Wound dressings and topical agents

Topical treatment of wounds is an important aspect of wound care, although secondary to surgical and systemic care. Dressing materials come in many forms to suit wound types and preferences. No hard evidence exists to place any one approach above another. All wounds deserve individualized attention and care plans. Likewise, a plethora of solutions exist to augment dressing materials in cleansing, antibiosis, and débridement. Traditional agents, including hydrogen peroxide, Dakin's solution, and povidone-iodine, are more tissue toxic than their common usage would indicate. We prefer frequent dressing changes with natural fiber gauze and nontoxic solutions such as saline. The scalpel, curette, and rongeur are, in our experience, much preferred to enzymatic agents when débridement is needed. We encourage scrutiny of commercial products based on clinical merit and effectiveness as documented in the medical literature. Platelet derived growth factors are an effective adjunct to wound healing and are primarily indicated when the condition of patients and their wounds has otherwise been optimized.