Understanding Dressings for Senior Wound Care
Choosing the right dressing for senior wound care is crucial. As you age the risk of wounds becoming chronic and failing to heal as expected increases. This occurs because older people have more fragile, dry and inelastic skin, and are liable to have conditions that delay wound healing such as diabetes, venous or arterial insufficiency, oedema, medications or immobility for example. As such, proper wound care needs careful attention, as inappropriate wound care may delay healing and increase the risk of complications for older adults.
At Vital Home Health Service we understand the frustration and anxiety that accompany senior wound care. From pressure injuries, venous leg ulcers, skin tears or diabetic foot ulcers, each type of wound has its own challenges. Using the wrong dressing can increase discomfort, slow down healing, or lead to extra problems. With so many options available, how do you choose the best dressing for wounds to make sure your senior clients or loved ones get the right care? At Vital Home Health Service we are here to help.
After reading this guide, you’ll have a better understanding of the:
- Importance of choosing the right dressing for elderly wound care
- Different types of dressings and how they are used
- Factors to consider when assessing the wound and choosing the dressing
Armed with this knowledge, you’ll be equipped to make informed decisions that promote healing, enhance comfort, and improve the overall quality of life for your senior patients or loved ones.
Why the Right Dressing Matters for Elderly Wound Care
Selecting the right dressing for wound care in the elderly is important, as their skin is more fragile and heals more slowly. Using the appropriate dressing can support the healing process by providing the ideal wound environment and protected from infection. More importantly, it ensures the patient’s comfort and reduces the risk of further injury. It is important though to understand that a dressing alone does not heal a wound, and underlying chronic conditions such as diabetes, heart failure, vascular conditions, oedema etc. will impact on the person’s ability to heal.
Taking the time to choose the right dressing isn’t just about healing the wound; it’s about boosting the overall well-being and quality of life of our elderly clients. It’s a small step that shows we care, bringing peace of mind and a sense of dignity to their healing journey.
The Challenge of Elderly Skin
As we age, our skin goes through a lot of changes. This means even minor bumps or scrapes can lead to wounds. Here are some skin changes related to aging:
- It becomes thinner and more delicate.
- The blood vessels in the deeper layers of your skin decrease.
- Your skin makes less collagen, a protein that keeps it firm.
- The layers of your skin stick together less.
- Fat moves around in your skin.
- You might feel less sensation in your skin.
- Your skin produces less sweat.
It’s important to recognise these changes because they play a big role in how we approach wound care. Knowing what makes elderly skin so delicate helps us choose the right dressings and care strategies, ensuring we give our clients the best possible support and protection.
Importance of Choosing the Right Dressing
The best dressing for elderly skin tear does more than just cover a wound. It creates an environment conducive to healing, protects against infection, and ensures comfort for the senior. Using the wrong dressing type may lead to delayed healing, discomfort, and even complications such as infections. Therefore, selecting an appropriate dressing is a critical step in promoting the health and well-being of elderly patients.
Choosing the right dressing for wounds offers several benefits, including:
- Promoting faster healing: Proper dressings can facilitate the wound healing process by creating an optimal environment for tissue regeneration.
- Reducing risk of infection: The right dressing acts as a barrier against bacteria and other pathogens, reducing the risk of infection.
- Managing moisture: Dressings help maintain an appropriate level of moisture in the wound bed, which is crucial for healing and preventing complications such as maceration or excessive dryness.
- Supporting debridement: The right dressing can aid in removing dead tissue (debridement), promoting healthy tissue growth and reducing the risk of infection.
- Reducing pain: Certain dressings protect nerve endings, minimising pain and discomfort associated with the wound.
- Enhancing patient comfort: Choosing the right dressing can improve patient comfort by minimising irritation and maximising mobility.
- Customising care: Different types of wounds may require specific dressings tailored to their characteristics and stage of healing, allowing for personalised and effective wound management.
Choosing the Best Dressing for Wounds in the Elderly
Choosing the best dressing for wounds in the elderly requires careful consideration of the wound’s characteristics and the unique needs of fragile aging skin. Skin tears, for example, are a common issue among the elderly due to their thinner, more delicate skin, and need dressings that can provide a moist healing environment, minimise pain, and reduce the risk of further injury. For more information specifically on the management of skin tears refer to “Wound Care for Seniors: What you Need to Know”
Assessing the Wound
Effective wound care begins with a thorough assessment of the wound. Consider the size, depth, and amount of exudation from the wound. This assessment will guide the selection of the most suitable dressing. For example, a highly exuding wound may require an absorbent foam dressing, while a dry, shallow wound might benefit from a hydrocolloid, hydrogel or film dressing.
Remember: Every wound and every elderly patient are different. Take the time to understand what’s needed, because the right choice can make a big difference in their comfort and healing time. The staff at Vital Home Health Service can assist in providing further information regarding your wound care needs.
Furthermore, before selecting a wound dressing, it’s important to check for factors that could affect which dressing to use. Discuss these factors with the GP or Nurse to make sure they are addressed if present.
- How the injury happened
- Risk of contamination
- Possible damage to deeper tissues
- Any nerve or tissue damage underneath
- Blood circulation problems
- Swelling of tissues
- Tetanus vaccination status
- Amount of tissue lost
- Signs of infection
Assessing the Dressing to Be Used
Knowing when to use specific types of wound dressings depends on several factors, including the type of wound, its healing stage, the goal of care and the location of the wound. While minor superficial wounds can often be with basic dressings like non-adherent dressings and bandages, deeper or more chronic and complex wounds may require more advanced options. Take the time to discuss wound care needs with those involved in your loved one’s care, such as the GP, the community nurse, pharmacist or podiatrist.
Tailoring the dressing to the specific needs of the wound ensures optimal care and supports the healing process of the wound of your elderly patient.
Types of Dressings Suitable for Elderly Wound Care
How do you know which one is the best dressing for skin tear in the elderly? Below is a table with some examples of dressing types to help you choose the right dressing for wound care in elderly patients.
| Dressing Type | Description | Advantages | Disadvantages | Preferred for | Applications | Frequency of Changing |
| Low-absorbent dressings | Woven cotton or synthetic fibres, used alone or with other dressings to absorb wound fluid |
|
| Minor, clean wounds needing protection or minimal absorption |
| Several times daily if used for packing |
| Low-adherent wound contact layer dressings |
|
| Low to moderate exuding wounds |
| Needs more frequent changes to ensure wound bed does not dry out | |
| Foam Dressings | Highly absorbent dressings that provide cushioning and protection |
|
| Moderate to highly exuding wounds needing cushioning |
| Depending on exudate levels. May initially be daily then decreasing in frequency |
| Hydrocolloid Dressings | Self-adhesive dressings that form a gel-like substance when in contact with wound exudate |
|
| Dry to moderately exuding wounds needing moisture |
| Every 2 to 4 days |
| Film Dressings | Thin, transparent sheets that stick to the skin, providing a waterproof and bacteria-proof barrier |
|
| Minor, shallow wounds needing protection |
| Every few days up to seven days |
| Alginate Dressings | Derived from seaweed, contain calcium and sodium ions that form a gel-like substance upon contact with wound |
|
| Moderate to heavily exuding wounds needing absorption |
| Every 1 to 3 days depending on exudate levels |
| Hydrogel Dressings | Composed of water or glycerine, these dressings maintain a moist wound environment |
|
| Dry or dehydrated wounds needing moisture |
| Every 1 to 3 days |
| Gelling fibres | An absorbent wound dressing composed of cellulose fibres and other super-absorbent materials | Absorb exudate, forming a gel to keep the wound bed moist. Comes as a flat sheet or ribbon for use in cavity wounds |
| Wounds where exudate management is required |
| Daily to every seven days |
| Silver Dressings | Dressings containing silver, known for antimicrobial properties |
|
| High-risk or infected wounds needing antimicrobial properties |
| Depends on clinical condition of wound. May initially be daily then frequency decreased as wound improves. Ongoing use should be assessed at least every two weeks. |
| Iodine Dressings | Dressings containing iodine – known for antimicrobial properties. | Broad spectrum antimicrobial properties. Short-term effect | May dry the wound bed out May cause pain or local irritation. Short term use – minimal risk to thyroid function | High-risk or infected wounds needing antimicrobial properties |
| Depends on dressing presentation. Alway read manufacturers information. Reassess ongoing use at least every two weeks |
| Superabsorbent dressings | Multilayer wound dressings containing a highly absorbent core that absorbs and locks exudate inside the dressing | Suitable for moderately to highly exuding wounds | Not suitable for dry wounds | Moderate to highly exuding wounds. | All wound types where exudate management is the goal of care | Exudate levels will dictate frequency. May be daily or up to 7 days wear-time. |
| Soft Silicone dressings | Can either be a wound contact layer or a silicone layer can be attached to foam or superabsorbent dressings | Designed to adhere gently to fragile skin minimising trauma. | May cause a reaction in people with sensitive skin – redness and itching | Fragile wounds where a conformable and flexible dressing is needed to reduce risk of trauma | Skin tears All wound types where minimising trauma is a consideration | Depending on type of dressing used. Extended wear time preferable to protect fragile wound bed |
Best Practices for Applying and Changing Dressings
Whether you’re picking the best dressing for skin ulcers in the elderly or just a shallow skin tear, there are best practices that you need to follow:
1. Pick the Right Dressing
Choosing the right dressing is important so the wound can heal effectively, and the risk of infection is reduced. Think about what type of wound they have, how far along it is in healing, and how much exudate or wound fluid is present. Just b picking the best dressing for elderly skin tear in their situation, you are already putting them on the right track for recovery.
2. Changing a dressing
When changing a dressing, it is important to keep the wound clean and to minimise the risk of introducing bacteria.
- Make sure you have a clean and clear area to work in such as a wipeable surface
- Remove any pets away from the area where you are working
- Keep the dressing products in their original sealed packaging. If they have been opened, store them in a clean Ziplock plastic bag.
- Keep any equipment you need to change the dressing in a clean sealed container (scissors, tape, disposable gloves). Don’t use this equipment for any other purposes.
- Wash your hands with soap and water before and after the dressing change
- Change your disposable gloves if they become soiled
- Change the dressing if it becomes loose, wet or dirty
- Keep the wound dressed until it is completely healed
- Avoid using tapes or adhesives on fragile skin
- Always follow instructions provided by your health care practitioner
3. Regular Monitoring and Changing
Regularly check the wound and dressing to monitor the healing process and to spot any signs of infection or complications early. How often you change the dressing will depend on the type of dressing, the wound’s condition and the recommendations from your healthcare practitioner. Follow the manufacturer’s guidelines and seek advice from your healthcare practitioner if unsure.
Final Words
Selecting the right dressing for wound care in the elderly is essential for effective healing, comfort, and preventing complications. By understanding the unique needs of elderly skin and the various dressing options available, caregivers can make informed decisions that lead to better care outcomes.
For more guidance on caring for elderly skin and managing wounds, including wound care for elderly thin skin, visit our wound care for seniors page.
References:
Alam, W., Hasson, J. and Reed, M. (2021) ‘Clinical approach to chronic wound management in older adults’, Journal of the American Geriatrics Society, 69(8), pp. 2327–2334. doi:10.1111/jgs.17177.
Britto, E.J., Nezwek, T.A. and Robins, M. (2024a) Wound Dressings. Fort Lauderdale-Davie, Florida: StatPearls[Internet]. Available at: https://www.ncbi.nlm.nih.gov/books/NBK470199/#:~:text=Choosing%20the%20proper%20wound%20dressing,professionals%20have%20different%20educational%20backgrounds. (Accessed: 2024).
Britto, E.J., Nezwek, T.A. and Robins, M. (2024b) Wound Dressings. Fort Lauderdale-Davie, Florida: StatPearls[Internet]. Available at: https://www.ncbi.nlm.nih.gov/books/NBK470199/#:~:text=Choosing%20the%20proper%20wound%20dressing,professionals%20have%20different%20educational%20backgrounds. (Accessed: 2024).
Cook, E. (2019) ‘Wound Management in the Elderly’, North Carolina Statewide Program for Infection Control & Epidemiology, 8 February. Available at: https://spice.unc.edu/wp-content/uploads/2019/02/08-Wound-Care-9_18ec-1.pdf (Accessed: 2024).
Khalid, K.A. et al. (2022) ‘Aging and wound healing of the skin: A review of clinical and pathophysiological hallmarks’, Life, 12(12), p. 2142. doi:10.3390/life12122142.
Massaro, L. (2021) Older adults more likely to develop chronic wounds, research shows, AJMC. Available at: https://www.ajmc.com/view/older-adults-more-likely-to-develop-chronic-wounds-research-shows (Accessed: 10 April 2024).
Schneider, M. (ed.) (2023) Wound Assessment and Management, The Royal Children’s Hospital Melbourne. Available at: https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Wound_assessment_and_management/#wound-assessment (Accessed: 10 April 2024).
Sinha, S.N., Free, B. and Ladlow, O. (2022) ‘The art and science of selecting appropriate dressings for acute open wounds in general practice’, Australian Journal of General Practice, 51(11), pp. 827–830. doi:10.31128/ajgp-06-22-6462.
West Coast (2023) 10 different types of wound care dressings and their uses, West Coast Wound & Skin Care. Available at: https://westcoastwound.com/types-of-wound-dressings-and-when-to-use-them/ (Accessed: 10 April 2024).
Yates, S. (2024) Wound Management in the Elderly. Available at: https://spice.unc.edu/wp-content/uploads/2017/05/06_Wound-Management-in-the-Elderly-rev2-17.pdf (Accessed: April 2024).
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