Steps of a wet to dry dressing

[oxyjen]

Hi, I need to write a plan of care for a wet to dry dressing, lots of steps and I'm not sure when the sterile gloves go on. Could you help?

Here is the scenerio I've come up with:

position patient pad bed, emesis basin handy for later irrigation

open and arrange supplies

nonsterile gloves

remove old dressing

measure wound with cotton applicator tip

irrigate wound with NS and Toomey stringe

apply sterile gloves

pack wound with 4x4's

dry skin which is wet with irrigant

apply ABD pad and tape

Please rearrange these if they aren't in the right order. Add your rational so I'll understand better. Thank You!

[Fiona59]

Our surgeons loove them, bid, tid....

[colter517]

Wet to dry dsgs is a method of debridement.

[dijaqrn]

We still use wet to dry dressings and they are effective. My docs don't order peroxide or Betadine any longer and I remember the days of antacid and sugar; all of these things sometimes worked!!!!!!!!!!!.

The student was assigned a wet to dry and was given the correct steps. I would want to be aware that these dressings can be harmful to the surrounding healthy skin, note this in the care plan.

The key thing is to follow MD orders(unless containdicated) and always explain the procedure to the patient first.

[sharlynn]

Wet to dry dsgs is a method of debridement.

But it is no longer recommended because it debrides healthy tissue as well.

[MedSurgeNewbie]

I am amazed that we still use wet to dries, I know it works but so did leaches and bleeding to an extent.. Since there are better tools why not use them - I really feel wound care is under utilized in a big way

[Lucyinthesky]

"7. Gently remove and discard the old tape and soiled dressing in a plastic trash bag. If the dressing sticks to the wound, moisten with sterile nss and then remove."

I am a nsg student and am being tested on wet to dry dressings tomorrow. My prof is actually a wound care specialist and says these are rarely used now but we are required to learn them. My question is this: if you are trying to debride do you want to wet the dressing when you remove it? I would think that removing it dry would be quite painful but that is what causes the debridement. Please let me know which way is correct: remove it when it is dry or rewet it? Thanks so much!

[WolfpackRed]

I am amazed that we still use wet to dries, I know it works but so did leaches and bleeding to an extent.. Since there are better tools why not use them - I really feel wound care is under utilized in a big way

When I was in my first Med/Surg rotation at Duke Universtiy hospital, they used medical leeches and sterile maggots for capillary circulation and wound debridment, respectively. Just because it seems arcane, does not mean that it is not effective.

[crawlyberry]

Nursing student here....So if they are not using wet to dry dressings anymore, what is more effective? Also, same question as Lucyinthesky, if wet to dry is ordered, how do you remove the dressing? Add saline or pull off dry? Any information is greatly appreciated.:wink2:

[tvstimson]

Wet to dry dressing are very antiquated, inadequate, and ineffective when compared to the available alternatives.

Wet to dry dressings require frequent changing. This subjects / exposes a wound to more instances of possible infection.

When compared to other type of dressings the wet to dry often mistakenly is considered to be a more economic procedure. But considering the frequency of dressing changed; the nursing time required; and the over all extended healing time; it becomes apparent the cost is much greater.

Again, because the wet to dry process is so slow the wound has a far greater chance of becoming chronic and again more suceptable to infection.

Very often wet to dry dressings are very Painful. In many cases narcotics are given to counter act this pain. Is this a good justification when there are many more non-painful procedures.

Wet to dry dressings are Indiscriminate of what tissue it removes. Wet to dry can remove viable, newly healed, and intacted tissue.

The WET portion of wet to dry holds moisture in contact with the exterior epidermal tissue which needs a dry enviroment to maintain its integrety. Constant contact to moisture causes it to break down.

The DRY portion of wet to dry also removes body fluid and nutrients necessary to to repair tissue. It also creates an isotonic imbalance leaving the tissue more suseptable to further break down.

Wounds will heal despite the wet to dry treatment, not because of it!

Besides being a poor selection for debridement I believe there well could be some legal ramifications by this continued practice.

For more information please read the article "Hanging wet-to-dry dressings out to dry" by Ovington, Lisa at:

http://findarticles.com/p/articles/mi_qa3977/is_200203/ai_n9080467

[violetrose]

So,so, True, I Work In Ltc, Frequently Get An Order For W-d Drsng. I Have To Call The Md To Clarify And Explain. A Wet To Moist Drsng Is An Exceptable Treatment.

[natrgrrl]

I am a student preparing for a patient tomorrow. I looked all through my textbooks and can only find wet-to-damp dressings. Are they the same thing as wet-to-dry dressings?

[sharlynn]

They are not the same thing. Wet-to-dry was pulled off dry as a debridement technique. It was generally very painful and is now out of favor because it does more harm than other methods.

Wet-to-damp or wet-to-moist is a kinder method. It promotes a moist wound bed, which is the preferred treatment now. Although many dressings are better and promote faster healing, this is a cheap and effective dressing technique.