Silly question but....whats the difference?

Daytonite, BSN, RN · Sep 20, 2009

A wet to dry dressing is when there is a open wound and the first dressings applied to the wound are wet--often the sterile gauze has been made wet (not sopping wet, but moist) with saline or hydrogen peroxide although other solutions can be used. Next, dry sterile gauze is placed on top of them and the dressing taped in place. The purpose is to help draw drainage from the wound.

Packing is done when the wound has depth and drainage. Wet or dry dressing is gently packed into the open wound to absorb the drainage and then other dressings applied on top and taped in place.

I had surgery 3 weeks ago and currently have a 2 inch deep draining wound with retention sutures that I pack with sterile gauze twice a day. I remove the packing each morning, shower and wash out the wound per the surgeon's orders and then repack the wound and apply a sterile ABD pad. I generally need to remove the ABD pad and packing in the evening and do a re-packing and apply a fresh ABD pad. We expect that it is going to take 4 to 6 weeks for this wound to heal. It is healing by second intention (from the inside to the outside).

Student4Now · Sep 20, 2009

When packing a wound should the gauze be wet or dry? Will the doctor specify that?

Daytonite, BSN, RN · Sep 20, 2009

The doctor should specify that. If he doesn't ask. Right now, my surgeon has told me to pack with dry, clean gauze dressings. Years ago when this same thing happened after my hysterectomy, the surgeon wanted me to change the dressing every 4 hours and pack one time with moist saline and the next time with moist hydrogen peroxide. Every doc has their preference. Just wash thy hands and keep as clean or sterile as possible.

It doesn't matter. Wet or dry to begin with, the packing comes out full of sanguinous gunk.

Student4Now · Sep 20, 2009

Thanks for the great feedback- I really appreciate it. Before I do my skills check off I will just ask my advisor what they want me to pack it with (wet, dry, saline, etc.,).Thank you!

Daytonite, BSN, RN · Sep 20, 2009

When we packed with, lets say saline, we put on sterile gloves, took a sterile gauze and poured or dipped it in saline that had been prepoured into a sterile container and then squeezed out the excess saline, straightened out the gauze to the way we wanted to use it and then gently packed it into the wound. If the wound is small, use sterile 6-inch cotton tipped applicators (long Q-tips) to help push the gauze into the wound. Leave a tail sticking out to pull the packing out later. At work I always tried to keep dressing changes sterile. At home the docs have told me to just be clean.

Student4Now · Sep 20, 2009

I'm having a bit of a hard time. None of these concepts or skills are difficult to grasp per say, Its just that our advisors do not do demos so its hard to know exactly how they want us to do things. They tell us to refer to book a, book b, and video c (if a video is even available) and it will just happen that all 3 will have conflicting techniques, or they will have holes in them somewhere. I have found some videos on youtube of nursing instructors giving demos and they are GREAT! But I am afraid that those certain techniques wont be accepted. For example, I watched a video where the sterile packages were opened and then the instructor put on sterile gloves and just maintained her field that way. I thought that was the cats meow! Lol because I have a hard time "flopping" things onto the field.

Daytonite, BSN, RN · Sep 20, 2009

i understand. there are some videos of procedures listed on this sticky: https://allnurses.com/nursing-student-assistance/any-good-iv-127657.html - any good iv therapy or nursing procedure web sites. i think it is post #25 that has a link to about 120 different short videos. what your instructors will look for is that you don't violate the things like contaminating the equipment if they tell you to do a sterile dressing change. as far as opening a sterile package and emptying its contents onto a sterile field, just keep practicing. play around at the different ways it can be done and are comfortable for you.

Student4Now · Sep 21, 2009

I will check it out and make use of them Im sure. Thank you so much for the great resource!