Advantages: Readily available in many sizes and forms, gauze can be used on infected wounds and can be combined with other topical products. It’s effective for packing wounds with tunnels, tracts, or undermining.Disadvantages: Gauze must be held in place by a secondary dressing, and fibers may shed or adhere to the wound bed. Gauze dressings should be changed frequently—if it dries out, it may stick to the wound bed and disrupt wound healing. Gauze isn’t recommended for effective moist wound treatment or bacterial barrier. Although research supports moist wound healing, the old standard of wet-to-dry gauze dressings is still being used in some places.
Made of polyurethane or copolymer, this type of dressing has a porous adhesive layer that lets oxygen pass through to the wound and moisture vapor escape from the wound.Indications: Partial-thickness wounds, Stage I and II pressure ulcers, superficial burns, and donor sites. It also can be used as a secondary dressing.Advantages: This dressing doesn’t have to be removed when you examine the wound. Transparent film also is impermeable to external fluid and bacteria, promotes autolytic debridement, and prevents or reduces friction. Available in numerous sizes, it conforms to the body. Change the dressing every 5 to 7 days, or if it becomes soiled, wet, or starts to leak fluid.Disadvantages: The dressing may stick to some wounds. Most transparent dressings don’t absorb moisture and aren’t indicated for draining wounds. However, some of the newer transparent films have absorption properties. Fluid retention under the dressing may lead to periwound maceration. This dressing can’t be used on third-degree burns.
Nonadherent and nonocclusive, foam is an absorptive dressing consisting of hydrophilic polyurethane or film-coated gel.Indications: Stages II through IV pressure ulcers, partial- and full-thickness wounds with minimal to heavy drainage, surgical wounds, dermal ulcers, and under compression wraps. Check the package insert to determine if the product can be used in infected wounds or those with tunneling or sinus tracts.Advantages: Many sizes, shapes, and forms are available. Foam is conformable, easy to apply, and easy to remove because it’s nonadherent. The frequency of dressing changes depends on the amount of wound drainage.Disadvantages: A secondary dressing or tape may be needed to secure some of the first foam dressings. Newer versions have an adhesive border to help keep them in place. Foam isn’t recommended for nondraining wounds or dry eschar. Some foams can’t be used on infected wounds or those with tunneling or tracts. Always read the package insert to determine if you can use the product for a particular wound type. If not changed appropriately, foam dressings can let excess moisture accumulate, macerating periwound skin.
Manufactured as a single dressing, composites are combinations of two or more different products. Features may include a bacterial barrier, absorptive layer, foam, hydrocolloid, or hydrogel. The dressing may have semi-adherent or nonadherent properties.Indications: Use composites as primary and secondary dressings for partial- and full-thickness wounds, for minimally to heavily draining wounds, dermal ulcers, and surgical incisions. Check the package insert to see if the dressing is suitable for pressure ulcers.Advantages: Composites facilitate autolytic debridement, are conformable, and are available in many sizes and shapes. Most include an adhesive border, so they’re easy to apply and remove. Check the package insert for frequency of dressing change.Disadvantages: Some composite dressings are contraindicated for Stage IV pressure ulcers. The adhesive borders of composites may limit their use on fragile skin. Not all composite dressings provide a moist healing environment, so monitor frequently for desiccation.