The concept of moist wound healing is not new; I recall the paradigm of moist versus dry as far back as the late 1970s. As a young nurse, I grew up in the antacid and heat lamp days. We did wet to dry dressings as a standard of care. As the work of George Winter1 and others began to be disseminated, educating that wounds maintained with an optimal moisture level closed faster and were less painful, we began to see the emergence of products into the wound care space to help us treat based on our assessment of the wound and the perceived exudate level. Last month’s “Back to Basics” explored options for exudate management. This month, I discuss options for hydrating the wound that is dry or possibly unintentionally getting dry between dressing changes.
Most dressings are designed to absorb or maintain the ambient level of wound exudate. Few are able to actually donate moisture to a wound that is dry, which is probably less of a problem than wounds that are draining. One obstacle we frequently face is ensuring we adequately teach patients the need to keep their wounds moist. We often must overcome what our mothers taught us — that is, “Don’t pick your scabs” (we pick most scabs) and “Let that get some air…it needs to breathe” (and we know the answer to that).