Clinical Impact Upon Wound Healing and Inflammation in Moist, Wet, and Dry Environments

Junker, Johan P.E.; Kamel, Rami A.; Caterson, Edward J.; Eriksson, Elof

doi:10.1089/wound.2012.0412

Cited by 327 publications

(245 citation statements)

References 65 publications

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“…However, a number of studies have indicated that a wound that is overly hydrated may not result in tissue damage, [50][51][52] and rather suggest that a wound bathed in a hyper-hydrated environment may benefit from the advantages of moist wound healing. 30 This is demonstrated in Figure 10.…”

Section: Hyper-hydration Of Tissue and Healingmentioning

confidence: 83%

“…22,[26][27][28] In Winter's studies, the air-dried partial-thickness wounds were compared with wounds that were occluded with polyurethane film dressing which maintained a moist environment and ensured that an adequate level of hydration was maintained. Since development of the concept that a moist environment aids wound healing, there has been growing evidence in support of this notion 30 and the wound care community has broadly accepted the concept of moist wound healing and the need for exudate management. 30,32 There have been numerous laboratory, preclinical and clinical studies that provides evidence for the benefits of moist wound healing (see Table 1) with positive outcomes for healing being achieved in a variety of wound types when wound dressings designed to provide optimal hydration levels in the wound are used as part of the overall wound care regimen.…”

Section: Moist Wound Healingmentioning

confidence: 99%

“…Since development of the concept that a moist environment aids wound healing, there has been growing evidence in support of this notion 30 and the wound care community has broadly accepted the concept of moist wound healing and the need for exudate management. 30,32 There have been numerous laboratory, preclinical and clinical studies that provides evidence for the benefits of moist wound healing (see Table 1) with positive outcomes for healing being achieved in a variety of wound types when wound dressings designed to provide optimal hydration levels in the wound are used as part of the overall wound care regimen. showing that wounds treated with dressings promoting a moist wound healing environment are associated with a lower infection rate despite the wounds being colonised by bacteria.…”

Section: Moist Wound Healingmentioning

confidence: 99%

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The importance of hydration in wound healing: reinvigorating the clinical perspective

Ousey

Cutting

Rogers³

et al. 2016

J Wound Care

127

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Balancing skin hydration levels is important as any disruption in skin integrity will result in disturbance of the dermal water balance. The discovery that a moist environment actively supports the healing response when compared with a dry environment highlights the importance of water and good hydration levels for optimal healing. The benefits of ‘wet’ or ‘hyper-hydrated’ wound healing appear similar to those offered by moist over a dry environment. This suggests that the presence of free water may not be detrimental to healing, but any adverse effects of wound fluid on tissues is more likely related to the biological components contained within chronic wound exudate, for example elevated protease levels. Appropriate dressings applied to wounds must not only be able to absorb the exudate, but also retain this excess fluid together with its protease solutes, while concurrently preventing desiccation. This is particularly important in the case of chronic wounds where peri-wound skin barrier properties are compromised and there is increased permeation across the injured skin. This review discusses the importance of appropriate levels of hydration in skin, with a particular focus on the need for optimal hydration levels for effective healing. Declaration of interest: This paper was supported by Paul Hartmann Ltd. The authors have provided consultative services to Paul Hartmann Ltd.

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Section: Hyper-hydration Of Tissue and Healingmentioning

confidence: 83%

Section: Moist Wound Healingmentioning

confidence: 99%

Section: Moist Wound Healingmentioning

confidence: 99%

See 1 more Smart Citation

The importance of hydration in wound healing: reinvigorating the clinical perspective

Ousey

Cutting

Rogers³

et al. 2016

J Wound Care

127

View full text Add to dashboard Cite

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“…An analysis of recent literature shows that there is consensus that for best healing, the wound microenvironment should be protected with moist or wet medication [4]. There is a continuous flow of literature which discusses different materials potentially useful for wounds treatment [5].…”

Section: Introductionmentioning

confidence: 99%

Aging Skin: Nourishing from Out-In – Lessons from Wound Healing

Corsetti¹,

Flati²,

Pasini³

et al. 2016

Textbook of Aging Skin

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Skin lesion therapy, peculiarly in the elderly, cannot be isolated from understanding that the skin is an important organ consisting of different tissues. Furthermore, dermis health is fundamental for epidermis integrity, and so adequate nourishment is mandatory in maintaining skin integrity. The dermis nourishes the epidermis, and a healthy epidermis protects the dermis from the environment, so nourishing the dermis through the epidermal barrier is a technical problem yet to be resolved. This is also a consequence of the laws and regulations restricting cosmetics, which cannot have properties that pass the epidermal layer. There is higher investment in cosmetics than in the pharmaceutical industry dealing with skin therapies, because the costs of drug registration are enormous and the field is unprofitable. Still, wound healing may be seen as an opportunity to "feed" the dermis directly. It could also verify whether providing substrates could promote efficient healing and test optimal skin integrity maintenance, if not skin rejuvenation, in an ever aging population.

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“…(3) Wound hydration has been the basis of modern wound care since the seminal papers of Winter (5)(6)(7)(8) in the 1960s. Since then scientific research in vitro and in vivo has supported this original premise (9)(10)(11)(12)(13)(14)(15) and moist wound healing has become the recognised tenet of clinicians working in the wound care field. (16) Specifically some studies have highlighted that moisture retained over the wound prevents desiccation of the wound surface and/or deeper tissues allowing for an unimpeded migration of epithelial cells over the wound surface.…”

mentioning

confidence: 96%

Wound healing and hyper-hydration: a counterintuitive model

2016

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Abstract:Winters seminal work in the 1960s relating to providing an optimal level of moisture to aid wound healing (granulation and re-epithelialisation) has been the single most effective advance in wound care over many decades. As such the development of advanced wound dressings that manage the fluidic wound environment have provided significant benefits in terms of healing to both patient and clinician. Although moist wound healing provides the guiding management principle confusion may arise between what is deemed to be an adequate level of tissue hydration and the risk of developing maceration. In addition, the counter-intuitive model 'hyper-hydration' of tissue appears to frustrate the moist wound healing approach and advocate a course of intervention whereby tissue is hydrated beyond what is a normally acceptable therapeutic level. This paper discusses tissue hydration, the cause and effect of maceration and distinguishes these from hyper-hydration of tissue. The rationale is to provide the clinician with a knowledge base that allows optimisation of treatment and outcomes and explains the reasoning behind wound healing using hyper-hydration.Key Words: Hyper-hydration, Hydration, Moisture Balance, Maceration, Skin, Wound Dressings Introduction:A homeostatic moist wound environment is generally accepted as beneficial to the healing process and co-exists with an adequately hydrated wound. Conversely, maceration of the peri-wound skin is considered to have a far-reaching and negative influence which impacts adversely on the patient, clinician (1, 2) as a result of putative excessive hydration. A lack of clarity exists in respect of the optimal level of hydration required to support healing and, in like manner, the origin of fear associated with excessive hydration of the peri-wound skin (maceration) appears to be founded on anecdotal evidence at best. (2) This paper endeavours to clarify understanding of tissue hydration in relation to wound healing, maceration and to rationalise the counter intuitive model of healing through hyper-hydration. Developing understanding, based on the available evidence, of wound/soft tissue hydration, peri-wound maceration and the nuances of hyper-hydration has the potential to improve not only patient outcomes but also clinicians' appreciation of topical wound dressings and the role they have to play in support of healing.

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Clinical Impact Upon Wound Healing and Inflammation in Moist, Wet, and Dry Environments

Cited by 327 publications

References 65 publications

The importance of hydration in wound healing: reinvigorating the clinical perspective

The importance of hydration in wound healing: reinvigorating the clinical perspective

Aging Skin: Nourishing from Out-In – Lessons from Wound Healing

Wound healing and hyper-hydration: a counterintuitive model

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