1. EUROPEAN JOURNAL OF CARDIOVASCULAR MEDICINE Volume:13 Issue:4
46
European Journal of Cardiovascular Medicine
Print ISSN: 2042-4884 | E-ISSN: 2042-4892
Language: Multilingual
Origin: United Kingdom
Website: https://www.healthcare-bulletin.co.uk/ Volume 13 Issue: 4 - 2023
A New Classification for Wound Dressings
Amit Kumar C Jain
INTRODUCTION
Wounds remain a challenging condition to health care professionals and millions of people are known to suffer from
different wounds annually [1, 2]. It was noticed that nearly one billion people suffered from wounds around the globe [3].
The wounds are either acute or chronic in nature [3, 4]. It is well known that healing process in acute wounds can be
estimated whereas in chronic wounds, healing cannot be predicted [5]. Some of the common chronic wounds are venous
ulcers, diabetic foot ulcers and pressure ulcers [6].
Dressing is one of the most used modalities in treatment of wounds [7]. There are many factors that determine dressing
selection and they include nature of wounds, its location, cost, and ranges of dressing materials available [8].
For years, traditional dressings (also known as passive dressings) like sterile gauges have been in use at many places
even today as primary dressing [9, 10]. Distinct modern dressings have evolved recently and they are either interactive or
bioactive categories [4]. Commonly used modern dressing include hydrogels, hydrocolloids, alginates, etc [4, 9].
The traditional dressings are dry dressing which does not create moist environment whereas modern dressing maintains
moist environment [9].
Abstract: Wounds are extremely common in clinical practice and they include diabetic foot
wounds, venous ulcers, burns, traumatic wounds, etc. These wounds occur frequently in
daily life and needs to be managed appropriately otherwise they can lead to complications.
Numerous wound dressings/products are available in Industry with each having merits
and demerits. Often, it is also difficult to understand their usage and mechanisms of action.
The primary author extended his ‘SCC’ classification series to wound dressings wherein
one can categorize them into 3 type’s namely simple, complex, and complicated wound
dressings. This article aims to discuss this new classification of wound dressings.
Keywords: Wounds, Diabetic Foot, Dressings, Types, Healing
AFFILIATIONS
Consultant and Head, Amit Jain’s
Diabetic Foot and Wound
Research Unit, Amit Jain’s
Institute of Diabetic Foot and
Wound Care, Brindhavvan Areion
Hospital, Bengaluru, India.
CORRESPONDING AUTHOR
Amit Kumar C Jain
Open Access
2. Article Title: A New Classification for Wound Dressings
EUROPEAN JOURNAL OF CARDIOVASCULAR MEDICINE Volume:13 Issue:4
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The author proposes a new, easy to remember descriptive classification for wound dressings/products which is an
expansion and extension of his ‘SCC’ classification in diabetic foot that was used for ulcers, footwears, offloading,
deformities, etc [11, 12, 13].
Based on distinct factors like ease of application, cost of dressing, mechanism of action and its understanding, etc, the
author divided the wound dressings into 3 distinct classes namely Class 1, Class 2, and Class 3 wound dressings (Figure
1).
Figure 1 showing the new Amit Jain’s Classification for Wound Dressings
The Class 1 dressings are simple dressings and they include sterile gauge dressings, hydrogels, hydrocolloids, foams
(Figure 2), polysaccharides like alginates, chitosan, etc. Most of these dressings are nowadays affordable and they aim at
providing moist environment for effective wound healing.
Figure 2 showing foam dressing. This is Amit Jain’s Type 1 wound dressing
3. Article Title: A New Classification for Wound Dressings
EUROPEAN JOURNAL OF CARDIOVASCULAR MEDICINE Volume:13 Issue:4
48
The Class 2 dressings are complex dressings and they include collagen-based dressing, Technology Lipido Colloid
(TLC), Growth factors, etc. The TLC dressings are newer dressings that comprises of matrix containing hydrocolloid and
lipophilic substances and it consists of neutral TLC, Silver combines TLC or with a protease inhibitor (TLC- NOSF) [14,
15]. Many of the complex dressings are costly.
The Class 3 dressings are complicated dressings and the best example in this class is the Skin Substitutes. The skin
substitutes are either acellular, cellular or dermo-epidermal types [16]. These are currently very expensive.
Just like other SCC classification in diabetic foot, this wound dressing classification can also have a triangle (Figure 3).
Figure 3 showing the Amit Jain’s triangle of wound dressings
One needs to be aware that although we mentioned some of the commonly available dressing used in practice, there are
more than 500 dressing available with each having different composition and properties [17]. In centres like ours, which is
an expert diabetic foot and wound care centre, on an average in a year, around 5 to 10 types of dressings are usually
available in the pharmacy. This means out of 500 available dressing in the industry, only 1-2% (max 10x100/500 =2%)
are used in clinical practice.
Many times, the dressings are available or used in combination in clinical practice. No single dressing today can be
suitable for all the types of wounds [8]. Further, one needs to understand that many dressings, especially the newer modern
dressings lack evidences with many being poorly designed studies, which in many are industry funded or they use saline
gauge dressing as control [16].
CONCLUSION
Wound dressings are essential in clinical management to achieve appropriate healing. There is no one ideal dressing
that fulfils all the criteria’s or is universally applicable. Hence, one needs to have a flexibility in using wound dressing
depending upon the type of wound, location, and patients’ affordability. The new Amit Jain’s classification for wound
dressing, based on SCC classification system, is an easy to remember descriptive classification and it can serve as a good
teaching tool especially its triangle, that provides the available options of dressings.
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4. Article Title: A New Classification for Wound Dressings
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