To begin, being a patient or caregiver is a difficult duty. Now you must change a wound care dressing that was once a simple procedure but has become emotionally charged. When you are the patient or caregiver, the dynamics change. This is now about educating yourself and reprogramming your mind to believe that you can do this. You’ve got this. Use your physician and practitioners as a resource and support system to ensure that wound care is performed appropriately. If you’re unsure about something, ask questions. The purpose of this blog is to provide guidance and information in order for you to feel more confident when changing a wound care dressing.
Wound healing, which is a normal biological process in the human body, happens in four stages: hemostasis, inflammation, proliferation, and remodeling. These stages are all very well-planned. For a wound to heal properly, it must go through all four stages in the right order and at the right time. Certain wounds stay stuck during the inflammatory phase. These are referred to as chronic wounds. Additional treatment or therapies may be necessary to assist these wounds in healing.
- Pressure Ulcers, also known as bedsores, form when your skin and soft tissue press against a harder surface, such as a chair or bed, over an extended period of time. The blood flow to that location is reduced as a result of the pressure. Due to a lack of blood supply, the skin tissue in this location may become injured or perish. A pressure ulcer may grow as a result of this.
- Check your feet every day, especially if you are diagnosed with diabetes. Look in between toes too. Report wounds to your doctor for monitoring.
- Check skin head to toe every day if you are able to do so yourself, or as a caregiver. Pay special attention to areas like heels, ankle, knees, ears, back of head, elbows, tailbone, hips, and spine. Also, look in skin folds and creases.
- Eat a healthy balanced diet. High protein foods are encouraged.
- Stay well hydrated with water
- Keep weight healthy. Too much weight increases pressure on bones and joints.
- Practice healthy hygiene habits and skincare
- Stop smoking. Ask your doctor about smoking cessation programs.
- Use special mattresses and seating supports for wheelchairs. Ask your doctor or wound care specialist for suggestions.
- Incontinence care (bowel and bladder care). Use absorbent pads or underwear. Check and change every 2 hours and or as needed. This may vary.
Dressing Removal and Wound Cleansing
How often you should change your dressing will be advised to you by your doctor or nurse.
- Dressing Removal
- Before you touch the dressing, wash your hands.
- Make sure you have all of your dressing supplies (normal saline, gauze, dressings, i.e.)
- Keep your working area clean.
- Remove the soiled dressing slowly. If it is sticking, use saline to moisten it to remove it easily.
- Put the old dressing in a plastic bag and set it aside.
- Clean your hands again after you take off the old dressing.
- Clean the area around your wound with a gauze pad or soft cloth.
- Wash hands before and after changing a dressing.
- Wear gloves during all dressing changes.
- Dispose of the old dressing in a plastic bag before placing it into the garbage.
- Cleanse the wound before applying a new dressing. The wound can be cleansed by the patient using water in the shower (if permitted by a physician), or by the caregiver.
Signs of Infection
If you experience one or more of the following signs, call your physician.
- Fever 100.5°F (38°C) or higher
- Drainage that is green or tan
- Pungent drainage
- Swelling of the wound area
- Warm skin surrounding the wound
- Loss of function and movement
- Increased pain in the wound or surrounding area
- Felling of overall malaise
Always follow your doctor’s orders and recommendations. Dressings and other treatments you use will depend on what caused the wound, what type of wound it is, how deep it is, how much drainage it has, and if there is an infection. Dressings should be able to keep tissue hydrated enough to keep cells alive, but not so much that they make the wound bed too wet.
The goal of the appropriate dressing is to maintain a BALANCE within the wound.
Wet dressings should be used on dry wounds and dry dressings on wet wounds.
Antibacterial dressings should be used on wounds that have been colonized or infected.
Maintain contact with your or a loved one’s doctor or nurse practitioner to learn more about how to prevent wounds or to report any new skin rashes or sores. A little bit of prevention goes a long way. Follow the advice in this blog to help prevent the development of skin or wounds.
The views and opinions stated in this blog are exclusively those of the author and do not reflect iWound, its affiliates, or partner companies.
Future Reading and References
Kirkland-Kyhn, Holly PhD, FNP-BC, GNP-BC; Generao, Stefanie Anne MSN, FNP-BC,CWCN; Teleten, Oleg MS, RN, CWCN; Young, Heather M. PhD, RN, FAAN Teaching Wound Care to Family Caregivers, AJN, American Journal of Nursing: March 2018 – Volume 118 – Issue 3 – p 63-67 doi: 10.1097/01.NAJ.0000530941.11737.1c
Reinhard SC, et al. Home alone: family caregivers providing complex chronic care. Washington, DC: AARP Public Policy Institute; 2012 Oct.
Guo, S., & Dipietro, L. A. (2010). Factors affecting wound healing. Journal of dental research, 89(3), 219–229. https://doi.org/10.1177/0022034509359125
Calianno, Carol RN, CWOCN, MSN How to choose the right treatment and dressing for the wound, Nursing: October 2003 – Volume 33 – Issue – p 6-14