Wound Care Concierge: Bandages and Dressings

Paul M. Graham, DO

Over the past two months we have covered various topics on wound care. This article is the last part of our Wound Care Concierge series and will discuss the various wound care dressings on the market today. This list is not meant to be all inclusive and should act as a guide to increasing your understanding of different types of dressings used in the management of chronic wounds. Enjoy!

Wound dressings are very important in setting up an environment that is conducive to proper wound healing. It was traditionally understood that wet-to-dry dressings offered the best healing properties, but this proved to be false. Wet-to-dry dressings caused intense pain when removed and indirectly destroyed the newly formed tissue needed for proper wound healing. Modern dressing technology focuses on the principle of creating and maintaining a moist wound environment. Dressings that create and maintain a moist environment provide optimal conditions required for proper wound healing. They also cause less pain during dressing removal. Adequate moisture within the wound environment increases the rate of  cell migration (reepithelization) and promotes new blood vessel formation, allowing proper circulation within the wound itself.

Types of Dressings – In order of absorption capacity (lowest to highest absorption potential)

Films – Impermeable dressing that acts as a barrier to the external environment. Holds in moisture and used in wounds with minimal drainage. Often has adhesive backing and not ideal for moist wounds.

 

 

Hydrogels – Composed of up to 96% water, hydrating the wound bed to maintain a moist environment. Functions to absorb excess wound exudate (drainage) and promotes wound debridement (dead tissue breakdown).

 

 

 

Hydrocolloids – Flat occlusive dressing that forms a gel on the surface of the wound, promoting a moist environment. Impermeable to water vapor and air and can be used to rehydrate dry eschar (dead hard tissue) and promote autolytic debridement (dead tissue breakdown).

 

 

Foams – Significant ability to absorb excess wound drainage. Functions to transmit moisture and oxygen to the wound bed, promoting an environment for proper healing.

 

 

 

 

 

Alginates – Produced from brown seaweed, these dressings function to absorb excess wound fluid. These dressings contain calcium and sodium salts that also act to control bleeding.

 

Antibacterials – Silver has been used on wounds for many years particularly in the treatment of burns. Silver-impregnated dressings has become widely available for treatment of wounds due to the antibacterial properties it possesses. Iodine-containing dressings also have antibacterial properties, which lowers the bacterial load within chronic wounds, promoting proper wound healing.

 

 

Hydrofibers – Permeable dressing composed of hydroxymethylcellulose fibers with significant absorption capability. Can remain on wound for several days. Silver-impregnated hydrofibers provide antibacterial properties.

 

Common Wound Dressings	Beneficial Effects
Prisma	Absorption of excess fluid, contains enzymes that prevent wound breakdown, and antibacterial properties
Iodoflex/Iodosorb	Absorption of excess fluid, removal of exudate, pus, and debris, formation of a gel layer over wound surface, and antibacterial properties from iodine
Santyl	Chemical debriding agent that cleans wounds to promote optimal healing environment without affecting healthy tissue
Aquacel AG	Management of exudative wounds with antibacterial properties from silver impregnated drainage
Aquacel	Management of exudative wounds
Mepilex/COPA	Permeable dressing with adhesive border and good absorptive capacity. Protects against shear forces on the wound
Duoderm/Tegasorb	Fluid trapping properties in exudative (draining) wounds. Impermeable suspension of polymers that forms to the wound shape
Medi-honey	Management of exudative wounds with chemical debridement properties. Promotes a balance wound environment for healing. Antibacterial properties from low pH.

Photo Credit: KarenZupko.com, McFarlane Medical, HealthCareSupply.com

References:  Wolverton, S. (2013) Comprehensive Dermatologic Drug Therapy. New York, NY: Elsevier

---

Please note, our medical disclaimer applies to all information, images, recommendations, and comments published on this page.