When are wet dressings used?
Wet dressings can be applied to your child’s skin when they are experiencing an acute episode of eczema. This is when the application of moisturisers and topical corticosteroids are not able to control the condition. Wet dressings can be applied to a specific part of the body or the entire body. This can be done at hospital or in the home, for short periods of time. The Sydney Children’s Hospital Network offers a service where staff will attend your child’s home for a 5 day period. During this time the staff member will help with wet dressings and teach parents about managing your child’s eczema.
Wet dressings cover and protect the skin from the damage caused by a child’s scratching. The application of cool linen can provide relief from the heat and itching sensation of eczema, as the water from the linen evaporates. The wet dressings also help to hydrate the skin and enhance the absorption of moisturisers and topical corticosteroids.
Please note: Applying steroid cream to bleeding or broken skin is unlikely to sting or hurt your child. The bandage must be applied carefully and not have overlapping wet linen, as your child may experience irritation.
How are wet dressings applied?
1. Preparation of the equipment
All equipment should be organised in advance as this makes the procedure less traumatic for your child
- Linen and tubifast is cut to the size of each part of your child’s body and bandages are collected.
- Short lengths of tape, about 5cm are cut if bandages will be taped closed. Bandages may also be tucked to hold them in place.
- A wooden spatula or plastic spoon may be used to remove moisturiser from the jar, to prevent contamination.
A bath is prepared for your child with lukewarm water and a small amount of bath oil. Your child is given a bath and then is gently patted dry. Bathing should be once a day to minimise the skin drying out.
3. Application of topical corticosteroid
Corticosteroid ointment is applied to the eczema lesions on one part of the body.
4. Application of moisturiser
A generous amount of moisturiser is applied to the part of the body which is being wet dressed.
5. Application of linen
The linen is placed into a bowl containing warm water. It is then gently wrung out to remove the excess water. The wet linen is placed onto one part of the body.
6. Application of crepe bandages
Crepe bandages are firmly applied over the wet linen, so that the bandage is comfortable and allows a range of movement. The bandage is applied directly over the linen, as the bandage can cause irritation if it rubs the skin. The bandages are held in place with pieces of tape, or tucked in securely. If your child’s hand needs to be wet dressed, the thumb and fingers may be wrapped separately depending on the age of your child.
7. Application of tubifast
Lengths of tubifast are cut to the size of the part of the body and are put on over the crepe bandage.
8. Application of a wet dressing to your child’s face
A wet dressing may be applied to your child’s face. A face mask is drawn on paper and adjusted to make sure it is comfortable around your child’s eyes, nose and mouth. The paper mask is then used as a template to make a mask of linen. Corticosteroid cream or ointment and moisturiser are carefully applied to your child’s face. The linen is moistened with warm water, and then wrung out to remove the excess water. The wet linen is then placed onto your child’s face carefully. The linen is held in place with a crepe bandage and tubifast. If your child is less than 12 months of age, the head dressing must be removed prior to the parents going to bed, due to the increased risk of SIDS.
Extra moisturiser may be applied to your baby’s face overnight if they wake.
Helpful information to know when applying a wet dressing
- Ask a friend or relative to assist you to apply your child’s wet dressing, particularly for the first few times.
- Choose a time for applying wet dressing carefully. It should be a time when your child is not feeling hungry, tired, or upset.
- A 100% cotton t-shirt can be used instead of linen when applying a wet dressing to your child’s chest.
- Collect a few of your child’s favourite toys and games to provide comfort and distraction for them. TV and music can also be a useful distraction.
- Show your child how they can become involved in applying the dressing. They can help prepare the bandages, or help you apply the moisturiser onto their body. Your child can gain a sense of involvement in their treatment by assisting in the dressing.
- If it is a warm day, you can remove the bandages and tubifast, and spray water onto the linen. Spray water using a new, clean plastic spray bottle. This can prevent your child from becoming uncomfortable.
- Dress your child with one layer of clothing over a wet dressing on a hot day. For example, a t-shirt and shorts, or a dress. This is to prevent your child from becoming over heated.
Hospital In the Home (HITH)
CHW- (02)9845 3857
SCH – (02) 9382 0888 Mobile: 0417 226 650
Wash all linen and bandages in between wet dressings and have all equipment set up and ready prior to commencing.