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Wound Dressings are used to cover wounds and are divided into different types depending on the type of wound. A Wound Dressing should provide a moist environment at the wound surface while absorbing blood and other fluids. This promotes wound healing and helps protect against bacterial infection and further injury.

Recent studies show that dressings can be left in place for several days. Problems arise when the exudate (fluid) from the wound builds up under the dressing causing the dressing to leak.

Various types of wound dressings

Plasters/Strips 

Plastic and fabric strips or plasters are designed to protect wounds against dirt and bacteria. Fabric plasters usually adhere to the skin strongly which is useful when applying to an active area of the body such as joints, e.g. elbows and knees. Plastic strips are less noticeable on the skin and are water-repellent. Water proof strips are also available. These flexible strips provide protection to the wound during bathing and swimming while still allowing air circulation to the wound. Soft and flexible strips have also been designed for adults and infants with sensitive skin. These strips are latex-free and painless to remove.

Tape

First aid tape is available for securing bandages and non-adhesive dressings to the skin. Elastic adhesive tape adheres strongly to the skin and paper tape is designed for more sensitive skin.

Spray on bandages

An aerosol spray is available for the management of grazes and scratches. The spray forms a transparent, breathable film over the wound that seals the area from water, dirt and bacteria. The spray is particularly useful for areas of the body where it is difficult to stick a traditional plaster e.g knuckles, feet, elbows and knees.

Occlusive film dressings 

Occlusive film dressings are made from a material which is clear and allows wound penetration. These dressings allow only oxygen and vapour to pass through and block the passage of water and bacteria. This allows oxygen to reach the wound site, which is necessary for healing, and helps to prevent infection. These dressings are flexible in many cases and are ideal to be placed over wounds at places on the body which are bent frequently such as at a limb joint e.g. the elbow.

Film dressings are indicated as the most suitable dressing for minor burns, simple injuries e.g. abrasions, lacerations, scalds and cuts and as a post operative layer over sutured wounds that are dry. Film should not be applied to weeping wounds or damaged or fragile skin as its removal may cause trauma.

Hydrocolloids

Hydrocolloids are adhesive and do not allow water or air to pass through to the wound site. When the inner layer of the dressing comes into contact with fluid from the wound a gel is formed which helps to prevent leaking from the dressing. These types of dressings provide an excellent seal around the wounds and can also protect areas against pressure. Fluid from the wound is absorbed by the hydrocolloid dressing which helps to keep the wound clear of dead skin and the nerve endings moist. Initially the injury might become smelly and appear to enlarge. It is important to choose a dressing which is at least 2cm larger than the wound. This will help when changing the hydrocolloid covering if there is any leakage of gel. The types of wounds which indicate this type of dressing include leg ulcers, minor burns, pressure areas and many types of granulating wounds. Hydrocolloids can be used on a red granulating wound. This type of dressing used for a partial or full thickness wound is in the form of a hydrocolloid paste or powder covered by a hydrocolloid sheet. Hydrocolloid dressings are sometimes used to help replace fluids lost from blackened, dead skin e.g., burns. These types of dressings are not recommended for infected wounds and wounds which have a large amount of exudate.

Alginate

Alginate dressings are derived from seaweed. The alginate fibres react with the sodium ions in the wound forming sodium alginate resulting in the formation of an inert (inactive) aqueous gel. Alginates also act to slow the bleeding from a wound and are used in acute bleeding wounds and post surgical wounds particularly in the nasal area. These types of dressings can absorb large amounts of pus and debris and can be applied to infected wounds. Alginate dressings are often used when a cavity wound needs to be packed. When to change this type of wound dressing is dependent on the amount of pus and/or fluid absorbed.

Hydrogels

Hydrogel dressings are the newer type of dressings and have a two fold function: to act as a moisture donor and to absorb a certain amount of fluid. The dressings consist of clear aqueous gels containing polymers which can absorb large amounts of fluid from wounds. Film dressings can be used as a secondary dressing, but foam is also used. Hydrogels help to keep a wound moist and can be placed over gels to keep the gel in place so that frequent dressing changes are not necessary. The latest types allow the passage of water, vapour and oxygen and are used for both minor and more serious wounds. Hydrogels are used in a partial or full thickness wound where there is low or no exudate. These types of dressings are not to be used on a wound which has a high amount of exudate or on a red granulating wound.

Absorptive foams 

The foam dressings are available in sheets and are used to absorb liquid which is drawn by capillary action to the back of the dressing and evaporates into the air. There are different types of foam dressings from single foams to multiple layer foams. It is suggested that foam dressings can be left in place for up to seven days depending on the amount of fluid being produced by the wound.

Absorptive beads 

The absorptive beads are made of polysaccharide (starchy substance) and readily absorb moisture when placed in wounds. The fluid from the wound includes bacteria and debris which is absorbed by the beads allowing the wound to be kept clean. The beads also help to keep the wound clear of dead skin and allows the application of other dressings. On the occasion of a granulating wound absorptive beads are not suggested.

Charcoal dressings 

Charcoal is also a combination product in both alginate and foam dressings. They are used to help deodorise wounds producing pus which can often have an offensive odour. An example of such a wound is a gangrenous lesion. Unfortunately these dressings do not maintain a moist environment and have to be changed frequently.

DISCLAIMER: This information is an educational aid only. It is not intended to replace medical advice for individual conditions or treatments. Talk to your doctor, pharmacist, nurse or naturopath before following any medical regimen to see whether it is safe and effective for you.