II. Category

  1. First-line, cost effective Occlusive Dressing
  2. Wafers, pastes and powders composed of gelatin or pectin

III. Characteristics

  1. Absorptive
  2. Occlusive or semipermeable
  3. Adhesive
  4. Moisture retentive

IV. Indications

  1. Light to moderately edudative wounds
  2. Autolytic Debridement
  3. Type 2 to 4 Pressure Sores (some dressings may be used in Type I sores)
  4. Dry necrotic eschar debridement
  5. Wounds with slough or necrosis

V. Contraindications: Relative

  1. Wound Infection (especially anaerobic)
  2. Exposed tendon or bone
  3. Diabetes Mellitus (may worsen necrotic Foot Ulcers)

VI. Preparation

  1. Powder, wafer, or paste forms

VII. Technique

  1. Change dressing every 3-5 days
  2. Consider stoma adhesive over top under film or tape
  3. May be used under compression dressing
  4. May be applied over an Alginate Dressing

VIII. Advantages

  1. Requires less care than other dressing types
  2. Become absorbent gels on contact with exudate
  3. Conformable
  4. Adheres to both wet and dry sites
  5. Water resistant
  6. Excellent microbial barrier (prevents infection)
  7. Assists with Autolytic Debridement
  8. Can be used under compression (e.g. Unna Boot)

IX. Disadvantages

  1. Expensive material
    1. Cost effective when compared with saline dressing
  2. Maceration of peri-wound margins
  3. May produce foul, sour odor
  4. Too frequent dressing changes may strip skin
  5. Limits wound visability, monitoring
  6. Secondary hypergranulation tissue may delay healing
    1. Leafy, friable beefy red tissue
    2. Remove with Silver Nitrate or Sharp Debridement

X. References

  1. Bello (2000) JAMA 283(6): 716-8 [PubMed]
  2. Degreef (1998) Dermatol Clin 16(2): 365-75 [PubMed]
  3. Findlay (1996) Am Fam Physician 54(5): 1519-28 [PubMed]
  4. Habif (1996) Clinical Derm, Mosby, p. 810-13
  5. Knapp (1999) Pediatr Clin North Am 46(6):1201-13 [PubMed]
  6. Krasner (1995) Prevention Management Pressure Ulcers
  7. Lewis (1996) Med-Surg Nursing, Mosby, p. 199-200
  8. Lueckenotte (1996) Gerontologic Nurs., Mosby, p. 800-7
  9. PUGP (1995) Am Fam Physician 51(5):1207-22 [PubMed]
  10. PUGP (1994) Pressure Ulcer Treatment, AHCPR 95-0653
  11. Way (1991) Current Surgical, Lange, p.95-108

Images: Related links to external sites (from Bing)

Related Studies (from Trip Database) Open in New Window

Ontology: comfeel (C0297311)

Concepts Pharmacologic Substance (T121) , Carbohydrate (T118)
MSH C093472
English comfeel, Comfeel