Foam7979 Jaffe L, Wu SC. Dressings, topical therapy, and negative pressure wound therapy. Clin Podiatr Med Surg. 2019;36:397-411.,8080 Walker RM, Gillespie BM, Thalib L, Higgins NS, Whitty JA. Foam dressings for treating pressure ulcers. Cochrane database Syst Rev. 2017;10:CD011332.: Polyurethane; absorption of exudate; Maintenance of humid environment; Hydrophilic properties; Painless/atraumatic exchange |
Total/partial thickness Moderate/high exudate Reduces pressure and friction Protects friable peri-ulcer skin |
Third-degree burns Ischemic ulcers with eschar at the base Dry/necrotic bed Ulcers with fistulas |
Primary/secondary dressinga Depends on the volume of exudate (1 to 7 days) |
Hydrogel7979 Jaffe L, Wu SC. Dressings, topical therapy, and negative pressure wound therapy. Clin Podiatr Med Surg. 2019;36:397-411.,8181 Kaya AZ, Turani N, Akyüz M. The effectiveness of a hydrogel dressing compared with standard management of pressure ulcers. J Wound Care. 2005;14:42-4.: Hydrophilic cross-linked polymers with 80%-90% water; non-adherent; autolytic debridement; absorbs minimal amounts of exudate |
Total/partial thickness |
Third-degree burns |
Apply at the base of the ulcer and cover with secondary dressing |
Dry lesions with minimal exudate |
Moderate/high exudate |
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Ulcers with critical colonization and infection |
Daily use |
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Do not use as a wound filler |
Calcium alginate7979 Jaffe L, Wu SC. Dressings, topical therapy, and negative pressure wound therapy. Clin Podiatr Med Surg. 2019;36:397-411.,8282 Percival SL, McCarty SM. Silver and alginates: role in wound healing and biofilm control. Adv Wound Care (New Rochelle). 2015;4:407-14.: Derived from seaweed; exudate absorption; formation of humid environment by gel formation (calcium and sodium salts + exudate); hemostatic properties; autolytic debridement; non-stick due to gel formation |
Moderate/high level of exudate Total/partial thickness Applied to surfaces and cavities |
Dry/necrotic bed Third-degree burns Minimal exudate |
Fix with secondary dressing When the dressing is saturated (1 to 7 days) |
Activated charcoal/silver8282 Percival SL, McCarty SM. Silver and alginates: role in wound healing and biofilm control. Adv Wound Care (New Rochelle). 2015;4:407-14.: Double layer of fibers; external: coal; internal: silver; absorption of exudate; coal: adsorption of microorganisms; silver: bactericidal action |
Chronic infected and exudative ulcers |
Clean, granulating, and uninfected ulcers Do not use on fascia/tendons/bones |
Some charcoal dressings can not be cut Fix with secondary dressing Exchange depends on saturation (1 to 7 days) |
Hydrocolloids7979 Jaffe L, Wu SC. Dressings, topical therapy, and negative pressure wound therapy. Clin Podiatr Med Surg. 2019;36:397-411.,8383 Sood A, Granick MS, Tomaselli NL. Wound dressings and comparative effectiveness data. Adv Wound Care (New Rochelle). 2014;3:511-29.: It contains an internal self-adhesive layer and a gel-forming agent such as gelatin or carboxymethylcellulose (CMC); inner layer of hydrocolloid in foam or film; increases its thickness in contact with exudate; autolytic debridement; puts up a form barrier against pathogens |
Total/partial thickness Minimum to moderate level of exudate Wound bed with granulation and necrosis |
Third-degree burns Infection Bedsores |
Direct application Adhesive edge 2.5 to 5 cm safety edge Exchange depends on exudate level (3 to 5 days) No secondary dressing required |
Transparent films8484 Tate S, Price A, Harding K. Dressings for venous leg ulcers. BMJ. 2018;361:k1604.: CMC in film form; aseptic; creation of a humid environment; exudate retention |
Total/partial thickness Secondary dressing Abrasions/graft donor areas Minimum to moderate level of exudate |
High level of exudate |
Minimum safety edge 2.5 cm |
Unna's boot8585 Gao AL, Cole JG, Stoecker WV. Unna boot central gauze technique for chronic venous leg ulcers. Dermatol Online J. 2017;23:13030.: 10% zinc oxide + starch on bandage of cotton fabric; non-elastic compressive action; stabilization of hydrostatic pressure; increased resistance to infections; creation of humid environment |
Venous ulcers |
Ulcers of ischemic origin |
Prior preparation includes Trendelenburg position for 6 to 8 hours to reduce swelling Wrap the ankle/knee limb |
Hydrofiber7979 Jaffe L, Wu SC. Dressings, topical therapy, and negative pressure wound therapy. Clin Podiatr Med Surg. 2019;36:397-411.,8383 Sood A, Granick MS, Tomaselli NL. Wound dressings and comparative effectiveness data. Adv Wound Care (New Rochelle). 2014;3:511-29.: Fiber CMC with or without silver; absorption of very much exudate; it forms hydrophilic gelatinous substance; provides humid environment; non-adherent; facilitates autolytic debridement, granulation and epithelialization |
Total/partial thickness Moderate/high exudate |
Dry or low exudate volume lesions |
Fix with secondary dressing Exchange according to saturation (1 to 2 days) |
Collagen7979 Jaffe L, Wu SC. Dressings, topical therapy, and negative pressure wound therapy. Clin Podiatr Med Surg. 2019;36:397-411.,8686 Sabo M, Le L, Yaakov RA, Carter M, Serena TE. A post-marketing surveillance study of chronic wounds treated with a native collagen calcium alginate dressing. Ostomy Wound Manage. 2018;64:38-43.: Bovine, porcine or sheep source; available in gel, tapes or powder; bioabsorbable; chemotactic for the cells involved; inactivates MMP, elastase and decreases the level of inflammatory mediators; stimulates endogenous collagen; in vitro bacteriostatic properties; some versions impregnated with silver; increases the epithelialization rate |
Total/partial thickness Minimum/moderate volume of exudate Uninfected lesion |
Allergy to source tissue |
Apply directly to the ulcer bed and cover with secondary dressing Exchange depends on exudate level |