The Benefits of Hydrogel Wound Dressings

As wound care clinicians, it’s important to understand the different types of wound dressings available and their functions.

If we take the time to learn the specifics of the available treatment choices, we can better tailor those choices to fit the needs of specific wounds. And if we’re intentional in our dressing choices, our healing rates will increase, and healing time will decrease.

Among all dressing options, one of the most common choices is hydrogel dressings. Let’s focus on its purpose and when to choose it.

A hydrogel dressing consists of 90% water in a gel base made of hydrophilic polymers suspended in water. It may be made of synthetic (PVA, PEG, PU, PLGA) or naturally derived polymers such as cellulose and hyaluronic acid.

Function of a hydrogel dressing

Hydrogel dressings are non-adherent and available as sheets, amorphous gels, or gauze impregnated with them. They’re often used to add moisture to a wound bed. Since hydrogel wound dressings are mostly water, they’re a great choice for maintaining a moist wound bed, which is necessary for wound healing.

Hydrogels are also available with silver ions. This helps wounds with significant bioburden or localized infection. Silver ions may reduce the need for topical and systemic antibiotics by decreasing bacteria and fungi in wound beds.

When to use these dressings

Hydrogel dressings have many uses and great versatility. Use them on the following types of wounds:

• Dry or lightly draining wounds
• Partial- and full-thickness wounds
• Granulating wounds
• Abrasions and partial-thickness burns
• Radiation skin damage
• Wounds with slough or eschar
• Painful wounds

Contraindications

Hydrogel dressings shouldn’t be used on patients with sensitivities to their components or on wounds with heavy drainage.

Because hydrogels add moisture to a wound, compounding this moisture with a wound’s heavy drainage can cause significant maceration to the peri-wound tissue. When using silver gel, ensure your patient isn’t sensitive to silver products.

5 advantages of hydrogel wound dressings

Hydrogel wound dressings offer numerous benefits, including pain reduction, promoting autolytic debridement, and serving as a medium for medication delivery.

1. Due to its cooling nature, hydrogel wound dressings can decrease pain within a wound as well as decrease painful dressing changes. Its gel consistency creates a barrier between the wound bed and dressings. Gels can help keep dressings from sticking to newly forming granulation tissue thereby reducing pain with dressing removal.
2. For patients who don’t tolerate sharp debridement, these dressings can assist in autolytic debridement. Over time, they will soften and loosen necrotic tissue so the tissue may be more easily removed during dressing changes. As always, when debriding by autolytic means, drainage may appear to increase during this process as the necrotic tissue liquidates and mixes with the wound’s own drainage. This is normally a slow process but a relatively painless way to debride necrotic tissue.
3. Hydrogel may also be used as a medium for medications. For example, specialty pharmacies may mix medications into a gel for topical application to a wound bed. In addition, mixing collagen powder with amorphous hydrogel is a great way to distribute collagen to uneven wound surfaces and areas of undermining and tunneling.
4. These dressings encourage granulation by moisturizing wound beds, reducing inflammation, and decreasing bacteria when using gel with silver ions.
5. Hydrogel may benefit infected wounds. When choosing to use a hydrogel in an infected wound, consider using the gel as the medium to deliver topical medications when systemic medications are not necessary.
6. Hydrogels can be cost-effective, as a single tube of the hydrogel can provide many dressing changes, which can be cheaper than using an alternate primary dressing.

Considerations to consider

A secondary dressing must cover hydrogel to keep the gel contained in the wound bed. When choosing a secondary dressing, consider one that will not displace or absorb the hydrogel. The gel needs to remain in the wound bed; otherwise, it won’t be effective. For this reason, avoid using foams, superabsorbers, alginates, and hydro fibers as secondary dressings.

Again, hydrogels aren’t appropriate for wounds with large drainage. Not only will the added moisture break down the peri-wound skin, but the hydrogel itself will likely wash out of the wound bed altogether. This would be a waste of product, money, and time; as no effective healing can occur in this environment.

Types of hydrogel dressings

Here are the different types of hydrogel dressings currently available:

• Amorphous gel: This is likely the most common form of hydrogel dressing because it is so versatile and easy to use. A light application of gel and a bordered gauze or gauze and tape is an effective and simple dressing. This option is relatively inexpensive and easy to teach patients and caregivers about home dressing changes. To be most effective and to prevent drying out, this dressing should be changed daily to several times per week.
• Hydrogel sheets: These are gel-like dressings containing hydrogel. These dressings are highly conformable and a great option for painful wounds like partial-thickness burns and wounds caused by radiation damage. They come in adhesive and non-adhesive forms. Non-adhesive forms require an appropriate secondary dressing, such as a bordered gauze or simple rolled gauze and tape, to hold the dressing in place. For effectiveness, this dressing should be changed several times weekly.
• Hydrogel impregnated gauze dressings: These are similar to petroleum impregnated dressings. They’re very versatile and can cover a larger surface area. They can also be used to pack depth, undermining, and measurable tunnels.

Research on hydrogel wound dressings and moist wound healing dates to the 1970s and 1980s. Although this dressing isn’t new, it continues to be a solid, effective dressing choice when used appropriately. Looking forward, the future of hydrogel appears to be expanding as biotechnology continues to develop in the medical field.