Which of the following statement(s) is/are true concerning the clinical management of an open wound?
A. A wet-to-dry dressing is the most optimal form of wound management B. A moist occlusive dressing promotes epithelialization and reduces pain C. The protein rich plasma exudate covering the open wound facilitates healing D. Irrigation of the wound disrupts epithelialization therefore inhibiting the healing process
A moist occlusive dressing promotes epithelialization and reduces pain-epithelialization is more rapid under moist conditions than dry conditions. without dressings, a superficial wound, or one with minimal devitalized tissue forms a scab or crust, meaning that the blood and serum will coagulate, dry, and form a protective moisture barrier over the open wound. if a wound is kept moist with an occlusive dressing, then epithelial migration is optimized. in addition, the pain of an open wound is dramatically reduced under an occlusive dressing. the traditional wet-to-dry dressing if truly left to dry, simply produces desiccation and necrosis of the surface layer of the wound which delays epithelialization. although wet-to-dry dressings can be effective for debridement of wound exudate, they are generally less desirable than a moist healing environment combined with effective cleaning of the wound (i.e. water irrigation). any open wound will leak plasma. with more inflammation, the plasma capillary permeability is further increased. this exudate of serum proteins and inflammatory cells serves as a rich culture medium. this, in turn, will continue to cycle bacterial proliferation and lead to further exudate formation. the net result of this cycle is delayed or absent wound healing. in addition, the edema that results from capillary dysfunction, increases the distance for diffusion from oxygen and nutrient sources to their metabolic targets.