What type of dressing is recommended for an adult patient with an open, oozing wound and no known allergies or medical history?

Dressing Selection for Open, Oozing Wounds

For an adult patient with an open, oozing wound, apply a clean nonadherent dressing as the primary layer, covered by an absorbent secondary dressing to manage exudate, after thoroughly cleaning the wound with running tap water or sterile saline. 1, 2

Immediate Wound Preparation

• Clean the wound thoroughly with running tap water or sterile saline before applying any dressing to remove bacterial contamination and foreign matter. 1, 3, 2
• Irrigation is essential for preventing infection in open wounds. 3
• Avoid povidone-iodine or other antiseptics for routine cleansing, as they show no benefit over simple irrigation. 3

Primary Dressing Layer: Nonadherent Coverage

Apply a nonadherent dressing directly to the wound bed to prevent tissue trauma during dressing changes and maintain a moist healing environment. 1, 2

Specific Nonadherent Options:

• Petrolatum-based dressings (plain white petrolatum or petrolatum gauze) provide moisture, reduce friction, and promote healing without causing irritation. 1, 3, 2
• Mepitel™ or Telfa™ are suitable nonadherent dressings for open wounds. 1
• For small wounds being managed at home, petrolatum-based antibiotic ointment, honey, or aloe vera may be applied under the nonadherent dressing. 1, 2

Critical caveat: Reserve topical antibiotics only for wounds showing signs of infection (increasing redness, swelling, purulent drainage, increased pain). 3, 2 Routine antibiotic use increases contact dermatitis risk and contributes to antibiotic resistance. 3

Secondary Dressing Layer: Absorbent Coverage

Cover the nonadherent primary layer with an absorbent secondary dressing to collect exudate and protect the wound from external contamination. 1

Absorbent Dressing Options Based on Exudate Volume:

• For moderate exudate: Standard gauze dressings or foam dressings provide adequate absorption. 4, 5
• For heavy exudate (copiously oozing wounds): Use superabsorbent dressings containing superabsorbent particles, which can absorb and retain large volumes of fluid while maintaining structural integrity. 6, 7
• Exu-Dry™ or similar foam/burn dressings are specifically designed to collect high volumes of exudate. 1

The absorbent layer prevents maceration of periwound skin and reduces dressing change frequency. 7

Dressing Change Frequency

• Change dressings regularly to monitor for infection and maintain wound cleanliness. 3, 2
• For heavily exuding wounds managed with superabsorbent dressings, frequency may be reduced from daily to twice weekly once exudate is controlled. 7
• Inspect the wound at each dressing change for signs of infection: increasing pain, redness extending beyond wound margins, swelling, or purulent discharge. 8, 3

Pain Management During Dressing Changes

• Provide adequate analgesia before dressing changes, as wound care can be painful. 2
• Over-the-counter pain medications such as acetaminophen or NSAIDs are generally effective. 1
• For severe pain, consider short-acting opioids or ketamine. 2

Common Pitfalls to Avoid

• Do not use occlusive dressings that completely seal the wound unless specifically indicated, as they may trap bacteria and increase infection risk in contaminated wounds. 9
• Do not apply topical antibiotics prophylactically to clean wounds without signs of infection. 3, 2
• Do not use silver sulfadiazine on superficial wounds for prolonged periods, as it may delay healing. 8, 2
• Do not break blisters if present, as this increases infection risk. 8

When to Seek Specialized Care

• Refer to emergency department or specialist if the wound shows signs of infection, involves deep tissue, covers large surface area, or fails to improve with standard care. 8, 3
• Wounds involving face, hands, feet, or genitals require specialized evaluation. 1, 8