Surgical dressings are sterile pads or compresses applied to wounds to promote healing. Their history dates back to ancient Egyptians using honey and Greeks using vinegar and fig leaves. Joseph Lister introduced antiseptic dressings in the 1860s. Ideal dressings create a moist environment, remove exudate, allow gas exchange, and protect from contamination. Selection depends on whether occlusion or absorption is needed. Dressings are classified as simple like gauze or composite with layers. Common types include non-adherent fabrics, absorptive foams and gauzes, and occlusive films, hydrocolloids, alginates, and hydrogels. Creams, ointments and solutions are also

1. SURGICAL DRESSINGS
Part- I
13/08/2021
Dr. Ankita Singh
Assistant Professor
ACMS, Delhi Cantt

2. Learning Objective
What is surgical dressing?
History
Ideal wound dressing
How to select appropriate surgical dressing?
Types/classification
Commonly used dressings
Modern/miscellaneous dressings

3. What is surgical dressing?
Surgical dressing:
sterile pad or compress applied to a
wound to promote healing and prevent further
harm
Bandage:
piece of material used either to support a
medical device such as a dressing or splint

4. History
Material like fabric, leaves, cobweb, dung etc.
Ancient Eqyptians (1500BC)- honey
Hippocrates (460BC)- vinegar & fig leaves
Roman physicians (100)- spices like saffron,
thyme, mint; silver & lead (antiseptic) but
were lost to Dark Ages

5. History..
Joseph Lister (1860s)-
Introduced antiseptic dressings (carbolic acid)
Decreased mortality

6. History..
“Johnson & Johnson”(1886)-
Iodinated dressings
Debuted commercial first aid kit

7. History..
“Johnson & Johnson”(1920)- e
Earle dickson- a cotton buyer invented BAND- AID
(brand adhesive bandage)

8. History..
George Winter (1962)-
Pioneered concept of moist healing & occlusive
dressings

9. History to modern dressings..
1990 onwards-
Hydrogels
Hydrocolloids
Alginates
Synthetic foam
dressings
Vapor permeable
adhesive films
Anti adhesives:
silicon meshes
Tissue adhesives
Barrier films
Silver/collagen
dressings
Miscellaneous:
Combination products
Engineered skin
substitutes

10. Ideal wound dressing
Creates moist
environment
Removes excess exudate
Prevents desiccation
Allows for gaseous
exchange
Impermeable to
microorganisms
Thermally insulated

11. Ideal wound dressing..
Prevents particulate
contamination
odorless
Non toxic to benefit host
cells
Provides mechanical
protection
Non traumatic
Easy to use
Cost effective

12. How to select appropriate surgical
dressing?
Concept of occlusion & absorption
Occlusive dressing-
Principle of moist healing
faster wound healing by reducing pH and
oxygen tension
Stimulating fibroblast proliferation
Harmful in infected wounds
Absorptive dressing-
Preferred in wounds with high bacterial counts
& ↑ exudate

13. Types of dressings
Simple vs. Composite dressings
Simple-
Saline gauze dressings
Film dressings
Parrafin gauze dressings
Composite-
Multilayered dressing – outer, middle & inner layer

14. Types of dressings..
Nonadherent fabrics
Absorptive dressings
Occlusive dressings
Creams, ointments, and solutions

15. Types of dressings..

16. Types of dressings..
1. Non adherent fabrics
Fine mesh gauze supplemented with
substance to augment occlusive property/
antibacterial properties
E.g. Paraffin gauze, Scarlet Red, Xeroform

17. Types of dressings..
1. Non adherent fabrics
E.g. Paraffin gauze

18. Types of dressings..
1. Non adherent fabrics
E.g. Xeroform

19. Types of dressings..

20. Types of dressings..
2. Absorptive dressings
Wounds with significant amount of exudate
E.g. Wide mesh gauze, Foams

21. Types of dressings..
2. Absorptive dressings
E.g. Wide mesh gauze- not effective when
saturated, Foams

22. Types of dressings..
2. Absorptive dressings
E.g. Foams-

23. Types of dressings..
2. Absorptive dressings
E.g. Foams-

24. Types of dressings..

25. Types of dressings..
2. Occlusive dressings
Two types-
Non biological-e.g. Films, Hydrocolloids, Alginates,
Hydrogels
Biologic-e.g. Homograft, Xenograft, Amnion, Skin
substitutes

26. Types of dressings..
2. Occlusive dressings
Non biological- Films

27. Types of dressings..
2. Occlusive dressings
Non biological- Hydrocolloid matrix
 gelatin, pectin, carboxymethylcellulose

28. Types of dressings..
2. Occlusive dressings
Non biological- Hydrogels
Polyethylene oxide or carboxymethylcellulose polymer
and water (80%)
Rehydrating agents for dry wounds ;little water
absorption

29. Types of dressings..
2. Occlusive dressings
Non biological- Alginates
derived from brown algae
contain long chains of polysaccharides (mannuronic
and glucuronic acid)
Processed as the calcium form, alginates turn into
soluble sodium alginate

30. Types of dressings..
2. Occlusive dressings
Biologic-
Homograft,
Xenograft,
Amnion,
Skin substitutes- Integra, Alloderm, Apligraf

31. Types of dressings..

32. Types of dressings..
2. Creams, Ointments & Solutions
 Traditional materials- zinc oxide paste
Antibacterial creams and ointments
Acetic acid, Silver nitrate, Silver sulfadiazine,
iodine containing ointments(iodosorbs), bacitracin
Enzymes
Growth factors
Indicated in infected wounds

33. Types of dressings..
2. Creams, Ointments & Solutions
Zinc oxide paste
Antibacterial creams and ointments
Acetic acid, Silver nitrate, Silver sulfadiazine,
iodine containing ointments(iodosorbs), bacitracin

34. Types of dressings..
2. Creams, Ointments & Solutions
Nano silver
Betadine

35. What did we learn?
What is surgical dressing?
History
Ideal wound dressing
How to select appropriate surgical dressing?
Types/classification
Commonly used dressings
Modern/miscellaneous dressings

36. Bibliography
Sabiston 21st ed., Chap. 6, Wound Healing,
wound dressings
SRB 5th ed., Chap 36-G, Dressings and
Bandages
Additional reading-
Science of wound healing and dressing material-
Vibhakar & Payal
Surgical wound healing and management- Mark &
Luc

37. Next reading
Pye’s Surgical Handicraft, 22nd ed.- Chap.6,
Application of bandages

38. Attendance!!
&
?

39. Thank you