Did your mom or grandmother ever tell you to leave a wound open so it could get air?
Many wound care clinicians have had this experience. In the 1960s, George Winter, M.D., Ph.D, reported that wound healing rates increased when animal wounds were kept moist. Moist wound healing principles continue to be used today. A moist wound bed promotes the movement of epithelial cells across the wound bed to aid in resurfacing, but a moisture balance must be maintained. Too much can damage healthy skin surrounding the wound.
There are hundreds of dressings and most fit into certain categories. Two categories typically are used to manage wounds with the least drainage:
1. Transparent Adhesive Dressings are polyurethane films coated with an adhesive. These are semipermeable membranes that allow oxygen and vapors to flow through but prevent bacteria entering the wound. They promote autolytic debridement and tend to reduce friction. Dressings are changed every five to seven days and as needed.
2. Hydrocolloid dressings are made of carboxymethylcellulose, pectin and gelatin. They are occlusive or semipermeable. They are impermeable so that environmental contaminants cannot invade the wound. They provide autolytic debridement and protect the wound bed. They are contraindicated in wounds that involve muscle, tendon or bone. They should be changed every three to seven days and as needed.
Both TADs and hydrocolloid dressings can be used as a primary or secondary dressing. Be sure to follow the manufacturer’s instructions. Next month, I’ll discuss other dressing categories.
From the August 01, 2014 Issue of McKnight's Long-Term Care News
