May be used as a protective dressing on at-risk skin. May be used on intact skin to protect
• Proven up to 7 day wear time
• Smooth outer surface helps reduce the risk of shear and friction
• Absorbs exudate without breaking down or leaving residue in the wound
• Fi lm border el iminates the need for tape and makes dressing appl ication easier
• Water-resistant lm border adheres rmly
• Fi lm border seals to help prevent premature dressing fai lure due to edge l ift
• Protects the wound and periwound skin from contaminants, body uids, bacteria and
viruses* *In vitro testing shows that the transparent lm provides a viral barrier from viruses 27
nm in diameter or larger whi le the dressing remains intact without leakage
Partial thickness dermal ulcers
• Supercial wounds and abrasions
• Supercial and partial-thickness burns
• Donor sites
Hydrocolloids are a type of dressing containing gel-forming agents, such as sodium carboxymethylcellulose (NaCMC) and gelatin. In many products, these are combined with elastomers and adhesives and applied to a carrier – usually polyurethane foam or film, to form an absorbent, self adhesive, waterproof wafer.
In the presence of wound exudate, hydrocolloids absorb liquid and form a gel, the properties of which are determined by the nature of the formulation. Some dressings form a cohesive gel, which is largely contained within the adhesive matrix; others form more mobile, less viscous gels which are not retained within the dressing structure.
In the intact state most hydrocolloids are impermeable to water vapour, but as the gelling process takes place, the dressing becomes progressively more permeable. The loss of water through the dressing in this way enhances the ability of the product to cope with exudate production.
One feature of hydrocolloids that is appreciated by clinicians is wet tack; unlike most dressings, they can adhere to a moist site as well as a dry one.
Hydrocolloids are easy to use, require changing only every 3-5 days, and do not cause trauma on removal. This makes them useful for clean, granulating, superficial wounds, with low to medium exudate.
Hydrocolloids provide effective occlusion; with dry wounds, they can have a softening effect, and they have been used to prevent the spread of MRSA (by providing a physical occlusive barrier).
Hydrocolloid wound dressings have been in use for some 20 years, and have rarely been associated with allergic contact dermatitis. However, some hydrocolloid dressings contain the pentaerythritol ester of hydrogenated rosin as a tackifying agent, and this substance retains the sensitizing potential of colophony.
The ability of hydrocolloids to absorb fluids varies considerably over time, and between products. Laboratory studies suggest that the dressings may not be suitable for medium to high exuding wounds. Other research suggested that when properly applied, the dressings might reduce the amount of exudate.
Silicone gel sheeting has been investigated for use in the treatments of keloids and hypertrophic scars. Its mechanism of action may be related to scar hydration. One randomized controlled prospective study set out to evaluate a hydrocolloid occlusive dressing that also acts by promoting a moist environment. Scar size and volume, color, patient symptoms, and transcutaneous oxygen measurements were taken.
The study found significantly reduced itching, reduced pain and increased pliability for both treatments, used over two months. The authors concluded that hydration of the scar offered symptomatic improvement, but no change in physical parameters.
Studies too numerous to cite have established that hydrocolloid dressings are more effective than ‘traditional’ dressings, such as parafin gauze, dry gauze and saline soaks. Despite this, and the relative reduction in cost over the decades, many health professionals continue to use obsolete materials and methods.
When the efficacy of hydrocolloid occlusive dressing technique is compared with conventional wet-to-dry gauze dressing technique, the patient has been shown to benefit with a greater chance of healing, faster healing times, and less pain.
Nursing time is very significantly reduced, because the wound does not need dressing so often (or for so long) dressing time is markedly reduced. Costs are saved in materials alone, before even considering the cost of professional time.
Pain is a feature of superficial wounds, such as skin graft donor sites, particularly at dressing changes.
One prospective randomized trial compared parafin gauze and a hydrocolloid dressing, applied on donor sites. The results showed that the hydrocolloid is a less painful dressing than parafin gauze, as well as achieving faster healing of skin graft donor sites
An open randomized controlled study was carried out in 44 patients with diabetes who had necrotic foot ulcers treated with adhesive zinc oxide tape or with an adhesive occlusive hydrocolloid dressing. Fourteen of the 21 patients treated with adhesive zinc oxide tape had their necrotic ulcers improved by at least 50%, compared to six out of 21 with the hydrocolloid dressing (statistically significant). Fifteen patients showed an increase in the area of necrosis during the course of the 5-week study and of these, 10 had been treated with the hydrocolloid dressing. 
However, these wounds were necrotic; other clinicians firmly recommend hydrocolloids, particularly for the protection of the wound after the removal of necrotic tissue. 
Foot ulcers in people with diabetes, often homogenised by the term diabetic ulcer, usually have both vascular and neuropathic aetiology; it would be unwise to assume that two apparently similar ulcers should be managed the same way. This issue has been controversial since the introduction of hydrocolloids; currently, the best advice would seem to be “use with caution in patients with diabetes.”
Reference 1: Apelqvist J., Larsson J., Stenstrom A., Topical treatment of necrotic foot ulcers in diabetic patients: a comparative trial of DuoDerm and MeZinc. Br J Dermatol 1990 Dec;123(6):787-792 [PubMed abstract]
Reference 2: Laing P., Diabetic foot ulcers. Am J Surg 1994 Jan;167(1A):31S-36S [PubMed abstract]
Thirty patients with lower limb ulcers of different aetiologies were treated with an occlusive hydrocolloid dressing twice a week for a maximum period of 12 weeks. No antibacterial chemotherapy was utilized. A culture was taken of the exudate of the ulcer before commencement of treatment and weekly or bi-weekly thereafter.
The results showed a mixed flora with prevalence of Staphylococcus aureus. The average duration of the treatment period was 67 days. The average interval between dressing changes was 4.1 days. Subsequent bacterial cultures showed a persistence of the original flora, but there was no correlation between the type of flora present and clinical evidence of infection or between the type of flora present and the rate of healing of the ulcer .
In another study, the bacterial flora of chronic venous ulcers treated with an occlusive hydrocolloid dressing were studied over eight weeks. The flora was generally stable. Once a species was present, it remained with the exception of Pseudomonas, which appeared to be inhibited by the dressing. Twelve out of 20 ulcers contained anaerobic bacteria and healing did not appear to be impaired by the presence of any particular species of bacteria .