You perform them the same way - you are to leave the wet-to dry in until it is dry- the concept is to debride with removal. Wet-to-moist you remove before totally dry - to help keep the wound bed moist. Wet-to-dry dressings are substandard and damaging to the wound tissue and should be avoided - per WOCN guidelines. You need to keep a wound moist and warm - not wet or dry- at all times to have an optimal healing environment. I work in HH and we all find ourselves CONSTANTLY telling MDs that this is inappropriate care and we need to change it to______. We are being the pt advocate and usually the MD lets us change it after explaining what I just said.
Im a student (hence the name hehehe), yesterday we covered Wet- to- damp and wet- to- dry in skills lab.....the way u JUST explained it is the way I UNDERSTOOD it.....half my classmates didn't get it. They went back and forth for 30 minutes....I tried to explain they wouldn't listen so I figured "oh well"......TY for clarifying!
Both of these dressings still remove healthy tissue. Neither should ever be used on a wound with less than 50 to 60 % necrotic tissue. And as a matter of fact, they don't ever have to be used. Their are so many products on the market that can be used instead.
well that is the only way it should be used. however it is archaic and painful if it is done properly. enzymatic debridement is what i use the most. it works great. it will break the non-viable tissue down at the cellular level and provide a moist environment to encourage granulation tissue growth. santyl is the name of what i use.<?xml:namespace prefix = o ns = "urn:schemas-microsoft-comfficeffice" /><o></o>
The above post said that wet-to-dry shouldn't be used at all. I believe there are different gels and such that are used to debride. They really should be teaching this in school not to use wet to dry. I graduated 2 yrs ago and they still teach this and apparently they still teach it now based upon a post from justmelpnstudent.
Well you know that all they teach in school is the basics. From LPN school to MD, this is all they teach. Wound Care is too subjective to get in to depth into any course. It's easyer to keep it the way it is. That way no one has to think about it...
Hmmm.... very interesting. I just searched for this b/c the ATI skills video said w2d should not be used for debridement which was a direct contradiction to what my clinical instructor told me a week ago. I came on here for clarification. I am only in my first nursing course and this is the second time I have learned the importance of staying up to date with best practice. I'm glad I'm the type of person that loves learning. I'm gonna have my hands full trying to stay current in the medical field, but, boy am I looking forward to trying!!
The problems with wet to dry is that it is not selective what tissue it will remove. You will remove the good with the bad. You have slough, medihoney is greater...even better than Santyl in my opinion. I was taught wet to dry is old school thinking and should not be done. When I see a wet to dry order, I recommend something different. Even a wet to moist, if not done right can macerate tissues around the periwound.