II. Category

  1. Semiocclusive dressing or filler

III. Characteristics

  1. Absorptive
  2. Adhesive or non-adhesive
  3. Moisture retentive

IV. Indications

  1. Light to moderately exudative wounds
  2. Autolytic Debridement
    1. Thin, stringy yellow eschar
    2. Dry necrotic eschar
  3. Infected wound (amorphous hydrogels such as Intrasite)
    1. Monitor wound daily if infected
  4. Filler for deep or extensive wounds
  5. Carrier for Topical Medications
  6. Type 2 to 4 Pressure Sores

V. Technique

  1. Change dressing every 5 to 7 days
  2. Apply gel
    1. Tongue blade
    2. Syringe (20 to 50 cc) filled with gel
  3. Cover wound site
    1. Gauze
    2. Foam Dressing (e.g. Lyofoam)
  4. Secure
    1. Transparent Film Dressing (e.g. Tegaderm)
    2. Paper tape

VI. Advantages

  1. Conformable
  2. Fills ulcer cavity to maintain moist healing environ
  3. Cooling, soothing Sensation and analgesia
  4. Assists Autolytic Debridement

VII. Disadvantages

  1. Requires moderate level of care
  2. Maceration of peri-wound edges
  3. Requires fixatives and dressings to hold in place
  4. Avoided in wounds with heavy exudate
  5. No trial data supporting use
  6. Secondary hypergranulation tissue may delay healing
    1. Leafy, friable beefy red tissue
    2. Remove with Silver Nitrate or Sharp Debridement

VIII. 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

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