Hydrocolloids are occlusive or semi-occlusive dressings consisting of a combination of gel-forming polymers that absorb exudate slowly by swelling into a gel-like mass. Hydrocolloids have different absorption capabilities depending on their thickness and composition. Upon removal, a residue commonly remains within the wound bed, which is often mistaken as a sign of infection. Although sometimes derided as a ‘low-tech’ option, hydrocolloids remain the most commonly used moist dressing in many settings for chronic wound management.
Hydrocolloid dressings offer many advantages in wound care. When wound exudate is absorbed by a hydrocolloid, it develops a thick colloidal gel in the wound bed that increases the moist healing environment necessary for granulation, epithelialization, and autolysis. Hydrocolloids also provide thermal insulation and are impermeable to water, oxygen, and bacteria. In addition, hydrocolloids conform to body shape and provide a waterproof surface. Wounds dressed with hydrocolloids have lower infection rates than wounds covered with gauze, semi-permeable films, sheet hydrogels, or semi-permeable foams.
There are a number of different types of hydrocolloid dressing, including thin, regular thickness, bordered, padded, or alginate-combined. Hydrocolloids are also available as pastes, granules, and powder for use in cavities. Hydrocolloid dressings come in a variety of sizes and shapes, including the sacrum shape that is designed to fit the gluteal fold of the buttocks. Some hydrocolloids have beveled edges to reduce the tendency for the dressing to roll when placed in high-friction areas, and others have a smooth satin-like outer coating to decrease friction and shear.
Hydrocolloids may be used for partial and full-thickness wounds, both granular and necrotic. While primarily used to treat pressure ulcers, hydrocolloids are also indicated for minor burns, donor sites and venous insufficiency ulcers. They may also be used in small-cavity wounds, as hydrocolloid paste, powder or granules.
There are a number of circumstances in which use of hydrocolloids is not appropriate. Hydrocolloids absorb fluid slowly, so they are not suitable for managing bleeding wounds or heavily-draining wounds. Hydrocolloids should not be used on dry wounds, wounds with minimal drainage or on wounds with exposed tendons or fascia. Because of their occlusive nature, hydrocolloids are contraindicated in infected wounds, and should be used with caution on immunosuppressed patients. Finally, because of the strong adhesive backings of most hydrocolloids, these dressings should only be used on patients with good skin integrity.
To learn more about these dressings and others, you may wish to consider becoming certified as a wound care specialist. The benefits of wound certification are immeasurable, both to your own career and to the standard of care that you can offer your patients. And, because Medicare and other organizations are now holding healthcare professionals responsible for outcomes in wound care, there has never been a better time to become a wound care specialist.
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