Home' Australian Pharmacist : Australian Pharmacist March 2015 Contents Australian Pharmacist March 2015 I ©Pharmaceutical Society of Australia Ltd. 61
CONTINUING PROFESSIONAL DEVELOPMENT
These dressings are used for wounds with
low to moderate exudate.1 Hydrocolloid
dressings are composed of a fine
suspension of polymers, that when mixed
with exudate, forms a soft, moist gel-like
mass between the dressing and wound.
Hydrocolloids also aid in autolytic
Hydroactive dressings are polymer
dressings that swell after absorbing
exudate into their structure. They
maintain a moist environment for healing
and are used for wounds with medium to
high exudate. These dressings are similar
to hydrocolloid dressings, except they do
not form a gel on the wound surface.1,4,5,8
Alginate dressings absorb moderate to
large amounts of exudate and encourage
autolytic debridement.1,2 They are
derived from alginic acids -- guluronic
and mannuronic acid, calcium alginate,
and sodium alginate from seaweed.
When mixed with exudate, alginates form
a highly absorbent gel, providing a moist
environment.1,4 Different combinations
and ratios of different alginic acids
produce gels of different structural
integrity, ranging from a soft amorphous
gel, to a firm gel that maintains its
structure after absorbing exudate.2,6,8
Alginate dressings also have haemostatic
properties. Sodium ions from the wound
exudate exchange with the calcium ions
in the seaweed to stimulate platelet
aggregation and coagulation.2,6,8
Gelling bre dressings
Gelling fibre dressings (also called
hydrofibre dressings) facilitate autolytic
debridement, and absorb moderate to
large amounts of exudate.2,4,6 They are
made of a synthetic, non-woven
sodium carboxymethylcellulose that is
spun into fibres then into sheets and
ribbon dressings. They can sometimes
be used as an alternative to alginate
dressings, however they do not have
Other bioactive dressings
These dressings are made of keratin
extracted from wool, and act to stimulate
hyperproliferation of keratinocytes to
encourage quicker epithelialisation.2
Dressings with various growth factors are
thought to stimulate the healing cascade
and facilitate the healing process.2,3,6
Collagen matrix/protease modelling
These dressings promote the healing
cascade and create a moist healing
environment.2,3 They are made of a
collagen matrix and oxidised regenerated
cellulose, which forms a biodegradable
gel when the matrix absorbs exudate.
The gel binds and inactivates
metalloproteinases, high levels of which
can delay wound healing.2,3
Anti-infective dressings are useful
for treating wounds with microbial
contamination. However, they need to
be used with caution as exposure to
antiseptics can negatively affect the
wound healing process.4,5 Some examples
of anti-infective dressings are listed
• Iodine inactivates bacteria, mycobacteria,
fungi, protozoa and viruses, and there has
been no evidence to suggest resistance
might be an issue. In dressings where
Table 1. Wound colour and stage of wound healing, and aim of wound dressing selection4,5
Wound colour Status or stage of healing Aim of dressing
Epithelialising -- a wound in
the final stages of healing, with
a covering of new epithelium.
Protect and insulate new tissue, maintain
a moist environment.
Granulating -- a granulating
wound with some areas of
Absorb excess exudate, maintain a
moist but not macerating environment,
promote granulation and epithelial
regeneration, and protect the wound.
Necrotic -- a wound with
an outer layer of thick hard
eschar and necrotic tissue.
To rehydrate and loosen eschar, and
promote autolytic debridement.
Sloughy -- a wound with a
sloughy layer of non-viable
Maintain moist environment, remove
slough by either rehydration or
absorption of exudate using active
dressings or surgery.
Infected -- an infected
wound, usually with a large
amount of exudate.
Absorb infected exudate and avoid
breaking down the surrounding skin.
Table 2. Considerations when selecting a wound dressing4,6
Wound characteristic Consideration
Amount of exudate
Absorbency of dressing should match exudate from wound.
State of wound/stage of
Aim of treatment varies depending on if the wound is
epithelialising, granulating, necrotic, sloughy or infected.
Depth of wound
Superficial or deep wounds require different dressings. Similarly,
only some types of dressings are appropriate for cavity wounds
Integrity of surrounding
Method of holding the dressing to the wound should avoid
trauma or further damage when the dressing is removed.
Size of dressing should be appropriate for wound size (Table 3).
Location of the wound will impact on how long the dressing will
stay in place.
Dressing should facilitate additional requirements e.g. application
of antibiotic therapy, or compression bandaging. Consider
precautions and contraindications.
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