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Facts about the skin from DermNet New Zealand Trust. Topic index: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z


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:

Silver-containg dressing Silver-containg dressing Silver-containg dressing
Silver 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:

Classification of wound dressings

Synthetic wound dressings can be broadly categorized into the following types.

Type Properties
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.

Dressing type Properties
Gauze
  • Dressings can stick to the wound surface and disrupt the wound bed when removed
  • Only use on minor wounds or as secondary dressings
Gauze
Tulle
  • Dressing does not stick to wound surface
  • Suitable for flat, shallow wound
  • Useful in patient with sensitive skin
  • E.g. Jelonet®, Paranet®
Tulle
Semipermeable film
  • Sterile sheet of polyurethane coated with acrylic adhesive
  • Transparent allowing wound checks
  • Suitable for shallow wound with low exudate
  • E.g. OpSite®, Tegaderm®
Transparent film dressings
Hydrocolloids
  • Composed of carboxymethylcellulose, gelatin, pectin, elastomers and adhesives that turn into a gel when exudate is absorbed. This creates a warm, moist environment that promotes debridement and healing
  • Depending on the hydrocolloid dressing chosen can be used in wounds with light to heavy exudate, sloughing or granulating wounds
  • Available in many forms (adhesive or non-adhesive pad, paste, powder) but most commonly as self-adhesive pads
  • E.g. DuoDERM®, Tegasorb®
Hydrocolloid dressings
Hydrogels
  • Composed mainly of water in a complex network or fibres that keep the polymer gel intact. Water is released to keep the wound moist
  • Used for necrotic or sloughy wound beds to rehydrate and remove dead tissue. Do not use for moderate to heavily exudating wounds
  • E.g. Tegagel®, Intrasite®
Hydrogel dressing
Alginates
  • Composed of calcium alginate (a seaweed component). When in contact with wound, calcium in the dressing is exchanged with sodium from wound fluid and this turns dressing into a gel that maintains a moist wound environment
  • Good for exudating wounds and helps in debridement of sloughing wounds
  • Do not use on low exudating wounds as this will cause dryness and scabbing
  • Dressing should be changed daily
  • E.g. Kaltostat®, Sorbsan®
Alginate dressings
Polyurethane or silicone foams
  • Designed to absorb large amounts of exudates
  • Maintain a moist wound environment but are not as useful as alginates or hydrocolloids for debridement
  • Do not use on low exudating wounds as this will cause dryness and scabbing
  • E.g. Allevyn®, Lyofoam®
Foam dressings
Hydrofibre
  • Soft non-woven pad or ribbon dressing made from sodium carboxymethylcellulose fibres
  • Interact with wound drainage to form a soft gel
  • Absorb exudate and provide a moist environment in a deep wound that needs packing
Hidrofibre dressing
Collagens
  • Dressings come in pads, gels or particles
  • Promote the deposit of newly formed collagen in the wound bed
  • Absorb exudate and provide a moist environment

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.

Wound type Dressing type
Ulcer Clean, medium-to-high exudate (epithelialising)
  • Paraffin gauze
  • Knitted viscose primary dressing
Ulcer Clean, dry, low exudate (epithelialising)
  • Absorbent perforated plastic film-faced dressing
  • Vapour-permeable adhesive film dressing
Ulcer Clean, exudating (granulating)
  • Hydrocolloids
  • Foams
  • Alginates
Ulcer Slough-covered
  • Hydrocolloids
  • Hydrogels
Ulcer Dry, necrotic
  • Hydrocolloids
  • Hydrogels

The dressings may require secondary dressings such as absorbent pad and bandages.

Adverse effects of dressings

Wound dressings can cause problems, including:

Related information

References:

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Author: Vanessa Ngan, staff writer

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If you have any concerns with your skin or its treatment, see a dermatologist for advice.