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Atraumatic dressings. A feature
or a requirement of wound management?
Justo Rueda López, Ana M.ª Muñoz
Bueno, Montserrat Arboix i Perejamo, Manuel Gago Fornells, R. Fernando
García González
SUMMARY
Pain is a very important component
of the lives of people suffering chronic injury and negatively affects
the quality of life of both the patients and their caretakers.
Medical professionals must make all efforts to prevent pain and
further injury to wounds and surrounding skin by carefully selecting
the most appropriate products for wound management. The goal is
to choose a dressing that will help the wound to heal without inflicting
unnecessary pain and further trauma.
The term adherence is described as the interaction between
a dressing and the wound, whereas the term adhesion should
be used to refer to the interaction that takes place between the
dressing and the uninjured peri-wound skin. The mechanisms responsible
for producing adherence as described in 1962 by G. Winter are, on
the one hand, adherence caused by wound exudates which, as they
dry out, stick to dressings lacking a protective interface and,
on the other, adherence processes that are produced by the growth
of granulocytes within the structure of the dressing and are incorporated
into the wound regeneration process through integration.
Products meriting a low-adherent description are those that are
able to reduce adherence in the interface area (between the wound
and the dressing), for example absorbent dressings, hydrocolloids,
etc., but which may often result in high adhesion processes affecting
the intact peri-wound skin.
The term adherence simply describes the interaction between the
dressing and the wound itself, without taking into account the trauma
that may be produced in the surrounding skin during dressing changes.
Atraumatic is a new term needed to refer to a feature of
certain dressings, where both factors (adhesion and adherence) are
taken into account. That is, the term should be adopted in describing
dressings that do not injure newly formed tissue or the surrounding
skin. Such products can be defined as “humid environment healing
based dressings which, on removal, do not cause trauma either to
newly formed tissue or to the peri-wound skin".
The atraumatic dressings currently available in the market in our
country are based on an adhesion technology where the product is
coated with soft-silicone. This enables the dressing to adhere to
dry skin, but not to the wet surface of a wound, and to be removed
and changed with no further trauma.
Atraumatic is a necessary element in the healing process and should
be one of the main features of dressings indicated for the treatment
of skin lesions.
KEY WORDS
Atraumatic dressings, wound care, atraumatism, adherence, adhesion.
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