Skill 18

Dressings

Dry and Moist-to-Dry

Dry dressings are commonly used for abrasions and nondraining postoperative incisions. Dry dressings are not appropriate for debriding wounds. Moist-to-dry dressings (also called wet-to-dry or damp-to-dry) are gauze moistened with an appropriate solution. The primary purpose is to mechanically debride wounds, specifically full-thickness wounds healing by secondary intention and wounds with necrotic tissue. A moist-to-dry dressing has a moist contact dressing layer that touches the wound surface. The moistened gauze increases the absorptive ability of the dressing to collect exudate and wound debris. This layer dries and adheres to dead cells, thus debriding the wound when removed. Use a sterile isotonic solution such as normal saline or lactated Ringer’s to moisten dressings. The outer absorbent layer is a dry dressing that protects the wound from invasive organisms.

Delegation Considerations

The skill of applying dry and moist-to-dry dressings may sometimes be delegated to nursing assistive personnel (NAP) if the wound is chronic (see agency policy and state Nurse Practice Act). All wound assessments, care of acute new wounds, and wound care requiring sterile technique cannot be delegated. The nurse directs the NAP about:

▪ Any unique modifications of the dressing change, such as the need for use of special tape or taping techniques to secure the dressing.

▪ Reporting pain, fever, bleeding, or wound drainage to the nurse immediately.