What is Telfa?
Telfa is a non-adherent wound dressing pad consisting of absorbent cotton fibers enclosed in a sleeve of thermoplastic polymers, designed to minimize adherence to wound surfaces while managing exudate and protecting healing tissue. 1, 2
Primary Composition and Design
- Telfa dressings are constructed with absorbent cotton fibers encased in a thermoplastic polymer sleeve that creates a non-stick interface with the wound bed 2
- Some formulations (Telfa AMD) incorporate polyhexamethylene biguanide (PHMB), an antimicrobial agent, though antimicrobial properties should not be the primary reason for selection 2
- The non-adherent surface prevents the dressing from sticking to wounds during removal, reducing pain and trauma to healing tissue 2, 3
Clinical Applications and Indications
Telfa should be selected primarily based on exudate control, comfort, and cost rather than for accelerating wound healing or antimicrobial effects. 1, 4
Appropriate Uses:
- Denuded dermis coverage in severe conditions like Stevens-Johnson syndrome/toxic epidermal necrolysis, where it serves as a non-adherent protective layer over exposed tissue 1
- Split-thickness skin graft donor sites, where it provides comfortable wound coverage during re-epithelialization 2
- Post-laser resurfacing wounds, particularly after CO2 laser treatment for wrinkles or acne scars 3
- Routine sutured wounds when combined with topical antibiotic ointment for basic wound protection 5
- Post-operative wound management in obstetric and gynecological surgeries 6
Clinical Performance Evidence
- In donor-site wound management, Telfa AMD demonstrated significantly faster re-epithelialization (9.25 ± 1.88 days) compared to chlorhexidine-impregnated paraffin gauze (14.00 ± 3.05 days, p < 0.001) 2
- Pain scores were markedly lower with Telfa AMD (1.57 ± 0.55) versus traditional paraffin dressings (4.70 ± 1.16, p < 0.001) 2
- Cost-effectiveness was comparable between Telfa and traditional dressings, with no significant difference in treatment costs 2
Important Limitations and Caveats
Do not use Telfa or any dressing with the sole aim of accelerating healing of chronic ulcers, particularly diabetic foot ulcers. 1, 4
Critical Considerations:
- Fragmentation risk in pathology specimens: When used to mount prostate core biopsies, Telfa significantly increases specimen fragmentation (46% fragmentation rate with 3 cores per jar versus 19% unmounted, p = 0.01), which can compromise diagnostic accuracy 7
- Telfa fibers can be difficult to remove completely from wounds, potentially requiring careful attention during dressing changes 3
- For chronic wounds, dressing selection should prioritize exudate management and patient comfort over any perceived antimicrobial or healing-enhancement properties 1, 4
Proper Application Technique
- Apply Telfa directly to the wound surface as a primary dressing layer 1
- May require a secondary absorbent dressing (such as foam or burn dressing) to collect excess exudate 1
- In severe burns or extensive skin loss, position the non-adherent layer widely to prevent adhesions between exposed tissue and surrounding structures 1
- Change dressings based on exudate saturation rather than a fixed schedule 3
Role in Comprehensive Wound Management
Telfa is a component of wound care, not a standalone treatment—address underlying causes of delayed healing such as pressure, infection, or poor perfusion. 4
- For infected wounds, systemic antibiotics are indicated rather than relying on antimicrobial dressing properties 4
- Wounds failing to improve after 2-4 weeks require reassessment and treatment modification 8
- Combine with appropriate wound cleansing, debridement, and pressure offloading as clinically indicated 4