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tendency for wound exudate to percolate through a dressing, allowing bacterial ingress through the dressing and colonization of the wound surface (see Table 1)
Table 1: Types of wound dressings and indications for their use
Dressing TypeFeaturesIndicated Use
Primary Wound-Dressing Films
Semi-permeable adhesive filmNon-absorbent
Non-adherent to wound surface
Gas and water vapour permeable, but impermeable to water
Transparent, allowing observation of wound
Low exudating wounds
Perforated film, absorbentLow adherence (absorbent pad covered by perforated film)
Low exudating wounds
Low-adherent Wound Contact Layers
Unmedicated viscoseNon-absorbent; non-sheddingNon-adherent primary dressing
Medicated tulleLow-adherent polyethylene glycol or paraffin impregnated tulle incorporating an antiseptic (e.g.: chlorhexidine gluconate; iodine)Topical antisepsis
Semi-permeable hydrogelsHydrophilic polymers in either sheet or amorphous formulations
Highly absorbent
Gas permeable, but impermeable to water
Dressing surface may dry out, and thus requires rehydration with saline
Removal of slough
Rehydration of dry, necrotic tissue to allow its later sharp debridement
Absorption of heavy exudation
Carrier of topical antimicrobials (e.g.: metronidazole)
HydrocolloidsInteractive (form a gel when in contact with wound surface)
Usually formulated with an occlusive, water-repellent backing
Promote an acidic and hypoxic wound environment, and facilitates neoangiogenesis
Not suitable for infected wounds
Maintain a moist, temperature controlled wound environment
AlginatesSeaweed derivatives which form a hydrophilic gel in contact with the wound surface
Require irrigation to remove from wound surface
Absorption of exudation
Moisten with saline before application
Polyurethane foamsSmooth low-adherent wound contact layer backed with hydrophobic foam
Highly gas-permeable
Maintain a moist wound environment and good thermal insulation
Absorption of moderate exudation
Outer layer prevents ‘strike through’
Silver agentsSilver ions impregnated into dressing
Antibacterial action
Topical antisepsis, including resistant forms