Wound Care: Wet Healing

How many times have you heard, "Keep the wound clean and dry." Me too. However, a plastic surgeon introduced me to a method of healing known as "wet or moist" healing for certain types of wounds. In particular, burns, blisters, and decubitus ulcers (bedsores). I have found that this method of wound care promotes faster healing with less scarring and a noticeable reduction in pain.

All wounds of the type I listed above tend to produce a yellow oozy discharge that in smaller cuts or abrasions would form a scab. If you pick off a scab then the wound will just ooze more and you’ll find a new scab the next morning. It's our body's natural Band-Aid.

Until about 20 years ago, it was thought that the best way to deal with burns was to keep the wound open to the air. Although this allowed the wound stay dry, it left it open to all types of infection. This healing method also inhibited new skin production.

In the early years of my disability, I got a pretty severe second-degree sunburn on my leg. My family physician sent me to a plastic surgeon as they are experts on healing without scars. He recommended the use of a partially occlusive dressing for the burn.

Occlusive means that air and water will not penetrate. Many years ago Vaseline coated gauze was used on burns because it created an occlusive dressing.

A partially occlusive dressing will allow some air and moisture to pass back and forth but still acts as a barrier to bacteria and viruses. It also traps all that yellow ooze. That ooze smells really bad. The thinking was that something must be rotting under the bandage. Nothing could be further from the truth.

The ooze, which is actually called "exudate" is full of proteins and enzymes that promotes healing. By applying a partially or totally (depending on the type of wound) occlusive dressing and trapping the exudate, a clean wound will generally heal faster with less inflammation, less pain, and a smaller chance of infection. Scarring is also reduced.

My doctor used a clear dressing that stayed on for a week. I had to constantly check for infection by watching for increased redness and any lines that might radiate from the wound. I also had to inspect the color of the exudate. Clear dark yellow, sort of the color of amber, is good but cloudy and a lighter yellow could indicate a problem.

Removal of the occlusive dressing has to be done carefully. It can pull blisters at the corners of the dressing and it can pull off healed skin.

Some doctors will wholeheartedly endorse this method while others will shy from it. I would not recommend trying it unless you're under medical supervision.

This kind of healing can produce amazing results but only for certain types of very clean wounds.

Let's hope you never have to deal with a serious burn or decubitus ulcer but if so then you might want to ask your doctor about moist/wet healing.

Look for more information in the links at the bottom of this hub.