Wound Care Products & Dressings

A stage 3 pressure injury with heavy exudate needs a fundamentally different dressing than a dry, granulating wound — choosing wrong stalls healing or causes maceration. Do you know which goes where?

Dressing selection is driven by one principle: match the dressing to the wound's moisture needs. Dry wounds need moisture donation; wet wounds need moisture absorption. Transparent films (like Tegaderm) are occlusive, retain moisture, and protect shallow wounds or IV sites — they have no absorptive capacity, so never place them on draining wounds. Hydrocolloids (like DuoDerm) provide a moist environment for partial-thickness wounds with minimal exudate; they self-adhere and are waterproof but should not be used on infected wounds because the occlusive seal traps bacteria. Hydrogels donate moisture to dry, necrotic, or granulating wounds and are soothing for painful wounds — they come as sheets or amorphous gel. Alginates (derived from seaweed) and hydrofibers absorb heavy exudate and are ideal for deep, heavily draining wounds; alginates form a gel on contact with wound fluid and require a secondary dressing. Foam dressings absorb moderate-to-heavy drainage while maintaining moisture balance and are commonly used over bony prominences. Wet-to-dry gauze, though still seen, is a form of mechanical debridement that is non-selective — it removes healthy and dead tissue alike and is largely being replaced by modern alternatives. Wound VAC (negative pressure wound therapy) applies sub-atmospheric pressure to promote granulation in large, complex wounds.

Key Distinctions

Don't confuse hydrogels (donate moisture to dry wounds) with hydrocolloids (retain moisture, used on minimal-exudate wounds) — the names sound alike but the moisture direction differs. Students often place transparent films on draining wounds, but films have zero absorption and will cause maceration. Alginates require exudate to work — placing an alginate on a dry wound causes it to stick and damages new tissue on removal.

Clinical Pearl

Think: "Dry wounds drink, wet wounds wick." Hydrogels hydrate (donate), alginates absorb (wick). Match the dressing to the moisture deficit.