Moist Gauze dressings?

[CharmedJ7]

Hi all,

I searched and didn't come up with much on this topic, so please point me in the right direction if this is redundant. Can someone please explain/provide evidence on moist gauze dressings? The best I can hope for on my floor is that "moist gauze" is what the MDs think they're ordering when they say "wet-to-dry" and I'd like to know exactly what it means and if/how it works. It seems to me that moist vs. wet-to-dry would have the advantage of avoiding the non-specific debridement but would not correct issues with improper wound temp, frequent changes (and thus, inc infection risk + nursing time), etc.

I would really appreciate any guidance!

[steelydanfan]

An order for "moist gauze dressings" means exactly nothing. It is completely non-specific so therefore, useless.

[K+MgSO4, BSN]

they could mean something like tender wet dressings which are pre made packs with a saline solution that keep a wound moist. They are better than doing 4 hourly irrigation with IV extension set in the dressing. not a fan of them.

[CoffeeRTC, BSN, RN]

What type of floor are you working on? What type of wounds?

[CharmedJ7]

Hmm... I guess I'm even more confused than I thought then. Basically, on a lot of wet-to-dry threads people have mentioned "moist gauze" dressings and I've seen it in the literature as what MDs sometimes think they're ordered when they say "wet-to-dry" or what some nurses interpret that as.

I guess my question is, is there anything like wtd that is a somewhat reasonable wound dressing alternative? My understanding of wtd is that it's purpose is mechanical debridement of a wound. Yes, there's better products for that (Collagenase/Santel comes to mind) but even beyond that, what do the MDs mean when they ask for that on a pink wound w/o slough?

[HmarieD]

There are gauze dressings that contain hydrogel or other products that retain moisture and promote a moist healing environment, which is particularly recommended for wounds with any depth, including pressure ulcers. These generally do not dry out and cause the mechanical debridement that WTD dressings do. Orders for "moist gauze" should be clarified.

Google WOCN for up-to-date wound care recommendations. Many doctors (dare I say most) do not have a clue when it comes to wound care. Educating yourself can be very helpful, as I couldn't tell you the number of times as a home health nurse I have been told by the doc "just do whatever you think is best".