Wound Dressings
Wound, whether it is a minor cut or a major incision, it is important to care for it properly, part of this process includes wound dressing. Dressing is designed to be in contact with the wound, which is different from a bandage that holds the dressing in place. Historically, wet-to-dry dressings have been used extensively for wounds requiring debridement. In 1600 BC, Linen strips soaked in oil or grease covered with plasters was used to occlude wounds. Clay tablets were used for the treatment of wounds by Mesopotamian origin from about 2500 BCE. They cleaned wounds with water or milk prior to dressing with honey or resin. Wine or vinegar usage for cleaning the wounds with honey, oil and wine as further treatment was followed by Hippocrates of ancient Greece in 460- 370 BCE. They used wool boiled in water or wine as a bandage. There was a major breakthrough in the antiseptic technique during the 19th century, antibiotics were introduced to control infections and decrease mortality. Modern wound dressing arrival was in 20th century.
When the wound is closed with dressing, such as transparent film dressing, they are continuously exposed to proteinases, chemotactic, complement & growth factors, which is lost in the wound exposed. So during late 20th century, production of occlusive dressing began to protect and provide moist environment to wound. These dressings helps in faster re-epithelialization, collagen synthesis, promotes angiogenesis by creating hypoxia to the wound bed and decreases wound bed pH which leads to decrease in the wound infection. Woven absorbent cotton gauze was used in 1891. Until the mid 1900’s, it was firmly believed that wounds healed more quickly if kept dry and uncovered whereas ‘closed wounds heal more quickly than open wound’ written in an Egyptian medical text -Edwin smith surgical papyrus in 1615 BC. Oscar Gilje in 1948 describes moist chamber effect for healing ulcers. In the mid 1980’s, the first modern wound dressing were introduced which delivered important characteristics providing moisture and absorbing fluids (e.g. polyurethane foams, hydrocolloids, iodine-containing gels). During the mid 1990’s, synthetic wound dressings expanded into various group of products which includes hydrogels, hydrocolloids, alginates, synthetic foam dressing, silicone meshes, tissue adhesives, vapor-permeable adhesive films and silver/collagen containing dressing.
