Moist Wound Healing - The Basics

Before we move on to the details of moist wound healing it is better if the definition of a wound and its classification is detailed first.

To describe a wound there are multiple ways. A wound is described either by its aetiology, anatomical location, if it is acute or chronic, the method of closure required, by the symptoms that it presents, by what predominant tissue types can be seen in the wound bed, wound depth, tissue loss or clinical appearance of the wound.

However for Pressure Ulcers (EPUAP), Burns (Rule of Nines), Diabetic Foot Ulcers (Wagner / San Antonio) and General Wounds there are separate grading tools or mechanisms that are used.

A wound can generally be classified as being:

- Superficial. This is where the person has only suffered loss of epidermis.

- Partial thickness. This is where the wound involves both loss of epidermis and the dermis.

- Full thickness. This is where the wound involves involve loss of the dermis, subcutaneous fat and maybe the bone.

These definitions are not just for symbolic purposes but they are critical in assessing and appropriately managing the wound in the course of symptom resolution or, if possible, healing.

If we really want to define a wound then by definition a wound can be said to be a breakdown in the skins protective function. This includes loss of epithelium continuity, with or without the loss of the underlying connective tissue (bones, muscles, nerves).

Healing of a wound is done by primary intention or secondary intention. This depends upon if the wound is closed with sutures or left to repair. Tissues damaged in the process are reconstructed by formation of connective tissue and re-growth of epithelium.

If surveyed we will find the commonly the method for classification of wound that is used is by identifying the predominant tissue types present at the wound bed. This is a visual classification method and is popular as it supports a good assessment and planning. This method also helps with continuous reassessment.

Moist Wound Healing is a method that is now days challenging the common physiological process that is used for repairing a wound in other words called dry healing (evident by formation of a scab).

Studies have backed and proved the fact that in conditions that are moist occlusive / semi-occlusive, epithelialisation takes place at a rate that is twice the rate when compared with one in dry conditions.

The way to carry out moist wound healing is by using advanced wound care dressings.

Please note that wet environment can also be detrimental as this could lead to maceration and tissue breakdown. What should be noted is that moist wound healing is not right for all types of wounds and should be done only in consultation with a doctor.

by: Alice Merry

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