Nurses’ Guide to Understanding Wound Dressings – Choosing the Right Options
Choosing the right dressing is one of the most important decisions in wound care. For plastic surgery patients, where cosmetic outcomes are as critical as safety, the wrong dressing can delay healing, increase infection risk, or compromise results.
For nurses in private practice, confidence in dressing selection requires knowledge of modern materials, wound physiology, and patient needs. This article breaks down common dressing categories, their indications, and practical tips to help nurses make informed choices.
Why Dressing Selection Matters
- Healing environment – dressings create conditions for repair.
- Moisture balance – prevents wounds from becoming too dry or too wet.
- Infection control – some dressings provide antimicrobial protection.
- Patient comfort – reduces pain and protects delicate tissue.
- Cost-effectiveness – choosing the right dressing reduces frequency of changes and clinic visits.
Categories of Wound Dressings
Film Dressings
- Thin, transparent, adhesive sheets.
- Allow oxygen exchange, prevent bacterial entry.
- Ideal for superficial, low-exudate wounds.
- Common in post-surgical incisions once sealed.
Foam Dressings
- Absorbent, soft, cushioning.
- Good for moderate exudate wounds.
- Provide comfort, especially under garments.
- Used for donor sites, pressure points, and surgical wounds.
Hydrocolloids
- Contain gel-forming agents.
- Maintain a moist environment, absorb light exudate.
- Promote autolytic debridement.
- Not suitable for infected wounds.
Alginates
- Derived from seaweed, highly absorbent.
- Excellent for heavy exudate or cavity wounds.
- Require secondary dressing.
- Not for dry wounds.
Hydrogels
- Water-based or glycerin-based sheets or gels.
- Rehydrate dry wounds.
- Provide cooling, pain relief.
- Useful for burns or radiation wounds.
Antimicrobial Dressings
- Contain silver, iodine, or honey.
- Reduce bacterial load.
- Ideal for high-risk or contaminated wounds.
- Must be used appropriately to avoid resistance.
Commonly Used Wound Dressings in Plastic Surgery
Osmocel® Hydroporous Foam
- Highly versatile foam dressing for wounds with varying moisture levels.
- Provides cushioning and comfort, especially useful under compression garments.
- Excellent for surgical wounds with moderate drainage.
Aquacel® Ag
- Combines Hydrofiber™ technology with ionic silver for antimicrobial protection.
- Absorbs exudate, locks in bacteria, and reduces infection risk.
- Particularly useful for high-exudate wounds at risk of infection.
Tegaderm™ Waterproof Transparent Dressings
- Flexible, breathable, and waterproof.
- Allow showering while protecting the wound.
- Best for superficial wounds, surgical incisions, and IV sites.
Sorbact® Dressings
- Binds bacteria and fungi irreversibly to reduce bioburden.
- Supports healing without releasing active chemicals.
- Useful for wounds with bacterial load but not suitable for heavy exudate.
Zorflex®
- Wound contact layer made of activated carbon.
- Cleans microorganisms from chronic, non-healing wounds.
- Shown to reduce infection signs within 4 weeks.
Micropore™ Tape (White and Brown)
- Gentle, breathable adhesive tape.
- Used for securing dressings or light support of surgical incisions.
- Favored for sensitive skin due to low irritation.
Strataderm® Silicone Gel
- Topical silicone for scar management.
- Creates a flexible, breathable film to soften and flatten scars.
- Widely used in post-surgical scar protocols.
Gauze Dressings
- Traditional, versatile option for packing or covering wounds.
- Best for short-term use or as secondary dressings.
- Less effective at moisture balance compared to modern dressings.
NPWT (Negative Pressure Wound Therapy) – VAC, PICO, 3M KCI Prevena
- Uses suction to remove exudate and improve blood flow.
- Ideal for complex wounds, high-risk incisions, and large surgical sites.
- Requires specialized equipment and monitoring.
Wound Packing (Daily or Every Few Days)
- Used for deep or tunneling wounds.
- Keeps wound cavities open to allow drainage and prevent abscess formation.
- Requires skilled nursing technique to prevent trauma.
Key Considerations for Dressing Selection
- Wound depth – shallow vs cavity.
- Exudate level – dry, low, moderate, or high.
- Infection risk – clean vs colonized vs infected.
- Patient comfort – sensitivity, pain, allergies.
- Location – face, breast, abdomen, or limb.
- Practicality – frequency of dressing changes, cost, and patient lifestyle.
Nurse Role in Dressing Decisions
- Perform thorough wound assessment at each visit.
- Match dressing type to wound stage and moisture needs.
- Educate patients on keeping dressings clean and dry.
- Monitor for allergic reactions or skin irritation.
- Document dressing type, change frequency, and wound response.
Do’s and Don’ts of Dressing Selection
Do’s
- Do match dressing choice to exudate level.
- Do maintain a moist wound environment.
- Do consider patient comfort and lifestyle.
- Do escalate non-healing wounds for review.
- Do monitor for skin sensitivity to adhesives.
- Do use antimicrobial dressings when infection is suspected.
- Do reassess dressing needs as the wound changes.
Don’ts
- Don’t use highly absorbent dressings on dry wounds.
- Don’t leave infected wounds under occlusive dressings.
- Don’t overlook cost and practicality for patients.
- Don’t allow adhesives to damage fragile skin.
- Don’t delay escalation if dressings are not effective.
- Don’t rely on one type of dressing for all wounds.
- Don’t forget to teach patients about wound protection at home.
FAQs on Wound Dressings
General FAQs
Q: How often should dressings be changed?
It depends on wound type and exudate. Some advanced dressings last 3–7 days; others require daily changes.
Q: Can patients shower with a dressing on?
Yes, waterproof dressings like Tegaderm allow safe showering. Otherwise, wounds should be kept dry.
Q: Do all wounds need dressings?
Not always. Small, superficial wounds may be uncovered once epithelialized.
Dressing Selection FAQs
Q: What’s the best dressing for a surgical incision with mild drainage?
Foam or hydroporous dressings like Osmocel are excellent choices.
Q: When should I use an antimicrobial dressing like Aquacel Ag?
When the wound shows signs of bacterial burden or when infection risk is high.
Q: Are traditional gauze dressings still useful?
Yes, but primarily for wound packing or as a secondary dressing — they are not ideal for moisture balance.
Antimicrobial and Specialty Dressings FAQs
Q: What makes Sorbact different from silver dressings?
It binds bacteria physically instead of releasing chemicals, lowering risk of resistance.
Q: When should Zorflex be considered?
For chronic or slow-healing wounds with microbial contamination.
Q: What’s the role of Strataderm silicone gel?
It is used for scar management after wounds have closed, not during open healing (that would be Stratamed).
NPWT and Packing FAQs
Q: How does negative pressure wound therapy help?
It removes fluid, improves circulation, and promotes granulation tissue.
Q: Can NPWT be used on all wounds?
No. It is for specific surgical or complex wounds and requires surgeon oversight.
Q: How often should packed wounds be re-dressed?
Usually daily, though frequency depends on drainage and surgeon protocol.
Private Practice FAQs
Q: Do patients in private practice expect advanced dressings?
Yes, patients often expect modern, evidence-based solutions and clear explanations.
Q: How can cost be balanced in dressing selection?
Use the most effective option while considering durability, comfort, and patient financial situation.
Q: Should practices standardize wound dressing protocols?
Yes. Standardization improves consistency, reduces errors, and supports evidence-based care.
Taking Action and Implementing
Dressings are not just coverings — they are active participants in healing. For plastic surgery patients, the right dressing makes the difference between smooth recovery and complications.
Nurses who understand dressing categories, product indications, and wound physiology can guide patients with confidence. By tailoring dressing choices to wound needs, educating patients about care at home, and monitoring for complications, nurses ensure safe healing, improved cosmetic outcomes, and patient satisfaction.
Further Reading