Removal of a wet to dry dressing

[muddyduckies]

I had read in my nursing procedures book that the correct way to remove a wet to dry dressing was to not moisten the dressing before removal because this defeats the purpose of the dressing, which is debridement. However, in clinical I was told to always moisten a wet to dry dressing before removal. I am just quite confused. What technique do you suggest/do?

[jmgrn65, RN]

If you were the patient which way would you want it?

Moisten, it will still debrid

[Jolie, BSN]

I had read in my nursing procedures book that the correct way to remove a wet to dry dressing was to not moisten the dressing before removal because this defeats the purpose of the dressing, which is debridement. However, in clinical I was told to always moisten a wet to dry dressing before removal. I am just quite confused. What technique do you suggest/do?

I am currently doing a clinical refresher with one of the most knowledgeble and experienced nurses I've ever had the pleasure to meet. This very topic came up, and she discussed that current research indicates that the dressing should be removed dry in order for maximum debridement to take place, that moistening the dressing defeats the purpose. She emphasized that this is a point of clinical practice that has changed due to research-based practice since most of us last worked in nursing.

[oldiebutgoodie, RN]

It depends on why the dressing is used. If it is used for debridement, the answer used to be to not wet it, because it would then remove the dead tissue, but unfortunately also the new granulation tissue.

If the dressing is being used to keep the wound base moist (in which case this should be a "moist to moist" dressing, then if it has dried, one should definitely moisten it before removal. One also needs to think about changing the dressing more often if it has dried out. The goal in this case is to keep the wound base moist (not wet).

Using a wet to dry dressing for debridement is outdated practice because it is so non-selective. Debridement can be done using many other modalities, including enzymatic, autolytic, chemical. If they are teaching wet to dry for debridement, they need to update their info.

Oldiebutgoodie