DRESSING SELECTION

The cost of wound care continues to rise on a global level. In the UK, the annual cost to the NHS attributable to wound management and associated comorbidities was estimated at £8⋅2 billion (Guest et al., 2017; Queen and Harding, 2024). In the USA, this has been estimated at $148.65 billion, Germany €23.33, Canada $9.34, Brazil $11.18, China $42.78 and Australia $6.04 billion. (Queen and Harding, 2024)

Wound care is often managed across multiple settings involving a wide range of health care professionals (HCPs), often with varying levels of expertise. In the UK, a large percentage of wound care is treated within community settings (Morgan, 2015; Gray et al., 2018). In 2016 alone, the prescription costs for dressings were £110 million (NICE, 2016). This is a significant amount, considering this represents just one route in which dressings can be obtained.

HCPs are frequently under pressure to make the right choices for their patients, and can be challenged by the array of wound care products. Alongside there is the challenge to reduce cost. Although a dressing should not be selected on cost alone, it is an important aspect that needs to be taken into consideration alongside other factors to ensure that the correct treatment is implemented. Understanding the basic principles of wound management, in conjunction with an understanding of dressing characteristics, will make the decision-making process more effective (Weir, 2014).

Product selection should be based upon a comprehensive and holistic assessment of the patient and their wound. Once the wound aetiology and the intended outcome of treatment (e.g. debridement) have been confirmed, an appropriate product can be selected (e.g. hydrogel).

Wound care products are tools that can help promote healing. Dressings do no more than facilitate wound healing by providing the optimal environment for healing to proceed (Vuolo, 2009). Wounds will repair if there is adequate oxygen and nutrients, and factors that impede healing need to be identified and corrected, if possible.

‘Advanced wound care’ products can be divided into first, second and third-line products. Most health care professionals would be expected to be familiar with the selection and use of first-line and second-line products. Most hospitals, community and primary care settings/trusts will have a wound management formulary, which lists the first-choice dressings in each product category and often the indication for use for each product.