5 Essential Rules of Wound Dressing: Clinical Best Practices
What are the 5 rules of wound dressing?
The Quick Answer
**1) Cleanse gently** with saline—never hydrogen peroxide. **2) Match dressing to exudate**—absorptive for heavy drainage, moisture-donating for dry wounds. **3) Maintain moisture balance**—neither maceration nor desiccation. **4) Change based on saturation**—not arbitrary schedules. **5) Assess at every change**—document size, tissue type, and signs of infection. Violating these rules delays healing more than the original injury severity.
Why We Ask This
Clinicians follow rigid dressing change schedules (e.g., 'every 3 days') without assessing actual wound needs—changing dry dressings unnecessarily traumatizes tissue or leaving saturated dressings in place causes maceration that expands wound size beyond original dimensions.
The Practical Science
Evidence-based dressing protocols prioritize wound physiology over convenience: hydrocolloids maintain moisture for 3–7 days until edge lifting occurs; alginates require changing when gel saturation reaches 75% capacity. TIME framework guides product selection: non-viable Tissue needs debridement before dressings can work effectively.
In Clinical Practice
A venous ulcer with moderate exudate receives foam dressing changed when strikethrough occurs (typically every 48 hours)—periwound skin remains intact with progressive granulation. The same wound with fixed 7-day changes develops maceration and 20% size increase—demonstrating how rigid protocols sabotage healing versus responsive assessment-driven care.
References & Context
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