What does it mean to pack a surgical wound?

Packing means placing gauze or packing tape inside the wound, filling the wound and any spaces under the skin, then covering it with a dry dressing. It keeps the skin from closing before the wound underneath fills in.

Packing means putting dressing material inside the wound rather than only over it. It is one step in wet-to-dry dressing changes: place the gauze pads or packing tape in your wound, carefully filling in the wound and any spaces under the skin.

There is a precise boundary that is easy to get wrong: avoid putting the moist gauze onto the skin; put it only into the wound. Moist material sitting on intact skin is a separate problem, and the instruction exists to prevent it.

The packed material is then covered. Cover the moistened gauze or packing tape with a large dry dressing pad, held in place with tape or rolled gauze.

Why pack at all? An open surgical wound heals from the inside to the outside, and a dressing helps absorb drainage and keeps the skin from closing before the wound underneath fills in. Packing is how a wound with depth, or with spaces under the skin, is kept open and absorbing while it fills.

In a wet-to-dry dressing specifically, the packing is doing a second job as it comes out. A wet or moist gauze dressing is put on the wound and allowed to dry. Wound drainage and dead tissue can be removed when you take off the old dressing.

There is a measure of progress built into this. As the wound heals, you should not need as much gauze or packing gauze.

Packing is taught by the people managing the wound, and the amount and the material are chosen for that wound. Nothing here is a substitute for being shown.

What to watch for

Avoid putting the moist gauze onto the skin; put it only into the wound.

As the wound heals, you should not need as much gauze or packing gauze. Needing more rather than less is worth reporting.

When you clean a packed wound, it should not bleed much. A small amount of blood is OK.

Reasons to contact your provider include worsening redness, more pain, swelling, bleeding, a wound that is larger or deeper or looks dried out or dark, and drainage that is increasing, not decreasing after 3 to 5 days, or becoming thick, tan, yellow, green or foul smelling.

Wound Wizard is general education and cannot assess your wound. The clinician who taught you the packing is the right person to ask.

What we look at

  • Measuring the wound and any spaces under the skin
  • Choosing the packing material and how much to use
  • Teaching the packing technique
  • Reducing the packing as the wound fills

Sources

  1. Wet-to-dry dressing changes — MedlinePlus, U.S. National Library of Medicine https://medlineplus.gov/ency/patientinstructions/000315.htm
  2. Surgical wound care - open — MedlinePlus, U.S. National Library of Medicine https://medlineplus.gov/ency/patientinstructions/000040.htm