OBJECTIVE: This retrospective descriptive study explored the prevalence of wet-to-dry dressings ordered for wound care of open wounds healing by secondary intention. Research questions included the following: How frequently are healthcare providers ordering wet-to-dry dressings for wound care? Which specialties of healthcare providers are most frequently ordering wet-to-dry dressings? Are wet-to-dry dressings being ordered appropriately?
METHODS: A retrospective chart review examined admission orders for 202 randomly selected Florida home care and health maintenance organization patients from 2002 to 2004. All subjects in the study had open wounds healing by secondary intention (42 partial-thickness and 160 full-thickness wounds). Frequencies are reported as the main outcome measure.
RESULTS: Wet-to-dry dressings accounted for 42% of wound care orders, followed by enzymatic (7.43%) and dry gauze (6.93%). Most wounds treated with wet-to-dry dressings were surgical (69%), followed by neuropathic ulcers (10%) and pressure ulcers (5.9%). Surgical specialists preferred wet-to-dry dressings (73%). Mechanical debridement was not clinically indicated in more than 78% of wounds treated with wet-to-dry dressings. Therefore, wet-to-dry dressings were inappropriately ordered in these cases.
CONCLUSIONS: These findings suggest that wet-to-dry dressings (or dry gauze) are prescribed inappropriately in situations where there is little evidence to support their use. To achieve evidence-based practice in wound care, clinical decision making should be scientifically based. Future research should focus on which wound dressings are most effective in optimizing wound healing, as well as on investigating the reasons for the continued use of wet-to-dry dressings.
In this retrospective descriptive study, the authors explore the prevalence of wet-to-dry dressings ordered for the care of open wounds healing by secondary intention.
Linda J. Cowan, MSN, ARNP, CWS, is a Wound and Ostomy Consultant, Gainesville Veteran's Administration Medical Center, and is a doctoral student, University of Florida College of Nursing, Gainesville, Florida; and Joyce Stechmiller, PhD, ARNP, FAAN, is Associate Professor, Department of Adult and Elderly Nursing, University of Florida College of Nursing.
Submitted August 28, 2007; accepted in revised form February 8, 2008.