Wound Dressings with Drains

   1. Perform hand hygiene, don gloves, and remove old dressing.
   2. Remove gloves, and perform hand hygiene.
   3. Establish sterile field.
   4. Don personal protective equipment.
   5. Clean and irrigate surgical wound or traumatic wound as indicated.
   6. Change gloves; apply liquid skin barrier to periwound area and allow to dry; open 4 x 4 gauze pad and apply on top of wound and around drains. Avoid wrapping gauze around drain site.
   7. Apply gauze dressings from area of least contamination to area of greatest contamination.
   8. If necessary, apply ABD or other absorptive dressing over 4 x 4 gauze pads.
   9. Apply tape or Montgomery straps to secure dressing. Hydrocolloid wafers may be placed on skin, creating a protective barrier for application of tape or Montgomery straps.

    * Tape: Apply hypoallergenic tape across the wound dressing extending approximately 2 inches beyond dressing onto skin.
    * Montgomery straps:
    * Apply a liquid or hydrocolloid barrier to surrounding skin when Montgomery straps are used.

   1. Peel paper backing off Montgomery straps and apply to skin surface using gentle, even pressure.
   2. Lace cotton tape (twill tape, umbilical tape, tracheostomy ties) through holes in the Montgomery straps in a crisscross fashion.
   3. Document in patient record.