Types of Wound Dressings

Primary dressing

The dressing is applied directly to the wound.

Secondary dressing

The dressing is applied over the primary dressing.

Indications of Dressing by Wound Type

Indications of Wound Dressing
Indication	Dressing
Infected wounds	Gauze Alginates Hydrogels Hydrogel sheets Impregnated gauze Foams
Burns	Alginates Hydrocolloids Hydrogels Transparent films Impregnated gauze Foams Biological dressings Collagen
Stage 1 pressure ulcers	Transparent films Foams
Stage 2 pressure ulcer	Alginates Hydrocolloids Hydrogels Transparent films Impregnated gauze Foams Collagen
Stage 3 pressure ulcer	Alginates Hydrocolloids Hydrogels Impregnated gauze Foams Collagen
Stage 4 pressure ulcer	Alginates Hydrocolloids Hydrogels Transparent films Impregnated gauze Foams Collagen
Venous ulcer	Alginates Hydrocolloids Hydrogels Foams
Artrial ulcers	Alginates Hydrogels Foams
Diabetic ulcers	Alginates Hydrocolloids Transparent film Foams
Donor sites	Alginates Hydrocolloids Hydrogels Hydrogels sheets Transparent films Impregnated gauze Collagen

1. Gauze

• Use as a primary dressing (Fig. 1).

• Gauze leaves contaminating fibers in the wound.

• Gauze is permeable to bacteria and causes a loss of normothermia.

• Gauze is painful on removal from the wound surface.

• Gauze ribbon is used to maintain an opening for drainage in a tunneling wound and to support cavity wounds.

Fig. 1: Sample of gauze dressing.

2. Impregnated Gauze

• Impregnated gauze is less adherent to the wound surface.

• Use as a primary dressing.

• This is minimal absorptive, provides less protection, does not increase the moist environment, and creates a greasy wound bed.

• This is appropriate for new sutures to prevent them from catching or sticking in a gauze.

3. Transparent Films

• Films are made of a transparent membrane with an acrylic adhesive layer (Fig. 2).

• Transparent films do not allow bacteria or moisture into wounds.

• They facilitate;

• Moist wound environment

• Trapping of endogenous fluids in the wound bed to assist autolytic debridement.

• Wound bed homeostasis

• Angiogenesis

• Films assist in the protection of skin from the effects of shearing and friction.

• Removal of dressing is done with great caution because this can cause skin tears.

Fig. 2:  Application of a film dressing.

4. Foam

• Foams are highly absorbent pads or sheets of polyurethane (Fig. 3).

• Foams are available in various sizes.

• Foams are available with or without adhesive property so that they can be used as a primary or secondary dressing.

• Foams are highly absorptive but also help to create an occlusive environment for moist wound healing.

• The should not be used alone on the dry wounds but could use as a secondary dressing if primary dressings were gel products.

Fig. 3: Samples of foam dressings.

5. Hydrogels

• Hydrogels are amorphous liquid-like-gel or sheets, consisting of a thin flexible sheet of polymer containing 90% water (Fig. 4).

• They increase moisture in the dry wound bed.

• The amorphous gel must be contained in the wound with a secondary dressing.

Fig. 4: Application of hydrogel dressing.

6. Hydrocolloids

• Most occlusive of the moisture retention dressings (Fig. 5).

• Also available in less occlusive or semipermeable styles.

• Hydrocolloids are available in various shapes and sizes.

Fig. 5: Sample of hydrocolloid dressing.

7. Alginates

• Also known as calcium alginate because the dressing is manufactured using the calcium salts of alginic acid.

• The raw material is woven and converted into flat sheets, ropes, or ribbon shapes (Fig. 6).

• Alginates absorb 20 to 30 times their own weight.

• The chemical reaction between dressing and exudate creat get a substance that helps to maintain a moist wound environment while absorbing excess exudate.

• Alginates do not provide a barrier against bacteria.

Fig. 6:  Sample of alginate dressing.