Limited Access Dressing

Pramod Kumar, MS, MCh, DNB


Wounds. 2008;20(2):49-59. 

In This Article

Moist Wound Healing

It has been claimed that occlusive dressings promote rapid wound healing by preventing dehydration and scab formation, facilitating debridement, minimizing inflammation, reducing pain, increasing the rate of epithelialization, and diminishing scarring.[1] However, there is concern that a moist environment may lead to bacterial proliferation and wound infection.[2,3,4] Moistwound healing achieved by occlusive hydrocolloid produces offensive-smelling exudates and has raised some doubt about its effect on bacterial flora, specifically anaerobes.[5,6]

In 1962, moist wound healing was first described in an experimental wound[7] and later in a human.[8] An occlusive dressing that traps moisture on intact skin can produce an explosive proliferation of bacteria.[9,10] Occlusive hydrocolloids are impermeable to water and the colloid gel, formed by absorption of exudate, produces an absorption gradient that removes the toxic components of the wound exudate that the cellular and bacterial destruction produce.[11] The bad odor that is produced has been explained as a result of either gelatin breakdown in the colloid gel[6] or anaerobic infection.[6,12,13]

Increasing evidence shows that the presence of many and varied bacterial species in chronic wounds does not adversely affect healing.[14,15,16,17,18,19] The need for routine bacteriological culture swabs does not seem to be a necessity in chronic leg ulcers.[20] This would result in considerable cost savings,and would avoid unnecessary use of antibiotics[20] and toxic chemicals that may delay wound healing.[21]


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