Moist healing versus wet-to-dry

The wound care orders read (гласят)”Wet-to-dry dressing, normal saline solution”. For many nurses, this treatment is still the standard of practice. But we think that wet-to-dry dressings are less effective and more expensive than the moist healing of the wound.

The purpose of “wet-to-dry” is to apply a gauze dressing saturated with normal saline to a wound, let it dry and then pull it off, taking the necrotic substance with it. The problem is that along (наряду) with the necrotic matter delicate growth cells and granulating tissue are also pulled up. As well, it can be a painful process for the patient.

In the early 1960s, studies were undertaken (предприняты) to determine if wounds healed better in a moist environment as compared to (по сравнению) to an “ open air” environment. It was proved that a covered wound healed more rapidly and with a smaller scar (шрам) than a wound left open to the air. Covering a wound with an occlusive dressing and leaving it there for several days can increase the rate of wound healing.

By keeping a wound moist, a scab (короста) formation is prevented or reduced, thus increasing the movement of epithelial tissue into the moist wound. This creates granulating, healthy tissue. By leaving the wound covered, the potential for infection is decreased and pain is minimized.

With the old technology (wet-to-dry), chronic pressure ulcers (пролежни) either did not heal at all or required months or even years of frequent dressing changes. Healing pressure ulcers in the new fashion provides more rapid healing.

Ex.3 Find answers to the questions:

1. Какие повязки считаются стандартными?

2. Что такое сохнущая повязка?

3. Влажные или сохнущие повязки более эффективны?

4. В чем недостатки сохнущих повязок?

5. Что было доказано в результате исследований, проведенных в 60-ые годы 20 века?

6. Что происходит, если рана сохраняется влажной?

7. Как проходило лечение пролежней при старой методике?

Ex.4 Tell in Russian the following text. Find the English equivalents to:

Приблизительно, бедро, обеспечить, был выписан, уменьшиться

Mr.Bill Smith, a 74-year-old gentleman with a pressure ulcer, approximately 8 – 8 cm and 5 cm deep on his right hip, was treated for three weeks with wet-to-dry dressings with no effect. The dressing was switched (переключилось) to a hydroactive gel which was covered with an occlusive, absorptive dressing to optimize the temperature within the wound to ensure adequate moisture. The dressing was left for four days. When it was removed and the wound irrigated (орошена) with normal saline to clean out the smelly “soup” of dead tissue, there was granulating tissue at the base of the wound. The wound was clean and moist. This treatment was continued, dressings were changed every four days. By the time Mr.Smith was discharged 10 days later, the ulcer had decreased in size to 5-5 cm and was 2 cm deep with a base of granulating tissue. Physicians and nurses saw with their own eyes the efficiency of moist wound healing. On discharge, our patient only required a home nurse to visit once every four days to change his dressing until it healed (in approximately four weeks post-discharge).

Tell about dressings using the following schemes: