Synthetic wound dressings
Synthetic wound dressings originally consisted of two types; gauze-based dressings and paste bandages such as zinc paste bandages. In the mid-1980s the first modern wound dressings were introduced which delivered important characteristics of an ideal wound dressing: moisture keeping and absorbing (e.g. polyurethane foams, hydrocolloids) and moisture keeping and antibacterial (e.g. iodine-containing gels).
During the mid 1990s, synthetic wound dressings expanded into the following groups of products:
- vapour-permeable adhesive films
- synthetic foam dressings
- silicone meshes
- tissue adhesives
- barrier films
- silver- or collagen-containing dressings
Ideal wound dressing
No single dressing is suitable for all types of wounds. Often a number of different types of dressings will be used during the healing process of a single wound. Dressings should perform one or more of the following functions:
- Maintain a moist environment at the wound/dressing interface
- Absorb excess exudate without leakage to the surface of the dressing
- Provide thermal insulation and mechanical protection
- Provide bacterial protection
- Allow gaseous and fluid exchange
- Absorb wound odour
- Be non-adherent to the wound and easily removed without trauma
- Provide some debridement action (remove dead tissue and/or foreign particles)
- Be non-toxic, non-allergenic and non-sensitising (to both patient and medical staff)
Classification of wound dressings
Synthetic wound dressings can be broadly categorized into the following types.
|Passive products||Traditional dressings that provide cover over the wound, e.g. gauze and tulle dressings|
|Interactive products||Polymeric films and forms which are mostly transparent, permeable to water vapour and oxygen, non-permeable to bacteria, e.g. hyaluronic acid, hydrogels, foam dressings|
|Bioactive products||Dressings which deliver substances active in wound healing, e.g. hydrocolloids, alginates, collagens, chitosan, keratin|
Wound types and dressings
The following table describes some of the many different types of wound dressings and their main properties.
|Polyurethane or silicone foams||
Different types of wounds and the different stages of a healing wound require different dressings or combinations of dressings. The following table shows suitable dressings for particular wound types.
The dressings may require secondary dressings such as absorbent pad and bandages.
Adverse effects of dressings
Wound dressings can cause problems, including:
- Maceration (sogginess) of surrounding skin (change dressing frequently and use a more absorbent dressing)
- Irritant contact dermatitis (protect skin with emollient or barrier film)
- Allergic contact dermatitis (uncommon: change dressing type, apply topical steroids)
- Surgical Dressings –Medscape Reference
- ABC of wound healing: Wound dressings. Vanessa Jones, Joseph E Grey, Keith G Harding. BMJ 2006;332:777-780, doi:10.1136/bmj.332.7544.777 Online
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