A post-operative ear bandage, often a mastoid dressing, serves a temporary role in recovery following ear surgery. The primary function of this compression dressing is to provide stabilization and gentle pressure to the surgical site. This helps minimize the accumulation of fluid or blood (seroma or hematoma) and reduces swelling immediately after the procedure. While this article offers general guidance, a surgeon’s specific post-operative instructions must be followed above all else.
Essential Supplies and Preparation
Meticulous preparation and hygiene are required before any dressing change to prevent introducing bacteria to the surgical site. Begin by thoroughly washing your hands or using sterile gloves to maintain a clean field. Typical supplies include sterile, non-stick pads (such as Telfa), multiple layers of sterile gauze, a conforming roller bandage (like Kerlix), and medical tape. Sometimes petroleum-soaked gauze is provided for the incision line.
A clean workspace should be set up, and all required materials must be opened and placed within easy reach before the old dressing is removed. If the surgeon permits home changes, gently inspect the skin surrounding the ear for changes in color, increased swelling, or discharge. If the old dressing is stuck due to drainage, soften it with water or a saline solution for gentle removal.
Step-by-Step Guide to Applying the Dressing
The dressing application is a layered process designed to provide uniform pressure and secure the inner padding. First, place a non-stick pad directly over the incision site, ensuring the entire wound is covered. Next, sterile gauze or fluffed cotton balls are layered behind the ear, in the natural curve of the auricle, to create a soft, absorbent cushion. This padding absorbs drainage and prevents the ear from folding forward, which could compromise circulation.
Use the conforming gauze roll to wrap the head and secure the cushion firmly against the ear. The wrap should begin by circling the head, covering the padded ear entirely. It often involves a figure-eight pattern that passes over the forehead and under the occiput (back of the head). This technique ensures the dressing remains snugly in position and prevents slippage. The wrap must be tight enough for gentle compression but should never cause severe discomfort, throbbing, or headache.
Secure the wrap with medical tape, ensuring the tape adheres well to both the gauze and the skin. Immediately check for signs of compromised circulation, such as the earlobe or exposed skin turning blue, pale, or feeling cold. If the patient reports numbness or severe, escalating pain, the dressing must be loosened immediately to restore proper blood flow.
Ongoing Bandage Maintenance and Daily Care
The frequency of dressing changes is determined solely by the surgeon and varies based on the procedure and drainage extent. The initial head wrap may be removed 24 to 48 hours after surgery, sometimes leaving only a small dressing over the incision. If the full wrap is removed, a broad, soft headband may be recommended to continue providing support and protection for a few weeks.
Keeping the dressing dry is a priority, especially during showering, as moisture increases the risk of wound infection. Use a plastic shield or cap over the head wrap. A cotton ball coated in petroleum jelly can be placed inside the ear canal to create a temporary, waterproof seal. Remove the coated cotton ball immediately after showering and replace it with a clean, dry piece of cotton.
Sleeping with the head slightly elevated, such as with two pillows, is generally recommended to help reduce swelling around the surgical site. Patients should also make a conscious effort to sleep on the unaffected ear to prevent putting pressure on the wound.
Disposal of soiled dressings should be done carefully by placing them inside a sealed plastic bag before discarding them with regular household waste. This practice helps maintain a hygienic environment and prevents the spread of potential contaminants. Avoid activities that cause straining or heavy lifting, generally defined as anything over 10 to 20 pounds, as this can increase pressure in the head and potentially cause bleeding at the surgical site.
Warning Signs Requiring Immediate Medical Attention
Monitoring the healing process is important, and certain symptoms warrant immediate contact with the surgical team or a trip to the emergency room. Severe, escalating pain that is not relieved by prescribed pain medication can indicate a developing complication such as a hematoma or infection.
- Excessive bleeding or a sudden increase in foul-smelling, greenish, or yellowish drainage from the wound site are strong indicators of a possible infection.
- A sudden, high fever, generally considered to be over 101 degrees Fahrenheit, should be reported to the doctor promptly.
- Any change in the appearance of the ear or surrounding skin, such as numbness, tingling, or a pale or blue discoloration, which suggests a possible circulation problem caused by a dressing that is too tight.
- If the head bandage constantly slips or becomes rapidly saturated with blood or fluid, this also requires immediate professional attention.