Wound Dressings

Dr. Joel ArudchelvamConsultant Vascular and Transplant Surgeon

Wound dressings

• The material which is applied to the surface of the wound to cover it is called a dressing. – 1ry – dressing which touches the wound– 2ry – dressing used to cover the primary dressing

Ideal wound dressing Dressings are applied to wounds for the following reasons; • To provide a protective cover • To maintain moisture • To reduce pain • To absorb exudates

In addition an ideal dressing have the following features; • does not induce pain or itching • easy to change • Allows gaseous exchange • Cheap • Freely available

Types of Wound Dressings• Gauze dressings• Tulle • Hydrocolloid dressings• Hydrogel dressings• Alginate dressings• Foam dressings• Transparent film dressings• Etc.

Gauze

• Cheap • Freely available

• Dry• Painful on removing• Damages epithelium

Tulle

• Cheap • Freely available• Easy removal– E.g : Vaseline

Hydrocolloid Dressings

Hydrocolloid Dressings

• Made up of pectin based material• Absorb exudate• Occlusive – should not be used on infected

wounds• Come in various shapes and sizes

Hydrogel Dressings

Hydrogel Dressings

• Made up of primarily water in a polymer to maintain moist wound base

• used in dry wounds• Should not be used in exudating wounds

Alginate Dressings

Alginate Dressings

• Made up of seaweed

• Absorb moderate amounts of drainage

• becomes a gel when it comes into contact with

wound fluid through Calcium/Sodium ion exchange

Foam Dressings

Foam Dressings

• Made up of polyurethane foam• Absorbs moderate to large amounts of fluid• Available in various sizes and shapes• Some types my macerate peri wound skin if it

allows drainage laterally

Silver Dressings

• Antimicrobial to reduce bio burden of wound through slow release of silver ion into the wound

• e.g. Acticoat, Biatin Ag, Atruman Ag

Vacuum assisted closure VAC

Vacuum assisted closure VAC

Vacuum assisted closure VAC• Macrostrain - visible stretch that occurs when negative pressure contracts

the foam.

– Draws wound edges together– Provides direct and complete wound bed contact– Evenly distributes negative pressure– Removes exudate and infectious materials

• Microstrain - micro deformation at the cellular level

– Reduces edema– Promotes granulation tissue formation by facilitating cell migration and

proliferation

Vacuum assisted closure VAC

• Indications for use– Large wounds– Cavities – Large amount of exudate

Summary

Wound type Dressing

Dry Hydrocolloid, Hydrogel

Exudating wound Hydrocolloid, foam

Slough Hydrocolloid, hydrogels

Dead space / cavity Alginate, foam

When to change dressings

• When there is an indication to change– Soaking– Pain– Need to inspect

• Discuss with doctor before changing

Avoid in chronic wounds

• Iodine (Betadine)• Hydrogen peroxide• Other toxic agents

Avoid

• Do not tie gauze bandage tightly around limbs, digits – causes ischaemia

• Use – plaster , crepe instead

Thank You