Skin is the body’s largest organ, which protects from infections, injuries, and harmful substances. When injured, even a small wound can disrupt this protective barrier, making the body more vulnerable to bacteria and other pathogens that can lead to infections.
You might wonder, what’s the best way to care for a wound to ensure it heals properly and doesn’t get infected? That’s where wound care basics like occlusive dressing come into play. While occlusive dressings can be beneficial, many wounds heal well with simple bandages or gauze, depending on the type and severity of the injury. They help protect the wound, maintain moisture, and promote faster recovery. This modern dressing type involves maintaining a moist wound surface when covered with an airtight or watertight seal. Let’s discuss more about what an occlusive dressing is, its types, indications, and its importance in wound care.
Different Types of Wounds
Wounds are caused in different ways by various objects, be it sharp, blunt, or projectile. They can be classified into multiple categories, depending on the cause and resulting injuries:
Incised wound
An incised wound is a straight, clean cut caused by a sharp edge, such as a knife. This type of wound tends to bleed heavily, as multiple vessels may be cut directly. Connecting structures such as tendons and ligaments may also be involved in these wounds.
Laceration
A laceration is a messy-looking wound caused by a crushing or tearing force. This wound type doesn’t tend to bleed as much as incised wounds. However, it often causes more damage to surrounding tissues.
Abrasion
An abrasion is a wound caused by scraping friction or force. It is not very deep but may contain several foreign bodies, such as dirt. Abrasions usually happen after a fall on loose ground.
Puncture
A puncture is a deep wound caused by a sharp, stabbing object like a nail. These wound types may appear small from the outside but often damage deep tissues. It is particularly dangerous on the chest, abdomen, or head as they house major organs that could be at risk.
Avulsion
An avulsion is a wound caused by a tearing force in which tissues are torn away from their normal position. It may bleed profusely depending on the location and size. In these cases, the tissue is often completely detached.
Amputation
An amputation is a wound that causes a loss of distinct body parts like a limb, finger, toe, or ear. These wounds are very severe with profuse bleeding and are often considered a medical emergency.
What Are The Basics of Wound Care?
There are several types of wounds, all varying in severity. A cut or abrasion is a surface wound, but a laceration may involve deeper tissue damage. Puncture wounds caused by sharp objects can be deep and highly susceptible to infection. However, burns and ulcers usually require special care because they damage the skin and heal slowly. These can be minor wounds that heal faster or moderate to serious wounds that need medical attention or stitches.
When it comes to treating wounds, proper care is important to avoid complications like infections. You can follow the below steps for wound care, which are simple but effective:
Clean the Wound
Always wash your hands first to avoid transferring germs. Clean the wound with mild soap and water. Avoid using harsh chemicals or alcohol, as they can damage healthy tissue by causing dryness and irritation, which can slow down healing. Instead, use saline solution as a gentle alternative which helps flush out debris without harming the surrounding skin. A gentle approach helps protect the wound while ensuring it remains free from dirt and bacteria.
Stop the Bleeding
If the wound is bleeding, apply gentle pressure with a clean cloth or gauze. If the bleeding persists, you need to seek medical help immediately. While minor cuts may stop bleeding on their own, deep wounds often require stitches to close properly. However, it is advised to seek medical attention immediately if heavy bleeding continues for more than 10 minutes. Uncontrolled bleeding can lead to blood loss and indicate a more serious injury.
Apply an Antiseptic
Apply an appropriate antiseptic solution, such as betadine or hydrogen peroxide, particularly for contaminated or open wounds. However, use these products sparingly, as they can damage healthy tissue and, if overused, may slow down the healing process. Some experts caution against hydrogen peroxide for wound care, as it can harm healthy cells and delay recovery. Instead, mild antiseptics or saline solutions are often recommended for gentle wound cleansing.
Cover the Wound
Choose the right dressing based on the type of wound. An occlusive dressing works best for wounds that need a moist healing environment, like burns, blisters, or surgical incisions. However, some minor wounds heal well with dry exposure, especially if they are shallow and not at risk of contamination. Analyze the wound type to determine whether a bandage or simple gauze is necessary.
Change the Dressing Regularly
Keep an eye on the wound. Change the dressing as directed, usually every 1-3 days. Avoid disturbing the wound too often, as this can slow healing. When changing the dressing, ensure that the wound is still clean and intact. Some occlusive dressings are designed for extended wear but always follow your doctor’s recommendations regarding dressing changes.
Monitor for Infection
Keep an eye on the wound for signs of infection, such as increased redness, swelling, or pus. If any of these occur, contact a healthcare provider right away. Infections can slow down the healing process and require professional treatment.
Keep the Wound Elevated
If possible, elevate the wounded area to reduce swelling. This is especially important for wounds on the limbs. When you elevate the wounded area, you can prevent fluid buildup and support faster healing.
Read More: How to Attend to a Stab Wound with First Aid: A Comprehensive Guide
What is an Occlusive Dressing?
Occlusive dressing facilitates healing wounds by providing the right environment. It usually assists in safeguarding wounds and their surrounding tissues from fluids, air, and other harmful contaminants like viruses and bacteria. Healthcare professionals use these modern dressings in several wound emergencies.
Chronic wounds impact the quality of life of around 2.5% of the total population in the United States. These wounds fail to heal on time, which leads to multiple complications and increased healthcare costs. In such cases, doctors suggest occlusive dressings to create a protective seal around the wound.
The extent of the seal through occlusive dressing also depends on the condition of the area around the same wound.
How Many Types of Occlusive Dressings Doctors Use?
Occlusive dressings aim to retain the excess moisture in the affected areas to ensure fast healing and prevent scab formation from dryness. The common types of occlusive dressing used in healthcare are discussed as follows:
Films
These are thin, clear dressings that have an adhesive side that faces your wound. These types of modern dressings are usually non-absorbent and used on minor burns and surgical sites.
Foams
Foams are absorbent dressings made of various substances, such as topical antibiotics. The dressing’s surface can be removed immediately if it remains moist because it has a non-absorbent quality. You can specifically use foams for partial- and full-thickness wounds. Please note that foams themselves do not contain antibiotics unless impregnated.
Hydrogels
This dressing type is made of water and can be slightly absorbent, which enables it to moisten dry wound beds. Hydrogels fall under the category of semi-occlusive dressing because they may allow bacterial penetration if they dry out. This specifically applies if hydrogels are used without secondary dressings.
Hydrocolloids
Hydrocolloid dressings are advanced, occlusive wound dressings designed to create an optimal healing environment. They consist of a moisture-retentive layer containing hydrogel that interacts with wound exudate to form a gel-like substance. This helps maintain a moist environment crucial for wound healing. The dressing typically includes a backing layer, often made of foam or film, which prevents bacterial penetration and provides structural support.
3 sided Occlusive Dressing
The 3 sided occlusive dressing is a specialized wound covering for chest injuries, such as open pneumothorax or sucking chest wounds. This dressing is sealed on three sides, with only one side open to act as a one-way valve. It allows trapped air or fluid to escape during exhalation while preventing outside air from entering the wound during inhalation. This occlusive dressing type is commonly used in emergency trauma care.
Occlusive Vs. Non-occlusive Dressing
Occlusive dressings create a sealed environment to retain moisture and protect the wound from external contaminants. Conversely, non-occlusive dressings allow fluids and air to pass through. This can promote drying and may not provide the same level of protection against bacteria or debris.
Some of the common differences between occlusive and non-occlusive dressings are summarised in the table below:
| Feature | Occlusive Dressings | Non-occlusive Dressings |
| Moisture Control | Creates a moist environment by sealing the wound. | Allows evaporation and may dry the wound. |
| Barrier Protection | Complete barrier against bacteria and contaminants. | Partial protection, which allows air and fluid passage. |
| Material Examples | Film dressings, Hydrocolloids, Hydrogels, Foam dressings. | Gauze, Cotton, Alginate dressings, Natural bandages. |
| Change Frequency | Less frequent (2-7 days) | More frequent (daily or as needed) |
| Cost | Generally higher | Generally lower |
| Best For | Partial-thickness wounds, Burns, Surgical sites, and Pressure ulcers. | Heavily exuding wounds, wounds requiring frequent inspection, minor cuts and scrapes. |
| Oxygen Permeability | Limited or no oxygen permeability. | Allows oxygen exchange. However, a few non-occlusive dressings, like petroleum gauze, do not allow sufficient airflow. |
| Exudate Management | Manages moderate exudate through absorption. | Variable absorption based on material. |
| Pain During Removal | Minimal due to maintaining moisture. | It can be painful if the dressing has dried the wound. |
| Healing Speed | Generally faster due to the moist environment. It can reduce healing time by up to 50%, especially for burns and chronic wounds. | It may be slower due to a drier environment. |
Read More: How to Stop Bleeding: A Guide to Stopping Bleeding
Which Occlusive Dressing Type Should I Choose?
The type of occlusive dressing you choose depends on the specific type of wound you are healing as a healthcare professional. For instance, first aid for cracked ribs or penetrating chest trauma often involves using a 3-sided occlusive dressing. This prevents air from entering the person’s chest cavity and allows the trapped air to escape.
Here are the things to consider when choosing an occlusive dressing type:
Mild to Moderately Exudative Wounds
Hydrocolloids are the best options to maintain a proper amount of wound moisture. They help form a gel upon contact with exudate and assist in autolytic debridement. It is a natural process where the body’s enzymes break down damaged tissue at a wound site. You will find different types of hydrocolloids with varying degrees of moisture retention and absorption.
Hydrocolloids are beneficial in pressure ulcers, slough dermal ulcers or wounds with necrotic tissue, and various forms of skin injury, such as tears and lacerations. However, they are not recommended for burns or heavily exudative and dry wounds.
Heavily Exudative Wounds
Foams can be used in heavily exudative wounds because they have better absorbing capacity. They are also suitable for tunneling and deep wounds. Alginates are ideal for wounds with moderate to heavy exudate, as they help manage moisture while providing some hemostatic properties. However, they are not suitable for wounds with heavy bleeding.
Dry Wounds
Hydrogels are the best choice for dry wounds and minor burns. They help limit gas exchange between the wound bed and its environment, which helps retain moisture in the wound. You can also use medical-grade honey to treat superficial and partial-thickness burns. Please note that honey is an alternative for minor burns and not the first choice for a dressing.
Transparent films are an excellent type of dressing that can also be used for dry wounds to retain moisture.
When Is Occlusive Dressing Indicated?
Occlusive dressings are the best first aid procedures to handle soft tissue injuries. They create a moist healing environment, which proves to be beneficial in the treatment process. The following are some common indications of these modern dressings:
Wound Treatment
Occlusive dressings are often combined with antibiotics, gauze, sponges, or hydrogels to treat various wounds. The dressing maintains the wound’s moisture level, accelerating healing. It can also act as a barrier against external contaminants, such as dirt and bacteria, reducing the risk of infection while allowing for optimal healing.
Pressure and Bleeding Control
Occlusive dressings are especially useful in managing pressure-related wounds or those involving bleeding. When applied properly, they exert gentle pressure on the wound area. This enables you to control minor bleeding while maintaining a stable environment.
Topical Ointments
Occlusive dressings make applying topical ointments like antibiotics or healing creams more effective. The dressing creates pressure on the ointment, enhancing its absorption into the wound. Additionally, it prevents evaporation of the ointment, ensuring that the medication remains in contact with the wound longer for better therapeutic effects.
Partial Evisceration
Occlusive dressings are used to protect the internal organs, such as the bowel, in cases of partial evisceration. It is a medical condition where only a part of your internal organs can extend through a surgical incision. When applied to the wound, the dressing provides a sterile barrier to protect the exposed organ until the patient can undergo surgical intervention.
Sucking Chest Wounds
In the case of a sucking chest wound, where air or fluid is drawn into the chest cavity through a wound, an occlusive dressing is used to seal the wound. It prevents air or fluid from being sucked in while also treating the puncture, which reduces the risk of further complications like pneumothorax.
What Are The Contraindications of Occlusive Dressings?
Despite having many benefits, occlusive dressings are not suitable for all types of wounds. The following are some contraindications that healthcare professionals must be aware of:
Maceration of the Skin
There is a risk of skin maceration if a wound is left covered for an extended period with an occlusive dressing. This condition occurs when the skin becomes excessively moist. It often leads to skin softening, tenderness, and a whitish appearance. Prolonged maceration can impair the skin’s ability to heal and increase the likelihood of infection. Ensure regular dressing changes, use moisture-wicking layers, and choose dressings that balance moisture while allowing the skin to breathe.
Infected Wounds with Pathogenic Germs
Occlusive dressings should not be used on wounds that are infected or have high levels of pathogenic microorganisms. However, some antimicrobial hydrocolloids manage infected wounds by controlling bacteria while maintaining a moist healing environment. While the modern dressing type creates a barrier, it can also trap harmful bacteria inside the wound. Ensure that you address the infection in the wound before applying an occlusive dressing. You may also use a dressing designed specifically to allow for air circulation and drainage in infected areas.
Use Occlusive Dressing Confidently For Wound Care!
Occlusive dressings are an effective and reliable method for treating wounds by keeping the affected area moist and protected. This approach accelerates healing and reduces the risk of infection. If you are a healthcare professional, consider learning more about these dressing types for various wounds through proper first-aid training. A certification program in first aid provides you with the knowledge of different dressing types, various ways to apply them, and the specific medical situations in which you can use them.
FAQs
- What does occlusive mean in dressing?
Occlusive means non-permeable in dressing. It is a type of bandage that creates a completely sealed barrier over a wound. It blocks air, water, and bacteria from reaching the injury. This protects the wound and keeps it moist, which can speed up healing. The goal is to create a healing-friendly environment for recovery.
- What is an occlusive dressing usually used for?
Occlusive dressings are commonly used for wounds that need protection from contamination, such as cuts, burns, or surgical incisions. They are also used for injuries that benefit from moisture retention, such as pressure ulcers or chronic wounds. This type of dressing ensures faster healing by preventing the wound from drying out or becoming infected.
- When would you use an occlusive dressing?
An occlusive dressing is ideal for clean wounds that aren’t heavily draining. It is also ideal for burns, surgical sites, and wounds in areas that move frequently, like joints. These dressings are especially helpful when you need long-lasting protection and want to minimize dressing changes.
- What is the difference between occlusive and non occlusive dressing?
Occlusive dressings are non-permeable, while non-occlusive dressings are permeable. Occlusive dressings seal the wound completely, blocking air and moisture loss. Thus, they are used to seal wounds. On the other hand, non-occlusive dressings are used to cover wounds. They are better for wounds needing ventilation to prevent infection.
