Simplifying Dressing Selection: Category and Wound Depth Protection Status
making wound product selection decisions


Whether you are a provider or a clinician, the challenge of wound dressing selection is ongoing. I have been an educator for quite some time now, and have found that the easiest way to teach dressing selection is by dressing category and wound depth.

First, do not get in the habit of learning every brand name. There are thousands of wound dressings on the market. I live and breathe wound care 24/7, and I do not know every dressing. However, I can select the appropriate dressing by category. I have provided an easy algorithm for you to help make dressing selection a bit simpler. It doesn’t matter where you work, you will know what to use. In many long-term care facilities that I speak at, I suggest a simple protocol such as this. This will help provide a structured wound management program.

Second, when selecting a dressing, you do not need to necessarily think about the wound type. Many times providers and clinicians over think this aspect when selecting a wound dressing. A wound is a break in the skin. Make it simple.

Our goals are pretty much the same with any wound type: wound bed preparation, optimizing moisture control, controlling bioburden, monitoring for signs and symptoms of infection, and wound healing progress.


About the Author
Cheryl Carver is an independent wound educator and consultant. Carver's experience includes over a decade of hospital wound care and hyperbaric medicine. Carver single-handedly developed a comprehensive educational training manual for onboarding physicians and is the star of disease-specific educational video sessions accessible to employee providers and colleagues. Carver educates onboarding providers, in addition to bedside nurses in the numerous nursing homes across the country. Carver serves as a wound care certification committee member for the National Alliance of Wound Care and Ostomy, and is a board member of the Undersea Hyperbaric Medical Society Mid-West Chapter.

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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Would you be interested in taking a look. Please contact me at above email.

Best Regards,

PS. I sent an invitation to you on linkedIn as well.

As a Certified Pedorthist (Canada) at Ashfield Orthotics, I do not diagnose nor dress wounds - although I contract the service at my clinic - but I do see people more frequently than I would like who have developed ulcers and don't even know it, especially if they came without a referral. It is helpful to be able to show them such a chart, explain dressing options & send them off to their doctor or podiatrist for primary treatment before I make them appropriate orthotics. Thanks!

At the 2015 WOCN National Conference I presented a poster abstract on an, "Assessment-based wound dressing selection model" based on 3 core assessments; 1) Depth 2) Exudate, and 3) Bioburden. These assessments were matched with dressing function; Hydration, Moisture Retention, Exudate Management, Super-Absorbents, Fillers, and Anti-microbials. In order for a dressing to function as "Moisture Retentive" I used Laura Botlon's operational definition from her 2000 OWM journal article, "Moisture and Wound Healing: Beyond the Jargon". Therefore, manufacturers cannot plug in products where they want. There are criteria for dressings to fit the functional category. The goals of the model are to optimize dressing wear times and decrease utilization of dressings used per dressing change.

With previous working knowledge of many algorithms and dressing selection guides, I learned that two things; 1) Novice clinicians using the guides and algorithms still struggle with complex assessments and 2) Following an algorithm or guide can lead to over-utilization of product. For example, a full thickness wound may be healing and shallow. The algorithm or guide may state to use a Primary and Secondary dressing. The result of this would be increased dressing costs, complexity of care, and longer time spent on dressing changes.

Feel free to reach out to me if you would like a copy of my "Model". After 15 years in wound care, I think I finally achieved a near perfect wound dressing selection cheat sheet for novice wound clinicians to minimize cost and optimize moist wound healing concepts.

Good morning, U just read your comment on wound Algorythm, I would love to receive a free copy of your wound dressing model. I am a wound care nurse, WCC, RN. I struggle sometimes with wound selections for various wound types. I am happy to come across this article.
Thank you. Chelseta Hardinf

How would you classify a "malignant" or "fungating" wound, due to breast cancer opening a chest wound that will never heal, leaking fluid and blood? I don't see an algorithm that fits.

Love to learn!

Would you ever use Silvadene on a diabetic/arterial heel wound with no S&S of infection?

Silvadene (SSD) has been used for almost every type of wound under the sun. If that is what the provider was taught, that is what they use. I suggest performing a literature search and if all you can get is the Abstract, read them. SSD was commonly used by DPMs on venous stasis ulcers like it was a standard of care. SSD has been shown to impair epithelial development thereby inhibiting wound healing (Level A evidence). Have you ever applied SSD on yourself, applied a dressing and changed it in 24 hrs? See how easy it is to remove from the skin. SSD is not even the best modality for burns with todays technology and advances. I say poo-poo to SSD unless I am backed into a corner with no other choices or alternatives. I provided my opinions, but it is up to you to do your due diligence via a lit. search.

Antiseptics - including silvadene - are not ideal for wound management because in general, if they are able to hinder bacterial growth, they also slow the motility or even kill human cells. We do not need to kill microbial contaminants though, we only need to remove them. One dressing type that is not listed on this algorithm is polymeric membrane dressings (PMDs). These dressings contain a continuous built-in wound cleansing system that is so powerful that usually there is no need to even rinse at dressing changes. I have had remarkably good results using PMDs on cancer wounds and on diabetic foot ulcers, two wound types commenters are asking about here. Studies show that the use of PMDs can lead to brisk healing of DFUs as wounds stay clean, and in my example case, the malignant wound did not become fungating - it never produced the characteristic foul odor that is so destructive to quality of life. For more information, see this new publication:

Linda Benskin, PhD, RN, SRN (Ghana), CWCN, CWS
Independent nurse researcher for rural areas of tropical developing countries and
Research & Education Liaison, and Charity Liaison for Ferris Mfg. Corp.

1. Benskin LLL. Polymeric Membrane Dressings for topical wound management of patients with infected wounds in a challenging environment: A protocol with 3 case examples. Ostomy Wound Management. 2016 Jun;62(6):42–62.

I was taught over 30 years ago that the amount of exudate helps dictate the type of secondary dressing. This concept continues to serve me well to this day. To rely solely on wound depth and category over simplifies the decision making process. The practice of wound healing is an art enhanced by experience. There are many other considerations to take in account when deciding on the most clinically appropriate cost-effective dressing. I opine that your chart is too simplistic to address the complexity of acute, chronic, dehiscence, compression, and so many other factors.

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