OCCLUSIVE DRESSINGS AND WOUND-HEALING

Over the last 15 years, there has been explosive growth in the use of occlusive dressings as an aid to wound healing. In 1980 synthetic wound dressings were rarely sold, whereas in 1987 it was estimated that $350 million was spent on these dressings.1 The number and variety of dressings on the market have also increased dramatically over the past decade to the point where more than 70 different brands exist today (Table 1). A dressing is said to be "occlusive" if a moist wound surface is maintained when the dressing is in place. Occlusive dressings prevent wound desiccation by inhibiting the transmission of water vapor from the wound surface to the atmosphere. A dressing that transmits moisture vapor at a rate lower than the rate of production of moisture by the underlying tissue creates a moist wound environment. Besides increasing the rate of epithelialization of wounds, other benefits of occlusive dressings are improving the granulation tissue in chronic wounds, providing a means of painless, autolytic debridement of necrotic ulcers,2 and protecting the wound bed from environmental toxins and microorganisms. These dressings reduce wound pain and help produce a better cosmetic appearance, that is, a less noticeable scar. Finally, occlusive dressings may be cost effective in the treatment of certain wounds by decreasing the nursing time required for wound care. In this review, we discuss the numerous types and uses of occlusive dressings. The proposed mechanisms responsible for the beneficial effects of wound occlusion and the microbiology of occluded wounds are also explored. © 1994.