From the Guidelines
Hydrocolloid dressings can be used on stage 3 pressure ulcers, but their effectiveness is equivalent to foam dressings for complete wound healing, as shown in a clinical practice guideline from the American College of Physicians 1. When considering the use of hydrocolloid dressings for stage 3 pressure ulcers, it is essential to weigh the benefits and limitations of this treatment option. Stage 3 ulcers involve full-thickness skin loss with damage to subcutaneous tissue, often presenting with visible adipose (fat) tissue and possibly undermining and tunneling. These wounds typically produce moderate to heavy exudate, which may exceed the absorption capacity of hydrocolloid dressings. Some key points to consider when using hydrocolloid dressings for stage 3 pressure ulcers include:
- Hydrocolloid dressings were superior to gauze dressings for reducing wound size, but equivalent to foam dressings for complete wound healing 1.
- The most commonly reported harms for local wound applications, including hydrocolloid dressings, were skin irritation, inflammation, and tissue damage and maceration 1.
- Other dressing options, such as calcium alginates or hydrofibrous dressings, may be more suitable for stage 3 ulcers with heavy exudate, as they can manage higher levels of drainage and provide better moisture balance.
- Wound care for stage 3 ulcers should also include regular debridement of necrotic tissue, management of bacterial bioburden, and addressing underlying factors such as pressure redistribution, nutritional support, and management of comorbidities that may impair healing. In summary, while hydrocolloid dressings can be used on stage 3 pressure ulcers, their use should be carefully considered and tailored to the individual patient's needs, taking into account the wound's exudate level, size, and overall condition, as well as the patient's overall health status and comorbidities 1.
From the Research
Hydrocolloid Dressing for Stage 3 Pressure Ulcers
- Hydrocolloid dressings can be used on stage 3 pressure ulcers, as evidenced by studies 2, 3, 4, 5, 6.
- A study comparing a transparent absorbent acrylic dressing and a hydrocolloid dressing found that the hydrocolloid dressing was effective in managing stage II and shallow stage III pressure ulcers 2.
- Another study found that a hydrocolloid/alginate dressing combination facilitated wound contraction and removal of fibrin slough in stage III and IV pressure ulcers 3.
- A controlled clinical study evaluating the use of hydrocolloid dressings on sacral pressure ulcers found that hydrocolloid dressings were effective in managing stage II and III sacral pressure ulcers 4.
- A randomized clinical study comparing a hydrocellular dressing to a hydrocolloid dressing found that the hydrocolloid dressing was effective in managing stage II and III pressure ulcers 5.
- A multicenter randomized trial found that sequential treatment with calcium alginate and hydrocolloid dressings accelerated pressure ulcer healing in older subjects with grade III or IV pressure ulcers 6.
Key Findings
- Hydrocolloid dressings can facilitate wound contraction and removal of fibrin slough in stage III pressure ulcers 3.
- Hydrocolloid dressings can be used in combination with other dressings, such as calcium alginate dressings, to accelerate pressure ulcer healing 6.
- The use of hydrocolloid dressings can promote faster healing of pressure ulcers compared to treatment with hydrocolloid dressings alone 6.
- Hydrocolloid dressings can be effective in managing stage II and III pressure ulcers, including sacral pressure ulcers 2, 4, 5.