Temple University School of Podiatric Medicine Journal Review Club
Article Title: Using the Entropic Wound Cycle as the Basic for Making Effective Treatment Choices
Authors: Mcguire, J, Sebag JA, Solnik, J
By Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS
There are more than 3,000 types of wound dressings available on the market today, and more are being launched every day. Although there are a number of protocols and algorithms available to help with the selection of wound dressings,1,2 and individual facilities are likely to have their own dressings of choice, the decision can still seem overwhelming. Even the most seasoned wound care practitioner can find it difficult to assess the advantages and disadvantages of each dressing available and to make the appropriate choice for a particular patient. Rather than consider each dressing in isolation, a useful technique can be to mentally place each type of dressing on a continuum of occlusion.3
Traditional gauze dressings are the least occlusive type of dressing and would lie at one extreme of the continuum. Then, in order of increasing occlusion would follow calcium alginate, impregnated gauze, semi-permeable film, semi-permeable foam, hydrogels, hydrocolloids, and finally latex as the most occlusive dressing type. Clearly, there will be some degree of overlap between dressing types, and other considerations will need to be taken into account. However, ordering dressing types in this way is an effective way of simplifying the final decision, allowing the wound care specialist to more easily select an appropriate wound dressing based on manufacturers’ claims and previous experience.
There are a number of types of dressing that don’t fit onto the continuum of occlusion, predominantly antimicrobial dressings, such as silver-based dressings or cadexomer iodine, as well as wound fillers, polyacrylates and other novel dressings including honey-based dressings. These types of dressing have specific properties and roles within wound management and will be considered in future articles.
To learn more about selecting the appropriate dressing for a particular wound, and how the properties of each dressing can determine its use and role in wound management, consider training for a certification in wound care. The training can take as much time as you like, and allows you to refresh your knowledge and investigate further subjects of particular interest.
1. Fleck CA. Wound Assessment Parameters and Dressing Selection.Adv Skin & Wound Care. 2006;19(7):364-373.
2. Hess CT. QUICK TIPS: Choosing a Wound Dressing. Adv Skin & Wound Care. 2005;18(2):70-72.
3. Myers BA. Wound management principles and practice. 2nd ed. Upper Saddle River, NJ: Pearson; 2008.
About The Author
Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS is a Certified Wound Therapist and enterostomal therapist, founder and president of WoundEducators.com, and advocate of incorporating digital and computer technology into the field of wound care.
The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.