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Absorbent dressings

VIEW PRODUCTS: Absorbent dressings

The main function of an absorbent dressing is the containment of wound fluid (exudate). There are many different types of absorbent dressing, reflecting the fact that wounds can produce different amounts of exudate and are different shapes and sizes. Applied in the correct circumstances, an absorbent dressing will effectively contain exudate and cellular debris and prevent microorganisms from entering the wound. 

How do absorbent dressings work?

Absorbent dressings are designed to absorb exudate while minimising adherence to the wound bed. They are multi-layer dressings comprising either a semi-adherent or a non-adherent layer, combined with highly absorptive layers of fibres, which are used to absorb the exudate. Some absorbent dressings also form a gel on contact with exudate.

Excess exudate and cellular debris is contained in the dressing, which helps prevent microorganisms entering the wound (Stephen Haynes, 2011).

Absorbent dressings may be used as primary or secondary dressings to manage surgical incisions, lacerations, abrasions, burns, donor or skin graft sites, or any exudating wound.

The ideal absorbent dressing should also maintain the wound at the optimum temperature, be easy to apply and remove, and not leave fibres in the wound on removal that could act as a hub for infection (Stephen-Haynes, 2011).

Note: Not all absorbents are the same: the amount of fluid absorbed varies from product to product.

There are many absorbent products available, how do I select the right one?

Each patient has different needs that need to be considered when choosing the correct product. The following questions can help with dressing selection.

How much exudate is the wound producing?

Normally, the amount of exudate produced by a wound will reduce over time as the wound heals. A certain amount of exudate is healthy as it aids moist wound healing by promoting growth factor as well as  proteins (metalloproteinases) and cells (macrophages), which help toward healing (Cutting, 2003). A 'healthy' amount of exudate also prevents a wound from drying out (World Union of Wound Healing Societies [WUWHS], 2007). However, if a wound becomes chronic (where healing is delayed) the amount of exudate can increase, which should alert the practitioner to problems such as infection or inflammation (Ratliff, 2009). Exudate becomes a problem when (Stephen-Haynes, 2011):‚Äč

  • There is leakage or infrequent dressing changes
  • The exudate is causing maceration of the surrounding skin
  • There is delayed healing
  • Electrolyte imbalance develops due to protein loss (a potential result of overproduction of exudate)
  • The patient is in discomfort due to the amount of exudate being produced.

An absorbent dressing should be used If a wound is producing too much exudate and impeding healing, or damaging the periwound area.

What kind of wounds can an absorbent dressing be used on?

Absorbent dressings can be used on a variety of wounds, including:           

  • Surgical incisions
  • Lacerations
  • Abrasions
  • Burns
  • Donor or skin graft sites
  • Exudating wounds.

Will an absorbent dressing stick to the wound?

When they come into contact with medium-to-high volumes of exudate, some absorbent dressings form a soft gel which prevents them from adhering to the wound bed. This means that they can easily be removed without trauma to the delicate tissue in the wound bed.

Does the patient have fragile skin?

Absorbent dressings can help to combat maceration by reducing the amount of exudate that leaks onto the periwound skin.

Is the wound dry?

Caution should be exercised in applying absorbent dressings to wounds with a dry bed, as the dressing can absorb what little moisture there is, resulting in the wound becoming too dry (Stephen -Haynes, 2011) 

Is the dressing going to be used under compression?

Applying compression can be a problem for wounds that produce a lot of exudate. Some absorbent dressings can be used under compression bandaging, while still absorbing and removing exudate and wound debris. It is important to check the manufacturer's instructions to make sure that the dressing is suitable for use with compression.

Is antimicrobial action needed?

Absorbent dressings can help prevent infection from gaining a hold in a wound as they retain bacteria inside the dressing, along with the exudate — this is removed at dressing change (Verrall, 2010). Some absorbent dressings also incorporate silver, which can help to destroy bacteria.

Cost-effectiveness

Although cost-effectiveness is important, choosing the cheapest absorbent dressing is not necessarily the best thing to do, as dressing choice should always be guided by the patient's needs. If a dressing fails to perform well, more frequent dressing changes will be needed, incurring greater nursing time. 

Patient choice

Patient choice and preference should always be considered. This helps to build up a good nursing-patient relationship and is in line with national policy.

Performance indicators

  • Fluid-handling capacity
  • Cushioning
  • Secondary dressing required
  • Antimicrobial
  • Can be used under compression.

References

Cutting K (2003) Wound exudate: composition and functions. Br J Comm Nurs 8(9): 4–9

Ratliff CR (2008) Wound exudate: an influential factor in healing. Adv Nurs Practice 16(7): 32–5

Stephen-Haynes J  (2011) Managing exudate and the key requirements of absorbent dressings. Wound Care March: 22–7

Verrall D, Coulborn A, Bree-Aslan C (2010) Evaluating a super absorbent dressing (Flivasorb) in highly exuding wounds. Br J Nurs 19(7): 449–53

World Union of Wound Healing Societies (2007) Wound Exudate and the Role of Dressings: a consensus document. Wounds International  Available online. (accessed 29/1/13)