Wound dressings are sometimes described as passive, active, or interactive. While passive wound dressings simply serve a protective function, active dressings actually promote healing through the creation of a moist wound environment. Interactive wound dressings, on the other hand, not only create a moist wound environment but also interact with the wound bed components to further enhance wound healing. For example, interactive wound dressings may reduce colonization count, reduce the level of exudate, improve wound bed moisture retention, improve wound collagen matrix, remove cellular products or provide protection for the epithelializing bed.
In this article, we will look at specific interactive dressings that fall into the general headings of ‘antimicrobials’ or ‘biologics and biosynthetics’.
- First, we will consider antimicrobial dressings. These dressings, containing broad spectrum antimicrobial agents, have been developed to minimize colonization and prevent local infection, thereby promoting wound healing. Let us now look at a number of antimicrobial dressings.
- Silver dressings. Silver has been known for centuries to have antimicrobial properties. There is currently an abundance of interactive wound dressings on the market that deliver ionic silver. Some of these dressings appear to be particularly effective at eliminating antibiotic-resistant bacteria, such as MRSA and VRE.
- PHMB dressings. Dressings have recently been developed that incorporate polyhexamethylene biguanide (or PHMB) – an odorless, colorless, clear broad-spectrum antimicrobial agent. This agent acts both as a bacterial barrier and as an active antimicrobial capable of destroying pathogens. PHMB does not irritate nor hypersensitize the skin, which make it particularly well-suited to chronic wound care.
- Cadexomer iodide dressings. Iodine is a potent broad-spectrum antiseptic agent but has been found to impair the function of cells if used in too high a concentration. Cadexomer iodine is a slow-release antimicrobial capable of absorbing excess wound exudate while offering a sustained level of iodine in the wound bed.
- Bacteriostatic foam dressings. These dressings prevent infection by inhibiting the growth of bacteria. They are indicated for the prevention of local wound infection in many types of wound, including pressure ulcers, venous stasis ulcers, arterial ulcers, donor sites, abrasions, laceration, radiation burns, post-surgical incisions, and other wounds caused by trauma.
- Honey-based dressings. These are a relatively recent innovation and are thought to offer anti-inflammatory, antibacterial, debridement and odor control effects. In addition, they are thought promote wound healing by increasing fibroblast activity, angiogenesis and epithelialization. Honey-based wound dressings can be used in a variety of chronic and acute wounds as well as burns and atopic dermatitis.
- Next, we will take a look at biologic and biosynthetic dressings. These dressings are derived from natural sources, and provide a healing scaffold or matrix that assists in the granulation and epithelialization of partial- and full-thickness wounds. Biologic and biosynthetic dressings have been shown to achieve a higher rate of wound closure in difficult-to-treat wounds compared with standard treatments. Let us now look at some examples of biologic and biosynthetic dressings.
- Collagen dressings. These dressings positively enhance and influence wound healing not only by encouraging the deposition and organization of newly formed tissue, but also by stimulating macrophages and fibroblasts. They are generally available in the form of sheets, gels, or particles, and can be moisturizing or absorptive, depending on the delivery system, to maintain moist wound healing. They are easy to apply and remove, and tend to be conformable.
- Polyacrylate dressings. Activated polyacrylate dressings facilitate wound debridement by retaining moisture while attracting and retaining proteins and bacteria. This interactive dressing supports both moist wound healing and autolytic debridement, gently removing dead tissue from the wound bed while creating an ideal healing environment.
To learn more about these interactive wound 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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