Integumentary: Applying dressings and bandages (for nursing assistant training)

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: a process called debridement.

As a nursing assistant, you will have the opportunity to assist the nurse with applying dressings or bandages, and in the cases where your facility policy allows, you may be asked to apply dressings and bandages for some clients without the nurse’s assistance.

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 just means that the gauze is moistened first before it’s applied to the wound 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.