Wound Dressing: the Developing Art and Science

Wound Dressing: the Developing Art and Science

With the continuous advancement of technology, new technologies and new products emerge in an endless stream. For wound healers, it is a difficult task to understand and master different wound dressings. Being able to compare and choose between different treatment options, grasp the timing and method of application, monitor and adjust at any time, is becoming more and more challenging for wound specialists.


With a plethora of wound dressings available, the choice of clinical specialists has grown enormously. Wet wound treatment has grown tremendously since the 1960s and today. Numerous clinical and scientific studies have improved physicians' understanding of the wound healing process and the importance of a suitable environment for wound healing. Today, to be a wound specialist, physicians must not only understand the physiology of wet healing, biofilms, metalloproteinases, infection, wound bed preparation, wound classification, etc., but also understand how to make wound dressings like foam dressing with adhesive border work in the right way best effect in the environment. Humans have applied dressings for thousands of years. From the earliest days when people used simple materials to protect wounds, and the patients received the magician's spell and elixir, to today's modern wound dressing, it has written an interesting history of dressing development.


1. Wound dressing in the 1990s


The 1990s also saw the rapid development of wound dressings, with new materials constantly being used in wound treatment, such as soft silicones and antimicrobials, and silver dressings experienced an explosion. Collagen and matrix dressings have also been extensively studied. Growth factors became a hot topic of research, and negative pressure therapy began to be used for heavily exuding wounds. Low-energy laser and electrical stimulation treatments were investigated for local cellular effects and effects on wound healing. Hyperbaric oxygen is also recommended for clinical use because of good performance. Others used for wound treatment are allografts or skin substitutes. Skin substitutes are composed of dermal cells, epidermal cells and matrix, and can be autologous, allogeneic or allogeneic.


In addition, new research has led researchers to focus on the role of proteolytic enzymes and growth factors contained in wound exudate on healing, and it has been found that there are large differences in the composition of exudate from healing and difficult-to-heal wounds. Qualitative and quantitative research has led to new ideas for wound management. In the 1990s, people's awareness of the impact and importance of aseptic wound dressing on wound healing rose to new heights. Wound healing is a dynamic process, and its nature and characteristics change over time, so dressing selection is not It should be from the beginning to the end. Throughout the wound healing process, we need to use different types of dressings. As the variety of dressings increases, the need for education about wound dressing becomes more urgent. The wound specialist must have a thorough understanding of the dressings in hand and differentiate them rather than apply them indiscriminately.


2. The new development of wound dressing in the 21st century


After the great development in the 1980s and 1990s, the 21st century and the new millennium started in 2000, the research and development of new technologies and new materials in the field of wounds still maintains vigorous vitality. Despite the large number of advanced products to choose from and the growing popularity of wet wound healing theory, gauze still has an important place in daily clinical practice. In particular, a large number of surgeons have little knowledge of modern dressings because they are not educated in modern wound care. Therefore, education is a big issue before us. We have learned a lot about the advantages of wet healing and the role of wet aseptic wound dressing from past research. In this century, the focus of attention has shifted to the wound tissue itself and the composition of wound exudate, in order to discover the intrinsic factors and dynamics of wound healing. .


As antimicrobial agents continue to be incorporated into dressings, more evidence-based medical evidence is being accumulated while research is ongoing into how antimicrobial agents alter wound bacterial load levels. It has been confirmed that the content of proteolytic enzymes in refractory wounds is increased, and the adverse effects of these enzymes on wound healing are the current research hotspots. With the deepening of research, it is believed that we can gain the ability to control these intrinsic factors.


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