Step-by-Step Surgical Bandage Change Instructions

1
How and When To Change a Surgical Bandage

Nurse changing surgical bandage on patient
Science Photo Library/Getty Images

Changing a surgical bandage is not difficult, but it is important that the dressing change be done correctly in order to protect your incision and prevent infection. To best protect your incision, your hands need to be very clean when doing this procedure. Most people think they wash their hands properly, but most do not, so consider reviewing proper hand washing technique prior to doing a bandage change.

If you are changing the bandage of a loved one, it is important to add gloves to the process, worn to protect both you and the surgery patient. Put on a clean pair of gloves after steps one, three and six.

When to Change Your Surgical Bandage

Plan on changing your bandage daily or more often if it is visibly soiled or wet, unless your surgeon has given instructions to the contrary.

2
Know Proper Hand Washing Technique

Read this document to learn how to wash your hands properly.

It may seem that there is an excessive amount of hand washing in the process of changing a bandage, but this is done to prevent infection and is necessary. Proper hand washing is the best way to prevent infecting your incision and spreading germs.

3
Remove the Surgical Bandage

To remove a bandage without inflicting pain, do not pull the bandage away from the skin, rather pull the skin away from the bandage. This way, pain is minimized and the process is far gentler on the tender skin surrounding the incision.

If you notice redness not on the incision, but where the tape rests, you may have a sensitivity to the tape you are using. Paper tape has less adhesive than other types of bandage tapes and while it doesn’t provide as strong a seal, it may irritate your skin less.

4
Change the Surgical Bandage

Again, you must wash your hands. Why? Now that you have your dirty bandage off, it is important to clean your hands again before touching your incision. The bandage and your hands will both have bacteria on them at this point so washing again is essential.

If you are going to shower before placing the bandages on your incision, you can wash your hands in the shower before you clean your incision.

5
Clean the Incision

Cleaning your incision can be done with soap and water. You can clean your incision in the shower, or you can do it at the sink. If you are providing this care for a surgery patient who cannot move to the bathroom, be sure to use a fresh and clean washcloth or other material to clean the incision and another clean washcloth to pat the incision dry.

Use soap and water to gently clean the incision, you do not have to use antibacterial soap. Do not scrub the incision, remove scabs, or attempt to clean the sutures or staples.

Pat the incision dry or allow it to air dry. Do not put the bandage on a damp incision unless you are changing a “wet to dry” dressing, which has its own method not discussed here.

6
Check the Incision

This is the best time to check your incision for signs of infection and to make sure the incision is staying closed.

Your incision may be red, but it should become less red as it heals. It should also be "well approximated" meaning that the sides join together neatly without gaps. It should not look as though it is beginning to pull apart.

At this time, check for any drainage from the wound, including blood and pus.

7
Wash Hands Again

You must wash your hands.

If you did not shower to clean your incision, it is important to clean your hands again. This way any infectious material that was cleansed from your incision will not be reintroduced into your wound.

This is especially important if there are signs of infection in your wound. Failing to clean your hands at this point may reintroduce infectious material to your clean wound.

8
Put on a New Bandage

You can now place your clean bandage on your incision. If your surgeon has prescribed any special ointments or treatments, this is the time to apply them. Do not use any lotions, powders or cleansers that have not been approved by your surgeon.

If possible, take the bandages out of the package as needed and place them directly on the incision. Avoid placing the bandages on the sink or the back of the toilet or on a table. This will help prevent contaminating the dressings that touch your incision. If you must set the bandage aside, try to use the clean inside of the paper wrapper to keep the bandage off of contaminated surfaces.

If your incision has drainage, you may need to place several layers of bandages. If there is a great deal of drainage, you may need to both reinforce the dressing with extra layer and plan on changing the dressing more frequently. This is also true if you have a surgical drain in place. 

Once the bandage is covering the incision with at least half an inch extra bandage on each side, you can tape it into place. Tape all four sides into place, until the bandage is sealed. You may need to use a few extra pieces of tape if the bandage is thick.

9
Dispose of Old Bandage Properly

Throw away the old bandage. If it is bloody or you have infectious drainage seeping from your wound, you may want to wrap the bandage in a plastic bag before disposing of the dressing. Putting bandages down the toilet is not advisable as most types will clog the plumbing.

Pets can be drawn to soiled bandages, so if you have a pet you may want to dispose of the bandage outside or in a container with a lid.

10
Wash Hands Again

Wash your hands (yes, again!).

Now that your incision is covered and your dirty bandage has been thrown away, wash your hands one last time. This last wash insures you can go about your day without spreading any bacteria or infection that was on your old bandage.

Sources:

Living With MRSA. Maine.gov http://www.maine.gov/dhhs/boh/documents/scLivWithMRSA06.pdf

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