Management of Macerated Wounds

Dressing Selection for Macerated Wounds

The American College of Cardiology recommends using absorbent dressings that control excess moisture while maintaining a moist wound environment, such as foam dressings or alginates, and avoiding occlusive dressings that can worsen maceration for macerated wounds 1, 2
For wounds with heavy exudate causing maceration, absorbent dressings that draw moisture away from the wound and periwound skin should be used 1, 3
The American Diabetes Association suggests selecting dressings primarily based on exudate control, comfort, and cost for macerated wounds 2

The Diabetes/Metabolism Research and Reviews guideline recommends cleaning the macerated wound regularly with clean water or saline to remove debris from the wound surface, and debriding the macerated wound when possible to remove slough and necrotic tissue that may impede healing 2, 6
Monitoring the wound daily for signs of infection, which can be exacerbated by maceration, is advised by Clinical Nutrition 5

The American College of Cardiology suggests considering negative pressure wound therapy (NPWT) for heavily exuding wounds that have led to maceration, especially after revascularization or minor amputation 1, 7
For diabetic foot ulcers with maceration, ensuring proper pressure offloading in addition to appropriate moisture management is recommended by the American College of Cardiology and the Diabetes/Metabolism Research and Reviews guideline 1, 2

The Journal of the American College of Radiology warns that failing to address the underlying cause of excess exudate will result in continued maceration despite appropriate dressing selection 3
The Diabetes/Metabolism Research and Reviews guideline advises that antimicrobial dressings should not be used with the goal of improving wound healing or preventing secondary infection in macerated wounds unless there are signs of clinical infection 2, 6