Changing the dressing on an infected wound is an important part of wound care and healing. The frequency with which dressings should be changed depends on several factors, including the severity of the infection, the amount of drainage, and the type of dressing used. In most cases, dressings on infected wounds need to be changed more often than dressings on clean wounds in order to monitor the infection and allow proper healing. Here is a quick overview of how often infected wound dressings typically need to be changed.
Initial Assessment
When a wound is first identified as being infected, the initial dressing change is very important. This first dressing change allows medical professionals to assess and clean the wound, determine the extent of the infection, and choose an appropriate dressing. This initial dressing change should happen as soon as possible once infection is identified.
Moderate to Severe Infections
For moderate to severe wound infections, dressings usually need to be changed at least once a day. Severe infections require frequent monitoring and wound cleaning, so daily dressing changes are often the minimum recommendation. Some severe wounds may even require twice daily dressing changes to manage drainage, debris, and monitor the state of the infection.
Mild Infections
For mild wound infections, dressings may be able to be changed less frequently than severe infections. Typically, dressings should be changed every 2-3 days for mildly infected wounds. The frequency should be adjusted based on factors like how much drainage is soaking through the dressing and the state of the wound when the dressing is removed.
Specialty Dressings
Some more advanced wound dressings are designed to remain in place for longer periods of time, even on infected wounds with drainage. These dressings include ones with absorbent layers, silver antimicrobial coatings, and other features to help prolong dressing wear time. With these specialty dressings, healthcare providers may recommend less frequent dressing changes, like every 3-7 days. It is important to follow the recommendations for the specific dressing type.
Signs It’s Time to Change the Dressing
For infected wounds, the maximum time between dressing changes should follow the general guidelines based on wound severity. However, there are certain signs that indicate when a dressing change is needed sooner:
- The dressing becomes soaked with drainage
- Leakage of exudate around the edges of the dressing
- An odor coming from the dressing
- The wound dressing becomes loose or falls off
- Signs the infection is worsening like increased redness, swelling, pain
Paying attention to these signs and changing the dressing promptly when they occur is key for proper wound infection care.
Factors that Impact Dressing Change Frequency
Several factors impact how often dressings need to be changed on infected wounds:
- Wound severity – More severe infected wounds require more frequent dressing changes
- Drainage amount – Large amounts of exudate require more frequent changes
- Wound location – Areas prone to moisture buildup like the groin may need more changes
- Dressing type – Some modern dressings are made to stay in place longer
- Medications – Some topical medications require more frequent dressing changes
- Provider recommendations – Follow recommendations from the treating medical provider
Considering these factors will allow for choosing an appropriate dressing change frequency to both manage the infection and avoid disrupting healing by changing dressings too frequently.
Steps for Dressing Changes
When changing a dressing on an infected wound, proper technique and infection control is vital. Here are the recommended steps:
- Wash hands and gather supplies – Have clean gloves, new dressing, antiseptic solution, and other items close by
- Remove old dressing gently – Remove soiled dressing and discard while avoiding contaminating surroundings
- Clean wound – Use antiseptic solution like saline or antiseptic wash and clean the wound surface of debris and drainage
- Assess wound – Note wound characteristics like size, depth, odor, and signs of infection
- Apply medication if needed – Apply any creams, ointments as prescribed
- Place new dressing – Cover wound with sterile, appropriate new dressing
- Secure dressing edges – Use tape or bandages to keep dressing in place and avoid leakage
- Wash hands – Wash hands after dressing change is complete and clean up area
- Document – Document dressing change details like wound assessment, appearance, odor in patient chart
Aseptic technique is vital to avoid contaminating the wound or introducing new pathogens during the dressing change process. Proper documentation also helps track wound progress over a series of dressing changes.
Signs of Healing
During dressing changes, assess the wound for signs of healing. Signs may include:
- Decreased amount of drainage
- Reduced swelling
- Less redness
- No odor
- Tissue regrowth
- Wound edges pulling together
These signs indicate the infection is responding to treatment and the wound beginning to heal. As healing progresses, dressing change frequency can gradually be reduced.
Common Dressing Types for Infected Wounds
Selecting an appropriate wound dressing is key for managing wound infections. Here are some common dressing types used:
| Dressing Type | Features |
|---|---|
| Gauze pads | Inexpensive, absorbs drainage, allows wound monitoring |
| Transparent film | Allows observation without removing, maintains moisture |
| Alginate dressings | Absorb drainage, facilitate autolytic debridement |
| Foam dressings | Cushion wound, absorb moderate drainage |
| Hydrocolloid | Absorb drainage, promote moist healing environment |
| Antimicrobial gauze | Impregnated with antimicrobials like silver to combat infection |
The healthcare provider will select the ideal dressing type for each patient and wound type. Following recommendations for use and change frequency is crucial.
Warning Signs of Infection
During dressing changes, assess the wound for any worsening signs of infection. These may include:
- Increased amount of exudate or pus
- Bright red wound bed
- New red streaks extending from wound
- Strong foul odor
- Increased wound pain
- New drained abscess
- Signs of systemic infection like fever, chills
Notify the provider immediately if any of these warning signs are present, as they may indicate a worsening or uncontrolled infection requiring medical intervention.
When to Seek Medical Attention
In some cases an infected wound requires urgent medical attention between dressing changes. Seek immediate care if:
- Fever above 100.4 F
- Redness, swelling, streaking, or tenderness expands rapidly
- New onset chills, dizziness, confusion
- Increasing pain that is not controlled by medication
- Green or brown pus draining from the wound
- Foul odor coming from the wound
These could signal a serious spreading infection, sepsis, or osteomyelitis. Prompt medical treatment is needed to address worsening infection.
Avoiding Infection When Changing Dressings
Proper technique during dressing changes is vital to avoid introducing new pathogens into the wound and causing additional infection. Tips to prevent infection include:
- Proper hand hygiene with thorough washing or alcohol-based hand sanitizer
- Using sterile gloves and sterile dressing supplies
- Careful wound cleaning using sterile technique
- Appropriate wound antiseptic solutions
- Properly discarding soiled dressings and gloves
- Keeping the wound covered between dressing changes
- Cleaning the dressing change area between patients
Meticulous aseptic technique and infection control practices during dressing changes are crucial for preventing additional contamination or infection.
Partnering With the Healthcare Team
Successfully managing wound infections requires an integrated care team approach. As the patient or caregiver, you play a key role:
- Attend follow-up appointments for wound checks
- Ask questions and discuss concerns with your provider
- Follow instructions for dressing changes and wound care
- Watch the wound appearance and contact the team with any changes
- Report signs of worsening infection promptly
- Share your preferences and goals for wound healing
By partnering closely with your healthcare providers and reporting details during dressing changes, the team can best assess and treat the infected wound.
Conclusion
Frequent dressing changes are a crucial part of properly managing infected wounds. For moderate to severe infections, dressings typically need to be changed at least daily, sometimes more often depending on the amount of drainage and other factors. Even for mild infections, dressings need to be changed every 2-3 days in most cases. Specialty dressings may allow for longer wear time between changes. It is important to assess for signs of worsening infection with each dressing change and contact the care team promptly if any are present. With a collaborative effort between patients, caregivers, and providers, infected wounds can be effectively treated and healed.