For a diabetic male client with a foot ulcer, the physician orders bed rest, a wet-to-dry dressing change every shift, and blood glucose monitoring before meals and bedtime. Why are wet-to-dry dressings used for this client?
A. They contain exudate and provide a moist wound environment.
B. They protect the wound from mechanical trauma and promote healing.
C. They debride the wound and promote healing by secondary intention.
D. They prevent the entrance of microorganisms and minimize wound discomfort.
Correct Answer: C. They debride the wound and promote healing by secondary intention.
For this client, wet-to-dry dressings are most appropriate because they clean the foot ulcer by debriding exudate and necrotic tissue, thus promoting healing by secondary intention. Treatment of diabetic foot ulcers should be systematic for an optimal outcome. The most important point is to identify if there is any evidence of ongoing infection, by obtaining a history of chills, fever, looking for the presence of purulence or presence of at least two signs of inflammation that includes, pain, warmth, erythema or induration of the ulcer.
Option A: Moist, transparent dressings contain exudate and provide a moist wound environment. Transparent films are indicated for use as primary or secondary dressings for wounds with little to no exudate such as stage I and II pressure ulcers, partial-thickness wounds, donor sites, and wounds with necrotic tissue or slough.
Option B: Dry sterile dressings protect the wound from mechanical trauma and promote healing. Dry dressings are gauze pads that lie under rolled gauze and tape – and the category also includes standard bandages. You may have this type of dressing, which is intuitive and simple for most people to take care of and change, for wounds that are relatively dry themselves.
Option D: Hydrocolloid dressings prevent the entrance of microorganisms and minimize wound discomfort. Hydrocolloid dressings provide a moist and insulating healing environment which protects uninfected wounds while allowing the body’s own enzymes to help heal wounds. These dressings are unique because they don’t have to be changed as often as some other wound dressings and are easy to apply.
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