From the Guidelines
It is not necessary to maintain dry dressings after surgical excisions, as occlusive dressings have been shown to result in better wound healing than dry dressings. According to the 2024 American Heart Association and American Red Cross guidelines for first aid, occlusive dressings such as film, petrolatum, hydrogel, and cellulose/collagen dressings are preferred over dry dressings for wound healing 1.
When considering postoperative wound care, it's essential to prioritize methods that promote optimal healing and minimize the risk of complications. The use of occlusive dressings can help maintain a moist environment that fosters healing, while also protecting the wound from bacterial contamination and other external factors.
Some key points to consider in postoperative wound care include:
- Following the surgeon's specific instructions for dressing changes and wound care
- Monitoring the wound for signs of infection, such as increasing pain, redness, swelling, discharge, or fever
- Keeping the wound clean and dry, but not necessarily using dry dressings
- Avoiding the use of antibiotic or antibacterial dressings, as they have not been shown to improve wound healing or decrease infection rates in clean wounds 1
In terms of specific dressing types, the 2023 World Society of Emergency Surgery guidelines suggest that negative pressure wound therapy (NPWT) may be beneficial for wound healing in certain cases, particularly for patients at high risk for surgical site infections 1. However, the most recent and highest quality evidence supports the use of occlusive dressings over dry dressings for optimal wound healing 1.
Overall, the goal of postoperative wound care is to promote optimal healing, minimize the risk of complications, and improve patient outcomes. By prioritizing the use of occlusive dressings and following evidence-based guidelines, healthcare providers can help achieve these goals and improve patient care.
From the Research
Importance of Postoperative Dressings
- Postoperative dressings play a crucial role in preventing surgical site infections (SSIs) and promoting wound healing 2, 3
- The choice of dressing is essential in maintaining a moist environment and reducing the risk of infection and blistering 3
- Dressings can be broadly categorized into different types, including vapour-permeable barrier dressings, standard dressings, and vacuum-assisted closure (VAC) dressings 2, 4
Types of Dressings
- Vapour-permeable barrier dressings are effective in providing a physical barrier and a moist environment for optimal wound healing 2
- VAC dressings have been shown to reduce the incidence of surgical site infections and wound-related complications in trauma patients undergoing posterior spinal fusion 4
- Standard dressings, such as conventional absorbent cellulose dressings, may have limited bacterial protection and can shed particles that remain in the wound 5
Maintenance of Dressings
- Regular wound assessment is necessary to ensure that the chosen dressing is suitable for the patient and the wound 2
- The use of modern dressings, such as hydrocolloid dressings, can reduce the incidence of wound sepsis and prevent cross-contamination 5
- Removing conventional dressings from bacterially colonized wounds can liberate wound bacteria into the air, highlighting the importance of careful dressing removal and infection control procedures 5