Ask the Care Expert about ... choosing dressings
Rosalyn Jordan, RN, BSN, MSc, CWOCN, WCC
With thousands of dressings on the market, which is the best for wound healing?
There are many factors to consider when making a dressing selection. These include wound etiology, allergies, wound status, condition of the periwound area, cost of the dressing, and whether there is someone who can be taught to apply the dressing.
An extremely important function of an optimal wound dressing is protecting the wound from additional trauma while providing thermoregulation. Several qualities characterize an ideal dressing: It is easy to apply and remove without causing damage to the adjacent skin; it conforms to the wound shape and does not adhere to the wound bed; it eliminates all dead space and absorbs wound drainage; and it is available in different sizes and shapes.
When choosing a dressing, skin maceration must be considered, as should allergies. If an allergy to a specific material is known or if the dressing or the dressing's securing material causes irritation, the dressing should be discontinued, the physician notified, and another dressing ordered.
Bacterial invasion must be avoided when placing the dressing. Signs of re-epithelialization should be noted about 14 days after the injury. If the wound has necrotic tissue, the dressing should promote debridement of the necrotic tissue by breaking down fibrin in the wound bed. An effective dressing should not leave material or fibers in the wound bed when removed.
There has been substantial clinical evidence, dating back to an animal study in the 1960s, that a healthy wound healing environment is one of moist healing, as long as a moisture balance is achieved. Plus, the wound and periwound area cannot be damaged by the moisture. Moist wound healing is the premier function of a wound dressing.