5.5 Packing of wounds Listen

Frequent and excessive packing of wounds should be avoided. In large cavity wounds where several pieces of dressing or ribbon are used to pack, it should be documented how many are used. This is to ensure that when the wound is redressed all of the dressings are removed and none are left retained in the patient. Retained dressings in cavity wounds can cause infection and prevent the wound from healing.

Wound dressings
Dressing choice should be selected depending on things such as the stage of healing the wound is at, the level of exudates being produced, whether the wound is infected or not. Patient preference should also play a role in dressing choice, as agreement from the patient will increase concordance with the treatment of their wound.

The criteria for an ideal dressing is that it should create and maintain a moist wound environment. It should be able to control excess wound exudates and maintain a constant temperature in the wound. It is also important that the dressing is impermeable to bacteria and can be removed without damaging the wound surface or the surrounding skin.

The dressing should remove exudates from the wound without drying it, and provide an environment contributing to a moist wound bed. The dressing should prevent contamination and not damage the tissues during the wound dressing changes.

A moist environment prevents evaporation and prevents the wound from drying out. The moisture stimulates the growth of epithelial cells and wound healing. In a moist environment necrotic tissue is more easily removed and the enzyme system is more effective. There is no evidence of an increase in bacteria in a moist wound environment.