Dr.

Clare Fenwick, 2010

Aim of wound dressings

Heal, prevent infection and manage exudate
Protect wound and surrounding tissue
Reduce pain and minimise client distress
Maintain wound temperature
Manage potential or actual haemorrhage
Manage wound odour
Immobilise an injury

Dr. Clare Fenwick, 2010

Product selection

Wound aetiology
Wound location
Wound exudate
Product life span
Cost factors
Availability

Dr. Clare Fenwick, 2010

Wound Bed Preparation

Cleansing techniques
Debridement
Sharp
Surgical
Mechanical
Enzymatic
Autolytic
Biodebridement (maggots)

Dr. Clare Fenwick, 2010

Sharp Debridement

Clare Fenwick Griffith University Gold

Coast 2010

Sharp Debridement

Clare Fenwick Griffith University Gold

Coast 2010

Surgical debridement using waterjet hydrosurgery

Intra-operative
Pre-operative

Clare Fenwick Griffith University Gold

Coast 2010

Mechanical debridement
Clare Fenwick Griffith University Gold
Coast 2010

Enzymatic Debridement

Clare Fenwick Griffith University Gold

Coast 2010

Autolytic Debridement

Clare Fenwick Griffith University Gold

Coast 2010

Biodebridement

Clare Fenwick Griffith University Gold

Coast 2010

Cleansing techniques
Clean versus sterile technique
Normal saline and tap water are OK
Hand washing is essential to reduce infection
Dirty hand & clean hand
Wound field concept

Dr. Clare Fenwick, 2010

Clean and dirty hand

Dressing
Equipment
clean

dirty

Dr. Clare Fenwick, 2010

Wound Field concept

Dressing
Equipment

Dr. Clare Fenwick, 2010

Dressing & Exudate

None Low

Films
Hydrogels

Low Mod

Hydrocolloid

Mod Heavy

Alginates
Hydrofibre
Foams

Dr. Clare Fenwick, 2010

Wound products

Inert non stick dressings

Film dressings
Foam dressings
Hydrogel dressings
Hydrocolloid dressings
Alginate dressings
Hydrofibre dressings
Zinc dressings
Nanocrystalline Silver dressings
Cadexomer Iodine
Vacum assisted closure
Manuka Honey

Dr. Clare Fenwick, 2010

Inert non stick dressings

Primary dressing
Gauze
Protective low absorption dressing

Paraffin tulle dressings (Jelonet,

Application:
Bactigras)
Clean wound base
Non-paraffin,
non-tulle,
woven products,
Place
shiny side of dressing
to wound.
May(eg
require
soaking if Inadine)
exudate strikethrough has
Adaptic,
occurred.

Non stick dressings (eg Melolin,

Cutilin)
Contraindications/Possible
Side effects:
Harsh
debridement of the wound bed if exudate dries
Combine
Limited use as a primary dressing
Fenwick Griffith University Gold
Dries out the woundClare
bed
Coast 2010

Film dressings
Primary and secondary dressing
Low exudating wounds, protective dressing.

Product names include

Opsite Flexigrid
Application:
Clean
wound base
Opsite
Post-Op
Prepare periwound area with a protective barrier wipe.
Apply
adhesive side to wound and remove outer layer.
Tegaderm
Adhesive strongest in first 24 hours, can remain for 7 days.
Polyskin
Observe
for maceration, remove if this occurs.
Contraindications/ Possible Side effects:
Do not apply to infected wounds or if allergic to tapes
If not removed correctly can be traumatic to the wound bed .
NB Green sided Opsite is for wounds, orange sided Opsite is
for vascular access devices
Clare Fenwick Griffith University Gold
Coast 2010

Film dressings

Film Dressing

Primary and secondary dressing

Low exudating wounds, protective dressing.

Product names include

Opsite Flexigrid
Application:
Clean
wound base
Opsite
Post-Op
Prepare periwound area with a protective barrier wipe.
Apply
adhesive side to wound and remove outer layer.
Tegaderm
Adhesive strongest in first 24 hours, can remain for 7 days.
Polyskin
Observe
for maceration, remove if this occurs.
Contraindications/ Possible Side effects:
Do not apply to infected wounds or if allergic to tapes
If not removed correctly can be traumatic to the wound bed .
NB Green sided Opsite is for wounds, orange sided Opsite is
for vascular access devices
Clare Fenwick Griffith University Gold
Coast 2010

Foam dressings
Primary and secondary dressing
Product names
available
Light/mod/highly
exudating
wounds, protective dressing, cavity
wounds

Allevyn

Application:

Allevyn
Adhesive
Clean wound base
Read
packagedCavity
for insertion side (patterned or shiny side up)
Allevyn
Sheet foam left insitu up to 7 days (24 hours if infected)
Cavi-Care
Cavity
foams left insitu up to 14 days (daily washing of foam
if infected)
Contraindications/ Possible Side effects:
Avoid covering with occlusive dressings.
Clare
Fenwick
Griffith University Gold
Avoid wounds dressed
with
antibacterial
solutions.
Coast 2010

Foam dressings
Primary and secondary dressing
Product names
available
Light/mod/highly
exudating
wounds, protective dressing, cavity
wounds

Allevyn

Application:

Allevyn
Adhesive
Clean wound base
Read
packagedCavity
for insertion side (patterned or shiny side up)
Allevyn
Sheet foam left insitu up to 7 days (24 hours if infected)
Cavi-Care
Cavity
foams left insitu up to 14 days (daily washing of foam
if infected)

Foam Dressing
Contraindications/ Possible Side effects:
Avoid covering with occlusive dressings.
Clare
Fenwick
Griffith University Gold
Avoid wounds dressed
with
antibacterial
solutions.
Coast 2010

Hydrogel dressings
Primary dressing
Product
names
available
Sloughy
or necrotic
wounds
requiring chemical debridement.
Lightly exudating wounds, hydrate dry wounds. .

Solugel

Application:
Intra
site
Clean
wound
base Gel
Coat
wound base with at least 5 mm gel.
Solosite
Gel
Apply sheet directly to
wound base.
Can
remain insitu up to 3 days
Clear-Site
Requires a secondary dressing

Duoderm Gel
Contraindications/ Possible Side effects:

Remove
if patient complains of burning or discomfort.
Aquaflo
Can cause maceration if too much is applied.
Dont use on highly exudating
wounds
or blind
Clare Fenwick
Griffith University
Gold sinuses
Coast 2010

Hydrogel dressings
Hydrogel Dressing

Primary dressing
Product
names
available
Sloughy
or necrotic
wounds
requiring chemical debridement.
Lightly exudating wounds, hydrate dry wounds. .

Solugel

Application:
Intra
site
Clean
wound
base Gel
Coat
wound base with at least 5 mm gel.
Solosite
Gel
Apply sheet directly to
wound base.
Can
remain insitu up to 3 days
Clear-Site
Requires a secondary dressing

Duoderm Gel
Contraindications/ Possible Side effects:

Remove
if patient complains of burning or discomfort.
Aquaflo
Can cause maceration if too much is applied.
Dont use on highly exudating
wounds
or blind
Clare Fenwick
Griffith University
Gold sinuses
Coast 2010

Hydrocolloid dressings
Primary and secondary dressing
Product
names
available
Sloughy
wounds
requiring
autolytic debridement, low/moderate
exudating
wounds.
Duoderm
Extra Thin
Duoderm CGF

Application:

Duoderm
Pastewipe periwound with barrier wipe
Clean
wound base,
Comfeel
Warm
productPlus
in hands
to activate adhesive
Transparent
Place
adhesive
side to
wound.Dressing
Comfeel
Plus
Contour
Leave at least 2 cm border around wound.

Plus
Pressure
Relieving Dressing
CanComfeel
be left insitu
up to
7 days, dependant
on exudate level.
Comfeel
Dressing
becomes
opaque when due for change
Paste
Comfeel Powder

Contraindications/ Possible Side effects:

Clarewounds
Fenwick Griffithor
University
Gold is allergic.
Do not apply to infected
if
client
Coast 2010
Remove if patient complains of discomfort.

Hydrocolloid dressings
Hydrocolloid
Dressing
Primary and
secondary dressing

Product
names
available
Sloughy
wounds
requiring
autolytic debridement, low/moderate
exudating
wounds.
Duoderm
Extra Thin
Duoderm CGF

Application:

Duoderm
Pastewipe periwound with barrier wipe
Clean
wound base,
Comfeel
Warm
productPlus
in hands
to activate adhesive
Transparent
Place
adhesive
side to
wound.Dressing
Comfeel
Plus
Contour
Leave at least 2 cm border around wound.

Plus
Pressure
Relieving Dressing
CanComfeel
be left insitu
up to
7 days, dependant
on exudate level.
Comfeel
Dressing
becomes
opaque when due for change
Paste
Comfeel Powder

Contraindications/ Possible Side effects:

Clarewounds
Fenwick Griffithor
University
Gold is allergic.
Do not apply to infected
if
client
Coast 2010
Remove if patient complains of discomfort.

Alginate dressings
Product names available
Kaltostat
Application:
Clean
wound base
Algoderm
Lightly pack or line the wound, product swells with exudate.
Sorbsan
Avoid
pre-moistening the product.
Discontinue use if the dressing remains dry.
Curasorb
Can
be left insitu up to 4 days, dependant on exudate level.
Requires a secondary dressing, do not use an occlusive dressing
Kaltocarb

Primary dressing
Medium to heavy exudating, bleeding, sloughy or infected wounds.

Contraindications/ Possible Side effects:

Do not use on dry wounds as it dehydrates the wound bed
Clare Fenwick Griffith University Gold
Coast 2010

Alginate dressings
Product names available
Kaltostat
Application:
Clean
wound base
Algoderm
Lightly pack or line the wound, product swells with exudate.
Sorbsan
Avoid
pre-moistening the product.
Discontinue use if the dressing remains dry.
Curasorb
Can
be left insitu up to 4 days, dependant on exudate level.
Requires a secondary dressing, do notCalcium
use an occlusive
dressing
Alginate
Kaltocarb
Dressing

Primary dressing
Medium to heavy exudating, bleeding, sloughy or infected wounds.

Contraindications/ Possible Side effects:

Do not use on dry wounds as it dehydrates the wound bed
Clare Fenwick Griffith University Gold
Coast 2010

Hydrofibre dressings
Product names available
Aquacel

Primary dressing:
Medium to heavy exudating or infected wounds
Application:
Clean wound base
Line the wound base with product
Cover with a secondary dressing.
Can be left insitu up to 7 days, dependant on exudate level.
Contraindications/ Possible Side effects:
Heavily infected wounds require Hydrofibre impregnated with
Silver.
Do not use in people allergic to hydrocolloids
Clare Fenwick Griffith University Gold
Coast 2010

Hydrofibre Dressing
Hydrofibre dressings

Product names available

Aquacel

Primary dressing:
Medium to heavy exudating or infected wounds
Application:
Clean wound base
Line the wound base with product
Cover with a secondary dressing.
Can be left insitu up to 7 days, dependant on exudate level.
Contraindications/ Possible Side effects:
Heavily infected wounds require Hydrofibre impregnated with
Silver.
Do not use in people allergic to hydrocolloids
Clare Fenwick Griffith University Gold
Coast 2010

Nanocrystalline Silver dressings

Primary dressing:
Product
names
available
Infected
wounds
(150 pathogens
including MRSA and VRE),
burns, donor and recipient sites.

Acticoat

Application:

Aquacel
Ag
Clean wound base
Moisten
product plus
with sterile
water, daily if not enough exudate
Actisorb
(charcoal)
Cut to wound size and shape, apply blue side down
Cover with a secondary dressing.
Can be left insitu up to 7 days, dependant on exudate level.

Contraindications/ Possible Side effects:

Do not use on people going for a Magnetic Resonance Imaging
Clare Fenwickto
Griffith
University Gold
Do not use in people allergic
silver
Coast 2010

Nanocrystalline Silver dressings

Primary dressing:
Product
names
available
Infected
wounds
(150 pathogens
including MRSA and VRE),
burns, donor and recipient sites.

Acticoat

Application:

Aquacel
Ag
Clean wound base
Moisten
product plus
with sterile
water, daily if not enough exudate
Actisorb
(charcoal)

Cut to wound size and shape, apply blue side down

Cover with a secondary dressing.
Can be left insitu
up toDressings
7 days, dependant on exudate level.
Nanocrystalline
Silver

Contraindications/ Possible Side effects:

Do not use on people going for a Magnetic Resonance Imaging
Clare Fenwickto
Griffith
University Gold
Do not use in people allergic
silver
Coast 2010

Zinc dressings
Product
names available
Primary
dressing
Sloughy wounds, epithelialising wounds and to protect limbs
Steripaste
at risk
of skin tears or degloving.
Viscopaste

Application:
Cut
length as required, usually 3-4 times the size of the wound
Flexidress
Fold to make a patch and place over wound.
Gelocast
Requires
a secondary dressing.
Can be left insitu up to 7 days.
Contraindications/Possible Side effects:
Allergy to zinc
Clare Fenwick Griffith University Gold
Coast 2010

Zinc dressings
Product
names available
Primary
dressing
Sloughy wounds, epithelialising wounds and to protect limbs
Steripaste
at risk
of skin tears or degloving.
Viscopaste

Application:
Cut
length as required, usually 3-4 times the size of the wound
Flexidress
Fold to make a patch and place over wound.
Gelocast
Requires
a secondary dressing.
Can
be Paste
left insitu
up to 7 days.
Zinc
Dressings
Contraindications/Possible Side effects:
Allergy to zinc
Clare Fenwick Griffith University Gold
Coast 2010

Other Dressings
Wound Honey
Cadexomer Iodine
Vacum assisted closure (VAC) (see

lecture)

Dr. Clare Fenwick, 2010

References
Carville, K. (2005). Wound Care Manual.

Western Australia: Silver Chain Foundation.

Ellis, T. (2002). Wound bed preparation- a
wound management imperative. Woundcare
Network(10), 1-4.
Myers, B. A. (2008). Wound Management
Principles and Practice (2nd ed). New Jersey:
Prentice Hall.
Dr. Clare Fenwick, 2010