Product Technology Overview: DuoDERM® Hydrocolloid Dressing Protection Status
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by Elliot Fialkoff and James McGuire DPM, PT, CPed, FAPWHc

Ulcers, wounds, and burns come in many different shapes and sizes based in part on their etiology, which also varies dramatically. As many different etiologies as there are for various dermatological insults, there is an even greater number of dressings and treatment options available. DuoDERM® Hydrocolloid is an occlusive gel dressing that helps maintain a moist wound bed. According to the ConvaTec website (the maker of DuoDERM®), "On contact with wound exudate, the hydrocolloid matrix forms a cohesive gel which supports moist wound healing."

Mechanism of Action

Exudate, a fluid that leaks from the capillaries into the wound bed, is part of the normal inflammatory process; however wounds that have delayed healing are stuck in the inflammatory phase and produce an excessive amount of exudate that is detrimental to the healing process. The goal with any wound dressing is to remove excess exudate, maintain a healthy moist wound environment, allow for the exchange of gasses, insulate the wound, protect the wound from contaminants, and have little or no trauma involved with dressing changes. The hydrocolloid in DuoDERM® is made up of sodium carboxymethylcellulose, gelatin, pectin and adhesive polymers, which helps provide absorbency, as well as a moist gel-like environment that helps promote autolytic debridement. Hydrocolloid dressings such as DuoDERM® work best with a wound that has a mild to moderate amount of exudate.

The Efficacy of DuoDERM®

A study by Michel Hermans treating small partial-thickness burns found that "HydroColloid Dressings (Duoderm, HCD) provide an optimum wound environment for more rapid re-epithelialization than either allografts or SSD. The cosmetic and functional results were also excellent."1 A meta-analysis of pressure ulcers performed by Matthew Bradley comparing a hydrocolloid dressing with a traditional treatment suggested that treatment with the hydrocolloid resulted in a statistically significant improvement in the rate of healing compared to wet-to-dry dressings.2

Application of DuoDERM®

The application of a hydrocolloid is very simple. The periwound area should be cleaned with saline or a wound cleanser, and a moisture barrier that improves adhesion applied to the periwound skin. It is helpful to warm the hydrocolloid dressing between your hands to increase the adhesive action and make sure the dressing is 1-2 inches larger than measured wound dimensions. The dressings can remain in place for 3-7 days, decreasing the number of changes needed per week.3 DuoDERM® Extra Thin CGF™ is indicated for the management of lightly exuding wounds; acute wounds such as minor burns, abrasions, lacerations and post-operative wounds or chronic wounds such as stage I-II pressure ulcers, or lightly exuding leg ulcers.

1. Hermans, Michel HE. "Hydrocolloid Dressing (Duoderm®) For the Treatment of Superficial and Deep Partial Thickness Burns." Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery 21.3 (1987): 283-285.

2. Bradley, Matthew, et al. "Systematic reviews of wound care management:(2) dressings and topical agents used in the healing of chronic wounds." Health technology assessment 3.17 II (1999).

3. Morgan, Nancy. "What you need to know about hydrocolloid dressings" May/June2013 Volume 2 number 3. Web. 02 Jun 2014.

About the Authors:Eli Fialkoff
A current fourth year student at Temple University School of Podiatric Medicine, Eli Fialkoff completed his Bachelor’s degree in 2007 from Touro College in Queens, NY. He is the current president of the Jewish Podiatric Medical Student Association at TUSPM where he together with fellow members hosted several Lunch and Learns on topics ranging from gait analysis and bio mechanics to APMLE board preparation. Eli resides in Lower Merion Township and enjoys running and spending time with his wife and daughters.

Dr. James McGuire is the director of the Leonard S. Abrams Center for Advanced Wound Healing and an associate professor of the Department of Podiatric Medicine and Orthopedics at the Temple University School of Podiatric Medicine in Philadelphia.

The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.

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If, by "moisture barrier" you refer to the category of products known as "skin sealants" , then it is inaccurate to say they increase the adhesion of the hydrocolloid wafer. These liquid plastic wipes and sprays protect the peri wound skin from maceration and from the adhesion of the wafer itself or any tape used to picture frame around the edges of the wafer. they can and should be cut to best fit whatever anatomy the skin breakdown is on- like cutting the wafer heart shaped to better fit the coccyx area.

It is also VERY IMPORTANT to mention that the hydrocolloid wafers like DuoDerm are OCCLUSIVE dressings , and should NOT be used on wounds with tunneling or undermining = wounds that may be colonized with anaerobic bacteria.

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