Wound Care Dressings: What Clinicians Should Know
Wound care dressings are materials placed directly or indirectly on the surface of wounds to promote wound healing by preventing infection or further damage to the wounded area and periwound skin. To healthcare experts, choosing the right dressing is critical to improving wound healing outcomes in patients.
Wound Dressing Types and Benefits
Wound dressings are available in a wide range of materials, shapes, and sizes. The most suitable dressing depends on several factors, such as the nature and severity of the wound, age of the patient, and even skin type. However, wound dressings broadly fall into eight categories:
Gauze wound dressings consist of woven or non-woven gauze material made of rayon, cotton, polyester, or a combination of any two. They are suitable for use as primary or secondary wound dressings. Gauze wound dressings can also be impregnated with an antiseptic or saline solution. They are inexpensive, compared with other wound dressing types, and help to retain a moist wound healing environment. However, gauze wound dressings are not ideal for high-drainage wounds such as wounds with heavy exudate. Gauze wound dressings are suitable for managing non-draining or minimally draining wounds.
These types of dressings are thin, semi-permeable, transparent films of polyurethane or other polymer material. Film wound dressings contain adhesives on one side which covers the wound while adhering to dry periwound skin. They are very elastic and can conform to any shape. The main benefit of film dressings is that they allow oxygen to pass through to promote wound healing while inhibiting bacteria. Moreover, due to their transparent nature, film dressings aid visualization of wounds, allowing wound care professionals to identify issues such as pooling of exudate under the dressing.
Foam wound dressings are made of permeable polyurethane foam of various thicknesses. They trap moisture and heat to maintain a moist wound environment and allow oxygen to permeate while preventing bacterial intrusion to the wound bed. Foam dressings are mostly used as primary dressings, although in some cases, they can function as a secondary dressing (e.g., with an amorphous hydrogel dressing). Due to their high absorption properties, foam wound dressings are ideal for partial or full-thickness wounds having moderate to heavy exudates such as postoperative traumatic wounds, pressure ulcers, and diabetic ulcers.
Alginate wound dressings are made from natural fibers derived from processed seaweed. They do not contain adhesives but can be used in combination with secondary wound dressings which are placed on top to secure them in place. When placed on a wound bed, an alginate dressing reacts with wound exudate to form a gel-like substance which aids the wound healing process. Alginate wound dressings are highly permeable and can absorb fluids up to 20 times their weight, making them suitable for wounds with medium to heavy exudate. They are suitable for use in managing partial and full-thickness wounds such as bleeding wounds, donor sites, pressure ulcers, and diabetic ulcers.
Hydrogel wound dressings are water or glycerine-based dressings consisting of hydrophilic polymers in amorphous or fixed shapes. Amorphous hydrogels may be applied from a tube while fixed ones are offered as thin, flexible sheets, both with moisture-donating properties. They are strictly used alongside secondary dressings such as gauze. Hydrogel wound dressings help retain moisture in the wound bed to promote wound healing. However, they are also pervious to water and gas from the environment, and may not serve as an effective bacterial barrier. Hydrogel wound dressings are suitable for use in managing minimally-draining wounds such as first and second degree burns and also aid autolytic debridement.
Composite wound dressings are made of composite materials having multiple layers that are waterproof, moldable, and conformable to a wide range of body shapes. They provide excellent thermal insulation and retain moisture in the wound bed to promote wound healing while acting as a bacterial barrier. The layers of a composite wound dressing serve different functions such as liquefaction of eschar or necrotic debris, absorption of exudate, preventing bacterial intrusion, and maintaining moisture in the wound bed. Composite dressings are suitable for use in managing both partial and full-thickness wounds with medium to heavy exudates such as donor sites, pressure ulcers, and diabetic ulcers.
Hydrocolloid wound dressings consist of gel-forming polymer materials (e.g., those containing gelatin, pectin, or cellulose) and can conform to a wide range of body shapes. Due to their gel-forming nature, hydrocolloid dressings provide excellent thermal insulation and help to retain moisture in the wound bed which is critical for epithelialization, granulation, and autolysis. Hydrocolloid dressings are suitable for managing wounds such as donor site wounds, pressure ulcers, and venous insufficiency ulcers.
Interactive wound dressings are active-type wound dressings that "interact" with components of a wound bed to enhance wound healing. These dressings are of two types; anti-microbial and bio-synthetic. The former contains antimicrobial agents (e.g., ionic silver compounds) which kills pathogens to prevent wound infections, while the latter is derived from natural materials such as collagen and polyacrylate that facilitate wound granulation and re-epithelialization. Interactive wound dressings are suitable for use in managing both partial and full-thickness wounds.