Dressings

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Gauze (Woven & Unwoven) Description:

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Manufactured from yarn or thread and come in many different shapes and sizes (e.g. squares, sheets, rolls, packing strips). Impregnated gauze is a variation of woven gauze in which various materials such as petroleum, zinc, or antimicrobials have been added. Indications include: Infected or non-infected wounds of any size and the dressings can be used for wet-to-wet, wet-to-dry, or wet-to-moist debridement.

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Gauze Advantages

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readily available, cost effective, can be used alone or with other dressings and topical agents, can modify number of layers to accommodate for changing wound status, can be used on infected or non-infected wounds.

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Gauze Disadvantages

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has a tendency to adhere to the wound bed traumatizing viable tissue upon removal, highly permeable, requires frequent dressing changes, prolonged use decreases cost effectiveness, and has an increased infection rate compared to occlusive dressings.

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Gauze Procedure

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As a primary dressing, it can be used to maintain an opening for drainage in a tunneling wound and gently support a cavity wound. It can also be used as a wet-to-dry dressing. Gauze is an effective secondary dressing holding the primary dressing in place.

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Gauze Medical Asepsis

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As primary dressing, gauze leaves contaminating fibers in the wound, contributes to desiccation, is permeable to bacteria, and releases excessive amounts of bacteria into the air on removal.

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Wet-To-Dry Description

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Use of gauze to mechanically debride a wound.

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Wet-to-Dry Advantages

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Quick and requires less time spent debriding the wound.

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Wet-To-Dry Disadvantages

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Painful and often removes viable tissue and causes bleeding and trauma to the wound bed

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Wet-to-Dry Procedure

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Wet gauze is applied directly to the wound bed and allowed to dry on the wound. Removing the dry gauze debrides the wound, pulling away any material that has adhered to the gauze

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Wet-to-Dry Medical Asepsis

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Leaves contaminating fibers in the wound, contributes to desiccation, is permeable to bacteria, and releases excessive amounts of bacteria into the air on removal

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Transparent Films Description

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Thin membranes made from transparent polyurethane with water-resistant adhesives. The dressings are permeable vapor and oxygen, but not to bacteria or water. Indications include: superficial or partial thickness wounds with minimal drainage (e.g. scalds, abrasions, lacerations).

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Transparent Films Advantages

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highly elastic to conform to the contours of the body, provide a moist environment for wound healing, enables autolytic debridement, allows visualization of the wound, resistant to shearing or friction, and cost effective over time

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Transparent Films Disadvantages

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excessive exudate accumulation can result in periwound maceration, adhesive may traumatize periwound over time, and cannot be used on infected wounds

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Transparent Films Procedure

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Primary dressing applied directly over the wound and adheres to the skin surrounding the wound. Removal of the film must be done with great caution to prevent skin tears. During dressing changes, clean wound, dry periwound area, and apply new dressing.

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Transparent Films Medical Asepsis

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Must be used on wounds free from infection. Prevents bacteria from entering the wound

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Hydrocolloids Description

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Dressings that consist of gel-forming polymers (e.g. carboxymethyl cellulose, gelatin, pectin) backed by a strong film or foam adhesive. The dressing does not attach to the wound itself but instead anchors to the intact surrounding skin. The dressing absorbs exudate by swelling into a gel-like mass and vary in permeability, thickness, and transparency. Indications include: partial and full-thickness wounds and can be used with granular or necrotic wounds.

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Hydrocolloids Advantages

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provides a moist environment for wound healing, enables autolytic debridement, offers protection from microbial contamination, provides moderate absorption, does not require a second dressing, and is waterproof

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Hydrocolloids Disadvantages

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may traumatize surrounding intact skin upon removal, may tend to roll in areas of excessive friction, and cannot be used on infected wounds

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Hydrogels Description

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Consist of varying amounts of water and gel forming materials such as glycerin. The dressings are typically available in both sheet and amorphous form. Indications include superficial and partial thickness wounds (e.g. abrasions, blisters, pressure ulcers) that have minimal drainage.

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Hydrogels Advantages

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Provides a moist environment for wound healing, enables autolytic debridement, may reduce pressure and diminish pain, can be used as a coupling agent for US, and some hsve absorptive properties.

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Hydrogels Disadvantages

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potential for dressing to dehydrate, cannot be used on wounds with significant drainage, typically requires a secondary dressing

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Foams Description

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Comprised of a hydrophilic polyurethane base that contacts the wound surface and a hydrophobic outer layer. The dressing allows exudate to be absorbed into the foam through the hydrophilic layer. The dressings are most commonly available in sheets or pads with varying degrees of thickness. Semipermeable foam dressings are produced in adhesive and non-adhesive forms. Non-adhesive forms require a second dressing. Indications: used to provide protection and absorption over partial and full-thickness wounds with varying levels of exudate. They can also be used as a secondary dressing over amorphous hydrogels.

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Foams Advantages

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provides a moist environment for wound healing, available in adhesive and non-adhesive forms, provides prophylactic protection and cushioning, encourages autolytic debridement, provides moderate absorption

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Foams Disadvantages

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may tend to roll in areas of excessive friction, adhesive form may traumatize periwound area upon removal, lack of transparency makes inspection difficult

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Alginates Description

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Derived from seaweed extraction, specifically, the calcium salt component of alginic acid. Alginates are highly absorptive, but are also highly permeable and non-occlusive. As a result, they require a secondary dressing. These dressings as a hemostat and create a hydrophilic gel through the interaction of calcium ions in the dressing and sodium ions in the wound exudate. Indications: typically used on partial or full thickness draining wounds such as pressure or venous insufficiency ulcers. They are often used on infected wounds due to the likelihood of excessive drainage

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Alginates Advantages

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high absorptive capacity, enables autolytic debridement, offers protection from microbial contamination, can be used on infected or non-infected wounds, non-adhering to wounds

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Alginates Disadvantages

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may require frequent dressing changes based on the level of exudate, requires a secondary dressing, cannot be used on wounds with an exposed tendon, joint capsule, or bone