Pressure Dressing Application: Avoiding Pressure Points

Correct Technique for Securing a Pressure Dressing

A pressure dressing must distribute force evenly. Never tie a knot directly over the wound – it creates a focal pressure point that can cause tissue necrosis or nerve injury.

Proper Application Steps

1. Place a sterile non‑adherent pad directly on the wound.
2. Apply a bulky gauze roll over the pad for absorption and pressure.
3. Wrap with an elastic bandage (e.g., Ace wrap, Israeli bandage) using a spiral, overlapping technique (figure‑8 for joints).
4. Each turn should overlap the previous by 50‑75%.
5. Secure the end with tape, clips, or the bandage’s built‑in fastener – no knots over the wound.

Check After Application

• Capillary refill < 3 seconds distal to dressing.
• Pulse palpable (if accessible).
• No numbness, tingling, or color change in the extremity.
• Dressing is snug but not tourniquet‑tight.

Why Knots Are Harmful

• Concentrate force on a small area → ischemia, pressure ulcer, nerve compression.
• Difficult to adjust or remove quickly.
• Can slip and become a constricting band.

Remember: Even pressure + secure fastener = effective hemostasis without iatrogenic injury.