An Overview of Composite Wound Dressing Innovation and Adoption

While advanced wound care dressings were evolving to cover the spectrum of wound exudate—from dry to highly-exuding—composite dressings were introduced that did not seem to fit-in with the new moist wound healing (MWH) paradigm.

Composite dressings are similar to Band-Aids® in that an adhesive tape is fitted with a central adsorbent pad (e.g., Telfa™) topped with a simple porous and perforated net (often PET) wound contact layer. Some classic examples include Alldress® (Mölnlycke), COVRSITE™ (Smith and Nephew) and CoverDerm® (DeRoyal).

MediPlus Advanced Wound Care Surgical Composite Wound Dressing

An example of a composite wound dressing: the MediPlus™Advanced Wound Care Surgical dressing.

Types of Composite Wound Dressings

Two configurations dominate the composite dressing category, and both find extensive use in both chronic and acute wounds. The first is characterized by use of the familiar non-woven adhesive tape (usually polyester, e.g., Sontara®) with an absorbent pad-incorporating wound contact layer. The second utilizes a transparent (waterproof) film adhesive tape with absorbent pad and contact layer.

The absorbent pad may run from edge-to-edge or be confined as an island to the central portion of the dressing. Island composite dressings are better at isolating the wound from external contamination, while continuous (edge-to-edge) pad products can be cut to convenient lengths to fit a wider variety of wound lengths.

A subcategory of the non-woven composite dressings adds an additional outer layer of transparent film that serves to protect the wound from external contamination, reduce the coefficient of friction to better glide over sheets and clothing, and to protect the non-woven material from liquids and soiling, which facilitates cleanup.

Adoption and Positioning of Composite Dressings

Composite dressings became readily adopted as most practitioners recognized their improvement over tape and gauze with a sterilized and convenient packaged presentation. Incorporation of the transparent film component or transparent tape formats provided practical advantages and allowed practitioners to become familiar with some of the advanced wound care materials and principles that would eventually dominate wound care.

Specialized composite dressings have been positioned for acute wounds (including post-operative wounds) and often contain the words “Post Op” or “Surgical” in their brand name or description (e.g., Silverlon® surgical dressings). Other composite dressings are sold for general use, including use for chronic wound indications.

Uses and Benefits of Composite Dressings

Composite dressings are available in a wide variety of sizes, but the basic shape is usually square or rectangular. Composites are indicated for low-to-moderate exudate, or, in cases where super-absorbers have been added for moderate to highly exuding wounds (e.g., Viasorb®).

The main benefits of composite dressings are their simplicity of use. Virtually everybody is familiar with the application of a Band-Aid, and by extension, the application of a composite dressing to cover a wound.

Basic composite dressings are relatively inexpensive, readily available, and versatile enough to find utility with many wound types. Though basic forms may not be seen to promote moist wound healing, they are quite adequate for most acute or surgical wounds and can function as inexpensive secondary dressings to hold advanced wound care products in place.

Non-woven composite dressings are extremely conformable and comfortable in use. The conformability insures they work well on a wide range of wound locations, adding to their versatility.

Newer composite dressing formats may switch out the basic fluff absorbent pad with foam or a hydrofiber pad, or basic or advanced pads with antimicrobial components (such as dressings with PHMB).

Comparing Island Dressings and Composite Dressings

There are absorbent island dressings that closely resemble composite dressings but are marketed more for their absorption than their cover and protection functionalities. Almost all advanced wound dressing categories have a bordered form where the hydrocolloids, foams, hydrogels, etc. are covered with an adhesive tape that creates an island dressing format. These products provide the wound healing/moisture management character of the central substrate, with the security of an extended adhesive border.

Bordered advanced dressings (advanced wound substrate with border) cost more than absorbers or composite dressings, but achieve higher rates of reimbursement from Medicare and third-party payers under HCPCS codes that differ from composite dressings.

Composite dressings can cover a large range of functions within the clinic, LTC or home care environment. They are inexpensive and come in a wide array of useful sizes. Composite dressings can serve as efficient secondary dressings and provide some additional security for highly exuding wounds while protecting primary dressings and the wound from external contamination.

Composite dressings with an outer, waterproof adhesive film reduce patient-to-sheet friction and can facilitate cleanup and bathing. They are convenient to always have on hand for first response while awaiting the development of a treatment plan that may include more advanced wound management products.


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