The Pseudo-Occlusive Dressing

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In surgical nursing, we will be changing a lot of dressings. This pseudo-occlusive dressing is our go-to dressing whenever a simple change is in need.

I call it pseudo-occlusive because it’s not a true occlusive (no fluids get through) dressing. The most common/cheapest occlusive dressing is likely the Tegaderm. However, Tegaderm dressings come in several different sizes and what we need might not always be stocked and (shocker) I hate waiting.

What is my version of a pseudo-occlusive dressing?

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It’s simple dressing applied with silk cloth surgical tape (2″ tape or larger is preferred). We start by applying whatever type of dressing is ordered for the wound, incision, Jackson Pratt (JP) site (etc.), then we layer overlapping pieces of tape covering the entirety of the dressing. The overlapping tape prevents drainage from getting on the patient. The dressing should be checked at minimum once a shift. It will leak on the patient if we allow it to become saturated. Silk tape works far better than paper or Transpore tape for adhesion and preventing drainage coming in contact with patient clothing.

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Tape framed dressing allows for drainage to quickly saturate its center.

Once we learn this technique, it’s there for life. Don’t ask me why, but I used to “frame” the majority of my dressings.

Benefits of the pseudo-occlusive dressing?

  • There’s always silk tape around
  • It’s easy to apply
  • It’s sturdy
  • Patients don’t get drainage on themselves (patient comfort)

When shouldn’t we use this dressing?

  • Anytime a site that should remain sterile needs reinforcing (Tegaderm is the dressing of choice because it comes in sterile packaging)
    • PICC dressings
    • Nephrostomy tubes
    • IV sites
    • Etc.
  • When patient is allergic to adhesives
  • Anytime the physician (usually a vascular surgeon) wants a specific dressing applied, which the order should reflect
  • When it’s clear drainage is no longer a problem

This versatile surgical dressing can be used in other areas and will set the foundation for when I begin writing about JP drains and other surgical applications. Remember to ensure it is an appropriate dressing and build a technique. Some surgeons will tell us, “You can’t change a dressing properly with gloves on.” I urge you to ignore that and use your personal protective equipment (PPE) when applicable.

-Nurse David

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