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Wound Dressings

Matthew DeLaney, MD, FACEP, FAAEM, Paul Simmons, MD, and Neda Frayha, MD
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Wet to dry dressings? Nope! Our Urgent Care RAP cousin Matt DeLaney schools Neda and Paul on a better way to do wound care. Such as: Foam dressings address the important elements of wound healing; they absorb exponentially more than gauze, keep wound somewhat moist, and can stay on for 3-7 days. Downsides are that they may not help all wounds (little benefit for arterial ulcers).

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Ian L., Dr -

For venous ulcers compression is needed and in Australia a doctor on the Gold Coast Queensland Dr Stephan Yelland has developed a trilateral tubular bandage plus a system of ulcer care involving Debridement Cleaning Foam bandages like Aquacil and a innovated tri layered bandage .
Arterial Ulcers need be excluded by their appearance and exam of the leg for vascular insufficiency -dry skin cool lack of hair and diminished or absent pulses plus vascular tests .

Kapil S. -

Can you comment on use of silver dressings? I heard theyve gone out of favour.

Neda F., MD -

Hi Kapil. Here's Dr. Matt DeLaney's response: "Typically I stay away from silver dressings. For a certain subset of wounds that have a high degree of bioburden or infection they may be helpful but in the vast majority of wounds they either offer no benefit or may actually impair wound healing. In the world of wounds there is a lot of debate about if there is still a role for silver dressings so I try to keep things simple and stay away from them."

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Primary Care RAP January 2020 Written Summary.pdf 1 MB - PDF

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