Dermafill works best on moist clean wounds and generally will not stick to dry wounds but if the wound is wet with a small amount of hydrogel, normal saline or water frequently Dermafill will adhere to the wound bed. It is often a good idea to wash a wound with water and a antimicrobial soap prior to application of Dermafill. Dermafill should not be placed over wound beds known to be infected unless infection is actively being treated and followed by a physician.

1. Begin by debriding necrotic tissue and slough. If debridement is not needed begin by washing thoroughly with water and an antimicrobial soap

2. Simply pat dry excess water after cleansing leaving surface wet or rinse wound clean with normal saline and leave wet.

3. The dressing works best if air bubbles are removed by gently pressing in middle of membrane and guiding the air bubble to the margins of the wound where they will escape. A small hole can also be made in the dressing and patched with remnant of membrane – the patch will seal seamlessly.

4. Avoid secondary dressings as outer surface of Dermafill must be dry to adhere to the moist wound surface below. Whenever possible have patient remain stationary until margins of the wound have sealed securing the dressing. If movement is required immediately use a loose air permeable secondary dressing to secure area until patient can rest then remove the secondary dressing. Frequently air permeable hypoallergenic tape along edges of dressing is satisfactory. Once scab has formed tape may be gently removed if desired.

5. If patient or family request for cosmetic reasons to cover the wound use a very thin air permeable gauze type dressing but it must be free to breathe. If the secondary dressing retains fluids it will prevent the Dermafill from adhering to the wound bed.

6. Dermafill is to be changed on an as needed basis. By design, the dressing can remain in place for extended periods and often times with stay in place until the wound is healed.

7. Rarely is it necessary to remove the whole dressing. If excess exudate forms a small hole can be made in the Dermafill and excess drainage expelled with gentle pressure. Once excess drainage is removed simply use a small piece of Dermafill and patch the hole – the Dermafill patch will adhere and become one with the rest of the dressing. The dressing can also be removed and the wound bed cleaned with normal saline or other wound cleaning agent as desired. If one suspects an infection has developed have patient report to their physician for appropriate treatment.

8. Once a scab forms under the dressing it will remain in place until the wound heals and should stay secure even if it gets wet for brief periods of time such as in a shower. If one wishes to remove the Dermafill dressing before it spontaneously frees itself, soak it with a wet warm compress for 10-15 minutes and the dressing and the underlying scab will free itself from the wound bed.

9. Dermafill should be removed and physician notified if signs and symptoms of infection become present.