Montgomery straps are adhesive strips that stick to the skin on either side of a wound, allowing dressings to be changed repeatedly without removing and reapplying tape each time. They work like a lace-up system: two adhesive panels sit on the skin flanking the wound, with eyelets or holes along their inner edges. Ties or laces thread through the eyelets and cross over the dressing, holding it in place. When the dressing needs changing, you simply unlace the ties, swap the dressing, and lace them back up.
How Montgomery Straps Work
Each strap has two parts. The bottom is an adhesive backing that attaches directly to the skin, similar to a large piece of medical tape. The top portion has a row of pre-punched holes or eyelets along one edge. Two straps are placed parallel to each other, one on each side of the wound, with the eyelets facing inward. A gauze tie, string, or elastic lace threads through the eyelets in a crisscross pattern over the dressing, cinching it snugly against the wound.
The key advantage is that the adhesive panels stay put for days. Only the ties are undone and redone with each dressing change. This is a simple concept, but it solves a real problem for wounds that need frequent attention.
Why Repeated Taping Damages Skin
Every time standard medical tape is pulled off the skin, it strips away some of the outermost skin cells. Do that once or twice and it’s minor. Do it several times a day for a week or more, and the skin becomes red, raw, and increasingly fragile. This type of injury has a clinical name: medical adhesive-related skin injury, or MARSI.
The problem is significant. In one study of post-surgical patients, 56.8% of those with standard acrylate adhesive dressings developed some form of adhesive-related skin injury. Nearly a quarter experienced outright mechanical damage to the skin, meaning visible stripping or tearing. Within just three days of surgery, 48% of patients in the standard adhesive group already showed signs of skin damage. Patients with gentler silicone-based adhesives fared better, with only 1% affected in that same three-day window, but even silicone adhesives cause some trauma over time when repeatedly removed.
Montgomery straps sidestep this cycle entirely. Because the adhesive panels stay in place and only the non-adhesive ties are handled during dressing changes, the skin underneath gets a break from the repeated peel-and-stick routine.
When They’re Most Commonly Used
Montgomery straps are most often used on abdominal wounds, particularly surgical incisions that need dressing changes multiple times per day. Abdominal surgery wounds are a natural fit because the surrounding skin is relatively flat, giving the adhesive panels a good surface to grip, and because these wounds frequently produce drainage that requires regular dressing swaps.
They’re also used for other large wounds in areas where tape would be impractical or painful to keep replacing. Any situation where dressings change more than once or twice daily is a strong candidate. Burn care, draining wounds, and wounds packed with gauze that needs regular repacking all benefit from this approach.
Who Should Avoid Them
Montgomery straps still require adhesive on the skin, so they aren’t suitable for everyone. People with extremely thin, fragile skin, common in older adults or those with conditions like venous insufficiency, can sustain tears or damage even from a single adhesive application. In these cases, the initial placement of the straps itself poses a risk.
Skin that is already broken, infected, or inflamed around the wound edges is another concern. The adhesive panels need intact, healthy skin to stick to. If the surrounding skin is compromised, alternative methods of securing dressings, such as body wraps, binders, or mesh netting, are typically used instead. In rare cases with severely compromised skin, clinicians may decide to avoid any adhesive contact altogether.
What They Look Like and What’s Available
Most Montgomery straps come pre-made in packages of paired strips. They are typically hypoallergenic, designed to minimize allergic reactions in sensitive skin. The adhesive panels are usually white or skin-toned, and the ties are often simple cotton gauze strips or elastic laces included in the kit.
They come in various widths and lengths to accommodate different wound sizes and body areas. A small wound might use narrow straps with just two or three eyelets per side, while a large abdominal incision could need wide, long strips with six or more eyelets to distribute pressure evenly across the dressing. Some versions use latex-free materials for patients with latex allergies.
How They’re Applied
Before placement, the skin on both sides of the wound is cleaned and dried thoroughly. Some clinicians apply a skin protectant or barrier wipe first, which creates a thin protective layer between the skin and the adhesive. This extra step helps the straps adhere better and reduces irritation when they’re eventually removed.
The adhesive panels are pressed firmly onto the skin, positioned far enough from the wound edge that they won’t interfere with the dressing or wound care but close enough that the ties can hold the dressing securely. Once both panels are in place, the dressing is laid over the wound, and the ties are laced through the eyelets and tied snugly. The tension should be firm enough to hold the dressing without compressing the wound or pulling uncomfortably on the skin.
When it’s time to change the dressing, the ties are simply untied or cut, the old dressing is removed, wound care is performed, a fresh dressing is applied, and the ties are relaced. The adhesive panels remain undisturbed throughout the process. They typically stay in place for several days before needing replacement, though this varies depending on how well they’re adhering and the condition of the surrounding skin.