Critical Appraisal Wet-to-Dry Wound Care
There is a need for surgeons and nurses to understand the impact of using a wet-to-dry dressing of wounds. Research on the usage of this method is over 50 years old and this was carried out by Dr. Winters. Although the research was pivotal and it demonstrated that wounds healed faster than those that were allowed to dry out. It is time for a change in practice. Nursing care is no longer about healing and treating, there is an aspect of care that is attached to it. There have also been major advancements, especially in wound care products. However, even with the advancements and development of superior products wet-to-dry dressing are still been used to date. According to Wodash (2012) wet-to-dry dressings are still the most commonly used primary dressing in most hospitals. The main reason has nothing to do with the appropriateness of them but rather on the lack of knowledge. Numerous nurses have reported the adverse effects that patients face when their wounds are dressed using this method. Patient care is reduced as the dressing has to be performed every 4 to 6 hours, which causes unbearable pain to the patient (Fleck, 2009). It is also assumed that the advanced products are expensive when compared to the wet-to-dry dressing products and this is not correct. The most common reason is the understanding by most physicians that gauze is a one size fits all and it is readily available.

Wet-to-dry dressings are meant to be used as a method of mechanical debridement (Wodash, 2012). Debridement is the mainstay of wound bed preparation because devitalized materials do harbor bacteria that delays healing and increases the risk of infection. While this is true, it does not mean that wet-to-dry dressing or moist gauze constitutes advanced wound care (Fleck, 2009). A wet-to-dry dressing is a nonselective debridement and it is painful for patients who are sensate and has the potential to result in numerous negative outcomes. Mechanical debridement is a non-selective form of debridement that not only removes necrotic tissue, but also healthy granulating tissue. A wet-to-dry dressing is not ideal as it impedes healing by local tissue cooling, increases risks of infection, and is labor intensive. This method has been discouraged by several clinical guidelines. It has been established that gauze dressings are not the best for wound care. Gauze dressings have been found to not support optimal granulation and healing and they are more labor intensive when compared to advanced dressings like polyacrylates, hydrocolloids, foams, hydrogels, transparent films, and alginates (Wodash, 2012). It is for this...…(Powers, Higham, Broussard, & Phillips, 2016). Initially it might seem that implementing a no more wet-to-dry protocol is cumbersome, however, it is worth the effort. It is expected that most clinical staff will resist the new protocol mainly because they are comfortable with the tradition of wet-to-dry dressings. Some of them would rather continue using this method in order to not offend physicians. With proper education and knowledge sharing, it is possible to fully eliminate the usage of wet-to-dry dressing.

In conclusion, nurses should question the usage of wet-to-dry dressing on patients who do not need mechanical debridement. This way they can push for advanced wound dressing protocol that has better outcomes and offers better patient care as compared to wet-to-dry dressing. There is also a need to increase knowledge amongst the physicians and nurses regarding the usage of advanced wound dressing therapies. This will increase knowledge and promote improved patient outcomes. Healthcare facilities can implement policies that discourage the use of wet-to-dry wound dressing and instead recommend the use of other methods. With this policy, it will be difficult for physicians to push for the archaic method. It should also be noted that costs are not as high as most people assume and nursing time should also be considered to be a cost.