Wound care dressing basics

Overview

Selecting appropriate dressings for wound care can improve lives and save limbs. The choice of topical treatment, debridement, the selection of appropriate dressings, and type of closure depends on the type of wound being treated.

General Considerations

The ideal wound dressing:

• has the ability to keep the wound bed moist while absorbing excess fluids
• protects the wound from further damage
• addresses bacterial bioburden
• does not injure viable surrounding peri-wound tissue
• achieves hemostasis
• debrides necrotic tissue
• is appropriate for wound size, depth, and location
• inexpensive with a long shelf life
• doesn't cause the patient pain during changes

Dressing Types

1. Hydrocolloid
2. Hydrogel
3. Alginate
4. Foam
5. Silver-Imprenated
6. Silicone
7. Collagen Matrix
8. Gauze

• Wet-to-Wet Dressings

Indication: To keep a clean wound clean and prevent the build-up of exudates. Technique: Moisten a piece of gauze with saline and just barely squeeze out the excess fluid so it isn't soaking wet. Unravel the gauze, place it onto the wound, and cover with a dry dressing over the top. The dressing should not be allowed to dry or stick to the wound. Change 2-3 times per day. Moisten with saline if it gets too dry.

• Wet-to-Dry Dressings

Indication: To clean a dirty or infected wound. Technique: Moisten a piece of gauze with saline and squeeze out the excess fluid so it is damp, not dripping wet. Unravel the gauze, place it onto the wound, and cover with a dry dressing over the top. The dressing is allowed to dry out and when it is removed it pulls off the debris. Ideally, change 3-4 times per day. Change more often on a wound that is in need of more debridement, less often on a cleaner wound. Switch to the wet-to-wet dressing when the wound is clean. Note: The wet-to-dry dressing is not a substitute for mechanical/sharp debridement.

Complications

Chronic wounds which are physiologically impaired may require special considerations.

See Also

• Burn dressings