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.
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)
3.5e  Monitor dressings applied near the anus, since they are difficult to keep intact. Consider use of special sacral-shaped dressings. Ib

[back to top]