American Nurse Journal (ANJ)Dress for Success: Wound Dressing Basics

With more than 5,000 wound care products available in the US, dressing selection remains one of the most challenging bedside skills. Wet-to-dry saline dressings are no longer standard of care — moist wound healing is the evidence-based foundation for all dressing decisions.

⚖️ Clinical Considerations

• Exudate volume drives dressing selection: match absorbency to drainage level to prevent maceration or desiccation
• Purulence, odor, and hypergranular tissue signal biofilm or infection requiring antimicrobial dressings and possible systemic antibiotics
• Macerated periwound skin indicates dressing is undersized for exudate volume; apply skin barrier and switch to higher-absorbency product
• Wounds without improvement in 4–6 weeks require full reassessment including perfusion, glucose control, pressure offloading, and nutritional status

🎯 Practice Applications

• Assess exudate type and volume with every dressing change to confirm moisture balance
• Document wound size, depth, tunneling, undermining, and periwound condition at minimum weekly
• Pack tunneled or undermined wounds with one continuous wicking agent, leaving a 2–3 cm tail for retrieval
• Escalate non-healing wounds at 4–6 weeks to wound care specialist or advanced provider

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