Jwc ewma final indd

J O U R N A L  O F WO U N D  C A R E   Vo l   2 2 .  N o   1 .  E W M A   D o c u M E N t   2 0 1 3

beads measuring 0.1–0.3mm in diameter, or as 

a paste with polyethylene glycol. The product 

consists of unbranched dextran-polymer chains 

which are interconnected by gycerol bridges into a 

three-dimensional network. 

Indication

Absorptive dressings are recommended for the 

treatment of exudative wounds (low, medium or 

high), with yellow sloughy surfaces.

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Mechanismofaction

Absorptive dressings are highly hydrophilic and 

rapidly absorb exudate from the necrotic, sloughy 

mass. One gramme of dextranomer can absorb up 

to 4g of fluid. Prostaglandins, hormones and other 

small molecules enter the matrix of the absorptive 

dressings, while larger particles, such as bacteria 

and wound debris, become concentrated at the 

surface of the dressing layer. When the dressings are 

changed, or the beads are washed out, the absorbed 

and trapped necrotic material is removed.

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Administration

Dextranomer should be applied in a thickness of a 

least 3mm on to wounds that have previously been 

cleaned with solutions. When the wound is dressed, 

there must be some room for expansion, as the 

dressing absorbs a lot of fluid. The absorbent dressing 

should be replaced after 1–3 days, depending on the 

extent of exudation. When it assumes a grey–yellow 

colour, it is saturated and should be removed.

Benefits

Absorptive dressings are easy-to-handle products 

that can be used even with highly exudative 

wounds and thus support the exudate management.

Contraindications

As with absorptive dressings with autolytic 

properties, absorptive dressings should not be 

used near the eyes, in deep wounds with narrow 

openings, or wounds in body cavities. Other 

contraindications are known contact sensitisation 

to ingredients of the dressings.

Sideeffects

Beside some reports of erythema, slightly blistered 

skin or dehydration of the wound bed,

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 the most 

important adverse effect is pain on removal of the 

saturated dressing from the wounds. This effect is 

the result of the adherence effects.

Honey

Background

The first records of the use of honey in 

wound management are already more than 

4000 years old.

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 Honey can be characterised 

as a combination products but is, as a purely 

natural substance, placed in a separate chapter. 

It is a viscous, supersaturated, sugar solution, 

containing approximately 30% glucose, 40% 

fructose, 5% sucrose and 20% water, as well as 

many other substances, such as amino acids, 

vitamins, minerals and enzymes. As well as honey 

preparations in tubes for wound treatments, 

dressing pads pre-impregnated with honey are 

also commercially available.

Indications

Honey has been used to treat a wide range of 

wound types with necrotic tissue or slough. Other 

indications are wound infections, even when they 

are caused by, for example, Pseudomonas aeruginosa 

or meticillin-resistant Staphylococcus aureus (MRSA).

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Action

Honey osmotically draws fluid from the 

surrounding tissue. This reduce wound oedema 

and, along with the increased exudate, results in 

autolytic debridement. The claimed antimicrobial 

effectiveness of honey may be partly explained by 

an osmotic dehydration, a low pH-value of 3.0–4.5 

and the release of small amounts of hydrogen 

peroxide or methylglyoxal.

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 Since honey is a 

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