The pioneering work of George Winter in the 1960s placed the concept of moist wound healing at the center stage of modern wound care. As a result, modern wound dressings were developed that can retain moisture in the wound bed. Despite the innovation in wound dressing technology, gauze wound dressings are still popularly used in several countries. One of the main reasons for their popularity stems from their cost-effectiveness. Gauze wound dressings have been used by wound care specialists and podiatrists for mechanical debridement and as primary dressings. 

Gauze Wound Dressings: An Overview

Before the 1960s, gauze was the primary wound dressing material for all wound types. It is one of the oldest wound dressing materials with its history dating back to ancient Egypt. It was used extensively and in large quantities. Due to its ability to absorb wound exudate and the formation of an eschar, gauze wound dressings were believed to stimulate wound healing. This is because, at the time, a dry wound microenvironment was believed to be conducive to wound healing through the inhibition of bacterial growth.

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There are two major types of gauze wound dressings: woven and non-woven. Wound care specialists and podiatrists need to be aware of the differing characteristics of these two subtypes. Woven gauze dressings are the oldest dressing types, and are manufactured from a hundred percent natural cotton. This type of dressing is considered problematic due to its linting effect with small pieces of fiber remaining in the wound after removal. This can lead to the exacerbation of wound inflammation. Non-woven gauze dressings, on the other hand, are made up of synthetic fiber or rayon. They were introduced as a replacement for woven gauze dressings as they have a lesser linting effect. In addition, non-woven gauze dressings are characterized by a lesser adherence to the wound bed. 

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Gauze dressings can be impregnated with other agents that can enhance their antimicrobial activity and can provide a hydrating effect to the wound. Some of the substances that can be added to gauze wound dressings include iodinated agents, zinc paste, hydrogel, aqueous saline, and chlorhexidine gluconate. It should be kept in mind that, unlike modern wound dressings, gauze is not able to maintain a moist wound microenvironment.

Benefits of Gauze Wound Dressings

Despite the ready availability of modern wound dressings, gauze wound dressings remain a popular choice in certain countries. 44% of patients with chronic wounds in Japan are treated with gauze wound dressings. In the United States, the application of ‘wet to dry’ wound dressing persists. Even though gauze wound dressings are now regarded as outdated in modern wound care, they are still widely used due to the following reasons:

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• Cost-effectiveness: When less frequent dressing changes are required, gauze dressings are found to be the least expensive dressing method available. However, their cost-effectiveness should be put into perspective by considering other factors. These include frequency of dressing change, wound healing time, patient discomfort, and the need for dedicated nursing.

• Ease of use: As gauze wound dressings are one of the oldest dressing materials available, the majority of healthcare providers are familiar with its use. Gauze wound dressings remain popular because of their ease of use. They can be packed into areas which might be inaccessible to other wound dressing types. For instance, they can be used for packing tunnels and sinus tracts.

• Versatile: Gauze wound dressings are available in a variety of shapes and sizes. Some of their forms include rolls, strips, ribbons, and pads.

Application of Gauze Wound Dressings

Traditional wound care involved extensive use of gauze for all wound types. Even though modern wound dressing is increasingly being specialized for specific wounds, gauze wound dressing still has a role in wound care. Some of the applications of gauze wound dressings include:

• Secondary dressing: Even though they were traditionally used as primary dressings, gauze wound dressings are now preferred to be used as secondary dressings.

• Wound cleansing: Gauze wound dressings are suitable for use in wound cleansing, scrubbing, and local hygiene care of surgical or non-surgical wounds.

• Homeostasis: Gauze dressings are effective in achieving homeostasis and can be used for bandaging.

Limitations of Gauze Wound Dressings

Compared to modern wound dressings which play an active role in the wound healing process, gauze dressings are limited in their ability to enhance wound healing. There are several limitations and disadvantages associated with using gauze wound dressings. It can be said that the limitation of traditional wound dressing prompted the development of innovative modern dressing solutions. Some of these include:

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• Gauze wound dressings are unable to maintain a moist wound environment which is considered a prerequisite for normal wound healing. They might dry up the wound leading to eschar formation.

• Gauze wound dressings are unable to provide an effective barrier against the entry of bacteria into the wound. As a result, gauze wound dressings are associated with a 50% greater chance of infection as compared to semi-occlusive dressings.

• Gauze wound dressings tend to adhere to the wound surface. This leads to painful removal and patient discomfort.

• As gauze wound dressings are not able to appropriately handle the wound exudate, they require frequent dressing changes. This is associated with an increased need for nursing care, patient dissatisfaction, and increased costs in the long run.