Wet wounds or dry wounds: film dressings in wound management

From "Worldwide Wound Management, 2008-1017," Report #S247

Prior to the late 1970s it was thought that wounds needed to dry out to prevent infection, form a scab, and subsequently heal well underneath the scab. In the late 1970s new work on occlusive film materials demonstrated that wounds heal better if a moist environment is maintained. A number of transparent film dressings are now commercialized under brand names such as Bioclusive, Opsite, and Tegaderm. Transparent film dressings can be made to have moisture vapor transmission levels from zero g/24h/m2 (occlusive) to levels beyond 3000 g/24h/m2 (semi-occlusive). If the speed of exudates production by the wound exceeds the moisture vapor permeability (MVP), then the film dressing effectively proves an occlusive barrier, although technically the dressing is still semi-occlusive. Indeed, gases will still be transmitted across the wound dressing. All film dressings provide a covering that is impermeable to microbes and therefore they protect the wound from infectious agents such as bacteria, viruses and fungi.

Transparent films that create a moist wound environment provide a semi-occlusive barrier that allows active wound fluid and cells to function in a physiological environment. Film dressings prevent scab formation, isolate the wound from contamination by microbes, and allow more rapid granulation and epithelialization of the wound surface. Film dressings are used to protect from friction and shear, and can serve as barriers to moisture. They are also useful as retention dressings and provide the proper environment for autolytic debridement. Film dressings in larger sizes serve as surgical drapes during surgery or in smaller sizes as I.V. catheter retention dressings. These applications for film dressings are designed to prevent movement of microbes from surrounding skin to the injury site. This is important because many microbes have an almost commensal relationship with normal skin. To remove them completely often requires injury to the skin, and yet if they are allowed to grow in wounds they can reach concentrations that become pathologic.

Companies in the Films Dressings Wound Management Market

  • 3M Health Care
  • Advanced Medical Solutions
  • AmeriDerm
  • B. Braun
  • BSN medical
  • DermaRite Industries
  • DeRoyal
  • Hartmann
  • Kendall (Covidien)
  • Lohmann & Rauscher
  • Medline Industries
  • Molnlycke
  • Smith & Nephew
  • Swiss American Products/Elta
  • Systagenix Wound Management*
  • Uromedical

Most film dressings on the market today are made of polyurethane film with acrylic adhesives and a disposable support or application system integrated into the design. The support function may provide a secondary function such as serving as a wound-tracing device for record keeping. Films differ in MVTR and extensibility or elasticity. Wound dressings generally provide a low to moderate MVTR (500 to 2,000 gm/24h/m2), whereas film dressings with MVTRs greater than 3000 gm/24h/m2 are produced for specialty applications such as surgical drapes or catheter retention dressings. These dressings are specially designed to allow all moisture at the surface of the skin to escape from the skin surface, to keep infectious agents out of the site, and to prevent the natural skin flora from infecting the wound site.

See Report #S247

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