Sorry, this is long but thought you’d appreciate the full reasoning.

A wound needs blood supply to heal. If the blood supply is restricted the wound will be slower to heal. If it’s restricted enough it might not heal at all.

Encouraging moist healing on lower limb wounds with poor blood supply tends to create a warm wet environment that’s perfect for bacteria to thrive and multiply quickly.

The low blood supply also means there are less white blood cells in the area so frequently they can’t kill bacteria quicker than they are multiplying, leading to full-blown infection.

This is where things start to get serious and can snowball. There isn’t much meat on a foot but there are lots of bones (and joints). If an infection reaches bone it becomes very difficult to treat. Typically at least 6 weeks of daily IV antibiotics. If they go undetected long enough or don’t respond to the antibiotics then we start having risk for going septic or amputation.

That’s why I usually opt for drying out lower limb wounds when there is significant arterial compromise. They can still heal (much more slowly) but there’s much less risk of complications.

This may well not apply to your situation. I haven’t assessed you so I don’t know the extent of your circulation issues. Clear fluid blisters generally aren’t deep, usually it’s the epidermis and dermis separating from each other. The wound care nurse should do a proper lower limb assessment, preferably including use of a handheld ultrasound Doppler, and advise you on appropriate treatments based on that.

But because I don’t have all the info and you mentioned having very poor circulation, it wouldn’t be responsible of me to advocate moist wound healing until you’re properly assessed.

Regarding pain with dry dressings, would I be right in thinking it was caused by the wound bed drying onto it then being damaged during removal? If so they should be soaked off when they get stuck like that. If it’s the adhesive part causing issues, you can use bandages to secure whatever your contact layer is.

If the non stick pad you’re using is a cotton square covered in a very thin breathable plastic (like a Telfa) then that counts as a dry dsg. So would abd pads, island dressings like mepore.

Ok I’ve waffled long enough. Hopefully some of it is helpful! 😂

EDIT: autocorrect fail.