There are a lot of absorptive dressings on the market because an important part of wound management is exudation management. Different types of absorptive dressings have different mechanisms of action, flat wounds and cavity wounds need different types, but the goal of these dressings is to reduce the unnecessary replacement under the premise of effective exudation management. If the exudate cann't be effectively absorbed, it might cause skin maceration, exudate leakage, clothing contamination, and unpleasant odor, etc., which would make patients feel uncomfortable, and more seriously affect their normal quality of life.
The wound dressing products must be changed immediately when the amount of absorbed exudation reaches a sufficient level (This can be observed from the back of the dressing) to avoid skin maceration. The size and shape of the dressing should be appropriate for the wound. Various manufacturers offer dressings with different sizes and shapes, even design the dressings for special anatomical sites, such as the sacrococcygeal region and the heel region.
1. Alginate wound dressings
Alginate dressings can be used in wounds with more exudates during debridement phase. After absorbing the exudate, they will become gelatinous, including sheets and strips, which are suitable for flat wounds and cavity packing respectively. There are different types of alginate dressings on the market, and their ability to absorb the exudate depends on the alginate content. Some of them remain intact after the absorption and can be removed as a whole, while some will be disintegrated after absorbing exudates and need to be rinsed to be completely cleared. Alginate wound dressings like sterile calcium alginate wound dressing can be used for packing of injured oral cavities but require a second layer of dressing to cover. Some companies add antibacterial ingredients into alginate dressings, such as silver ions, to make them antibacterial. And some use calcium alginate dressings (Deshikang) to fill after endoscopic sinus surgery instead of oil gauze, in addition to absorbing exudates, the calcium ions in the dressing can also play a slight hemostatic effect. Anorectal departments also use alginate packing because of the particularity of wounds, which often have sinus tracts.
Mainstream dressing manufacturers basically have alginate dressings.
2. Hydrophilic fiber wound dressings
The white fibrous dressing is composed of 100% hydrophilic fibers (NA-CMC), which can be transformed into a gelatinous sheet after absorbing exudates. It can be used in moderate to severe exudative wounds and must be changed while the exudate has saturated absorption. Patients often feel "sucked" because the wound dressing products are absorbing the exudate. This dressing can adhere to the skin around the wound sometimes, so don't exceed the edge of the wound when using it.
3. Foam wound dressings
There are many types of foam dressings, the main purpose of them is to absorb exudates. Some can "lock" the exudate inside them, and some turn into gels, which divided into the one with adhesive edge and the one without adhesive edge. When patients have skin allergies, it's better to use the one without adhesive edge, and foam dressings are more appropriate for wounds with moderate to severe exudations. Because the primary role of foam wound care dressings is to absorb exudates, some foam dressings with strong absorptive ability are not suitable when the wound exudate is little, such as the epithelial stage. If it's necessary to use them, it's better to choose foam dressings with anti-adhesion coatings, such as silicone, lipid hydrocolloid, etc., but these dressings all maintain the moist environment by retaining the water of the wound itself. Recently, there is a kind of foam dressing that can manage wound humidity balance intelligently be launched, it adds a layer of hydrogel structure on the surface of the foam dressing without affecting the exudate absorption ability, and can actively release moisture to keep the wound in humidity balance while the wound dries, which extends the indications of dressings and reduces the error rate of dressing selection. And silver ions are added into the surface of some dressing products to make them have anti-infection function and suitable for some infected wounds with more exudations. In addition, foam dressings specifically for tamponade are available but are less frequently used. Foam dressing is a class of high maturity dressing, each dressing manufacturer basically has its own special products, so while selecting the dressing, we should combine the patient and wound conditions, and meanwhile refer to the manufacturers' suggestion.
