You may have heard from your colleagues about the gap when assessing the wound. In this episode, you will learn about:
1: What is the gap exactly?
2: What are the risks associated with the gap?
3: How do you assess the gap?
The gap is defined as the space between the wound bed and the wound dressing. There is an agreement amongst health care professionals that it is important to manage the gap to promote an optimal healing environment. If you don't assess and manage the gap properly, it can lead to complications and might delay the healing process. If the gap is not effectively managed, exudate pooling may occur. This happens when exudate collects in the gap and is not managed by the dressing.
Why is it a problem? Exudate can leak onto the wound edge and periwound skin, cause maceration and delay wound healing. If the gap and exudate pooling is not managed properly, it creates an environment that promotes bacterial growth. As a result, it can increase the risk of wound infection and subsequently biofilm development.
To be able to manage the gap successfully you need to assess the wound thoroughly and focus on the following steps:
Start with looking at the wound and check the dressing when you remove it. Ask yourself: Has the dressing managed the gap? Has the dressing conformed to the wound bed? Do you see any damage to the wound edge and periwound skin?
Assess the wound depth. Ask yourself: How deep is the wound? Is the wound bed irregular? Do you see cavities or pockets where exudate can pool? Pay attention the the tissue quality and any new granulation tissue. Assess the wound exudate. Look at its amount quality, colour, consistency and odour. Remember, assessing the gap should form part of a holistic wound assessment.
Also, take note of some additional elements: What has caused the wound? Do you see any changes in the wound edge and periwound skin? These elements are closely linked to a wound gap assessment. To recap, it is important to manage the wound gap to reduce the risk of further complications.
Assessing and managing the gap should form part of a holistic wound assessment and should be addressed in the treatment plan.
