Wet to Dry Dressing: How to Perform

Introduction on Use of Wet to Dry Dressings

Wet to Dry Dressing: Some wounds heal on their own without the need for dressing to help them heal. Others require a dressing to allow them to heal properly and keep out elements that can cause the wound not to heal properly. The wound’s dressing allows the dead skin cells to collect in the dressing so that the wound can heal effectively. The wet to dry dressing change is an effective way to help wounds heal properly because the process allows a nurse to evaluate the wound for the signs and symptoms of various types of infections. The patient’s doctor will determine a schedule for the changing of wet to dry dressings.

Changing dressings is a skill nurses use daily, so it’s important to master this skill early on in your training. One technique is wet to dry dressing, which nurses use in wound care to help remove dead tissue and promote healing.

Removing the Old Dressing

Follow these steps to remove your dressing:

• Wash your hands thoroughly with soap and warm water before and after each dressing change.
• Put on a pair of non-sterile gloves.
• Carefully remove the tape.
• Remove the old dressing. If it is sticking to your skin, wet it with warm water to loosen it.
• Remove the gauze pads or packing tape from inside your wound.
• Put the old dressing, packing material, and your gloves in a plastic bag. Set the bag aside.

Cleaning the Wound

Follow these steps to clean your wound:

• Put on a new pair of non-sterile gloves.
• Use a clean, soft washcloth to gently clean your wound with warm water and soap. Your wound should not bleed much when you are cleaning it. A small amount of blood is OK.
• Rinse your wound with water. Gently pat it dry with a clean towel. Do not rub it dry. In some cases, you can even rinse the wound while showering.
• Check the wound for increased redness, swelling, or a bad odor.
• Pay attention to the color and amount of drainage from your wound. Look for drainage that has become darker or thicker.
• After cleaning your wound, remove your gloves and put them in the plastic bag with the old dressing and gloves.
• Wash your hands again.

Changing the Dressing

Follow these steps to put a new dressing on:

• Put on a new pair of non-sterile gloves.
• Pour saline into a clean bowl. Place gauze pads and any packing tape you will use in the bowl.
• Squeeze the saline from the gauze pads or packing tape until it is no longer dripping.
• Place the gauze pads or packing tape in your wound. Carefully fill in the wound and any spaces under the skin.
• Cover the wet gauze or packing tape with a large dry dressing pad. Use tape or rolled gauze to hold this dressing in place.
• Put all used supplies in the plastic bag. Close it securely, then put it in a second plastic bag, and close that bag securely. Put it in the trash.
• Wash your hands again when you are finished.

Step-by-Step Procedure:

Wet Phase:

1. Clean hands and put on gloves.
2. Irrigate wound with saline solution.
3. Soak gauze pads in saline solution.
4. Apply soaked gauze pads to wound.

Dry Phase:

1. Allow gauze pads to dry completely (usually 4-6 hours).
2. Remove dried gauze pads, taking care not to disturb wound bed.
3. Irrigate wound with saline solution.
4. Repeat wet-dry cycle as ordered.

Frequency of Dressing:

1. Every 4-6 hours (or as ordered)
2. Adjust frequency based on wound drainage and healing progress

Usage of Solution for Wet to Dry Dressing?

You can use sterile water to moisten the gauze in a wet-to-dry dressing.

But health care providers often prefer saline solution because it’s isotonic and less likely to irritate. Don’t use unsterile tap water, as it could contaminate the wound.

Alternatives to Wet to Dry Dressing

Depending on the wound and the care setting, other dressings include:

• Alginate: Made from seaweed, these dressings are super absorbent and promote healing.
• Antimicrobial: These dressings have substances that fight infection and reduce odor.
• Foam: Foam dressings are known for their excellent absorbency. Use for wounds with moderate to heavy exudate.
• Honey: Medical-grade honey dressings promote healing and have antibacterial properties.
• Hydrocolloids: They form a gel when in contact with wound drainage, providing protection and promoting healing.
• Hydrogel: These dressings absorb water and have a cooling effect, which can reduce pain. They also help keep the wound moist for healing.
• Transparent film: This dressing allows you to monitor the wound without removing it.

REFERENCES

1. Fleck CA. Why “wet to dry”? J Am Col Certif Wound Spec. 2009 Oct 6;1(4):109-13. doi: 10.1016/j.jcws.2009.09.003. PMID: 24527129; PMCID: PMC3601877.
2. Chilcott M. Wound dressing. In: Fowler GC, ed. Pfenninger and Fowler’s Procedures for Primary Care. 4th ed. Philadelphia, PA: Elsevier; 2020: chap 33.
3. Smith SF, Duell DJ, Martin BC, Gonzalez L, Aebersold M. Wound care and dressings. In: Smith SF, Duell DJ, Martin BC, Gonzalez L, Aebersold M, eds. Clinical Nursing Skills: Basic to Advanced Skills. 9th ed. New York, NY: Pearson; 2016:chap 25.

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