Say Goodbye to Wet-to-Dry Wound Care Dressings:

[NRSKarenRN, BSN, RN]

Home Healthcare Nurse:

July/August 2011 - Volume 29 - Issue 7 - p 429-440

Say Goodbye to Wet-to-Dry Wound Care Dressings: Changing the Culture of Wound Care Management Within Your Agency

In the past two decades, randomized controlled trials have repeatedly demonstrated that wet-to-dry dressings are not the most appropriate in all healthcare settings or wound care situations emphasizing the previously documented historical research. In fact, the first research-based recommendation for moist wound healing as opposed to allowing the wound to dry out was published nearly 50 years ago (Winter, 1963).

Research-based evidence published by the U.S. government as clincial practice guidelines has shown that a moist wound environment is a primary factor for the wound healing process to occur. Wet-to-dry dressings allow the wound base to dry and healing cells to desiccate within the wound. These dressings can also be very painful for the patient, they physiologically impede wound healing, and the labor and supplies involved can add up to unnecessarily spent dollars.

[wooh, BSN, RN]

Sad this article is from 2011 (when it was already well-known wet to dry wasn't great) and we're STILL getting orders for it.

What's really annoying is that most of the orders for wet-to-dry I've had over the years, the doctor didn't actually intend for wet-to-dry to be done, they wanted a moist dressing.

Big reason I'm grateful we have a very involved team of WOCNs at our facility.

[JZ_RN]

I have always hated wet to dry dressings. They don't make sense in so many ways.

[mommy.19, MSN, RN, APRN]

We are no longer in the Stone Age! There are numerous dressing options for wounds of all types which are easily accessible in today's world of instant gratification. The key is recommending appropriate options to the ordering practitioner, be your patient's advocate! Would it be any different if the practitioner ordered a questionable dose of an oral med? No---- we as nurses would call to confirm and possibly recommend other options. :)

[tokmom, BSN, RN]

I know. I had a physician order W/D. I informed him of all the other options in our cupboard. What did he order? W/D..

[tyvin, BSN, RN]

We need to help educate our docs. Print up some current research and fax/email it to the docs who are famous for ordering the wet to dry. Perhaps implementing a policy that when wet to dry is ordered that so and so be done. If facilities would ban these dressings then the docs would get on board real quick.

Do we really need the Federal Government to come in and do it for us like they do with chemical restraints? There are some serious issues with people getting the wet to dry dressings. We do have the power.

[CapeCodMermaid, RN]

We haven't used wet to dry dressings in long term care for years. We refuse to take orders for them and educate the docs who try to tell us to use them. We have a doc who specializes in wound care. He makes rounds weekly. He would flip if he ever saw a wet to dry.

[CrazyCoconut]

So what's being used now?

[NRSKarenRN, BSN, RN]

Clean with wound cleaner or NSS, apply hydrogel, insert fluffed gauze pad to lightly pack wound, cover DSD or ABD dependent on size wound + drainage, secure with tape/tegraderm.

[turnforthenurse, MSN, NP]

I haven't done any W/D dressings in a few years...I honestly didn't like them.

[onthemark]

NRSKarenRN, I'm still confused. I thought that going from the hydrogel to the DSD was a moist to dry dressing. In my facility, we almost always do the moist to dry but still refer to it as wet to dry. Would you please clarify if you mean the moist to dry is still ok but to just avoid the truly wet to dry? Thank you. I'm trying very hard to learn all this but I have a lot to learn :)

[mommy.19, MSN, RN, APRN]

Wet to moist dressings are the kosher version of wet to drys, the gauze is intended to never dry out and inevitably rip out viable tissue. However, there are so many better options for wounds with many facets contributing to their presence. The wound dressing should address the wound environment and etiology if possible.