The following is a list of some of the most common wound care accessory
products as well as a brief description of how each product is used.
1. Skin cleansers — clean the skin area around the wound of
contaminates, such as urine or stool, which may get on the skin of patients who
have difficulty controlling their bladder (called "urinary
incontinence") or bowels (called "fecal incontinence"). Skin
cleansers also can neutralize drainage and its odor.
Guidelines for use:
- Pat skin dry after applying — do not rub.
- Do not use on wounds or pressure ulcers.
Some brand name skin cleanser products include: Clean n’ Moist (from
Hollister), PerinealCleans Foam (from Carrington), Sproam (from Sween), and
TripleCare (from Smith & Nephew)
2. Moisturizer — hydrates, softens, and protects the skin against
Guidelines for use:
- Creams are preferred over lotions. Moisturizing creams are
concentrated formulas that have less water content than lotions and have
been proven to provide intensive rehydration for severely dry skin for 24
- Apply to all skin surfaces.
- Apply immediately after bathing while the pores of the skin are
- Do not massage reddened areas.
- Do not use on wounds or pressure ulcers.
Some brand name moisturizers include: Sween Cream (from Coloplast) and
3. Moisture barrier ointment — protects skin from urine or stool when
patients have urinary incontinence or mild fecal incontinence. Products that act
as moisture barriers typically contain dimethicone, zinc, or petrolatum.
Dimethicone provides a protective layer; zinc helps dry denuded skin (i.e., skin
that has several layers removed); petrolatum provides a resistant layer.
Guidelines for use:
- Clean the skin then apply the moisture barrier product
(apply a thin layer if using a zinc product).
Some brand name moisturizers include: Proshield (from Healthpoint), Baza
Protect (from Coloplast/Sween), Desitin, and petrolatum.
4. Wound dressings — play a vital role in the care and healing of
pressure ulcers. Wound dressings provide many functions, including:
- helping to protect the ulcer from further injury
- helping to protect the ulcer from germs/becoming infected
- helping to provide the proper environment for healing
- filling in the wound’s dead space
A variety of wound dressings is available. Unlike ordinary gauze dressings or
bandages, wound dressings are special because they help keep an ideal level of
moisture in the wound. Decades of research have shown that the closer the wound’s
moisture level is to that of healthy skin, the better the wound’s chance that
it will heal. This concept is called moist wound healing.
Keeping wounds covered. Although you may think otherwise,
keeping a dressing in place for several days aids in the early healing process
because the wound is left undisturbed. This is important because it provides a
moist environment as well as keeps the wound at body temperature--conditions
necessary to promote healing. To explain further, frequent dressing changes cool
the temperature of a wound by exposing it to the air. This slows the healing
process until the body can rewarm the area. So changing wound dressings less
frequently actually assists the healing process.
This illustration shows why wounds that are kept moist heal more
quickly. The moist environment provided by covering a wound (left)
allows the epidermal cells to move easily across the wound surface,
healing the wound. In a dry wound environment (right), the epidermal
cells must tunnel down to a moist level and secrete enzymes to lift the
scab away from the wound surface before the cells can migrate and begin
to allow healing to occur.
Types of moist wound dressings. There are several types of
moist wound dressings and more than one may be recommended by your health care
provider during the course of the healing of your pressure ulcer. For this
reason, it may be important to learn a little more about some of the more
frequently used types of wound dressings (described below).
Foam. Foam dressings can absorb a lot of
fluid, so they are particularly useful for wounds in the early stages of
healing, when drainage from the wound is greatest. Foam dressings are
comfortable and gentle to the skin and can be left in place for several
days. Foams come in a variety of different sizes, shapes, and
thicknesses as well as with a without an adhesive surface.
Some brand name foam products include: Allevyn Adhesive Dressings (from Smith
and Nephew), Lyofoam (from ConvaTec), Polymem Non-Adhesive Dressings (from
Soft silicone foam pad/absorbent pad dressings.
A type of dressing that uses the man-made material silicone in its
adhesive as well as in its wound contact layer. Silicone helps prevent
the dressing from sticking to the wound or to the surrounding skin,
which causes less trauma to the area as the dressing is repositioned or
removed and therefore aids in the healing process. Dressings
incorporating soft silicone are designed for wounds with a wide range of
Some brand name soft silicone-containing dressings include: Tendra Mepilex
Border, Tendra Mepitel (a silicone mesh contact layer), and Tendra Mepilex Lite
(all from Molnlycke Health Care).
Adhesive wafer dressings/hydrocolloid dressings.
Hydrocolloid "water-loving" dressings are formulations of
elastic, adhesive, and gelling agents (such as pectin or gelatin) and
other absorbent ingredients. When applied to a wound, the wound drainage
interacts with the dressing’s components to form a gel-like substance
that provides a moist environment for wound healing. Hydrocolloid
dressings come in several shapes, sizes, and thicknesses and are used on
wounds with light to medium levels of wound drainage. This type of
dressing is typically changed once every 5 to 7 days, depending on the
method of application, location of the wound, degree of exposure to
"friction and shear," and incontinence. Hydrocolloid dressings
are not usually used on wounds that have become infected.
Some brand name hydrocolloid dressings include: Comfeel Ulcer Care Dressing
(from Coloplast), DuoDerm CGF Control Gel Formula Dressing (from ConvaTec), and
Tegasorb (from 3M Health Care)
Hydrogels. Hydrogels are available in sheets,
saturated gauze, or a gel. Gels provide a soothing and cooling effect on
the wound, which promotes patient comfort. Gels are excellent for
creating or maintaining a moist healing environment and are used on
wounds with low levels of wound drainage. Gels are applied directly to
the wound, do not adhere to the wound, and are usually covered with a
secondary dressing (foam or gauze, for example) to maintain the moisture
level needed to promote wound healing.
Some brand name hydrogel dressings include: Carrasyn Hydrogel Wound Dressing
(Carrington Laboratories), Curasol Hydrogel Saturated Dressing (from Healthpoint)
Tegagel (from 3M Health Care), DuoDerm Hydroactive Wound Gel (from Convatec)
Hydrofibers. Hydrofibers are soft nonwoven
pad or ribbon dressings made from sodium carboxymethylcellulose fibers
(the same absorbent material used in hydrocolloid dressings). The
dressing components interact with wound drainage to form a soft gel that
can be easily removed. Hydrofibers are used on wounds with a heavy level
of wound drainage and wounds that are deep and need packing. Hydrofibers
can also be used on a dry wound as long as the dressing is kept moist
(by adding normal saline solution). This type of dressing can also
control minor bleeding. Hydrofibers require a cover dressing. Hydrofiber
dressings may stay in place for up to 7 days depending on the amount of
drainage from the wound.
The only brand name hydrofiber dressings is: Aquacel Hydrofiber Wound
Dressing (from ConvaTec)
Alginates. Alginates are soft nonwoven fibers
derived from brown seaweeds, particularly the kelps. Alginates are
available in pad or rope form. Alginates and hydrofibers are similar
types of products. In this case, the alginate product itself turns into
a soft, nonadhesive gel when in contact with wound drainage. Alginates
are used on wounds with a moderate to heavy level of wound drainage and
can also control minor bleeding. Alginates require a cover dressing and
should not be used in dry wounds. Dressings may be cut to fit the size
of the wound and loosely packed or may be layered for additional
Some brand name alginate dressings include: Pads: Kaltostat (from ConvaTec),
Restore CalciCare (from Hollister), Sorbsan (from Dow Hickam Pharmaceuticals);
Ropes: from the same manufacturers listed above and others
Gauze. Gauze dressings are made from woven
and nonwoven fibers of cotton, rayon, polyester or a combination of
these fibers. Most woven products are a fine or coarse cotton mesh,
depending on the thread count per inch. Fine mesh cotton gauze is
frequently used for packing, such as normal saline wet-to-moist
dressings. Coarse mesh cotton gauze, such as a normal saline wet-to-dry
dressing, is used for nonselective debriding (ie, the removal of
dead/dying tissue and debris). Most nonwoven gauze dressings are made of
polyester, rayon, or blends of these fibers and appear to be woven like
cotton gauze but are stronger, bulkier, softer, and more absorbent. Some
dressings, such as dry hypertonic saline gauze used for debridement,
contain substances to promote healing. Other products contain petrolatum
or other wound healing elements indicated for specific types of wounds.
Some brand name chemical-containing gauze dressings include: Adaptic
Non-adhering Dressing (from Johnson & Johnson), Mesalt Impregnated Absorbent
Dressing (Molnlycke Health Care), Xerofoam Dressing (Kendall Healthcare Products
Note: Your doctor is the final judge in deciding which wound dressing is best
for your wound.
5. Wound cleansers — clean the surface of the wound by removing
bacteria and drainage. Products used may contain a detergent; normal saline also
can be used to clean wounds without harming new tissue.
Some brand name wound cleansers include: Puri-Clens (from Coloplast),
Shurclens (from ConvaTec), UltraKlenz (from Carrington), Biolex Wound Cleanser
Instructions for making saline solution:
Use 1 gallon of distilled water or boil 1 gallon of tap water for 5
minutes. Do not use well water or sea water.
Add 8 teaspoons of table salt to the distilled or boiled water.
Mix the solution well until the salt is completely dissolved. Be sure
storage container and mixing utensil are clean (boiled).
Note: Cool to room temperature before using. This solution can be stored
at room temperature in a tightly covered glass or plastic bottle for up to 1