An abdominal dressing requiring frequent changes can be secured with Montgomery straps to promote the patient's comfort. If ready-made straps aren't available, follow these steps to make your own:
- Cut four to six strips of 2″ or 3″ wide hypoallergenic tape of sufficient length to allow the tape to extend about 6″ (15.2 cm) beyond the wound on each side. (The length of the tape will vary according to the patient's size and the type and amount of dressing.)
- Fold one of each strip 2″ to 3″ (5 to 7.5 cm) back on itself (sticky sides together) to form a nonadhesive tab. Then cut a small hole in the folded tab's center, close to its top edge. Make as many pairs of straps as you'll need to snugly secure the dressing.
- Clean the patient's skin to prevent irritation. After his skin dries, apply a skin protectant. Then apply the sticky side of each tape to a skin barrier sheet composed of opaque hydrocolloidal or nonhydrocolloidal materials, and apply the sheet directly to the skin near the dressing. Next, thread a separate piece of gauze tie, umbilical tape, or twill tape (about 12″ [30.5 cm]) through each pair of holes in the straps, and fasten each tie as you would a shoelace. Don't stress the surrounding skin by securing the ties too tightly.
- Repeat this procedure according to the number of Montgomery straps needed.
- Replace Montgomery straps every 2 to 3 days or whenever they become soiled. If skin maceration occurs, place new tapes about 1″ (2.5 cm) away from any irritation.
