An evaluation of properties related to wear time of four dressings during a five-day period

In the 1960s, Winter (1962) identified that moisture was required to provide an optimum environment for reepithelialisation (and hence healing) to occur. Since then, further research has added to our knowledge and now the broad criteria for an ideal wound dressing includes: Provision of a moist environment Protection from the external environment (including the prevention of ingress of foreign particles/microorganisms) Removal of wound exudate (through absorption, retention and moisture vapour transmission) Promotion of tissue regeneration Prevention of damage to the fragile wound bed or surrounding skin on removal, and minimisation of dressing-related pain (Moura et al, 2013). Fundamentally the dressing also has to stay in place for a reasonable amount of time to enable healing to occur. Frequent removal and reapplication of dressings may delay healing due to: Trauma to the wound bed and surrounding skin that disturbs the healing process (Rippon et al, 2012) Temperature loss at the wound site, which affects the cellular processes of healing (Romanelli et al, 2002; McGuiness et al, 2004) A greater opportunity for pathogenic bacteria to infect the wound (Lawrence, 1994; Bowler et al, 1999) Psychological stress and pain suffered by the patient at dressing change that has been shown to delay healing (Solowiej and Upton, 2012). Dressings that incorporate silicone-based adhesives (such as the ones evaluated in this study), generally cause less trauma and pain on removal compared with dressings that use traditional adhesives. Wear time of the dressing is dependent upon many factors related to the patient (such as mobility, type and frequency of bathing, and interference with the dressing), the characteristics of the wound (such as location, size, level of exudation, condition of peri-wound skin and level of microbial contamination) and the actual properties of the dressing itself. Two of the key factors that determine how long a dressing can be left in place are adhesion of the dressing to the wound or surrounding skin and the ability of the dressing to manage wound exudate. If the level of adhesion is too low then the dressing will fall off, too high and there is a higher propensity to cause damage to either the wound bed or peri-wound skin (Dykes, 2007; Waring et al, 2011), leading to pain and, as a result of the skin damage, possible infection (Charlesworth et al, 2014). Good conformability will aid dressing adhesion. If the dressing cannot manage the level of wound exudate (through MARK G RIPPON Visiting Clinical Research Fellow, University of Huddersfield, Huddersfield, UK