Translating the Properties of Physicochemical Dressings into Clinical Decision-Making for Heavily Exuding Wounds

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Introduction: Heavily exuding wounds can macerate perilesional skin and favour infection. Information on the properties and use time of dressings should be clear and available to healthcare providers. Methods: Our aim was to evaluate the updated series of the AQUACEL® dressing family, because their evolution from a single layer of carboxymethylcellulose (NaCMC) to a multicomponent antiseptic or its combination with polyurethane covered with a silicon layer has developed the technology beyond simple exudate absorption. Using gravimetric analysis, we evaluated the porosity, water uptake, and water vapour transmission rate (WVTR) of AQUACEL® Ag+Extra, AQUACEL® Foam, and Foam Pro. By modifying the method of measuring WVTR, we assessed this outcome during the progressive saturation of the dressings. We also performed a disc diffusion assay on agar to determine the antimicrobial effects of the dressings. Results: Independently of porosity, a second layer of cellulose in AQUACEL® Ag+Extra doubles water uptake and quadruples WVTR compared to foam forms. When the different dressings were evaluated for WVTR under progressive saturation, we did not observe any statistically significant changes, indicating that retained liquids do not alter dressing properties, which is a more biologically suitable approach. Despite the acidic character of the cellulose hydrofibre contained in the three dressings, the lack of any antiseptics in the foam forms makes them unsuitable for use in colonised or infected wounds, although they can act as a physical barrier for microorganisms and mechanical damage. The opposite results were observed for the AQUACEL® Ag+Extra dressing, which contains silver, EDTA, and benzethonium chloride. Discussion: Data on the physicochemical composition of dressings can enable healthcare providers to choose the appropriate dressing series to use during wound bed preparation and beyond.

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