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This page describes products and general use; it is not medical advice.
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Short answer: the 2019 international pressure injury guideline recommends hydrocolloid dressings for non-infected Category/Stage II pressure injuries (the partial-thickness stage most people call a bed sore), and it also states that no wound dressing is superior to others. Who uses this page: clinic and care-home staff, buyers and students comparing dressing types. It covers what the guideline says, how hydrocolloid compares with foam, and the criteria a dressing choice is based on.
For how a hydrocolloid dressing is built and its general sizes and wear time, see our hydrocolloid wound care guide. This page is specific to pressure injuries.
What a hydrocolloid dressing is
The guideline defines hydrocolloids as absorbent dressings containing gel-forming agents held in an adhesive compound laminated onto a foam or film. They are either fully occlusive or semi-permeable, and some have features that help the dressing stay on and reduce edge roll. For the general category of occlusive products, see occlusive dressings; for a side-by-side with the gel alternative, see hydrogel vs hydrocolloid.
Bed sore, pressure ulcer, pressure injury: the terms
These words describe the same kind of injury to skin and underlying tissue caused by pressure. The 2019 guideline uses “pressure injury” and the staging labels “Category/Stage”. Product pages and search queries often still say “bed sore” or “pressure ulcer”, so a dressing listed for one is being described for the same condition. A broader view of wound classes is in our types of wounds guide.
What the 2019 guideline says about hydrocolloid for Stage II
The guideline (Evidence to Decision Framework 14, Wound Dressings, from the European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel and Pan Pacific Pressure Injury Alliance) contains Recommendation 14.3: “Use hydrocolloid dressings for non-infected Category/Stage II pressure injuries.” Its strength of evidence is graded B1: Level 1 studies of moderate or low quality providing direct evidence.
Two limits matter for anyone reading a product page. The recommendation is for non-infected Category/Stage II injuries, not for every stage. And the guideline’s justification states that selecting a dressing needs a comprehensive evaluation of the pressure injury, the individual and the environment each time the dressing is changed, and that “there is no wound dressing that is superior to others.”
Hydrocolloid vs foam dressings for pressure ulcers
Foam is the other dressing family the guideline discusses most for pressure injuries. Recommendation 14.8 reads: “Use foam dressings (including hydropolymers) for Category/Stage II and greater pressure injuries with moderate/heavy exudate.” The comparison rows below come from the guideline’s evidence summaries; all of the trial findings are graded Level 1, low quality.
| Point of comparison | Hydrocolloid | Foam | Source |
|---|---|---|---|
| Guideline recommendation | Non-infected Category/Stage II (14.3) | Category/Stage II and greater with moderate or heavy exudate (14.8) | EPUAP/NPIAP/PPPIA 2019, EtD 14 |
| Pressure injuries completely healed within 30 days (one trial; 79% Category/Stage II, 21% Stage III) | 16% | 24% (the guideline reports no significant difference) | EtD 14, Level 1, low quality |
| Participants rating absorbency as “good” (Category/Stage II or III injuries) | 26% | 81% (p<0.001) | EtD 14, Level 1, low quality |
| Ease of removal rated by participants | Rated harder to remove | Rated significantly easier to remove | EtD 14, Level 1, low quality |
| Conforming to the body | Less often rated “good” | More often rated “good” (p=0.018) | EtD 14, Level 1, low quality |
The table describes how the guideline’s evidence is laid out; it is not a ranking. The same document says foam dressings may not be accessible in all geographic locations (expert opinion).
Foam dressings for bed sores
The guideline describes foam dressings (including hydropolymers) as absorbing exudate from the wound bed. Simple foams wick exudate to the surface of the dressing, complex foams absorb it by dispersing it through the dressing, and gelling foams manage excess exudate and protect surrounding skin from prolonged exposure to wound or body fluids.
What a dressing is matched against: the guideline’s assessment points
Good Practice Statement 14.1 bases dressing selection on clinical assessment and the characteristics of the wound, and on the goals and self-care abilities of the individual and any informal caregiver. The assessment points it lists show what a product description is matched against:
- Diameter, shape and depth of the wound
- The need to address bacterial bioburden
- The ability to keep the wound bed moist
- The nature and volume of exudate
- The condition of the tissue in the wound bed
- The condition of the skin around the wound (the peri-wound skin)
- Tunneling or undermining
- Pain
The guideline adds that the dressing type most appropriate may change as the pressure injury heals or deteriorates. A supply list for a clinic is a different task from a clinical decision; for stocking, see our wound care clinic supply checklist.
What are bed sore patches?
“Bed sore patches” is a search term, not a defined product class in the guideline. Two different uses sit behind it: dressings applied to an existing injury (the subject of the sections above) and dressings applied to intact skin to help prevent injury. For the second use, the Prophylactic Dressing Standards Initiative paper by EPUAP and NPIAP states that there are no established and accepted standards to evaluate the prophylactic function of dressing materials, and that its working groups cover mechanical behaviour and durability, thermal performance, moisture management and adhesiveness. The paper notes that products differ: some give more cushioning, others insulate heat more. A patch described as preventive therefore cannot be checked against an agreed standard yet.
Safe use and handling basics
- Wear time and size differ between products and are set in the manufacturer’s instructions for use for the specific product, not by the guideline.
- The guideline’s background notes that a dressing in contact with the wound bed, or a skin barrier product, keeps the peri-wound skin dry and prevents maceration.
- In one trial reported in the guideline, a hydrocolloid dressing with a low-friction nylon outer layer was associated with more peri-wound skin erythema than a ceramide dressing (16.67% vs 4.17%; Level 2, low quality), and peri-wound skin is on the assessment list.
For the general product family, see what a wound dressing is.
Common misreadings
- Assuming one dressing outranks the rest. The guideline states that no dressing is superior to others.
- Reading a prevention patch as a standardised product. No accepted standard for prophylactic function exists yet.
- Mixing up the vocabulary. Bed sore, pressure ulcer and pressure injury refer to the same condition, but products and guidance use different words.
FAQ
Can hydrocolloid dressing be used for pressure ulcers?
The 2019 guideline recommends hydrocolloid dressings for non-infected Category/Stage II pressure injuries (Recommendation 14.3, evidence grade B1).
Is foam better than hydrocolloid for a pressure ulcer?
The guideline says no dressing is superior to others. It recommends foam for Category/Stage II and greater injuries with moderate or heavy exudate, and in one low-quality trial participants rated foam higher for absorbency and ease of removal.
What is the difference between a bed sore, a pressure ulcer and a pressure injury?
They describe the same condition; “pressure injury” is the term used in the 2019 guideline.
Are bed sore patches the same as hydrocolloid dressings?
Not necessarily. A hydrocolloid dressing is a defined dressing type; “bed sore patch” is a search phrase that can describe a treatment dressing or a preventive product, and there is no accepted standard for the preventive function.
Sources
- EPUAP/NPIAP/PPPIA, International Guideline 2019, Evidence to Decision Framework 14: Wound Dressings, internationalguideline.com (checked 1 November 2026).
- Prophylactic Dressing Standards Initiative (EPUAP/NPIAP), PubMed Central PMC9284620 (checked 1 November 2026).
