Prevalence of Wet-to-Dry Dressings in Wound Care

Gainesville Veteran's Administration Medical Center, Gainesville, Florida, USA.
Advances in skin & wound care (Impact Factor: 1.11). 12/2009; 22(12):567-73. DOI: 10.1097/01.ASW.0000363469.25740.74
Source: PubMed


This retrospective descriptive study explored the prevalence of wet-to-dry dressings ordered for wound care of open wounds healing by secondary intention. Research questions included the following: How frequently are healthcare providers ordering wet-to-dry dressings for wound care? Which specialties of healthcare providers are most frequently ordering wet-to-dry dressings? Are wet-to-dry dressings being ordered appropriately?
A retrospective chart review examined admission orders for 202 randomly selected Florida home care and health maintenance organization patients from 2002 to 2004. All subjects in the study had open wounds healing by secondary intention (42 partial-thickness and 160 full-thickness wounds). Frequencies are reported as the main outcome measure.
Wet-to-dry dressings accounted for 42% of wound care orders, followed by enzymatic (7.43%) and dry gauze (6.93%). Most wounds treated with wet-to-dry dressings were surgical (69%), followed by neuropathic ulcers (10%) and pressure ulcers (5.9%). Surgical specialists preferred wet-to-dry dressings (73%). Mechanical debridement was not clinically indicated in more than 78% of wounds treated with wet-to-dry dressings. Therefore, wet-to-dry dressings were inappropriately ordered in these cases.
These findings suggest that wet-to-dry dressings (or dry gauze) are prescribed inappropriately in situations where there is little evidence to support their use. To achieve evidence-based practice in wound care, clinical decision making should be scientifically based. Future research should focus on which wound dressings are most effective in optimizing wound healing, as well as on investigating the reasons for the continued use of wet-to-dry dressings.

Download full-text


Available from: Linda Cowan, Jul 29, 2014

  • No preview · Article · Jul 2011 · Home healthcare nurse
  • [Show abstract] [Hide abstract]
    ABSTRACT: Abstract: The presence of a chronic ulcer presents a challenge to clinicians in long-term care while being both a physical and psychological burden to the residents and their families. Dressings play an important adjunctive role in concert with overall efforts to manage the underlying causes of chronic, non-healing wounds. With more than 2000 dressings and a variety of treatment protocols available, chronic wound management is as much an art as it is science. Each wound requires a unique combination of dressings that is matched to the needs of the patient and the clinical presentation of the wound. Treatment often depends on the skill level of the clinician and the ability to develop appropriate interventions and plan of care. This retrospective series of four case studies serves to demonstrate the improved potential for healing outcomes when collagen dressings are used appropriately.
    No preview · Article · Aug 2011 · Wounds: a compendium of clinical research and practice
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Traditional criteria used in selecting wound care interventions are being slowly replaced with an evidence-based practice approach. The value of such an approach for providing optimal care has been established, but the definition of evidence- based care and the process used to generate evidence continue to evolve. For example, the role of studies developed to demonstrate efficacy, randomized controlled trials (RCT), the value of effectiveness studies designed to evaluate outcomes in real world practice, and the use of disease-oriented (interim) study outcomes for wound care research such as reduces wound fluid or improves granulation tissue formation have been topics of international conversations and consensus documents. In addition, the use in some clinical studies and most systematic study reviews of ingredient- or characteristic-based categories to group products that may not share a common operational definition of how they function has led to a high variability in outcomes, resulting in inconclusive or low-level evidence. These concerns and debates, along with their influence on practice, may cast doubt on the value of evidence-based practice guidelines for some clinicians, slowing their rate of implementation and extending the discussion about definitions of evidence-based care and the relative merits of various research designs. At the same time, amid growing concerns about medical device safety, clinicians must answer three questions about an intervention and its related products or devices in order to provide safe and effective care: 1) Can it work? 2) Does it work? 3) Is it worth it? Reviewing current knowledge about wound care, wound treatment modalities, and the basic principles of research within the existing framework of questions to be answered suggests a clear path toward obtaining much-needed evidence. In wound care, using clearly defined process- es to study patient-centered outcomes (eg, quality of life, complete healing) and only product groupings that meet an operational definition of functioning (eg moisture-retentive) will help clinicians decide whether an intervention can work and does work and whether the value of the clinical and economic benefits is greater than the potential harm and cost.
    Full-text · Article · Sep 2011 · Ostomy/wound management
Show more