Dressing Changes

The right dressing for the right wound is as important as technique. Applying an inappropriate dressing — even with perfect technique — can impair healing, macerate surrounding skin, or allow infection to establish.

Section 01

Why Dressing Selection Matters

The wrong dressing can create excess moisture causing skin maceration, allow the wound to dry excessively impairing granulation, adhere to wound bed and damage healing tissue, or allow environmental organisms in. Dressings are clinically selected based on wound type, healing stage, drainage level, and infection status.

Section 02

Common Dressing Types

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Gauze (wet or dry)

Most versatile. Dry for lightly draining wounds. Wet-to-dry (saline-moistened) for debridement of necrotic tissue — removes dead tissue when dried gauze is changed. Not for clean granulating wounds — disrupts healing tissue at removal.

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Foam dressings

Highly absorbent for moderate-to-heavy drainage. Maintains moist healing environment. Can remain in place for several days. Common for pressure injuries and diabetic foot wounds.

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Hydrocolloid

Creates moist occlusive environment promoting autolytic debridement. For low-to-moderate drainage with good surrounding skin. Self-adhesive. Can remain up to 7 days.

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Transparent films

Semi-permeable — gas exchange but not bacteria. For superficial wounds with minimal drainage. Allows visual inspection without removal.

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Antimicrobial dressings

Contain silver, iodine, or other antimicrobials for infected or high-risk wounds. Not for routine use on clean wounds — antimicrobials can impair healing when not clinically indicated.

Section 03

Dressing Change Frequency

⚠ Follow the care plan — do not change frequency without nurse guidance

Frequency is clinically determined by drainage amount, wound type, dressing type, and infection status. Some dressings are designed for multi-day wear — daily changes disrupt the healing environment. Never change more or less frequently than specified without consulting the nurse. More is not always better.

Section 04

Protecting Periwound Skin

Skin barrier around the wound: Zinc oxide or petroleum jelly around — not in — the wound protects periwound skin from drainage and tape adhesive.
Gentle tape for fragile skin: Paper or silicone tape for elderly or thin skin. Standard cloth tape tears fragile skin on removal.
Avoid taping over bony prominences: Tape over a bony prominence creates pressure that can cause skin breakdown.
Do not overtape: Multiple tape layers prevent moisture vapor escape, causing maceration under edges.

Section 05

Documentation After Every Dressing Change

✓ Document immediately — while fresh

Date and time, old dressing findings (drainage amount/color/odor), wound assessment (appearance, size, progress), cleaning method, new dressing applied (type and pieces), client response and any symptoms, and any concerns and whether reported to nurse.