Silicone foam dressings have been widely used for wound management since the 1970s. Wound healing is a physiological process, and therefore, the overall health of the patient is important. A comprehensive assessment is an important part of the wound care process, helping us determine the cause of the wound and the treatment needed. Doctors can't heal wounds, the patients themselves are the key. However, to create an effective wound healing environment, patient education is key, for example: explaining to the patient how dressings and other products are used and what they do, such as the role of pressure bandages in the treatment of venous leg ulcers, or how decompression devices and equipment work to help relieve pressure for pressure ulcer patients.
1. The mechanism of action of silicone foam dressings
Different companies' products have different modes of action, but the main function is to absorb and lock in exudate, provide high absorbency and prolong use time. Silicone foam dressings have different sized holes to absorb exudate from the wound bed and lock it in. The dressing surface is usually smooth and hydrophilic. However, some products have larger openings on the surface, which can absorb and lock the debris, so it has the effect of minimal debridement.
Most foam dressings absorb exudate vertically. It can be seen that the exudate imprint of the dressing after absorbing exudate is consistent with the shape of the wound, which is to avoid maceration of the surrounding skin. There are also foam dressings that absorb laterally, that is, exudate enters the foam and spreads throughout the foam, so there is a greater risk of maceration of the surrounding skin. There are also some wound dressing products that combine the above two methods, that is, the foam dressing is divided into different layers such as contact layer, absorption layer, and backing. The layer in contact with the wound absorbs vertically, and after entering the absorbing layer, it can move to the side to make full use of the absorbing capacity of the material. However, due to the locking effect of the absorbent layer, the exudate does not escape and therefore does not increase the risk of maceration.
The silicone foam dressing not only locks in exudate, but excess fluid evaporates from the semi-permeable backing, further increasing its exudate management capabilities. The absorption capacity of each foam dressing has its limit. During use, the surface of the dressing should be observed. When the exudate mark is close to 2 cm from the edge of the dressing, it should be replaced in time to prevent exudate leakage. Different manufacturers may use different methods to test products, so the parameters declared by manufacturers are not necessarily comparable, and experienced wound specialists can often have an intuitive feeling and experience of different products after years of personal practice.
2. Clinical indications of silicone foam dressings
Foam dressings are used for exudate management and are therefore mainly used for wounds with varying degrees of exudation. Absorptive capacity varies by product size and brand. The manufacturer will indicate the scope of application of the product (mild to severe exuding wounds) on its packaging, and medical staff can choose the appropriate product according to the degree of exudation of the wound. Silicone foam dressings should not be used on dry necrotic wounds or dry epithelial wounds. Foam dressings have good exudate absorption management ability, so they can be used for a long time (up to 7 days), but the frequency of replacement must be determined according to the amount of exudate in the wound in actual use.