DRESSINGS AND WOUND-INFECTION

Wounds will readily acquire bacteria, unless protective measures are t aken. The bacterial protection afforded by conventional absorbent cell ulose dressings has been shown to be limited, particularly in the pres ence of serous exudate that may compromise dressing integrity. In addi tion, dressings may shed particles that remain in the wound. By contra st, many modern dressings are impermeable to bacteria, are removed com pletely, have been found to optimize reepithelialization rates and red uce the incidence of wound sepsis. Recently, it has been found that th ey could also play a role in preventing cross-contamination. Removing conventional cellulosic dressings from bacterially colonized wounds li berates wound bacteria into the air, and the numbers are slow to decli ne. However, using an in vitro wound model, use of the hydrocolloid dr essing Granuflex (ConvaTec, Skillman, NJ) on experimentally colonized wounds resulted in significantly fewer numbers of airborne bacteria. D ispersal from wet conventional dressings was lower than from dry dress ings; nevertheless, the numbers of bacteria per liter of air following removal of the hydrocolloid dressing were approximately 20% of those observed for gauze. These findings have also been confirmed in the cli nic. To reduce the incidence of complications, wound care in general, and infection control procedures in particular, requires carefully dis ciplined team work.