About 310 million surgeries are performed worldwide each year. Post-surgery, incisions and wounds are often dressed to promote healing.
But, surgical dressings are not interchangeable. With this guide, discover key details about different types of surgical dressings and when to use them.
Surgical Dressing: Overview
A wound dressing covers and protects a wound: an injury causing “discontinuity of the epithelial lining of the skin or mucosa due to physical or thermal damage.” Most wounds are lacerations, sores,or burns.
Dressings cover the exposed tissue to protect it from the elements, then hold the tissues in place to facilitate healing. Dressings are typically cloth or foam capable of absorbing excess fluid that might seep from the wound.
Wound dressings can be basic or sophisticated. Surgical dressings are designed to address the unique challenges inherent to healing post-surgical wounds and prevent surgical site infection (SSI).
How Are Surgical Dressing Different From Other Types of Wound Dressings?
Basic dressings protect wounds and, often, absorb excess exudate. Surgical dressings do that and much more.
Specialized surgical dressings facilitate wound healing with structures and features that promote tissue regeneration, maintain the optimal wound environment, and kill or prevent microbial infections.
They’re also often designed to speed the closure and healing of deep surgical incisions. Many types of surgical dressings are designed to be compatible with post-surgical treatment, like negative pressure wound therapy.
Unlike non-surgical dressings, surgical dressings must be sterile.
Understanding Types of Surgical Dressing
Different surgical dressings are appropriate for different wounds.
Some are single layers, intended for use in combination with others, while other dressings combine multiple layers into a single product. Dressings also differ by materials and qualities that affect their efficacy in healing one type of wound over another.
Surgical Dressing Layers
Most surgical dressings have 3+ layers.
Interior Contact Layer
The first is the wound contact layer a thin, non-adhering sheet that touches the wound directly.
Interior surgical dressing layers, like the Mepitel AG Wound Contact Layer, facilitate healing by protecting the wound from pathogens and irritation.
Simultaneously, they allow an appropriate amount of fluid to leave the wound to be absorbed.
Absorbent Layer
The second is an absorbent layer. Absorbent dressing parts like Sorbalux ABD Absorbent Abdominal Pads are made of porous materials intended to take in and hold exudate fluid.
Certain dressings incorporate additional middle layers to improve absorption of different kinds of fluids, or to eliminate odors.
Exterior Layer
The third (or, outermost) layer offers protection from clothing and environmental hazards. The majority of exterior surgical dressing layers, like Tegaderm HP Transparent Film Dressing, are waterproof.
Types of Surgical Dressing Materials
Different surgical dressing materials provide varying degrees of flexibility, softness, and anti-microbial action.
Moreover, some dressings are “occlusive, meaning they form an airtight and watertight seal. Non-occlusive dressings are more permeable, letting the wound breathe.
Synthetic (Polymer) Foam
Polymer foam dressings, like AQUACEL Foam Pro Wound Dressing, are firm enough to stay stable while absorbing exudate. Foam dressings can also offer extra cushion to tender wounds.
Calcium Alginate
Calcium alginate is a natural, hemostatis-promoting material. The calcium ions can move in exchange with the sodium ions in wound fluid. This speeds the earliest stages of wound healing, controlling bleeding.
Alginate dressings like AQUACEL Extra Calcium Alginate Dressings with Hydrofiber Technology are particularly known for effectively maintaining the wound environment. It prevents the wound from drying out while also preventing maceration of the periwound skin.
Moreover, calcium alginate dressings promote autolytic debridement,enabling the body to independently remove dead tissue in the wound.
Collagen
Collagen dressings speed and facilitate new tissue growth. Biological materials BIOPAD Collagen Dressing offer a structure and framework to tissues, enabling them to grow across the wound correctly.
Composite dressings like FIBRACOL Plus Collagen Wound Dressing with Alginate bring together the best aspects of both materials.
Woven & Knitted Fabric Mesh
Fabric mesh dressings are versatile. Sterile mesh, sometimes called “clean mesh,” is a true neutral, flexible layer. A sterile mesh like DeRoyal Fine Mesh Gauze Dressing Rolls offers a “blank slate,” letting medical professionals soak it in the right coating for the job.
In contrast, “impregnated gauze” is fabric that’s imbued with a substance that facilitates healing. For example, the Curity Non-Adhering Oil Emulsion Dressing combines sterile gauze and oil, to prevent injury to delicate sutures when applied.
Silicone
Silicone dressings are incredibly gentle. They’re used to minimize pain and the risk of tearing during application and removal. The ConvaFoam Adhesive Silicone Hydrofiber Foam Dressing, for instance, is recommended for fragile skin and delicate surgical wounds.
Specialized Surgical Dressings
Superabsorbent & Hydrating Dressings
Superabsorbent dressings incorporate extra layers to absorb moderate to high levels of exudate. The AGILE Superabsorbent Dressing is ideal to prevent a “watery” wound from damaging the structural integrity of the wound’s tissues and periwound skin.
Hydrating dressings use unique formulas to generate gels. Hydrogels are gel sheets at the time of application, while hydrocolloids are adhesive squares that swell into a gel as they interact with the wound’s exudate.
An example of a particularly durable, effective hydrocolloid is AQUACEL Ag Advantage Rope Antimicrobial Dressing. It improves on standard hydrocolloids by absorbing vertically and confirming to the wound bed.
Hydrating dressings maintain a moist wound environment.
Waterproof Surgical Dressings
Waterproof surgical dressings effectively protect wounds from water and similar fluids in the environment. They make it easier for the wound patient to bathe or take a shower.
Most outer-layer transparent film dressings are waterproof. Popular dressings like the five-layer Proximel Silicone Bordered Foam Dressing create a watertight seal on the skin. Any water touching the outermost layer simply beads and slides off.
Waterproof dressings are also useful for those whose wounds face some risk of damage from bodily fluids like sweat or urine.
Bioscaffolds
According to the Journal of Biological Engineering, a bioscaffold is “a three-dimensional structure that supports the growth of new tissue in the body.”
Bioscaffold surgical dressings typically use collagen, as well as other materials naturally occuring in human tissue.
Dressings like Endoform Antimicrobial Restorative Bioscaffold – Fenestrated are uniquely well-suited to chronic wounds and surgical wounds. They’re particularly effective at speeding the regrowth of skin with a skin graft.
Dissolving Exudate Absorption Sponges
Dissolving sponges are unlike any other dressing. Unlike other surgical dressings, these sponges never have to be removed.
After Absorbing low amounts of exudate from surgical wounds, they break down cleanly. Varieties like the SURGIFOAM Absorbable Gelatin Sponge nourish the body as it dissolves.
How To Use Surgical Dressings In 5 Steps
To apply a specific dressing, follow the application process instructions that come with that dressing. They’re often available on the dressing’s package, or the manufacturer’s website.
You can also use the National Library of Medicine’s guide to surgical wound care. The following is a quick summary of that information.
1. Wash your hands for 15-20 seconds, using either soap and running water or an alcohol-based hand sanitizer.
2. Remove the old dressing carefully, peeling away the tape to lift it off.
3. Contain the old dressing in a bag, then wash or sanitize your hands again. Optionally, put on medical gloves.
4. Cleanse the skin around the wound carefully, using mild soapy water or saline.
5. Apply the new dressing. Do not touch the contact-side surface of the dressing. Instead, only tape the edges.
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Edited for content by JORDAN GAYSO.
