Steps of a wet to dry dressing

Irrigating a wound is not a wet to dry dressing. That is a separate step and needs a physician order especially for that.

A wet to dry dressing is one where either 0.9% NS or a medicated soln such as Dakin's soln are poured over the dressing, just enough to wet them while they are in their opened package, and it can also be a kerlix roll. You then wring it out, with your sterile gloves on, and place it in the wound. Then cover with an ABD.

Wounds do not get measured with every dressing change, most times get measured every few days or once a week. Depends on your facilities policies and procedures.

And if it is one that is getting done three times er day, you want to use Montgomery Straps so that you are not removing tape each time.

I had to google a Toomy syringe.

Are you irrigating it to flush the wound or clean it?
We don't need an order it cleanse with NSS.
As far as measuring...we do it once a week.

Why does this have to be in a care plan? Couldn't you just say...wet to dry dressing per protocol?

Dressing Changes: Sterile Technique
Wash Hands then:
1. Explain the procedure to the patient/caregiver
2. Assemble the supplies at a convenient work area
3. Assist the patient to a comfortable position to expose the wound. Place a plastic sheet under the patient to prevent soiling the linen. Drape the patient for privacy.
4. Place a clean towel underneath the working area to minimize contamination.
5.Open the sterile dressings, the irrigation and cleaning solution, and the instrument set to provide a sterile field.
6. Wear a protective apron when caring for a patient with a draining wound. Don nonsterile gloves.
7. Gently remove and discard the old tape and soiled dressing in a plastic trash bag. If the dressing sticks to the wound to the wound, moisten with sterile nss and then remove.
8. remove and discard nonsterile gloves. Don sterile gloves.
9. Cleanse and irrigate the wound as prescribed by the physician. Clean from the least contaminated area to the most contaminated area.
10. Inspect the wound, and evaluate it for healing versus signs of infection.

11. Apply a (moist) dressing,(gently feed moist gauze into the wound with cotton-tip applicators if packing is required)Place dry gauze over wet gauze. Then cover with a gauze dressing,or ABD pad and secure it with hypoallergenic tape,Montgomery ties or a binder.
12. Provide patient comfort measures.
13. Clean and replace the equipment. Discard disposable items in a plastic trash bag, and secure.

These steps are from "Handbook of Home Health Nursing Procedures" by Robin Rice.

You are very welcome--I thought you would find it helpful!!

NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO
NO more wet to dries. Research has proclaimed wet to dries to be harmful. Leave fibers in wound, non-selective debridment- removes granulation and epithelial tissue! Good article out there called hanging wet to dries out to dry. If you work in a LTC facility- beware- you will get flagged for this!!

Very interesting. I found the article over here:
http://www.findarticles.com/p/articl...03/ai_n9080467

Can experienced wound care nurses please comment? Are you still using wet-to-dry gauze? Are student nurses still being trained in this method or are they being taught advanced wound care methods?

We are still being taught w/d dsg. changes. I did one past this week.