Table 1. Wound categories with recommended dressings | ||
Wound type | Dressings recommended | Special comments |
Skin tears | Apply silicone-covered foam dressing directly over the wound. If bleeding, apply haemostatic alginate dressing as primary dressing under a silicone-coated foam dressing. | Do not use any adhesive products on fragile skin as they may contribute to further skin tears, especially on forearms and hands of the elderly. Remover wipes should be used when removing a dressing from fragile skin. Removal of the dressing should be done in a direction that does not disturb viable tissue edges and flaps. |
Minor cut/laceration | Cover with a low-absorbent dressing that prevents further trauma and absorbs exudate (dry island dressing). | Check for diabetes and the presence of at least two signs or symptoms of inflammation (redness, warmth, induration, pain/tenderness) or purulent secretions indicating infection. |
Postoperative wounds | For wounds without exudate, dress over sutures with a film or thin hydrocolloid. For wounds with exudate, apply a bordered low‑absorbent dressing (dry island dressing). | In case of wound dehiscence, organise prompt surgical review. |
Small superficial burns | After initial first aid treatment, cover burns area with hydrogel or hydrocolloid or film. | Refer to burns specialist for burns that are deep or infected or located on hands, feet, face or genitalia. |
Diabetic foot | Apply a primary antimicrobial dressing product with secondary dressing according to exudate: low exudate – low-absorbent pad moderate exudate – silicone foam high exudate – absorbent pad. | Check pedal pulses and sensation; if there is poor perfusion, referral to a diabetic foot clinic or vascular surgeon is recommended. Silicone foams on feet, if applied, should be without borders and anchored with tape or bandages. |
Table 2. Dressing types | |||
Dressing class (generic) | Purpose/action | Limitations and cautions | Wear time |
Films | Permeable to gas but impermeable to bacteria and liquid. Useful on superficial wounds with minimum exudate. | May be traumatic on removal. | 1–4 days |
Foam | Suitable for moderately exudating wounds, skin tears, skin grafts and donor sites. | Nonsilicone types should be avoided in patients with fragile skin. | Up to seven days |
Low adherence, low-absorbent dressing | Passive breathable dressing for low-exudating wounds. Protection over sutures or shallow wounds. | Not suitable for fragile papery skin as adhesive border can cause skin tear on removal. Not showerproof. Require secondary dressings for absorbing exudate – added cost. | 1–4 days |
Hydrocolloid | The sheet form of the dressing is self-adhesive and waterproof, and it does not need a secondary dressing, which makes this dressing type easy to use. | Low absorbency, produce unpleasant odour during removal. | Up to seven days |
Alginate | Promotes haemostasis in actively bleeding wounds, used in moderate-to-high-exudating wounds, wicks away fluid from the wound, can be used in packing wounds. Available in sheets or ropes. | Will dry firm within 48 hours; may need to be soaked off to remove. Allergic reaction has been reported. | Up to two days |
Antimicrobial | The clinical evidence supporting the routine use of antimicrobial dressings is weak. | Bacterial resistance with long-term use. High cost of silver-impregnated dressings. | 1–4 days |