From the Guidelines
Wounds should be covered with an occlusive dressing to promote wound healing after thorough irrigation, as recommended by the 2024 American Heart Association and American Red Cross guidelines for first aid 1. When deciding whether to cover a wound, it's essential to consider the type and severity of the wound.
- Superficial wounds and abrasions should be thoroughly irrigated until there is no obvious debris or foreign matter in the wound, and then covered with an occlusive dressing 1.
- Wounds caused by animal or human bites, or contaminated with human or animal saliva, should be evaluated in a medical facility as soon as possible 1.
- Clean superficial wounds and abrasions can be covered with an occlusive dressing to promote wound healing 1.
- If a wound develops signs of infection, such as redness, swelling, foul-smelling drainage, increased pain, or fever, the dressing should be removed, and medical care should be obtained 1. The use of running tap water or sterile saline solutions for wound irrigation is recommended instead of antiseptic agents like povidone-iodine 1. It's also important to note that some minor scrapes or very shallow wounds in clean environments may heal better when exposed to air after the initial cleaning and treatment. In general, covering wounds provides a barrier against bacteria and other contaminants, maintains a moist healing environment that speeds up the healing process, and protects the wound from further trauma. However, the decision to cover a wound should be made on a case-by-case basis, taking into account the individual's overall health and the specific characteristics of the wound.
- For example, wounds with heavy exudate may require a dressing that absorbs moisture, while dry wounds may need topical treatments that add moisture 1.
- The type of dressing used should be based on the size, depth, and nature of the wound, and dressings should be changed at least daily to allow for careful examination of the wound for infection 1.
From the FDA Drug Label
Directions adults and children 2 years of age and older: ... may be covered with a sterile bandage Wounds may be covered with a sterile bandage, according to the directions for adults and children 2 years of age and older, as stated in the drug label for bacitracin (TOP) 2.
From the Research
Wound Coverage Guidelines
The decision to cover a wound depends on various factors, including the type and severity of the wound, as well as the risk of infection. According to 3, occlusion of the wound is key to preventing contamination, but there is no evidence that antiseptic irrigation is superior to sterile saline or tap water.
Types of Wounds and Coverage
- Minor wounds: Can be kept covered and dry after suturing, but can get wet within the first 24 to 48 hours without increasing the risk of infection 3.
- Contaminated wounds: Should not be closed primarily, but rather cleaned, debrided, and dressed in preparation for delayed primary closure or further exploration and management by skilled surgeons 4.
- Infected wounds: Require debridement, antibiotic therapy, and coverage with a muscle flap to achieve stable coverage without recurrent infection 5.
- Chronic wounds: Require a multidisciplinary approach, including assessment, wound cleansing, timely dressing change, appropriate dressing choice, and considered antibiotic prescription 6.
General Principles of Wound Care
- Provide a temporary protective physical barrier 7.
- Absorb wound drainage 7.
- Provide moisture necessary to optimize re-epithelialization 7.
- Clean and debride the wound to prevent infection 3, 4, 5.
- Choose the appropriate dressing based on the anatomical and pathophysiological characteristics of the wound 7.