What outcome is most likely when wet-to-dry dressings with acetic acid are used on a wound with beginning granulation tissue?

• A. Wound infection
• B. Hypogranulation with little to no epithelialization
• C. Hypertrophic scarring
• D. Wound healing

Answer: (B)

Wet-to-dry dressings act as non-selective debridement, and applying them with acetic acid on a wound that is just beginning to form granulation tissue tends to disrupt that delicate new tissue. As the dressing dries and is removed, it mechanically pulls away granulation tissue and any newly forming epithelium. This trauma hinders the wound’s ability to lay down new granulation tissue and to migrate epithelial cells across the bed, leading to hypogranulation and minimal epithelialization. Acetic acid has antimicrobial effects, but it does not promote healing and can contribute to tissue irritation or drying if used with this debridement approach. So the most likely outcome is hypogranulation with little to no epithelialization.