How to choose a right dressing
Moisture wound healing theory
Moist wound healing is the practice of keeping a wound in an optimally moist environment in order to promote faster healing.
- Favorable for the dissolution of necrotic tissue
A. Hydrate with exudate to release plasmin
B. Dissolve the fibrous sheath around small blood vessels and restore normal nutrient exchange
C. Immune cell chemokines, accelerate debridement
- Hypoxic condition of maintaining local microenvironment of wound
- Help cell proliferation, differentiation and migration
A. Maintain cell and enzyme activity
B. Rapid cell migration
- Retention of growth factors in exudates and promotion of their release.
A. Stimulate the proliferation of fibroblasts
B. Chemotactic agent for macrophages and neutrophils
- Keep wound temperature close or same as human body temperature:37
A. The mitotic rate of cells increased by 108%.
- Keep wound moist
B. No form scab and avoid twice machanical damage.
C. Avoid exposure of nerve endings to air and reduce pain
- Lower infection rate
A. Occlusive dressing, block outside microbe.
B. Moist wound infection rate 2.6%
C. Dry wound infection rate 7.1%
- The problem of saturated absorption or excessive stickiness of the dressing and staying on the wound:
• Wound Maceration
• Dressing leakage
• Damage surrounding skin
Wound bed preparation
“Complex” wounds
“Wound bed” preparation
- Tissue management
- Infection management
- Exudate management
- Edge of wound
“Wound bed” preparation complete
“Normal” wounds
How to choose a right dressing
Dressings should be selected based on the characteristics of the wound.
Wound type by Color of wound
Black wound: Necrotic tissue lacking blood supply, soft or hard, scabby, with little or no exudate.
Red wound: Granulomatous tissue with healthy blood flow, clean, healing
Pink wound:
- pink epithelial tissues
- The neoepithelial tissue is delicate and in the stage of skin climbing.
Alginate dressing and CMC dressings, which are useful for moderate to heavily exuding wounds, are primary dressings designed for use on wounds with moderate to heavy drainage.
A superabsorbent dressing can be a primary or secondary dressing which manages moderate to heavy wound exudate.
CMC dressing, foam dressing, transparent PU dressing are secondary dressings.
The longer wear time of these dressings minimizes the number of times the wound bed is disturbed which may improve healing outcomes.
Cost effectiveness should always be considered when selecting a dressing, however the least expensive dressing may not be the most cost effective. Longer wear time reduces clinician labor costs, a significant factor in overall wound care costs.
Dressing selection should be based on the needs of the wound to obtain the best outcomes for healing.
