Choosing wound dressings by tissue type and exudate
People often ask for “the best wound dressing”. The honest answer: the best dressing is the one that suits the wound right now, and it may change as healing progresses. This article explains the reasoning specialists follow; it does not replace a wound assessment.
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.
What determines the choice of dressing?
- The tissue in the wound bed: healthy red granulation, yellow slough, black eschar, or new skin.
- 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.
- Pain, how often the dressing can be changed, and what the patient or family can manage.
The overall aim is balanced moisture: not so dry that cells can’t work, and not so wet that the skin is damaged.
The main types of dressing
| Category | Common use | Usually not suitable for |
|---|---|---|
| Films | Superficial wounds with low exudate, or as a secondary dressing | Moderate or high exudate, and very fragile skin |
| Hydrocolloids | Superficial wounds with low to moderate exudate | Infected wounds and heavy exudate |
| Hydrogels | Dry wounds or wounds covered with dead tissue, to rehydrate and soften it | Heavily exuding wounds |
| Foams | Moderate to high exudate, with some cushioning | Dry wounds |
| Alginates / gelling fibres | Moderate to high exudate, and filling cavities | Dry wounds and dry eschar |
| Antimicrobial dressings (silver, iodine, PHMB, medical-grade honey) | Local infection or high risk, for a set period followed by review | Long-term routine use on wounds that are not infected |
| Non-adherent contact layers | Protecting a fragile wound bed or skin graft | Use without an absorbent secondary dressing |
| Superabsorbent dressings | Very heavy exudate | Dry or low-exudate wounds |
Some products have specific precautions, such as caution with iodine dressings in thyroid disease or large wounds. The treating team decides this.
When does the dressing change?
- When the wound changes, for example from dead tissue to healthy granulation.
- When exudate clearly increases or decreases.
- When signs of infection or irritation of the surrounding skin appear.
- If there is no progress after an adequate period, the whole plan is reassessed, not just the dressing.
An important note
Don’t change the dressing type, or how often it is changed, without advice from the treating team, even if a dressing worked for someone else.
The information here is general education and does not recommend any specific brand.
Educational videos
Watch the educational videosShort wound-care explainers on InstagramA multidisciplinary team
A complex wound is never treated by one specialty alone. Care is coordinated with a multidisciplinary team according to each case, because healing depends on treating the cause: circulation, infection, pressure, nutrition and the need for surgery.
- Orthopaedic surgery
- Vascular surgery
- General surgery
- Plastic and reconstructive surgery
- Podiatry
- Infectious diseases
- Clinical nutrition
- Other healthcare professionals as each case requires
Get in touch
For patients and families: discuss any change to your care plan with your treating doctor or care team.
For enquiries, training and collaboration with healthcare teams and facilities across Jordan.
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References
- World Union of Wound Healing Societies (WUWHS). Consensus Document: Wound exudate — effective assessment and management. Wounds International; 2019.
- 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.
- Schultz GS, Sibbald RG, Falanga V, et al. Wound bed preparation: a systematic approach to wound management. Wound Repair and Regeneration. 2003;11(Suppl 1):S1–S28.
- International Wound Infection Institute (IWII). Wound Infection in Clinical Practice: Principles of Best Practice. International Consensus Update 2022. Wounds International.
Independent content
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.