Start with your own dressing plan
Use this routine only after your nurse has said you can change your dressing at home and shown you how. A new graft, flap, BTM wound or special pressure dressing may need a different routine or clinic-only changes.
Before leaving, ask the nurse to write down the dressing names, cleaning method, change frequency, showering instructions and next review date. Do not remove an initial surgical dressing just because a general guide says to change one.
The aim is a protected wound with the right moisture balance. A moist wound surface and a saturated outer dressing are different things. Do not deliberately dry the wound in sunlight.
Gather what you need
- A clean work surface and somewhere to wash your hands.
- The cleaning fluid recommended by your nurse, such as saline.
- Clean gauze and the prescribed non-stick dressing. The clinic guide includes Melolin and, for selected wounds, Jelonet.
- The advised outer absorbent layer and tape or other securing material.
- Any specifically prescribed ointment or skin-protection product.
- A bag for used dressings.
Product choice depends on the wound and your skin. Ask the team about sensitive-skin alternatives if tape irritates you. A pharmacy or medical supplier can help obtain the exact items on your list.
Your dressing change, step by step
1. Prepare and wash your hands
Set out your supplies. Wash and dry your hands before starting. Avoid touching the inside of the new dressing or the wound surface.
2. Remove the old dressing gently
Follow the removal method your nurse demonstrated. Do not pull at a stuck dressing. Use saline to loosen it only if your plan allows, or contact the clinic. Do not soak a graft, BTM or other protected wound to remove a dressing.
3. Check the wound
Notice changes in drainage, pain, surrounding skin or appearance. Contact the clinic for an unexpected or worsening change, particularly spreading redness, increasing pain or fever.
4. Clean as instructed
Use the recommended fluid and gentle technique. Do not scrub, pick off tissue or remove stitches, staples or a BTM membrane. Follow the instructions for drying the surrounding skin.
5. Apply only advised products
Use ointment or barrier cream only where and how your nurse has directed. Iodine, antibiotic ointments and other antiseptics are not automatically needed for every wound.
6. Cover and secure
Apply the prescribed contact dressing and outer layer. Secure without excessive pressure. If a wrap causes increasing pain, numbness or colour change, seek prompt advice. Dispose of used materials and wash your hands again.
When to change or seek advice
Change at the frequency written in your plan. Wounds producing more fluid may need daily changes; others may use dressings designed to stay in place longer.
For an ordinary dressing you have been taught to change, replace it if it becomes wet through, dirty or loose. If this is an initial surgical, graft or BTM dressing, contact the team for instructions rather than dismantling it yourself. Repeated soaking, bleeding or leakage needs review.
Keep the dressing dry between changes as instructed. A cover may help in the shower, but do not assume every dressing is waterproof. Avoid baths, swimming and other soaking until cleared.
Special products and soaks
The clinic’s source guide describes Betadine and vinegar soaks for selected wounds. These are not general instructions for everyone. Only use them if your nurse or surgeon has prescribed a plan for your specific wound.
Ask for the exact product, concentration, duration and frequency in writing. Do not mix a solution from memory or substitute another product. Stop and contact the team if a prescribed product causes new irritation or increasing pain.
If you were given a separate Mesalt or other specialised dressing plan, follow that plan and ask the team to demonstrate it.
When to seek help
- Increasing or spreading redness, warmth or swelling.
- Pain that is getting worse rather than settling, pus, a new unpleasant smell, fever or feeling unwell.
- A wound that opens, a rapidly growing swelling, or a dressing that is repeatedly soaked.
- An unexpected change in the colour or appearance of a graft, flap or BTM wound.
Call 07 7520 8580 promptly. If the clinic is closed and the problem is urgent, seek an urgent medical assessment. Do not wait for a routine review.
For bleeding, apply firm, continuous pressure with a clean dressing. If bleeding persists despite pressure, seek urgent care. For severe bleeding, collapse or another medical emergency, call 000.