Ask the treatment expert: Are wet-to-dry dressings substandard for optimal wound care?

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What is xerosis?
What is xerosis?
At a recent seminar I attended, we were told wet-to-dry dressings are considered substandard for optimal wound care. Is this true?

Yes, the majority of wound care experts consider wet-to-dry dressings an unacceptable choice. The reason: Wet-to-dry dressings do not support the theory of moist wound healing.

Since the 1960s, research has shown that moist wound healing decreases wound pain and cell death, increases and encourages new cell growth, and results in wound closure two times faster.   

Wet-to-dry dressings, on the other hand, do not offer a continuous moist wound bed and therefore allow the wound to dry out between dressing changes. When tissues in a wound bed dry out, the result is tissue death. Tissue death does not support healing.

Many healthcare professionals will say, “But I do not let it dry out—I moisten the gauze before I remove it.” However, if the physician's order were for “wet-to-dry,” moistening the dried gauze prior to removal would be considered “not following physician's order.”

The correct procedure for a wet-to-dry dressing is to apply moistened saline gauze to the wound bed, allow gauze to dry, and firmly pull dried gauze out of the wound bed at a right angle, repeating every four to six hours.

The National Pressure Ulcer Advisory Panel (NPUAP) and European Pressure Ulcer Advisory Panel (EPUAP) released International Pressure Ulcer guidelines in October 2009 that specifically state: “Avoid use of gauze dressings for clean, open pressure ulcers because they are labor-intensive to use, cause pain when removed if dry, and lead to desiccation of viable tissue if they dry. “

To find out more about pressure ulcer care, go to the online version of the International Pressure Ulcer guidelines at: http://www.epuap.org.
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