Understanding Wound Dressing Innovations: From Basics to Advanced Therapies

Announcer:
You’re listening to Clinician’s Roundtable on ReachMD. On this episode, Dr. Geoffrey Gurtner will discuss modern wound dressings and strategies. He’s the Chair of the Department of Surgery and a Professor of Surgery and Biomedical Engineering at the University of Arizona College of Medicine in Tucson. Here’s Dr. Gurtner now.

Dr. Gurtner:
The spectrum of wound care dressings is very broad, and there’s many products out there. The simplest ones are things like gauze and band-aids and wound coverings, which are inert. And then you have lubricating dressings, such as Xeroform or petrolatum gauze, and then, hydrocolloid or hydrogel dressings.

And then you have advanced wound care dressings, which are things like negative pressure wound therapy, amniotic membranes, and skin substitutes, and those are typically more costly and sometimes are reimbursed, and they are at the very end of the dressing spectrum.

So most of the antimicrobial dressings that are out there use silver or other metallic ions for their antimicrobial properties or topical antimicrobials that are broad spectrum. And I do think there are some concerns with selecting out organisms, certainly for the antimicrobial dressings.

There’s also a non-zero rate of people developing hypersensitivity and rashes to some of the antimicrobial dressings, and so although it sounds like a good idea in general, they should be used with some degree of caution because not only can you select out things that are worse than the normal skin flora, but you can cause allergy and worsening of the skin and the wound itself.

The hydrocolloid and hydrogel dressings certainly prevent dressings from becoming desiccated or drying out—certainly with complicated wounds and deep wounds. If you have the wound dry out, it forms a scab or an eschar that then can be a place for bacteria to grow, and it can lead to worsening in the wounds. And the moist hydrocolloid or hydrogel dressings prevent that from occurring.

They also tend to be more comfortable for patients because when they’re removed, they don’t tend to stick to the raw surface, and so for both those reasons, they’ve been very helpful in ongoing wound care and in a variety of settings, from chronic wounds to pressure ulcers to diabetic ulcers to burn care.

The thing that really drives the need for new wound dressings and innovation in this space is the fact that even with all these different products, we have many patients who don’t heal—who go on to amputation and who have chronic wounds for years and years and years. And so the hope is that new, innovative dressings might be able to close that gap. That’s the big impetus for all the different types of dressings that are out there.

Announcer:
That was Dr. Geoffrey Gurtner talking about our available options for wound dressings. To access this and other episodes in our series, visit Clinician’s Roundtable on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!