Dressing (medical)
Encyclopedia
A dressing is an adjunct used by a person for application to a wound
to promote healing
and/or prevent further harm. A dressing is designed to be in direct contact with the wound, which makes it different from a bandage
, which is primarily used to hold a dressing in place. Some organisations classify them as the same thing (for example, the British Pharmacopoeia) and the terms are used interchangeably by some people. Dressings are frequently used in first aid
and nursing
.
or where medicinal Castor oil
was used in the first surgical dressings
In the 1960s, George Winter
published his controversial research on moist healing. Previously, the accepted wisdom was that to prevent infection of a wound, the wound should be kept as dry as possible. Winter demonstrated that wounds kept moist healed faster than those exposed to the air or covered with traditional dressings.
Various types of dressings can be used to accomplish different objectives including:
Occlusive dressings, made from substances impervious to moisture such as plastic
or latex
, can be used to increase the rate of absorption of certain topical medications into the skin.
skill, although many people undertake the practice with no training – especially on minor wounds. Modern dressings will almost all come in a prepackaged sterile
wrapping, date coded to ensure sterility. This is because it will come in to direct contact with the wound, and sterility is required to fulfil the 'protection from infection' aim of a dressing.
Historically, and still the case in many less developed areas and in an emergency, dressings are often improvised as needed. This can consist of anything, including clothing or spare material, which will fulfil some of the basic tenets of a dressing – usually stemming bleeding and absorbing exudate.
Applying and changing dressings is one common task in nursing
.
An "ideal" wound dressing is one that is sterile, breathable, and conducive for a moist healing environment. This will then reduce the risk of infection, help the wound heal more quickly, and reduce scarring.
Wound
A wound is a type of injury in which skin is torn, cut or punctured , or where blunt force trauma causes a contusion . In pathology, it specifically refers to a sharp injury which damages the dermis of the skin.-Open:...
to promote healing
Wound healing
Wound healing, or cicatrisation, is an intricate process in which the skin repairs itself after injury. In normal skin, the epidermis and dermis exists in a steady-state equilibrium, forming a protective barrier against the external environment...
and/or prevent further harm. A dressing is designed to be in direct contact with the wound, which makes it different from a bandage
Bandage
A bandage is a piece of material used either to support a medical device such as a dressing or splint, or on its own to provide support to the body; they can also be used to restrict a part of the body. During heavy bleeding or following a poisonous bite it is important to slow the flow of blood,...
, which is primarily used to hold a dressing in place. Some organisations classify them as the same thing (for example, the British Pharmacopoeia) and the terms are used interchangeably by some people. Dressings are frequently used in first aid
First aid
First aid is the provision of initial care for an illness or injury. It is usually performed by non-expert, but trained personnel to a sick or injured person until definitive medical treatment can be accessed. Certain self-limiting illnesses or minor injuries may not require further medical care...
and nursing
Nursing
Nursing is a healthcare profession focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life from conception to death....
.
Core purposes of a dressing
A dressing can have a number of purposes, depending on the type, severity and position of the wound, although all purposes are focused towards promoting recovery and preventing further harm from the wound. Key purposes of a dressing are:- Stem bleedingBleedingBleeding, technically known as hemorrhaging or haemorrhaging is the loss of blood or blood escape from the circulatory system...
– Helps to seal the wound to expedite the clotting process - Absorb exudateExudateAn exudate is any fluid that filters from the circulatory system into lesions or areas of inflammation. It can apply to plants as well as animals. Its composition varies but generally includes water and the dissolved solutes of the main circulatory fluid such as sap or blood...
– Soak up blood, plasma and other fluids exuded from the wound, containing it in one place - Ease painPainPain is an unpleasant sensation often caused by intense or damaging stimuli such as stubbing a toe, burning a finger, putting iodine on a cut, and bumping the "funny bone."...
– Some dressings may have a pain relieving effect, and others may have a placeboPlaceboA placebo is a simulated or otherwise medically ineffectual treatment for a disease or other medical condition intended to deceive the recipient...
effect - DebrideDebridementDebridement is the medical removal of a patient's dead, damaged, or infected tissue to improve the healing potential of the remaining healthy tissue...
the wound – The removal of slough and foreign objects from the wound - Protection from infectionInfectionAn infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...
and mechanical damage, and - Promote healingHealingPhysiological healing is the restoration of damaged living tissue, organs and biological system to normal function. It is the process by which the cells in the body regenerate and repair to reduce the size of a damaged or necrotic area....
– through granulationGranulation tissueGranulation tissue is the perfused, fibrous connective tissue that replaces a fibrin clot in healing wounds. Granulation tissue typically grows from the base of a wound and is able to fill wounds of almost any size it heals...
and epithelialization
Types of dressing
Historically, a dressing was usually a piece of material, sometimes cloth, but the use of cobwebs, dung, leaves and honey have also been described. However, modern dressings include gauzes (which may be impregnated with an agent designed to help sterility or to speed healing), films, gels, foams, hydrocolloids, alginates, hydrogels and polysaccharide pastes, granules and beads. Many gauze dressings have a layer of nonstick film over the absorbent gauze to prevent the wound from adhering to the dressing. Dressings can be impregnated with antiseptic chemicals, as in boracic lintBoracic lint
Boracic lint was a type of medical dressing made from surgical lint that was soaked in a hot, saturated solution of boracic acid and glycerine and then left to dry.It has been in use since at least the 19th century, but is now less commonly used....
or where medicinal Castor oil
Castor oil
Castor oil is a vegetable oil obtained from the castor bean . Castor oil is a colorless to very pale yellow liquid with mild or no odor or taste. Its boiling point is and its density is 961 kg/m3...
was used in the first surgical dressings
In the 1960s, George Winter
George D. Winter
Dr. George D. Winter was the British-born pioneer of moist wound healing. In 1962, while working at the Department of Biomechanics and Surgical Materials at the University of London, Winter published his landmark Nature paper Formation of the scab and the rate of epithelisation of superficial...
published his controversial research on moist healing. Previously, the accepted wisdom was that to prevent infection of a wound, the wound should be kept as dry as possible. Winter demonstrated that wounds kept moist healed faster than those exposed to the air or covered with traditional dressings.
Various types of dressings can be used to accomplish different objectives including:
- Controlling the moisture content, so that the wound stays moist or dry. An example of a moisture-rateining dressing is Aquacel, which is a "hydrofiber" that is indicated, for example, for partial-thickness burnBurnA burn is an injury to flesh caused by heat, electricity, chemicals, light, radiation, or friction.Burn may also refer to:*Combustion*Burn , type of watercourses so named in Scotland and north-eastern England...
s. - Protecting the wound from infectionInfectionAn infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...
, - Removing slough, and
- Maintaining the optimum pHPHIn chemistry, pH is a measure of the acidity or basicity of an aqueous solution. Pure water is said to be neutral, with a pH close to 7.0 at . Solutions with a pH less than 7 are said to be acidic and solutions with a pH greater than 7 are basic or alkaline...
and temperature to encourage healing.
Occlusive dressings, made from substances impervious to moisture such as plastic
Plastic
A plastic material is any of a wide range of synthetic or semi-synthetic organic solids used in the manufacture of industrial products. Plastics are typically polymers of high molecular mass, and may contain other substances to improve performance and/or reduce production costs...
or latex
Latex
Latex is the stable dispersion of polymer microparticles in an aqueous medium. Latexes may be natural or synthetic.Latex as found in nature is a milky fluid found in 10% of all flowering plants . It is a complex emulsion consisting of proteins, alkaloids, starches, sugars, oils, tannins, resins,...
, can be used to increase the rate of absorption of certain topical medications into the skin.
Usage of dressings
Applying a dressing is a first aidFirst aid
First aid is the provision of initial care for an illness or injury. It is usually performed by non-expert, but trained personnel to a sick or injured person until definitive medical treatment can be accessed. Certain self-limiting illnesses or minor injuries may not require further medical care...
skill, although many people undertake the practice with no training – especially on minor wounds. Modern dressings will almost all come in a prepackaged sterile
Sterilization (microbiology)
Sterilization is a term referring to any process that eliminates or kills all forms of microbial life, including transmissible agents present on a surface, contained in a fluid, in medication, or in a compound such as biological culture media...
wrapping, date coded to ensure sterility. This is because it will come in to direct contact with the wound, and sterility is required to fulfil the 'protection from infection' aim of a dressing.
Historically, and still the case in many less developed areas and in an emergency, dressings are often improvised as needed. This can consist of anything, including clothing or spare material, which will fulfil some of the basic tenets of a dressing – usually stemming bleeding and absorbing exudate.
Applying and changing dressings is one common task in nursing
Nursing
Nursing is a healthcare profession focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life from conception to death....
.
An "ideal" wound dressing is one that is sterile, breathable, and conducive for a moist healing environment. This will then reduce the risk of infection, help the wound heal more quickly, and reduce scarring.