The document discusses different types of wound dressings, including hydrogel dressings which are used for dry wounds or wounds with minimal drainage due to their high water content. Hydrocolloid dressings form a moist environment to promote healing but cannot be used on infected wounds. Alginate dressings absorb moderate to high amounts of drainage from infected or non-infected wounds. Composite dressings have multiple layers and can be used for wounds with varying amounts of drainage or tissue types. Transparent film dressings conform easily, allow monitoring of the wound, and create a moist environment.

1. TYPES OF DRESSINGS
Hydrogel Dressings
Hydrogels are indicated for management of pressure ulcers, skin tears, surgical
wounds, and burns, including radiation therapy burns. Because they contain up to
95% water, hydrogels cannot absorb much exudate and should be reserved for dry
wounds or wounds with minimal to moderate drainage.
An impregnated-gauze hydrogel, which is an amorphous hydrogel impregnated into a
gauze pad, can be used to fill dead space in a large wound.
Hydrocolloid Dressings
Because they are occlusive, hydrocolloid dressings do not allow
water, oxygen, or bacteria into the wound. This may help
facilitate angiogenesis and granulation. Hydrocolloids also
cause the pH of the wound surface to drop; the acidic
environment can inhibit bacteria growth.
Like hydrogels, hydrocolloids can help a clean wound to
granulate or epithelialize and encourage autolytic debridement
in wounds with necrotic tissue. However, because of their
occlusive nature, hydrocolloids cannot be used if the wound or
surrounding skin is infected.

2. Alginate Dressings
Previous columns have addressed products that are
appropriate for dry wound beds or wounds with minimal
exudate or drainage-namely, hydrogels and hydrocolloids. In
contrast, alginate dressings absorb moderate to high amounts
of wound drainage.
In wounds with moderate to heavy drainage, the alginate
forms a gel when it comes in contact with wound fluid. Capable
of absorbing up to 20 times its weight in fluid, an alginate can
be used in infected and noninfected wounds. Because an
alginate is highly absorbent, it should not be used with dry
wounds or wounds with minimal drainage; it could dehydrate
the wound, delaying healing.
Composite Dressings

3. Composite dressings have multiple layers and can be used as
primary or secondary dressings. They are appropriate for
wounds with minimal to heavy exudate, healthy granulation
tissue, necrotic tissue (slough or moist eschar), or a mixture of
granulation and necrotic tissue (Figure 1).
Use composite dressings cautiously if the patient is dehydrated
or has fragile skin. Keep in mind that some insurers will not
reimburse a facility or provider if a composite dressing is used
as a secondary dressing with a hydrogel or impregnated
gauze.
Composite dressings are made of three layers. The layers of the composite dressings
combine to form an antimicrobial barrier for moderate to heavy exuding wounds. Some
composite dressings also gradually release silver over time to promote healing. Our
selection of silver dressings include the popular Acticoat, Aquacel and Aquacel AG.
Transparent Films
Film dressings are flexible sheets of transparent polyurethane coated with an
acrylic adhesive. They can be used as a primary or secondary dressing.
These dressings are semipermeable, vary in size and thickness, and have an
adhesive that holds the dressing on the skin. They conform easily to the
patient's body but do not hold well in high-friction areas, such as the sacrum or
buttocks. Because films are transparent, the wound can be easily monitored.
Because films are semiocclusive and trap moisture, they allow autolytic
debridement of necrotic wounds and create a moist healing environment for
granulating wounds.