Hydrocolloid dressings are a new type of wound dressing widely used in clinical practice. They are made by blending elastic polymer hydrogel with synthetic rubber and adhesive. These dressings can absorb low to moderate amounts of exudate. The airtightness prevents microbial invasion, provides a moist environment for wound healing, and partially debride wounds. These features can make up for the shortcomings of traditional dressings represented by gauze, which have poor barrier function and cannot promote wound healing. They offer a preventive and therapeutic benefit for pressure ulcers of all stages. Hydrocolloid dressings also promote collagen synthesis in epithelial cells, create a hypoxic environment, stimulate capillary angiogenesis, and increase capillary blood perfusion, effectively preventing and treating various types of phlebitis. As a new type of dressing, the application is expanding. Beyond treating pressure ulcers and phlebitis, is also gradually expanding to wound care, dermatitis prevention and treatment, catheter fixation, and infant care.
Introduction to Hydrocolloid Dressings
Origin and Development of Hydrocolloid Dressings
Over time, dressing types have evolved endlessly, from traditional gauze and cotton pads to biological dressings for allogeneic skin, and finally to today's gel-based dressings. Before the 18th century, wounds were primarily covered with natural materials, animal fur, and mineral-based occlusive dressings. The 19th century pioneered dry wound healing. In 1962, the discovery that polyethylene film accelerated wound healing laid the theoretical foundation for new wound protection dressings. However, it wasn't until the 1980s that the first gel-based dressing was developed.
With the advancement of technology, people have come to realize that the purpose of using a dressing is far more than just covering a wound; it must also promote wound healing. Consequently, new evaluation criteria have been proposed for medical dressings, namely, the ability to control and absorb exudate, block bacteria and provide a favorable environment for tissue growth, allow for the permeability of air and water vapor, and be easy to use and remove. New products, such as hydrocolloid dressings, have gained widespread clinical application.
Basic principles of hydrocolloid dressings in promoting wound repair
Hydrocolloid dressings promote wound healing in accordance with the principles of moist healing. Firstly, hydrocolloid dressings promote the dissolution of necrotic tissue and fibrin. When the epidermis is damaged, hydrocolloid dressings dissolve fibrin, which acts as a chemotactic factor for certain inflammatory cells, promoting the secretion of growth factors and accelerating the healing process. Furthermore, hydrocolloid dressings create a hypoxic environment and promote capillary angiogenesis, maintaining a relatively sealed and moist wound surface, thereby maintaining a low oxygen tension in the wound. With this type of dressing, wound capillary perfusion is significantly increased, accelerating capillary angiogenesis. The dressings also promote the release and activity of various growth factors. And, hydrocolloid dressings can alleviate pain and reduce wound re-injury during dressing changes without increasing infection rates.
Clinical application of hydrocolloid dressings
Prevention of Pressure Ulcers
Pressure ulcers are one of the most common complications of long-term bedridden patients. Hydrocolloid dressings can be used to prevent the development of pressure ulcers. Their mechanism of action is to create low oxygen tension, promote tissue microcirculation, provide breathability and waterproofing, and reduce shear and friction forces on the skin. Furthermore, the dressing's translucent and elastic nature allows for easy observation of the local skin condition, enhancing patient comfort.
Treatment of Pressure Ulcers
Pressure ulcers are divided into four stages. The treatment can be summarized as follows: For stage I , hydrocolloid dressings are recommended, which are conducive to the repair of pressure ulcer wounds. For stage II , the following dressings can be used: foam dressings, hydrocolloid dressings, and alginate dressings. Among them, alginate dressings can keep the wound surface continuously moist, but are not suitable for use alone. These can be used in combination with hydrocolloid dressings. If used in combination with ostomy skin care powder, it can effectively remove foreign matter and bacteria from the wound surface, and the treatment effect is considerable. For stage III to IV , different dressings can be selected according to the amount of exudate from the wound surface. For shallower pressure ulcers with less exudate and no infection, hydrocolloid dressings can be used.
Preventing Phlebitis
Phlebitis is a localized chemical inflammatory reaction in the vein wall caused by the intravenous administration of high-concentration, highly irritating drugs or the prolonged placement of an irritating plastic catheter. Hydrocolloid dressings can stimulate the release of macrophages and interleukins, accelerating the resolution of inflammation. Their superior ability to absorb exudate effectively prevents bacterial phlebitis.
Promoting Acute Wound Healing
Abrasions and contusions are acute skin injuries caused by the combined forces of trauma. They are complications of abrasions and contusions, with a high incidence. The wound surface is often exposed and heavily contaminated. Traditional treatment involves debridement, followed by the application of wet compresses or astringents to allow the wound to form a dry scab before healing. This results in increased susceptibility to infection, pain, a high incidence of post-healing scarring, and poor therapeutic efficacy. Hydrocolloid dressings are airtight dressings that create low oxygen tension, promote local blood circulation, accelerate inflammation resolution, absorb exudate, maintain local dryness, and promote rapid wound healing without scab formation. Hydrocolloid dressings also have similar effects in the treatment of burns.
Protecting Surgical Incisions
Numerous clinical studies have demonstrated that hydrocolloid dressings can alleviate postoperative wound pain, promote wound healing, and reduce scarring. By maintaining local moisture in the wound, hydrocolloid dressings prevent adhesion to newly formed granulation tissue, forming an occlusive barrier that provides a near-physiological healing environment, thereby reducing the chance of infection and accelerating wound healing. Furthermore, these dressings protect nerve endings in the wound and reduce pain. Studies have shown that hydrocolloid dressings can be used in gynecological surgery, hypospadias correction, and ureterocutaneous cystectomy, resulting in fewer dressing changes, shorter healing times, and no significant wound infection.
Dermatitis
Prevention and Treatment of Radiation Dermatitis
Radiation-induced moist dermatitis is caused by radiation-induced skin damage, resulting in redness, edema, and blisters that often persist for a long time, leading to interruption of radiotherapy or skin infection. Hydrocolloid dressings promote autolytic wound debridement, promote the growth of granulation tissue, and accelerate wound healing, reduce scab formation, alleviate wound damage and pain, and prevent microbial invasion, effectively preventing and treating radiation dermatitis."
Treatment of Autosensitive Dermatitis
Autosensitive dermatitis is a systemic inflammatory reaction caused by an allergic reaction to substances produced within the patient's body or in the skin. Most patients with autosensitive dermatitis after trauma or surgery experience severe itching. If combined with ulcers, diabetes, or secondary infection, the affected areas can become painful. Hydrocolloid dressings have antibacterial, tissue-stimulating, and bioactive properties. Their closed environment can also accelerate keratinocyte migration, promoting epithelialization in superficial wounds and accelerating healing.
Treatment of Intraperitoneal Dermatitis
With the widespread use of PICC catheterization, many studies have found that prolonged PICC placement and frequent dressing changes can lead to allergic dermatitis around the puncture site, disrupting patients' rest and sleep, and even requiring catheter removal in severe cases. Transparent hydrocolloid patches are absorbent and self-adhesive, stimulating the release of macrophages and interleukins, promoting local blood circulation, alleviating wound pain, accelerating endothelial repair, providing optimal temperature conditions, and preventing microbial passage. These patches are simple to administer and easy to use, effectively curing localized dermatitis. They also prevent adhesive residue and tearing during use, improving patient comfort and compliance.
Features
It blocks microorganisms outside the skin and absorbs exudate, keeping the puncture site dry, thereby reducing the chance of infection. It can be used to secure intravenous catheters or indwelling catheters. Studies have shown that hydrocolloid patches can reduce the incidence of phlebitis when used to secure intravenous catheters. When used to secure deep venous catheters, they can effectively reduce complications during catheterization, lower the rate of catheter removal, and ensure proper function of deep venous catheters. Hydrocolloid dressings can also be used to secure PICC lines. Studies have shown that when different dressings were used to secure PICC lines, the hydrocolloid dressing group had the lowest incidence of contact dermatitis and the best results. Furthermore, patients with allergies and those who sweat easily can also use hydrocolloid dressings to secure intravenous catheters. While reducing the risk of local skin allergies and infections, they can also extend the time between dressing changes, saving care costs.
Protecting Infant and Child Skin
Hydrocolloid dressings are also ideal for infants and children. They can create local tension, promote blood circulation, accelerate inflammation resolution, alleviate medication-induced pain, and effectively protect blood vessels. Using a hydrocolloid dressing during intravenous erythromycin therapy in children can effectively alleviate pain associated with the infusion. Can also be used to treat neonatal diaper rash, offering excellent efficacy and ease of use. The airtight nature of hydrocolloid dressings reduces scratching and protects against bacterial infection. Children can still play freely during use. Furthermore, removal of the hydrocolloid dressing is painless.
summary
Hydrocolloid dressings are a new type of wound dressing developed based on the principles of moist healing. They offer advantages such as maintaining wound moisture, absorbing exudate, autolytic debridement, accelerating wound healing, and protecting exposed nerve endings. Hydrocolloid dressings have self-adhesive edges, eliminating the need for tape fixation, making them simple and convenient to use. Easy to cut and can be made into various thicknesses and shapes based on the structural characteristics of different wounds, effectively adapting to pressure ulcers, lower limb arteriovenous ulcers, phlebitis, surgical incisions, and burn wounds. Consequently, hydrocolloid dressings are widely used in clinics and home.
