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Wound dressing selection in aged care: the clinical case for getting it right
When FAD reviews the wound care range for a new facility account, the most common finding is the same foam dressing being used on every wound type. Skin tears, heavily exudating leg ulcers, stalled pressure injuries. It's usually the product that was cheapest per unit at the last procurement cycle. It's almost never the cheapest per healed wound.
Under the strengthened Aged Care Quality Standards, which took effect in November 2025 under the new Aged Care Act, clinical decisions including wound care product selection need to be evidence-based and documented. Choosing the right wound dressing isn't a procurement shortcut. It's a clinical decision that directly affects healing time, infection risk, resident comfort, and overall cost.
Here are four dressing categories that cover the majority of aged care wound presentations, when each one is the right choice, and what happens when the match is wrong. For a broader overview of dressing types beyond aged care, see advanced wound dressings explained. For alginate dressings and cavity wound management, that sibling article covers the detail.
The cost of getting it wrong
Wound dressing selection in aged care should be guided by wound assessment, not procurement convenience. Matching the right dressing type (foam, hydrofiber, silver, or silicone) to the wound's exudate level, infection risk, and surrounding skin condition reduces healing time, lowers infection risk, and decreases overall cost per wound.
When a dressing doesn't match the wound, three things tend to happen. The wound heals more slowly, increasing the total number of dressing changes and the nursing time attached to each one. The risk of infection rises, particularly with chronic wounds that are already slow to respond. And the resident experiences unnecessary pain, especially when an adhesive dressing bonds to a fragile wound bed and causes trauma on removal.
The financial cost follows the clinical cost. A wound that could have been managed with four dressing changes per week under the right protocol might require daily changes under the wrong one. FAD's clinical team sees this regularly with new facility accounts: a wound that's been on daily dressing changes for weeks will often resolve within a fortnight once the product is properly matched to the wound type. Multiply the unnecessary changes across a facility with dozens of residents managing wounds at any given time, and the product and labour costs add up quickly.
Wounds Australia's Australian Standards for Wound Prevention and Management (4th edition, 2023) reinforces that dressing selection should be guided by wound assessment, not by habit or convenience. The right dressing applied to a properly assessed wound is cheaper over the life of the wound than a cheaper dressing applied to every wound regardless.
Wound dressings for aged care: four categories that matter
| Dressing type | Best for | Avoid when | Typical change frequency | Example products |
|---|---|---|---|---|
| Foam | Moderate exudate; pressure injuries; leg ulcers | Dry or low-exudate wounds; fragile skin (use silicone-bordered variant) | Every 2–3 days | Allevyn, Biatain |
| Hydrofiber | Heavy exudate; maceration risk; cavity wounds | Dry wounds; superficial skin tears | Every 3–5 days (or at saturation) | Aquacel |
| Silver | Infected wounds; high infection risk; stalled chronic wounds | Clean, healing wounds (adds cost without benefit) | Per clinical protocol; typically 3–7 days | Aquacel Ag+ |
| Silicone | Fragile skin; skin tears; low-trauma removal needed | Heavily exudating wounds without a secondary absorbent layer | Every 3–5 days (wound contact layer may stay longer) | Mepilex, Urgotul |
Foam dressings
Foam dressings manage moderate to high levels of exudate while maintaining a moist wound environment. They're the workhorse of aged care wound management, suitable for pressure injuries, leg ulcers, and surgical wounds producing moderate fluid. Products like Smith & Nephew's Allevyn and Coloplast's Biatain are commonly used in Australian facilities.
Where foam dressings fall short is on fragile, papery skin. A standard adhesive-bordered foam can cause skin stripping on removal in elderly residents. This is where silicone-bordered foams, which use a gentle adhesive layer, make a significant clinical difference.
Hydrofiber dressings
Hydrofiber dressings are designed for heavily exudating wounds. The fibres gel on contact with wound fluid, locking exudate away from the wound bed and the surrounding skin. ConvaTec's Aquacel range is one of the most widely used hydrofiber products in Australian aged care.
The distinction between foam and hydrofiber matters clinically. A foam dressing on a heavily exudating wound will saturate, requiring frequent changes and increasing the risk of maceration to the periwound skin. A hydrofiber manages that fluid volume more effectively, often reducing change frequency and protecting intact skin around the wound.
Silver dressings
Silver dressings provide sustained antimicrobial activity and are indicated for wounds showing signs of local infection or those at high risk of infection, such as chronic wounds that have stalled. Products like Aquacel Ag+ (ConvaTec) combine hydrofiber technology with ionic silver for infection management in high-exudate wounds.
Silver dressings aren't a default choice. They're appropriate when infection is present or the wound assessment indicates elevated risk. Routine use on clean, healing wounds adds cost without clinical benefit.
Silicone dressings
Silicone wound contact layers and silicone-bordered dressings are specifically designed for low-trauma removal. In aged care, where skin tears are among the most common wound presentations, this is critical. Molnlycke's Mepilex range and Urgo's Urgotul use soft silicone to adhere gently without bonding to the wound bed.
Facilities still using basic gauze and tape on skin tears are causing avoidable harm. The dressing adheres to the wound bed, tears the skin further on removal, and the wound reopens. Switching to a silicone contact layer changes the outcome: less pain for the resident, fewer dressing changes, and lower overall cost because the wound actually heals instead of cycling through repeated trauma.
Why range in stock matters
The most common wound care mistake in aged care procurement is ordering one dressing type in bulk and applying it universally. A single foam dressing can't manage a heavily exudating leg ulcer, a fragile skin tear, and an infected pressure injury with equal effectiveness. Clinical staff need access to the right dressing for each wound type, and that means stocking a considered range rather than a single product line.
The most common call FAD receives from clinicians about dressings is a request for a clinical equivalent to a branded product in a different size, or a substitute when their usual product is on back-order. Most clinicians know one or two brands well but don't have visibility across the full range of manufacturers. Having a supplier that stocks across ConvaTec, Smith & Nephew, Molnlycke, Coloplast, and Urgo means the right product is available, not just the product that happens to be in the catalogue.
FAD's wound dressings range covers foam, hydrofiber, silver, and silicone dressings from multiple manufacturers, giving facilities genuine choice based on clinical need rather than supplier limitation.
If your facility's wound care procurement hasn't been reviewed against current clinical guidelines, it's worth a conversation. Contact FAD's clinical team on 03 5443 2239 or email info@firstaiddistributions.com.au to discuss wound care procurement for your facility.
