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Module 6: Wound Dressing Selection
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Topic Two: Wound Contact Layers

Wound contact dressings are recommended as a primary dressing when adherence to the wound is a potential problem (Thomas, 1998; Beldon, 2010). Exudate, if present, passes through the dressing to the secondary pad (Benbow, 2005; NICE BNF, 2020). They are indicated for minor injuries, burns, superficial skin loss injuries and skin tears.

These dressings are typically thin, non-adherent sheets made of woven or perforated material that can be placed on an open wound bed to protect tissue. They provide a boundary between the wound and the dressing, thus protecting fragile healing tissue. This helps to prevent new epithelium from sticking to the dressing.

Wound contact layers may also be used as a liner for deep tissue wounds that require packing as it assists with ease of removal of the packing dressing. Contact layers conform to the shape of the wound. (Wound Source, 2017)

Wound contact layer dressings can:

  • Decrease the pain experienced during dressing changes
  • Can be cut to fit or overlap the wound edges
  • Can be cost effective when used in combination with an absorbent secondary dressing

(Vuolo, 2009)

NB: Historically, gauze dressings impregnated with substances such as paraffin (known as tulles) were used as wound contact layers. However, these dressings are no longer advocated because they do not provide the ideal wound healing environment and have no absorbent capacity. On occasions, granulation tissue can grow into the dressing and pain and trauma have been reported at dressing changes (Hollinworth & Collier, 2000).

Wound contact layers can be impregnated with iodine, other antimicrobials and antiseptics (e.g. chlorhexidine). These types of dressing are designed for use on shallow, open, clinically infected wounds (Benbow, 2005). These dressings provide effective treatment for infected, sloughy, chronic wounds such as ulcers while preventing re-infection. They are suitable for moderate to low exuding infected wounds or for prophylaxis in minor traumatic wounds (Dealey, 2005; Edwards et al., 2013).