Wound Dressings may serve one or more of the following functions:

1. Protection

Dressings protect wounds from further trauma by providing a barrier from external forces. Open wounds with partial thickness burns hurt more than those wounds whose surface is protected from the atmosphere and temperature fluctuations. Covered wounds usually attract less attention from curious passers-by than do open or sutured wounds. Dressings help diminish desiccation of open wounds which might lead to further tissue loss.

2. Absorption

Dressings absorb exudate from open wounds. This diminishes the likelihood of bacterial proliferation and subsequent infection. Moist dressings act as a wick to draw fluid from the wound rather than letting it accumulate to form a crust or scab.

3. Compression

Appropriate compressive forces can be exerted by a properly placed dressing. Care should be taken not to have this compression to an excessive degree for fear of resultant ischemia and pain. This function helps diminish edema in some wounds.

4. Immobilization

By promoting immobilization, a properly applied dressing can assure less pain and improved healing.

5. Aesthetics

A carefully applied dressing can be a more acceptable sign of injury compared to an open wound or one with exposed sutures.

CHARACTERISTICS OF A GOOD DRESSING
A dressing should appear neat and tidy and be clean on the outer surface. The first layer of a dressing in contact with the wound surface should not adhere. A lightly lubricated gauze with intersticies allowing fluid to pass is recommended for this layer. Occlusive dressings such as Telfa ^TM should not be used since maceration is promoted with retained fluid beneath the dressing.

The next layer should be of absorbent material sufficient to attract any drainage that might exude from the wound.

Following this, usually soft gauze rolls are wrapped to secure the initial materials in place. This is most reliably achieved with a non-elastic roll gauze. Stability can be provided to this dressing by reinforcement with adhesive tape. Mild compression, without strangulation or resultant ischemia, is the goal. If additional immobilization is required, a plaster splint or prefabricated splint might be required. This should be well padded so that additional adverse pressure is not provided.

THE OPEN WOUND - A SPECIAL CONSIDERATION
Dressings for an abrasion, burn or open wound serve the same functions as dressings for closed wounds: Protection, absorption, compression, and immobilization. However, some modification is required.

Partial thickness injuries should be cleaned of all forgein material and covered with a non-adherent lightly lubricated gauze such as Xeroform ^TM or Adaptic ^TM. This layer should be kept in place so that newly formed epithelial cells are not disturbed. The absorptive layers placed over this non-adherent material should be changed when required with care not to dislodge the layer contacting the open wound.

So-called "wet-to-dry" dressings are utilized for debriding open wounds but may destroy newly proliferating epithelium when they are removed. In addition, they are painful to the patient when being removed. Rather, wet-to-damp dressings are preferable since they are less painful when removed and also provide a moist environment, which helps promote epithelialization. If this dressing should dry between dressing changes, moisture in the form of saline should be applied before removal.