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  Health Information Center  :  W  :  Wound Care

 Wound Dressings and Other Accessory Products

 


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 breakdown

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 hours.
  • Apply to all skin surfaces.
  • Apply immediately after bathing while the pores of the skin are still open.
  • Do not massage reddened areas.
  • Do not use on wounds or pressure ulcers.

Some brand name moisturizers include: Sween Cream (from Coloplast) and Eucerin

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 Ferris)

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 drainage.

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 absorbency.

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 Co.)

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 (from Bard)

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 week.








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