Practice ABC of wound healing

Wound dressings

BMJ 2006; 332 doi: https://doi.org/10.1136/bmj.332.7544.777 (Published 30 March 2006) Cite this as: BMJ 2006;332:777
  1. Vanessa Jones1,
  2. Joseph E Grey,
  3. Keith G Harding
  1. 1 Vanessa Jones is senior lecturer at the Wound Healing Research Unit, Cardiff University.

    Traditionally wet-to-dry gauze has been used to dress wounds. Dressings that create and maintain a moist environment, however, are now considered to provide the optimal conditions for wound healing. Moisture under occlusive dressings not only increases the rate of epithelialisation but also promotes healing through moisture itself and the presence initially of a low oxygen tension (promoting the inflammatory phase). Gauze does not exhibit these properties; it may be disruptive to the healing wound as it dries and cause tissue damage when it is removed. It is not now widely used in the United Kingdom.


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    Left: Healthy venous leg ulcer suitable for dressing with low adherent dressing. Right: Wound suitable for dressing with semipermeable film


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    Characteristics of the ideal dressing

    Occlusive dressings are thought to increase cell proliferation and activity by retaining an optimum level of wound exudate, which contains vital proteins and cytokines produced in response to injury. These facilitate autolytic debridement of the wound and promote healing. Concerns of increased risk of infection under occlusive dressings have not been substantiated in clinical trials. This article describes wound dressings currently available in the UK.


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    Venous leg ulcer suitable for dressing with hydrocolloid

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    Low adherent dressings—suitable for use on flat, shallow wounds with low exudates

    Low adherent dressings

    Low adherent dressings are cheap and widely available. Their major function is to allow exudate to pass through into a secondary dressing while maintaining a moist wound bed.

    Most are manufactured in the form of tulles, which are open weave cloth soaked in soft paraffin or chlorhexidine; textiles; or multilayered or perforated plastic films.

    They are designed to reduce adherence at the wound bed and are particularly useful for patients with sensitive or fragile skin.

    Semipermeable films

    Semipermeable films were one of the first major advances in wound management and heralded a major change in the way …

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