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MOIST
HEALING AND WOUND CARE INCLUDING BURNS
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(Advantages
and Current Approaches)
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Section
II. MOIST WOUND HEALING (CURRENT CONCEPTS)
A.
THE NON-BURN WOUND
A
landmark study in 1962 by Winter demonstrated that partial
thickness wounds re-epithelialized more rapidly under
occlusive dressings with the reason being that occlusive
dressings maintained a moist wound surface. This environment
accelerated the re-epithelialization process. Numerous studies
followed which demonstrated that wound occlusion and moisture
increased all phases of healing. Wound bacterial colonization
which can occur in a moist healing environment did not appear
to retard healing or cause sepsis. However, wound infection,
as expected, did decrease the healing process, the difference
between colonization and infection being the quantity of
bacteria. (colonization is defined as less than 104
bacteria/gram of tissue and infection being over 105
bacteria/gram. The data, demonstrating that a moist wound
surface increases re-epithelialization and all other
components of wound healing, is now well established. Any
surface desiccation leads to both an increase in wound depth
and infection.
Problems
of Surface Desiccation
Non-Burn
Wounds
Problems
of Wound Infection
Cutaneous
wounds managed with moist healing using an occlusive dressing
beginning in mid-20th century
Exposure
Method
Click
the Image to Enlarge
Surface
desiccation results in impairment to rate of
re-epithelialization and decreases all phases of healing
Moist
Healing
Click
the Image to Enlarge
Fluid
layer on wound surface increases not only the rate of
re-epithelialization, but all aspects of healing
  
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