Dressings and Bandages: Wound Care Materials to Choose From

Bandages and dressings are both used in wound management. A bandage is a piece of cloth or other material used to bind or wrap a diseased or injured part of the body. Usually shaped as a strip or pad, bandages are either placed directly against the wound or used to bind a dressing to the wound. A dressing can consist of a wide range of materials, sometimes containing medication, placed directly against the wound. Wound care materials come in a variety of product classes and have a broad range of applications: ◆ Alginate dressings are used on wounds that exude moderate to heavy amounts of fluid. They are useful for packing wounds, although strip-packing gauze may be preferable for deeper wounds because it is easier to retrieve. These are primary dressings that need be covered by a secondary dressing. ◆ Biosynthetic dressings are used on burns and other wounds. Another application is as a temporary dressing for skin autograft sites. Some persons may be allergic to these dressing materials. ◆ Collagen dressings are believed to hasten wound repair and are often used on stubborn wounds. They are most effective on wounds that contain no dead tissue. Collagen dressings should not be used in dry wounds, third-degree burns, or on any patient who is sensitive to bovine (cow) products. ◆ Composite dressings are sometimes used alone, sometimes in combination with other dressings. Deep wounds should first be packed with wound-filler material. These dressings should not be cut, and are not recommended for use on third-degree burns. ◆ Gauze is used to pack wounds, and also for debridement and wicking. It is especially desirable for packing deep wounds. When using gauze to pack wounds, a loose packing technique is preferred. ◆ Hydrocolloid dressings are used for leg ulcers, minor burns, pressure sores, and traumatic injuries. Because they are not painful to remove, hydrocolloid dressings are often employed in pediatric wound management. ◆ Hydrofibers are highly absorbent, so they are particularly useful for wounds that are draining heavily. For this reason, they are not recommended for dry wounds or wounds with little secretion, because they may result in dehydration. ◆ Hydrogels are often used on wounds that contain dead tissue, on infected surgical wounds, and on painful wounds. They should not be used on wounds with moderate to heavy secretions. As with all dressings, it is important to check and follow the directions of the manufacturer. ◆ Hydropolymers are typically used on wounds with minimal to moderate drainage. They are not indicated for dry wounds or third-degree burns. ◆ Leg compression/wrapping products are used to increase blood flow and reduce edema in the lower extremities of the body. ◆ Polyurethane foam dressings are very absorbent and are typically used on wounds with moderate to heavy secretions. ◆ Skin substitutes are a relatively new product category, approved for treating venous leg ulcers. It is often advisable to cut slits in the artificial skin, so that wound secretions underneath do not lift the newly applied skin. ◆ Superabsorbents are employed on wounds that are secreting heavily, or in applications requiring extended wear. A packing material is commonly employed under this product. ◆ Transparent films are often employed as a secondary cover for another, primary dressing. They are used on superficial wounds and on intact skin at risk of infection. It is important to remove transparent films very carefully to avoid damaging fragile skin. ◆ Wound fillers are primary dressings that are usually used in conjunction with other, secondary dressings. Wound fillers are considered appropriate for shallow wounds with little or moderate secretions. Wound pouches are useful in treating wounds with high volumes of sRunners Alliance