By WoundSource Editors

Wound dressings can accelerate the healing process by protecting the injury or wound from bacteria and creating an environment which supports healthy healing. Foam dressings are an effective tool for moist wound healing and are particularly useful in preventing dressing-related trauma, managing exuding wounds, and minimizing dressing discomfort and pain.

Construction and Features of Foam Dressings

Made of semipermeable polyurethane, foam dressings contain foamed polymer solutions with small, open cells that can hold fluids. These cells may be layered with other materials. Their absorptiveness varies depending on the thickness of the dressing. The contact area of a foam dressing is nonadherent and nonlinting, so the dressing is easy to remove. The outer layer of the dressing is often hydrophobic or waterproof to keep out bacteria and other contaminants. Foam dressings come either with or without an adhesive border and in many sizes and shapes. Some foam dressings also include a bacterial barrier made from a transparent film. Additionally, some foam dressings are impregnated with an antimicrobial agent such as silver, Manuka honey, cadexomer iodine, antibiotics, or include surfactants as a vehicle for delivery of these substances to the wound bed.

A primary feature of foam dressings is that they help maintain a moist wound environment. Also important is that foam helps cushion the wound and periwound area from additional trauma, as well as providing thermal insulation for wounds. Easy to apply and remove, foam dressings don't cause wound trauma. Foam dressings can be used when there is an infection and during compression therapy. In addition, foam dressings are compatible with enzymatic debridment agents. Depending on the amount of exudate, foam dressings have a wear time of one to seven days.

Indications and Contraindications for Foam Dressing Use

Foam dressings are excellent for wounds which are exuding, whether minimally or heavily. Generally, foam dressings are meant for partial- or full-thickness wounds. Wounds which benefit from the use of foams dressings include:

• leg ulcers
• surgical wounds
• skin grafts
• minor burns
• abrasions
• infected wounds
• lacerations
• draining peristomal wounds
• pressure ulcers/injuries (stages 2 to 4)
• wounds needing negative pressure wound therapy (NPWT)
• tracheotomy and gastrostomy tubes
• wound cavities

Foam dressings can be used on wounds that have softened necrotic tissue. They are also flexible and can be cut to fit specific body parts like toes, fingers, or ears. Because of their thermal properties, foam dressings can be used on a wound which needs insulation to keep it warm. Additionally, foam dressings can be helpful in protecting the skin on top of bony prominences or high friction areas on the skin.

Non-draining wounds and third-degree burns are generally not good candidates for foam dressings. These dressings are also not effective on wounds which have dry eschar because with no exudate, the wound bed may be too dry for a moist wound healing environment (though in these cases foam dressings can be used to keep the eschar dry and protect it from accidental removal). Excessive exudate can be a contraindication if the foam is being soaked through quickly, possibly allowing external bacteria to enter the wound. In addition, excessive exudate can require too many dressing changes and cause maceration of the periwound area. In such cases, a more absorbent foam or another dressing type is indicated.

Proper Foam Dressing Application Instructions

The procedure for applying a foam dressing is as follows:

1. Put on gloves.
2. Clean the wound area with saline solution.
3. Dry the skin around the wound with sterile gauze.
4. Apply a foam dressing which extends a minimum of one inch beyond the edges of the wound.
5. If the dressing does not have an adhesive border, you may need to apply a secondary dressing or use wrap or tape to hold it in place.
6. When changing the dressing, peel off the foam dressing carefully, clean the wound and apply a new foam dressing.

The flexibility of foam dressings allows for a wide variety of clinical applications with wounds that have from moderate to heavy exudate. Because they are easy to use and can be easily cut to fit irregular wound areas, they are a good dressing choice for many situations.

The views and opinions expressed in this blog are solely those of the author, and do not represent the views of IncontinenceSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.