Which of the following statement(s) is/are correct concerning the management of an open wound?
A. Frequent surgical debridement is usually necessary B. Water irrigation can effectively debride most wounds C. Hydrogen peroxide is particularly useful in the management of open wounds D. A number of the newer dressing products have clearly been shown to promote wound healing compared to simple moist occlusive dressing
Water irrigation can effectively debride most wounds-although there are numerous dressing products commercially available at present, no treatment has been demonstrated to improve healing beyond that of standard treatment which adheres to basic principles. in the absence of large amounts of necrotic tissue, wound debridement does not need to be accomplished surgically. simple water irrigation either with whirlpool or by water from a hand held shower spray can generate enough power to effectively debride most wounds. frequent moist dressing changes can accomplish this as well, and in some cases, occlusive absorptive dressings can generate enough tissue proteases to effectively degrade proteins which the absorptive dressings remove. deeper portions of a wound may accumulate exudate and bacteria. in such cases, water irrigation may be particularly useful. commonly used agents such as hydrogen peroxide actually may be harmful to normal tissue and are weak oxidants and do a poor job of debriding. enzymatic debriding agents can be effective when used properly. most of the newer dressing products have been designed to be more absorptive and achieve moist healing without infection from excess exudate. however, it must be emphasized that as long as moist healing is achieved, there has been no evidence that one product is better than another.