Type | Actions | Indications/use | Precautions/contraindications |
Alginates/CMC* | - Absorb fluid.
- Promote autolytic debridement.
- Moisture control.
- Conformability to wound bed.
| - Moderate to high exuding wounds.
- Special cavity presentations in the form of rope or ribbon.
- Combined presentation with silver for antimicrobial activity.
| - Do not use on dry/necrotic wounds.
- Use with caution on friable tissue (may cause bleeding).
- Do not pack cavity wounds tightly.
|
Foams | - Absorb fluid.
- Moisture control.
- Conformability to wound bed.
| - Moderate to high exuding wounds.
- Special cavity presentations in the form of strips or ribbon.
- Low-adherent versions available for patients with fragile skin.
- Combined presentation with silver or PHMB for antimicrobial activity.
| - Do not use on dry/necrotic wounds or those with minimal exudate.
|
Honey | - Rehydrate wound bed.
- Promote autolytic debridement.
- Antimicrobial action.
| - Sloughy, low to moderate exuding wounds.
- Critically colonized wounds or clinical signs of infection.
| - May cause "drawing" pain (osmotic effect).
- Known sensitivity.
|
Hydrocolloids | - Absorb fluid.
- Promote autolytic debridement.
| - Clean, low to moderate exuding wounds.
- Combined presentation with silver for antimicrobial activity.
| - Do not use on dry/necrotic wounds or high exuding wounds.
- May encourage overgranulation.
- May cause maceration.
|
Hydrogels | - Rehydrate wound bed.
- Moisture control.
- Promote autolytic debridement.
- Cooling.
| - Dry/low to moderate exuding wounds.
- Combined presentation with silver for antimicrobial activity.
| - Do not use on highly exuding wounds or where anaerobic infection is suspected.
- May cause maceration.
|
Iodine | | - Critically colonized wounds or clinical signs of infection.
- Low to high exuding wounds.
| - Do not use on dry necrotic tissue.
- Known sensitivity to iodine.
- Short-term use recommended (risk of systemic absorption).
|
Low-adherent wound contact layer (silicone) | - Protect new tissue growth.
- Atraumatic to periwound skin.
- Conformable to body contours.
| - Low to high exuding wounds.
- Use as contact layer on superficial low exuding wounds.
| - May dry out if left in place for too long.
- Known sensitivity to silicone.
|
PHMB | | - Low to high exuding wounds.
- Critically colonized wounds or clinical signs of infection.
- May require secondary dressing.
| - Do not use on dry/necrotic wounds.
- Known sensitivity.
|
Odor control (eg, activated charcoal) | | - Malodorous wounds (due to excess exudate).
- May require antimicrobial if due to increased bioburden.
| - Do not use on dry wounds.
|
Protease modulating | - Active or passive control of wound protease levels.
| - Clean wounds that are not progressing despite correction of underlying causes, exclusion of infection, and optimal wound care.
| - Do not use on dry wounds or those with leathery eschar.
|
Silver | | - Critically colonized wounds or clinical signs of infection.
- Low to high exuding wounds.
- Combined presentation with foam and alginates/CMC for increased absorbency. Also in paste form.
| - Some may cause discoloration.
- Known sensitivity.
- Discontinue after 2 weeks if no improvement and reevaluate.
|
Polyurethane film | - Moisture control.
- Breathable bacterial barrier.
- Transparent (allow visualization of wound).
| - Primary dressing over superficial low exuding wounds.
- Secondary dressing over alginate or hydrogel for rehydration of wound bed.
| - Do not use on patients with fragile/compromised periwound skin.
- Do not use on moderate to high exuding wounds.
|