Alginate Wound Dressings: Benefits And Applications
In the United States, approximately 6 million people are affected by chronic wounds. The number is only expected to increase with the rise in the elderly population. Wound dressings form an essential component of wound care. A variety of wound dressing materials are available in the market and it can be daunting to choose the best wound dressing for a particular wound. Podiatrists and wound care specialists need to be aware of the different properties of major wound dressings that are currently available. The selection of an appropriate wound dressing can improve patient outcomes through improved wound healing.
Alginate Wound Dressings: An Overview
Alginate dressings are a special type of biodegradable wound dressings that are made up of polysaccharides obtained from brown seaweed and carboxymethylcellulose. The absorptive capacity of alginate wound dressings depends upon the type of polysaccharide used but in general, they are more suitable for wounds with heavy exudate. Alginate wound dressings are not soluble in water but in the presence of sodium-rich wound exudate, these dressings exchange calcium ions and form an amorphous gel-like substance. The exchange of calcium ions with sodium ions present in the wound fluid also facilitates hemostasis.
Alginate wound dressings are excellent in creating a moist wound environment because of their high absorptive capacity. In addition, alginate wound dressings reduce the risk of bacterial contamination and promote the formation of granulation tissue. The improved healing with alginate wound dressings can be attributed to the activation of macrophages which activate the inflammatory process essential for wound healing.
Alginate wound dressings are available in numerous sizes and shapes such as sheets, pads, ropes which can be cut according to the size of the wound. As alginate wound dressings are highly absorptive, they are not appropriate for dry wounds. They might also require an additional layer of foam or hydrocolloid dressing to prevent the drying of the wound.
Benefits of Alginate Wound Dressings
Even though the application of alginate dressings is at least fifty years old, the first commercially available alginate wound dressings emerged in the 1980s. Due to their non-toxicity and biodegradability, they have emerged as a favorable alternative to traditional wound dressings. Some of the benefits of alginate wound dressings are described below:
- Moist wound environment: The pioneering work of George Winter established moist wound healing as standard care in wound care. They are highly absorptive and are transformed into a gel in the presence of wound exudate. The gel can retain moisture in the wound bed which is conducive for wound healing.
- Highly absorptive capacity: Alginate wound dressings have an excellent absorptive capacity. They can absorb fluid that is about 15-20 times their weight. This makes them excellent for wounds that have a heavy exudate. It should be kept in mind that due to their highly absorptive capacity, they should be avoided in dry wounds.
- Reduced risk of infection: Alginate wound dressings are known to reduce the risk. This effect could be attributed to the presence of M-block in alginate dressings which induce a cytokine response. Bacterial infection is a leading contributing factor to delayed wound healing. Therefore a reduced risk of infection improves wound healing outcomes.
- Hemostatic property: Alginate wound dressings are appropriate for wounds with minor bleeds due to their hemostatic property. They can facilitate blood coagulation through the exchange of calcium ions present in the matrix with sodium ions in the wound fluid. Calcium is essential in the activation of the coagulation cascade which in turn assists hemostasis.
- Versatile shapes: Alginate wound dressings are available in a variety of shapes and forms. They can be in the form of sheets, pads, ropes, or wafers. They can be used for wound packing and can be cut to conform to different-sized wounds.
- Granulation tissue formation: Alginate wound dressings have been found to improve reepithelialization and formation of the granulation tissue. They also promote autolytic debridement which is the removal of necrotic, dead tissue. Hence, alginate wound dressings play an active role in the wound healing process.
- Easy application: Alginate wound dressings are easy to apply and provide a painless removal.
Alginate wound dressings are excellent for wounds that produce a heavy wound exudate. Other indications for alginate wound dressings include:
- Pressure ulcers
- Vascular ulcers
- Large draining cavity wounds
- Sinus tracts
- Skin graft donor sites
- Surgical incisions
- Infected wounds
- Minor bleeding wounds
Due to their use in wounds with heavy exudate, alginate dressings should be changed almost daily. The frequency can later be decreased depending upon the amount of exudate produced by the wound. A major disadvantage in every dressing is that they can be drying for wounds with minimal exudate. In addition, they require a secondary dressing to maintain their gel-like form. Contraindications to alginate wound dressings include third-degree burns, dry wounds, and wounds that are covered with eschar.
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