From the Guidelines
The best dressing for an oozing hematoma is a commercial pressure dressing, which may be effective in maintaining hemorrhage control, as recommended by the 2024 American Heart Association and American Red Cross guidelines for first aid 1.
Key Considerations
- The dressing should be applied by someone who has received bleeding control training, including non–health care personnel.
- The use of elastic adhesive dressings may also be effective in controlling bleeding.
- It is essential to monitor the wound and change the dressing when it becomes saturated or at least once daily to prevent infection.
Additional Measures
- Cold therapy can be applied intermittently for the first 24-48 hours to help constrict blood vessels and reduce bleeding.
- Elevation of the affected area above heart level will also help minimize blood flow to the area and reduce oozing.
- Occlusive dressings, such as film or hydrogel dressings, may result in better wound healing than dry dressings, as stated in the 2024 American Heart Association and American Red Cross guidelines for first aid 1.
Important Notes
- There is no indication that antibiotic or antibacterial dressings improve wound healing or decrease infection rates in clean wounds 1.
- Hemostatic dressings, including those with hemostatic agents, may be useful in controlling bleeding, but their use should be considered on a case-by-case basis, taking into account the type of bleeding, severity, and coagulation status, as discussed in the European guideline on management of major bleeding and coagulopathy following trauma: sixth edition 1.
From the Research
Dressing Options for Oozing Hematoma
- The ideal dressing for an oozing hematoma should provide a moist environment, have an optimal water vapor transmission rate (WVTR), and absorptive capacity 2.
- Moist wound dressings, including films, foams, hydrocolloids, hydrogels, and alginates, can be used to create and maintain a moist environment for healing 2.
- For oozing hematomas, dressings with high absorptive capacity, such as alginates or foams, may be more suitable 3.
Topical Hemostatic Agents
- Topical hemostatic agents, such as fibrin sealants, microfibrillar collagen, and gelatin hemostatic agents, can be used to aid in hemostasis 4, 5, 6.
- These agents can be effective in controlling bleeding and promoting hemostasis, but their use should be guided by the surgeon's experience and the specific clinical situation 5.
Wound Dressing Selection
- The selection of a wound dressing should be guided by an understanding of the wound's properties, including the level of drainage and depth 3.
- Moisture-retentive dressings, antimicrobial-impregnated dressings, and tissue-engineered dressings can be useful in various clinical settings, depending on the wound's specific needs 3.
- The ideal dressing type may change as the wound heals, and recognition of the changing healing environment is crucial for successful wound dressing selection 3.