Focus | Clinical
Reprinted from AJGP Vol. 51, No. 11, November 2022 827 © The Royal Australian College of General Practitioners 2022
Sankar N Sinha, Belinda Free,
Oliver Ladlow
Background
Acute open wounds constitute a
significant part of general practice. With
an expanding global market of dressing
products, selection of wound dressings
remains an area of concern among
doctors entering general practice.
Objective
The aim of this article is to describe a
practical guide for choosing appropriate
dressings when treating acute open
wounds in general practice.
Discussion
Although dressing is an essential element
of standard wound care, it is important to
remember that dressing alone does not
heal the wound. Judicious selection of
dressings based on wound characteristics,
physical properties of dressings and their
costs, shelf life and availability are
important for delivering appropriate care
towards timely healing of acute wounds.
A SUPERFICIAL OPEN WOUND with loss of
epithelial lining is described as an ulcer.
However, the words ‘open wound’ and
‘ulcer’ are often used interchangeably.
In this article, an acute wound/ulcer is
defined as an injury to the skin that occurs
suddenly following an accident or surgical
injury and is expected to heal through an
orderly and timely reparative process.
1,2
Patients with acute wounds of the skin
(eg minor cuts, lacerations, puncture
wounds, skin tears, animal bites, small
burns) constitute a significant proportion
of patients who present to general practice.
Patients with diabetes may present with
small and minor skin breakdowns, as
these minor wounds have the potential
to become serious and require attention
to address systemic issues as well. The
appropriate treatment of acute wounds
involves avoiding deterrents to normal
healing and preventing complications
that may lead to conversion to a chronic
wound,
2
which is a major burden on
the healthcare system. In Australia, the
estimated annual cost was $3 billion
in 2014.
3
Teaching of wound care, including
selection of wound dressings, as part of
the undergraduate medical curriculum
occurs in some medical schools
4
and
remains an area of concern among doctors
entering general practice.
5
The focus
of this article is to provide a practical
overview for general practitioners (GPs)
when choosing an appropriate dressing for
acute open wounds, with the assumption
that holistic assessment of the patient and
the wound, and other important aspects
of treatment (eg tetanus prophylaxis,
need for antibiotics, wound cleansing and
debridement),
6,7
have been addressed.
Dressings for puncture wounds/
needlestick injuries and animal/human
bites are not included here because of their
complex management, often requiring
non-GP specialist consultation and care.
Descriptions of dressings for post-surgical
wounds
6
and minor burns in general
practice
8
are available in earlier issues
of Australian Journal of General Practice
and Australian Family Physician.
Wound dressings
Although dressing is an essential element
of standard wound care, it is important to
remember that dressing alone does not
heal the wound.
Ideally a wound dressing aims to
promote healing or prevent further tissue
damage. A good dressing accomplishes
multiple goals, including providing
an appropriate level of moisture and
serving as a barrier to bacterial invasion.
Additional benefits of an ideal dressing
may include thermal insulation,
debridement, enzymatic and growth factor
The art and science
of selecting appropriate
dressings for acute open
wounds in general practice