Choice of Wound Dressing

Wound dressings are a kind of important medical materials used to cover wounds or other injuries. They can replace damaged skin to play a temporary barrier role, avoid or control wound infection, and provide an environment conducive to wound healing.


Ⅰ. Important functions of wound dressing


Maintaining a moist wound environment (the wound bed); Absorbing excess exudates; Filling the dead cavity to avoid local accumulation of exudates and causing infection or excessive humidity; Removing necrotic tissue and exudates; Providing a protective environment for the wound, avoiding the invasion of bacteria, foreign bodies, and the direct influence of external temperature change or pressure; Wound dressing supplies can support, fix the wound, and relieve pain; It has a debridement effect and helps the enzymes of wound exudates decompose necrotic tissue; Delivering drugs to the wound; Controlling odors.


Ⅱ. There are many wound dressings with different performance available for clinical nursing staff to choose at present


The types of medical dressing supplies can be divided into the followings: Passive dressings (traditional dressings): Covering the wound and absorbing exudates passively to provide limited protection for the wound. We can see them commonly such as gauze, cotton pads, etc.; Interactive dressings: there are many forms of interaction between dressings and wounds, such as absorbing exudates and toxic substances, allowing gas exchanges, thereby creating an ideal environment for healing. These dressings also can block the outer structures, Prevent microorganisms in the environment from invading, and prevent the cross-infection of wounds, etc. The common ones are film dressings, foam dressings, hydrogels, hydrocolloid dressings, alginate dressings, etc.; Biological dressings: These dressings have their own activity or can promote the release of active substances and bactericidal silver ions, so as to speed up wound healing, including dressings containing growth factor and silver ions dressings.


Ⅲ. Choosing the right wound dressing


1. According to the assessment of patients' individual condition


The patient's physiological, psychological and economic acceptance of the dressing is very important. Patients with different constitutions have different degrees of sensitivity to wound dressings, and some dressings might cause some patients' skin allergy. Some patients cannot accept dressings with obvious odors, such as hydrocolloids and alginate dressings. If patients have high requirements for quality of life, the comfort  and convenience of dressings are important reference factors for the dressing selection. The price of new dressing is higher than that of traditional dressings, but new dressing can promote wound healing, improve patient comfort, relieve pain, and more importantly, the replacing frequency is lower than that of traditional dressing. Therefore, the appropriate dressing should be selected according to the individual condition of patients, especially the wound condition, and combined with the patients' wishes.


2. Selecting dressing according to the wound assessment


For primary healing wounds, it's better to choose gauze and film dressings; Superficial wounds are better to use film dressings; Wounds with minimal to moderate exudations should be treated by hydrogel dressings; Alginate dressings like alginate foam dressings are better for wounds with moderate to severe exudations; Dry necrotic wounds should choose hydrogel and hydrocolloid dressings.


3. Dynamic evaluation during using


Since the condition of the wound is constantly changing, evaluations of the wound must be made at regular intervals. According to the process of wound healing or the degree of deterioration, evaluating real-timely whether the most appropriate dressing has been chosen and whether it has been correctly used.


Of course, the standards of ideal dressings are relative. It is difficult to say which dressing would be the most appropriate for wounds, and even though the effectiveness of a certain dressing for this wound has been proven, it might not be suitable for all patients. Therefore, it is most reasonable to select wound dressings dynamically according to different people, combine application, and choose the dressing that is safest, most effective, simple to use, and has a high potency ratio. There are many products to be chosen from and new products are constantly launched at present. The condition of the wound should be accurately evaluated, and an economical, simple and convenient, and practical wound coverings should be selected to promote wound healing.

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