Modern concept of creating a moist environment for better healing has, in fact, revolutionized the entire system of wound management. Latest wound dressings have been developed based on this concept-which ensure effective healing, eliminate infection, facilitate removal of damaged and infected tissues, reduce odor, and effectively manage exudates.
The following factors need to be considered while choosing a dressing:
(a) Type of wound: With a view to choosing an appropriate dressing, it is important to know the type of wound you are dealing with. Wounds can be classified in four categories, as under:
i. Necrotic wounds: As ‘necrosis’ implies “death of circumscribed tissue”, the Necrotic wounds are those which contain dead tissues that are black colored.
ii. Sloughed wounds: As ‘slough’ implies “separated dead matter in ulceration”, the Sloughed wounds are those which contain a layer of glutinous/ropy yellow colored dead tissues.
iii. Granulating wounds are those wounds which are properly healing and contain red colored granulation tissues. ‘Granulation’ implies “formation of small elevations on the healing surface”.
iv. Epithelializing wounds: These are one stage ahead of the granulating wounds in healing and are pink in color.
(b) Location of the wound:
The location and size of the wound cannot be ignored while selecting an appropriate dressing. Similarly, the condition of the wound at the time of applying the dressing is very significant. For example, a wound that has large quantity of exudates will require a dressing which is capable of handling it. Besides, a wound in a location like elbows will require specifically designed dressing for covering the wound properly.
(c) Other factors:
In addition to the type of wound and its location, it is important to know the stage of infection of the wound at the time of applying the dressing. Besides, product-related factors are equally important for consideration. It is generally believed that an infected wound should be treated with a topical antibiotic and then dressed. However, research suggests that the use of antibiotic may cause some problems. In such cases, therefore, it is advisable to use specially formulated medicated dressings-instead of administering antibiotic orally.
With regard to the choice of wound dressing, the following product related factors will eventually influence the decision of the buyer:
- How well it conforms to the wound site;
- Can it effectively handle the amount of exudates;
- Does it effectively eliminate or reduce the odor;
- How effectively does it help to stop the bleeding;
- Does it allow passage to fluids, oxygen and microorganisms;
- Is it easy to apply and does it cause pain and discomfort at the time of removing; and
- How frequently it is required to be changed.