How to Choose the Suitable Wound Dressing

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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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