Literature review on the management of diabetic foot ulcer

Table 3 Classification of advanced wound dressings used for diabetic foot ulcers healing

Type	Example	Explanation	Advantages	Disadvantages
Hydrocolloids	Duoderm (Convatec) Granuflex (Convatec) Comfeel (Coloplast)	These kind of dressings usually composed of a hydrocolloid matrix bonded onto a vapor permeable film or foam backing. When in contact with the wound surface this matrix forms a gel to provide a moist environment[102]	Absorbent Can be left for several days Aid autolysis[96]	Concerns about use for infected wounds May cause maceration Unpleasant odor[96]
Hydrogels	Aquaform (Maersk Medical) Intrasite Gel (Smith and Nephew) Aquaflo (Covidien)	These dressings consist of cross-linked insoluable polymers (i.e., starch or carboxymethylcellulose) and up to 96% water. These dressings are designed to absorb wound exudate or rehydrate a wound depending on the wound moisture levels. They are supplied in either flat sheets, an amorphous hydrogel or as beads[96]	Absorbent Donate liquid Aid autolysis[96]	Concerns about use for infected wounds May cause maceration using for highly exudative wounds[96]
Foams	Allevyn (Smith and Nephew) Cavicare (Smith and Nephew) Biatain (Coloplast) Tegaderm (3M)	These dressings normally contain hydrophilic polyurethane foam and are designed to absorb wound exudate and maintain a moist wound surface[103]	Highly absorbent and protective Manipulate easily[96] Can be left up to seven days Thermal insulation[96]	Occasional dermatitis with adhesive[96] Bulky[6] May macerate surrounding skin[6]
Films	Tegaderm (3M) Opsite (Smith and Nephew)	Film dressings often form part of the construction of other dressings such as hydrocolloids, foams, hydrogel sheets and composite dressings, which are made up of several materials with the film being used as the outer layer[107,108]	Cheap Manipulate easily Permeable to water vapor and oxygen but not to water microorganisms[95]	May need wetting before removal[96] Aren’t suitable for infected wounds[107,108] Nonabsorbent If fluid collects under film it must be drained or the film replaced[6]
Alginates	Calcium Alginate Dressing (Smith and Nephew Inc., Australia) Kaltostat (ConvaTec) Sorbalgon (Hartman United States, Inc.l) Medihoney (Derma Sciences Inc., Canada)	The alginate forms a gel when in contact with the wound surface which can be lifted off with dressing removal or rinsed away with sterile saline. Bonding to a secondary viscose pad increases absorbency[104]	Highly absorbent Bacteriostatic Hemostatic Useful in cavities[96]	May need wetting before removal[96]
Silver-impregnated	Acticoat (Smith and Nephew) Urgosorb Silver (Urgo)	These dressing used to treat infected wounds as silver ions are thought to have antimicrobial properties[109]	Antiseptic Absorbent[96] Reduce odor Improved pain-related symptoms Decrease wound exudates Have a prolonged dressing wear time[112]	High cost[96]