Special Edition of COVID-19: How to Correctly Change Wound Dressings at Home

This is the 3771th article of Da Yi Xiao Hu

During this special period when the COVID-19 pandemic is raging, in this beautiful metropolis of Shanghai where lockdowns are in place everywhere, I am feeling extremely complicated as I write this popular science article which is very practical for readers, to guide everyone on how to perform "wound dressing changes" correctly and in a standardized manner at home.

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Due to the epidemic, it is really inconvenient to see a doctor in various places in Shanghai. Learning how to correctly and standardizedly change wound dressings at home can not only save time and energy spent on going to the hospital for medical treatment, but also avoid the risk of infection, and give limited medical resources to those critically ill patients. It is highly recommended.

First of all, I want to make it clear to everyone that "dressing change" is just a medical term, which means we check and clean the wound and change the dressing outside the wound. It is not like "sprinkling medicine on the wound" or spraying topical medicine as many people imagine.

As the saying goes, "If you want to do your work well, you must first sharpen your tools." When changing dressings at home, it is essential to prepare medical supplies for dressing changes. We need to prepare sterile gloves, disinfected drapes, iodine, cotton balls, saline, tweezers, gauze, bandages and tape. There are also many disposable dressing kits on the market. Except for the tape or bandages that need to be prepared by yourself, everything else is included. It is very convenient and can be purchased by express delivery to the pharmacy during the epidemic. The person changing the dressing must wash his hands and wear a mask and hat before the operation.

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The second step is to check the wound. When removing the gauze, be gentle and slow to avoid further damage to the wound. For some wounds with severe adhesion, you need to apply saline first, and then slowly remove the wound after the innermost dressing softens. Observe whether the wound is healing well, whether there is redness and swelling, continuous bleeding, exudation, suppuration, and subcutaneous blood and fluid accumulation.

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The third step is to open the dressing bag and put on sterile gloves, being careful not to touch the outer layer of the gloves. Place a towel around the wound, and then use iodine cotton balls to disinfect the wound from the innermost part to the outside 2-3 times, within a 5 cm diameter around the wound. After disinfection, use tweezers to cover the wound with clean dressings, and secure the dressings with bandages or adhesive tape. After the operation is completed, tidy up the items.

There are a few points that require special attention: ① If the wound is red and swollen, you need to soak the gauze with alcohol or iodine and apply it to the innermost layer of the dressing, which can play a good role in reducing inflammation and swelling. ② For wounds with more epidermal defects, it is recommended to use vaseline gauze to avoid further damage to the wound due to adhesion when changing the dressing. ③ It is necessary to use self-adhesive dressings selectively. Remember that gauze and cotton pads are always the most breathable dressings. Band-Aids have poor breathability and are not recommended. Medical dressings have good breathability and are easy to use. They can be used when the wound is well healed, dry without exudation, and the epidermis is intact and without defects.

If the wound is bleeding, exuding, festering, or has subcutaneous blood and fluid accumulation, drainage, external fixation plaster, or chronic wounds that do not heal for a long time, don't worry. If there are medical staff in your community, you can contact the neighborhood committee for help to change the dressing at home. Just take good protection. The new crown is ruthless, but people are kind. During this epidemic, medical staff and volunteers have made a lot of efforts and hardships to protect their homes.

Regarding the frequency of dressing changes, for clean wounds, the dressing should be changed every 2 to 3 days until the wound is healed or the stitches are removed. If the wound is infected or special, the specific plan will be determined based on the professional doctor's opinion and an individualized plan will be developed.

There is one more thing that I need to share with readers, that is, the time to remove stitches is different for different parts of the body. Usually, the head, face and neck are removed after 4 to 5 days, the lower abdomen and perineum are removed after 6 to 7 days, the chest, upper abdomen, back and buttocks are removed after 7 to 9 days, and the limbs are removed after 12 to 14 days. If the patient is diabetic or the wound heals poorly, the time should be extended appropriately. Some cosmetic intradermal sutures and skin suture patches do not need to be removed, but the healing time is the same, that is, the dressing needs to be changed until the time to remove the stitches.

I personally think it is very meaningful to recommend this article to all of our lovely friends who are staying at home during this special period. If those trauma patients can change their dressings at home at this time, it will save them time, effort and worry, and also make a small contribution to our epidemic prevention work. I hope that we can work together to defeat the epidemic as soon as possible and let our beautiful Shanghai shine again.

Ju Yufeng, Shanghai Seventh People's Hospital