I may be completely wrong and I probably am. But, as far as I can figure a wound dressing has two primary functions.

1. to apply direct pressure on the wound to keep it from bleeding.

2 .to protect the wound from infection, and further damage.

The primary function of gauze is to absorb fluid. A Trau Medic dressing supposively absorbs a pint of blood. Do we really need to absorb all this blood or simply ensure the two primary goals?

The only thing I would use it for is wound packing such as for a severe bloody nose or seeping infection ; or cushioning a wound.

If you are losing pints of blood, you would need resus and quickly!
Direct pressure and elevation would stop most bleeding. And a dressing should not be judged by the amout of blood which is absorbed, although in the ER if I see a completely soaked TrauMedic dressing, I could guess the casualty would have lost more than a pint of blood.
A dressing should be to:(as you rightly said)
1. Apply pressure to a wound to reduce/stop bleeding.
2. Protect the wound from further injury/damage/exposure.
3. Blood clotted in the dressing would enchace the clotting mechanism to ensure that the bleeding is arrested, assuming of course the casualty doesn't go into shock 1st though.

I've always been told to pile on 4 x 4 gauze with plenty of direct pressure, then put a dressing on over that. I guess a gauze/dressing combo eliminates the need for the seperate steps...

I have always assumed it was to encourage the clotting process (even if temporary), a place for the platelets to "gather".

Sue

Let me ask the medics on this list about pressure. Say the wound is a gash on a limb. If it was me, I'd avoid putting pressure directly onto the gash, as I imagine that would tend to open the wound further -- like pressing down on a slit in a hot dog.

Rather, I'd try to press the gash closed by wrapping a bandage around the limb.

If this is "right thinking" then the pad may serve to moderate the pressure placed on the gash. It might serve to cushion the wound from the pressure of the wrapping bandage.

Bear

I think you're all overthinking it. I'm not any sort of medic, and I don't even play one on TV, but here's my take. The absorbent properties are there just so you don't make a mess of things around you, dripping blood everywhere.

That reminds me of one of my knee surguries. The doctor repaired some cartiledge, and he deliberately caused some bleeding to attempt to nourish the cartiledge to help it heal. A lot of that blood ended up in the dressings. The doctor didn't tell me about that at the time, so I was suprised at how much blood there was when I took it off. So I set it aside to ask my wife about it, since she's a physician. Well, my dog ate it in the meantime!

Direct pressure to the wound is still the best way to control bleeding. By adding elevation, pressure bandage and if needed, the use of pressure points, most (99%+) of all bleeding can be controlled. Only < 1% would ever require a tourniquet. When controlling bleeding with direct pressure, opening the “gash” further is really not an issue. Once bleeding is controlled, under the appropriate medical setting and with correct wound care, closure of the wound can then occur. Pete