What you need to know about hydrogel dressings

By Nancy Morgan, RN, BSN, MBA, WOC, WCC, DWC, OMS

Each issue, Apple Bites brings you a tool you can apply in your daily practice.

Description

Hydrated polymer (hydrogel) dressings, originally developed in the 1950s, contain 90% water in a gel base, which helps regulate fluid exchange from the wound surface. Hydrogel dressing are usually clear or translucent and vary in viscosity or thickness. They’re available in three forms:

amorphous hydrogel—free-flowing gel, packaged in tubes, foil packets, and spray bottles
impregnated hydrogel—amorphous hydro­gel saturated onto a gauze pad, nonwoven sponge ropes and/or strips
sheet hydrogel—a gel supported by a thin fiber mesh. The dressing can overlap intact skin and generally won’t harm it. It’s available with and without adhesive borders and can be cut to fit the wound.

Benefits

By providing moisture to the wound, hydrogel dressings create a moist healing environment, which promotes granulation, epithelialization, and autolytic debridement. The high water content of hydrogel dressings cools the wound, producing pain relief that can last up to 6 hours. Dressing-change discomfort is also reduced because hydrogels don’t adhere to the wound surface.

In summary, hydrogel dressings:

• are soothing and reduce pain
• rehydrate the wound bed
• facilitate autolytic debridement
• fill in dead space (amorphous and impregnated types)
• can be used when infection is present.

Indications

Examples of wounds that may benefit from a hydrogel dressing include:

• dry or slightly moist wounds
• soothing painful wounds
• partial- and full-thickness wounds
• wounds with granulation tissue, eschar, or slough
• abrasions or minor burns
• radiation skin damage.

Disadvantages

Hydrogel dressings are not recommended for wounds with heavy exudate. In
addition:

• some require a secondary dressing
• some are difficult to secure
• they may cause periwound maceration
• they can dehydrate easily if not covered.

Frequency of dressing changes

The frequency of dressing changes varies from daily to every 4 days depending on specific manufacturer guidelines.

1. Wash your hands and put on gloves.
2. Note the date on soiled dressing; then remove it and put it in a trash bag.
3. Remove your gloves, wash your hands, and put on new gloves.
4. Clean the wound with normal saline or prescribed cleanser.
5. Pat the tissue surrounding the wound dry with clean gauze.
6. Remove your gloves, wash your hands, and put on new gloves.
7. Apply liquid barrier film or moisture barrier ointment to the periwound area to protect the skin from maceration.
8. Apply the dressing

Amorphous hydrogel dressing

a. Apply the product with a sterile tongue blade or cotton-tipped applicator, spreading it evenly over the wound bed to a thickness of 5 mm (¼ inch). Or, a sterile gauze pad may be saturated with hydrogel and placed into the wound with no overlap onto the surrounding skin.
b. Insert appropriate packing materials as needed.
c. Cover the dressing with a secondary wound dressing. The secondary wound dressing should cover the entire wound bed.

Gauze impregnated with hydrogel

a. Lay the dressing directly on top of the wound or loosely pack it into the wound bed.
b. Cover the dressing with a secondary wound dressing. The wound dressing should cover the entire wound bed.

Sheet hydrogel

a. Use a marker to trace the outline of the wound on the dressing.
b. Using clean scissors, cut the hydrogel sheet to the size of the wound.
c. Apply the sheet to the wound bed, taking care not to overlap onto intact skin.
d. Cover the sheet with a secondary wound dressing. The wound dressing should cover the entire wound bed.
9. Dispose of waste in an appropriate container. Remove your gloves and discard; then wash your hands.

How to remove

1. Wash your hands and put on gloves.
2. Gently remove the secondary wound dressing.
3. Remove the hydrogel dressing:
a. Amorphous hydrogel dressing: Rinse away any remaining gel with a wound cleanser or normal saline if necessary.
b. Hydrogel impregnated gauze or hydrogel sheet: Gently lift one edge of the dressing and peel it back slowly. If the dressing has adhered to the wound surface, saturate the dressing with wound cleanser or normal saline to soften it; then gently remove.
4. Check the removed dressing for type, amount, color, and consistency of
exudate.

Discard the old dressing in an appropriate container. Remove your gloves and
discard; then wash your hands.

Examples

Here are links to samples of each type of hydrogel dressing:
Amorphous hydrogel dressings
Impregnated hydrogel dressings
Sheet hydrogel dressings

PATIENT EDUCATION RESOURCE
University of Virginia Health System hydrogel dressing instructions

Selected references
European Pressure Ulcer Advisory Panel and National Pressure Ulcer Advisory Panel. Treatment of Pressure Ulcers: Quick Reference Guide. Washington, DC: National Pressure Ulcer Advisory Panel; 2009.

Hess CT, ed. Clinical Guide to Wound Care. 7th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2012.

Nancy Morgan, cofounder of the Wound Care Education Institute, combines her expertise as a Certified Wound Care Nurse with an extensive background in wound care education and program development as a nurse entrepreneur. Read her blog, “Wound Care Swagger.”

Information in Apple Bites is courtesy of the Wound Care Education Institute (WCEI), copyright 2013.

Related posts:

Wound Care Advisor

10 thoughts on “What you need to know about hydrogel dressings”

  1. Elizabeth McDermott says:

    Is there a wound gel called Hydrogel?

    1. Nancy Morgan says:

      Hi Elizabeth,
      “Hydrogel” is the broad category term given to capture many specific name brand products that fall within the hydrogel amorphous (free flowing) “gels” category. Depending on the manufacturer you may find them called different names, but they all fall under the Hydrogel category. Some brand name hydrogels for example would be: Solosite, Safe-Gel, Normlgel, or Curasal just to name a few.
      Thanks!
      Nancy WCEI

  2. stephanie says:

    Can this be used on an infected venous stasis ulcer?

    1. Nancy Morgan says:

      Hi Stephanie. Hydrogels are not your first choice for use on an infected venous ulcer. Most venous ulcers have lots of drainage so this product that gives additional moisture to the wound would not be needed and could cause the drainage to to get on the surrounding tissue and damage it. But more importantly you want to select a therapy to combat the infection in the wound first. You can use antiseptic solutions and/or dressings containing antimicrobials like silver. Once the infection is resolved the patient may need an evaluation for compression therapy which is the standard of care for venous ulceration. They need a thorough evaluation first. If you need more input, email me directly at nancy@wcei.net Good luck and keep healing.
      Nancy WCEI

  3. kathleen mcshane says:

    Question: How long can Kendall Hydrogel wound dressings stay on a wound? particularly on the nipple? Most information indicates 4 days. Should they be washed; (no soap) if removed and then put back on the breast/nipples?

    1. Nancy Morgan says:

      Hi Kathleen, I am going to assume you are using Kendall hydrogel breast feeding pad and if so I found this on their website.
      Question: How long should I use each Kendall™ hydrogel breast feeding pad?
      Answer from Kendall: Each Kendall™ hydrogel breast feeding pad can be used for several days. However, due to residual leakage, it may need to be changed more often. We recommend that you rinse (not soak) the pad with cool to warm water after each use to help get rid of any residual milk left behind. If, after a couple of days, the pad becomes milky or cloudy, it is advised that they are changed for a new pair.
      Here is the website for more info: http://www.mothermates.com/pages.aspx?page=product
      Hope that helps!
      Nancy

  4. Rebecca says:

    I am new to using solo site wound gel. I am doing home health as an RN. I removed a telfa from ski tears on an older patient. The wound gel had been spread over the tears and in a way looked like an opsite in a tube. It formed a skin on the skin tears which did not easily come off. Should it be peeled off with each dressing change?

    1. admin says:

      Rebecca, This is hard for me to advise because I am not seeing the wound. However telfa + hydrogel tends to macerate which can make things worse.

      Since you are having trouble with the current tx consider changing it into something that you can leave on for extended period of time and is skin friendly to the pt.

      Example: If you have min-mod drainage consider foam drsg with a silicone border. (Silicone border allows you to remove and replace without harming the skin or causing epidermal stripping, very nice for you to monitor the site this way as well.

      Here is an example of a product like that, this site has instructions and videos and the products comes in diff sizes. http://www.smith-nephew.com/key-products/advanced-wound-management/allevyn/allevyn-life/

      Hope this helps!
      Nancy

  5. Shail Soni says:

    Normally doctors prefer some kind of anti-infective agent for wounds to prevent infections. Does hydrogel provide anti-infective property? If not than can we apply both hydrogel and anti-infective agent (like silver or other) together?

  6. xochiicualli says:

    hello,

    Can we put a bit of hydrogel, solosite gel, on a 3 week avulsed toenail . Toenail has not scabbed but does have a bit of sloughing/eshar on nail folds.

    If you would like to see pictures of the complete avulsed toenail after 3 weeks, you can see my photos

    (only 9 of them) at

    https://www.flickr.com/photos/139604605@N06

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