Dressings for Success

Dressings for 

SUCCESS 

Today’s Speaker: 

Axel Rohrmann 

Podiatrist 

B-Tech.POD(S.A.),M.Pod.A.(S’pore)

TALK OUTLINE 

What is wound care 

10 minutes 

Classifications 

Treatment options 

10 minutes 

10 minutes 

Case studies and discussion 

5 minutes

What does wound care mean to you? 

• My patient X …. 

• Return to normalcy, routine activities of daily 

living. 

• Improved quality of life. 

• Long term success.

Dressings for success! 

• Understanding the basic principles of wound 

management and coupling that with 

knowledge of the dressing characteristics can 

help to make the decision-making process 

easier.

A wound dressing is a substitute for 

native epithelium 

• The process of wound repair occurs in stages each of which 

will require different dressings. 

• Dressings provide the optimum environment for rapid healing 

by protecting the wound from further: 

– trauma, 

– bacterial invasion or 

– exposure to caustic substances, 

• Be able to: 

– conform to the wound shape, 

– absorb wound fluid, 

– provide pressure for hemostasis 

– should also support the wound and surrounding tissues, 

– eliminate pain, 

– easily applied and removed with minimal injury to the wound.

Not all wounds are the same! 

• Neuropathic, arterial, venous, chronic, acute, 

mixed, gout, 

• Clean, granulating, epitheliizing, remodeling, 

• Healing, stalled, non-healing. 

• Wound Aetiologies differ from wound to 

wound!

Wound dressing categories 

- Alphabet soup - 

• Absorptive Dressing 

• Alginates 

• Antimicrobials 

• Cleansers 

• Closure Devices 

• Collagen 

• Compression Dressing & Wraps (Leg) 

• Composite Dressing 

• Contact Layer 

• Enzymatic Debriders 

• Fillers (wound) 

• Foam Dressings 

• Growth Factors 

• Hydrocolloid 

• Hydrofiber 

• Hydrogel 

• Hydrogel Impregnated Gauze 

• Hydrogel Sheet 

• Miscellaneous Devices 

• Negative Pressure Wound Therapy 

(NPWT) 

• Odor Absorbing 

• Scar Therapy 

• Skin Care 

• Skin Substitutes 

• Tissue Engineering / Growth Factors 

• Transparent Films

•Wound healing phase

Progression of Acute wound healing

Chronic wounds can get stalled.

FACTORS AFFECTING WOUND HEALING 

• PVD 

• Infection 

•Trauma 

• Presence 

of necrosis 

or slough 

• Age 

• Poor 

Nutrition 

•Poor wound care 

•Drugs 

•Other systemic 

diseases: 

• DM 

• Anaemia

FACTORS DELAYING WOUND HEALING 

• Bio-film 

•Damaged matrix 

•Growth factors 

receptors/deficiency 

•Infection 

•High proteases 

•Inflammatory environment 

•Non migratory cells 

•Senescent cells 

•Hyper proliferative edge 

epithelium 

CAN WE MODULATE THESE EVENTS?

• Dressings will create an environment 

that may facilitate healing 

• If underlying causes are not treated 

then the wound is unlikely to heal. 

• Remember there is no miracle dressing 

that will heal all wounds!!!

Properties of an ideal dressing 

• Bacteria proof 

• Allows gaseous exchange 

• Manages exudate 

• Non-adherent 

• Fibre and toxin free 

• Hypoallergenic 

• Maintain haemostasis and optimum 

temperature. 

• Acceptability to patient 

• Cost effective.

Choosing the right dressing! 

• Thorough patient & wound assessment. 

• Don’t make the wound fit the dressing. 

• Consider the wound and patients needs. 

– Dressing frequency, home care, compression, TCC 

• Size of the wound – cost effectiveness 

– NPWT till wound is smaller 

• Exudate 

• Surrounding skin – peri wound protection 

• Bioburden – threat of contamination at changes 

• Pain at dressing changes

Tissue type in the wound 

• Necrotic – debride 

• Epitheliizing – protect 

Granulating – maintain 

Remodeling - assist

he commonly used dressing categories 

• Excluding gauze and other cotton packing 

materials, 

• Include transparent film dressings, 

hydrocolloids, hydrogels (amorphous and 

sheet), calcium alginates and foams, and will 

be discussed

Transparent film dressings 

• Semi permeable adhesive polyurethane 

• Can cause maceration as non absorbent 

• Vapour permeable. 

• Can be left for upto 7 days 

• Waterproof protection 

• Can be used as primary and secondary dressing 

• Remove by lifting corner and stretching 

horizontally.

Hydrocolloid dressings 

• Composed of pectin, carboxymethylcellulose 

and adhesives. 

• Gel is formed at the wound interface 

• Indicated for wounds that are low-tomoderately 

exuding. 

• Not recommended for use on infected wounds 

• can be left in place up to seven days

Hydrogels 

• Moisture-donating materials composed of polymers 

• Have additional water or glycerin for moisture 

• Hypertonic sodium for enhanced fluid shift to aid in 

autolytic debridement 

• Ability to hydrate a dry wound surface fairly rapidly 

• Promotes debridement of eschar and slough. 

• Hydrogel sheets may reduce pain. 

• Caution if used on infected wounds. 

• Requires secondary dressing

Calcium alginates 

• Non-woven fibres derived from brown seaweed 

• Have a haemostatic effect – release of Ca ions 

• Contact with sodium-rich fluid, such as wound 

exudate, creating sodium alginate gel 

• Changed according to the level of exudate. 

• Highly absorbent and biodegradable can absorb 

20 times own weight. Made from brown 

seaweed. 

• Suitable for wet or cavity wounds.

Hydrofibers® 

• Sodium carboxymethylcellulose fibres absorb 

moderate-to-large amounts of wound exudate 

• Absorbs wound fluid and transforms into soft gel. 

• Highly absorbent 

• Promotes debridement. 

• Absorbs and locks in bacteria and exudate 

• Decrease in fluid can cause the dressings to dry 

out and become painfully adherent

Foams 

• polyurethane with or without a film outer 

layer to prevent 'strike-through' 

• differences between the various foam 

dressings, including thickness and the ability 

to donate rather than absorb moisture 

• may be used in most wound types 

• frequency of change will be dependent upon 

the primary dressing 

• Can be use as primary or secondary dressing

Wound contact layers 

• Non adherent dressings for lightly 

exuding granulating wounds 

• Prevents trauma to wound bed.

Antimicrobials

Inadine and cadexomer iodine 

Inadine –10% 

povidone-iodine 

Cadexamor iodine – 

released from starch 

when in contact with 

wound exudate 

Caution in thyroid 

patients iodine 

sensitivity, renal 

problems

Silver 

Aqucel AG -1.2% 

Acticoat – nano 

crystalline silver – 

rapid bacteria kill due 

to high concetration of 

elemental silver 

Actisorb silver – with 

charcoal for odour

PHMB (Polyhexamethylene 

•Wound cleanser- 

Surfactant 

•Debriding hydro gel 

•Contains betadine 

which penetrates and 

removes bacteria 

biguanide)

Honey 

Algivon 

Non –adherent alginate 

impregnated with medical 

grade Manuka honey 

•Facilitates debridement 

•Inhibits bacterial growth 

•Reduces odour.

Photo courtesy of Dr. Axel Rohrmann, Podiatrist. 

Case studies

•Diagnose cause 

•Good wound care 

•Appropriate pressure 

relief 


PRESSURE ULCER

Photo courtesy of Dr. Axel Rohrmann, Podiatrist.



Conclusion 

• There is no miracle dressing that will 

heal a wound if underlying aetiologies 

are not addressed. 

• It is important that you understand the 

properties of different dressings and 

their function. 

• If you think that a dressing is not 

meeting the needs of the patient you 

must ensure that a qualified member 

of staff reassess the wound ASAP!

• Find a way to have fun 



Thank you 

axelrohrmann@gmail 

Tel.: 306)522 3346 Fax.: 306) 522 3348 

Copyright 

2013. Dr. Axel Rohrmann. All rights reserved

List of products & manufacturer. 

• Please not this list is not exhaustive and 

manufactures may choose to add, remove or 

rename products periodically. 

• All categories are not included in this list. 

• Please check for dressing products available in 

your health region, province or country.

Absorptive dressing 

• Product 

Manufacturer 

• Medipore 3M 

• Aquacel Hydrofiber 

• CombiDERM ConvaTec 

• Absorptive Border DermaRite 

• IODOFLEX HEALTHPOINT 

• TIELLE Johnson & Johnson 

• CURITY ABD 

• TELFAMAX 

• TENDERSORB ABD Kendall 

• Mepore Molnlycke Health Care 

• EXU-DRY 

• Primapore Smith & Nephew

Alginates 

• Product 

Manufacturer 

• AlgiSite M 

Smith & Nephew, Inc. Wound 

• Hyperion Advanced Alginate Hyperion Medical, Inc. 

• KALTOSTAT 

ConvaTec 

• Melgisorb 

Molnlycke Health Care 

• PolyMem 

Ferris Mfg. 

• Restore CalciCare Hollister 

• SILVERCELL 

Johnson & Johnson 

• Sorbalgon 

Harmann-Conco Inc. 

• SeaSorb 

Coloplast Corp. 

• Tegagen HG 

• Tegagen HI 

3M Health Care

Antimicrobial dressings 

• Product Manufacturer 

• 3M Tegaderm Ag Mesh 3M 

• Amerigel Amerx Health Care Corp. 

• Contreet Coloplast Corp. 

• Collatamp G Theramed 

• Aquacel Ag ConvaTec 

• Hydrofera Blue Hydrofera Inc. 

• Actisorb Johnson & Johnson 

• Kerlix AMD 

• Curity AMD 

• Excilon AMD 

• TELFA AMD Kendall / Tyco 

• Acticoat 3 

• Acticoat 7 

• Acticoat Moisture Control 

• IODOFLEX 

• IODOSORB S Smith & Nephew

Collagen dressings 


• Medifil 

• Skin Temp BioCore 

• BGC Matrix Brennen 

• WOUN'DRESS Coloplast Sween 

• Collagen/AG DermaRite 

• ColActive Ag Hartmann-Conco, Inc. 

• FIBRACOL plus Collagen 

• Prisma 

• Promogran Prisma Johnson & Johnson 

• Biostep 

• Biostep Ag Smith & Nephew

Contact layer 

• Product 

• Tegapore 

• TELFA CLEAR 

• Mepitel 

• Profore Contact Layer 

Manufacturer 

3M 

Kendall 

Molnlycke Health 

Smith & Nephew

Foam dressings 


• - 3M Foam Dressing (nonadhesive) 

• - 3M Foam Adhesive Dressing 3M 

• Lyofoam 

• Lyofoam EXTRA ConvaTec 

• BIOPATCH Johnson & Johnson 

• CURAFOAM Kendall 

• Mepilex 

• Mepilex Border Molnlycke Health Care 

• Allevyn Adhesive 

• Allevyn Cavity 

• Allevyn Dressing Smith & Nephew

Hydrocolloid dressing 


• Tegasorb 

• Tegasorb THIN 3M 

• Comfeel Coloplast 

• DuoDERM CGF 

• DuoDERM 

• SignaDRESS Sterile ConvaTec 

• DermaFilm HD 

• Restore Hollister 

• NU-DERM Johnson & Johnson 

• Ultec Kendall 

• RepliCare 

• Cutinova Hydro 

• Cutinova Thin Smith & Nephew

Hydrogels 


• Tegagel 3M 

• Amerigel Topical Ointment Amerx Health Care 

• Purilon Coloplast 

• DuoDERM 

• SAF-Gel ConvaTec 

• Restore Hollister Inc. 

• NU-GEL Johnson & Johnson 

• CURAFIL Kendall 

• Hypergel 

• Normlgel Molnlycke Health Care 

• IntraSite 

• SoloSite Smith & Nephew 

Hydrofibre 

Aquacell 

ConvaTec

Odour absorbing 

• Product 

• CarboFlex 

• LyoFoam C 

• Odor Absorbing Dressing 

Manufacturer 

ConvaTec 

Dumex

Transparent films 


• Tegaderm HP 

• Tegaderm 3M 

• BIOCLUSIVE MVP 

• BIOCLUSIVE Johnson & Johnson 

• Blisterfilm 

• POLYSKIN II 

• POLYSKIN M.R. Kendall 

• Mefilm Molnlycke Health Care 

• OpSite FLEXIGRID 

• OpSite 

• UniFlex Smith & Nephew

Tissue engineering 

• Product 

Manufacturer 

• Apligraf 

Organogenesis 

• Dermagraft 

• GRAFTJACKET® Wright Medical Technologies, Inc. 

• GRAFTJACKET® XPRESS 

• Oasis 

Healthpoint 

• Orcel 

Ortec International, Inc. 

• Regranex 

Johnson & Johnson

CLASSIFICATION OF WOUNDS 

‣Grade 0 = No open lesions 

‣Grade 1 = Superficial ulcer 

‣Grade 2 = Deep ulcer to tendon, joint or bone 

‣Grade 3 = Deep ulcer with abscess, osteomyelitis 

‣Grade 4 = Localised gangrene 

‣Grade 5 = gangrene of the whole foot

Grades wounds first with numbers 0 to 3 referring to 

depth: 

‣0 : pre- or post-ulcer with epithelialization, 

‣1 : superficial and not involving tendon, bone or capsule, 

‣2 : ulcer penetrates through to tendon or capsule, 

‣3 : penetrating to bone or joint. 

A second classification tier, A to D, refers to other burdens on the wound. 

‣ A : indicates non-infected/non-ischemic, 

‣ B : indicates infection, 

‣ C : indicates ischemia, 

‣ D : indicates infection plus ischemia.

Dressings for Success

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