Content area
Full text
Many misconceptions exist regarding what hydrocolloid dressings can and cannot do. Because there are several hydrocolloid dressing brands on the market - each with its own specifications - it is useful to start with a generic definition. Hydrocolloid dressings have two layers. The inner, hydrocolloid adhesive layer has particles that absorb exudate to form a hydrated gel over the wound, creating a moist environment that promotes healing and protects new tissue. The outer layer (film, foam, or both) forms a seal to protect the wound from bacterial contamination, foreign debris, urine, and feces; it also maintains a moist environment and helps prevent shearing.
Hydrocolloid dressings are designed to be worn for up to a week. Infrequent dressing changes are less disruptive to the wound bed, provided that healthy skin is not compromised. Many patients - and even some medical professionals - still believe that wounds need to be exposed to the air to heal properly. This is not true. All body tissue below the skin surface is moist, and scientists have long documented that a moist wound environment is the most favorable environment for healing.
Hydrocolloid dressings are appropriate for moderately draining Stage II and Stage III wounds, as well as for other superficial wounds with moderate exudate, such as second degree burns (Figures 1 and 2). Because they can remain in place for up to 7 days, they are also appropriate for use on patients whose fragile skin dictates minimal dressing changes. If maceration occurs - or if there is potential for maceration at the wound's edges or on healthy skin - a "liquid film" barrier should precede application of the dressing. Liquid film is a clear liquid that when dry, protects the skin from drainage and /or tape.
When there is black eschar or necrotic debris in the wound and drainage is minimal, a transparent dressing will help liquefy it - and also will be more cost-effective than a hydrocolloid dressing (Figure 4). Ideally, black eschar should be débrided before applying a hydrocolloid dressing. Hydrocolloid dressings are generally not used if bone or tendon are visible, as frequent monitoring is essential. Hydrocolloid dressings are contraindicated in infected wounds. Be aware that all wounds are contaminated, but...