Wound Dressings

“You can’t teach an old dog new tricks”. How often have we heard this saying and never thought of it as applying to ourselves? All of us can be guilty of clinging to the old and familiar at times, and wound care is no exception. Are you still attached (pardon the pun) to old ways of dressing wounds, simply because that’s the way you’ve always done things? If this applies to you, our new series of articles will provide you with an overview of all of the “new” dressings available, and when and why they should be used. It’s time to bid a fond farewell to our old friend, the traditional dressing.

 

Older is Not Always Better

Traditional dressings, which usually refer to gauze dressings and sometimes the application of an ointment, are quickly becoming a thing of the past, as today’s emphasis on evidence-based practice has shown these dressings to be inefficient and costly in terms of labour. Gauze dressings require frequent changing, or at least frequent remoistening, and are not cost-effective in today’s climate of cost efficiency.

Not only are they not cost-efficient, but they are not particularly effective in terms of healing, either. Ovington (2001) points out that gauze dressings, even wet-to-dry gauze dressings, cause tissue debridement, but often of healthy tissue as well. This can lead to increased pain, delayed healing, and risk of infection for the patient; thus, wet-to-dry dressings are no longer acceptable practice.

Several agents commonly used to treat wounds in the past have now become more and more obsolete, as evidence shows hem to be more harmful than helpful. Old standards, such as Betadine and peroxide, lead the pack. The Agency for Health Care Research and Policy (2008) states, “Do not use povidone iodine, iodophor, sodium hypochlorite solution, hydrogen peroxide and acetic acid as they have been shown to be cytotoxic”. These agents may add to your patient’s discomfort and may delay healing.

 

The New Guard- Advanced Dressings

What can the new generation of dressings do that the old dressings can’t? You may think of the new dressings as “specialists”, each tackling specific areas of wound healing, such as:

Ÿ  Absorbing exudate

Ÿ  Maintaining hydration

Ÿ  Donating moisture

Ÿ  Addressing the biochemical wound environment

 

However, the most important precept of wound care has not changed: moist wound healing is still the gold standard. Research has been able to show that keeping wounds moist increases rates of healing, reduces patient discomfort, decreases rates of infection, improves cosmesis, and reduces associated costs.

 

Over the next several weeks, we will examine the “next generation” of advanced wound dressings, paying particular attention to indications and contraindications, as well as advantages and disadvantages of each dressing.

 

If you would like to know more about becoming a wound care management specialist, please visit www.woundeducators.com for more information.

 

References:

Ovington, L. (2007). Advances in wound dressings. Clinics in Dermatology, 25, pg. 33-38.