Foam dressings were introduced about 25 years ago. Foams are formed from polymers, such as polyurethane, that have small open cells that are able to trap moisture. They are permeable to gas, with relatively high moisture-vapor transmission rates, but act as a barrier to bacteria.
Foam dressings have many different compositions and structures so they can be used on a variety of wounds, including leg ulcers, traumatic wounds, minor burns, donor sites, malignant wounds and cavity wounds.
Foams are absorbent and are available either in adhesive or non-adhesive form. They are often used as a primary dressing, but may also be used as a secondary dressings in some circumstances. Some foam dressings are thin, while others are thicker and provide greater cushioning and absorption.
Foam dressings help maintain the wound moist, absorb fluids that exude from the wound (exudate), and protect the wound and skin around the wound against trauma. Foam dressings that do not adhere to skin are beneficial for people with fragile skin.
Foam Dressing Characteristics:
- May have nonadhesive layer that allows for nontraumatic removal. Some have an adhesive border
- May have an occlusive backing to assist with drainage control
- Available in sheets or cavity packing
- Available with or without adhesive border
- Some foam dressings are thin, while others are thicker and provide greater cushioning and absorption.
- Some foam dressings also have antimicrobial activity.
Indications:
- May be used as primary or secondary dressings. Use as primary for absorption and insulation, or as secondary for wounds with packing
- May be used on Partial and full-thickness wounds
- May be used for Light to moderate drainage
Foam dressings do not provide autolytic activity. This form of debridement uses the body’s own processes (enzymes and moisture) to break down tough eschar and slough. It does not damage healthy skin, but breaks down dead and devitalized tissue over time quite effectively. The idea is to keep wound fluids in constant contact with the wound.
Contraindications:
- Occlusive foams should not be used on heavily draining or infected wounds
- Foams should not be used over dry, necrotic black ulcers
- Do not for use with third-degree burns, and sinus tracts
Application:
- Clean the area with a saline solution or appropriate cleanser
- Dry the surrounding skin with a sterile piece of gauze
- Apply the dressing to extend at least one inch beyond the wound edges
- Cover with a secondary dressing if necessary. If the dressing is not bordered with an adhesive, you may need to use tape or wrap to hold it in place
Foam Dressings may be used under compression wraps. Because venous ulcers, especially early in treatment as edema is reducing, may have substantial exudate, use of absorbent dressings is essential. Foams are ideal dressings in this case as they are absorptive and also provide local compression over the ulcer. For high exudate, use foams that do not have film backing so that drainage can wick out into the wrap.
Disadvantages:
- Foams require more frequent dressing changes compared to alginates and hydrofibers and accommodate relatively less wound fluid than these dressings. In addition, foam dressings may by associated with a malodorous discharge similar to the gel and smell observed in hydrocolloids.
- They can be expensive if exudate requires daily dressing changes
- Wound beds may dry out if there is no exudate from the wound
- A secondary dressing might be required
- If it becomes saturated, it can lead to breakdown of the peri-wound
Foams are made of polyurethane or silicone material. Silicone Foam dressings are sterile, foam dressings made with a highly absorbent foam pad, protective film backing and gentle silicone adhesive. Silicone foams consist of a polymer of silicone elastomer derived from two liquids, which, when mixed together, form a foam while expanding to fit the wound shape forming a soft open-cell foam dressing. The major advantage of foam is the ability to contain exudate. In addition, silicone foam dressings protect the area around the wound from further damage.
Polyurethane foams consist of two or three layers, including a hydrophilic wound contact surface and a hydrophobic backing, making them highly absorbent. and are generally made from semipermeable polyurethane, so they're nonadherent and nonlinting and the dressings allow water vapor to enter but keep out bacteria and other contaminants. They facilitate uniform dispersion of exudate throughout the absorbent layer and prevent exterior leakage (strike-through) due to the presence of a semipermeable backing.backing.
Examples of foams:
Advazorb - Hydrophilic Foam Dressing
ALLEVYN Ag Gentle Border
Allevyn Gentle Border Lite
Allevyn Heel
Allevyn Life
Allevyn* Adhesive Dressing
Aquacel Foam
Aquacel Foam Pro
Kerasorb®
Mepilex Border
Mepilex Foam Dressing
Mepilex Transfer
Optifoam Gentle
PolyMem WIC® Cavity Filler
XTRASORB® Foam Adhesive and Non-Adhesive
If you have coverage through Medicare Part B, you may be eligible to have this product covered by Medicare. You will need a written order prescribed by a provider enrolled in Medicare, so that you can purchase this product at a Durable Medical Equipment store that accepts Medicare. You will need to pay deductibles and co-payment. The actual co-payment amount varies according to your state. If you do not have Medicare Part B or your condition does not meet the requirements needed for coverage, you can find this product at pharmacies and medical supply stores. When available, please see pricing in "Other Stores" below.
