Indecent Exposure: A descriptive study of wound exposure times associated with dressing changes

Abstract

The main functions of a wound dressing are to facilitate the healing process and to protect the wound from further trauma. Regular wound dressing changes are required by health professionals to assess wound healing. However, unnecessary exposure of the wound awaiting assessment and/or to be redressed could be harmful. To determine the frequency of unnecessary exposure of wounds a descriptive study in a surgical unit of a major tertiary hospital in South Australia was completed in December 2002. The impetus for this study was anecdotal evidence of unnecessary wound exposure during the wound dressing change. Patients with ‘open’ wounds (no approximation of skin edges) were included in the study and the duration of exposure was observed and timed. This study showed that of 282 wound dressing changes observed, 126 had unnecessarily extended durations of exposure to the environment. Of the 126 wounds exposed, 106 had the dressing removed to enable wound assessment to occur, with a mean exposure time of 103.17 minutes (range 5–564 minutes); this was a statistically significant result (p < 0.004) compared to the other 20, which were routine dressing changes. Wounds left exposed to the environment are unprotected and at risk of trauma, cooling, dehydration and pathogen invasion, which could lead to delayed healing. Clinicians can improve the outcome of wound care by basing their practice on these research findings. This study clearly demonstrates that unnecessary wound exposure is a problem in the clinical area that needs to be addressed.