Wound Care with Packing
Your child has a wound with dressings that will need to be changed at home. Changing the dressing prevents infection and promotes healing of the wound. If you or your child has a cough, cold, or sore throat, wear a mask during the dressing change to keep germs away from the wound. If you do not have a mask, do not cough or sneeze on the wound.
Patient instructions for the dressing change:
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Consider giving prescribed or over the counter pain medicine about 30 minutes before the dressing change to improve your child’s comfort. Follow the dosing instructions for the medicine.
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Distract your child using music, books, toys, etc. and seek help if necessary. For younger children it is best to have one person hold and distract the child, while another changes the dressing.
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Identify a clean area and surface for the dressing change.
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Gather your supplies and lay them on a clean surface. (Figure 1) Your supplies may include:
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| (Figure 1) Gather supplies needed on a clean surface |
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Wash your hands with soap and water and dry well using a clean towel or paper towel.
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Place gloves on hands.
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Open the packages of dressing materials
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If using gauze, completely unfold the gauze pad and moisten with saline (Figure 2). Squeeze out the gauze so that it is not dripping wet. (Figure 3) Other packing materials are ribbon-like dressings; these may or may not need to be moistened before placement.
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| (Figure 2) Unfold gauze |
(Figure 3) Squeeze out gauze after moistening |
NOTE:Only a single, continuous piece is used to pack wound tunnels or areas beneath skin that are not visible. Packing material may be lost inside a wound if more than one piece is used. Lost packing delays wound healing and may result in a serious infection.
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Remove old dressings and throw them away. Be sure all dressing material is removed from the wound. You may see some bleeding when the packing is removed. If the packing is dry and stuck to the wound, moisten it with saline before removing. This will prevent you from damaging the healing wound.
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Remove gloves, use hand sanitizer or wash your hands again with soap and water after removing the old dressing.
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Place new gloves on your hands.
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Cleanse the wound using the ordered solution (saline, water, etc.) If using a wound cleanser, set the nozzle to “Stream” function.
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Look at your child’s wound carefully. Wounds heal from the bottom up and then slowly close together. A “beefy red” wound is normal. Call your doctor’s office with any concerns. You may upload wound pictures to your child’s MyCHOP record. Take pictures of the wound after cleansing the wound.
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Apply a thin layer of No-Sting Barrier Film to the healthy skin around the wound. This prevents irritation of the skin.
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15. Starting with an edge or corner, lay the gauze or dressing along the bottom of the wound. Ensure the dressing makes contact with the wound surface
16. If packing a tunnel or a pocket beneath the skin along the wound edge, use a moistened cotton-tipped applicator to loosely pack the gauze or dressing into the bottom of the wound. (Figure 4) Do not pack tightly remembering to “fluff not stuff” the material into the wound. (Figure 5).
For steps 14 and 15: Do not allow moistened gauze or dressing to sit on the healthy skin around the wound. The wetness could cause breakdown of the healthy skin.
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| (Figure 4) Use a moistened cotton-tipped applicator to loosely pack the gauze into the bottom of the wound if wound is deep |
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| (Figure 5) "fluff not stuff" |
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17. Place a cover dressing on top of the dressing material and tape in place, if indicated. (Figure 6)
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| (Figure 6) Place a cover dressing on top of the dressing material |
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Nice Job!! Give Your Child a Hug!!
To help the wound heal as fast as possible, you need to do the dressing change as described in the discharge instructions or if it becomes wet or soiled. Your healthcare provider will tell you how often to change it. Good nutrition will also help the wound heal faster, so encourage healthy foods and snacks!
Call your CHOP healthcare team at the number on your discharge instructions with questions, concerns or if:
Use MyCHOP to upload pictures or to ask non-urgent questions that may take up to 2 business days to answer https://mychop.chop.edu/mychart/
Reviewed February 2024 by Adam Boroughs, BSN, RN, CWOCN