Podcast Episode 12: Wound Dressings

Hello, this is Kate Bain from The Wound Guy. In this podcast, we'd like to briefly discuss the role that dressings play in assisting a wound to repair itself. The first thing that must be said is that all wounds have a cause and those wounds which are slow to heal have underlying reasons for that to be the case. So if you have a wound that is slow to improve or if you're a health professional caring for someone with a wound that is slow to improve or perhaps seems to get better only to then reappear and reoccur, then the most important point here is to ensure that a diagnosis is determined because this allows treatment to be designed for this specific situation and need. The second thing to point out is that wounds heal when the skin or the integumentary system interacts with and is sustained by the body's other systems. So if a wound is getting enough blood supply, nutrition, waste removal and immune support, then it is likely to get better. The process of repairing a wound is actually a holistic activity, it's a whole body activity and a wound which is capable of healing itself will mostly do so regardless of what type of dressing is placed on top of it. Healing does progress most efficiently if the wound's environment is moist and warm, so close to body temperature. It's not ideal if the wound surface is too dry, too wet or too cold. Other things which could slow down healing would be repetitive trauma such as bumps or knocks or scrapes or dressings getting stuck to the wound surface. Dressing Remnants, dead tissue within the wound, crusts and retained ooze also combine to challenge a wound's ability to get better. So before you consider a dressing, the wound and its surrounding skin needs to be well cleaned. Wound discharge and associated debris can be washed, irrigated or wiped away. In many community situations, water, especially if it's water that is good enough to drink, then it can be used to clean a wound. The water can be boiled and used once it's comfortably warm to touch. For health professionals, you will have many other wound cleaning options which could be used to support wound healing and minimize infection, especially for an individual who is frail or has multiple health issues. So it's always worth a chat with your health professional to see which solution best suits your circumstances. There are many wound dressings now available. Some dressing types have been around for a long time, decades. Things like gauze, petroleum, tools and coated pads. Newer dressings have biological scaffolds, ingredients to stimulate tissue cells and can apply therapies involving things like suction, electric currents and even deliver concentrated oxygen to the wound from room air. As we better understand the biology of wound healing, so it is that technology is increasingly providing us with more options and pathways for treatment. So with the vast array of products available to us now and into the future, it can become rather overwhelming figuring out what to choose to put on a wound. Perhaps the best way to think about all this is to revisit your specific wound or the wound that you're caring for. What does it require? Do you need to rehydrate a dry base? Do you need to soak up fluid from a constantly oozing site to stop clothing and bed linen from always getting wet? How about dealing with odour, pain or bleeding? Is the wound base clean or does it present with a yellow cover? What is the skin like around the wound edges? Is it excoriated, tender or soggy and white. The thing is, dressings are in fact tools. They're great at doing certain jobs for your wound at certain times, so they can help reduce pain, they can assist to eliminate a bad smell, they can get rid of devitalized tissue within the wound base and so on. But as a wound repair journey proceeds, the type of dressing it needs should be determined by an assessment of what the wound and the surrounding skin require. For instance, once a heavily oozing wound becomes cleaner and displays healing tissue within the base and has less discharge, then a very absorbent dressing can give way to one designed for protection and a longer dwell time on the wound. To have three or four different types of dressings as a wound gets better is not unusual. The key thing is that the wound needs to be measured, it can also be photographed and then the dressings need to have a goal or a purpose for their use. Regular measurements and photos together can help you to determine whether the dressing is doing its job. You will also get feedback from observations such as ranking the amount of wound odour or the volume of wound discharge. Health professionals have access to lots of information about the technical aspects of dressings. This can originate from the manufacturers of the dressing or from a professional literature or associated websites. So speak to your nurse, medical officer, pharmacist or podiatrist for good dressing advice. Your local Lindsay Leg Club will be able to put you in contact with experts who can help you make good dressing choices. Keep safe and well, and thank you for listening. Bye for now.