Ask the treatment expert ... about choosing a wound dressing
Rosalyn Jordan, RN, BSN, MSc, CWOCN, WCC
With so many wound care dressings and treatments available, how can you make the right decision?
With so many choices, the decision as to which product to use for a particular wound may be difficult at times. Of course, the physician ultimately makes the decision, but he or she will frequently ask nurses for input on the dressing.
The best decisions are based on the goals for wound care of each particular wound. This requires the consultation and inclusion of the multidisciplinary team involved in the care of the resident.
The choice of wound dressings and therapies are basically dependent on:
1. The routine assessment and reassessment of both the condition of the resident and the wound.
2. Careful consideration of basic wound care principles of care.
3. Progression of the specified wound healing or wound care outcomes.
Realize that the outcomes, goals and objectives of wound healing will vary during the course of the treatment and should be individualized for each specific resident. Therefore, the plan of care will change periodically during the sequence of wound healing.
The initial goal could be to ensure that the wound bed is free of necrotic tissue, for example. For palliative care residents, the goal may simply be to sustain the current status of the wound, prevent infection of the wound, odor control, and, of course, pain management. Toward the end of the wound healing cycle, the goals of care might include reepitheliazation of the wound or to maintain the wounded area with no additional break in skin integrity.
With routine careful assessment and a multidisciplinary team approach to wound healing, choosing the correct dressing is made less difficult. Understanding the purpose of the dressing and the wound's requirements are vital to proper selections.