Surgery Book


Saline Gauze Dressing

Aka: Saline Gauze Dressing, Moistened Gauze Dressing, Continuously Moist Gauze Dressing, Wet-to-Moist Dressing, Wet-to-Dry Dressing
  1. Category
    1. Traditional Wound Dressing or filler
  2. Characteristics
    1. Absorptive
    2. Nonocclusive
    3. Nonadhesive
    4. Moisture retentive (gauze must be kept moist)
  3. Indications
    1. Light to moderately edudative wounds
    2. Wounds with sinus tracts, tunneling or undermining
    3. Deep wounds
    4. Types 2 to 4 Pressure Sores
    5. Mechanical Debridement (Wet-to-Dry Dressing)
  4. Technique: Wet-to-Moist Dressing
    1. Change twice daily
    2. Wet to Moist Dressing Example
      1. First layer: wet 4x4 gauze with saline
      2. Second layer: Vaseline Gauze
      3. Third layer: dry 4x4 gauze
      4. Kerlix dressing to hold in place
  5. Technique: Wet-to-Dry Dressing (Debridement only)
    1. Debrides at the expense of removing healthy tissue
      1. Wet-to-Moist Dressing is preferred in most cases
    2. Technique
      1. Apply gauze wet with Normal Saline to wound
      2. Allow gauze to dry
      3. Remove dressing with attached wound debris
      4. Repeat several times daily
  6. Advantages
    1. Inexpensive and efficacious
  7. Disadvantages
    1. Requires more intense wound care (due to repeated moistening, reapplication)
      1. Consider Hydrocolloid Dressing as simpler alternative
    2. Maceration of peri-wound edges
    3. Leaves lint or fiber residue in wound
    4. Requires tape or film to secure in place
    5. Wet-to-dry removes normal tissue with Debridement
      1. Adherance to healthy granulation tissue if dries
      2. May destroy healthy epithelial cells and slow healing
      3. Use Wet-to-Moist Dressing to avoid this
  8. References
    1. Bello (2000) JAMA 283(6): 716-8 [PubMed]
    2. Degreef (1998) Dermatol Clin 16(2): 365-75 [PubMed]
    3. Findlay (1996) Am Fam Physician 54(5): 1519-28 [PubMed]
    4. Habif (1996) Clinical Derm, Mosby, p. 810-13
    5. Knapp (1999) Pediatr Clin North Am 46(6):1201-13 [PubMed]
    6. Krasner (1995) Prevention Management Pressure Ulcers
    7. Lewis (1996) Med-Surg Nursing, Mosby, p. 199-200
    8. Lueckenotte (1996) Gerontologic Nurs., Mosby, p. 800-7
    9. PUGP (1995) Am Fam Physician 51(5):1207-22 [PubMed]
    10. PUGP (1994) Pressure Ulcer Treatment, AHCPR 95-0653
    11. Way (1991) Current Surgical, Lange, p.95-108

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