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Wound assessment and dressing selection: an overview

11 March 2021
14 min read
Volume 30 · Issue 5

Abstract

Wound healing consists of four overlapping phases. Holistic assessment of a wound is essential and can confirm whether healing is progressing as anticipated. Frameworks can assist the clinician to conduct the assessment in a systematic way and to plan appropriate care for the patient. Dressings form a relatively small part of the overall care plan, but with such an array available the choice can be overwhelming. This article provides an update on wound assessment using the TIMERS framework and considers the factors influencing dressing choice.

Normal wound healing is a process consisting of four overlapping phases—inflammation, proliferation, epithelialisation, and remodelling (also known as maturation). Assessment of a wound can confirm that healing is progressing in a timely manner and identify any factors that may delay or stall the process.

‘Acute’ is the term used for a wound progressing through the phases of healing at the expected rate (Lazarus et al, 1994) whereas a ‘hard-to-heal’ wound (sometimes referred to as a ‘chronic’ wound) does not progress through the phases of healing in a timely and orderly manner. Definitions vary, but those that do not heal within 6 weeks to 3 months are often considered hard-to-heal (Kyaw et al, 2018).

Dressings are used to protect wounds from infection and assist with moist wound healing, but knowing what dressing to choose can be complex. Although appropriate dressing selection is important, dressings form just a small part of the holistic treatment package. Wound assessment guides the clinician in their dressing choice as part of a wider plan of care.

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