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
Select a wound dressing based on:
- the ability to keep the wound bed moist
- the need to adress bacterial bioburden
- nature and volume of wound exudate
- condition of the tissue
- condition of periulcer skin
- wound size, depth, and location
- presence of tunneling or undermining
- goals of the individual
Topical Therapy
Dressings
- 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.
Closure
Complications
Chronic wounds which are physiologically impaired may require special considerations.