Dressings for Chronic and Acute Wounds

Abstract

Since antiquity, dressings have formed an integral part of the art of treating wounds. Earlier than 2000 B.CSumerian writings described dressings based on plants, mud, milk, wine, beer, oil and flour. In 1550 B.C., the Egyptians used plant fibres for their absorbent qualities, as well as honey and fats, inventing the first greasy dressings. They often used bandages as a means of holding these dressings in place.The same products were indeed used over subsequent centuries. In the 19th century, Semmelweis, Pasteur and Lister participated in the development of antiseptics and thought they could prevent infection by keeping a wound as dry as possible: at that time, the purpose of dressings was therefore to absorb and eliminate all traces of exudate and moisture. This concept was finally called into question by the studies of Winter [46] and Hinman [17] during the 1960s, who demonstrated again what the Egyptians had known already: the beneficial effects of a moist environment on healing. During the second half of the 20th century, it was technological advances in polymers, adhesives and textiles which were the source of intensive research and development into modern dressings.Thus the introduction of hydrocolloids represented a real revolution in the treatment of all types of wounds. However, for some heavily exuding wounds, they do not enable the optimum control of exudate. It is, then, necessary to use more absorbent polymers: alginates, foams or hydrofibres. Similarly, some little-exuding wounds require an input of moisture, which today is possible thanks to the development of hydrogel dressings.