Decision Making For Dressing Product Selection

Dressing product selection is based on comprehensive assessments of the wound and the patient’s overall physiology. Determining whether a person’s body can support complete wound healing requires clinical skills and significant knowledge of the many barriers to healing, including which impediments can be influenced by the wound care team and which cannot. When making decisions for treatment, one should consider whether the wound has healing potential, is more likely maintenance wound, or has evolved to a non healable ulcer unable to garner the endogenous constituents needed for wound closure and healing.^(12,16) For instance, a patient with end-stage cancer who has a Stage 4 infected pressure injury located on the sacrum may benefit from interventions aimed at pain and odor control, addressing the infection, support for activities of daily living, and other health-related quality-of-life issues addressed through a palliative care approach rather than aggressive debridement and advanced dressings looking at the end goal of wound closure.⁽¹⁶⁾ In such a case, maintenance wound care would be more appropriate.

The advent of modern dressings in the 20^th and 21^st centuries has significantly enhanced wound care practices and improved outcomes for people with chronic wounds. However, deciding which product to use through the wound’s trajectory toward healing, or in some cases deterioration, requires ongoing assessment of a multitude of factors that influence wound healing in addition to local considerations that drive dressing selection decisions. Another issue regarding dressings is that there is little evidence supporting the effectiveness of one dressing product over another, particularly within the same category of dressings, such as one company’s hydrogel being better than another’s.⁽¹⁶⁾ However, with that said, it is important to learn how to choose the best dressing products in an attempt to create a functional wound environment capable of healing while addressing patient-centered concerns affecting the quality of life.^(12,14)

Excerpted from Textbook of Chronic Wound Care: An Evidence-Based Approach to Diagnosis and Treatment

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