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How to dress and bandage a wound

It’s necessary to dress and bandage a wound in order to protect it from contamination during the healing process while keeping the right balance of moisture by absorbing excess drainage.

Dressing and bandaging are two different but closely related concepts. A dressing goes directly against the wound to absorb excess fluids (called exudate) and prevent foreign debris from getting inside after you’ve already cleaned it. The purpose of bandaging is to protect and hold the dressing in place.

Some products, such as the standard Band-Aid, are a hybrid. The white gauze pad is the dressing and the tan adhesive strip is the bandage.

Dressing and bandaging is one step in the overall process:

  1. Get bleeding under control (use a tourniquet if it’s serious)
  2. Clean the wound
  3. If it makes sense, close the wound (sutures, staples, etc.)
  4. Dress and bandage

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Simple combo bandages are great for simple injuries. But larger wounds and those in awkward or active body locations tend to need more specialized solutions where you mix multiple components together.

We dig into different types of off-the-shelf products and DIY methods below. But the basic tips of how to dress and bandage a wound apply to every scenario.

Because one of the most important parts of the healing process is to prevent more contamination, you should use a proper, sterilized (ideally sealed) dressing. Try not to touch or contaminate the parts that will touch the wound.

In an austere survival situation, anything clean can work in a pinch — for example, you can boil strips of a cut t-shirt or bedding for 20 minutes.

wound bandage
Tip: Run a new white cotton t-shirt through a high heat cycle in your dryer, then put it in a ziploc bag for future use as a dressing, bandage, or clean-up cloth.

Whatever dressing you use should be slightly larger than the wound itself to create a little overlap. It’s fine to use several dressings to cover a larger injury.

If the dressing is a basic dry material, such as standard gauze or a cloth, you should add a thin layer of white petroleum jelly directly to the materials. The petroleum jelly will help keep the wound moist and prevent the dressing from sticking to the wound or scab.

will gauze stick to a wound
Petroleum jelly on plain gauze

However, studies have shown that adding an antibiotic cream — such as Neosporin or other products that contain Neomycin — doesn’t add any benefit beyond plain petroleum jelly. Worse still, the Neomycin runs the risk of causing an allergic reaction in some patients.

Even in an austere setting, don’t get creative or use homeopathic junk you heard about in a prepper forum. The only natural material that has enough medical evidence behind it is honey (although the official word is “this still needs more research”). Studies show that honey’s natural anti-bacterial, anti-oxidant, and anti-inflammatory qualities sometimes work well as a natural dressing.

Lay the dressing flat over the wound. If you can, use small medical tape around the edges to hold the dressing in that spot as you begin bandaging.

Dressing a pig’s foot

You have more flexibility in picking the bandaging material because it doesn’t directly contact the wound. A bandage can be rolled gauze, elastic, or even plastic saran/cling wrap. It’s helpful if the bandage is stored rolled so that you can easily wrap it around the patient.

purpose of bandaging
Plastic wrap bandaging

Making the bandage too tight delays healing because blood brings the body’s healing supplies to the wound. Make it just tight enough to keep the dressing protected.

Why you should trust us

Your three guides have 80 years of combined experience teaching or using these skills:

Tom Rader. 18 years in emergency medicine. Former paramedic and Navy Corpsman (medic) with Marine Recon in Iraq. Teaches wilderness medicine nationwide to students including wildland firefighters, first responders, and remote tribes.
Dave is a retired Forest Ranger and Tactical Medic, and currently teaches several Wilderness Medicine programs. In addition to involvement with medicine since the '80s he also has degrees in Wilderness Recreation Leadership and Forest Technology.
Mike Ruane retired after 27 years in emergency medicine as a paramedic and nurse. His career spanned from the streets of east Oakland to teaching military special warfare medics.

Do wounds heal faster covered or uncovered? Do wounds need air?

Covered wounds heal faster than those exposed to air because research shows a little moisture and warmth creates a better environment for tissue growth.

The extra protection also helps reduce new contamination, meaning you’re not adding more problems after the fact.

Scabs are basically the waste materials of reconstruction, and they impede the healing process by blocking the formation of new tissue where the scab is. So by keeping the area protected and moist, you make it easier for the body to heal. But you should never remove a scab — that will do more harm than good.

Airing out a wound can be helpful when it gets too wet. If you change a dressing and notice there’s too much drainage, or even rain and shower water that’s been absorbed, let the wound air dry a little before applying a new one.

Why tight bandages are counterproductive

The human body wants to heal — your main goal is to let it happen.

Right after the injury, the body enacts a number of processes to begin healing itself. In the first few minutes, the body attempts to minimize bleeding through clotting. Fibrous cells and platelets converge to plug the holes.

In the few hours after injury, the body starts sending in the “construction workers” and materials needed to lay down the foundations for the new tissues. At the same time, defensive cells are sent to fight infection.

Those processes slow down or stop when you choke off blood flow. Even other factors like cold temperatures, diabetes, and smoking can affect the process by crippling how well the body can move nutrients and oxygen to the wound.

If a dressing is soaked with blood, pus, or alien creatures

It’s time to troubleshoot when you notice a saturated dressing. A little spotting is expected, but anything more is a sign that you at least need to replace the dressing.

If you see blood: Dressings aren’t meant to absorb lots of blood — that should happen before dressing and bandaging.

You may have been taught to add clean dressings on top of blood-soaked dressings. The thinking used to be that the new dressings would work in tandem with the soaked ones, aiding the clotting process. But this has been disproven and is no longer taught.

If you see pus: A significant amount of discharge indicates an infection is present, especially if the exudate is colorful. After removing the dressing and any closures, you will need to clean the wound again.

Types of dressings

Band-Aids and other common “plasters” or strip bandages are always a good idea for small wounds. There are also special H-shaped Band-Aids designed to work between fingers, knuckles, and toes.

When treating an injury, you should consider the size and location of the wound in addition to how likely it will drain. Larger wounds and wounds that were contaminated before cleaning are more likely to have drainage.

Non-adherent pads (Telfa dressings)

Non-adherent pads are best for use on wounds that have light drainage.

We recommend Telfa dressings for most wounds because they have a cotton core inside a non-stick coating that breathes and absorbs fluids well. They can also be cut down to size or to fit in awkward areas.

Those qualities are why Telfa dressings are very common in hospitals, such as this dressing used after a knee surgery.

Wet dressings

Wet dressings include products like Xeroform and Vaseline Impregnated Gauze. These dressings conform well to contours and help keep the wound moist. Like Telfa dressings, wet dressings do not stick to wounds.

You can make your own wet dressing by thinly and evenly spreading white petroleum jelly on a gauze pad.

Tip: Resist the urge to be a crafty prepper — it’s too difficult to make and store your own wet dressings ahead of time in a way that keeps things sterile during storage.

Hydrogel dressings

Hydrogel dressings are great for surface abrasions and wounds that are dry or dehydrated because they transfer moisture to the wound. You don’t want to use a hydrogel dressing on a wound that is moist or showing signs of fluid discharge.

Hydrogel dressings need to be used with a protective bandage that will help keep them from drying out. Plastic wrap is a good choice.

Hydrocolloid dressings

Hydrocolloid dressings, like hydrogel, provide a moist environment to support wound healing.

They are longer lasting than most other types of dressings, yet they’re very flexible and easily molded around body parts that have a lot of motion.

Hydrocolloid dressings also do an excellent job of protecting the wound as they provide an impermeable barrier against bacteria and contamination.

The downside is that you cannot easily see the wound, so checking for infection and drainage is a challenge.

Transparent dressings (Tegaderm)

Transparent dressings such as Tegaderm are typically used in hospitals to secure IVs. Although they’re not great at absorbing wound discharge, they do a fine job letting moisture from under the dressing escape while keeping external wetness from coming in — a quality they want for an IV, but don’t want for an open wound.

Gauze sponges

Gauze sponges are a popular staple because they’re easy to find, cheap, and simple. But their 100% cotton construction means they will stick to a wound if used dry.

Gauze sponges are very economical, and you can make your own from a gauze roll by cutting off the size you need. They can also be used to create your own wet dressings.

Types of bandages

Plastic wrap

We recommend using plastic wrap in most cases. Plastic wrap is particularly great for preppers because you can find it almost everywhere, it’s versatile, cheap, reusable, washable, won’t stick to wounds, and makes it easy to see the dressing without removing the bandage.

We keep a few different sizes of plastic wrap rolls in our personal medical bags

Unlike elastic bandages, it’s difficult to overtighten a plastic wrap bandage, creating a natural ‘backstop’ that might help you during an adrenaline-pumping emergency.

Although plastic wrap can stick to itself, you’ll probably want to anchor the wrap with tape. Medical tape is great, but duct tape and other methods are fine.

A downside to plastic wrap is that it doesn’t breathe very well. So it’s essential to periodically relax the bandaging to air it out and keep moisture from building.

Tip: Buy a standard roll of plastic wrap from your grocery store and cut the roll into convenient sizes. We recommend a four-inch wide and two-inch wide roll.

Elastic bandages

Elastic bandages (commonly referred to as ACE wraps) work well on the extremities because they can wrap neatly around the limb.

It’s best to start wrapping the bandage below the dressing, working your way up towards the heart. Each pass should cover half of the previous wrap.

Do not pull the elastic bandage tight as you are passing around the limb. The point isn’t to create a pressure dressing for hemorrhage control.

Elastic bandages usually come with clips to secure the ends. You can also use tape.

The downside to elastic bandages is that you cannot see the dressing. You will need to visually inspect the dressing several times a day in the first couple of days and once a day after that. If the bandage becomes soaked with fluids, you should change it out for a clean one after resolving the issue.

Tip: Keep your ACE bandages rolled in a way that makes it easy to start the wrap and unroll around the patient.

Rolled gauze

how to bandage a wound with gauze

Rolled gauze is a common component in field kits and can be used as both a dressing and bandage by cutting off pieces to fit over the wound as a dressing, leaving the rest to form the bandage.

A gauze roll works well on tricky areas like the head and joints. You use it just like you would an elastic bandage: wrap the gauze around the dressing in overlapping layers, then secure with tape.

The biggest problem with rolled gauze is that it is absorbent and can stick to the dressing (and underlying wound), or can pick up moisture from the environment. It also obscures the dressing and is not easily reused once tainted.

Tip: Just like with elastic bandages, gauze has a “direction” and should easily unroll around the patient while allowing you to maintain control of the unused portion. There is no need to unroll it before use.

Self-adherent wrap (Coban; vet wrap)

A self-adherent wrap is a slightly-elastic material that coheres (it adheres to itself but not other materials), so you don’t need tape or clips to secure the wrap. Coban is a common name brand.

Coban does not do well in hot environments because the self-adhesion can get messy. It also contains latex, which can trigger an allergy in the patient.

How to stop a bandage from sticking to a wound

Wounds generally exude blood, pus, and other fun fluids during the healing process. Sometimes the fibers of the bandage or dressing absorb these fluids and create a connection with the wound and scab. Stickiness generally happens with dry cloth dressings on a wound that’s been allowed to dry out.

If a dressing does stick, try running a little clean and warm water over it to break the connection. Or you can gently press something wet and absorbent over the stuck dressing.

It may take a while for this process to work. Never force the dressing to come off, as you don’t want to disrupt the healing process by tearing fresh tissue away with the dressing.

How to bandage around an impalement

Removing an impalement is part of the wound care and cleaning process before you get to the bandaging step. But if you can’t or shouldn’t remove the impalement, you can dress around it with a “donut” bandage.

Place your dressing around the base of the impalement and then place the donut over top of the dressing. Secure the donut with another bandage, making sure to capture above and below the impalement.

How to make a donut bandage:

  1. Take a cravat (triangular bandage) and roll it starting with the 90-degree corner.
  2. Make a loop large enough to loosely fit around the impaled object. You can use your fingers or hand as a model for the size of the impaled object.
  3. Lace the loose ends around the body of the loop, starting outside and going inside the loop. Repeat this a few times until the donut is snug against the model. Tuck in the loose ends.
  4. Carefully slide the donut over the impalement.
  5. Secure the donut with another bandage wrapping around the bolstered sides.
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  • Avatar
    Joshua

    Favourite part of my month is seeing a new article in my email.

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    • Tom
      TomThe Prepared Joshua

      Thanks, @Joshua! We are happy to hear you find the content valuable.

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  • Jonnie Pekelny
    Jonnie Pekelny

    Here’s a general question about first aid and self-treatment of medical problems when SHTF. My problem is that I have a pretty bad phobia of “blood and guts.” (Don’t know where it comes from, possibly the fact that I had a tonsillectomy without anesthesia! when I was a kid.) Just listening to or reading about a description of injury or wound in any kind of graphic detail makes me literally weak and nauseated. I guess most folks aren’t quite at my level but I’ve heard of other people who faint at the sight of blood, etc. For me that’s always been a block to doing any kind of serious first aid prepping, although I know it’s important. I just don’t know how to get past that block. Are there any kinds of desensitization programs or something?

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    • Tom
      TomThe Prepared Jonnie Pekelny

      First off, what you are describing is very common. It is called an Acute Stress Reaction (ASR), and many people experience it in relation to medical situations, especially trauma. Humans are generally not wired to deal with other humans injured. I’ve had stone-cold, pipehitting Marines literally pass out when I was giving a flu shot (needles are another medical ASR trigger).

      You are correct in that desensitization is how you learn to move past it. If a description (or picture) of a wound is what triggers the response, avoid that in the initial stages.

      First work on building up the mechanical skill. Practice applying the dressing and bandage on a person (or section of PVC pipe) until you can do it without thinking. Once you have the skill down pat, you have to practice while progressively increasing your stressors.

      The next step is to make simulated, abstract wounds. Use a red sharpie and draw a simple line on the patient’s arm (or PVC). Practice with that until you are comfortable—you just have to work through it.

      Next move up to strawberry jam (or similar). The idea is to progressively use things that look like injuries but that you know are not. From there add some Karo syrup with red food coloring.

      What also helps is to understand that your training will be helping someone else through an emergency.

      Another thing to consider is that the trigger could be just from reading (or listening) to descriptions—you could be fine with an actual injury (or a moulaged simulation). Personally, there are certain photos of injuries that make me sweat, but that I have absolutely treated without problems in real life.

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    • Jonnie Pekelny
      Jonnie Pekelny Jonnie Pekelny

      Great suggestions — thank you. But what do you do to keep building up exposure tolerance once you’re past the strawberry jam on pipe model? I mean, eventually you want to expose yourself to things that are more and more like actual wounds, I guess… (Doesn’t sound fun to me, LOL). Not sure how to arrange that in stages in real life.

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    • Tom
      TomThe Prepared Jonnie Pekelny

      You are right that the progression needs to continue, and unfortunately the real-world test is not something that can be simulated 100 percent.

      When we teach wilderness medicine classes we use pigs feet for the wound cleaning and dressing/bandaging lab. You can also use a turkey/chicken leg, etc.

      If you are near an urban EMS department, you can likely do a ride-a-along for exposure–though there is no guarantee you will see something (also no guarantee on limiting exposure either).

      How do you manage simple cuts and scrapes right now? Shaving nicks? Paper cuts? Somehow I end up with some kind of minor injury at least a couple times a month. If you are able to manage those, realize that larger injuries are really the same thing–just a little bigger. The same principles apply.

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    • Jonnie Pekelny
      Jonnie Pekelny Jonnie Pekelny

      I do okay with small cuts and scrapes as long as they’re not super deep or bleed for really long periods of time. In fact last summer I managed to burn myself fairly significantly with hot oil on my leg while cooking. It looked pretty gross once it started peeling. That was borderline okay. Not sure if it would’ve been okay on another person. So maybe the solution is for me to inflict more and more serious wounds on myself? (Kidding).

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    • Tom
      TomThe Prepared Jonnie Pekelny

      Ha! Yeah, don’t do that!

      It sounds like it is more the thought of the injury rather than the action. Which means you’ll probably be fine. Just practice until the skills are second nature and it won’t be a thought process–just “muscle memory”… 🙂

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  • Nick

    Thanks for the detailed presentation. If I understand correctly, there is no need to treat the wound itself with antibiotics (once its properly cleaned). Should antibiotics be taken by mouth right away, or only if and when there are signs of infection? Or does it depend on the severity of the wound?

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    • Tom
      TomThe Prepared Nick

      Hi @Nick, that is correct–no need to put antibiotics into the wound. The most important thing is to clean the wound thoroughly and then protect it from contamination while also keeping it moist and warm (which can be done with white petroleum jelly on gauze).

      There is research that shows taking a prophylactic antibiotic at the time of injury can reduce the chance of infection, but you have to dose with a solid multispectral antibiotic. In the military we had “pill packs” that (at the time) contained a dose specifically for that purpose and we instructed to take those packs for any soft tissue injury. That said it is important to have a good understanding of antibiotics before choosing one.

      In general, I would take as few medications as possible, and would probably wait until there were signs of an increasing infection. If the wound was grossly contaminated, though, I would probably consider taking an appropriate antibiotic as soon as possible.

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