There are many types of dressings, and many of them work phenomenally well, but most are intended for use under certain circumstances, and contraindicated in other situations. Let’s get a little more specific here! There are four stages of healing. We’re going to see right now which wound care dressing to choose, depending on what stage of the healing process you’re at right now.

Stage One: Hemostasis 

Hemostasis is the process of clotting, and it begins as soon as blood exits the wound. First, the blood vessels immediately constrict, in order to increase the blood pressure. Then the platelets form a plug, which holds back the blood and prevents it from flowing out of the wound. Once that has occurred, fibrin reinforces the plug, helping the clot to bind together. 

When the wound is bleeding (and possibly secreting clear exudate simultaneously), you want to irrigate the wound with water or saline, and ensure that it is clean. Once you’ve done that, apply a dressing that will keep the wound moist, while absorbing exudate. You’ll need the following

  • Primary contact layer
  • Transparent film dressing
  • Hydrocolloid dressing
  • Absorbent Pad

Stage Two: Inflammation

Inflammation is caused when damage cells, bacteria and pathogens are engorged from the wound, so that cells which will help repair the wound can take their place. During the inflammatory stage, which typically lasts up to three full days, it is natural for skin to be swollen, sloughy, and excreting immense exudate. 

At this point, debridation needs to occur. Also, the wound still needs a moist environment, and it requires a dressing that will manage its exudate and bacteria, as well as protect it. The following would be beneficial:

  • Foam
  • Alginate dressing
  • Hydrocolloid
  • Hydrogel
  • Superabsorbent dressing

Stage Three: Proliferation

The wound contracts as fresh granulation tissue is created, and new blood vessels form. The skin now returns to its normal coloring of pink or red, and is not smooth – it has an uneven texture. Dark granulation can be a sign of infection.

This stage can last between three days and about three weeks. During this stage, you want to protect new tissue, absorb exudate, and keep the area moist. To achieve this, apply the following to the wound bed:

  • Foam
  • Film
  • Hydrocolloid 

Stage Four: Maturation

During maturation, the number of blood cells in the wound bed is reduced by means of apoptosis (elimination of unwanted cells), and the amount of cellular activity also goes down. Collagen is now remodeled from type III to type I. 

During this stage, you want to cover the wound and keep it protected, to lower the risk of reinjury.

  • Non-adherent pad