Wound dressings, does it matter and why?

Abstract

Compression therapy and treating venous insufficiency is the standard of care for venous leg ulcers. The need for debridement on healing venous leg ulcers is still debated. Dressings are often used under compression bandages to promote faster healing and prevent adherence of the bandage to the ulcer. A wide range of dressings is available, including modern dressings with different kinds of biological activity. Microbial burden is believed to underlie delayed healing, but the exact role of microbiofilm in wound healing is uncertain. Before choosing a specific wound dressing, four main functions should be considered: (1) cleaning, (2) absorbing, (3) regulating or (4) the necessity of adding medication. There is no clear evidence to support the use of one dressing over another, as demonstrated by many Cochrane review studies. In addition, the prescriber should enquire about contact allergies that may also develop during wound treatment. It is shown that early intervention and early investment may reduce the cost of treatment. The choice of wound dressings should be guided by cost, ease of application and patient and physician preference and be part of the complete strategy. The role of the medical specialist is evident. Wound dressings matter as part of the optimal treatment in VLU patients.

Influence of Porous Dressings Based on Butyric-Acetic Chitin Co-Polymer on Biological Processes In Vitro and In Vivo

“…The problem of difficult-to-heal wounds is trying to be solved with the use of target therapies or with the use of innovative dressings which show bioactivity features [45]. Unfortunately, difficult-to-heal wounds are usually infected by drug resistance bacteria, which hampers the healing and regeneration process [46].…”

Adsorbent Dressings from Sodium Carboxymethyl Cellulose With Silver Ions in Primary Knee Arthroplasty: A Randomized Trial

“…Перевязка в этом случае выполняется либо при чрезмерном промокании повязки, как было продемонстрировано в нашем исследовании, либо по личному желанию врача, что не всегда является обоснованным. Для ряда хирургов и пациентов было в непривычно впервые осматривать рану лишь через 5-7 дней после оперативного лечения [8]. Поэтому было бы оптимально, если используемое после операции раневое покрытие не препятствовало осмотру раны, позволяя оценить гиперемию паравульнарных кожных покровов, выявить изменение местной температуры, что крайне важно для диагностики ранних инфекционных послеоперационных осложнений [17].…”

“…К первой категории можно отнести целый ряд проспективных рандомизированных исследований и обзоров, показывающих, что адсорбирующие раневые покрытия, чаще используемые для лечения ран в общей и гнойной хирургии, демонстрируют хорошие результаты и при использовании у пациентов, перенесших плановые ортопедические вмешательства [4,5,6,7,8].…”

Venous Leg Ulceration

“…Some of the dressings show biological activity on its own, while some provide the release of bioactive constituents. Different types of wound dressings such as hydrogels, hydrocolloids, foams, films, and wafers may comprise of antimicrobials, anti-inflammatory agents, analgesics, growth factors, and proteins, which would be useful in different problems of wound healing [78,79]. During the choice of the wound dressing type, features of the ulcer should be considered and the mostly desired function of the dressing (such as cleaning, absorbing, regulating, creating a moist environment, and the possibility of adding medication, protecting the periulcer skin) should be decided [80].…”