Composite dressings are dressings that combine the advantages of multiple layers, providing more than one function in wound care management. Each layer of dressing is physiologically distinct. To learn how to use these dressings, and when not to, read on.
Most composite dressings have three layers. The bottom layer is usually composed of a semi- or non-adherent material, which allows moisture to travel though to the next layer while preventing the dressing from sticking to the freshly granulating tissue of the wound bed. The middle layer is generally composed of an absorptive material which pulls moisture away from the wound bed, keeping it moist but preventing maceration of the skin. It also helps to inhibit bacterial growth and assists in the process of autolytic debridement. The outermost layer protects the wound from bacterial invasion and allows air to circulate. The outer layer also prevents moisture from leaking through to the top layer of dressing, allowing for less frequent dressing changes.
- Partial- and full-thickness wounds
- Wounds that have minimal or heavy exudate
- Wounds with granulating tissue
- Wounds that are necrotic (have necrotic tissue)
- Wounds that have a combination of necrotic and granulating tissue
- Patients who are very dehydrated
- Patients who have fragile skin ie. the elderly
- Can be used as both primary and secondary dressings
- Can be used on a variety of wounds with varying degrees of exudate
- Easy to remove, as the bottom layer is usually non-adherent
- Prevent maceration of the surrounding skin
- Have antibacterial properties
- Facilitates autolytic debridement
- Shape well to different wounds on different parts of the body
- Can be cost-effective, owing to less frequent dressing changes
- Some of these dressings are not appropriate for use on infected wounds (check the manufacturer’s directions for use)
- Composites with an adhesive border require that there be intact skin around the wound edges
- Some insurers will not reimburse for these types of dressing when they are used as secondary dressings
As each of these dressings are different, it is important to read the manufacturer’s instructions for use. They should be changed when saturated, or when recommended by the manufacturer. To learn more about these dressings and others, you may want to consider becoming certified as a wound care specialist. The benefits to you and your patients are immeasurable, and WoundEducators.com is dedicated to helping you take this all-important step in your career. Because Medicare and other government entities are now holding health care professionals responsible for outcomes in wound care, the time has never been better to consider becoming a wound care specialist, able to handle any type of wound you may encounter in your practice.