Is it better to keep a wound moist or let it dry out in the air? There’s a lot confusion about it. In fact, the notion that it aids the healing process to let wounds such as minor cuts and scrapes dry out in the air is still widespread.
But this assumption is incorrect. As various studies have demonstrated over the past decades.
Read on to find out why it’s best to keep a wound moist. *
And about the best way to take care of a wound and how to keep it from scarring (or at least minimize the risk).
[update] * As commenters point out, the choice of moist vs dry wound healing largely depends on which part of the body a wound is located. Some areas benefit from letting wounds scab. As always, follow the advise of your doctor for your particular situation.
What You May Not Know About Scabbing..
Scabs slow the wound healing process. When wounds are kept exposed to the air they will dry and form a scab.
The purpose of the scab is to protect the wound from environmental contamination. But, at the same time, scabbing has some disadvantages.
A scab forms a barrier to the generation of new tissue. Studies have shown that under influence of scabbing the regenerative wound healing processes take more time, thus increase the risk on scarring.
“”Moisture prevents the formation of a hard scab, which acts as a barrier to the development of new tissue,”
source: dermatologist Bruce Katz, M.D., associate clinical professor at Columbia University College of Physicians and Surgeons.
Scabs Inhibit Quick Healing
Scabs are blockades. They block the skin’s process of creating new cells and tissue. Or as quoted by a dermatologist:
“Grass doesn’t grow well under a rock; skin cells don’t grow well under a scab.”
reference: Nurse’s Notebook
A poll on another website of mine showed that of the 448 people who voted, 69% thought that it’s best for a scrape or cut to dry and scab. Of these people 30% already knew a moist and clean environment makes a wound heal quicker.
Why Keep a Wound Moist?
Wounds heal faster and better when kept moist. The first scientist to discover the benefits of keeping a wound moist was George D. Winter.
In 1962 he found out that the regrowth (epithelialization) of skin would proceed twice as fast in a moist environment than under a scab.
He demonstrated this in a controlled study in which wounds covered with a film dressing healed in about 12 to 15 days while similar wounds exposed to the air healed in about 25 to 30 days.
“Our body’s cells need moisture to survive”
Benefits of Moist Wound Healing
The benefits of moist wound healing
- Wounds heal up to 50% faster
- There’s less (risk on) infection
- removal of wound dressings is painless and newly formed tissue will remain intact
- less scar tissue thus better cosmetic appearance.
Optimal Wound Healing
“Moist wound healing is considered the ideal environment for optimal wound healing,”
said Patricia Burns, RN, CWOCN Certified Wound, Ostomy and Continence Nurse (professional nurse certification).
“The development and use of advanced wound care dressings enhances the body’s natural defenses and healing processes to improve healing outcomes and contributes to improved patient comfort.”
Another Study Proving Benefits of Moist Wound Healing
“Wounds in wet, moist, and dry environments were completely epithelialized * on days 6, 7, and 8, respectively.
* = To become covered with epithelial tissue, as of a wound. epithelialize
Why You Should Be Cautious With Gauze Dressings
Gauze dressings are so common. We are used that when we are wounded we clean the wound and put a gauze on it. But recent research shows that there are some major disadvantages to gauze when compared with moist wound dressings. Here’s why.
- Gauze dressings dry out the wound surface, delay wound healing, involve more wound pain, and contribute to scar creation.
- They interfere with the wound healing process because the cells in our body need moisture to survive and to move across the wound surface.
- Studies show there’s also a bigger risk on infection with gauze dressings.
- Because gauze dressings absorb wound exudate frequent dressing changes are needed. Due to the dry air around the wound bed they tend to stick to the wound bed which results in painful dressing removal and damage the newly formed tissue.
How To Keep Wounds Moist
So how do we keep wound moist? By covering them with dressings. In fact, there are several ways to provide this ideal, moist wound healing environment.
Probably the most low-cost remedy is to use petroleum jelly (Vaseline). Some antibiotic creams and ointments are also moist inducing but prolonged use isn’t recommended because of side effects.
More convenient treatments are hydrogel dressings and hydrocolloid dressings because once they are applied they can stay in place for two days ore more.
So called foam dressings aren’t appropriate for minor wounds because:
“Wounds with minimal drainage won’t benefit from a foam dressing because the dressing may dry out the wound and decrease the moist healing environment.” Source: nursingcenter.com
Benefits of Putting Vaseline on Wounds
Did you know that petroleum jelly (Vaseline) keeps bacteria out and moist in?
According to Wikipedia studies have shown that Vaseline (petroleum jelly) isn’t absorbed by the skin and has no medicinal effect. Vaseline’s effectiveness in accelerating wound healing is thought to stem from its sealing effect on cuts, scrapes, and burns.
The occlusion inhibits bacteria and other contamination from getting into the wound. It also stops the skin’s moisture from evaporating which is thought to keep the injured area supple. Which is probably the explanation of Vaseline’s excellent moisturizing properties.
Honey as a Wound Dressing
Susan Mendez-Eastman is a research nurse for the University of Nebraska Medical Center College of Nursing and is certified in both wound care and plastic surgical nursing.
“Many of the practices throughout the centuries have come full circle – proving to be scientifically sound by today’s standards. In ancient Egyptian practice, which was surprisingly modern for its time, they treated many wounds with honey and oil.
Modern medicine has revealed that honey does have some antibacterial properties and oil kept the wounds moist. So, with that said, the history of wound care includes many variations on the same types of treatments. History does repeat itself through the ages; the proven traditional remedies come back to us with modern names and marketing programs, and hopefully scientific evidence of efficacy.” source: wounds1.com
The Secret of Using Honey To Keep Wounds Moist
Honey, especially manuka honey, is a great way to hydrate damaged skin tissue. But it has various other advantages.
The past decades many clinical trials and other studies on the effectiveness of honey in wound care have been conducted. This research shows that the moist environment created by honey kills bacteria and hastens wound healing.
Infections are prevented and when already existing, cleared rapidly. Bad wound odor is removed quickly, and swelling and pain are reduced considerably. Indirect result of these enhanced wound healing aspects is minimal scarring.
Medical Grade Wound Honey
Medihoney wound dressings are FDA approved class 1 medical devices. These dressings and wound paste contain sterilized manuka honey. This is a unique type of honey endemic to New Zealand.
The use of these dressings and honey have shown to cure allegedly incurable wounds. There’s a vast amount of studies showing the extraordinary properties of this natural wound healing agent.
Why Use Topical Antibiotics for Wounds Moderately
Its use has some downsides, use it moderately and if possible only on fresh wounds.
Prolonged use of topical antibiotics on wounds may cause skin irritation and could possibly worsen a wound. Antibiotic ointments, such as Neosporin, should not be used longer than a few days. Also because of the chance on wound bacteria getting resistant to the antibiotics they are encouraged to use in moderation.
“Topical antibiotics work best when they are used only to prevent infection in a fresh wound, not to treat an infection that has already started.”
“Another common mistake is applying antibiotic ointments. These ointments may keep the wound moist, he said, but they can also lead to swelling and an allergic reaction called contact dermatitis.”
said Dr. Mark D. P. Davis, a professor of dermatology at the Mayo Clinic in Rochester, Minn. Source: see link below.
More information on topical antibiotics for wounds on answers.com
Hydrocolloid Wound Dressings
Occlusive hydrocolloid dressings form a protective barrier restraining environmental pollution from entering a wound. These dressings also lower the pH of a wound. This acidic environment inhibits bacterial growth.
Contrary to manuka honey dressings, hydrocolloid dressings can’t be used in case of an infected wound. Read more about the benefits of hydrocolloid wound dressings.
Hydrocolloids provide effective occlusion; with dry wounds, they can have a softening effect, and they have been used to prevent the spread of MRSA (by providing a physical occlusive barrier).”
Reference: Thomas, S., Hydrocolloids Journal of Wound Care 1992:1;2, 27-30
The best selling hydrocolloid wound dressings on Amazon are made by DuoDERM .
How Hydrogel Dressings Amazed Me..
Recently I fell off my bike onto the street (don’t ask). I hit the tiles hard with my nose and my right hand folded double.
Apart from a little fracture in my finger I also had three nasty scrapes on the part where the finger bends (closest to the fingernail). As you know there´s relatively soft, cushy skin there. The scrapes were rather deep and I just missed whole parts of the skin. I was a bit worried about it healing well.
At first I just let the wounds dry in the air. Later on I saw those big crusts forming and the wounds were healing very slowly. So I bought hydrogel strips (wound plasters from Geoplast) and put these on my wounds. Hydrogel dressings are designed to maintain a moist environment.
After wearing them a day or so the surrounding skin had turned white(ish) and the crusts had dissolved into yellow stuff. This appeared to be an infection but I realized it was just the residue of the dissolved crusts. So no worries, I decided to keep wearing the hydrogel strips.
After a few days I really noticed improvement. The wound surface had become much smaller. The surrounding skin seemed to have grown towards the center (where the crusts previously were). The damaged area was also less deep. So I am really satisfied by using moist inducing wound strips.
I already knew this from reading about it but now I have experienced it myself. From now on I will keep my more severe wounds moist.
If I’m correct hydrogel dressings are roughly the same as hydrocolloid dressings. (hydrocolloid dressings are more suitable for exudating wounds) The hydrogel strips I bought in my local drugstore were only 5 bucks. Maybe you can find them in your area as well.
“Odland first observed in 1958 that a blister healed faster if left unbroken.”
Slowly Healing Wound?
If you are prone to slow wound healing you could benefit from using nutritional supplements. Especially people who suffer from malnutrition (lack of the appropriate nutrients in the body.) have to deal with wounds that won’t heal or heal slowly. Adding the missing nutrients by taking supplements can significantly boost the healing process.
“Exposing a Cut so it Can Breathe Slows Healing”
Most parents and school nurses have a time-honored approach to treating a small wound: clean it up, stop the bleeding and then let it get some air.
The point of this approach, as described in medical texts, is to lower the odds of infection and to speed the healing process. But over the years, researchers have found that what many people know about treating small cuts and scrapes is wrong. Read more here: New York Times – Health
Keeping Scrapes Covered
Apart from cuts, scrapes also benefit when kept moist. What exactly is a scrape? In dermatology, a scrape is a mild abrasion. This is a wound caused by superficial damage to the skin, no deeper than the epidermis. Bleeding, if present, is minimal. Most scrapes (or grazes), do not scar or bleed, but deep abrasions may lead to the formation of scar tissue. Other denominations are; road rash, scratch, abrasion, or laceration.
Here are a few simple steps to follow in order to optimize scrape healing.
Photo by underwhelmer | via Flickr
1. Clean The Scrape
Stop the bleeding, remove debris, wash the wound.
The first step is to stop the bleeding (if present). Minor scrapes usually stop bleeding after a few minutes. If not so gentle pressure can be applied with a bandage or clean cloth. Keep it on for a while (about 10 minutes) because repeatedly removing the bandage to watch if the bleeding has stopped will only keep the blood coming.
After that the scrape should be cleaned with a mild soap or saline. Debris, dirt also has to be removed from the wound bed.
2. Topical Antibiotic Prevents Infection of Scrape
first aid to help prevent infection in scrapes
A topical antibiotic (e.g. Bacitracin or Neosporin) can be applied to prevent infection and to keep the wound moist. There are also special Band-Aids with antibiotic ointment on them available.
“Neosporin helps to minimize the appearance of scars, based on a clinical study comparing the appearance of treated and untreated minor abrasions.”
Personally, I never use antibiotic ointments. Just because I am not prone to infections. In case you fell on the street and debris have entered the wound it may be wise to use a topical antibiotic. But use it sparsely.
I did use hydrogel dressings recently on three scrapes on my fingers. Due to the bike accident I talked about earlier I had some nasty abrasions on my fingers. (The parts where they bend and the soft, wrinkled skin tissue is.) Since the scrapes healed slowly I bought some hydrogel dressings to put on them. I did notice improvement and the fact that they were covered also felt more comfortable.
3. Occlusive Dressings for Scrapes
Creams, ointments, films, and dressings.
There are various hydrogel wound dressings available on Amazon but it may be wise to check your local drugstore first. Some come in ointments, others are in sheet/ film form. They seal out water, germs, and dirt.
Hydrogel dressings are suitable for dry to mild exudating wounds and for blisters. For wounds with more exudate,hydrocolloid dressings are better suitable.