How to Change Wound Dressings

Wounds must be kept clean and free of dead tissue to heal. The following instructions provide good general advice for you and your caregiver. In addition to this information, your health care provider might provide additional wound care instructions.

1. Remove the old dressing

• Wash your hands with soap or an antibacterial cleanser and warm water.
• Put on the exam gloves.
• Start by lifting the corners or edges of the dressing or tape. If the dressing or tape appears to be sticking to the skin, dab the edges with an adhesive remover, a moistened gauze pad, or a moistened paper towel. To ease discomfort, hold down the skin surrounding the bandaged area and gently and slowly remove the tape or dressing. Peel away in the same direction the hair grows (from hair root toward the hair end), keeping the bandage or tape as close to the skin as possible as it is being removed.
• Carefully throw the old dressing into a plastic bag.
• Wash your hands with soap and water.

2. Cleanse the wound

• Place a towel under the wound to catch drainage.
• Rinse the wound site with normal saline, regular tap water and soap, or wound cleanser. (Your health care provider will tell you what type of solution to use on your wounds, and will show you and your caregiver how to rinse and/or clean your wound.)
• Do NOT use antiseptics such as hydrogen peroxide or iodine. These chemicals can damage sensitive tissue and prevent healing.
• Use a clean soft cloth or gauze to remove additional loose debris not fully removed by rinsing. Gently wipe from the center of the wound outward. Use a new piece of cloth or gauze each time you wipe the wound.
• Discard the soft cloth or piece of gauze into a plastic bag.
• Dry the skin surrounding the ulcer by patting it with a soft clean towel.
• Clean the wound each time the dressing is changed.

3. Check the healing process

• Check for signs of infection. Every time you clean a wound, look for any of the following:
  -Swelling, tenderness, redness, or warmth around the wound
  -Thick yellow or green pus
  -A bad smell from the sore

Signs that an infection might have spread include the development of fever or chills, mental confusion or difficulty concentrating, rapid heartbeat, or weakness. If any of these signs appear, call your health care professional right away. Wounds that become infected heal more slowly and can spread a dangerous infection to the rest of your body.

4. Apply the new dressing

• Open the new dressing, remove it from the package and remove its paper backing. Your health care provider will tell you exactly which type of dressing to use. (See above for this information.)
• Touching only the corners of the dressing, center it over the wound and seal the edges. Try not to create any wrinkles in the dressing.
• Tape the dressing if necessary. In some cases, it might be necessary to use Skin Prep (contains alcohol) or No Sting (low alcohol content) to help the dressing and tape adhere. After applying either of these products to the intact skin area surrounding the wound, let them begin to dry. When the skin feels sticky, the dressing and tape should be applied.
• Wash your hands with soap and water.

Keep in mind that:

• Dressings should be used only once.
• Unused dressings should be kept in their original package or other closed plastic package.
• Unused dressings should be stored in a clean, dry place.
• Dressings should be discarded once they get wet, contaminated, or dirty.
• Packaged dressings should not be touched after the ulcer is touched.

How to make saline

1. Use 1 gallon of distilled water or boil 1 gallon of tap water for five minutes. Do not use well water or sea water.
2. Add 8 teaspoons of table salt to the distilled or boiled water.
3. Mix the solution well until the salt is completely dissolved. Be sure storage container and mixing utensil are clean (boiled).

Note: Cool to room temperature before using. This solution can be stored at room temperature in a tightly covered glass or plastic bottle for up to one week.

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.This document was last reviewed on: 4/29/2005