How do I clean a wound that has packing in it?

Follow an ordered sequence: remove the old packing with gloves on, clean the wound gently with warm water and soap and pat it dry, inspect it, then repack with saline-moistened gauze squeezed until it is not dripping and cover with a dry pad. Wash your hands and change gloves between stages.

This is done as an ordered sequence during a wet-to-dry dressing change, and the order is the useful part: the packing comes out, then the wound is cleaned, then new packing goes in.

Taking the old packing out. Wash your hands thoroughly with soap and warm water. Put on a pair of non-sterile gloves. Carefully remove the tape, then 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 the wound. Put the old dressing, packing material and gloves in a plastic bag and set it aside.

Cleaning the 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. 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.

Looking, while you have it open. This is the part that gets skipped. Check the wound for increased redness, swelling, or a bad odor. Pay attention to the color and amount of drainage, and look for drainage that has become darker, thicker or foul smelling. Then remove your gloves into the bag and wash your hands again.

Repacking. New gloves again. Pour saline into a clean bowl and place the gauze pads and any packing tape in it. Squeeze the saline from them until they are no longer dripping. Place them in the wound, carefully filling the wound and any spaces under the skin. Avoid putting the moist gauze onto the skin. It goes only into the wound. Cover with a large dry dressing pad held with tape or rolled gauze.

Afterward. Put all used supplies in the plastic bag, close it securely, put it inside a second bag, close that, and put it in the trash. Wash your hands again.

Two things that are easy to miss. Your wound should not bleed much while you are cleaning it, and a small amount of blood is OK. And as the wound heals, you should not need as much gauze or packing gauze.

What to watch for

Check the wound at every change for increased redness, swelling, or a bad odor. Pay attention to the color and amount of drainage, and look for drainage that has become darker, thicker or foul smelling.

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, drainage that is increasing, drainage that is not decreasing after 3 to 5 days, and drainage that becomes thick, tan, yellow, green or smells bad.

Your wound should not bleed much when you are cleaning it. A small amount of blood is OK.

Avoid putting the moist gauze onto the skin. It goes only into the wound.

Wound Wizard is general education and is not a substitute for being shown. The clinician managing the wound is the right person to ask.

What we look at

  • Teaching and reviewing the packing technique
  • Measuring the wound and any spaces under the skin
  • Choosing the packing material
  • 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