How to Choose the Suitable Wound Dressing

Update time : 2021-07-27 12:01:01

Choosing the right dressing to suit the conditions of a patient’s wound is vital for optimum healing and quality of life.

First Step: Asses your wound situation based on your following factors.
1) Wound measurement. Measure length, width, and depth in centimeters. Careful measurement of wound size is invaluable in evaluating the wound’s progress.
2) Appearance. Describe the color of the wound bed and assess the edges of the wound. These factors can help you determine the age of the wound, if healing has started, or if pressure or infection is present.
3) Exudate. Assess the color, amount, consistency, odor, and nature of wound drainage (exudate) before choosing a dressing.
4) Periwound tissue. Assess for signs of infection, such as erythema, edema, induration, warmth, crepitus, and damage from previous dressings.

Second Step: Asses your wound type.
1) Arterial wounds.
Atherosclerosis is the most common cause of arterial wounds. Other causes include trauma and thrombosis. Arterial wounds develop on the legs or feet distal to the narrowed or blocked artery.
2) Venous wounds
Venous wounds are almost the exact opposite of arterial wounds: Instead of getting too little blood, the legs have too much because the damaged vein valves can’t adequately return blood to the heart. Venous wounds often are large, with diffuse edges and yellow-white exudate.
3) Neuropathic wounds
Neuropathic wounds are most common over bony prominences and often occur on the foot below the ankle. The wounds are usually small and deep with thick callus formation at the wound edges (called hyperkeratosis).
4) Pressure ulcers
Pressure ulcers can be the most difficult and challenging wounds to care for. It’s important to remember that wounds covered with nonviable tissue can’t be staged.

Use this staging system that follows the recommendations of the National Pressure Ulcer Advisory Panel.

● Stage I—a defined area of persistent redness (in light-skinned patients) or persistent red, blue, or purple colors (in darker-skinned patients). The skin is intact, but compared with surrounding skin may be warmer or cooler, feel firm or boggy, and have altered sensation such as pain or itching.
● Stage II—a partial-thickness skin loss involving the epidermis or dermis and appearing as an abrasion, blister, or shallow crater.
● Stage III—a full-thickness skin loss including damage or necrosis of subcutaneous tissue. Damage may extend to, but not through, the fascia. Adjacent tissue may be undermined.
● Stage IV—a full-thickness loss with extensive skin damage, tissue necrosis, and possible damage to muscle, bone, tendons, or joint capsules. Sinus tracts and tunnels may be present.
5) Other wound types
surgical wounds, traumatic wounds and so on.

By knowing which type of wound care product you need, you can select the specific product.

Types of Wound Dressing	Features
Dry gauze dressing	Surgical wounds Limit bleeding for first 24 hours after sharp debridement Absorb exudate and wick drainage Fill dead space Secondary dressing Protect dry gangrene area that can’t be debrided Wounds that require a moist environment Pain and bleeding of viable tissue
Wet-to-dry gauze dressing	Absorb exudate and wick drainage Fill dead space Debride moist necrotic wounds Wounds that require a moist environment Partial-thickness wounds Pain and bleeding of viable tissue
Wet-to-moist gauzes dressing	Infected wounds Absorb exudate and wick drainage Fill dead space Debride necrotic wounds Highly exudating wounds Severe maceration of surrounding tissue
Transparent adhesive films	Superficial wounds Wounds with minimal exudate Protection of intact skin Moderate to heavily exudating wounds Friable surrounding skin that can be injured by dressing removal Wounds with sinus tracts Full-thickness wounds
Hydrogels wound dressing	Abrasions, minor burns, and other partial-thickness wounds Radiation injuries (must be approved by radiation oncologist if treatment is ongoing) Maintain moist environment in healing wounds Donor sites First- and second-degree burns Hydrate and autolytically debride nonviable tissue Moderate to heavily exudating wounds Infected wounds if dressing is occlusive Fungal wounds Third-degree burns Avoid using only a sheet hydrogel over a cavity wound. (Dead space must be filled.)
Alginates wound dressing	Exudating wounds with slough Fill dead space and aid in debridement of sloughing wounds Third-degree burns Sensitivity to alginate, collagen, or other additives Heavily bleeding wounds Dry wounds
Odor-absorbent dressings	Neutralize odors in necrotic wounds Provide comfort and palliative care for terminal patients with draining wounds Infected or noninfected wounds with moderate drainage Dry, superficial wounds
Foams wound dressing	Moderate to heavily exudating wounds Provides thermal insulation and a moist wound environment Secondary dressing to provide additional absorption in deep wound; use with packing Can be used under compression dressings to absorb heavy drainage Dry wounds Partial-thickness wounds with minimal exudate Wounds with exposed muscle, tendon, or bone Arterial ischemic lesions
Hydrocolloids wound dressing	Wounds with minimal to moderate exudate Wounds with slough or granulating wounds Partial-thickness wounds Protection of intact skin Infected wounds Wounds with sinus tracts Deep cavity wounds Heavily exudating wounds Wounds with friable surrounding skin Third-degree burns
Nonadherent dressings	Skin grafts and donor sites Abrasions and lacerations Reduce bacterial proliferation in superficial wounds Heavily exudating wounds Sensitivity to antibacterial or bactericidal compound

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How to Choose the Suitable Wound Dressing

Dry gauze dressing

Wet-to-dry gauze dressing

Wet-to-moist gauzes dressing

Transparent adhesive films

Hydrogels wound dressing

Alginates wound dressing

Odor-absorbent dressings

Foams wound dressing

Hydrocolloids wound dressing

Nonadherent dressings