Q: What dressing is best for wet wounds?
A: When making a decision on the type of dressing to apply to wounds there are several factors to initially consider.
They include:
• Is the wound infected?
• What does the periwound skin look like?
• What do the wound edges look like?
• Is there necrotic tissue present?
• Does the wound have depth and how much?
• Is there tunneling or undermining?
• How much exudate does the wound have?
Following the basic assessment, the wound can be classified. If the wound has depth and large amounts of exudate, then it is classified as deep and wet. If the wound is shallow and has large amounts of exudate, then it is classified as shallow and wet.
With both deep and shallow wet wounds, it is important to consider if the dressing absorbs or hydrates. For wet wounds, a dressing that absorbs is desired. To treat deep and wet wounds, an absorptive filler and a cover dressing should be selected. Filler dressing options include: absorptive dressing, calcium alginate (flat or rope), hydro-fiber, hydropolymer or specialty gauze. If the wound has a tunnel or undermining present, then a lightly packed dressing is needed to fill the dead space. Cover dressing options include: waterproof adhesive foam dressing, gauze/tape and/or transparent adhesive.
To treat shallow and wet wounds, select a foam dressing with an adhesive border, flat alginate, hydrofiber or a nonadherent contact layer. Cover dressings include adhesive foam, wrap gauze (if limb is involved) or product with adhesive border.
The periwound also needs protection from moisture. This can be achieved with a moisture barrier ointment, a skin sealant and nonadhesive dressings.
Please send your wound treatment-related questions to Susan Wickard at [email protected].
From the July 01, 2011 Issue of McKnight's Long-Term Care News
