Skin and Wound MythBusters Revealed

Brooke Phillips, CWCMS
Editor | Shield HealthCare
06/21/24  10:38 AM PST
Does air help wound healing

Does air help wound healing?

Have you ever heard the phrase “My wound needs to ‘breathe’ in order to heal”? It’s a common misconception that wounds need to “air out” in order to heal.

For more than 50 years, healthcare professionals have known that a moist environment encourages faster replication of epithelial cells (the cells covering your skin, body cavities, and blood vessels), leading to faster wound healing. In 1962, Dr. George Winter identified that wounds managed in a moist environment showed better healing than wounds which were exposed to the air and allowed to dry. His work was the basis for the concept of moist wound healing, a concept reinforced in more than 40 subsequent studies.

See the table below for some of the advantages of moist wound treatment over dry wound treatment, with the associated studies that support each advantage.

Advantages of Moist Wound Treatment Over Dry Wound Treatment:

Advantage Experimental evidence Clinical evidence
Up to 50% faster wound healing Winter, 1962; Dyson et al, 1988 Varghese et al, 1986; Falanga, 1988; Madden et al, 1989; Rubio, 1991; Beam, 2008
Faster wound contraction Wigger-Alberti et al, 2009
Enhanced and faster reepithelialisation Eaglstein, 2001; Triller et al, 2012 Jones and Harding, 2007
Generally increase cellular proliferation Romanelli et al, 2004; Attinger et al, 2008; Harding, 2012
Keratinocyte proliferation, fibroblast growth Korting et al, 2011
Promotes angiogenesis/ revascularisation Svensjö et al, 2000; Rusak and Rybak, 2013 Field and Kerstein, 1994; Dowsett and Ayello, 2004
Greater quantity and quality of ECM Dyson et al, 1992; Mosti, 2013
Collagen synthesis Chen et al, 1992; Leung et al, 2012
Lower rate of infection Hutchinson and Lawrence, 1991; Kannon and Garret, 1995; Kirsner et al, 2004; NICE, 2008
Cleansing/irrigation Dulecki and Pieper, 2005; Hall, 2007; Tao et al, 2015
Painless removal of the dressing without destroying newly formed tissue Wiechula, 2003; Metzger, 2004; Coutts et al, 2008; Leaper et al, 2012
Less scarring and better cosmetic results Atiyeh et al, 2003; Tandara et al, 2007; O’Shaughnessy et al, 2009; Mustoe and Gurjala, 2011 Atiyeh et al, 2004; Metzger, 2004; Hoeksema et al, 2013
Enhance autolytic debridement Gray et al, 2005; King et al, 2014
Decrease in initial donor site pain and improved donor site healing Weber et al, 1995


Why moisture helps wound healing

“Wounds need oxygen, but oxygen comes from the hemoglobin in your blood,” says Anita Prinz, RN, MSN, CWOCN, WCC, “not from the air.” Myth…busted!

Moisture is essential for the normal functioning and maintenance of healthy skin. Leaving a wound uncovered not only exposes open wounds to more bacteria and dirt, it can dry out the new cells our bodies are creating. This can increase pain as well as slow the healing process. Most wound treatments or products promote a moist — but not wet — wound surface.

Moisture balance is important. Have you ever taken off a bandaid and seen wrinkled, macerated skin beneath? Skin that is too moist (macerated) can also delay wound healing. Macerated skin is a less effective barrier against harmful microorganisms, increasing risk of delayed wound healing and potential complications such as infection, inflammation, and pain. Macerated skin and is also more fragile and more susceptible to injury.

While moist wound healing is generally preferred, it may not be appropriate in the following situations:


How do Wounds Heal?

Wound healing is divided into four overlapping phases:

  1. Hemostatis:  When your body stops the bleeding, or coagulation.
  2. Inflammatory:  When your body destroys bacteria and removes debris in the wound.
  3. Proliferative:  When your body focuses on filling in and covering the wound with new cells.
  4. Maturation:  When your new tissue filling/covering the wound gains strength and flexibility.

You can explore the four main phases of wound healing in detail here: How Wounds Heal: The 4 Main Phases of Wound Healing.


Busting some commonly-held skin myths

Letting wounds breathe are not the only common misconception. Read below for more statements that bust some popular skin myths:

  • All wounds are contaminated with bacteria, but not all wounds are infected.
  • The collagen you buy in face creams will not promote wound healing.
  • While sterile saltwater can help heal wounds, seawater is not good for wounds. Sea water is not sterile and can harbor bacteria that can cause infection.
  • Hydrogen peroxide and alcohol are cytotoxic to open wounds (they kill good, healing cells along with bacteria). Use hydrogen peroxide and alcohol only on intact skin.
  • The honey you buy in the store will not be effective for wound healing; only medical-grade honey is effective for wound treatment.
  • Full thickness wounds are deep and fill with granulation tissue, not muscle.

For more information about wound healing, visit our wound care community.

Sources include:

Recent Wound Care

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