Hydrogel and Hydrocolloid.

Moved to the Wound/Ostomy/Continence discussion forum

Just update a typo. "Can Hydrogel be covered with a foam dressing? In my onion, Hydrogel shouldn't be covered with a foam as it can be absorbed by the foam.", would be better explained as follows:

Can Hydrogel be covered with a foam dressing? In my opinion, Hydrogel shouldn't be covered with a foam as it can be absorbed by the foam after the breakdown of Hydrogel.

https://cms.qut.edu.au/__data/assets/pdf_file/0003/451767/Book2-wound-dressing-guide.pdf

At P. 12, the appropriate use of foam is explained.

You can apply a hydrogel under a foam dressing?

False

Reason: The action of the dressing is to absorb fluid. If you moisten the dressing with a hydrogel it will then not be able to absorb any fluid.

However, the combination of hydrogel and foam dressing is in practice by some nurses.

Could any wound care specialists share your experience?

Generally a hydrogel is used on a wound that needs moisture donated and probably does not have a lot of drainage. A lite/thin foam could be used over this but generally a regular foam would not be necessary unless the dressing will be changed less often. Insurance will not cover foam dressings for anything less than moderate drainage. Hydrogels aren't indicated in wounds with that much drainage. So, you could use this combination without harm--it just wouldn't be very practical and likely not covered by insurance.

This sort of combination I have seen underneath compression wraps. It would help absorb a week's worth of drainage and also distribute pressure evenly over the wound beneath the wrap.

According to your reply, it seems that the examples from the document "Pressure ulcers – prevention and treatment: A Coloplast quick guide" are not much practically appropriate or even wrong. However, this practical guidance was made from a famous wound dressing organization.

Although I don't agree with the examples from this organization, I don't think the examples are wrong practice. I want to have better understanding about the rationale of these dressing examples from this organization.

It is highly possible that the examples from this organization would be the best practice for pressure ulcer.

In your opinion, if Hydrogel can't be covered by Hydrocolloid or foam dressing, what kind of absorbent dressing would you use to cover Hydrogel?

Please feel free to join the discussion.

You can use gauze, ABD, gauze roll, lite or regular foams...

1 hour ago, michksmith14 said:

You can use gauze, ABD, gauze roll, lite or regular foams...

If Hydrogel is covered by a gauze, will it be absorbed by the gauze?

If Hydrogel is covered by a foam dressing, will it be absorbed by the foam? According to the previous literature:

https://cms.qut.edu.au/__data/assets/pdf_file/0003/451767/Book2-wound-dressing-guide.pdf

Hydrogel should not be covered by a foam dressing.

Please explain the rationales of using a foam to cover Hydrogel. If Hydrogel can be absorbed by a foam, it wouldn't make much sense to use a foam to cover Hydrogel.

Also, please explain the rationales of using a gauze to cover Hydrogel.

Wounds need moisture balance in order to heal. Not too wet, not too dry. If you use a hydrogel with a hydrocolloid or plain film dressing, the wound will likely become way too wet, macerating the periwound and increasing the chances of hypergranulation. All of which slow wound healing.

A gauze dressing is not that absorbent where it will wick all of the hydrogel away from the wound. The gel will still provide the moisture a wound needs with gauze covering it.

54 minutes ago, michksmith14 said:

A gauze dressing is not that absorbent where it will wick all of the hydrogel away from the wound.

What kind of gauze dressing would you use? Please give a few examples of gauze you would like to use.

Meanwhile, according to the previous literature:

https://cms.qut.edu.au/__data/assets/pdf_file/0003/451767/Book2-wound-dressing-guide.pdf

Hydrogel should not be covered by a foam dressing.

Is this practice correct or wrong?