Dressing Selection

Wound dressings provide a physiologically moist wound environment shown to enhance healing, reduce pain, debride necrotic tissue, and decrease infection rates in pressure sores. Dressing selection depends on the stage, amount of exudate, size, site, and condition of surrounding skin. No moist-dressing type has proved superior to the others (Bouza et al., 2005). The main categories of modern dressings are polyurethane films, hydrocolloids, amorphous hydrogels, hydrogel sheets, polyurethane foams, foamed gels, alginates, and hydrocolloid/alginate combinations (Table 4-10).

For deep, stage III and stage IV pressure sores, packing is often needed to eliminate dead space. This can be accomplished with saline-moistened gauze, calcium alginates, gels, and dextranomers. After packing, the wound is covered with an occlusive or semiocclusive dressing. If excessive exudate is present, the dressing must have absorptive properties to control exudate without drying the wound bed. Examples include saline-moistened gauze, alginates, and combination hydrocolloid/alginate dressings.

Pressure sores should be evaluated weekly by a health care professional. Reevaluation of the treatment plan should be considered if there are not signs of healing within 2 weeks of treatment (Ferrell, 1997; Goode and Thomas, 1997).

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Soccer Fitness 101

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