How to use triad hydrophilic wound dressing

Alginates

Dressing material: alginates

Alginates are made from marine brown algae. As a basis for the production of the fibers, the alginic acid is extracted from the brown algae. Alginates consist of active ingredient-free calcium alginate fibers and are easy to pack and drape. When exchanged with sodium from blood and exudate, the alginate transforms into a hydrophilic, non-sticky gel. 1See S. Danzer, Wound Assessment and Wound Treatment, 2nd expanded and revised edition, p.260 Depending on the manufacturer and product, the alginate is additionally reinforced with fibers or enriched with carboxymethyl cellulose (hydroalginate) to ensure an even higher absorption capacity.2see S. Danzer and Anke Bültemann, 100 new questions on wound treatment, 2013, p.57

Functions of the alginates

  • An ion exchange occurs on contact with liquid / wound exudate. Calcium ions are released from the alginate and sodium ions, on the other hand, are absorbed. 3see K. Protz, modern wound care, 7th edition 2014, page 41
  • The alginate swells up like a gel, including excess liquid / wound exudate, germs, detritus and other waste materials from the wound. 4see K. Protz, modern wound care, 7th edition 2014, page 41
  • Calcium has a hemostatic (hemostatic) effect. As a result, alginates can be used on wounds that tend to bleed.
  • Alginates have a good wound cleansing effect and can help to loosen wound coverings slowly and gently.
  • Have a high and spontaneous absorption capacity. Alginates have a low weight, which limits the general fluid intake. 5see S. Danzer, Wound Treatment, 2020, p.149

Areas of application / indications

  • moderately to heavily exuding, greasy coated and infected / non-infected, superficial and deep wounds. Alginates can only develop their cleaning function in a sufficiently moist environment, otherwise the gel does not change.
  • for undermined wounds with cavities or pockets, fistulas and abscesses, wound dehiscence (should be visible, see instructions for use)
  • A secondary covering is required, this depends on the amount of exudate.
  • Alginates are available with and without silver, as a compress or as a tamponade

Instructions for use

  • Newly formed granulation tissue can be traumatized by the swelling process of the alginate. Therefore, the alginate should only be draped loosely in deep wounds, otherwise there is a risk of tissue / pressure damage (necrosis). 6see K. Protz, modern wound care, 7th edition 2014, p.42
  • Alginates absorb liquids not only vertically, but in all directions ("like blotting paper"). A precisely fitting application on the wound is important in order to avoid macerations on the wound edge and in the surrounding skin. An additional use of a wound edge protection is recommended.
  • The alginate is not an endogenous substance and must therefore be completely removed from the wound. Therefore, alginates should not be used in invisible wound pockets / fistula ducts. A precise insepion of the wound must be carried out in order to identify possible fiber residues. 7see S. Danzer, Wound Treatment, 2020, p.149
  • In the case of moderately exuding wounds, the pad can also be moistened with Ringer's or physiological saline solution. It should be noted, however, that the capacity is reduced accordingly. This also applies to the additional use of hydrogels. 8see K. Protz, modern wound care, 7th edition 2014, p.42
  • Alginates release the absorbed liquid almost completely under pressure, which can lead to problems (e.g. macerations), especially under compression or storage.9see K. Protz, modern wound care, 7th edition 2014, p.42
  • There is a risk of drying out with dry to weakly exuding wounds, exposed tendons, muscles and bones. Alginates should not be used in these wound conditions. This dressing material should also not be selected for 3rd to 4th degree burns. 10See S. Danzer, Wound Assessment and Wound Treatment, 2nd expanded and revised edition, p.261

Product examples

  • Suprasorb® A / + AG by Lohmann and Rauscher
  • Sorbalgon®by Paul Hartmann
  • Biatain Alginate / AG®from Coloplast
  • AlgiSite® M/ AG by Smith & Nephew
  • Cutimed Alginateby BSN Medical11Manufacturer information from Lohmann & Rauscher; Paul Hartmann; Coloplast; Smith & Nephew; BSN medical
Sources: - [1] see S. Danzer, Wundbeprüfung und Wundmedizin, 2nd expanded and revised edition, p.260 - [2] see S. Danzer and Anke Bültemann, 100 new questions about wound treatment, 2013, p.57 - [3], [4] see K. Protz, modern wound care, 7th edition 2014, p.41 - [5], [7] see S. Danzer, wound treatment, 2020, p.149 - [6] , [8], [9] see K. Protz, modern wound care, 7th edition 2014, p.42 - [19] manufacturer information from Lohmann & Rauscher; Paul Hartmann; Coloplast; Smith & Nephew; BSN medical Photo: By User: Stemonitis - Wikipedia en: Fucus_serratus.jpg, CC BY-SA 2.5, https://commons.wikimedia.org/w/index.php?curid=1167241