What you need to know about hydrocolloid dressings

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

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View: How to apply a hydrocolloid dressing

Description

A hydrocolloid dressing is a wafer type of dressing that contains gel-forming agents in an adhesive compound laminated onto a flexible, water-resistant outer layer. Some formulations contain an alginate to increase absorption capabilities. The wafers are self-adhering and available with or without an adhesive border and in various thicknesses and precut shapes for such body areas as the sacrum, elbows, and heels. Click here to see examples of hydrocolloid dressings.

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Hydrocolloid dressings are occlusive, so they provide:
• a moist healing environment
• autolytic debridement
• insulation.

Advantages

• Impermeable to bacteria and other contaminants
• Self-adherent and mold well (don’t adhere to the wound, only to the intact skin around the wound)

• May be used under venous compression products
• Easy to apply
• Minimally disrupt healing (the dressing can be worn for several days before it needs to be changed. See “Frequency of dressing changes” for more information.)

Disadvantages

• Not recommended for wounds with heavy exudate, sinus tracts, or when infection is present
• Must be used with caution on the feet of patients with diabetes. It’s suggested that hydrocolloid dressings can be used safely on diabetic foot ulcers if 1) they are used only on appropriate wounds after a thorough patient assessment, 2) the wound is superficial with no signs of infection, 3) there is low to moderate exudate, 4) there are no signs or symptoms of ischemia, and 5) dressings are changed frequently
• Assessment can be difficult if the hydrocolloid dressing is opaque
• May become dislodged if the wound produces heavy exudate
• May curl or roll at the edges
• Upon removal, dressing residue may adhere to the wound bed and there may be an odor
• May cause periwound maceration (see photo)
• May cause trauma/injury to fragile skin upon removal
• May cause hypergranulation

When to use

A hydrocolloid dressing is appropriate for these situations:
• noninfected wound with scant to moderate drainage
• necrotic or granular wound
• dry wound
• partial- or full-thickness wound
• protection of intact skin or a newly healed wound.

Frequency of dressing changes

• Change the dressing every 3 to 7 days depending upon exudate and manufacturer guidelines.
• If daily dressing changes are required, reconsider the appropriateness of this approach because these dressings are designed for extended wear for up to
7 days.

How to apply a hydrocolloid dressing

1 Wash your hands and put on gloves.
2 Remove the soiled dressing (noting the date it was applied) and place it in a trash bag.
3 Remove your gloves, wash your hands, and put on new gloves.
4 Clean the wound with normal saline
solution or prescribed cleanser.
5 Use clean gauze to pat dry the tissue surrounding the wound.
6 Remove your gloves, wash your hands, and put on new gloves.
7 Apply liquid barrier film or moisture barrier to the periwound area.
8 For deep wounds, apply wound filler or packing materials as indicated.
9 Before applying the hydrocolloid dressing, warm it by holding it between your hands to increase adhesive ability.
10 Remove the paper backing from the dressing.
11 Gently fold the dressing in half lengthwise and apply it from the center of the wound outward.
12 Smooth the dressing in place from the center outward. Hold the dressing in place for a few seconds to improve
adhesion.
13 The dressing should be at least 1 inch larger than the wound. (Some manufacturers may require a 2-inch border.)
14 You may apply tape around the edges to secure the dressing.
15 Dispose of the waste.
16 Remove your gloves and discard.

How to remove a hydrocolloid dressing

1 Press down on the skin and carefully lift an edge of the dressing. Continue lifting around the dressing until all adhesive edges are free.
2 Gently peel away the dressing from
the skin in the direction of the hair growth.

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.

Learn more about wound care at the blog “Wound Care Swagger.

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

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Wound Care Advisor

61 thoughts on “What you need to know about hydrocolloid dressings”

  1. Art says:

    Hi Nancy, An elderly relative’s best current option for urinary incontinence is to use an external petal catheter with hydrocolloidal adhesive, such as the ReliaFit or Men’s Liberty products, but he is afraid of tearing the perfectly normal but delicate/sensitive skin of the glans, upon removal of the adhesive. I notice that you list possible damage to delicate skin as a disadvantage of these adhesives. But is this a realistic reason to avoid such adhesive for normal skin of the glans? With plenty of care during removal (very slow peeling, soaking the bandage’s peeled edge, etc.), is damage a large or small, serious or minor, risk? All other options that permit independent living seem not to have worked out. Thank you for any advice!

    1. Nancy Morgan says:

      Art this is a consideration on the list based on indiv patient situation. It does not necessarily mean to stay away from everything on the list. Just to take precaution.
      Reliafit looks like on the video may have a adhesive removal item (that is not part of the kit) this might be worth investigating as well to avoid skin breakdown
      http://www.eloquesthealthcare.com/reliafit/#

  2. rachel says:

    I have HS and am wondering at what stage should I NOT be using this type of dressing. I am currently draining and am not sure but would love the relief it gives right now. Thank you in advance!

    1. Nancy says:

      Hi just to clarify what is a HS?

  3. Hazens S says:

    Hi Nancy,
    I used to have an abscess in the right buttock just about 1 in away from the right hip bone. It was for about 4 years, opened in its own right, and being drained, then it was self-closed, then it was re-open to drain, etc. I used to put a gauze and taped it every once in a while, until 1 month ago, I’ve seen a surgeon in ER and he drained it well, squeeze it, put a pack. The process was continued for two more days. After a week, I didn’t feel much pain in the abscess but the pain was very close to the right hip bone (about 0.5 cm away), I asked the same surgeon who cleansed the abscess, he told me this causes some necrosis because of the pressure. He advised to both lessen my sitting down, and to use a special cushion adhesive. An ER nurse suggested me to use the ConvaTec DuoDERM extra thin CGF dressing. I just applied it, and it works as magic, no more pain in the hip’s bone.

    Does it really over the 4-year period abscess I developed the skin pressure ulcer? Is this DuoDERM will heel the ulcer or do I need to seek more medical advise?
    Thank you Nancy.

    1. Nancy Morgan says:

      Hazens this is hard to give you my opinion cause I don’t know enough on this case and I can’t see it. However I have seen this “opening and closing ” going on alot with abscesses. And they are challenging wounds no doubt. Just when you think its all good…….then it reopens. Pressure can complicate things yes……but I won’t “label” it as a “pressure ulcer” because the cause of this was a abscess. And you now have “complications” from this where decreasing “pressure” to the site is helpful for the healing process. If there is depth to this site the depth would need to be packed and then the site covered. So if you using duoderm and you have depth in the wound you need to fill the dead space (depth) with a packing type dressing then cover the wound. Continue to be monitored by your doctor to make sure no more complications happen.
      Good luck with this Hazens!

  4. Rod Iddles says:

    I have a open leg wound approx 8″ in length & 3″ wide it is just over 12mth old could you suggest a dressing such as DUODERM or AQUACEL to dress it as the leg needs to breathe ive been using a elastic bandage on it for the last 12mth the wound has shrunk considerably in 12mth the wound is about 3mm deep would it need a filling thanx

    1. Donna Sardina says:

      Rod,
      Unfortunately without seeing your wound, we cannot give you directions on specific treatment. I encourage you to contact your healthcare provider for detailed instructions.
      Some wound products such as foam dressings and hydrocolloids swell and expand when moist and therefore do not always need additional packing.
      Good luck with healing.

  5. Diane North Carolina says:

    Can you use hydro colloid dressings on boils

  6. Nancy Morgan says:

    Diane I would not recommend using this product on boils. I would consult with your MD on treating the boil.

  7. Liz Texas says:

    Nancy, my father has been bedridden for almost 2 years. He is unable to communicate or do anything for himself. Although he has been getting great care he has developed pressure wound on his sacral area. It has at times, broken through with mild bleeding but currently is just swollen and purple red in color. Are the thin hydrocolloid wound bandages appropriate to use to prevent trauma to area when he is moved in the bed and will they help in preventing progression of the pressure wound?

    thank you

    1. admin2 says:

      Hi Liz,

      Hydrocolloid can be in place if the wound bed is flush with the wound edges (not deep)it would help decrease friction to the site. However if there are any signs of infection which there might be based on your comment that its swollen and bleeding, I would not use this product unless you know there is no infection.

      The purple red color concerns me I would make sure he has a special bed (low airloss or alternating air) and also a chair cushion in place.

      An option for a dressing to consider would be a foam dressing get it about 1-2 inches larger then the area and that will help insulate it and protect it from friction and its a dressing that you can leave in place for an extended period of time. Allevyn is a brand name of one here is a link: http://www.smith-nephew.com/key-products/advanced-wound-management/allevyn/allevyn-adhesive/

      I would off load any pressure to the site to allow this area to heal.

      Definitely consult with your primary MD as its hard to advise you with not seeing the wound myself.

      Nancy

      DISCLAIMER: All clinical recommendations are intended to assist with determining the appropriate wound therapy for the patient. Responsibility for final decisions and actions related to care of specific patients shall remain the obligation of the institution, its staff, and the patients’ attending physicians. Nothing in this consultation shall be deemed to constitute the providing of medical care or the diagnosis of any medical condition.

  8. Ed says:

    Can Aquacel Extra be used over Adaptic Non Adherent Dressing for a wound with heavy exuding? With Aquacel Extra and ExuDry secondary dressing there is sever strike through onto macerated skin. If Aquacel could be used over Adaptic it would provide for easier dressing changes an less pain. Before Aquacel we were just using Adaptic with Gentamicin and an ExuDry cover.

  9. Linda McFarland says:

    I have an apparently uninfected wound . (never cultured). I am retired RN-some wound care knowledge. Not sure about my PA provder. Given these instructions :
    Karen reviewed the pictures and feels that the healing is going okay. She understands that you feel it has been very slow going, but she would like you to continue the duoderm, BUT add exposing the wound site to air for an hour or so a couple times daily. Follow up with pictures in 7-10 days. Thank you.
    i think these are opposing instructions. what is my best response to her?

  10. Grace says:

    Hi Nancy:

    I used it on my cat so he doesn’t lick his wound. Now it is almost healed but the gel residue also got stuck with his hair. What would be the best solution for cleaning it from his hair?

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