Frequently Asked Questions on Hydrocolloid Dressing

Hydrocolloid Dressing
What are the properties of hydrocolloid dressings?
This dressing is easy to use and offers effective occlusion. It has a softening effect on dry wounds. User needs to change the dressing once in every 3 to 5 days. The hydrocolloid dressing is ideal for granulating, superficial wounds with low to medium exudate. And does not cause trauma on removal.
What is a hydrocolloid dressing?
Hydrocolloid dressing is among the most widely used contemporary dressing. It contains gel-forming agents like sodium carboxymethylcellulose and gelatin. This is combined with elastomers and adhesives and when applied to a carrier – generally polyurethane foam or film – it forms an absorbent, self-adhesive waterproof wafer.
How does this dressing work?
Wound exudates are absorbed by this dressing and turned into a gel. In some cases the cohesive gel stays within the dressing. But most of the times, the gel is less sticky and not retained within the dressing. When in the whole state, this dressing is watertight. But with the advancement of gelling, the dressing becomes porous and allows for the loss of water. This helps the dressing cope with the exudate being produced.
What is DuoDerm and why is it used to treat bed sores?
DuoDerm is the brand name for a commonly used hydrocolloid dressing manufactured by ConvaTec that is used to treat bed sores (or similarly referred to as: pressure sores, pressure ulcers or decubitus ulcers).

DuoDerm dressings are impermeable to water vapor, oxygen and bacteria. One of the reasons DuoDerm dressings are so popular is because they will not stick to the wound bed itself and can be removed without tearing the granulation tissue underneath. They are best applied to wounds that produce light to medium exudate or transudate (extravascular fluid with low protein content, a low specific gravity and low nucleated cell counts).

Depending on physician orders, DuoDerm dressings can be used on stage 1, 2, 3 and 4 bed sores. The length of time a DuoDerm patch may be left on a wound is determined by the amount of moisture in the wound. Under normal conditions, DuoDerm can be left on the wound for 3-4 days.

One of the advantages to using DuoDerm is that, unlike other dressings, it can be placed on wet wounds and wet surrounding skin and will remain in place due to the product’s ‘wet tact’. Because DuoDerm essentially creates a moisture barrier, they should not be used on people with infected bed sores. Under normal circumstances, wounds covered with DuoDerm are likely to develop a strong odor after several days. The odor is consider to be a normal part of of the product.
On what types of wounds should a hydrocolloid dressing be used?
Hydrocolloid dressings can be used on a wide variety of wound types, including:
  • Pressure ulcers (stages 1 and 2)
  • Leg ulcers
  • Surgical wounds
  • Abrasions
  • Minor burns
Hydrocolloid dressings can cope with different volumes of exudate, from light to heavy. As the gelling process progresses, the dressing’s permeability to water vapour will increase, thus allowing it to absorb more exudate.
Hydrocolloids can also be used in granulating wounds (where new tissue is forming), and wounds that contain a high percentage of slough (yellow, fibrous tissue) or necrosis (dead tissue). Because hydrocolloids are waterproof, they can also be used as secondary dressings to prevent other dressings from becoming contaminated.
Thinner versions of hydrocolloid dressings can also be used on drier wounds or those with lower exudate volume.
Does a hydrocolloid dressing have any side-effects?
There does not seem to be any pronounced side-effect of a hydrocolloid dressing. There is no noted association of the dressing with allergic contact dermatitis. But, some of these dressings contain the pentaerythritol ester of hydrogenated rosin and this has the sensitizing potential of colophony.
What are the reasons for using a Tegaderm hydrocolloid dressing?
Tegaderm may be used for the following reasons:
  • Tegaderm film border provides extended wear time for up to 7 days
  • Provides a waterproof backing and protection from bacteria and viruses
  • Efficiently absorbs exudate
  • Low allergenicity product – does not contain gelatin, pectin or tackifiers such as colophony or its derivatives
Can hydrocolloids protect the periwound area?
Some hydrocolloid dressings overlap the edges of the wound, thus providing protection for the periwound area. Similarly, some hydrocolloids have an adhesive border that can help to prevent maceration of the periwound skin.
What are the points to remember when applying a hydrocolloid dressing?
A hydrocolloid can be gently warmed between the hands before application as this will help the dressing adhere to the wound. It is also important to leave a small margin around the wound (up to 2cm) and, where possible, make sure that the patient does not put any weight on the wound for a short period (up to 20 minutes if possible).
This will help the dressing adhere. The gelling action of a hydrocolloid can be mistaken by some patients or inexperienced practitioners as discharge from the wound. It is important to reassure patients that this is, in fact, a normal effect.
When should a hydrocolloid not be used?
A hydrocolloid dressing should not be used in the following circumstances (Ousey et al, 2012):
  • Sinus tracts
  • Infected wounds
  • Deep burns
  • Where there is exposed bone or tendon
  • Ulcers (resulting from diabetes, fungal infection, tuberculosis or syphilis)
  • If the patient has vasculitis
What are the main indications for hydrocolloid dressings?
Hydrocolloids are easy to use, require changing only every 3-5 days and do not cause trauma on removal. This makes them useful for clean, granulating, superficial wounds, with low to medium exudate.
Hydrocolloids provide effective occlusion; with dry wounds, they can have a softening effect and they have been used to prevent the spread of MRSA (by providing a physical occlusive barrier).
How much fluid can hydrocolloid dressings absorb?
The ability of hydrocolloids to absorb fluids varies considerably over time, and between products. Laboratory studies suggest that the dressings may not be suitable for medium to high exuding wounds. Other research suggested that when properly applied, the dressings might reduce the amount of exudate.
What is the role of hydrocolloid dressings in maggot therapy?
Despite decades of experience in maggot therapy, selecting appropriate dressing materials continues to be a problem. The dressing has to: 
  • Prevent the maggots from escaping
  • Permit oxygen to reach the maggots
  • Facilitate drainage
  • Allow inspection of the wound
  • Require minimal maintenance
  • Be of low cost
One center developed a two-layered cage-like dressing, the bottom layer of which comprised a hydrocolloid pad, applied to the surrounding healthy skin and covered by a fine chiffon or nylon mesh. Liquefied necrotic tissue drained through the mesh and was absorbed in a top layer of gauze which was replaced periodically. Thus, it was possible to contain the maggots within the wound by means of readily available materials.
Are hydrocolloid dressings cost effective?
Studies too numerous to cite have established that hydrocolloid dressings are more effective than 'traditional' dressings, such as parafin gauze, dry gauze and saline soaks. Despite this, and the relative reduction in cost over the decades, many health professionals continue to use obsolete materials and methods.
When the efficacy of hydrocolloid occlusive dressing technique is compared with conventional wet-to-dry gauze dressing technique, the patient has been shown to benefit with a greater chance of healing, faster healing times and less pain.
Do hydrocolloid dressings reduce pain?
Pain is a feature of superficial wounds, such as skin graft donor sites, particularly at dressing changes. One prospective randomized trial compared parafin gauze and a hydrocolloid dressing, applied on donor sites. The results showed that the hydrocolloid is a less painful dressing than parafin gauze, and achieves faster healing of skin graft donor sites.
Another study, which involved patients with lacerations, abrasions and minor operation incisions, compared a hydrocolloid dressing with a non-adherent dressing. While time to heal was similar for both groups, patients using the hydrocolloid experienced less pain, required less analgesia and were able to carry out their normal daily activities including bathing or showering without affecting the dressing or the wound.
What are the effects of a hydrocolloid dressing on bacterial growth?
In a research, thirty patients with lower limb ulcers of different aetiologies were treated with an occlusive hydrocolloid dressing twice a week for a maximum period of 12 weeks. No antibacterial chemotherapy was utilized. A culture was taken of the exudate of the ulcer before commencement of treatment and weekly or bi-weekly thereafter.
How effective are hydrocolloid dressings for partial thickness burns?
A study compared a hydrocolloid formulation with silver sulphadiazine/chlorhexidine parafin gauze dressings in the outpatient management of small partial skin thickness burns. Burn wounds were followed until complete re-epithelialization occurred. There were no statistical differences between the groups, with respect to healing time and patients' subjective responses to treatment.
However, dressing application (but not removal) was easier in the hydrocolloid group. Furthermore, that group had significantly fewer dressing changes; a mean of three changes per subject group compared with eight in the silver sulphadiazine/chlorhexidine parafin gauze group. In this study, both modalities were found to be equally suitable and effective for small partial skin thickness burns.