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Advanced Dressing

Management of healing of different types of wounds including, acute and chronic, infected and non-infected by means of advanced dressings accounts for as one of the newest and most effective ways in modern medicine. We recommend people who are inclined to reach wound healing in the earliest possible time and also have a protection for their skin around the wound; join us to learn about the design, structure, and also compounds of various kinds of advanced dressings, which can provide many healing benefits, so that you can make the best choice according to your wound type.

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Types of Advanced Dressing

The most common advantages of advanced dressings

In comparison with other types of dressings, advanced dressings possess some benefits, including:

In addition to being cost-effective, calcium alginate dressings are capable of managing the absorption of wound exudate while keeping the wound moist.

With the help of SAP granule polymers in the central layer of the dressing and directing the exudate toward the center, super absorbent dressings offer a high absorption capacity compared to other super absorbent coverings. Another merit of super absorbent dressings is their affordable price, which makes suitable for paients.

Hydrogel dressings are used to create a moist environment for dry wounds and also wounds with dead tissue (necrotic tissue). They are available in both gel tube and sheet forms. The other benefits of hydrogel dressings are their high capability in wound debridement and also their cost-effective price.

Hydrocolloid dressings can be used as primary and secondary dressings. They are beneficial for poorly permeable or dry wounds.

Foam dressings are flexible enough to be shaped based on the degree of indentation and curvature of the wound.

What is a normal dressing?

Normal and simple wounds are considered as ruptures and tears in the skin tissue, which include injuries with a shallow depth in the subcutaneous area. The point here is that the injuries should not affect the underlying structures such as muscles, arteries, veins, bones, nerves and the joints. Also, the lost tissue should not be too big.


 normal dressing

Human beings has always been sought for an efficacious and optimal avenue for wound healing, which can also have the least side effects during and after the healing process. In addition, this method can restore the integrity of the damaged tissue as quickly as possible.

To heal the simple and superficial wounds, a disinfection process is generally used, which is done in two facile ways, including the simple primary method and the stop bleeding. If the superficial wound and the effects of rupture relate to the upper layers of a non-infected skin, normal dressings can be used in the first steps of the healing process.

In ancient times, people employed natural methods for wound healing, which sometimes were ineffective and sometimes were toxic and deadly. For example, in ancient Egypt, in some regions, people used animal fat tissues, honey, and plant fibers whereas in other regions, they used leaves and flowers, cloth fibers, etc.

How normal dressings affect the wounds?

Normal dressings commonly are neutral coverings, which are used for non-infected wounds, non-pressure ulcers, and also simple, non-cancerous, and non-burn wounds. This type of dressing can specifically provide a cover with the possibility of gaseous exchange and also prevent the penetration of contaminants.

It should be noted that when there is not a significant distance among the edges of an injury or a rupture wound and also there is no need for sutures, simple dressings can be effective.

Normal dressings are simple coverings, which are put on the wound; therefore, water, contaminants, and fats are not able to enter temporarily into the wound during the healing process. Also, they should be changed quickly.

In fact, the usage of normal dressings aims to facilitate the wound healing process, prevent invasive infections, inhibit bleeding, heal the wound, insulate against temperature loss, maintain moisture, and protect the wound from any mechanical damage. Finally, normal dressings are adhesives or coverings, which are simply placed on the wound as a cover.

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Advanced dressing

In many cases, the damage to the skin and the wound is critical and dangerous. Or, the wound is caused by various types of burns, or patients with diabetes suffer from complicated wounds. In these situations, we require more special dressings for healing the wounds.

Important conditions for wound healing using advanced dressings

An ideal advanced dressing should meet some important requirements for wound healing, which are as follow: 

  • Should be cost-effective
  • Act as a thermal insulator for the wound
  • Provide the best conditions for wound healing
  • Protect the wound from mechanical and abrasion damages
  • Do not cause sensitivity and inflammatory reactions for the immune system
  • Do not get damaged as a result of the interaction with the wound, and keep its properties
  • Does not need frequent exchange and can maintain its effectiveness during the healing process
  • Do not leave any particles or other materials in the wound during or after the healing process
  • Usage of advanced dressing should be safe and should be biocompatible during the healing process
  • It should have enough capacity to absorb exudate and wound fluids in different steps of wound healing.
  • It does not adhere to the wound and also the tissue is being healed. Moreover, it can be easily removed from the wound during the exchange.
  • Despite the old belief in keeping the wound dry, it should maintain the necessary and adequate moisture for wound healing.
  • In urgent situations, it allows gas exchanges, such as oxygen, carbon dioxide and water vapor for wound healing.

In general, advanced dressings are employed to provide special conditions for healing the chronic and acute wounds.

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Types of advanced dressings

Advanced dressings have different types, which are:

Foam dressing

Foam dressings are commonly used to absorb and remove wound exudates. The first and the most important role of foam dressings in wound healing is to manage moisture and wound exudates by absorbing them, while maintaining a moist environment to help the healing process. The foam covering aids the wound and its surrounding environment to prevent further damages.

Foam dressings also act as thermal insulator for the wounds. The usage of the foam dressings is easy and they can be removed if necessary. Foam dressings are typically made up of medical polyurethanes, which are semi-permeable and porous. Moreover, they possess an open structure, which can enable them to absorb and retain wound exudates.

In fact, this type of dressings consists of various compounds, including polyurethane, acrylic materials, and materials with high absorption capacity. They are available as sheets with different thicknesses, one side of which is a layer of a transparent adhesive film increasing the amount of absorption of blood exudates several times the weight. If you encounter wounds with high exudates in the granulation stage, the best type of dressing is foam dressing. This type of dressing has several advantages, one of which is that it is non-adhesive. Also, there is difference in its absorption and thickness. The outer layer of foam dressings is usually waterproof in order to hinder the penetration of bacterial contents and other contaminants.

Depending on the level of exudate, foam dressings can be left in place from one to seven days. Foam dressings benefit from a good flexibility to be used in special and complex situations. In addition, they are advantageous for permeable and semi-permeable wounds. Foam dressings are a good thermal insulator, which can help keep the temperature of the wound.

Hydrocolloid dressing

Hydrocolloid dressings are another advanced wound dressing composed of materials such as gelatin, pectin, and carboxymethyl cellulose. This type of dressing simultaneously provides a moist environment for the wound and prevents the penetration of bacteria and microorganisms into it. The usage of hydrocolloid dressing aids accelerate the healing process, relieve the pain during the healing process, and reduce the time of changing the dressing.

Hydrocolloid dressings are beneficial for healing the small wounds and also burns with small thicknesses. In addition, they can maintain moisture through formation of a gelatin layer in contact with the wound, which is impermeable to the transfer of vapors. Also, they are impermeable to oxygen, which results in an increase in the creation of epithelial covering (covering tissue) and also the synthesis of collagen. This can led to formation of new tissue, control of the pH level of the environment, and subsequently inhibition of the infection. It should be noted that hydrocolloid dressings have no effect when there is lots of exudate in the wound.

Hydrogel dressing

Hydrogels are materials based on water or glycerin, which are mostly non-crystalline (amorphous). They are available as sterile gas or sheet. Also, they couldn’t absorb large amounts of natural wound exudates. Hydrogel dressings are made up of gel and hydrophilic polymer materials, which can absorb 90% of water in the structure.

Hydrogel dressings can be adopted for various applications, including helping to maintain a moisture environment, creating granulation tissue in healing process, accelerating the creation of an epithelial covering in the wound, helping to enzymatically destroy the necrotic tissues, alleviating the pain, and being applicable during the presence of contaminants in the wound.

It should be noted that destroying the necrotic tissue in the wound by hydrogel dressings does not cause any damage to the granulation tissues being formed. In addition, they easily destroy and remove the necrotic crust on the wound. Hydrogel dressings can cool the wound; hence, they cannot act as a thermal insulator for the wound. Specifically, they are applicable for wounds with partial thicknesses. Hydrogel dressings can be used for 3 days.

Calcium alginate and silver calcium alginate dressing

Calcium alginate and silver calcium alginate dressings are available in both ropes and sheets, and are obtained from algae. In the past, they were used by sailors as wound dressings.

These types of dressings are classified in two groups: calcium alginate and sodium alginate. Calcium alginates are the insoluble salt of alginic acid and sodium alginates are the soluble salt of alginic acid.

When calcium alginate dressings are in contact with the exudates in the wound, the calcium ions in the dressing are exchanged with the sodium ions in the wound environment, which are similar a gel. In this case, they absorb excess exudates and provide a moist environment for wound healing. Referring to a report, calcium alginate dressings can absorb water up to 20fold their weight. These types of dressings are suitable for wet infected and non-infected cavity and tunneling wounds.

Due to the nature of gelation in wounds having controlled bleeding, calcium alginate dressings can also be used for stop bleeding. Also, keeping the dressing moist can help further granulation during the wound healing process.

Calcium alginate dressings are structurally biodegradable. Moreover, they have components which could not give rise to inflammation at the wound site and could not cause chain reactions in the immune system.

These types of dressings are typically non-woven with non-adhesive pads. They are also soft and flexible. Like foam dressings, calcium alginate dressings can be changed based on anatomical position. They are suitable for cavity wounds in the form of silk ropes or as a sheet.

Calcium alginate dressings can be employed for the low to high level exudates. This wound dressing is applicable for all types of pressure ulcers, infected wounds, and venous wounds. They typically require a secondary coating and can be left on the wound for several days.

Calcium alginates are coverings, which are made up of monouronic and alginic acid. Owing to the presence of calcium and sodium ions, they can ionize and form a gel. The physical and mechanical properties of these types of dressings rely on the amount of monouronic and alginic acid and also the percentage of calcium and sodium ions.

Sometimes, because of the nature of infected wounds or possibility of the infection and growth of biofilms in the wound environment, calcium alginate or sodium alginate dressings are used. As it is mentioned, alginate dressings contain silver, and depending on the concentration of silver ions in their structure, the antibacterial property of these dressings can be intensified.

Once they come into contact with wound exudates, silver ions are released from the calcium alginate dressing structure and penetrate the membrane of the bacteria, which leads to their destruction. The antibacterial property of calcium alginate dressings lasts up to 5 days after being used in the wound place. One of the main advantages of this dressing is that they do not require to be changed frequently, which consequently reduces the costs of the nursing and also the patients. Worth mentioning that the continuous release of silver ions in calcium alginate dressings is an evidence for their long-term antibacterial properties.

Superabsorbent dressings

The exudates in acute wounds can help healing wound process, while they are detrimental to chronic wounds. Although exudates in chronic wounds can destroy proteases and inflammatory cytokines because of their high amounts of enzymes, they have no effect on the healing process and can delay this process.

The exudates in chronic wounds such as pressure ulcers or venous ulcers can simultaneously limit the level of growth factors necessary for wound healing and cell expansion. Also, they can enclose the formation of granulation tissue by inducing the activity of metalloproteinases. The exudates in chronic wounds is very viscous and thick because it has a high level of immune cells, proteins, and bacteria.

Superabsorbent dressings appear in multi-layer structures, which have a very high absorption capacity compared to common foams. Due to their high absorbency and also being hydrophilic, superabsorbent dressings can usually be last on the wound for a longer time.

This type of dressings possesses the ability to absorb large amounts of natural wound exudates, which is done through their central core. In fact, the structure of this type of dressing consists of multi-layer absorbent powders, which can turn into gel and swell, and at the same time, they are surrounded by a water-proof and moisture-proof layer.

This property of the superabsorbent dressings enables them to manage a significant part of the wound exudates without adhering to the tissue being healed, and at the same time, it prevents the wound from flaking and layering. Thus, the superabsorbent dressings benefit from the property of continuous and rapid absorption of natural wound exudates whereas prevent the growth of bacteria and wetting.

In summary, it should be noted that superabsorbent dressings does not need to be changed very much. In addition, they are more cost-effective for the hospital applications.

FAQ about advanced dressings

Type of dressing is chosen according to the diagnosis of specialist doctors and wound therapists, and commonly, hydrocolloid dressings are beneficial for wounds with low level of exudates and do not need much gas exchange.

Patients should follow the advice and also the healing process under the supervision of specialist doctors and specialist therapists because the type of dressing is chosen based on the condition of the wound and the type of disease.

When it is required to remove the necrotic (dead) tissues of the wound to follow up the process of healing and the formation of granulation and epithelial tissue. The best time to use hydrogel dressings is to create a moist environment for the wound and remove the necrotic tissues.

It is not right to predict a precise and specific time for the duration of each stage of wound healing. Generally, the treatment of wounds depends on their type, severity, the involvement of different layers of the skin, the diseases of the person, and the collaboration and patience of the patient and therapists.

When the wounds have a significant level of exudates and simultaneously, the level of moisture in the wound should be maintained in order to heal and debride the wound, the calcium alginates are used. On the other hand, if it is required to reduce the infection content and control the infection in the wound, calcium alginates containing silver ions are employed to provide antibacterial properties in the wounds.

Because of their good management in absorption of excess exudates, foam dressings can be used when the wound is in an inflammatory situation and has a significant level of exudates.

No, advanced wound dressings can be employed in many steps of wound healing, but some wounds and some steps cannot be treated with advanced dressings and require other treatment methods or can be healed without the usage of advanced dressings.

No, in high levels and when the wound has very high exudates, other methods like vacuum therapy are used.

No, regardless of the usage of different dressings in all steps of wound healing, this process requires care and preparations by therapists and patients in order to conduct all steps as accurately as possible.

These two types of dressings are used for the management of exudates in permeable wounds with a large amount of exudates, but the absorption capacity of superabsorbent dressings and their mechanism in keeping the exudates are respectively more and different, so that they direct the exudates to the center of their structures and remove particles from it. Foam dressing and superabsorbent dressing are made from a special polymer, turns into the gel in contact with the fluid and swells.

Yes, due to bone and cartilage sensitivity, superabsorbent and calcium alginate dressings should not be used when wounds and injuries have reached bones and tendons.

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