Does a wound have to be kept dry?
Many people grew up hearing from older relatives that a wound needs to "breathe" and should "dry out and form a scab" to heal. This advice, passed down for decades, goes against the medical evidence behind modern wound care.
As early as 1962, research by the British scientist George Winter showed that a wound grows new skin (epithelialisation) twice as fast in a moist environment as in a dry one. This finding became the basis of modern moist wound care.
The science of moist wound healing
Wound healing involves complex physiological processes, and it needs the right micro-environment to move forward smoothly.
Speeds up cell migration
- A moist surface lets repair cells move smoothly towards the centre of the wound
- It raises the activity of fibroblasts, which makes collagen faster
Keeps growth factors
- Wound fluid itself contains many growth factors, including EGF and PDGF
- A slightly moist environment stops these growth factors from drying out and losing their effect, so they keep repairing the wound
Autolytic debridement
- Natural enzymes in the fluid help soften and break down dead tissue
- It provides a suitable environment for immune cells to keep up normal clearing and defence
Less pain at dressing changes
- A moisture-retaining dressing covers and protects exposed nerve endings and reduces stinging
- The dressing does not tear fragile new tissue when it is changed
Common modern moist dressings
Different kinds of wounds need matching dressings to adjust the moisture.
Hydrogel dressing
- A gel material with a high water content
- Suitable for rather dry wounds
- Adds moisture to the wound and softens dry, hard dead tissue
- Transparent, so changes in the wound can be seen directly
Foam dressing
- Absorbent polyurethane foam
- Suitable for wounds with moderate to heavy fluid
- Has some thickness to cushion and protect the wound
- Absorbs excess fluid so that the wound stays slightly moist but not too wet
Alginate dressing
- A fibre dressing extracted from natural seaweed
- Turns into a soft gel after absorbing fluid
- Made for wounds with a lot of fluid
- Soft and conforming, and can be packed into deeper wounds or wounds with cavities
Transparent film
- A semi-permeable material that blocks water from outside while staying breathable
- Suitable for shallow, superficial wounds
- Can also be placed over other dressings to hold the underlying dressing in place
When choosing a dressing, consider the type of wound, the amount of fluid and whether there is infection. With the wrong dressing, a wound that is too wet soaks and damages the skin, and one that is too dry forms a scab, and both slow recovery. The safest approach is to have a healthcare professional check the wound first and then decide which dressing to use.
Common questions
Does keeping a wound moist make it more likely to become inflamed?
Modern moist dressings aim for a wound that is slightly moist without pooled water. The right level of moisture actually helps immune cells such as white blood cells to work and fight bacterial infection. The key is to choose the right dressing so that the moisture stays in a suitable range.
Will sealing a wound with a dressing stop it breathing?
Most medical dressings today are made of semi-permeable or breathable materials. Water vapour and oxygen can pass through, but water droplets and bacteria from outside cannot get in. In addition, the oxygen that wound tissue needs comes mainly from the blood supply, not from direct contact with air.
Is it normal for fluid to keep seeping from a wound?
A moderate amount of fluid during recovery is a normal physiological process and contains growth factors that help repair. However, if the fluid suddenly increases, smells bad or turns cloudy, it may be a warning sign of infection and medical help should be sought promptly.
When to ask a professional for help
Seek medical help straight away if any of the following occur:
- Redness and swelling around the wound that spread, fever or chills
- Pus-like fluid or a bad smell
- Red lines appearing around the wound
- Severe pain that gets worse
A detailed assessment by a healthcare professional is advised in the following situations:
- The wound has not healed after two weeks
- The wound of a person with diabetes
- A chronic wound or pressure sore
- Unsure how to choose a dressing
Home nursingwill check the patient's wound, choose a suitable dressing, teach the correct way to clean the wound and follow up on progress. If the patient has difficulty moving, or the wound has not healed for a long time, regular care from a professional can help the wound close faster and lower the risk of complications.
Does the patient have a chronic wound or pressure sore that needs care? Our home nurses can visit to assess the wound and change dressings.
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