II. Category
- First-line, cost effective Occlusive Dressing
- Wafers, pastes and powders composed of gelatin or pectin
III. Characteristics
- Absorptive
- Occlusive or semipermeable
- Adhesive
- Moisture retentive
IV. Indications
- Light to moderately edudative wounds
- Autolytic Debridement
- Type 2 to 4 Pressure Sores (some dressings may be used in Type I sores)
- Dry necrotic eschar Debridement
- Wounds with slough or necrosis
V. Contraindications: Relative
- Wound Infection (especially anaerobic)
- Exposed tendon or bone
- Diabetes Mellitus (may worsen necrotic Foot Ulcers)
VI. Preparation
- Powder, wafer, or paste forms
VII. Technique
- Change dressing every 3-5 days
- Consider stoma adhesive over top under film or tape
- May be used under compression dressing
- May be applied over an Alginate Dressing
VIII. Advantages
- Requires less care than other dressing types
- Become absorbent gels on contact with exudate
- Conformable
- Adheres to both wet and dry sites
- Water resistant
- Excellent microbial barrier (prevents infection)
- Assists with Autolytic Debridement
- Can be used under compression (e.g. Unna Boot)
IX. Disadvantages
- Expensive material
- Cost effective when compared with saline dressing
- Maceration of peri-wound margins
- May produce foul, sour odor
- Too frequent dressing changes may strip skin
- Limits wound visability, monitoring
- Secondary hypergranulation tissue may delay healing
- Leafy, friable beefy red tissue
- Remove with Silver Nitrate or Sharp Debridement
X. References
- Bello (2000) JAMA 283(6): 716-8 [PubMed]
- Degreef (1998) Dermatol Clin 16(2): 365-75 [PubMed]
- Findlay (1996) Am Fam Physician 54(5): 1519-28 [PubMed]
- Habif (1996) Clinical Derm, Mosby, p. 810-13
- Knapp (1999) Pediatr Clin North Am 46(6):1201-13 [PubMed]
- Krasner (1995) Prevention Management Pressure Ulcers
- Lewis (1996) Med-Surg Nursing, Mosby, p. 199-200
- Lueckenotte (1996) Gerontologic Nurs., Mosby, p. 800-7
- PUGP (1995) Am Fam Physician 51(5):1207-22 [PubMed]
- PUGP (1994) Pressure Ulcer Treatment, AHCPR 95-0653
- Way (1991) Current Surgical, Lange, p.95-108