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A dressing or compress is a piece of material such as a pad applied to a
wound A wound is any disruption of or damage to living tissue, such as skin, mucous membranes, or organs. Wounds can either be the sudden result of direct trauma (mechanical, thermal, chemical), or can develop slowly over time due to underlying diseas ...
to promote
healing With physical trauma or disease suffered by an organism, healing involves the repairing of damaged tissue(s), organs and the biological system as a whole and resumption of (normal) functioning. Medicine includes the process by which the cells ...
and protect the wound from further harm. A dressing is designed to be in direct contact with the wound, as distinguished from a
bandage A bandage is a piece of material used either to support a medical device such as a dressing or splint, or on its own to provide support for the movement of a part of the body. When used with a dressing, the dressing is applied directly on ...
, which is most often used to hold a dressing in place. Modern dressings are sterile.


Medical uses

A dressing can have a number of purposes, depending on the type, severity and position of the wound, although all purposes are focused on promoting recovery and protecting from further harm. Key purposes of a dressing are: * Stop
bleeding Bleeding, hemorrhage, haemorrhage or blood loss, is blood escaping from the circulatory system from damaged blood vessels. Bleeding can occur internally, or externally either through a natural opening such as the mouth, nose, ear, urethr ...
– to help to seal the wound to expedite the
clot A thrombus ( thrombi) is a solid or semisolid aggregate from constituents of the blood (platelets, fibrin, red blood cells, white blood cells) within the circulatory system during life. A blood clot is the final product of the blood coagulatio ...
ting process; * Protection from
infection An infection is the invasion of tissue (biology), tissues by pathogens, their multiplication, and the reaction of host (biology), host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmis ...
– to defend the wound against germs and mechanical damage; * Absorb
exudate An exudate is a fluid released by an organism through pores or a wound, a process known as exuding or exudation. ''Exudate'' is derived from ''exude'' 'to ooze' from Latin language, Latin 'to (ooze out) sweat' (' 'out' and ' 'to sweat'). Medi ...
– to soak up blood, plasma, and other fluids exuded from the wound, containing it/them in one place and preventing maceration; * Ease
pain Pain is a distressing feeling often caused by intense or damaging Stimulus (physiology), stimuli. The International Association for the Study of Pain defines pain as "an unpleasant sense, sensory and emotional experience associated with, or res ...
– either by a medicated
analgesic An analgesic drug, also called simply an analgesic, antalgic, pain reliever, or painkiller, is any member of the group of drugs used for pain management. Analgesics are conceptually distinct from anesthetics, which temporarily reduce, and in s ...
effect, compression or simply preventing pain from further trauma; *
Debride Debridement is the medical removal of dead, damaged, or infected tissue to improve the healing potential of the remaining healthy tissue. Removal may be surgical, mechanical, chemical, autolytic (self-digestion), or by maggot therapy. In p ...
the wound – to remove slough and foreign objects from the wound to expedite healing; * Reduce
psychological stress In psychology, stress is a feeling of emotional strain and pressure. Stress is a form of psychological and mental discomfort. Small amounts of stress may be beneficial, as it can improve athletic performance, motivation and reaction to the envi ...
– to obscure a healing wound from the view of the patient and others. Ultimately, the aim of a dressing is to promote
healing With physical trauma or disease suffered by an organism, healing involves the repairing of damaged tissue(s), organs and the biological system as a whole and resumption of (normal) functioning. Medicine includes the process by which the cells ...
of the wound by providing a sterile, breathable and moist environment that facilitates
granulation Granulation is the process of forming grains or granules from a powdery or solid substance, producing a granular material. It is applied in several technological processes in the chemical and pharmaceutical industries. Typically, granulation inv ...
and
epithelialization Wound healing refers to a living organism's replacement of destroyed or damaged tissue by newly produced tissue. In undamaged skin, the epidermis (surface, epithelial layer) and dermis (deeper, connective layer) form a protective barrier again ...
. This will then reduce the risk of infection, help the wound heal more quickly, and reduce scarring.


Types

Modern dressings include dry or impregnated
gauze Gauze is a thin, translucent Textile, fabric with a wikt:loose, loose open Weaving, weave. In technical terms, "gauze" is a weave structure in which the weft yarns are arranged in pairs and are crossed before and after each Warp (weaving), w ...
, plastic films, gels, foams,
hydrocolloids A colloid is a mixture in which one substance consisting of microscopically dispersed insoluble particles is suspended throughout another substance. Some definitions specify that the particles must be dispersed in a liquid, while others extend ...
,
hydrogels A hydrogel is a biphasic material, a mixture of porous and permeable solids and at least 10% of water or other interstitial fluid. The solid phase is a water insoluble three dimensional network of polymers, having absorbed a large amount of ...
, and alginates. They provide different physical environments suited to different wounds: * Absorption of
exudate An exudate is a fluid released by an organism through pores or a wound, a process known as exuding or exudation. ''Exudate'' is derived from ''exude'' 'to ooze' from Latin language, Latin 'to (ooze out) sweat' (' 'out' and ' 'to sweat'). Medi ...
, to regulate the moisture level surrounding the wound- for example, dry gauzes absorb exudate strongly, drying the wound, hydrocolloids maintain a moist environment and film dressings do not absorb exudate; * Gas permeability and exchange, especially with regard to
oxygen Oxygen is a chemical element; it has chemical symbol, symbol O and atomic number 8. It is a member of the chalcogen group (periodic table), group in the periodic table, a highly reactivity (chemistry), reactive nonmetal (chemistry), non ...
and
water vapour Water vapor, water vapour, or aqueous vapor is the gaseous phase of water. It is one state of water within the hydrosphere. Water vapor can be produced from the evaporation or boiling of liquid water or from the sublimation of ice. Water vapor ...
; * Maintaining the optimum temperature to encourage healing; * Mechanically debriding a wound to remove
slough Slough () is a town in Berkshire, England, in the Thames Valley, west of central London and north-east of Reading, at the intersection of the M4, M40 and M25 motorways. It is part of the historic county of Buckinghamshire. In 2021, the ...
. * Pressure dressings are commonly used to treat burns and after skin grafts. They apply pressure and prevent fluids from collecting in the tissue. Dressings can also regulate the chemical environment of a wound, usually with the aim of preventing
infection An infection is the invasion of tissue (biology), tissues by pathogens, their multiplication, and the reaction of host (biology), host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmis ...
by the impregnation of topical
antiseptic An antiseptic ( and ) is an antimicrobial substance or compound that is applied to living tissue to reduce the possibility of sepsis, infection, or putrefaction. Antiseptics are generally distinguished from ''antibiotics'' by the latter's abil ...
chemicals. Commonly used antiseptics include
povidone-iodine Povidone-iodine (PVP-I), also known as iodopovidone, is an antiseptic used for skin disinfection before and after surgery. It may be used both to disinfect the hands of healthcare providers and the skin of the person they are caring for. It may ...
,
boracic lint Boracic lint () is a type of medical dressing made from surgical lint that is soaked in a hot, saturated solution of boracic acid and glycerine and then left to dry. Medical dressing It has been in use since at least the 19th century, but is no ...
dressings or historically
castor oil Castor oil is a vegetable oil pressed from castor beans, the seeds of the plant ''Ricinus communis''. The seeds are 40 to 60 percent oil. It is a colourless or pale yellow liquid with a distinct taste and odor. Its boiling point is and its den ...
.
Antibiotics An antibiotic is a type of antimicrobial substance active against bacteria. It is the most important type of antibacterial agent for fighting pathogenic bacteria, bacterial infections, and antibiotic medications are widely used in the therapy ...
are also often used with dressings to prevent bacterial infection.
Medical grade A biomaterial is a substance that has been engineered to interact with biological systems for a medical purpose – either a therapeutic (treat, augment, repair, or replace a tissue function of the body) or a diagnostic one. The corresponding f ...
honey is another antiseptic option, and there is moderate evidence that honey dressings are more effective than common antiseptic and gauze for healing infected post-operative wounds.
Bioelectric Bioelectromagnetics, also known as bioelectromagnetism, is the study of the interaction between electromagnetic fields and biological entities. Areas of study include electromagnetic fields produced by living cells, tissues or organisms, the ...
dressings can be effective in attacking certain
antibiotic-resistant Antimicrobial resistance (AMR or AR) occurs when microbes evolve mechanisms that protect them from antimicrobials, which are drugs used to treat infections. This resistance affects all classes of microbes, including bacteria (antibiotic resista ...
bacteria and speeding up the healing process. Dressings are also often impregnated with analgesics to reduce pain. The physical features of a dressing can impact the efficacy of such
topical medication A topical medication is a medication that is applied to a particular place on or in the body. Most often topical medication means application to body surface area, body surfaces such as the skin or mucous membranes to treat ailments via a large ...
s. Occlusive dressings, made from substances impervious to moisture such as
plastic Plastics are a wide range of synthetic polymers, synthetic or Semisynthesis, semisynthetic materials composed primarily of Polymer, polymers. Their defining characteristic, Plasticity (physics), plasticity, allows them to be Injection moulding ...
or
latex Latex is an emulsion (stable dispersion) of polymer microparticles in water. Latices are found in nature, but synthetic latices are common as well. In nature, latex is found as a wikt:milky, milky fluid, which is present in 10% of all floweri ...
, can be used to increase their rate of absorption into the skin. Dressings are usually secured with
adhesive tape Adhesive tape is one of many varieties of backing materials coated with an adhesive. Several types of adhesives can be used. Types Pressure-sensitive tape Pressure-sensitive tape, PSA tape, self-stick tape or sticky tape consists of a pre ...
and/or a
bandage A bandage is a piece of material used either to support a medical device such as a dressing or splint, or on its own to provide support for the movement of a part of the body. When used with a dressing, the dressing is applied directly on ...
. Many dressings today are produced as an "island" surrounded by an adhesive backing, ready for immediate application – these are known as island dressings.


Passive products

Generally, these products are indicated for only superficial, clean, and dry wounds with minimal exudates. They can also be used as secondary dressings (additional dressings to secure the primary dressing in place or to absorb additional discharge from the wound). Examples are:
Gauze Gauze is a thin, translucent Textile, fabric with a wikt:loose, loose open Weaving, weave. In technical terms, "gauze" is a weave structure in which the weft yarns are arranged in pairs and are crossed before and after each Warp (weaving), w ...
, lint,
adhesive bandage An adhesive bandage, also called a sticking plaster, sticky plaster, medical plaster, or simply plaster in British English, is a small medical dressing used for injuries not serious enough to require a full-size bandage. They are also known by ...
(plasters), and cotton wool. The main aim is to protect the wound from bacterial contamination. They are also used for secondary dressing. Gauze dressing is made up of woven or non-woven fibres of cotton,
rayon Rayon, also called viscose and commercialised in some countries as sabra silk or cactus silk, is a semi-synthetic fiber made from natural sources of regenerated cellulose fiber, cellulose, such as wood and related agricultural products. It has t ...
, and
polyester Polyester is a category of polymers that contain one or two ester linkages in every repeat unit of their main chain. As a specific material, it most commonly refers to a type called polyethylene terephthalate (PET). Polyesters include some natura ...
. Gauze dressing are capable of absorbing discharge from wound but requires frequent changing. Excessive wound discharge would cause the gauze to adhere to the wound, thus causes pain when trying to remove the gauze from the wound. Bandages are made up of cotton wool,
cellulose Cellulose is an organic compound with the chemical formula, formula , a polysaccharide consisting of a linear chain of several hundred to many thousands of glycosidic bond, β(1→4) linked glucose, D-glucose units. Cellulose is an important s ...
, or
polyamide A polyamide is a polymer with repeating units linked by amide bonds. Polyamides occur both naturally and artificially. Examples of naturally occurring polyamides are proteins, such as wool and silk. Artificially made polyamides can be made throug ...
materials. Cotton bandages can act as a secondary dressing while compression bandages provides good compressions for
venous ulcer Venous ulcer is defined by the American Venous Forum as "a full-thickness defect of skin, most frequently in the ankle region, that fails to heal spontaneously and is sustained by chronic venous disease, based on venous duplex ultrasound testing ...
s. On the other hand,
tulle gras Tulle gras ( French, "oily tulle") or tulle gras dressing is a type of bandage commonly used in France, although the term is also used in English. It consists of fabric impregnated with soft paraffin oil (98 parts), balsam of Peru (1 part), and ...
dressing which is impregnated with paraffin oil is indicated for superficial clean wound.


Interactive products

Several types of interactive products are: semi-permeable film dressings, semi-permeable foam dressings, hydrogel dressings, hydrocolloid dressings, hydrofiber and alginate dressings. Apart from preventing bacteria contamination of the wound, they keep the wound environment moist in order to promote healing. Semi-permeable film dressing: This dressing is a transparent film made up of
polyurethane Polyurethane (; often abbreviated PUR and PU) is a class of polymers composed of organic chemistry, organic units joined by carbamate (urethane) links. In contrast to other common polymers such as polyethylene and polystyrene, polyurethane term ...
. It allows the movement of water vapor, oxygen, and carbon dioxide into and out of the dressing. It also plays an additional role in autolytic
debridement Debridement is the medical removal of dead, damaged, or infected tissue to improve the healing potential of the remaining healthy tissue. Removal may be surgical, mechanical, chemical, autolytic (self-digestion), or by maggot therapy. In ...
(removal of dead tissue) which is less painful when compared to manual wound debridement inside the operating theater. It is highly elastic and flexible, thus is closely adhered to the skin. As the dressing is transparent, wound inspection is possible without removing the dressing. Due to the limited absorption capacity, such dressing is only used in superficial wounds with low amount of discharge. Semi-permeable foam dressing: This dressing is made up of foam with
hydrophilic A hydrophile is a molecule or other molecular entity that is attracted to water molecules and tends to be dissolved by water.Liddell, H.G. & Scott, R. (1940). ''A Greek-English Lexicon'' Oxford: Clarendon Press. In contrast, hydrophobes are n ...
(attracted to water) properties and outer layer of
hydrophobic In chemistry, hydrophobicity is the chemical property of a molecule (called a hydrophobe) that is seemingly repelled from a mass of water. In contrast, hydrophiles are attracted to water. Hydrophobic molecules tend to be nonpolar and, thu ...
(repelled from water) properties with adhesive borders. The hydrophobic layer protects the wound from the outside fluid contamination. Meanwhile, the inner hydrophilic layer is able to absorb moderate amount of discharge from the wound. Therefore, this type of dressing is useful for wound with high amount of discharge and for wound with
granulation tissue Granulation tissue is new connective tissue and microscopic blood vessels that form on the surfaces of a wound during the healing process. Granulation tissue typically grows from the base of a wound and is able to fill wounds of almost any size ...
. Secondary dressings are not required. However, it requires frequent changing and is not suitable for dry wounds.
Silicone In Organosilicon chemistry, organosilicon and polymer chemistry, a silicone or polysiloxane is a polymer composed of repeating units of siloxane (, where R = Organyl group, organic group). They are typically colorless oils or elastomer, rubber ...
is a common material that make up the foam. The foam is able to mold according to the shape of the wound.
Hydrogel dressing Hydrogel dressing is a medical dressing based on hydrogels, three-dimensional hydrophilic structure. The insoluble hydrophilic structures absorb polar wound exudates and allow oxygen diffusion at the wound bed to accelerate healing. Hydrogel dre ...
: This dressing is made up of synthetic polymers such as
methacrylate Methacrylates are derivatives of methacrylic acid. These derivatives are mainly used to make poly(methyl methacrylate) and related polymers. *Monomers ** Methyl methacrylate ** Ethyl methacrylate ** Butyl methacrylate ** Hydroxyethyl methacrylate ...
and polyvinyl pyrrolidine. It has high water content, thus provides moisture and cooling effect for the wound. The dressing is easy to remove from the wound without causing any damage. The dressing is also non-irritant. Therefore, it is used for dry necrotic wound, necrotic wound, pressure ulcers, and burn wound. It is not suitable for wounds with heavy discharge and infected wounds. Hydrocolloid dressing: This type of dressing contains two layers: inner
colloid A colloid is a mixture in which one substance consisting of microscopically dispersed insoluble particles is suspended throughout another substance. Some definitions specify that the particles must be dispersed in a liquid, while others exte ...
al layer and outer waterproof layer. It contains gel forming agents such as
carboxymethylcellulose Carboxymethyl cellulose (CMC) or cellulose gum is a cellulose derivative with carboxymethyl groups (-CH2-COOH) bound to some of the hydroxyl groups of the glucopyranose monomers that make up the cellulose backbone. It is often used in its sodiu ...
,
gelatin Gelatin or gelatine () is a translucent, colorless, flavorless food ingredient, commonly derived from collagen taken from animal body parts. It is brittle when dry and rubbery when moist. It may also be referred to as hydrolyzed collagen, coll ...
and
pectin Pectin ( ': "congealed" and "curdled") is a heteropolysaccharide, a structural polymer contained in the primary lamella, in the middle lamella, and in the cell walls of terrestrial plants. The principal chemical component of pectin is galact ...
. When the dressing is in contact with the wound, the wound discharge are retained to form gel which provides moist environment for wound healing. It protects the wound from bacterial contamination, absorbs wound discharge, and digests necrotic tissues. It is mostly use as secondary dressing. However, it is not used in wound with high discharge and
neuropathic ulcer Diabetic foot ulcer is a breakdown of the skin and sometimes deeper tissues of the foot that leads to sore formation. It is thought to occur due to abnormal pressure or mechanical stress chronically applied to the foot, usually with concomitant pre ...
s. Alginate dressing: This type of dressing is made up of either sodium or calcium salt of
alginic acid Alginic acid, also called algin, is a naturally occurring, edible polysaccharide found in brown algae. It is hydrophilic and forms a viscous gum when hydrated. When the alginic acid binds with sodium and calcium ions, the resulting salts are kn ...
. This dressing can absorb high amount of discharge from a wound. Ions present in the dressing can interact with blood to produce a film that protects the wound from bacterial contamination. However, this dressing is not suitable for dry wounds, third degree burn wound, and deep wounds with exposed bone. It also requires secondary dressing because wounds can quickly dry up with alginate dressing. Hydrofiber dressing: Made up of sodium
carboxymethyl cellulose Carboxymethyl cellulose (CMC) or cellulose gum is a cellulose derivative with carboxymethyl groups (-CH2-COOH) bound to some of the hydroxyl groups of the glucopyranose monomers that make up the cellulose backbone. It is often used in its sod ...
, hydrofibers can absorb high amounts of wound discharge, forming a gel and preventing
skin maceration Maceration is defined as the softening and breaking down of skin resulting from prolonged exposure to moisture. It was first described by Jean-Martin Charcot in 1877. Maceration is caused by excessive amounts of fluid remaining in contact with t ...
.


Bioactive products

Advancements in understanding of wounds have commanded biomedical innovations in the treatment of acute, chronic, and other types of wounds. Many biologics, skin substitutes, biomembranes and scaffolds have been developed to facilitate wound healing through various mechanisms.


Usage

Applying a dressing is a
first aid First aid is the first and immediate assistance given to any person with a medical emergency, with care provided to preserve life, prevent the condition from worsening, or to promote recovery until medical services arrive. First aid is gener ...
skill, although many people undertake the practice with no training – especially on minor wounds. Modern dressings will almost all come in a prepackaged
sterile Sterile or sterility may refer to: *Asepsis, a state of being free from biological contaminants * Sterile (archaeology), a sediment deposit which contains no evidence of human activity *Sterilization (microbiology), any process that eliminates or ...
wrapping, date coded to ensure sterility. Sterility is necessary to prevent infection from pathogens resident within the dressing. Historically, and still the case in many less developed areas and in an emergency, dressings are often improvised as needed. This can consist of anything, including clothing or spare material, which will fulfill some of the basic tenets of a dressing – usually stemming bleeding and absorbing exudate. Applying and changing dressings is one common task of medical personnel.


See also

* * Hydrocolloid dressing *
Hydrogel dressing Hydrogel dressing is a medical dressing based on hydrogels, three-dimensional hydrophilic structure. The insoluble hydrophilic structures absorb polar wound exudates and allow oxygen diffusion at the wound bed to accelerate healing. Hydrogel dre ...
*
Field dressing (bandage) A field dressing or battle dressing is a kind of bandage intended to be carried by soldiers for immediate use in case of (typically gunshot) wounds. It consists of a large pad of absorbent cloth, attached to the middle of a strip of thin fabric u ...
*
Esmarch bandage Esmarch bandage (also known as Esmarch's bandage for surgical haemostasis or Esmarch's tourniquet) in its modern form is a narrow ( wide) soft rubber bandage that is used to expel venous blood from a limb (exsanguinate) that has had its arterial ...


References

{{Major drug groups *