For the most part wet to dry dressing are obsolete. Used for debridement they typically pull off good granulation tissue (when left to dry) and leave the dead slough remaining. If debridement is needed there are more cost effective methods to use -- Also although materials, gauze, are cheap the time spend changing dressings and the extra time needed to clean out wound make it more expensive. Also in some cases what is meant is moist saline dressing(the physician never wants it to dry out to promote moist wound healing).. This typically needs to be changed more often in order to keep the wound bed moist.
Just my 2 cents worth
Exactly wound nurse. I feel these dressings are a waste, and difficult to teach pt's to do as well, esp older folks who can't reach heels. I find a duoderm for a stage 2, and sometimes even a tegaderm, works much better, if not too much drainage. They also don't need to be changed as often. CHeck out this article http://nursingcenter.com/library/Jou...icle_ID=100496 it is fairly recent.
One of the other factors that I dont like about wet-to-dry drsgs are that they are usually painful for the patient. Most time the only thing that relieved the removal was soaking the drsg with topical 4% lidocaine. Now thats not very cost effective.
The ltc facility I work for, has a mds cordiator that has had a great expericene with wet to dry dressings. I have had a very difficult time getting her ideas to change. I am hoping now, with a fiancial crisis in our hands at the facility, having them look at the expense of wet to dry compared to modern methods, will change her outlook.Which by the way, has a great impact on out don.
Heel ulcerations or otherwise... the technology we have now makes traditional "gauze and saline" dressings obsolete. Not only are they difficult to maintain... they HURT.
One manufacturer (dang, i forgot their name) has come up with a product that actually LOOKS like gauze, to help physicians who are still passionate about "gauze" to consider this product instead. It seems it isn't the efficacy of an item, it's the "sentimental" attachement associated with it... you know, the "tried and true."