wound care

Hydrofiber vs. Calcium Alginate Dressings

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For medium- to heavy-exudate wounds, Hydrofiber® and calcium alginate dressings are two common solutions. These advanced dressings help draw in wound fluid, reduce infection risks and protect the wound bed from bacteria so new tissue can form. 

Both materials share common characteristics: They’re both highly absorptive, hemostatic primary dressings designed to hold onto high amounts of exudate. This action helps generate a moist wound healing environment that aids in removing necrotic tissue and the granulation process. 

These characteristics mean that, depending on the wound and a medical provider’s recommendations, Hydrofiber and calcium alginate dressings can be left on for multiple days, therefore reducing the number of total changes required. Neither dressing needs to be moistened before application. However, due to composition and strength, both Hydrofiber and calcium alginate dressings are not designed for use with no- to low-exudate wounds. 

Beyond these similarities, understand the differences between Hydrofiber vs. calcium alginate dressings:

What Are Calcium Alginate Dressings

This type of advanced wound care dressing uses polysaccharides or xerogel sourced from brown seaweed or kelp, with the goal of drawing in exudate and keeping it away from the wound bed. This action means that calcium alginate dressings can hold up to 20 times their weight in wound fluid. 

Composition-wise, calcium alginate dressings come as non-woven, non-occlusive and non-adhesive pads, ropes and sheets that can be cut to the wound’s shape. Contact with exudate causes the material to take on a softer, gel-like form that can be shaped or packed into the wound bed. This is due to a chemical reaction between the dressing’s calcium ions and the wound fluid’s sodium ions. These aspects:

  • Help calcium alginate dressings conform to a range of wound types and depths.
  • Allow these dressings to treat various high-exudate wounds, including infected injuries, tunneling and cavity wounds, sinuses, surgical incisions and venous insufficiency ulcers. 
  • Help keep the wound bed moist to prevent dehydration. 
  • Help encourage autolytic debridement to aid the wound-healing process. 
  • Create a material that holds onto and deactivates bacteria present in the wound exudate; taking off the dressing then removes the bacteria and other microorganisms.
  • Let the dressing be lifted off or rinsed away with minimal trauma to the wound bed. 

Calcium alginate dressings include two standard types:

  • Carboxymethylcellulose (CMC) dressings use a natural cellulose source, help divert inflammatory cells to improve wound healing and take on a transparent appearance once they are in contact with wound exudate. 
  • Silver alginate dressings are formulated with an antibacterial solution to better deactivate and control microorganisms. SILVERCEL™ dressings are one example of this type. 

Note that a secondary dressing will be needed to hold any calcium alginate solution in place. During changes, the wound will need to be irrigated to remove all alginate fibers before a new dressing is applied. Contact with a low- or no-exudate wound can dry out and cause the dressing to adhere to the wound bed. 

What Are Hydrofiber Dressings

Also called gelling fiber or hydrogel dressings, this is a non-adhesive, non-occlusive and non-woven CMC-based hydrophilic dressing that absorbs high amounts of exudate. The typical Hydrofiber dressing can draw in up to 30 times its weight.

Hydrofiber dressings:

  • Are considered a hybrid wound care solution that brings together the benefits of alginate and hydrocolloid dressings. 
  • Take on a gel consistency once in contact with exudate and can be shaped to the wound bed.
  • Offer vertical absorption properties to stop wound fluid and bacteria from spreading. 
  • Create a moist healing environment that diverts exudate from the wound and holds onto bacteria to reduce the spread of infection.
  • Help remove necrotic tissue from the wound bed during dressing changes. 
  • Lessen maceration risks to protect periwound skin during removal.
  • Help lessen pockets around the wound bed where bacteria can thrive and prevent the wound from healing. 
  • Can provide antimicrobial activity. 
  • Can be used on chronic and acute wounds. 

Common Hydrofiber and hydrogel dressings include:

  • AQUACEL® dressings are built on Hydrofiber technology. AQUACEL Ag adds ionic silver for improved antimicrobial action.
  • KerraCel is a hydrogel dressing that allows for autolytic and osmotic debridement to aid in tissue granulation and keep moisture in check. These dressings can be used on no- and low-exudate wounds. KerraCel is also available in an Ag version, which features the added antimicrobial properties of silver.
  • The new CONVAFOAM dressing, which combines Hydrofiber technology with the absorbent, protective qualities of silicone foam dressings.

 

Sources:

What are Xeroform Petrolatum Dressings?

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Xeroform Petrolatum Dressings are a primary, non-adherent solution for creating an ideal wound healing environment and absorbing exudate. Each uses fine, soft, non-adherent gauze construction impregnated with a white petrolatum and 3% bismuth tribromophenate solution.

This combination conforms to the wound bed, allows for painless removal and can be used across a range of conditions, including pressure ulcers and tunneling wounds. Xeroform Petrolatum Dressings are designed for home wound care and in wrap form for operating room settings.

What Is a Petrolatum Dressing?

In general, petrolatum dressings improve upon traditional gauze. The low cost and conformability gave gauze an edge for years. However, the material can adhere to the surface of the wound, causing pain and tissue damage upon removal and increasing maceration risks.

Petrolatum-impregnated gauze dressings like Xeroform offer a number of benefits:

  • Petrolatum prevents the material from sticking to the wound, offering cleaner, less painful dressing changes, even when used with a secondary dressing.
  • A smaller pore size helps retain moisture and any creams applied to the wound bed. This prevents the wound from drying out and helps reduce biofilm formation.
  • The healing process is less likely to be disturbed, allowing new tissue to form without interruption.
  • The dressing adapts to a range of shapes and configurations, allowing it to be used on multiple body parts.

How Do Xeroform Petrolatum Dressings Work?

The combination of petrolatum and 3% bismuth tribromophenate prevents the dressing from sticking to the wound bed and creates a moist healing environment. Once applied, Xeroform Petrolatum Dressings:

  • Conform to the body part being dressed.
  • Provide a layer of sterility in an operating room environment.
  • Help the wound heal as the dressing absorbs exudate.
  • Reduce potential odors.
  • Won’t damage existing or new tissue during dressing changes.

What Is Xeroform Used For?

Xeroform Petrolatum Dressings are designed to assist with addressing:

  • First- and second-degree burns
  • Skin grafts
  • Light- to medium-exudate wounds
  • Surgical wounds
  • Donor sites
  • New circumcision sites
  • Lacerations
  • Abrasions

Xeroform Petrolatum Dressings should not be used on infected wounds.

Xeroform for Venous Ulcers

Petrolatum dressings like Xeroform are an option for helping heal venous ulcers. In this regard, Xeroform dressings:

  • Hold onto exudate while reducing leaks to prevent maceration.
  • Create a moist healing environment through thermal insulation, keeping the wound at the ideal temperature.
  • Help maintain the wound’s pH.
  • Provide a degree of permeability: excess moisture can evaporate, but bacteria won’t enter through the dressing.
  • Help control infection.
  • Lessen trauma and pain during dressing removals, and won’t damage granulating tissue.
  • Allow for comfortable wear.

How to Use Xeroform Petrolatum Dressings

To apply Xeroform Petrolatum Dressings:

  • First cleanse the wound with sterile water to remove debris.
  • Dry the periwound skin with a soft, clean cloth.
  • Apply the Xeroform gauze dressing directly to the wound after applying any lotion or cream directly to the wound bed.
  • Apply a non-adherent secondary dressing on top.

Xeroform Petrolatum Dressings should be changed daily, based on your doctor’s recommendations and the amount of exudate absorbed. Used Xeroform and secondary dressings should be discarded rather than reused.

Sources:

Wound Packing Strips – uses and applications

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Medical packing strips are an important part of wound care. This article explores the uses and applications of packing strips for wound care, the types of wound packing materials available and cautions to consider when engaging in this type of procedure.

What Are Medical Packing Strips?

Packing strips for wound care are long, slender, continuous pieces of a fine-mesh, gauzy material intended to fill wounds that extend into the dermal layer, also known as cavity wounds.

Why Use Wound Packing Strips?

Cavity wounds and wounds with a sinus, tunnel or undermining with an unknown endpoint require medical packing. There are several purposes behind packing a wound. The primary goal is to loosely fill empty space, but packing is also crucial in assisting the healing process. Properly applied medical packing strips can prevent premature wound closure and the formation of abscesses by promoting granulation tissue growth in the wound bed.

When Are Medical Strips Contraindicated?

  • Do not use wound packing materials for fistula management, which should be referred to the attending physician or nurse practitioner.
  • Do not use packing strips for wound care if the undermining, sinus tracts or tunnels of a wound are deeper or more extensive than the reach of a 15-centimeter (6-inch) cotton-tipped applicator or probe. If the tunnel or undermining extends beyond this depth or you are unable to determine the depth of the cavity wound, medical packing is not recommended.

Types of Wound Packing Strips

As a versatile part of traditional wound care, packing strips are available in many forms. A secondary dressing or wound cover should always be part of the medical packing procedure.

  • Plain Packing Strips – Sterile packing strips without impregnation are generally made from fine-mesh, cotton gauze and are compatible with wet-to-dry wound packing. Plain packing strips are available in various pre-cut sizes.
  • Lodoform Packing Strips – Iodoform is an antimicrobial compound that is effective against common infectives like pseudomonas and E. coli. Iodoform-impregnated wound packing strips can support debridement and overall healing.
  • More Medical Packing Strip Options – In addition to iodoform and plain packing strips, wound packing gauze is available infused with other antiseptic compounds, like polyhexamethylene biguanide (PHMB), silver and alginate to help manage exudate and maintain a moist environment.

Cautions for Using Any Wound Packing Material

Best medical packing practices call for extreme caution when removing or changing a dressing. Leaving a piece of wound packing material behind can cause infection and seriously impede the healing process. Therefore, use only one continuous packing strip to fill the space whenever possible. If multiple wound packing strips are necessary to fill a cavity of more than 1 centimeter deep, carefully count and document the strips as they are inserted, then verify the number of strips as they are removed.

Resources:

https://www.clwk.ca/buddydrive/file/procedure-wound-packing/

https://go.drugbank.com/drugs/DB13813

https://www.woundsinternational.com/uploads/resources/content_11730.pdf

Mepilex Border Has Been Discontinued. Meet Mepilex Border Flex.

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Mölnlycke’s Mepilex Border has long been an industry leader in the field of advanced wound care. Among bordered silicone foam dressings, Mepilex is more than a brand name. It has become synonymous with the product itself, like Kleenex or Band-Aid. 

It follows that consumers have become pretty used to the classic Mepilex Border, and its sister product, Mepilex Border Lite. And yet, as day must turn to night, all good things must come to an end. Read on to learn about the exciting changes taking place in the world of Mepilex.

Is Mepilex Border Discontinued?

In a word: yes… but with some exceptions. If you are using the Mepilex Border Ag, the Border Post-Op, the Sacral or the Heel dressings, nothing will change. The classic square/rectangle Border and Border Lite are the items affected here. 

But classic Border users should not panic. Mepilex Border is being replaced by the Mepilex Border Flex line, which includes the standard Border Flex, the Mepilex Border Flex Lite and the Mepilex Border Flex Oval.  These dressings are very similar to their discontinued counterparts, with a few key improvements, one of which is an updated five-layer design: 

 

Image showing the layers of the mepilex pad

Is Mepilex Border Flex Different from Regular Mepilex Border?

It is, but only on the inside. On a practical level, the average Mepilex user will notice no change in appearance or application. They should expect improved results, however, given the internal upgrades of the Border Flex and Border Flex Lite.

The biggest upgrade is Mölnlycke’s proprietary Flex Technology. This provides a more secure fit by allowing the dressing to move in every direction, reducing skin stress and increasing comfort. The Border Flex also has the excellent fluid management you’ve come to expect from Mepilex. The five-layer design absorbs, channels and traps exudate with aplomb.  

The Border Flex, like all Mepilex dressings, also employs Safetac® Technology. This means less pain and skin trauma during changes. It can also aid in the prevention of pressure injuries when used as part of a prevention protocol:

 

Where Can I Get Mepilex Border Flex?

At Medical Monks of course! You can shop the entire Mepilex Border Flex line of products here. 

If you have any questions or concerns about this product transition, or any other product on our site, please contact us via phone or chat Monday to Friday 8am-7pm eastern, or via email any time at customercare@medicalmonks.com. 

Wound Cleanser or Normal Saline?

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Wound cleansing involves more than simply rinsing a cut under water. In fact, the process of wound cleansing helps encourage wound healing, removing factors that could stall its progression. A vital element in every dressing change, wound cleansing helps remove exudate and various debris, including necrotic tissue and bacteria. It can also help eliminate residue from dressings and topical gels, prepping the wound bed for a new dressing. 

Various wound cleansers and/or saline solutions can be used in the process of would cleansing. Read on to understand when each is ideal for controlling irritants and encouraging healing.

The Importance of Wound Cleansing

If left unattended, microorganisms (including bacteria) and necrotic tissue can accumulate in a wound, affecting how quickly a wound heals and reducing the effectiveness of a dressing or topical agent. 

Neglecting the growth of bioburden and bacteria can invite infection and delay wound healing. Certain wounds, including diabetic foot ulcers, are more susceptible to this pattern than others. Thus, cleansing is essential for controlling bioburden and preventing chronic wounds.

Using Normal Saline Solution

Normal saline is one of the most commonly used cleansing solutions for wounds. Saline may be preferred for wound cleansing for the following reasons:

  • Normal saline is a physiologic, isotonic solution that won’t irritate or damage the skin.
  • As a solution for washing away larger physical debris and preparing the wound bed, normal saline solution won’t disrupt the wound repair process.
  • It uses a low-toxicity formula that won’t alter the skin’s composition or cause an allergic reaction.
  • While it might not provide antiseptic properties, normal saline won’t invite an infection on its own.

However, for more serious wounds, normal saline might not be strong enough:

  • Because normal saline washes away physical substances contained within the wound, it doesn’t effectively control bioburden. 
  • Normal saline isn’t always strong enough for infected or necrotic wounds, as it doesn’t function as an antibacterial agent. Nor does it include surfactants, which assist with physically removing bacteria and more stubborn debris.
  • A container of saline may start attracting bacteria not long after it is opened. Patients and their caretakers are recommended to dispose of the solution within 24 hours after opening.

Using Wound Cleansers

Wound cleansers distinguish themselves from normal saline with the following factors:

  • Surfactants, which help remove bacteria and cellular-level debris without requiring mechanical force.
  • Preservatives lessen the growth of bacteria, mold and fungi in the solution, resulting in a longer shelf life and a more cost-effective cleansing solution. 
  • Choice of application methods range from washes (such as Vashe) to spray bottles, like BIAKŌS and Anasept, which help with removing debris without placing excessive pressure on the wound. 
  • Additional agents help with softening, loosening and removing necrotic tissue, assisting with debridement. 
  • Wound cleansers may additionally offer antibacterial or antiseptic properties for controlling bioburden. 

In considering the process of cleansing infected or heavily exuding wounds, wound cleansers:

  • Allow for more targeted yet gentle application.
  • Provide a longer shelf life. 
  • Typically won’t damage healthy and emerging tissue. 
  • Are ideal for treating acute, chronic and deep wounds and reducing infection risks. 
  • Help reduce bioburden and microorganism colonies, encouraging faster infection healing, more reliably than with normal saline. 
  • Streamline the healing process: wounds treated with a cleanser tend to decrease in size sooner and develop tissue granulation faster than with normal saline. 

Yet, especially with the variety of wound cleansers available, these solutions have potential to affect emerging growth factors and tissues if too strong or not appropriate for the injury. Patients are advised to discuss with their doctor the best types of wound cleansers to use before caring for an injury at home. 

 

Sources:

https://www.lvhn.org/sites/default/files/uploads/research_education/EmergencyMedicineMedStudents/WoundCleansing.pdf

https://dermnetnz.org/topics/wound-cleansers 

https://www.hmpgloballearningnetwork.com/site/wmp/content/a-comparison-antimicrobial-wound-cleanser-normal-saline-reduction-bioburden-and-its-effect-w

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