Abstract


Dressing is an essential element of standard wound care. The main purpose of wound dressing is: a) provide a temporary protective physical barrier, b) absorb wound drainage, and c) provide the moisture necessary to optimize re-epithelialization. The choice of dressing depends on the anatomical and pathophysiological characteristics of the wound. Contemporary wound dressings provide additional benefits, such as antimicrobial properties and pain relief. In this concise review, we discuss the principles of wound dressing, highlight the features of basic and advanced types of dressings, and offer some practical tips on the choice and application of dressings.

Abstract


Introduction: Comprehensive wound management programs that employ a standardized integrated care bundle (ICB) and advanced wound dressings are generally recognized to decrease healing times and treatment costs. The purpose of this study was to compare wound healing rates and cost efficiencies as measured by nursing-care requirements for patients not on an ICB versus patients on an ICB and using a gentian violet/methylene blue-impregnated (GV/MB) antimicrobial advanced wound dressing.
Materials and Methods: The comprehensive wound management programs enabled continuous, standardized measurement of each patient’s wound episode from admission with a wound to healing and discharge. Data was recorded over 24 months from 2016 to 2018. The variables recorded for each patient included: wound healing time (number of weeks), wound acuity based on the Bates-Jensen Wound Assessment Tool (BWAT), a comorbidity index (using the Charlson Comorbidity Index), and the number of wound dressing changes. The wound dressing changes required a visit by a registered nurse and, therefore, served as an indicator of care delivery costs where the dressing change visit cost was $68 (CAD).
Results: A total of 6300 patients (25% of the total study population) were identified as using GV/MB dressings within the context of an ICB. The mean healing time for these patients was accelerated more than 50% versus patients not on an ICB. The average total cost of patient care was reduced by more than 75% from diagnosis to wound healing when patients were on an ICB with GV/MB dressings. These results compared well to patients on ICBs that had other types of advanced dressings.
Conclusion: The study demonstrates that a comprehensive wound management program based on integrated care bundles in conjunction with GV/MB dressings can be a highly-effective clinical option. The benefits showed significant reductions in healing times and treatment costs.