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Understanding wound dressings: Hydrocolloids

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VOL: 101, ISSUE: 46, PAGE NO: 51

Jacqui Fletcher, MSc, PGCertEd, RGN, is principal lecturer, tissue viability, Department of Nursing and Midwifery, University of Hertfordshire

Hydrocolloid dressings are available in a variety of shapes, sizes and presentations (Fig 1). Hydrocolloid is also included as a constituent in a number of other generic wound management products, for example, gels or silver dressings. These products will be covered later in this series. In addition, there are a number of combination products available, such as Alione, CombiDerm and Versiva, which contain hydrocolloid particles. The products identified in this article are those in which the main constituent is a hydrocolloid - usually carboxymethylcellulose (Box 1).

Indications for use

Hydrocolloid dressings are indicated for low to moderately exuding wounds. Thin versions are generally used on wounds that are dry or which have low levels of exudate.

Action at the wound dressing interface

When hydrocolloid comes into contact with wound exudate it forms a hydrophilic gel that facilitates autolytic debridement of the wound. Patients and less experienced practitioners may think that this is a purulent discharge, but they should be advised that this is not so. The gel is easy to remove and does not indicate that the condition of the wound has deteriorated.

Characteristics of hydrocolloid dressings

These products are waterproof and generally impermeable to bacteria. Thin and bordered products, or those with a profiled edge, are less likely than the thicker hydrocolloids to roll or ruck at the edges.

Different shapes and sizes of dressings are produced for specific anatomical areas: for example, flat sheets can be cut and folded to recreate the appropriate body shape, although this is not always possible with some bordered or profiled products, as the adhesive covering is lost.

Application of the dressings

Hydrocolloid dressings should be gently warmed between the hands before use to improve adhesion and, where possible, the patient’s weight should be kept off a dressing for a minimum of 20 minutes to allow it to adhere to the skin. This will maximise the wear time. It is usual to allow a margin of 1.5 to 2cm around the wound, although gravity should be considered when placing the dressing on parts of the body such as the lower legs.

Individual manufacturer’s instructions should be consulted before using hydrocolloid dressings on an infected wound. Hydrocolloid paste is useful on wet, excoriated areas such as peri-stomal or peri-anal wounds and may also be used under the flat sheets in cavity wounds to increase absorbency.

- The list of hydrocolloids in Box 1 is not exhaustive.

FURTHER READING

Morgan, D. (2004)Formulary of Wound Management Products (9th edn). Haslemere: Euromed Communications.

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