Hydrogels are indicated for management of pressure ulcers, skin tears, surgical wounds, and burns, including radiation therapy burns. Because they contain up to 95% water, hydrogels cannot absorb much exudate and should be reserved for dry wounds or wounds with minimal to moderate drainage.

An impregnated-gauze hydrogel, which is an amorphous hydrogel impregnated into a gauze pad, can be used to fill dead space in a large wound.

Hydrocolloid Dressings

Because they are occlusive, hydrocolloid dressings do not allow water, oxygen, or bacteria into the wound. This may help facilitate angiogenesis and granulation. Hydrocolloids also cause the pH of the wound surface to drop; the acidic environment can inhibit bacteria growth.

Like hydrogels, hydrocolloids can help a clean wound to granulate or epithelialize and encourage autolytic debridement in wounds with necrotic tissue. However, because of their occlusive nature, hydrocolloids cannot be used if the wound or surrounding skin is infected.

Alginate Dressings

Previous columns have addressed products that are appropriate for dry wound beds or wounds with minimal exudate or drainage-namely, hydrogels and hydrocolloids. In contrast, alginate dressings absorb moderate to high amounts of wound drainage.

In wounds with moderate to heavy drainage, the alginate forms a gel when it comes in contact with wound fluid. Capable of absorbing up to 20 times its weight in fluid, an alginate can be used in infected and noninfected wounds. Because an alginate is highly absorbent, it should not be used with dry wounds or wounds with minimal drainage; it could dehydrate the wound, delaying healing.

Composite dressings have multiple layers and can be used as primary or secondary dressings. They are appropriate for wounds with minimal to heavy exudate, healthy granulation tissue, necrotic tissue (slough or moist eschar), or a mixture of granulation and necrotic tissue (Figure 1).

Use composite dressings cautiously if the patient is dehydrated or has fragile skin. Keep in mind that some insurers will not reimburse a facility or provider if a composite dressing is used as a secondary dressing with a hydrogel or impregnated gauze.

Transparent Films

 Film dressings are flexible sheets of transparent polyurethane coated with an acrylic adhesive. They can be used as a primary or secondary dressing.

These dressings are semipermeable, vary in size and thickness, and have an adhesive that holds the dressing on the skin. They conform easily to the patient's body but do not hold well in high-friction areas, such as the sacrum or buttocks. Because films are transparent, the wound can be easily monitored.

Because films are semiocclusive and trap moisture, they allow autolytic debridement of necrotic wounds and create a moist healing environment for granulating wounds.  Medical Supplies.