Do Not Place Stress on a Wound
Any physical stress, especially on a surgical wound, can cause the edges of the skin to separate. This is very important during the first 24 to 72 hours after surgery. Protect a person’s wound by following these tips:.
- Have the person place a pillow (or folded towel) over their wound, and hold it firmly with their hand over the wound to splint it when coughing. If the person cannot splint a wound themselves, you can position a pillow or take your hands and place them flat over the wound, and apply light pressure to splint as the person coughs.
- Vomiting places stress on a wound. Have the person take any prescribed anti-emetic medicines.
- Movement places stress on a wound. Have the person move slowly and not try to exercise past the level ordered by their doctor.
Observe the Dressing and Wound
The person’s doctor will decide whether you should change a dressing or not at home. If you do, observe the wound carefully each time you change a dressing. Follow the directions of the doctor or the home health nurse for how often to change a dressing.
Dressing:
- Look for signs of any drainage – you will notice a change in the color of the gauze when drainage is present.
- Notice the size of the area discolored on the gauze, this gives you an idea of the amount of drainage. Also – when you change a gauze dressing, count the number of gauze pads that contain drainage.
- What color is the drainage? Clear, bloody, yellowish or greenish?
- Does the wound look different since you last looked at it? Has the size changed or does it look deeper?
- Are the wound edges closed together?
- Are the wound edges reddened or swollen?
- Is there any drainage? If so what color: clear, yellowish, or greenish?
- Does the person tell you there is pain or discomfort when you remove the dressing?
- Are you needing to change the dressing more often than instructed? If so, why?
- If the wound has stitches or staples – are they all in place?
Write down your observations of the dressing and wound in your care diary. This information will be helpful when the person visits their doctor.
How to Apply and Remove Tape
If you do not remove tape correctly from a gauze dressing, there is the chance of pulling and placing stress on the wound edges. Tape comes in ½, 1, 2, and 3 inches, and there are several types: adhesive, plastic, paper and non-allergenic. Know if the person you care for has an allergy to latex. Your doctor or home health nurse can help you choose the right size and type.
To Apply Tape:
- Choose a size that secures the dressing over a wound.
- Places edges of tape over several inches of skin on both sides of the dressing.
- Place the tape over the middle of the dressing.
- Press the tape gently to secure it over the dressing, but do not place pressure directly on the wound.
- Never place tape on broken or irritated skin.
- Do not tape all the way around any body part. If applied too tightly, this may cut off circulation to the area.
- First loosen the tape ends.
- Use one hand to apply light traction to the skin away from the wound.
- Then with the other hand, pick up the loose end and pull it gently toward the dressing.
- If tape covers an area of hair growth, pull the tape in the same direction the hair grows.
- If the person has a lot of hair, trim the hair with scissors. Do not shave the area as this leaves tiny scrapes that can lead to infection.
A Montgomery Tie:
If the person you care for has fragile skin (common in older adults and persons taking large doses of steroid medicines) use caution in applying tape. A Montgomery Tie is one option to use, avoiding the need to reapply tape each time you change a gauze dressing. The Montgomery Tie is best suited for large wounds requiring several layers of gauze.
- Apply the tape edges of the ties along the sides of the wound, leaving space for the gauze.
- Then secure the wound by tying the ribbon ties.
When to Change a Dressing
IThe outer part of a gauze dressing should always be dry. Your doctor or home health nurse will suggest how often to change a dressing.
- A gauze dressing is usually changed routinely (every day) to keep a wound clean and protected.
- Change a gauze dressing if it becomes saturated with drainage.
- Change a gauze dressing if it becomes soiled from bath water, or spills.
