Wound care at home

Dressings are not interchangeable

A dressing is chosen for the wound's stage, its moisture level and its tissue type. An alginate for heavy exudate, a foam for moderate, a hydrogel to add moisture to a dry wound, a hydrocolloid to keep a shallow wound sealed, an antimicrobial where infection risk is high.

Swapping one for a gauze pad because that is what is in the cupboard sets healing back. If your supplier substitutes without telling you, that is worth complaining about.

The basics of a dressing change

1. Wash your hands and set out everything before you start.
2. Remove the old dressing gently — support the skin rather than pulling the adhesive.
3. Cleanse as instructed. Usually saline or a wound cleanser; not hydrogen peroxide or undiluted antiseptics unless specifically told, as they damage healing tissue.
4. Look at the wound and note what you see — size, color, smell, amount of fluid.
5. Apply the new dressing as specified, including any packing.
6. Wash your hands again, and record the change.

What to watch for

Things that help beyond the dressing

• Offload the pressure. A pressure injury will not heal while it is still being compressed, and a diabetic foot ulcer will not heal while it is still being walked on.
• Compression, for venous ulcers. Venous ulcers heal with compression and usually do not heal without it — but compression is dangerous with arterial disease, so it must be prescribed after assessment.
• Nutrition. Healing needs protein, calories, fluid, and often zinc and vitamin C. Malnourished people do not heal.
• Blood sugar control, if diabetic.
• Stopping smoking. It measurably slows healing.

Getting the supplies

Quantities allowed by plans are derived from the wound's size, the number of wounds and the change frequency — which is why your wound clinic keeps measuring. Send us the updated measurements when they change and we will adjust the shipment before you run short.

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