Hydrocolloid dressings consist of absorptive ingredients (typically carboxymethylcellulose, pectin, or gelatin). Like Control Gel Formula Dressing, hydrocolloids can absorb minimal to moderate amounts of drainage. They can be used for acute and chronic wounds that are partial- or full-thickness. Some sheet hydrocolloids are opaque, making wound assessment difficult; others are translucent or transparent.

Because they're occlusive, hydrocolloid dressings don't allow water, oxygen, or bacteria into the wound. This may help facilitate angiogenesis and granulation. They also cause the wound surface's pH to drop; the acidic environment can inhibit bacteria growth.

Like hydrogels, hydrocolloids can help a clean wound to granulate or epithelize and encourage autolytic debridement in wounds with necrotic tissue. However, because of their occlusive nature, hydrocolloids can't be used if the wound or surrounding skin is infected.

Three forms are available: pastes, powders, and sheets.

Hydrocolloid pastes generally come in tubes, and hydrocolloid powders come in packets. Use them as wound fillers and don't allow them to protrude above the level of the surrounding skin. Cover them with a secondary dressing, such as a hydrocolloid sheet dressing.

Hydrocolloid sheet dressings are available in various thicknesses and in precut shapes for body areas such as the sacrum, elbows, and heels. Highly conformable to the patient's body, these dressings adhere well to high-friction areas, such as the sacrum and heels. All sheet hydrocolloid dressings have a film covering to make the product waterproof.

Hydrocolloid dressings react with wound drainage and swell or "melt out," leaving a residue in the wound. When you gently remove the hydrocolloid dressing, you may find a gel residue in the wound bed. (If you've used a paste or powder form of hydrocolloid, you'll likely find a residue

11 plug" in the center of the wound.) Remove this residue by cleaning gently with a wound cleaner before assessing the wound. You might also notice a distinctive foul odor, which may be from product breakdown, not infection.

Hydrocolloids in practice

Now let's look at some examples of when to use a hydrocolloid dressing. Stage III pressure ulcer of the left buttock (Figure 1). This wound has a granular base and a small amount of exposed subcutaneous tissue. Your goal is to maintain wound hydration. Fill the wound cavity with a hydrocolloid paste and cover the wound with a hydrocolloid sheet dressing.

Partial-thickness wound to the lateral aspect of the left lower leg (Figure 2). This wound is clean, healthy, and granulating, with a scant amount of serous drainage. Your goal is to maintain a moist wound environment. The best topical wound management product choice for this wound is a hydrocolloid sheet dressing.

Pressure ulcers of the left and right heels (Figure 3). These wounds are covered with two types of necrotic tissue-slough and eschar. The wounds aren't infected and are draining a scant amount of serous fluid. Use a hydrocolloid to autolytically debride these wounds.

Hydrocolloid hints RepliCare Hydrocolloid Dressing

* Hydrocolloids adhere best at body temperature. To ensure proper placement, place your hand over the dressing after applying it to the wound.

* Hydrocolloid dressings with thick edges may "roll up" and adhere to the patient's clothing or bed linens, decreasing the dressing's wear time. Dressings with thinner, tapered edges generally adhere better to the periwound skin without rolling up.

* Because sheet hydrocolloids are adhesive, the patient's skin may be vulnerable to tearing when you remove the dressing. Evaluate the integrity of the periwound skin to determine if a hydrocolloid can be used.