Consensus panel recommendations for chronic and acute wound dressings

Objective: To seek a consensus on recommendations that would help health professionals choose appropriate wound dressings in daily practice, since a systematic review found only limited evidence to support reported indications for modern wound dressings. Participants: A steering committee selected a panel of 27 experts with no declared conflicts of interest from lists of nursing staffs and physicians (specialists or general practitioners) with long-standing experience of wound care. The lists were put for-ward by 15 French learned societies. Evidence: The panelists received a recent systematic review of the literature, a classification of indications established by a working group, and definitions for the dressings. Consensus Process: The steering committee designed questionnaires on chronic wounds and on acute wounds including burns for each of the 2 panels. The consensus method was derived from the nominal group technique adapted by RAND/UCLA. Panelists rated the relevance of each possible dressing-indication combination on the basis of the published evidence and their own experience. After the first round of rating, they met to discuss results and propose recommendations before taking part in a second round of rating. The working group peer reviewed the final recommendations. Conclusions: A strong consensus was reached for use of the following combinations: for chronic wounds, (1) debridement stage, hydrogels; (2) granulation stage, foam and low-adherence dressings; and (3) epithelialization stage, hydrocolloid and low-adherence dressings; and for the epithelialization stage of acute wounds, low-adherence dressings. For specific situations, the following dressings were favored: for fragile skin, low-adherence dressings; for hemorrhagic wounds, alginates; and for malodorous wounds, activated charcoal.