Ask the treatment expert: What is the acronym for Principles of Topical Therapy?

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What's the best way to prevent skin tears?
What's the best way to prevent skin tears?
Q: What is the acronym for Principles of Topical Therapy?

The acronym you are referring to is DIWAMOPI. Let's take a look at it letter by letter:

D (Debride): Removes medium for bacterial growth and helps to move wound from inflammatory phase into proliferative phase of repair. 

I (Identify and treat infection): Infection prolongs the inflammatory phase and is a profound inhibitor of all aspects of the repair process.

W (Wick dead space): Goals are to wick fluid from tunneled or undermined areas and to prevent premature closure of the wound at the surface. Strictly avoid overpacking, as this creates pressure dressing/ischemic effect and interferes with wound healing. Focus on wicking as opposed to packing.

A (Absorb excess exudate):
Exudate contains inflammatory mediators that interfere with wound repair and can cause maceration of intact skin.

M (Maintain moist wound surface):
Moist wound surface promotes cell migration and prevents cell death; a dry cell is a dead cell.

O (Open or excise closed wound edges):
Nonproliferative wound edges prevent re-epithelialization.

P (Protect healing wound from infection/trauma): Infection and repeat injury can prevent or prolong the repair process.

I (Insulate): Maintenance of normal temperature at wound surface reduces vasoconstriction and enhances cellular activity. This may be promoted by hydrocolloid foam, transparent adhesive dressings and less frequent dressing changes.

The source of this explanation, and a lot of other excellent information, is the Emory University School of Medicine Wound, Ostomy, and Continence Nursing Education Center.

Please send your wound treatment-related questions to Susan Wickard at


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