, briefly assess the wound for severity, checking for excessive bleeding, deep penetration, or the presence of foreign objects that would require immediate professional medical attention.
The wound must be cleaned to remove any debris and bacteria. Use clear, running water or a sterile saline solution, which is the preferred cleaning agent because it does not interfere with the healing process. Avoid applying harsh soaps, hydrogen peroxide, or iodine directly into the wound bed, as these can irritate the delicate tissue. Gently clean the surrounding skin with mild soap and water, working outwards from the wound center to avoid dragging contaminants back into the injury.
After cleaning, gently pat the surrounding skin completely dry with a clean cloth or gauze, but avoid direct contact with the wound bed itself. The dressing relies on the surrounding skin being dry for proper adhesion. Finally, gather all necessary sterile supplies, opening the packaging for the dressing, tape, and any prescribed topical ointment, ensuring the sterile surfaces do not touch any non-clean surface.
The Process of Applying the Dressing
The physical application of the dressing requires a non-touch technique to maintain the sterility of the material that will contact the wound. Carefully unwrap the dressing, touching only the edges or the non-contact backing, preventing your fingers from touching the absorbent pad. The dressing should be an appropriate size, extending approximately 2.5 centimeters beyond all edges of the wound. Center the absorbent pad directly over the injury and gently press it down, ensuring the entire wound is covered.
Once the dressing is in place, securing it firmly is necessary to create a protective seal against the environment. For dressings without an adhesive border, use medical tape, ensuring the tape strips extend well past the dressing edges onto the clean, dry skin. Placing the tape in a “window pane” pattern around all four sides of the dressing can improve the seal.
When securing a dressing over a mobile joint, such as an elbow or knee, a figure-eight wrapping technique with a roller bandage is often used to allow movement without dislodging the dressing. Begin by anchoring the bandage with two circular turns above the joint, then alternate turns that cross over the joint space, with each new layer covering about two-thirds of the previous layer. Applying the dressing when the joint is slightly extended can accommodate the change in skin tension during movement.
Ensure that the securing material is firm but not so tight that it restricts blood circulation. This can be checked by observing the color of the skin or nail beds beyond the wrap.
Ongoing Care and When to Seek Medical Attention
Maintaining the dressing requires regular monitoring and timely changes to support uninterrupted healing. A dressing must be changed immediately if it becomes wet, dirty, or if the fluid drainage (exudate) has soaked through the outer layer, indicating a loss of the protective barrier. If the dressing remains clean and dry, follow product instructions, which may recommend changing it every one to three days, or as directed by a healthcare provider.
When removing the used dressing, do so gently, pulling parallel to the skin to minimize trauma, and use sterile saline or water to loosen it if it has stuck to the wound bed. After removal, inspect the wound for signs of improvement or complications before applying a new dressing. Dispose of the contaminated material by sealing it securely in a plastic bag before placing it in the household trash to prevent the spread of pathogens.
Seek immediate medical attention if the wound shows signs that the infection is progressing beyond the local site. These concerning indicators suggest a systemic response or require professional assessment and treatment:
- Fever above 100.4°F (38°C) or chills.
- Pain that suddenly increases or worsens.
- Redness that spreads outward from the wound edges, or the appearance of red streaks moving away from the injury.
- Foul odor, thick yellow or green discharge (pus), or swelling that intensifies rather than decreases.