Wound Care
Sample Scripts for Care of Different Wound Types
Burn
Initial Dressings (when wound drainage is heavy, first 1-2 weeks): Usually changed 1-2x/day.
- Bacitracin ointment applied to Adaptic then applied to wound
- Cover with Abdominal pad
- Secure with Kerlix or Flexicon
Once Drainage Slows: Usually changed every 2 days.
- Cover wounds with just Polymem or Mepilex
- Secure with Flexicon
Aquaphor or similar emollient should be applied to newly healed skin daily to prevent drying out and cracking.
Frostbite
Initial Dressings (when wound drainage is heavy, first 1-2 weeks): Usually changed 1-2x/day.
- Bacitracin ointment applied to Adaptic then applied to wound.
- Cover with Abdominal pad.
- Secure with Kerlix or Flexicon.
Once Drainage Slows: Usually changed every two days.
- Cover wounds with just Polymem or Mepilex.
- Secure with Flexicon.
Aquaphor or similar emollient should be applied to newly healed skin daily to prevent drying out and cracking.
Allow blackened areas to remain dry. No ointment application here.
Abscess
Lightly fill wound cavity with Packing Strip (usually ¼” width) or Calcium Alginate (Sorbalgon).
If drainage is heavy: Usually changed daily.
- Cover with Adaptic and ABD pad.
- Secure with Flexicon.
If drainage is light: Usually changed every two days.
- Cover with Polymem or Mepilex.
- Make sure all edges are secure (Medipore tape, Medipore pad, Tegaderm or wrap).
Discontinue packing once wound bed has filled and cavity no longer exists
Tunneling Abscess
Lightly fill wound tunnel with Packing Strip to base of tunnel. Then fill remaining cavity with more Packing Strip or Calcium
Alginate (Sorbalgon).
If drainage is heavy: Usually changed daily.
- Cover with Adaptic and ABD pad.
- Secure with Flexicon.
If drainage is light: Usually changed every two days.
- Cover with Polymem or Mepilex.
- Make sure all edges are secure (Medipore tape, Medipore pad, Tegaderm, or wrap).
Discontinue packing once tunnel is <2 cm.
Pressure Ulcer/Injury
Stage II: Usually changed every 3 days.
Cover wound with Tegaderm Hydrocolloid or Duoderm.
Stage III and IV
Fill wound cavity with Packing strip (usually ¼” width) or Calcium Alginate (Sorbalgon).
If drainage is heavy: Usually changed daily.
- Cover with Adaptic and ABD pad.
- Secure with Tegaderm transparent film.
If drainage is light: Usually changed every three days.
Cover with Duoderm or Tegaderm Hydrocolloid
Laceration
If edges are slightly jagged but can nearly come together:
Apply Steri strips or tissue adhesive.
If edges are quite jagged and cannot approximate: Usually changed daily.
- Apply bacitracin to wound (use <1 week).
- Cover with Adaptic and gauze and secure with Medipore pad for first 2-3 days.
Once bleeding/drainage slow: Usually changed every 2-3 days.
- Cover with Polymem or Mepilex.
- Make sure all edges are secure (Medipore pad, Tegaderm, Medipore tape, or wrap).
Abrasion
If drainage is heavy: Usually changed daily.
- Cover with Adaptic and gauze.
- Secure with Medipore pad.
If drainage is light: Usually changed every 2-3 days.
- Cover with Polymem or Mepilex.
- Make sure all edges are secure (Medipore pad, Tegaderm, Medipore tape, or wrap).
See Physical Therapy for information about Wound Care.
