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SRPS Volume 10, Number 7, Part 1 Table 6 Suture Repair of Soft-Tissue Injuries (Reprinted with permission from Markovchick V: Suture materials and mechanical after care. Emerg Med Clin North Am 10(4):673, 1992.) 21
SRPS Volume 10, Number 7, Part 1 WOUND DRESSINGS There are more than 2000 wound dressing materials available commercially. See the Appendix for an overview of their respective properties, indications, advantages, and disadvantages. The red-yellow-black classification of wounds has removed the mystery in choosing a dressing. The RYB system is used for wound healing by secondary intention and is based on the balance of healthy granulation tissue and necrotic tissue (Table 7). When treating a wound with multiple colors, the worst problem should be treated first: black before yellow before red. Semipermeable Occlusive Dressings There is evidence that debridement, angiogenesis, dermal repair, and epithelialization are accelerated under occlusive dressings. The mechanisms involved include thermal insulation, changes in wound pH, PO 2 and PCO 2 , and maintenance of growth factors in the moist environment. 250 Because occlusive dressings can cause skin maceration from excessive fluid accumulation, many popular modern dressings are semipermeable, allowing escape of moisture vapor and passage of gases but preventing entry of bacteria and liquid water. 250 Carver and Leigh 250 review the various types of commercially available occlusive dressings, Table 7 Wound Management Protocol: The Red-Yellow-Black Classification 22
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