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Dressing Wounds

Dressings by wound type


Granulating wound (red) dressings that keep wound warm and moist allowing tissue growth and absorb exudate (e.g. hydrocolloid, alginate, foam)
Epithelialising wound (pink) dressings that keep wound warm and moist allowing tissue growth (e.g. low-adherent tulle/textile, hydrocolloid, semi-permeable film)
Partial-thickness burns as above; for simple burns, low-adherent impregnated tulle gauze (e.g. Jelonet layers with secondary dressing) review in 1-2 days
Necrotic/sloughy dressing that debrides dead tissue, retains moisture and absorbs exudate (e.g. hydrocolloid, hydrogels) review in 3-4 days
Highly exudative wound absorbent dressing (e.g. fibrous hydrocolloid, alginate) review in 3-4 days
Infected wound dressing that inhibit bacteria and absorb exudate (e.g. antimicrobial dressings) review in 1-2 days
Cavity allow to granulate from bottom up (e.g. hydrogel, foam)
Venous ulcer low adherent tulle/textile
Temporary dressing for large open wound saline soaked large non-adherent absorbent dressings with thick sterile absorbent pads above (secure with bandages)
Closed wound non-adherent absorbent dressing secured with bandages/dressing fixing tape, or large plaster

Dressing layers
1. PRIMARY DRESSING = dressing in contact with wound
2. SECONDARY DRESSING = sterile absorbent pad (i.e. non-adherent absorbent dressing e.g. Telfa/Melolite, or simple gauze) required if primary dressing is not
absorbent
3. SECURING LAYER = something to secure dressing in place (i.e. dressing fixing tape e.g. Hypafix, or bandages) required if dressing is not secure or does not fully
protect the wound from contamination

Types of Dressings Available most common dressings (in bold) are pictured
Dressing class Some examples Definition Key properties Wound types
Simple
Simple gauze Simple gauze Basic cotton-woven gauze Stick to wound and disrupt it when Rarely used as primary dressing mainly
removed used as secondary dressing inner layer
Can be soaked with saline or betadine etc
Wet-to-dry to debride dirty wounds, or
wet-to-wet to moisten
Non-adherent Telfa Absorbent pad which will not Moderately absorbent Closed wounds e.g. post-stitches
absorbent pad Melolite adhere to wound Used as secondary dressing inner layer
dressing
Low-adherent Jelonet Non-adherent moist single gauze Cheap Simple superficial wounds healing by
impregnated Atrauman layer impregnated with paraffin Allow exudates to pass through (dont secondary intention (with low exudates)
Bactigras
tulle gauze or equivalent absorb any) Burns (use multiple layers)
Paranet
Very low adherence to wound
(changed every *Require secondary dressing
2-3 days)

Semi- Hydrofilm Plastic film coated with Transparent primary wound cover Simple flat shallow wounds with low
permeable Tegaderm hypoallergenic adhesive Creates moist wound environment by only exudate or epithelialising wound
Bioclusive
adhesive films being permeable to air and vapour
Mefilm
Adheres to healthy skin, not wound
(changed every No ability to absorb exudate
5-7 days) Flexible therefore good for moving skin e.g.
joints
Moistening
Hydrocolloids Hydrocolloid sheets Hydrocolloid sheets Film completely impermeable so can Dry wounds only
Alione Adhesive colloid coated film on rehydrate dry skin for re-epithelisation Hydrocolloid sheets
CombiDERM
(changed every plaster that absorbs exudate and Colloid forms gel on wound surface Flat shallow or cavity wounds with
Combifeel
3-5 days) Hydrocolloid fibres swells promotes healing low/medium exudate
Aquacel Hydrocolloid fibres Comfortable Clean, granulating or necrotic wounds
Non-woven sheet converts to a Hydrocolloid fibres can absorb a lot of Minor burns, pressure sores, ulcers
gel sheet on contact with exudate Hydrocolloid fibres
exudate Any medium to high exudate wounds
*Require secondary dressing
Hydrogels Aquaform Polymer matrix gel liquid Can donate water molecules to the wound Standard management for sloughy or
Intrasite containing up to 96% water to maintain moist wound necrotic wounds
(changed every squeezed on to wound Absorb some exudate Shallow low to medium exudate wounds
1-3 days) Promote wound debridement by *Require secondary dressing
rehydration of dead tissue
Absorbent
Foam dressings Adhesive sheets Polyurethane or silicone foam Very absorbent Regular foams
Allevyn adhesive pad with or without adhesive Provide cushioning Flat shallow wounds control of exudate
Biatain adhesive
(changed every plaster. Maintain moist environment but not used Cavity foams
Non-adherent sheets
5-7 days) Allevyn for wound debridement Cavities with medium/high exudates
Liofoam Some cavity foams are liquids *Require secondary dressing
Cavity foams poured in that contain foam
Cavi-care chips to fill cavities
Allevyn cavity
Alginates Kaltostat Dressings made from alginic acid Can absorb 15-20x their weight in fluid Any highly exudating wound
Algisite salts (from seaweed) that swell Trap bacteria Venus ulcers, severe pressure ulcers
Algosteril
(changed every and form a gel with exudate Gel creates moist environment Can pack cavities
2-7 days) Should not sit on peri-wound skin Bleeding wounds
Encourage haemostasis *Require secondary dressing
Debriding
Antimicrobial Silver Dressings may be impregnated Debride wounds Dirty/colonised/locally infected
dressings Acticoat with antimicrobials such as: wounds
Arglaes
(changed every Silver Silver may be used on burns
Avance
day) Iodine Iodine absorb exudate while
Inadine iodine is slowly released *Require secondary dressing
Iodoflex

2014 Dr Christopher Mansbridge at www.OSCEstop.com, a source of free OSCE exam notes for medical students finals OSCE revision