Wounds can be present over different anatomical parts of the body. However, the basic principles of choosing a wound dressing remain the same. In the United States, chronic wounds affect more than six million people, and this will grow in numbers due to our elderly and diabetic populations. Choosing the correct dressing will lessen the time of healing, provide cost-effective care, and improve the patient’s quality of life.
The goal is to help the wound heal as soon as possible by using an appropriate dressing material to maintain the right amount of moisture. When the wound bed is dry, use a dressing to increase moisture and if too wet and the surrounding skin is macerated, use material which will absorb excess fluid and protect the surrounding healthy skin.
Important criteria to consider before choosing a specific wound dressing are cleaning, absorbing, regulating, and the need to add medication.
After following the principles of wound debridement (discussed in another article), the wound should be profusely irrigated with a neutral solution like normal saline to wash off any debris. Never use toxic or irritating solutions like hydrogen peroxide which are detrimental to wound healing.
Next chose a dressing material which is easy to replace, stays in place with appropriate anchoring, and does not cause harm to the wound bed or normal surrounding skin by shearing force or sticking to the skin. Patients can develop complications like contact or allergic reactions.
The ideal dressing should keep the wound moist but not macerated, limit bacterial overgrowth, keep odor to a minimum, and be comfortable to wear. Frequent inspection of the wound is necessary to optimize wound dressing selection.
Today there are many types of dressings and even techniques to manage wounds. For the most part, the majority of wounds that require special dressings are chronic wounds or surgical wounds. The overall objective of wound dressing include the following:
Before applying any type of wound dressing, it is important to assess the following:
When there is a nonhealing or chronic wound or a wound caused by trauma, it is important to get an x-ray to ensure that there is no fracture or a foreign body left in the tissues. If the x-rays do not reveal a foreign body, then ultrasound is a useful technique to identify radiolucent foreign bodies like splinters or thorns.
Currently Available Dressing Options
Certain special wounds will need more specialized wound dressings, for example, skin substitute, biological skin products, and other complex wound dressing products. Compression therapy is needed for venous leg ulcers.
Types of Wounds and Dressing Options
There are dozens of wound dressings and it is important for the healthcare team caring for wounds to know the key differences between them. The key to wound healing is to ensure that there is adequate blood supply and the wound is clean. A wound care nurse and a surgeon should regularly inspect the wound to ensure that it is healing. The dietitian should be involved in the care of the patient and ensure that the calorie intake is adequate. The floor nurses should change the dressings as scheduled and consult with the wound care nurse if there is any sign of infection or inflammation. The medical team should work together to monitor the progression of wound healing and report deviations of progression to the team leader. 
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