Some years ago, caregivers would get nightmares handling patients with chronic wounds. The issues were many… what kind of dressing to use, when to change it. Then came research into the various types of wounds, their healing pattern and how to tackle them. Now, major advances have taken place in the field of wound care. And looking after a wound has become a relatively easy task for a caregiver.
A dressing, say experts, is not the management of a wound… it is only a part of it. Before treatment starts, a doctor must take into consideration many factors apart from the wound. These include general evaluation of the patient. Only after a detailed look into coordinated cellular and biochemical events, is a dressing prescribed. It could be one to manage wounds with different exudates amounts. Or to support autolytic debridement and promote granulation tissue leading to wound closure. It could be an occlusive dressing to manage pain or a silver/iodine dressing. A compression therapy dressing could be given to aid in edema control and wound healing.
Today, there are two systems of wound care dressing – traditional and advance. Traditional dressings are good for wound covering, exudates absorption and drying of wound, hemostasis, antisepsis and safeguard from infection.
Advanced wound dressings are polyurethane films, foams, hydrogels, hydrocolloids and alginates. They provide a moist microenvironment, thermal stability and eliminate exudates and necrotic tissues.
Let’s take a detailed look at them…
A hydrocolloid dressing is totally occlusive with waterproof film. The wound area is sealed up and moisture not allowed to escape. Therefore, fluid is absorbed and the dressing swells up forming a non-adherent gel over the wound.
A hydrogel dressing means controlled absorption. It absorbs the wound exudates, allowing moisture to evaporate through a semi-permeable film backing. It is non-adherent and can be removed without trauma to the wound and skin. Because of its restricted absorption, it may not be appropriate for moderate to highly-exuding wounds.
A calcium alginate dressing has a dehydrating effect and therefore, should not be used with dry wounds. The calcium in it reacts with sodium in the wound exudates. This causes a chemical ion exchange to occur and a gel-like substance is formed. The gel covers the wound providing a soft, moist healing setting.
A foam dressing is generally made from hydrophilic polyurethane foam. It has an open pore structure that allows moisture to be transmitted. This kind is ideal for partial-thickness or superficial wounds.
An amorphous hydrogel dressing needs a secondary dressing to check evaporation of moisture.
A film dressing is non-absorbent and prepared from a thin, transparent polymer membrane layered with a sheet of acrylic adhesive. It is permeable to moisture vapor but not to bacteria and viruses.
Silver dressing received an impetus recently because of advances in impregnation system and polymer expertise. And also because of bacterial resistance to antibiotics. This dressing offers high resistance to bacteria. It is excellent in the treatment of wounds with pyoderma, radiation and chemical burns, venous stasis ulcers, yeast infections, folliculitis and infected wounds.
There are more variants in the dressing type and one only has to make the right choice in order to ensure quick and effective healing.