Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Local Wound Care - Management Approaches
Recommendation Level of Evidence
3.5a  For comprehensive wound management options, consider the following: Etiology of the wound;
  • Client’s general health status, preference, goals of care and environment;
  • Lifestyle;
  • Quality of life;
  • Location of the wound;
  • Size of the wound, including depth and undermining;
  • Pain;
  • A dressing that will loosely fill wound cavity;
  • Exudate: type and amount;
  • Risk of infection;
  • Risk of recurrence;
  • Type of tissue involved;
  • Phase of the wound healing process;
  • Frequency of the dressing change;
  • Comfort and cosmetic appearance;
  • Where and by whom the dressing will be changed;
  • Product availability; and
  • Adjunctive therapies.
IV
3.5b  Moisture-retentive dressings optimize the local wound environment and promote healing. Ia
3.5c  Consider caregiver time when selecting a dressing. Ib
3.5d  Consider the following criteria when selecting an interactive dressing: Maintains a moist environment (Level of Evidence Ia)
  • Controls wound exudate, keeping the wound bed moist and the surrounding intact skin dry (Level of Evidence IV)
  • Provides thermal insulation and wound temperature stability (Level of Evidence IV)
  • Protects from contamination of outside micro-organisms (Level of Evidence IV)
  • Maintains its integrity and does not leave fibres or foreign substances within the wound (Level of Evidence IV)
  • Does not cause trauma to wound bed on removal (Level of Evidence IV)
  • Client/patient preference (Level of Evidence IV)
  • Is simple to handle, and is economical in cost and time (Level of Evidence IV)
Ia-IV
3.5e  Monitor dressings applied near the anus, since they are difficult to keep intact. Consider use of special sacral-shaped dressings. Ib

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