Basic Wound Dressing Categories and Moist Wound Healing Principles

Conclusions

• Moist wound healing is preferred because dry scabs impede epithelialization, but excessive moisture must be avoided to prevent maceration and infection.
• There is no single best dressing for every wound; dressing choice should be individualized and reassessed over time based on wound depth and exudate.
• Hydrogels are useful for dry wounds or eschar because they add moisture and can support autolytic debridement.
• Hydrocolloids are mildly absorbent, occlusive dressings that can be effective for dry eschar and may also be repurposed as acne patches.
• Foams are versatile moderate-absorbency dressings that work well as secondary dressings and can provide cushioning and protection.
• Alginates are highly absorbent and especially useful for hemostasis in bleeding wounds because their calcium content helps activate clotting.
• Gelling fiber dressings are highly absorbent primary dressings that gel on contact with wound fluid and are useful for heavy exudate.
• Combining dressing categories can improve care, such as using a hydrogel with a foam for a dry wound under compression or layered absorbent dressings for highly exudative wounds.
• Occlusive dressings like films or hydrocolloids are generally poor choices under compression wraps because they increase the risk of maceration.
• Evidence for antibacterial dressings such as silver and honey is limited or inconsistent, so they should be reserved for select wounds with high bioburden or odor rather than confirmed infection.
• Contact layers are helpful for protecting the wound bed and surrounding skin while allowing absorbent secondary dressings to be changed without trauma.
• General dermatology clinics can manage many wounds effectively if they stock and understand the major dressing categories rather than focusing on brand names.