How Often Should You Change a Wound Dressing
Wound dressing can be a complex business. If a wound is healing by secondary intention, packing the cavity and sealing it up with an occlusive dressing is a time-consuming procedure, not to mention unpleasant for the patient, even if they are given pain relief.
It’s important to know when a wound dressing needs to be changed. Not only will this minimise the number of times the nurse and patient need to go through dressing changes, but it’ll help the wound heal faster and without complications.
In this article, we’ll ask ‘how long should a dressing stay on a wound?’ and cover when to remove wound dressing.
What happens under a wound dressing?
Under a wound dressing, the body works hard to heal the damaged tissues. Depending on the dressing used, there will be a different environment under the wound pad.
Skin Maceration
When the body is healing a wound, pus and other exudate collect in the wound bed, and this is what can cause skin maceration. Skin maceration is what you can see if you’ve spent too long in water and your fingertips become pale and wrinkly. Once your skin is exposed to air, it usually dries out, and the issue is resolved.
But underneath a wound dressing, there’s much less air circulation, and the constant exposure to moisture can create a problem with skin maceration that doesn't go away as easily. Wounds cause the body to activate the histamine response, which causes plasma and other fluids to accumulate around a wound and the wound tissues to swell. This compounds skin maceration.
Skin maceration can cause chronic open wounds like bed sores, blisters, and ulcers to become worse. It’s important to change wound dressings to minimise skin maceration regularly. Occlusive dressings which prevent moisture from spreading to healthy skin and hydrofibre dressings that draw out extra moisture are good options for wound dressing to avoid skin maceration.
Wet-to-Dry Dressings
Although wet-to-dry dressings are rarely used these days, they need to be monitored closely. Once the gauze layer on a wet-to-dry dressing has dried out, it’s ready to be removed from the body. All the dead tissue and exudate from the wound will have fused to the gauze, and this will be removed from the body when the dressing is taken off.
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Wound Packing
If presented with a deep, open wound healing by secondary intention, the wound will likely be packed. Packing a wound keeps the cavity open to prevent epithelialisation around a hole or infection. The packing will need to be changed regularly to remove exudate and give way to more space as the wound granulates.
Infections
Any wound is a target for bacteria and other potentially infectious agents. The warm, moist environment of the wound bed is an optimal breeding ground for germs that can make their way into the body without the intact skin to protect it. Germs can be present in the environment around a wound and in the wound bed as the body pushes them out in fluids.
Regular changes to clean dressings are vital to remove bioburden and reduce infection.
How often should you change wound dressing?
Getting wound dressing change frequency right is very important when caring for a healing wound. Maintaining the optimal environment underneath the dressing is essential because this helps the body get on with its natural healing process.
Suppose your dressing comprises a primary, non-adherent layer and a secondary, absorbent layer. In that case, it may be possible just to change the secondary layer so that the wound bed is not disturbed, but the exudate is removed and replaced with a fresh pad with maximum absorbency capacity.
How long to keep a dressing on a wound changes depending on the dressing used. Here’s a table to give an idea of when to change different types of dressings.
| Dressing Type | When to Change (unless stated otherwise) |
|---|---|
| Wet-to-Dry | Every 4-6 hours |
| Wound Packing | Twice a day |
| Occlusive | Every 3-7 days |
| Hydrocolloid | Up to every 7 days |
| Hydrogel | Every 2-3 days |
| Alginate | Every 5-7 days |
| Dressing for low exudate wound | Weekly or less. When the dressing is soiled or not dry |
| Dressing for moderate exudate wound | Every 2-3 days. When the dressing is soiled but not soaked |
| Dressing for high exudate wound | At least daily. Whenever the dressing is saturated |
| Dressings for closed surgical incision wounds | Every two days |
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How often to change wound dressing after surgery?
Wounds resulting from surgery are usually closed up unless the wound is healing by secondary intention or if there is a skin graft, for example. A wound will be closed with stitches, wound closure strips, or surgical glue.
Because of this, the wound will have a low quantity of exudate. The most important thing is keeping the wound dry and protecting the stitches while it heals. Patients are usually recommended to keep the dressing in place and not to shower the area for two days. After two days the patient can shower and change the dressing. The dressing will not need to be changed frequently; only to keep the area clean and dry.
A waterproof adhesive dressing is usually used to protect a post-op wound.
How often to change a dressing on an infected wound?
If a wound is infected or chronic, the dressing will probably need to be changed more frequently to remove the higher levels of bacteria and exudate from the wound bed.
How often should I change my wound dressing at home?
If you’ve been sent home with a dressed wound and supplies to dress a wound, or need to look after someone else, you must get clear instructions from your GP. Wounds, dressing types, and healing times vary massively, so you must have your GP or whoever treated your wound explain what you need to do and when.If you’ve been sent home with a dressed wound and supplies to dress a wound, or need to look after someone else, you must get clear instructions from your GP. Wounds, dressing types, and healing times vary massively, so you must have your GP or whoever treated your wound explain what you need to do and when.
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Signs a Wound Dressing Needs to be Changed
When wondering how long you should keep a dressing on a wound, there are some signs to look out for that indicate it’s time for a change.
- The dressing becomes wet or soiled.
- The patient complains of increased pain.
- Blood or exudate is visibly soaking through the dressing.
- There is an unpleasant smell coming from the dressing (sometimes this is expected in wound dressing, but if it happens unexpectedly, you need to change the dressing and inspect the wound).
- There are signs of infection: the area around the wound is hard, hot, and swollen, and the patient may feel sick, dizzy, and have a temperature.
If something goes wrong with your wound dressing, it could put you at risk of an infection or make the healing process last longer. Check our guide, Troubleshooting Wound Dressing: What to Do When Something Goes Wrong to find out what to do in many common situations.
Learning to notice the signs that a dressing needs changing is just as important in veterinary wound dressing, if not more because vets have to rely on their observation skills rather than asking their patients. Find out more about proper animal wound dressing in our articles The Basics of Animal Wound Dressing and How to Choose the Right Veterinary Wound Dressing.
When to Stop Dressing a Wound
When it comes to how long to leave a dressing on a wound, some wounds take longer to heal than others. Where a minor laceration can close and heal up quickly, an abrasion or stab wound can involve a longer healing process with many steps. Generally, a wound no longer needs to be dressed when it is no longer weeping or when the skin has closed.
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