Wound Awareness on Moist Wound Environment

Published in Wound Care on June 08, 2022

By Heather Trumm, Director, VGM Wound Care

Heather Trumm When thinking about wound care awareness month, all the common topics that affect wound healing come to my mind - good nutrition, offloading, managing the disease state, debridement, compression, etc. But when focusing on the word “awareness,” moist wound healing popped in my brain! Keeping a wound moist during the healing process is one of the most important aspects of wound healing.

Dr. Winters wrote an article in 1962 titled, “Hanging wet to dry dressings out to Dry!” He explained in his research that moist wounds healed two to three times faster than those that were allowed to dry out. I still find it fascinating when I hear of physicians who prescribe wet to dry dressing changes. In light of wound care awareness month, if you are using or prescribing a wet to dry wound treatment regiment, PLEASE STOP!!! There have been multiple articles and literature reviews written since Dr. Winters’ time that support a moist wound environment backed by evidence-based research to produce positive outcomes in wound care. Advanced wound dressings that support moist wound healing lead to positive outcomes and also save money for our healthcare system versus wet to dry dressings. I’d like to review some of drawbacks of wet to dry dressings and highlight the benefits of advanced wound care dressings, which are available to us as healthcare professionals today.

Negative Implications for Wet to Dry Dressing Usage

Wet to dry dressings can be painful for the patient and we know that pain affects wound healing in a negative way. It may increase infection rates because bacteria can travel through gauze rapidly. Wet to dry dressing changes may disrupt and damage the good granulation tissue during dressing changes. It delays wound healing because when changing the dressing multiple times a day, the temperature in the wound bed decreases, which slows the rate of healing. Many healthcare professionals think wet to dry dressings are cost effective because gauze is so inexpensive versus advanced wound dressings. In fact, the opposite is true. When you add up all the nursing time plus three daily dressing changes a day, advanced wound dressings are actually more cost-effective. They can stay on the wound from three to seven days and the healing rate is faster.

Benefits of Using Advanced Dressings

Okay, now the benefits of advanced dressings. Advanced wound dressings aid in keeping a wound bed optimally moist. Key features of a physiologic wound environment are temperature control, pH regulation, control of bacterial burden, and keeping an adequate moisture level. The benefits of an advanced wound dressing include how they eliminate and minimize pain, protect the wound and the skin around the wound, remove nonviable tissue without compromising the good tissue, maintain an appropriate moisture level, maintain normal body temperature, control odor, and prevent and mange infection. They are also cost-effective.

The fifth principle in wound healing is to provide a moist wound environment. This means that we don’t want the wound dry, but we don’t want it sopping wet either. It should be optimally moist and many of the semi-occlusive dressings in the marketplace today help the wound achieve that goal.

Based on the advantages of advanced wound dressings and the drawbacks of wet to dry dressings, there’s no doubt we should be supporting advanced wound care dressings for improved outcomes and savings.