Wound dressings play an essential role in wound care and healing. What you might not know is there are a wide variety of different types of wound dressings, each with its own unique characteristics that make them suitable for specific wounds. In fact, there are more than 3,000 different wound dressings to help address all the different aspects of wound care.
While a wound care specialist can help you determine the appropriate dressing for your wound, having a thorough understanding of the different types of dressings and when to use them can be crucial in promoting wound healing and preventing complications.
Wound dressings are materials applied to wounds to promote healing, protect them from infection, and prevent further injury. They come in different forms and types; each with its own purposes and benefits. That said, the primary function of wound dressings is to provide a moist environment for wound healing, which promotes the growth of healthy cells and facilitates the process of healing.
Let's take a deeper look at some of the most common traditional and modern wound dressings often used in wound care. It's important to note that some wound dressings may not be suitable for all types of wounds, and it's always best to consult with a wound care specialist to determine the best course of treatment for a particular wound.
Gauze dressings are a type of traditional wound dressing made of woven cotton or synthetic fibers. They are versatile, inexpensive, and readily available, making them a popular choice for wound care. They can be used alone or in combination with other dressings to absorb wound exudate (the liquid secreted by wounds during the healing process, otherwise known as pus) and provide a protective barrier to the wound bed. However, they are not suitable for several types of serious wounds, as they can dry out and stick to the area, causing trauma and delaying the healing process.
Examples where gauze wound dressings might be used:
Covering and protecting superficial wounds, such as abrasions or lacerations.
Absorbing wound drainage from surgical incisions or lacerations.
Applying topical medications to wounds using impregnated gauze dressings.
Covering and protecting second-degree burns.
Dressing pressure ulcers or chronic wounds with light drainage.
Packing deep wounds or cavities with plain gauze to help control bleeding and promote clotting.
Non-adherent dressings are designed to minimize trauma and pain during dressing changes. They are made of materials that don't stick to the wound, such as silicone or low-adherent fabrics. These types of dressings can be used for wounds with delicate or fragile tissue, such as burns, skin grafts, and donor sites. However, they may not be suitable for heavily exudating wounds or infected wounds, as they can create a warm and moist environment that encourages bacterial growth.
Examples where non-adherent dressings might be used:
Superficial wounds such as abrasions.
Protect burns from further damage.
Donor sites where the skin has been removed for grafting.
Postoperative wounds to help protect the area.
Hydrocolloid dressings are absorbent pads with a strong adhesive back, often used for low to moderate exudating wounds. The gel-forming agents in these dressings are highly absorbent and help keep the area moist. They help protect the wound from contamination, reduce pain, and promote wound healing.
Examples where Hydrocolloid dressings might be used:
Pressure ulcers
Diabetic foot ulcers
Minor or superficial burns
Abrasions
Skin tears
Donor sites
Often made from polyurethane foam, foam dressings are often used for moderate to severe wounds. These dressings have a soft, cushioning effect and absorb a large amount of wound exudate, which helps reduce the risk of maceration.
Examples where foam dressings might be used:
Venous leg ulcers
Pressure ulcers
Diabetic foot ulcers
Surgical wounds
Traumatic wounds
Skin tears
Fistulas
Alginate dressings are made from seaweed and contain calcium and sodium ions that create a gel-like substance when in contact with a wound.
Examples where alginate dressings might be used:
Moderate to heavily exudating wounds
Surgical wounds
Traumatic wounds
Partial thickness burn wounds
Manage sinus tracts
Transparent film dressings are thin, transparent, and waterproof, allowing for wound observation without removing the dressing. They are often made from polymer membranes that allow oxygen to reach the wound while vapor is released. Transparent film dressings can help reduce pain and protect the wound from contaminants while it's healing.
Examples where Transparent film dressings might be used:
Superficial wounds
Secure and protect IV sites
Skin tears
Pressure ulcers
Donor sites
Protect post-surgical incisions
Hydrogel dressings are composed of water or glycerin and create a moist wound environment conducive to wound healing. Hydrogel dressings are a common choice for dry wounds with minimal drainage, as they can help prevent desiccation, promote autolysis, and reduce wound pain.
Examples where hydrogel dressings might be used:
Hydrate dry or dehydrated wounds
Manage partial thickness burn wounds
Pressure ulcers
Donor sites
Radiation dermatitis
Necrotic wounds
This type of wound dressing contains collagen, a protein found in the human body that facilitates healing. These dressings can be derived from animal or human sources, and are available in various forms, including gels, powders, and sheets. Collagen wound dressings can help reduce inflammation, and provide a protective barrier around the wound. However, they may not be suitable for wounds with excessive exudate, as they can become saturated and lose their effectiveness. Additionally, collagen wound dressings may not be appropriate for individuals with allergies to collagen or other animal-derived products.
Examples where collagen dressings might be used:
Chronic wounds
Surgical wounds
Deep burn wounds
Acute wounds
Wounds with granulation tissue
SCICO CARE are exported all over the world and different industries with quality first. Our belief is to provide our customers with more and better high value-added products. Let's create a better future together.
Silver wound dressings contain silver, a natural antimicrobial agent that can help prevent and treat wound infections. These dressings may contain silver in various forms, including ions, particles, or compounds, and are available in different applications, such as gels, foams, and films. While effective in some cases, prolonged use of silver wound dressings may lead to silver toxicity, which can cause skin discoloration, impaired wound healing, and other adverse effects. As such, it is important to use silver wound dressings under the guidance of a healthcare professional or wound care specialist.
Examples where silver dressings might be used:
Infected wounds
Chronic wounds
Burn wounds
Surgical wounds
Trauma wound
Composites wound dressings are a type of dressing that combines different materials, such as foam, hydrocolloid, and alginate, into a single dressing. These dressings are designed to provide a combination of benefits, such as absorption, moisture control, and protection, and are often used in the management of complex wounds. Composites wound dressings are particularly useful for wounds with multiple stages of healing, or for wounds that have different needs at different stages of healing. They may also be used to manage wounds with complex drainage patterns, such as fistulas or sinuses.
Specialized wound dressings are used for specific types of wounds, often during extremely serious cases. Only medical professionals administer them. Specialized wound dressings may include:
Negative pressure wound therapy (NPWT) dressings
Biological dressings
Bioengineered skin dressings
NPWT dressings are advanced dressings that use negative pressure to remove excess fluid. It uses subatomic pressure to decrease exudate caused by inflammation.
Biological dressings are made from human or animal tissue or other natural sources and are used to encourage healing in severe wounds. Bioengineered skin dressings are autografts typically grown from the skin cells of the patient and are used to replace lost skin tissue.
The appropriate wound dressing to use largely depends on various factors such as the wound type, the stage of healing, and the site of the injury. Wounds dressed at home will be far different from wounds dressed in a professional, wound care center. As referenced above, it's always recommended to consult a wound specialist on the type of dressing and recommendations on changing them.
Superficial wounds can typically be treated at home with simple dressings like gauze, plasters, bandages, and cotton wool. However, these traditional dressings can, at times, hurt when removed, as they usually adhere to the wound. They also do not provide a moist environment on their own, which is why it's important to use a wound-healing gel or topical cream so that the site of the broken skin remains moisturized.
Deep wounds may require advanced dressings like foam or alginate. Some of these can be bought over the counter and administered at home, but if the wound is deep or is at risk of infection, it is best to get a specialist to do it. Depending on whether the wound is secreting, needs drainage, is burning, or has a variety of other factors, a suitable dressing is determined.
Dressings for more serious wounds can vary depending on the type of injury. For example:
can benefit from collagen dressings
may be treated with silver dressings
are typically treated with specialized dressings that provide cooling and pain relief
can be treated with dressings that reduce pressure on the affected area
typically require dressings that promote healing and prevent infection
may require specialized dressings for tissue regeneration
may also require special dressings that promote healing and protect against infection
When you get a cut, scrape, or any other type of wound, it's vital to take care of it properly to help it heal and prevent infection. Here are a few additional tips for proper wound care dressing:
Choose the Right Type of Wound Dressing
Choosing the right dressing is essential to ensure that your wound heals properly and to prevent the risk of infection. Factors such as the type of wound, the stage of wound healing, and the amount of fluid or exudate produced by the wound should be considered when selecting a dressing.
Clean the Wound Before Applying the Dressing
Before applying a wound dressing, it's necessary to ensure the wound is thoroughly cleaned. You can do this with mild soap, water, or saline solution. Cleaning properly helps to remove any dirt or debris that may be present and also reduces the risk of infection. This step might be painful, so remember to be gentle.
Use Proper Application Techniques
Proper application techniques are essential for promoting healing and preventing complications. Follow the instructions provided with your wound dressing and change it as needed to ensure that your wound stays clean and protected.
Monitor the Wound for Signs of Infection
Keep an eye on the wound for any signs of infection. If you notice it before it gets worse, you'll likely save yourself a lot of trouble in the long run. Some common signs of concern can include redness, swelling, or pus. If you notice any of these symptoms contact your wound care specialist right away.
Seek Medical Attention If Necessary
If you have a deep or severe wound, it can get worse and result in severe complications if left untreated. If you have any concerns about your wound or your wound dressing, please seek medical attention from a wound care specialist who can treat you properly.
If you have suffered from a wound or would like to learn more about what type of dressing you should be using the expert team at West Coast Wound Center is here to help. We are committed to providing high quality care to every patient we serve and can help put you on the path to healing. Book an appointment today.
The aim of this article is to describe a practical guide for choosing appropriate dressings when treating acute open wounds in general practice.
Although dressing is an essential element of standard wound care, it is important to remember that dressing alone does not heal the wound. Judicious selection of dressings based on wound characteristics, physical properties of dressings and their costs, shelf life and availability are important for delivering appropriate care towards timely healing of acute wounds.
A superficial open wound with loss of epithelial lining is described as an ulcer. However, the words 'open wound' and 'ulcer' are often used interchangeably. In this article, an acute wound/ulcer is defined as an injury to the skin that occurs suddenly following an accident or surgical injury and is expected to heal through an orderly and timely reparative process.1,2
Patients with acute wounds of the skin (eg minor cuts, lacerations, puncture wounds, skin tears, animal bites, small burns) constitute a significant proportion of patients who present to general practice. Patients with diabetes may present with small and minor skin breakdowns, as these minor wounds have the potential to become serious and require attention to address systemic issues as well. The appropriate treatment of acute wounds involves avoiding deterrents to normal healing and preventing complications that may lead to conversion to a chronic wound,2 which is a major burden on the healthcare system. In Australia, the estimated annual cost was $3 billion in .3
Teaching of wound care, including selection of wound dressings, as part of the undergraduate medical curriculum occurs in some medical schools4 and remains an area of concern among doctors entering general practice.5 The focus of this article is to provide a practical overview for general practitioners (GPs) when choosing an appropriate dressing for acute open wounds, with the assumption that holistic assessment of the patient and the wound, and other important aspects of treatment (eg tetanus prophylaxis, need for antibiotics, wound cleansing and debridement),6,7 have been addressed.
Dressings for puncture wounds/needlestick injuries and animal/human bites are not included here because of their complex management, often requiring non-GP specialist consultation and care. Descriptions of dressings for post-surgical wounds6 and minor burns in general practice8 are available in earlier issues of Australian Journal of General Practice and Australian Family Physician.
Although dressing is an essential element of standard wound care, it is important to remember that dressing alone does not heal the wound.
Ideally a wound dressing aims to promote healing or prevent further tissue damage. A good dressing accomplishes multiple goals, including providing an appropriate level of moisture and serving as a barrier to bacterial invasion. Additional benefits of an ideal dressing may include thermal insulation, debridement, enzymatic and growth factor supplementation, gas exchange facilitation and protection of free nerve endings to reduce pain.9
The French military surgeon Ambroise Paré revolutionised the field of wound dressings when he abandoned the use of boiling oil and successfully applied his own concoction of egg yolk, rose oil and turpentine on wounds.10 Much later, the experimental work of George Winter in led to the foundation of modern-day moisture-retaining semipermeable dressings.11
Normal wound healing follows a typical pattern of progression: haemostasis, inflammation, proliferation and remodelling. In open cutaneous wounds, it is usually described in three processes: epithelialisation, connective tissue deposition and contraction.12 No single dressing is suitable for the management of all types of wounds. Dressings may need to be selected depending on the wound's stage in the healing cycle. Hence, an understanding of the healing process combined with knowledge of the properties of the various available dressings is essential.
Wounds covered with moisture-retentive dressings and ointments heal faster than exposed or traditional gauze-covered wounds.13 Occlusive dressings allow for maintenance of a balanced moist environment on the ulcer surface. The natural moisture in a wound contains proteins and cytokines that facilitate autolytic debridement, angiogenesis, formation of granulation tissue and keratinocyte migration.14
The ideal wound dressing should facilitate collagen synthesis and epithelial regeneration by removing deterrents that delay healing, including bacteria, exudate, external trauma and other barriers.15 It should also have a prolonged storage time, be inexpensive and have minimal or no antigenicity, toxicity or carcinogenicity.12 Involving patients in dressing choices helps to maximise compliance, ensures minimising impact of dressings on activities of daily living16 and optimises follow-up care through telehealth, when deemed suitable.
Dressings can be divided into several generic categories.17 Described here are the commonly used dressings suitable for acute open wounds (Table 1) from their initial stage of haemostasis (day one) to epithelialisation (approximately on day 12), with a summary in Table 2. Dressings may be left intact for up to seven days depending on the wound type and location, assessment of the wound bed and patient, the volume of exudate and the ability of the dressing to contain the exudate and protect the surrounding skin. Disturbances to wound temperature and granulating tissue is minimised by less frequent dressing changes.17
Dressing types include the following:
Table 1. Wound categories with recommended dressings
Wound type
Dressings recommended
Special comments
Skin tears Apply silicone-covered foam dressing directly over the wound.Table 2. Dressing types
Dressing class (generic)
Purpose/action
Limitations and cautions
Wear time
Films Permeable to gas but impermeable to bacteria and liquid. Useful on superficial wounds with minimum exudate. May be traumatic on removal. 1'4 days Foam Suitable for moderately exudating wounds, skin tears, skin grafts and donor sites. Nonsilicone types should be avoided in patients with fragile skin. Up to seven days Low adherence, low-absorbent dressing Passive breathable dressing for low-exudating wounds.The issue of wound care costs in general practice has been highlighted by Whitlock et al19 as representing a financial burden for care providers. Australian general practice faces a dilemma over how best to involve GPs and practice nurses in treating wounds and in choosing between affordable lower quality dressings or expensive higher quality dressings. Some dressings for chronic wounds and ulcers are subsidised under the Repatriation Pharmaceutical Benefits Scheme (RPBS) for eligible Department of Veterans' Affairs (DVA) card holders. Referral to community nursing services may also provide patients with a range of dressing options for a service fee that may include dressing costs.
Telemedicine is defined as 'the use of electronic information and communication technologies to provide and support health care when distance separates the participants'. Although evidence for telemedicine in acute wound care in the general practice setting is lacking, it is an area worth exploring, especially in the context of the COVID-19 pandemic.21 Studies on teledermatology for diagnosis and management of skin conditions22 and telemedicine follow-up care of leg and foot ulcers23 support this initiative. A few recent studies have shown that telehealth has a positive impact on wound healing, reducing healing time and improving patient satisfaction.24
Limitations of telehealth include lack of patient or doctor familiarity with the software, or lack of software availability in offices. Furthermore, while telehealth allows inspection of a wound, the practitioner is unable to conduct a more detailed examination. In this regard, during the initial consultation, demonstrating change of dressings with some wound photographs to the patient is advisable. The involvement of auxiliary members of the healthcare team, such as community nurses in the local network, would facilitate caring for the patient with the wound.
Initial dressing selection for patients with acute open wounds is important for their timely healing to prevent progression to a chronic wound, which is more difficult and expensive to treat. The process of selecting dressings may seem daunting, with numerous existing options. This article provides an evidence-informed practical guide to dressing selection for acute open wounds in the context of busy general practice.
Are you interested in learning more about Cotton Dressing? Contact us today to secure an expert consultation!