Which dressings are indicated for care of wounds surrounded by fragile skin?

Updated: Apr 24, 2020
  • Author: Brian J Daley, MD, MBA, FACS, FCCP, CNSC; Chief Editor: Zubin J Panthaki, MD, CM, FACS, FRCSC  more...
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Answer

Hydrogel sheets and nonadhesive forms are useful for securing a wound dressing when the surrounding skin is fragile.

Table 1. Characteristics and Uses of Wound-Dressing Materials (Open Table in a new window)

Category

Examples

Description

Applications

Alginate

AlgiSite, Comfeel, Curasorb, Kaltogel, Kaltostat, Sorbsan, Tegagel

Alginate dressings are made of seaweed extract contains guluronic and mannuronic acids that provide tensile strength and calcium and sodium alginates, which confer an absorptive capacity. Some can leave fibers in the wound if they are not thoroughly irrigated. These dressings are secured with secondary coverage.

These dressings are highly absorbent and useful for wounds have copious exudate. Alginate rope is particularly useful to pack exudative wound cavities or sinus tracts.

Hydrofiber

Aquacel, Aquacel-Ag, Versiva

An absorptive textile fiber pad, hydrofiber is also available as a ribbon for packing of deep wounds. This material is covered with a secondary dressing. The hydrofiber combines with wound exudate to produce a hydrophilic gel. Aquacel-Ag contains 1.2% ionic silver that has strong antimicrobial properties against many organisms, including methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci.

Hydrofiber absorbent dressings used for exudative wounds.

Debriding agents

Hypergel (hypertonic saline gel), Santyl (collagenase), Accuzyme (papain urea)

Various products provide some chemical or enzymatic debridement.

Debriding agents are useful for necrotic wounds as an adjunct to surgical debridement.

Foam

LYOfoam, Spyrosorb, Allevyn

Polyurethane foam has absorptive capacity.

These dressings are useful for cleaning granulating wounds with minimal exudate.

Hydrocolloid

CombiDERM, Comfeel, DuoDerm CGF Extra Thin, Granuflex, Tegasorb

Hydrocolloid dressings are made of microgranular suspension of natural or synthetic polymers, such as gelatin or pectin, in an adhesive matrix. The granules change from a semihydrated state to a gel as the wound exudate is absorbed.

Hydrocolloid dressings are useful for dry necrotic wounds, wounds with minimal exudate and for clean granulating wounds.

Hydrogel

Aquasorb, DuoDerm, Intrasite Gel, Granugel, Normlgel, Nu-Gel, Purilon Gel, KY Jelly

Hydrogel dressings are water-based or glycerin-based semipermeable hydrophilic polymers; cooling properties may decrease wound pain. These gels can lose or absorb water depending upon the state of hydration of the wound. They are secured with secondary covering.

These dressings are useful for dry, sloughy, necrotic wounds (eschar).

Low-adherence dressing

Mepore, Skintact, Release

Low-adherence dressings are made of various materials designed to remove easily without damaging underlying skin.

These dressings are useful for acute minor wounds, such as skin tears, or as a final dressing for chronic wounds that have nearly healed.

Transparent film

OpSite, Skintact, Release, Tegaderm, Bioclusive

Transparent films are highly conformable acrylic adhesive films with no absorptive capacity and little hydrating ability. They may be vapor permeable or perforated.

These dressings are useful for clean, dry wounds with minimal exudate. They also are used to secure an underlying absorptive material, to protect high-friction areas and areas that are difficult to bandage (eg, heels) and to secure intravenous catheters.


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