The types of wound dressings and care will play a big role in determining the end result of wound healing. With the right care, the wound can heal optimally with minimum scarring maintaining its esthetics. On the other hand, if the wound care is not carried out properly, the wound may take longer time to heal or suffer re-infection causing incomplete wound healing.
Wound Dressing Concept
Wound care itself has changed along the years. The important concept is to maintain balance between cleanliness and moisture control with organism growth that can hamper wound healing. It has been observed that wound can heal better in moist environment. However, the main therapy usually focuses on drying the wound location with no bandage use.
The closed wound has more advantages in exposing the wound continuously to proteinase, complement, and growth factors in the environment. Closed care will hasten re-epithelization, stimulation of collagen synthesis, and create a hypoxic environment supporting angiogenesis and lowering the pH at wound location while creating an unfriendly environment for bacterial growth.
Wound Dressing Criteria
The choice of wound dressing must follow these criteria:
- Maintain moist environment
- Support epidermal migration
- Support angiogenesis and tissue synthesis
- Enables gas exchange between wound tissue and environment
- Maintain suitable tissue temperature to support blood flow to the wound bed
- Provide protection from bacterial infection
- Not adherent to the wound and enables easy removal
- Sterile, non-toxic, and non-allergic
Types of Wound Dressings
For consideration, first we must know the condition of the wound:
Is It Wet or Dry?
If the wound is dry then we can choose a treatment that will provide moisture such as hydrogel. If the wound is too moist or exudates then choose a treatment that can absorb extra moisture such as alginate.
Is there Necrotic Tissue?
If the wound is in granulation stage without necrotic/dead tissue then it is enough to protect the wound and its surrounding area while maintaining moisture control. The use of simple gauze or transparent film can be adequate. But, if the wound has necrotic tissue than choose treatment that has autolytic cleansing such as foam, hydrocolloid, or alginate.
Are There Signs of Infection?
If the wound is infected then choose treatment with silver or iodine.
The medical team will choose the wound dressing while the patient, family, or caregiver just continues the treatment at home according to the given instruction. Be sure to understand the treatment and inquire clear information prior to hospital discharge. Return for consultation if there are signs of infection such as swelling, pain, or redness.