Wound Care Dressings

Myth # 3-Wound dressings cover a wound and offer little in the way of healing

Choosing the right type of dressing to optimize wound healing and prevent complications is key to wound management. However, the proliferation of wound dressings that have flooded the market in recent years causes confusion among healthcare professionals. How can we, as wound care practitioners, be expected to keep up with new advances and new knowledge in the specialty of wound care management? I hope that the following will shed some light on new advances in wound dressings.

Moist Wound Healing

The old standard of wet-to-dry dressings has been replaced with a myriad of wound dressings that are geared towards treating specific wound care issues, but moist wound healing remains an important concept in wound care management. Moist wound healing is still the gold standard, as it provides and maintains moisture of exposed tissues and does not encourage these fragile tissues to dry out. Research has shown that keeping wound tissues moist has the following benefits:

• Increased rates of healing
• Improved cosmetic results
• Reduced pain for the patient
• Reduced rates of infection
• Reduced associated costs

In general, wound tissues should be moist; that is, not dry and not wet.

Dressings That Absorb Exudate

These dressings are used for wounds that create levels of exudate that are moderate to high. They have the ability to capture and hold fluid, which means that patients will require fewer dressing changes. The advantage of these dressings is that they permit undisturbed wound healing, are less labor intensive for caregivers, and afford increased cost savings. Examples of these types of dressings include foams and calcium alginate dressings.

Dressings That Maintain Hydration

These dressings are used on wounds that have progressed to the formation of granulation tissue, and have begun to fill in with new connective tissue. Wounds of this nature have decreasing levels of exudate, so continuing use of an absorbent dressing could dehydrate the wound tissues, causing delayed healing. These types of dressings actually maintain the natural moisture levels of the wound without active absorption. Examples of dressings that maintain hydration include hydrocolloid and transparent film dressings.

Dressings That Donate Moisture

These dressings are designed for wounds that are already dehydrated and covered by dry, dead tissue. Wounds such as these will not heal unless these tissues are removed. These dressings promote autolytic digestion, or the slow digestion of dead cells by the process of phagocytosis. These dressings maintain a moist environment to facilitate the process of breaking down these dead cells, and to actively add moisture to the wound. These dressings contain water. Examples of these types of dressings are amorphous hydrogels and sheet or water hydrogels.

Dressings That Address The Biochemical Wound Environment

Newer dressings can be particularly useful for wounds that have stalled in the healing process. They function by interacting with the chemical environment of the wound itself, and are considered an “active” dressing because they actually change the environment of the wound. There are several biochemical aspects of a wound that may affect the cells or cellular processes thought to be important in the healing process. Some of these include:

• Local levels of tissue proteases
• Levels of cytokines and growth factors
• Presence and duration of tissue hypoxia
• Reactive oxygen species
• Levels of bacteria (bioburden)

New dressings are currently available (and more are being developed) which will address the biochemical imbalance that occurs in chronic and nonhealing wounds. Three types of dressings are available that seek to correct imbalances in levels of proteolytic enzymes (specifically MMP’s), collagen, and microbes.

As is obvious, rapid changes in knowledge and technology have led to the development of numerous dressings that are specifically targeted towards the treatment of different types and stages of wounds. In this day and age of such rapid development, it is imperative that healthcare professionals stay abreast of the most current and evidence based knowledge available. Woundeducators.com can help you stay current by providing up-to-date information as it becomes available and by making it easy for you to become certified in wound care. Wound care certification provides documentation of a health care practitioner’s knowledge in current dressing availability and use.

Take the first step towards improving your life and the life of the patients that you care for.  Become wound care certified.   Register Today!