Article Content

Get quick tips that you can use in daily practice from Advances in Skin & Wound Care's Clinical Associate Editors, Elizabeth Ayello, PhD, RN, APRN, BC, CWOCN, FAPWCA, FAAN, and R. Gary Sibbald, MD, BSc, FRCPC (Med) (Derm), FAPWCA, MEd.


This month's clinical practice tip is on selecting a wound dressing. Keep this handy for an easy reminder.


NICE(C) for dressing decision making: 20-second enablers for practice*

With thousands of dressings available, clinicians must be able to select the best dressing for each wound. Ask yourself these questions about the wound to help determine the dressing that will be NICE(C) to use:


* Is there any Necrotic tissue that needs to be debrided?Make sure the wound has the ability to heal. If it does not, then moist interactive dressings and active surgical debridement to bleeding tissue are contraindicated.


* Is the wound Infected or inflamed?Clinicians often look for more than 1 sign or symptom before diagnosing infection.


* Do the specific wound Characteristics, such as location, need to be considered as special needs (eg, around the anus where a waterproof adhesive dressing may be preferred)? Is pain an issue?


* Is there any Exudate?If so, determine why and how much, as well as the color and consistency.



Exudate may indicate that the cause of the wound has not been treated (such as edema because of venous insufficiency), congestive heart failure (look for bilateral involvement and extension above the knee), low albumin (malnutrition, kidney, or liver disease), or infection (check for symptoms or signs). Protect the periwound skin from exudate by using absorbent dressings. Select a dressing by answering the 4 questions above. Try using this memory jogger to help remember them:

Table. NICE to pick ... - Click to enlarge in new windowTable.