108 The Use of Wet-to-Dry Wound Dressings

Abstract

Purpose: The purpose of this study was to determine the current use of wet-to-dry dressings as the principal wound care modality ordered by health care providers. In addition, this study describes the types of wounds wet-to-dry dressings are currently used for, the specialty of health care providers most likely to order these dressings, and associated data that indicates whether or not the clinical condition of the wound warrants the use of wet-to-dry dressing for mechanical debridement. Method: This descriptive study involved a retrospective chart review of 202 home health and HMO case managed patients with open wounds One hundred and two HMO charts were reviewed; only 74 had sufficient data documented. One hundred and sixty-one home health charts were reviewed; only 128 were appropriate for data collection (closed incisions, drainage tubes, ostomies, and those charts where more than six items on the data collection sheet were not documented in the chart, were not used). The data was analyzed using SPSS. Findings: This study suggests that the current use of wet-to-dry dressings is over 41% of all principal wound care modalities, followed by enzymatic (7.43%) and dry gauze (6.93%). The majority of wet-to-dry dressings ordered are for surgical wounds (69%), followed by neuropathic ulcers (10%) and pressure ulcers (5.9%). Furthermore, this study suggests that general surgeons are most likely to order wet-to-dry dressings (38%). Data also indicated that in over 78.6% of wounds treated with wet-to-dry dressings, mechanical debridement was not indicated (the percent of granulating tissue in the wound bed was > 75%). In only 3.5% of wounds treated with wet-to-dry dressings was mechanical debridement possibly indicated by the amount of nonviable tissue in the wound bed. Discussion: Clinicians need to be involved in research that will lead to evidenced based clinical practice and standardized wound care. The scientific literature suggests that wet-to-dry dressings are not evidenced based, but are detrimental to the granulating wound bed, painful, costly, and one of the least effective methods of debridement available today.