Clinical notebook: Wound and skin care

Basic wound management or what is a DIP A MOP I?

Wound management has changed dramatically in the past few years. By keeping the DIP A MOP I acronym in mind, even the most difficult wound can be managed and go on to heal.

D = Debride. Dead tissue and debris provide the food for bacteria and must be removed from the wound bed.

I = identify and treat infection.

P = Pack dead space lightly. Deep wounds need to granulate and fill in from the bottom. If a wound closes prematurely, an abscess may develop.

A = Absorb excess exudate (excess fluid). Choose a dressing that will absorb the drainage sufficiently and allow for infrequent changes. Disturbing the wound bed as little as necessary allows the wound a better chance to heal.

M = Moisture. Wounds heal faster in a moist, not wet, environment.

The goal is to keep the wo Und moist without allowing the periwound area (surrounding wound area) to become wet, therefore causing maceration and further breakdown.

0 = Open the wound edges. Because the skin cells come in from the edges to close the wound, it is important to keep the wound edges free of debris that might inhibit this closure.

P = Protect. The wound bed needs to be protected from trauma and bacterial contamination.

I = Insulate. Wounds heal best if a consistent warm temperature is maintained. Always use warmed sterile solution to cleanse the wound, Cool irrigation causes thermal shock and delays healing.

Clinical Tip

Warm sterile saline is the cleanser of choice for wounds. It doesn't harm healthy cells, it is comfortable, inexpensive and easily attained. it can be used for 24 hours after opening without risk of bacterial contamination.

Jane Ratay is a member of the wound clinic team at the Misericordia Hospital in Edmonton.

Copyright Alberta Association of Registered Nurses Jan/Feb 2000
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