hydrocolloid dressings contraindicated

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Hi every one

I have been looking for a more comprehensive reason for why hydrocolloid dressings are contraindicated for use on the diabetic foot apart from them being occlusive.

Do any of you use hyrdocolloids, would you not use them at all or not a neuroischemic ulcer but you would on a neuropathic ulcer.

 

Hi Richie,

We do use hydrocolloids in a very limited capacity on diabetic foot ulcers.
They must be low exudate, not infected or colonised and have a superficial granulating base.
Basically, this is when the wound is very close to healing and just needs a small amount of protection.

We don't specify whether they are neuropathic or ischaemic, ultimately it is the local condition of the wound which determines dressing choice.

Of course, all comorbidities need to be managed in addition to the wound.

I would take care to avoid maceration of the periwound skin which could encourage the growth of infection, so if someone has a sweating problem, I would prefer a drier dressing like a foam and use a hydrocolloid paste (like comfeel paste) as an alternative.

Hope this gives you some guidance.

Cheers,

ERP.

 

Very helpful many thanks. If any one has any thing to add I would love to hear it (well read it).

Thanks again Erp

 

Richie,

the only true contraindication for a hydrocolloid is infection. And this is only for the sheets not the paste, as it is the occulding properties that can cause the problem.

I have used them on neuropathic, ischemic, neuroischemic and pressure wounds. as said before you have to be wary of macceration. it is not one of my 1st line dressings, but it does have its place.

 

Hi Richie
In our high risk clinic we only use hydrocolloids on ischemic wounds where rehydration of a wound bed is an issue and/or we need to promote tissue debridement or pain control. My experience is that the risk of maceration is too great on any neuropathic wound which bears weight. I feel that some the issues which arose with hydocolloids, when they were first used, related to the inappropriate use of the dressings on neuropathic wounds.
Laurie Foley

 

Many thanks for all your help every one, very helpful.

 

I would just add that applying a very adhesive dressing, whether hydrocolloid or not, can be an issue in patients who have (potentially) poor skin integrity to surrounding tissues, and this would include diabetics and people with arterial ulcers.

Where avoidance of maceration is an issue, there are several barrier films/cream/ sprays which could be applied to the surrounding skin prior to applying the fresh dressing. Cavilon is a particularly useful and effective one.