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Educational guide · Advanced wound dressings

Advanced wound dressings

Written by: Aissar Shawaqfeh, RN, CWS® Last reviewed: Credentials and verification

Modern dressings do more than cover a wound. Each type is designed for a specific job: absorbing exudate, rehydrating a dry wound, reducing bacteria or protecting fragile skin. This guide sets out the main types and what each is typically used for.

This information is general education and does not replace an individual medical assessment. Do not change your treatment or dressings without speaking to your care team.

Find by wound situation

Choose a situation to highlight the dressings typically used for it. The final choice is made by the treating team after assessing the wound.

Core dressing types

The most widely used categories in modern wound care, usually chosen by the amount of exudate and whether infection is present.

  • Antimicrobial

    Antimicrobial dressings

    Reduce the bacterial load in the wound.

    Active agents

    • Silver (Ag)
    • Iodine
    • Medical-grade honey
    • Chitosan

    Typically used for

    • Infected wounds

    Used for a set period, then the need for them is reassessed.

  • Alginate

    Alginate dressings

    Seaweed-derived fibres that turn into a gel as they absorb exudate.

    Materials

    • Calcium alginate (Ca)
    • High guluronic acid (High G)

    Typically used for

    • Moderate to heavy exudate
    • Infected wounds
    • Cavity wounds (filling cavities)

  • Hydrocolloid

    Hydrocolloid dressings

    Contain gel-forming agents that interact with exudate and keep the wound moist.

    Materials

    • Gel-forming agents

    Typically used for

    • Low to moderate exudate

  • Foam

    Foam dressings

    Absorbent foam that holds exudate away from the wound, some with a gentle silicone layer.

    Materials

    • Polyurethane
    • Silicone

    Typically used for

    • Moderate to heavy exudate

  • Hydrogel

    Hydrogel

    A water-based gel that adds moisture to a dry wound and helps soften dead tissue.

    Materials

    • Hydroactive amorphous gel

    Typically used for

    • Dry wounds
    • Necrotic wounds (dead tissue)

Dressings for specific needs

Chosen for a specific goal: supporting new tissue, handling very large volumes of exudate, protecting fragile skin, or controlling odour.

  • Collagen

    Collagen dressings

    Collagen-based dressings that support new tissue forming in the wound bed.

    Sources and types

    • Bovine, fish or ovine source
    • Collagen with ORC or silver
    • With growth factors

    Typically used for

    • Chronic wounds that have stopped progressing, as assessed by a specialist

    ORC: oxidised regenerated cellulose.

  • Superabsorbent

    Superabsorbent dressings

    Contain polymers that lock large volumes of exudate inside the dressing.

    Materials

    • Superabsorbent polymers

    Typically used for

    • Wounds with very high exudate

  • Film

    Film dressings

    A thin transparent film that lets the wound be checked without removing the dressing.

    Materials

    • Transparent polyurethane film

    Typically used for

    • Superficial wounds
    • IV cannula sites
    • As a secondary dressing

  • Silicone

    Silicone dressings

    A silicone layer that does not stick to the wound, reducing pain and skin damage at dressing changes.

    Key property

    • Atraumatic, non-adherent layer

    Typically used for

    • Fragile skin
    • Skin tears

  • Charcoal

    Charcoal dressings

    Contain activated charcoal that absorbs wound odour.

    Function

    • Odour control

    Typically used for

    • Malodorous wounds

Advanced therapies and systems

Options usually reserved for complex or hard-to-heal wounds, decided by the treating team and used under specialist supervision.

  • Bioengineered skin substitutes

    Bioengineered skin substitutes

    Biological products that support wound closure and contain cellularised epithelial tissue.

    Composition

    • Cellularised epithelial tissue

    Typically used for

    • Hard-to-heal wounds, under a specialist team

  • Contact layer

    Contact layers

    A thin layer placed directly on the wound bed to protect it and stop the secondary dressing sticking.

    Types

    • Petroleum-impregnated
    • Paraffin-impregnated

    Typically used for

    • Protecting the wound bed

    Usually needs an absorbent secondary dressing on top.

  • NPWT

    Negative pressure wound therapy

    A device that applies controlled negative pressure to the wound through foam or gauze and tubing.

    Systems

    • VAC system
    • Incisional NPWT for closed surgical wounds (to help prevent surgical site infection, SSI)
    • Open abdomen system
    • Irrigation (instillation) system

    Read about negative pressure wound therapy

How is the right dressing chosen?

  • The tissue in the wound bed: healthy granulation, dead tissue or dry eschar.
  • The amount of exudate: dry, low, moderate or high.
  • Signs of infection, or a high risk of it.
  • Wound depth, and any cavity that needs filling.
  • The surrounding skin: fragile, irritated or waterlogged.

The dressing is part of the plan, not the whole plan: treating the cause of the wound, such as pressure, poor circulation, diabetes or infection, comes first.

Read: choosing wound dressings by tissue type and exudate

Before using any dressing

Don’t choose or change a dressing, or how often it is changed, without advice from the treating team, even if it worked for someone else.

The names here are generic categories. This guide does not recommend any brand.

Emergencies: nearest emergency department or 911

References

  1. World Union of Wound Healing Societies (WUWHS). Consensus Document: Wound exudate — effective assessment and management. Wounds International; 2019.
  2. National Institute for Health and Care Excellence (NICE). Chronic wounds: advanced wound dressings and antimicrobial dressings (ESMPB2). 2016.
  3. Dhivya S, Padma VV, Santhini E. Wound dressings – a review. BioMedicine (Taipei). 2015;5(4):22.
  4. International Wound Infection Institute (IWII). Wound Infection in Clinical Practice: Principles of Best Practice. International Consensus Update 2022. Wounds International.
  5. Atkin L, Bućko Z, Conde Montero E, et al. Implementing TIMERS: the race against hard-to-heal wounds. Journal of Wound Care. 2019;28(Sup3a):S1–S50.
  6. Apelqvist J, Willy C, Fagerdahl AM, et al. EWMA Document: Negative Pressure Wound Therapy. Journal of Wound Care. 2017;26(Sup3):S1–S154.

Independent content: Content on this website is educational and independent and does not promote any brand. Product choices for any patient follow clinical assessment and the treating team’s plan.

Training and professional enquiries

Lectures and hands-on workshops for healthcare teams on wound assessment, dressing selection and negative pressure wound therapy.

Ask about wound-care education

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