The simplest nonadherent dressing is a ribbon of petrolatum-based ointment applied to the wound with a small gauze pad over it. When wrapped with gauze and secured with tape, such a dressing will remain moist for the first 24 h. This simple approach is appropriate for clean, closed wounds with minimal exudate. Several nonadherent dressing materials have been developed for use on open, larger, and more exudative wounds and burns. These materials can be occlusive, semipermeable, or porous. While wounds treated with the newer semipermeable materials may tend to heal faster and with less pain, there is no clear benefit over the older and less expensive porous materials. The nonadherent material should be cut to extend beyond the wound area.
A layer of gauze squares is placed over the nonadherent layer to absorb any exudate. While it is possible to tape the gauze squares directly to the adjacent skin, this is uncomfortable for the patient; moreover, as the sweat loosens the tape, such a dressing usually does not last for more than a few days. In general, the first two layers are held in place by a wrap, usually of gauze. Wrapping is easy over tubular body portions (e.g., the forearm) and more difficult over irregular areas (e.g., the shoulder).
Either tape or elastic bandages secures the wrapping layer. Tape should be applied in a spiral manner to allow for edema and swelling; it should never be wrapped circumferentially around an extremity or digit. Elastic bandages must likewise be applied with allowance for expansion during the following 24 h.
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