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Ideal Properties for Foot Wound Dressings

Foot Wound DressingsThere are many different sub-types of foot wound dressings on the market to choose from. Choice of foot wound dressings will depend on size and location of wound, infection, excaudate levels, allergies, wound bed and surrounding skin integrity.

Further caution must be taken when choosing a dressing to apply on the foot, as the dressing will have to undergo increased sheer force, friction and pressure than anywhere else on the body.

 

 

The Ideal Properties for  Foot Wound Dressings:

  • Provides a moist wound environment.
  • Provide thermal insulation and mechanical protection.
  • Act as a barrier to micro-organisms.
  • Leaves no fibers behind in the wound.
  • Non-toxic, non-allergenic and non-irritating.
  • Promotes wound healing.
  • Non-adherence to the wound or to the surrounding skin.
  • Allows for removal without pain or trauma.
  • Capable of absorbing excess exudate without coming through the dressing.
  • Allows for gaseous exchange.
  • Antimicrobial/antifungal if clinical signs of infection need to be treated.
  • Easy to use.
  • Cost-effective.

 

Here are a list of the different groups of dressings that may aid in your decision of an appropriate wound dressing:

 

Gauze

  • Sterile gauze can be used to loosely pack wounds and aid in mechanical debridement.
  • Used mainly as a secondary dressing.
  • Can adhere to the wound bed surface and cause more trauma on removal if too dry.

 

Tulle e.g. Jelonet

  • Does not stick to wound surface, so no mechanical irritation is caused on removal.
  • Suitable for flat, shallow clean wounds.
  • Useful in patients with sensitive skin.

 

Hydrocolloids e.g. DuoDerm, Tegasorb

  • Composed of carboxymethylcellulose, gelatin, pectin, elastomers and adhesives that turn into a gel when exudate is absorbed.
  • Non- breathing (occlusive) dressing, contraindicated in infection, especially with anaerobic organisms.
  • Promotes autolysis and aids healing of the wound bed (granulation tissue).
  • Depending on the hydrocolloid dressing chosen, it can be used in wounds with light to heavy exudate, sloughing or granulating wounds.
  • Can remain in place for up to a week.
  • Over-granulation can occur.
  • Not to be used on the plantar surface of the foot.
  • Contraindicated in people with diabetes.
  • Available in many forms but most commonly as self-adhesive pads.

 

 Cadexomer Iodine  e.g. Iodosorb

  • It is a water-soluble modified starch polymer containing 0.9% iodine, within a helical matrix.
  • Can come in a range of forms (powder, ointment, sheet).
  • Aids in autolytic debridement and desloughing of wounds.
  • Suitable for light to moderate exudating wounds.
  • Suitable for clinical infection, having antimicrobial properties.
  • May be contraindicated in certain conditions (kidney dysfunction, Grave disease etc.) due to systemic absorption of iodine.
  • May cause allergic reactions especially if sensitive to iodine.
  • May be used with gangrenous wounds to keep dry and clean.

 

Alginates e.g Sorbsan, Kaltostat

  • Composed of calcium alginate (a seaweed component).
  • Calcium in the dressing is exchanged with sodium from wound fluid and turns into a gel that maintains a moist wound environment.
  • Highly absorbent.
  • Useful in medium to heavily exudating wounds.
  • Secondary covering is required.
  • Aids in debridement of sloughing wounds.
  • Has haemostatic properties.
  • Do not use on low exudating wounds as this will cause dryness and scabbing.
  • May leave fibers in the wound if too dry.
  • Dressing should be changed daily.
  • Not the dressing of choice in clinically infected wounds.

 

Hydrofibre e.g. Acquacel,  Aquacel Ag

  • Soft non-woven pad or ribbon dressing (depending on wound type) made from sodium carboxymethylcellulose fibers.
  • Ribbon dressing can be used to pack sinuses.
  • Interacts with wound exudate to form a soft gel and help maintain a healthy wound environment.
  • Aquacel Ag is a silver impregnated dressing that should be used in moderate to heavily exudating clinically infected wounds.

 

Foam dressings e.g. Biotain, Allevyn, Lyofoam

  • Useful for moderately exudating wounds.
  • Desloughs wounds by maintaining a moist environment but not as effective as an alginate or hydrocolloid for debridement.
  • Provides some mechanical protection to bony prominences.
  • Designed to absorb large amounts of exudate/ fluids.
  • Do not use on low exudating wounds as this will cause dryness and scabbing.

 

Semi-permeable film dressings e.g. Opsite, Tegaderm

  • Sterile sheet of polyurethane coated with acrylic adhesive.
  • Transparent allowing wound checks without removal of dressing.
  • Suitable for shallow wounds with low exudate.

 

Hydrogels e.g.  Intrasite Gel

  • High water polymer gel content in a complex network of fibers to creates a moist wound surface.
  • Debrides wounds by hydration and promotion of autolysis.
  • Will absorb a light exudate.
  • Not appropriate for heavily exudating wounds.
  • Not to be used in conjunction with a foam dressing.
  • Used for necrotic or sloughy wound beds to rehydrate and remove dead tissue. If vascular supply is adequate.
  • Do not use for moderate to heavily exudating wounds.

 

A new wound dressing that is showing promising results on the market is Altrazeal, which can be left in place for up to 30 days. To read more click on the link below for full details.

Altrazeal Wound Dressing Information

Proactive Podiatry is trained and skilled in diagnosing and treating foot wounds. If ongoing management is required for chronic non-helaing ulcers the podiatrist may refer you to a multi-disciplinary clinic in the public sector for specialised treatment.

 

 

 
  • Calendar icon December 13, 2013
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3 Comments

  • Denis Mountain

    Among all these dressings I had used Alginate Dressings and on the basis of my personal experience, I would say it is a really good dressing. I have purchased it from

    https://www.wound-care.co.uk/cutimed-alginate-dressings.html

  • Valerie Sharon

    I am a 78 year old woman with a venous wound on my foot around the ankle bone. An MRI scan has revealed no osteomyelitis and that the wound is shallow with slight granulation. I am using Aquacel but find this painful to remove unless really wet. i.e taking a shower. Your article has mentioned a new dressing Altrazeal. Is this available in England please? The wound originally began years ago after an accident but has cleared up several times. I suffer from rheumatoid arthritis and take Methotrexate and infusions of Rutiximab. I should welcome any advice you can give as this is really impeaching my life. kind regards

    • admin

      HI Valerie,

      Thank you for your comment. Altrazeal is available in most of Europe but I am unsure about the UK. My advice would be to ask your local doctor, treating specialist and/or pharmacist if they are able to source the product. You could also try contacting local wound care dressing suppliers to see if they stock it? You may also be able to purchase the product online. If you are under a vascular specialist, they would be the best person to ask initially. I wish you all the best of luck with locating the product. If you have any further questions please do not hesitate to ask.

      Warmest Regards

      Proactive Podiatry

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