Wound dressings

Traditionally wet-to-dry gauze has been used to dress wounds. Dressings that create and maintain a moist environment, however, are now considered to provide the optimal conditions for wound healing. Moisture under occlusive dressings not only increases the rate of epithelialisation but also promotes healing through moisture itself and the presence initially of a low oxygen tension (promoting the inflammatory phase). Gauze does not exhibit these properties; it may be disruptive to the healing wound as it dries and cause tissue damage when it is removed. It is not now widely used in the United Kingdom.​Kingdom.​ Figure 1 Left: Healthy venous leg ulcer suitable for dressing with low adherent dressing. Right: Wound suitable for dressing with semipermeable film Table 1 Characteristics of the ideal dressing Occlusive dressings are thought to increase cell proliferation and activity by retaining an optimum level of wound exudate, which contains vital proteins and cytokines produced in response to injury. These facilitate autolytic debridement of the wound and promote healing. Concerns of increased risk of infection under occlusive dressings have not been substantiated in clinical trials. This article describes wound dressings currently available in the UK.​UK.​ Figure 2 Venous leg ulcer suitable for dressing with hydrocolloid Table 2 Low adherent dressings—suitable for use on flat, shallow wounds with low exudates