Previous reactions to ulcer and wound dressings

Many patients report allergies to wound dressings. Skin redness underneath the dressing can occur for many reasons (eg accumulation of moisture under the dressing, infection); allergy should not be assumed. Dressings can cause irritant contact dermatitis or allergic contact dermatitis; see Contact dermatitis. Topical antibiotics can be sensitising agents, especially with prolonged use, resulting in an allergic dermatitis after repeated exposure. Poor skin condition and using creams or ointments under a dressing also increase the risk of an adverse reaction. Medical adhesive–related skin injury can also occur; see Retaining ulcer and wound dressings.

Accurate diagnosis of the cause of skin redness is important. If patients are considered allergic to a dressing, their options will be restricted. See Common causes of a red leg for alternative causes of redness. If patients report an allergy to a dressing, ask about the reaction, the previous wound characteristics and use of other dressings to determine the likelihood of allergy. Specialist review (by an immunologist or dermatologist) may be required.