With all the heat waves in August, we may be longing for the cold winter days of December so this is a good time to talk about the dangers inherent in cooling down the wound bed. Please share this column with the clinical team at your agency.
Keep the wound covered and warm!
Exposure to room temperature air and wound cleansing solutions stored at room temperature, can slow wound healing.1,2 Wounds heal best at normal core body temperature with body surface temperatures between 33°C and 42°C.1,2 Below 33°C , the cells needed for wound healing decrease in activity.1
The typical dressing change processes have been found to dramatically decrease wound temperatures below the temperatures that are best for healing.1 This undesirable cooling is caused by the length of time the wound is exposed to room temperature air and solutions, stored at room temperature, used to cleanse and debride the wounds.1,2 In the studies that have documented the impact of wound cooling on healing, the dressing changes took an average of 11 minutes to perform.1
The wound bed temperature drop during dressing changes averages 2.7°C.1 Just cleansing wounds with room temperature, normal saline has been shown to cause a 2°C drop inwound temperatures.1
What is the impact on healing caused by cooling the wound during dressing changes? Cooling the wound inhibits cell growth.1,2 A newly cleansed and dressed wound will require about 40 minutes under the new dressing before the body re-establishes the appropriate healing temperatures, but cell division will not begin again for 3 to 4 hours after the dressing change is completed.1,2
So, each dressing change slows the healing process by 3 to 4 hours that day. It is estimated that a once-daily dressing change, which includes rinsing the wound with a room temperature solution, results in the wound essentially being “off-line” for the equivalent of 1 day spread over the week.2
When wound temperatures are maintained at optimum levels, blood flow to the area is increased, which enhances wound repair and increases wound tensile strength.2 Improving blood flow to the area also helps reduce the risk of infection.2
PolyMem® wound dressings are designed to work closely with the patients’ natural wound healing responses. The dressings provide continuous cleansing and debridement of the wound so that dressing changes can be performed rapidly which helps maintains the wound in a continuous healing state. Usually, the previous dressing can be removed and a new dressing applied without the need for additional wound bed rinsing or manipulation during the dressing change process. PolyMem dressing use has resulted in reducing patients’ pain levels while improving their healing.3
- McGuinness, W. et al (2004) Influence of dressing changes on wound temperature. Journal of Wound Care; 13:9, 383-385
- Gannon, R. (2007) Wound cleansing: sterile water or saline? Nursing Times; 103: 9, 44-46
- Davies SL, White RJ. Defining a holistic pain-relieving approach to wound care via a drug free polymeric membrane dressing. Journal of Wound Care. May 2011; 20(5): 250-256