ELI5: Is letting wounds 'breathe' a thing, if so, what purpose does it serve?

I’m a nurse and have taken a number of courses on wound dressing and healing. Here’s what I can quickly write out for you.

The goal of wound care is moist wound healing. If wounds are draining plenty of blood/pus/serous drainage and it isn’t being removed from the wound by an absorbent dressing, the tissue can become macerated and will appear white. It’s too wet, the tissue is swollen with water. This is bad for wound healing. This is maybe where people got the idea of letting a wound “breathe” to dry up some of the excess moisture.

However, letting it dry out completely is not ideal either.

Natural healing involves developing a scab, a dry cover for the wound. However, if the wound were instead moist (not wet), you would have faster migration of immune cells, new cells, growth factors, etc. as they can move through a moist environment easier. This is what topicals like polysporin (besides the Abx) help to achieve. Petroleum products will moisturize without macerating.

And the other question everyone asks: should I use peroxide to clean it? no. maybe. Here’s the thing. You can clean a wound very well with water or saline (although who has saline at home). Many wounds wash themselves out by bleeding! Peroxide will kill bacteria, but it also hurts exposed skin cells/other tissue, and that can slow healing. The surface of your skin is mostly keratin and peroxide won’t affect intact skin, but when it’s cut, the deeper layers can be affected. Basically, don’t peroxide every wound, but something like a cat bite, go for it.

*edit: I’m aware now of how many people have saline. I pour like half a liter over new wounds, so I’m not sure people have that much contact solution. I have 25/20 vision privilege so am unaware. Yes, you should see a doctor quickly for cat bites. I’ve seen people need strong antibiotics 4x a day to avoid death from cat bites. Go to ER NOW if your wound starts streaking red up your limb. Helpful to outline areas of redness with a pen and the time you marked it to show how it’s progressing.

Explain Like I`m Five: good questions, best answers.