HARTMANN in South Africa
Wound Care > Tips for treatment and care > The stage-adapted use of hydroactive wound dressings

The stage-adapted use of hydroactive wound dressings

After the cause of the chronic wound was clarified using differential diagnosis and a corresponding causal treatment was initiated, treatment of the wound can be started. The stage-adapted use of hydroactive wound dressings has proven to be successful in clinical practice. The therapist must however take into account not only the phase the wound-healing process is in when selecting a suitable wound dressing. Local disruptive elements such as infections, necroses, coatings, macerations etc. also play an important role.

Wound cleansing stage (exudative/inflammatory phase)

Coatings and necroses must be removed in the cleansing stage.

Non-vital, necrotic tissue as well as purulent coatings must be removed to enable a chronic wound to heal. Different conservative and operative procedures are available for debridement.

In addition to the different debridement procedures, wound dressings which are very absorbent but still keep the wound moist should be used in the cleansing stage. An accumulation of exudate can promote wound infection. In addition macerations should be avoided.


 

 

Suitable wound dressings in the cleansing stage:

  • Foam dressings (e.g. PermaFoam)
  • Calcium alginate (e.g. Sorbalgon)
  • Wound dressings for wet treatment (TenderWet)
  • The use of argentiferous wound dressings (e.g. Atrauman Ag) in addition to hydroactive dressings may be appropriate for wounds which are infected or in danger of infection.

Granulation stage

In the granulation stage the dressing must protect the wound from drying out.

The primary goal of wound treatment in the granulation stage is to protect the growing tissue from drying out by keeping it permanently moist. Because if the wound dries out, cells die and wound healing is set back severely.  Simultaneously excessive wound exudate must be bound to prevent macerations at the margins of the wound. If the wound is rather dry, it is advisable to moisten it with hydrogels. Dressings with a high absorption capacity such as alginate or foam dressings should be used for heavily exudating wounds. In addition the very sensitive granulation tissue should be protected from traumatization. Under optimum wound healing conditions wound contraction and formation of epithelial tissue usually occur rapidly.  


Suitable wound dressings in the granulation stage:

  • Foam dressings (e.g. PermaFoam)
  • Hydrocolloids (e.g. Hydrocoll)
  • Hydrogels (e.g. Hydrosorb)
  • Calcium alginate (e.g. Sorbalgon)
  • Wound dressings for wet treatment (TenderWet)

Epithelization stage

In the epithelization stage the protection of the healing wound is the most important goal.

The last and decisive step in wound healing is re-epithelization. Like well formed granulation tissue, the growing epithelial tissue also needs moist and warm conditions for the migration of epithelial cells. The wound should however also be protected against mechanical ingresses from the outside as well as possible cell stripping during dressing changes.

 

 


 



Suitable wound dressings in the epithelization stage:

  • Hydrocolloids (e.g. Hydrocoll)
  • Hydrogels (e.g. Hydrosorb)
  • Self-adhesive transparent film dressing (e.g. Hydrofilm)

How often a wound dressing has to be changed varies individually for every wound. The frequency of dressing changes depends on the condition of the wound as well as the choice of wound dressing. If the wound dressing is soaked with secretion and detritus, it should be changed. Therefore a dressing change is necessary more frequently in the cleansing stage than in the granulation or epithelization stage. Even if the use of a hydroactive wound dressing contributes significantly to wound healing, it is only one - although important – part of therapy. It does not replace good care of the patient who must be treated holistically.