It is often supposed that
occlusive dressings potentiate
wound infection. However, even though heavy colonization by skin and
wound flora is often seen under certain types of occlusion, clinical
infection is not a frequent occurrence. Commensal
wound flora consists of a variety of Gram-positive and Gram-negative organisms and fungi which do not appear to be detrimental to healing. Certain aspects of wound healing may in fact be promoted by bacterial colonization, although clinical
infection can lead to
wound breakdown and systemic
infection.
Wounds compromised by devitalized tissue, drains or
sutures are more susceptible than clean
wounds to clinical
infection.
Occlusive dressings may help prevent
infection by presenting a barrier to potential pathogens, and
hydrocolloid occlusive dressings have been shown to prevent dissemination of methicillin-resistant Staphylococcus aureus. The rate of clinical
infection as deduced from published trials of dressings is lower under occlusion than when non-
occlusive dressings are used, and this is likely to be a result of normal activity of the host defences under
occlusive dressings.