Ask the treatment expert: What dressing works best on dry wounds?

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What's the best way to prevent skin tears?
What's the best way to prevent skin tears?
Q: What dressing is best for dry wounds?

A: As with wet wounds, there are several questions that need to be asked when determining the best dressing to use.

They include:  How much exudate does the wound have? Is the wound necrotic? Is there evidence of infection? What does the periwound skin look like? What do the wound edges look like? Is there tunneling or undermining present? Is the wound exposed to urine, stool or other contaminants?

The information gained through the assessment will enable the wound to be classified. Is this a deep dry wound or a shallow dry wound? A deep dry wound has minimal or no exudate but has depth, tunnels and or undermining present. A shallow dry wound has minimal or no exudate and is less than 0.5 cm deep with no tunnels or undermining present.

 A hydrating dressing is needed to maintain or provide moisture for both types of wounds. If the wound is deep and dry, then consider the following: hydrating filler dressings, amorphous gel dressings applied to the wound bed with damp saline gauze lightly fluffed to fill the cavity, or gel-soaked damp gauze fluffed to fill the cavity (usually not the best choice due to drying and frequency of dressing changes needed). Cover dressing may include gauze, transparent adhesive dressings and waterproof adhesive foam dressing.

If the wound is shallow and dry, then consider the following: gel dressings (solid gel sheets), hydrocolloid dressings, transparent adhesive dressings, nonadherent gauze/contact layers and zinc-oxide-based ointment. Cover dressing may include: gauze, foam and transparent adhesive, as mentioned above.

As with wet wounds, the periwound needs to be protected from moisture. This may be achieved by the use of a moisture barrier ointment, a skin sealant and non-adhesive dressings.

Please send your wound treatment-related questions to Susan Wickard at ltcnews@mcknights.com.