By Nancy Morgan, RN, BSN, MBA, WOC

Each month Nancy Morgan Wound Care brings you a tool you can apply in your daily practice.

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12 Top Wound Dressings

Description

Transparent film dressings are thin sheets of transparent polyurethane (polymer) coated with adhesive. These dressings are available in a lot of different sizes and shapes.  I think of it like a big sticker you can look through.

Transparent film dressings provide a moist, healing environment; promote autolytic debridement; protect the wound from mechanical trauma and bacterial invasion; and act as a blister roof or “second skin.” Because they are flexible, these dressings can conform to wounds located in awkward areas such as the elbow. The transparency makes it easy to visualize the wound bed.

Transparent film dressings are waterproof and impermeable to bacteria and contaminants. Although these dressings can’t absorb fluid, they’re permeable to moisture—allowing one-way passage of carbon dioxide and excess moisture vapor away from the wound.

Indications

• Partial-thickness wounds with no or minimal drainage
• When protection is needed for intact skin to protect from friction injuries
• To promote debridement of eschar
• To protect and secure critical access lines
• To secure another dressing.

Consider the following when deciding whether to choose this type of dressing

• A transparent film dressing won’t adhere to a moist surface because its adhesive properties are deactivated by moisture
• Don’t use this dressing in patients who have moderate to heavy exudate, third-degree burns, suspected or active infection, fungal infection, or active herpetic lesions
• These dressings can cause periwound maceration
• Transparent film dressings aren’t recommended for patients with fragile or thin skin, especially elderly patients, or in patients receiving steroids because removal may cause epidermal stripping or skin tears

How to apply

Follow these steps to apply a transparent film dressing.

1. Wash your hands and put on gloves.
2.  Remove the soiled dressing and place it in a trash bag.
3. Remove your gloves, wash your hands, and put on new gloves.
4. Clean the wound with normal saline solution or prescribed cleanser
5.   Dry the tissue surrounding the wound by patting it with a 4″ × 4″ gauze pad.
6.  Remove your gloves, wash your hands, and put on new gloves.
7.  Make sure the skin is clean and dry. Some manufacturers recommend defatting the skin with alcohol to increase dressing adhesion. Apply a liquid barrier film or moisture barrier to the peri-wound area to protect the skin from wound exudate.
8. For deep wounds, apply wound filler or packing material as indicated.
9. Peel the liner from the dressing to expose the adhesive surface.
10. View the wound or site through the film and center the dressing over it. Don’t stretch the  dressing during application.
11. Smooth the dressing in place from the center outward.
12. Remember that the dressing should be at least 1″ larger than the wound. Check individual manufacturer recommendations because some dressings require a 2″ border.
13. Dispose of the waste; then remove your gloves and discard them.

How to remove

Follow these steps to remove a transparent film dressing.
1   Lift a corner of the dressing and stretch it horizontally along the skin surface to break the adhesive band.
2   Continue stretching from the edge of the dressing toward the center.
3   When two sides of the dressing are partially removed, grasp both sides and stretch them horizontally and parallel to the skin until the entire dressing lifts.

Frequency of dressing changes

The average time between transparent film dressings is 3 to 5 days, although the dressing may be left in place up to 7 days. The frequency of change can vary based upon manufacturer recommendations. If the transparent dressing becomes loose, if leakage is present, or new skin irritation or redness is noted, change the dressing and reassess whether continued use is appropriate.

Selected References

Moore, Zena; Patton, Declan; Avsar, Pinar; McEvoy, Natalie L.; Curley, Gerard; Budri, Aglecia; Nugent, Linda; Walsh, Simone; O’Connor, Tom.  (2020, June 2).

Prevention of pressure ulcers among individuals cared for in the prone position: lessons for the COVID-19 emergency. 29(6):312-320.  Retrieved from https://pubmed.ncbi.nlm.nih.gov/32530776/).

Nancy Morgan RN, BSN, MBA, WOC is an experienced clinician, successful business leader, and accomplished nurse educator in the field of wound management. She is the co-founder of the Wound Care Education Institute, (WCEI®), Wild on Wounds Productions; and, most recently established Nancy Morgan Wound Care offering innovative, educational resources including seminars, webinars, social media and wound care marketing tools to assist and support wound care clinicians at the bedside.  Nancy is one of the most distinguished wound care educators, delivering nearly 1200 lectures, conference keynote addresses, seminars, webinars, and bedside consultations during her career.

Information in Nancy Notes is courtesy of Nancy Morgan Wound Care, copyright 2022.

DISCLAIMER:  All clinical & legal information, text and graphics, in this blog are intended to assist with determining appropriate wound therapy or proper legal information.  It is not intended to be a substitute nor constitute providing legal or medical care or advice, diagnosis, or treatment.  Responsibility for final decisions and actions related to legality and care of specific patients shall remain the obligation of the institution, its staff, and the patients’ attending physicians  and their legal representation.  Individuals should always contact their healthcare providers for medical or emergency-related care and/or contact their retained attorneys or their legal representation.