Commercial wound dressings for the treatment of exuding wounds: an in-depth physico-chemical comparative study

Burns Trauma. 2022 Jun 21:10:tkac024. doi: 10.1093/burnst/tkac024. eCollection 2022.

Abstract

Background: Nowadays, a wide range of wound dressings is already commercially available. The selection of the dressing is of paramount importance as inappropriate wound management and dressing selection can delay the wound healing process. Not only can this be distressing for the patient, but it can also contribute to complications such as maceration and subsequent infection. Many researchers are targeting the design of dressings with superior properties over existing commercial dressings. However, reported results in the state-of-the-art are rarely benchmarked against commercial dressings. The aim of this study was to determine several characteristics of a large variety of the most frequently used commercial wound dressings, providing an overview for both practitioners and researchers.

Methods: For this comparative study, 11 frequently used commercial wound dressings were selected, representing the different types. The morphology was studied using scanning electron microscopy. The dressings were characterized in terms of swelling capacity (water, phosphate buffered saline and simulated wound fluid), moisture vapour transmission rate (MVTR) and moisture uptake capacity (via dynamic vapour sorption) as well as mechanical properties using tensile testing and texturometry.

Results: The selected dressings showed distinctive morphological differences (fibrous, porous and/or gel) which was reflected in the different properties. Indeed, the swelling capacities ranged between 1.5 and 23.2 g/g (water), 2.1 and 17.6 g/g (phosphate buffered saline) or 2.9 and 20.8 g/g (simulated wound fluid). The swelling capacity of the dressings in water increased even further upon freeze-drying, due to the formation of pores. The MVTR values varied between 40 and 930 g/m2/24 h. The maximal moisture uptake capacity varied between 5.8% and 105.7% at 95% relative humidity. Some commercial dressings exhibited a superior mechanical strength, due to either being hydrophobic or multi-layered.

Conclusions: The present work not only offers insight into a valuable toolbox of suitable wound dressing characterization techniques, but also provides an extensive landscaping of commercial dressings along with their physico-chemical properties, obtained through reproducible experimental protocols. Furthermore, it ensures appropriate benchmark values for commercial dressings in all forthcoming studies and could aid researchers with the development of novel modern wound dressings. The tested dressings either exhibited a high strength or a high swelling capacity, suggesting that there is still a strong potential in the wound dressings market for dressings that possess both.

Keywords: Burns; Exudate management; Exuding wounds; Physico-chemical; Wound dressings; Wound healing.