๐ ็ธฝ็ฎ้ ๏ฝ ๐ ่ฑๆๅๆ๏ผๆฌ็ฏ๏ผ ๏ฝ ๐ ๅฎๆด็ฟป่ญฏ ๏ฝ โญ ็ฒพ่ฏ็ญ่จ
HISTORY OF WOUND DRESSINGS
The use of wound dressings dates back to antiquity. For at least 4000 years, fabrics such as linen were employed, until woven absorbent cotton gauze was introduced in 1871. The Edwin Smith Surgical Papyrus, which is one of the earliest medical treatises (circa 1615 BCE), describes the use of linen strips and plaster to dress wounds, stating that closed wounds would heal more quickly than open wounds. Ancient documents disclose how lint was used to pack and fill open wounds and how bandages were used to re-approximate wounds in order to facilitate healing. Linen strips were sometimes coated with grease or oil in order to prevent adherence to wounds or with honey to create a semi-occlusive and adherent dressing.
Until Lister connected the presence of pus with infection, pus had been viewed as beneficial (โlaudable pusโ). However, this association became linked so strongly that it was held that one is always indicative of the other, which is not always true. The association significantly interfered with the acceptance of occlusive dressings, despite better and faster healing, due to the fear of an increased number of bacteria under the dressing. Although the work of Pasteur, Koch, and Lister in the late 1800s on the cause of bacterial infections spurred the investigation of specific therapies for wound management, it was not until the mid-1900s that the understanding of wound healing changed.
Despite the teaching of the Smith Papyrus, it was believed that wounds healed faster if kept dry and uncovered. However, in 1948, Oscar Gilje described a โmoist chamber effectโ for wound healing. Two years later, Schilling and colleagues studied common minor wounds with highly occlusive or semi-occlusive nylon films and found semi-occlusive dressings to be more effective for healing than open treatment. The finding that semi-occlusive dressings were more effective than the highly occlusive dressings is thought to have set back further study. In 1962, George Winter conducted the landmark study on moist wound healing, demonstrating a 30% greater benefit of occlusive dressings compared with air drying of wounds. Many studies conducted since Winterโs seminal work, including in the porcine model of wound healing, have supported the benefits of moist wound healing by occlusive dressings.