What are the best wound dressings?

Best Wound Dressings for Different Wound Types

Occlusive dressings should be selected primarily based on exudate control, comfort, and cost as they result in better wound healing than dry dressings for most wounds. 1, 2

General Principles for Wound Dressing Selection

• Thoroughly clean and irrigate wounds until there is no obvious debris or foreign matter before applying any dressing 1
• Use running tap water or sterile saline solutions for wound irrigation instead of antiseptic agents like povidone-iodine 1
• Cover clean superficial wounds with occlusive dressings to promote wound healing 1
• Monitor for signs of infection (redness, swelling, foul-smelling drainage, increased pain, fever) and remove dressing to inspect the wound if these develop 1

Dressing Types Based on Wound Characteristics

For Superficial Wounds and Abrasions

• Hydrogel dressings: Recommended for dry or minimally exuding wounds 1, 3
• Film dressings: Suitable for dry wounds with minimal exudate 2, 3
• Hydrocolloid dressings: Good for minimal to moderate exudate 2, 3

For Moderately Exuding Wounds

• Foam dressings: Excellent for moderate to heavy exudate 2, 4
• Hydrofiber dressings: Highly absorbent for moderate to heavy exudate 3

For Heavily Exuding Wounds

• Alginate dressings: Best for heavily exuding wounds 3
• Foam dressings with higher absorption capacity: Can handle significant drainage 4

Special Considerations

For Diabetic Foot Ulcers

• Select dressings principally on the basis of exudate control, comfort, and cost 1
• Consider sucrose-octasulfate–impregnated dressing as an adjunctive treatment for non-infected, neuro-ischaemic diabetic foot ulcers that are difficult to heal 1
• Do not use antimicrobial dressings with the sole aim of accelerating healing 1

For Burns

• For small burns (adults <20% TBSA, children <10% TBSA), cooling the burn is recommended in the absence of shock 1
• Apply simple sterile gauze, interface dressings, or non-adhesive dressings in the pre-hospital phase 1
• Avoid external cooling devices for prolonged periods to prevent hypothermia 1
• Silver sulfadiazine may be associated with prolonged healing if used for extended periods on superficial burns 1

For PEG Tube Sites

• Glycerin hydrogel or glycogel dressing is recommended during the first week(s) after insertion 1
• After stoma healing, dressings can be reduced to once or twice a week 1
• The site can be cleansed using soap and water of drinking quality 1
• Alternatively, dressings can be omitted and the site left open after healing 1

Dressing Change Frequency

• For most wounds, dressing changes can be reduced to once or twice a week as the wound heals 1, 2
• More frequent changes may be needed for heavily exuding wounds 5, 3
• Monitor the wound regularly and adjust dressing change frequency based on exudate level and healing progress 6, 3

Common Pitfalls to Avoid

• Avoid occlusive dressings if there are signs of infection as they may promote bacterial growth 2
• Do not use antimicrobial dressings routinely as they have not shown benefit for improving wound healing or preventing secondary infection 1
• Avoid povidone-iodine for wound irrigation as it has not demonstrated benefit over saline or tap water 1
• Do not apply bandages too tightly, especially on limbs, to prevent tourniquet effect 1