Know Your Dressings: Collagen Dressings For Wound Healing

Wound healing occurs as the body naturally restores damaged tissue. Wound healing is a complex series of events and interactions that result in an orderly process with 3 overlapping, yet distinct stages.

What interferes with wound healing?
Unfortunately, there are times when the wound fails to progress through the orderly wound healing process. This is commonly the result of an extended inflammatory phase, often caused by increased matrix metalloproteases (MMP’s) in the wound. 2 MMP’s are necessary to break down damaged tissue, however too many can destroy the healthy extracellular matrix and impede wound healing. Bioburden, or the presence of biofilm in the wound, can also delay the wound healing process. 5 When delayed wound healing occurs, collagen dressings can restart the wound healing cascade.

What is collagen?
Collagen, the most abundant protein in the body, is a major component of the extracellular matrix or biological glue which supports cells. 2 Collagen plays an important role in all phases of wound healing due to its chemotactic nature, which attracts fibroblasts to the wound site. 3 Collagen supports new blood vessel formation, granulation tissue formation, the debridement of the wound and the ability of the wound to re-epithelize. 1

How do collagen dressings support wound healing?
Collagen dressings support a moist wound healing environment, encourage the deposition of new collagen fibers, support new tissue growth and granulation tissue formation in the wound bed. 4

Excessive MMP’s in the wound bed can interfere with the normal wound healing process. Collagen dressings bind and inactivate MMP’s found in the extracellular matrix. MMP’s attack and break down collagen, so collagen dressings give these enzymes an alternative collagen source. 4 This allows the body’s natural collagen to be readily available for tissue growth during the wound healing process.

Collagen dressings are available in many forms. They can be found as an amorphous gel to provide moisture or in sheet or powder forms that are capable of absorbing various levels of wound exudate. Collagen dressings may also be combined with silver to deter bioburden or biofilm in the wound environment. Some collagen dressings are combined with additional ingredients such as ethylenediaminetetraacetic acid (EDTA), carboxymethyl cellulose (CMC) or alginate to enhance the performance of the collagen, giving a dual action to decrease MMP activity or control exudate.

Using a collagen dressing appropriately may stimulate healing in a stalled wound. Wound healing success is dependent on clinical assessment and treatment, choosing the right dressing on the right wound at the right time. 6 Acceleration of wound healing in chronic or stalled wounds may decrease healing time and reduce over-all wound care costs. 6

DermaRite Collagen Dressings
DermaRite has a comprehensive line of collagen dressings designed to meet various levels of wound drainage, as well as collagen dressings with silver to control bioburden in the wound environment. Select the dressing that is right for the wound you are treating:

NEW! DermaCol 100™ DermaRite’s newest collagen dressing, DermaCol 100, is a highly absorptive type 1 bovine powder, that is easily applied for intimate contact with the wound surface. DermaCol 100 supports moist wound healing and granulation tissue formation, binds and decreases MMP levels at the wound site. DermaCol 100 features extended wear time and may be left in place up to 7 days*.

SilvaKollagen Gel® is a hydrolyzed type 1 bovine collagen gel infused with silver oxide. The water-based gel supports moist wound healing and autolytic debridement. SilvaKollagen Gel is conformable, maintains intimate contact with the wound bed and manages bioburden. SilvaKollagen Gel is used for wounds with dry to moderate wound drainage.

DermaCol™ is made from porcine collagen with sodium alginate, CMC and EDTA for dual MMP inhibition. The dressing transforms to a soft gel and conforms to the wound bed when in contact with wound exudate. DermaCol supports moist wound healing and may be trimmed and layered for management of deep wounds. DermaCol may be applied to wounds of any drainage level. Moisten the dressing prior to application for dry or minimally draining wounds.

DermaCol Ag™ is infused with silver to decrease bioburden in the wound environment. DermaCol Ag is a gelling dressing that is easy to apply and conforms to the wound bed when in contact with wound exudate. DermaCol AG may also be trimmed and layered to manage deep wounds and can be applied to wounds of any drainage level. Moisten the dressing prior to application for dry or minimally draining wounds.


* Dressing wear time is always based on the condition of the wound and caregiver assessment. Consult MD or qualified health care professional for specific medical guidance on dressing change frequency for individual treatment plans.


  1. Simon, P. E., Meyers, A. D., Moutran, H. A., & Romo, T., III. (2017, June 20). Skin Wound Healing. Retrieved March 26, 2018, from
  2. Hochstein, A. O., DPM, & Bhatia, A., DPM. (2014, August). Collagen: Its role in wound healing. Podiatry Management.
  3. Westgate, S., Cutting, K. F., Deluca, G., & Assad, K. (n.d.). Collagen dressings Made Easy (page 1 of 3) › Made Easy › Wounds UK. Retrieved March 26, 2018, from
  4. What you need to know about collagen wound dressings. (2017, April 07). Retrieved March 26, 2018, from
  5. A review of collagen and collagen-based wound dressings. (2009, February 13) Retrieved March 26, 2018, from
  6. Galea, E., Managing chronic/stalled arterial, venous and pressure ulcers with collagen and oxidized regenerated cellulose dressings. (2001, March) World Wide Wounds. Retrieved March 26, 2018 from

Deeper Dive

Want to learn more about this topic? In addition to the reference links above, here are some great articles and resources that you can explore.

  1. Yandell P, Korzendorfer H, Hettrick H, Vaughn M, Gokoo C. The use of collagen dressings in long-term care: a retrospective case series. Wounds. 2011;23(8):243–25. Available at:
  2. Adkins, C. L. (2013, May). Wound Care Dressings and Choices for Care of Wounds in the Home. Home Healthcare Now, 31(5). doi:
  3. Harding, K., & Leaper, D. (2011). Role of collagen in wound management. Wounds, 7(2), 54-63.
  4. Fleck, C. A., & Simman, R. (2010, September). Modern Collagen Wound Dressings: Function and Purpose. Journal of the American College of Wound Specialists, 2(2), 50-54.
Posted in Clinical Insights Newsletter

Know Your Dressings: Calcium Alginates, CMC, and Gelling Fibers

Successful wound care involves selecting the appropriate dressing to optimize the wound healing environment. Dressing selection plays an important role in supporting autolytic debridement and promoting wound healing. 1 Wounds with heavy drainage require dressings that are absorptive, yet still maintain a moist wound environment to promote healing, such as calcium alginate or carboxymethylcellulose (CMC) gelling fiber dressings.

What is a calcium alginate dressing?
Calcium alginate dressings are made from sodium alginate extracted from brown seaweed and processed with calcium salts into nonwoven biodegradable dressings. 2 Alginate dressings can be found in sheet or rope form. The dressings uniquely gel as they come in contact with wound exudate to provide a moist wound environment that facilitates autolytic debridement. The dressings can fill wound dead space and absorb up to 20 times their weight in exudate depending on the manufacturer’s process. 3
What is a CMC gelling fiber dressing?
Carboxymethylcellulose (CMC) dressings are highly absorptive textile fiber dressings derived from natural cellulose sources and are commonly known as CMC gelling fiber dressings. 9 CMC dressings form a transparent moist gel as they bind wound exudate into the dressing. 9 The exudate cannot reenter the wound bed and inflammatory cells, especially neutrophils, are sequestered which helps to hasten wound healing. 4 CMC dressings are available in rope and sheet form and the fiber strength of these dressings makes them suitable for loosely packing sinus cavities. 4 CMC dressings do provide a moist wound environment, supporting autolytic debridement as the dressing gels and traps exudate.
Calcium alginate and CMC gelling fiber dressings:

  • Are designed for use in moderately to heavily draining wounds
  • Are non-adherent, conformable and can be cut and manipulated in the wound bed
  • May contain silver which can provide antimicrobial protection in the dressing
  • Should not be used for dry wounds since they can adhere to the dry wound bed
  • Expand in the wound due to the natural swelling of the dressing as it comes in contact with exudate, avoid overfilling the wound space
  • Can be left in place for several days depending on the condition of the wound
  • Require a secondary dressing
  • Are appropriate for use on partial and full thickness wounds, surgical incisions, pressure ulcers, infected wounds, donor sites, and in sinus tracts and tunnels. 8

What is a superabsorbent dressing?
Superabsorbent dressings also have the ability to manage exudate for moderately to heavily draining wounds. These dressings have multiple layers which include a nonadherent contact layer, a middle layer which contains fibers or gelling material to absorb exudate, as well as a water repelling outer layer. 7 Superabsorbent dressings may have an adhesive border. If an adhesive border is not present, these dressings will require a secondary bandage or adhesive to secure the product to the wound site. A superabsorbent dressing can be used on a variety of wounds including pressure ulcers, venous ulcers, diabetic foot ulcers, trauma wounds or arterial ulcers. 7
Select the correct dressing
Dressings should be selected based on the characteristics of the wound.
Calcium alginate and CMC dressings are primary dressings* designed for use on wounds with moderate to heavy drainage.
A superabsorbent dressing can be a primary or secondary dressing** which manages moderate to heavy wound exudate.
The longer wear time of these dressings minimizes the number of times the wound bed is disturbed which may improve healing outcomes. 6 Cost effectiveness should always be considered when selecting a dressing, however the least expensive dressing may not be the most cost effective. Longer wear time reduces clinician labor costs, a significant factor in overall wound care costs. 5 Dressing selection should be based on the needs of the wound to obtain the best outcomes for healing.
* Primary Dressing: The dressing that is in contact with the wound and may remain on the surface of the wound over an extended period of time and in some cases until the wound is completely healed.
** Secondary Dressing: A cover dressing contains an absorbent material which will absorb wound exudate and which can be changed without disturbing the position of the primary dressing on the surface of the wound.
AquaRite™ Extra CMC is a highly absorbent CMC fiber wound dressing that converts into a clear, soothing gel sheet when exposed to exudate or other liquids.

  • Highly absorbent
  • Traps debris & bacteria in the dressing
  • Maintains dressing integrity for one piece removal

Click here to learn more!
Plus, be sure to explore these other fiber / superabsorbent dressings from DermaRite:
HydraLock SA

  1. Murphy, Patrick S., and Gregory R.D. Evans. “Advances in Wound Healing: A Review of Current Wound Healing Products.” Plastic Surgery International, vol. 2012, Sept. 2012, pp.1-8, doi:10.1155/2012/190436.
  2. Qin, Yimin. “Gel swelling properties of alginate fibers.” Journal of Applied Polymer Science, vol. 91, no. 3, 2003, pp. 1641–1645., doi:10.1002/app.13317.
  3. Morgan, Nancy. “Calcium alginate.” Wound Care Advisor, vol.1, no.2, July/Aug.2012 pp. 26-27.
  4. Merry, A., “Absorbent Hydrofiber and Calcium Alginate Foam Dressings” Accessed 23 Sept. 2017.
  5. Making The Case For Cost-Effective Wound Management.
  6. “Challenging Wounds.” Accessed 27 Sept. 2017
  7. Wound Care Today-Product Pyramid-Superabsorbent Dressings. Accessed 26 Sept. 2017
  8. “Evidence Summary: Wound Management: Dressings –Alginate”, Wound Practice and Research, vol. 21, no. 2, pp 90-92., Accessed 23 Sept. 2017.
  9. Bahai, H S, et al. Carboxymethylcellulose wound dressings. 15 Mar. 2005. Accessed 23 Sept. 2017.

Deeper Dive

Want to learn more about this topic? In addition to the reference links above, here are some great articles and resources that you can explore.

  1. Qin12*, Yimin, et al. “Marine Bioactive Fibers: Alginate and Chitosan Fibers-A Critical Review.” Journal of Textile Engineering & Fashion Technology, MedCrave Online, 15 May 2017,
  2. “Alginates.” Alginate Dressings | Calcium Alginate Dressings for Wounds,
  3. “Practical Treatment of Wound Pain and Trauma: A Patient-Centered Approach. An Overview.” Practical Treatment of Wound Pain and Trauma: A Patient-Centered Approach. An Overview | Ostomy Wound Management,
Posted in Clinical Insights Newsletter

Choosing The Right Dressing

A wide variety of advanced wound care products are available to treat wounds, from simple dressing materials to sophisticated products. Selecting a wound dressing requires the clinician be knowledgeable in both the process of tissue repair during wound healing and the intended use of the dressing product selected to treat the wound.1

Dressings are used to:

  • facilitate healing
  • reduce pain
  • contain wound drainage
  • provide adequate moisture for wound healing
  • maintain normothermia in the wound bed
  • minimize bioburden
  • provide a cosmetic covering for the wound

The correct dressing will improve outcomes for wound healing. Dressing selections should be based on a complete clinical assessment addressing wound characteristics, clinical efficacy, and cost of the dressing.1

Wound Characteristics
Dressing selections should be based on the type of tissue present in the wound, wound drainage, bacterial burden, condition of the periwound skin and the wound location.2

Tissue Types: More than one tissue type can be present in a wound. Select a dressing that addresses the most prevalent tissue type in the wound bed. Necrotic tissue requires dressings that support debridement while managing wound drainage. Healthy granulating wound tissue requires dressings that support adequate moisture levels.1

Wound Drainage: Select a dressing that supports moist wound healing and manages exudate effectively. Dressings such as Hydrogels, Transparent Films and Hydrocolloids are designed to donate or retain moisture in the wound.4 Hydrogel and Transparent Film dressings work best for wounds with minimal to low wound exudate. Hydrocolloids address low to moderate exudate. Absorbent dressings such as Alginates, Foams, Gelling Fibers and Super Absorbent dressings are designed to be used for moderate to heavily draining wounds.2 Collagen dressings come in several forms and can be used for all drainage levels.

Maintain Wound Temperature: Cooling of the wound surface can impact wound healing. The cells and enzymes necessary to the wound healing process are negatively impacted by moisture loss from evaporation or inadequate moisture in the wound bed. This is due to the cooling effect moisture loss can have on the wound. Dressing removal can result in wound bed temperature variations that take over 4 hours to return to normal.7 Select wound products that minimize dressing changes and maintain wound temperature. Preparation for the dressing change can decrease the time the wound bed is exposed to room air reducing the effect of cooling on wound healing.

Bacterial Burden: Wounds exposed to bacteria can become colonized within hours of exposure to contaminents. Microbial burden in the wound can lead to delayed wound healing, infection and biofilm formation.3 Advanced wound dressings help prevent wound bed contamination. Dressings with antimicrobial additives, such as silver, help to minimize bacterial load in the dressing. Several types of antimicrobial agents are found in dressings. Silver is the most common antimicrobial additive to wound dressings and can be found in most dressing categories.6

Periwound Skin: Maintaining the health of peri-wound skin is an important part of wound dressing selection. Choose dressings that effectively manage moisture and promote skin integrity. Using a liquid skin protectant during dressing changes adds an additional layer of protection for periwound skin and can safeguard the skin from the effects of moisture and adhesive removal.

Location: Where the wound is located on the body will influence the dressing selection. Characteristics of the body such as body contour, moisture, or delicate tissue will impact the dressing choice. Some wound locations can be impacted by activity, so the adherent capabilities of the dressing should be considered.

The Agency for Healthcare Research and Quality estimates our national cost for pressure ulcer care to exceed $1.4 billion annually.5 Caregivers need to select dressings that achieve wound healing results and are cost effective. The number of dressing changes required as well as the cost of the dressing material further impact wound care costs.


  1. Bennett-Madison, M., (2010). How to select a wound dressing. Clinical Pharmacist, Vol. 2. Retrieved from
  2. Green, B. (2013). Wound care: Making an informed decision: how to choose the correct wound dressing. Professional Nurse Today, 17(1), 6-13.
  3. Thomas, Stephen. “A Structured Approach to the Selection of Dressings.” A Structured Approach to the Selection of Dressings. World Wide Wounds, 14 Nov. 1997. Web. 12 May 2017. Retrieved from
  4. Retrieved on June 16, 2017.
  5. Soon, S., & Chen, S. (2004). What are wound outcomes. Wounds, 16(5). Retrieved from
  6. Sood, A., Granick, M., & Tomaselli, N. (2012, April 1). Wound dressings and comparative effectiveness data – Europe PMC Article – Europe PMC. Retrieved from
  7. McGuiness, W., Vella, E., Harrison, D., (2004). Influence of Dressing changes on wound temperature. Journal of Wound Care, 13(9), 383-384.

Deeper Dive

Want to learn more about this topic? In addition to the reference links above, here are some great articles and resources that you can explore.

  1. Retrieved on June 16,2017.
  2. Retrieved on June 16, 2017.
  3. Expert Working Group, (2012). International concensus: Optimising wellbeing in people living with a wound. Retrieved from
  4. Sussman G. Technology update: Understanding film dressings.Wounds International 2010; 1(4). Retrieved
    from: product-reviews/technologyupdate-understanding-filmdressings
Posted in Articles, Clinical Insights Newsletter

DermaRite Industries Appoints Barbara Osborne as Chief Commercial Officer

North Bergen, New Jersey – June 2017 – DermaRite Industries, LLC (“DermaRite”) announced it has named Barbara J. Osborne as Chief Commercial Officer of the company. In her role, Ms. Osborne will be responsible for driving the company’s sales and commercialization efforts.

Ms. Osborne is an experienced healthcare industry executive. Most recently, she served as the U.S. Division President and CEO of LEO Pharma. Previously, Ms. Osborne served as the President of Mölnlycke Health Care’s U.S. Wound Care business.

Ms. Osborne has a broad background encompassing sales, marketing, finance, accounting, business development and R&D. During her tenure in the healthcare industry, she also held senior leadership positions at C.R. Bard, Microtek Medical, and Covidien.

“Ms. Osborne is joining the company at a key stage in our development,” says Naftali Minzer, Chief Executive Officer of DermaRite. “Her extensive experience in the wound care industry and her proven success leading and growing similar size organizations will be a strong addition to our business as we position the company for future growth.”

“I am honored to be joining DermaRite, and I am looking forward to building on the company’s strong foundation,” commented Ms. Osborne. “It is an exciting time to impact the next growth phase of the company.”

Ms. Osborne holds a Master of Science in Accounting from New York University’s Stern School of Business and received her undergraduate degree from Colgate University.

About DermaRite Industries:
DermaRite Industries has been providing high-quality, clinically effective and cost-effective skin and wound care products to nursing homes, home health agencies, hospice and wound clinics for over 20 years. Based in North Bergen, New Jersey, the company’s Healing In D.E.P.T.H. program provides caregivers with the tools and services needed to assure optimal care.

For more information about DermaRite, visit

Please direct all inquiries to Yalitza Hernandez,, 973-569-9000 x113.

Posted in Press Release

Senior Digestive Health

Fruit Salad

Many systems of the body change with age, including the digestive system. It’s estimated that 40% of seniors experience digestive changes. 1 Many factors impact bowel health and result in constipation including age, medical conditions, poor diet, medications, lack of fiber, inadequate exercise and frequent laxative use. Constipation or diarrhea, a common complaint for seniors, is a symptom the body sends indicating that something is not right.3

What is Constipation?  Simply stated, constipation is infrequent stool elimination. After eating, food is passed through the intestines by a rhythmic, wavelike movement called peristalsis. Intestinal contraction and rest allows food and liquid to be mixed together and propels fecal matter through the digestive tract for elimination. 4 Humans are creatures of habit, and bowel habits will vary. Bowel movements from 3 times per day to once every other day can be considered “normal”. Infrequent stools become hard, difficult to pass, and can cause damage to the nerves and muscles in the rectal area.4

Why are seniors more likely to suffer from constipation?  Aging can weaken muscles in the bowel and abdomen. Muscle contractions are necessary to move food and waste products through the digestive tract. When this process slows, more water is absorbed from the food waste resulting in hard, difficult to pass stool. 1 Nerves may function less effectively and bowel tissue can lose the ability to stretch also making stool more difficult to pass. 5 Seniors dealing with mobility issues or conditions requiring bedrest face changes in bowel habits resulting from inactivity. Disease processes such as Parkinson’s, endocrine disorders, diabetes mellitus, or stroke are also associated with constipation.7

Does diet play a role?  Poor diet or lack of adequate hydration and fiber can play a significant role in the development of constipation. Fiber is found in fruits, vegetables and whole grains. Adding fiber to your diet softens and adds weight to food waste, resulting in bulky, easy to pass stool. Consuming “fast” food or heavily processed food can lead to constipation since these foods are usually lacking in fiber, which is vital for bowel health.3 Healthy diets should contain about 25-30 grams of fiber daily. Adequate fluid intake keeps stool soft and easy to pass. Consuming 8 glasses of water per day can decrease the likelihood of constipation. 6 Adequate fiber and fluid intake may be difficult to achieve in the senior population without assistance from caregivers to promote a healthy diet.2

Do medications play a role?  Opioid pain medications, antacids with calcium, antidepressants, iron supplements, anti-parkinsonian drugs, diuretics and antispasmodics are some of the medications that can result in constipation. Many of these medications are necessary for the health of seniors and their use cannot be avoided.6

Won’t laxatives fix the problem? Laxatives may be used to relieve occasional constipation. Overuse of laxatives to treat constipation may result in poor tone in the intestinal muscles. These muscles become “lazy” and unable to function independently. 2 Americans spend nearly $22 million on laxatives each year. Overall cost to treat constipation is estimated to be $1 billion dollars annually.2

What is your normal?  Bowel movements give significant insight to overall health status. The Bristol Stool chart is an easy to use guide to determine how “normal” you are. Types 3, 4 or 5 are considered normal. Sudden changes in bowel habits not associated with factors known to cause constipation can be indicators of serious health concerns.4

DermaRite FiberHeal™ Liquid Fiber assists in maintaining good bowel health. It combines the stool-softening effects of fiber with all-natural sorbitol, which aids in gentle elimination without diarrhea. FiberHeal has the added benefit of FOS (fructooligosaccharides) to promote the growth of beneficial intestinal bacteria. As part of a healthy diet, FiberHeal helps maintain regularity, reducing dependence on harsh laxatives, and helps maintain lower cholesterol levels and supports blood sugar control. FiberHeal provides 15 grams of fiber in a great tasting one ounce dose. The sugar-, lactose- and gluten-free formula is compatible with most diets.


  1. Aging and Digestive Health. Retrieved January 18, 2017, from
  2. Evaluating and Managing Constipation in the Elderly, David A. Ginsberg, MD; Sidney F. Phillips, MD; Joyce Wallace, MSN, CRNP, APRN-BC; Karen L. Josephson, MD Urol Nurs. 2007;27(3):191-200, 212.
  3. Did everything come out okay? Senior bowel issues. Retrieved January 18, 2017, from
  6. Cashin-Garbutt, A. (2013, March 20). Drugs that Cause Constipation. Retrieved January 18, 2017, from
  7. Constipation in the Elderly. Retrieved January 18, 2017, from

Deeper Dive

Want to learn more about this topic? In addition to the reference links above, here are some great articles and resources that you can explore.

  1. Gainer, C. Bowel Habits and Aging. Retrieved January 30, 2017, from
  2. Strategies for Establishing Bowel Control. Retrieved January 30, 2017, from
  3. Constipation And Laxatives – Are You Aware of the Dangers? Retrieved January 30, 2017, from
  4. Bostock,N., Kelly, A., (2011) Help for people who care for someone with bladder or bowel problems. Retrieved January 20, 2017 Department of Health and Aging website:
Posted in Articles, Clinical Insights Newsletter

The Results Are In – Healing Never Tasted This Good!

An independent taste test conducted on November 8, 2016 revealed that over 70% of participants preferred the taste of ProHeal™ Liquid Protein when compared to the leading brand.

The blind taste test comparison occurred on 11/8/16 in a dining room of a post-acute care setting using a sample of convenience that included 20 residents and 5 staff members. The residents were from assisted living, long-term care and rehabilitation. All participants were informed of the taste trial for the 2 cherry flavored products (ProHeal™ and ProStat SF®). No food allergies were reported. The facility’s staff conducted the trial and no manufacturer representative was present during the taste test. The samples were unlabeled and the identities of the products were known only to the testers. The subjects reported their preference based on taste after sampling both products.


Staff reported preference (n=5):  Prostat=1 (20%); ProHeal=4 (80%).

Residents reported preference (n=20):  Prostat=5 (25%); ProHeal=14 (70%); no preference=1 (5%). Statistical analysis using one sample t-test between the percents shows a statistically significant (p=.031) difference in test preference in favor of ProHeal.

Cumulative staff & residents (n=25):  Prostat=6 (24%); ProHeal=18 (72%); no preference=1 (4%). Statistical analysis using one sample t-test between the percents shows a statistically significant (p=.010) difference in test preference in favor of ProHeal.

This product has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

Click here for more information

Posted in Press Release

Palliative Wound Care

Palliative Wound CarePalliative care is defined by the World Health Organization (WHO) as an “approach that improves quality of life in patients and their families facing the problems associated with life-threatening illnesses”. 1 Palliative care focuses on prevention and relief from suffering, providing pain control, spiritual support and symptom control, done with respect for cultural differences and individual needs. Care decisions should be made through a process that involves open dialogue between patient, family and caregivers. 1

What do we know about wounds that occur at end of life?     

The skin is the largest organ of the body and is vulnerable to wound development when the organs begin to fail. End of life wounds include pressure injury, ischemic wounds and Kennedy ulcers. 3 In 2009, Skin Changes at Life’s End (SCALE) was a concept introduced to describe end of life wounds. 4 These ulcers are considered unavoidable especially in immobile patients at the end of life. Management of wounds should focus on patient comfort and minimizing the impact of the wound on quality of life, not necessarily healing wounds. 2 However, palliative care does not imply less care or lack of care, but may change the focus to more emphasis on patient comfort and prevention of new ulceration formation. 2

Where does wound care begin?   

As for any patient, good skin and wound care begins with a comprehensive assessment including a risk assessment, and wound assessment. 2 These individuals will also require a comprehensive pain assessment and discussion of quality of life and personal choices. Care should be coordinated between the patient, family and caregivers with the patient’s comfort taking precedence.

How to manage pain and exudate?

Wound pain is often experienced during dressing changes.   The wound surface is fragile, and adherent dressings or crusted, dry exudate can be traumatic to the wound during dressing removal and result in significant pain for the patient. 3 Gauze dressings have been found to be more painful due to granulation tissue growing through the porous gauze material evoking pain and trauma with

dressing changes. 3 Careful selection of dressings and utilization of dressing material such as silicone, foam, alginate or hydrocolloid dressings will help to manage exudate and control pain.

Are there other concerns?

Odor from wounds can have a significant impact on the quality of life for the patient.  Odors can increase patient stress and embarrassment, resulting in depression and a decreased quality of life. 1 Odors are often a result of increased bacteria in the wound or wound dressing. When odor persists, antibiotic therapy or dressings designed to reduce microbial contamination may be needed. Dressings with silver have been found to be effective in reducing odor producing microbes in the wound environment. 3

How can DermaRite help?

DermaRite’s skin and wound care products help caregivers meet the needs of even the most challenging wound conditions. DermaGinate, our calcium alginate dressing line, is designed for moderate to highly exuding wounds.  DermaGinate conforms easily to the wound bed and acquires a soothing gel-like consistency when in contact with moisture and exudate, yet maintains its integrity for ease in dressing removal. DermaGinate AG contains silver to protect against microbial contamination of the dressing, minimizing odor. Both DermaGinate and DermaGinate AG are available in pad and rope forms.

Learn More About Calcium Alginate Dressings >

  1. Burt T. Palliative care of pressure ulcers in long-term care. Annals of Long-Term Care: Clinical Care and Aging. 2013; 21(3):20-28.
  2. National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel and Pan Pacific Pressure Injury Alliance. Prevention and Treatment of Pressure Ulcers:  Clinical Practice Guideline.  Emily Haesler (Ed.) Cambridge Media: Perth, Australia 2014
  3. Palliative wound care management strategies for palliative patients and their circles of care. Clinical Management, 283, 130-141.
  4. Krasner, D. (2015, 04). SCALE wounds: unavoidable pressure injury. Retrieved 10, 2016, from

Deep Dive

Want to learn more about this topic? In addition to the reference links above, here are some great articles and resources that you can explore.

Posted in Articles, Clinical Insights Newsletter