II. Category

III. Characteristics

  1. Semipermeable
    1. Allows gaseous and oxygen exchange across polyurethane membrane
    2. Retains exudate to create moist environment
  2. Adhesive
  3. Moisture retentive

IV. Indications

  1. Non-exudative wounds
  2. Autolytic Debridement
  3. Type 1 to 2 Pressure Sores
  4. Secure other Wound Dressings
  5. Protect vulnerable areas from friction injury
    1. Elbows
    2. Heels
    3. Coccyx
    4. Skin Tear (generally avoid this bandage over tears due to risk of maceration and pulling up skin on removal)

V. Contraindications

  1. Absolute
    1. Cavity wounds
    2. Wounds with sinus tracts, undermining or tunneling
  2. Relative
    1. Infected Wounds (especially anaerobic)
    2. Wounds with excessive exudate
      1. Unless combined with foam, gauze, or hydrogel

VI. Technique

  1. Change dressing every 3 to 7 days
  2. Check dressing daily (transparent)
  3. Consider protecting skin edge from maceration
    1. Stomal adhesive wafer
    2. Vaseline
    3. Zinc Oxide

VII. Advantages

  1. Requires less care than traditional dressing (gauze)
  2. Conformable
  3. Water resistant
  4. Wound visualized without dressing removal
  5. Protects against secondary infection
  6. No additional dressing needed (no tape or wrap)

VIII. Disadvantages

  1. Expensive
  2. Maceration of peri-wound edges (wound border must be intact)
  3. Too frequent dressing changes may strip skin
  4. No absorptive capacity (can only use in non-exudative wounds)
  5. Difficult to apply
  6. No data showing efficacy in Pressure Ulcers
  7. Contraindicated in infected wounds
  8. Separates from skin in high friction areas

IX. References

  1. Bello (2000) JAMA 283(6): 716-8 [PubMed]
  2. Degreef (1998) Dermatol Clin 16(2): 365-75 [PubMed]
  3. Findlay (1996) Am Fam Physician 54(5): 1519-28 [PubMed]
  4. Habif (1996) Clinical Derm, Mosby, p. 810-13
  5. Knapp (1999) Pediatr Clin North Am 46(6):1201-13 [PubMed]
  6. Krasner (1995) Prevention Management Pressure Ulcers
  7. Lewis (1996) Med-Surg Nursing, Mosby, p. 199-200
  8. Lueckenotte (1996) Gerontologic Nurs., Mosby, p. 800-7
  9. PUGP (1995) Am Fam Physician 51(5):1207-22 [PubMed]
  10. PUGP (1994) Pressure Ulcer Treatment, AHCPR 95-0653
  11. Way (1991) Current Surgical, Lange, p.95-108

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