INTRODUCTION
Some of the clients you care for will have dressings on their wounds, which are used to protect the wound; absorb wound drainage, or exudate; keep microorganisms from entering the wound; promote comfort; or keep the wound dry during bathing. Some dressings can even be used to apply pressure to control bleeding, while others can help remove dead or infected tissue; this process is called debridement. As a nurse, you will have the opportunity to apply dressings and bandages.
TYPES OF DRESSINGS
One of the most common types of dressings you will apply are gauze dressings, which are made of cotton or synthetic material. A dry gauze dressing is applied to protect a wound and absorb small amounts of exudate. Sometimes a moist-to-dry gauze dressing is applied, which means that the gauze is moistened before it’s applied to the wound, and then a dry gauze is layered on top. As the moist dressing dries, it helps with debridement and removal of exudate.
Gauze dressings are usually secured with tape, which can sometimes irritate the client’s skin, especially as it is peeled off for dressing changes. In cases where the dressing is large and needs to be changed frequently, it can be secured with Montgomery ties, or tape ties, which is when a wide strap is attached to the skin and then tied together over the wound. Whenever the dressing needs changing, the ties are untied and then tied again over the new dressing, so no peeling of tape is required! If a dressing needs to be secured over a joint, such as a wrist or knee, a bandage made of rolls of webbing, gauze, or stretchy elastic material is wrapped around the dressing.
Some small wounds, minor burns, or intravenous catheter insertion sites can be covered with a transparent dressing, which is a thin film with an adhesive coating on one side. Transparent dressings do not absorb exudate, but they allow you to see through the dressing, so you can observe the wound, and it allows the exchange of air at the wound site while preventing water or bacteria from entering. This dressing also creates a moist healing environment for the wound.
Figure 1: Types of dressings and items used to secure them. A. Gauze. B. Tape. C. Montgomery ties. D. Stretchy elastic. E. transparent dressing.
APPLYING GAUZE AND TRANSPARENT DRESSINGS
Supplies
When applying a dressing, first gather the supplies you need:
- clean gloves and other personal protective equipment (PPE) like a mask or gown if needed
- a towel or similar item to protect the client’s bed linen, like a bed protector
- appropriate dressings
- tape or bandages to secure the dressing
- sterile 4x4 gauze squares or cotton balls and saline solution if needed
- forceps
- paper towels
- a biohazard bag for disposal of soiled materials
Figure 3: Supplies that you may need to apply dressings. A. Gloves. B. PPE. C. Towel or bed protector. D. Appropriate dressings. E. Tape or bandages. F. Sterile gauze. G. Cotton balls. H. Saline solution. I. Forceps. J. Paper towels. K. Biohazard bag.