DuoDerm vs. Medifoam: the answer comes down to how much exudate there is

Please check this before reading


Q. Isn’t DuoDerm better? It’s expensive too.

A. That’s a bit nuanced. For wounds with little exudate, DuoDerm is the right choice, but for wounds with a lot of leaking exudate, Medifoam is actually better for recovery.


Q. Then what should be used for which wound?

A. The key is just one thing: the amount of exudate. This matters before wound depth or size.

They all look similar, right? But DuoDerm and Medifoam work on completely different principles

DuoDerm is what’s called a hydrocolloid,

an occlusive dressing product that turns into a gel.

When you put it on a wound, it absorbs exudate,

and gradually swells up and turns white.

Medifoam is a foam dressing,

with a structure that soaks up exudate like a sponge.

Unlike DuoDerm, Medifoam

doesn’t gel; it just absorbs.

This structural difference ultimately determines

"what should be used for which wound."

Why does DuoDerm lift off and Medifoam stick well on the same wound?

"For wounds with little exudate, DuoDerm,

and for wounds with so much exudate that it overflows, choosing Medifoam, which has superior absorption, is better for recovery.

"

— Director Wi Young-jin (Hongdae Beautystone Clinic)

You might be a little surprised to hear this.

Last month, a 36-year-old woman came in,

and she had put DuoDerm on a scraped knee,

but by the next day the exudate had leaked out to the side,

so her clothes and bedding were all soaked.

When I looked at the wound, the scraped area was fairly large,

and the exudate was at a stage where it was running down freely.

In this case, honestly,

DuoDerm just can’t handle that amount.

DuoDerm’s absorption capacity is limited.

Because of the hydrocolloid’s nature,

it absorbs exudate and turns it into gel,

but once its capacity is full, it starts leaking over the top.

By contrast, Medifoam, depending on the foam thickness,

absorbs about 3 to 5 times more exudate than DuoDerm.

That’s why Medifoam is much better for the first 2 to 3 days of a wound with a lot of exudate.

So when do you use DuoDerm?

When there is almost no exudate,

or when the initial stage has passed and exudate has decreased,

it’s good for shallow wounds, acne scars, and small abrasions.

In particular, DuoDerm maintains a moist environment,

preventing scabs from forming,

so it has the advantage of leaving less scarring.

But that doesn’t mean it’s always good.

If you put it on a wound with lots of exudate,

it can actually cause maceration (skin softening)

or make the surrounding skin raw.

That 36-year-old patient switched to Medifoam,

let it absorb for about two days,

and once the exudate had subsided, finished with DuoDerm.

It was almost completely healed in a week.

This is the flow we usually recommend in the clinic.

"Medifoam first, DuoDerm later."

Director Wi Young-jin’s key summary


DuoDerm is not automatically better just because it’s more expensive. On wounds where exudate is flowing freely, DuoDerm actually leaks. In terms of absorption, Medifoam is 3 to 5 times superior, so the fastest route to recovery is Medifoam in the beginning and DuoDerm later.

So what should I buy?

If I summarize it in a table, it looks like this.

This is the one criterion I usually give patients.

"If a gauze pad is soaked through within an hour, use Medifoam,

if not, use DuoDerm."

It’s simpler than you might think.

But people who don’t know this and use only DuoDerm no matter what

come into the clinic two or three times a week, guaranteed.

Three things patients ask about a lot — I’ll answer honestly

Q1. DuoDerm has swollen up white — is it festering?

A. This is a part many people misunderstand,

but the white swelling is not pus;

it’s a normal reaction where exudate is absorbed and turned into gel.

That’s actually how DuoDerm works.

However, if exudate leaks out from the edges,

if there’s a strong odor, or if the surrounding skin turns red and spreads,

you should suspect infection,

so it’s safest to remove it right away and get examined.

And this is something people ask about a lot too.

Q2. How often should I change it, and how big is the price difference?

A. To be honest,

DuoDerm should be changed every 2 to 5 days

depending on the amount of exudate,

and Medifoam should be changed once or twice a day in the early stage when exudate is heavy,

then every 2 to 3 days as it decreases.

As for price, when bought at a pharmacy,

DuoDerm tends to be about 1.5 times more expensive than Medifoam.

But if you use DuoDerm on a wound with lots of exudate,

you’ll end up throwing away a sheet a day because it leaks,

so in many cases Medifoam is actually more economical.

Finally, let me point out this part too.

Q3. Is there a way to make sure neither one falls off?

A.

For DuoDerm, cut it with about 2 cm of margin

around the wound so it sticks well.

If you cut it exactly to size, the edges

will lift up quickly.

For Medifoam, depending on the product, there are versions

with or without an adhesive border,

and the ones without a border need separate fixing tape.

And both products

tend to come off easily on joints or areas with a lot of movement.

For these areas, if you seal the top with

waterproof tape once more, it lasts much longer.

If you send me a photo of the wound, I’ll tell you over KakaoTalk which product would be best. In the next post, I’ll explain the "dressing sequence I really recommend in the clinic right after suture removal." I’ll show with cases why scar outcomes differ from person to person. This has been Wi Young-jin.

Read more

• Hongdae filler: "Who injects it matters more than the price" (the difference when the director performs the procedure herself)

• DuoDerm replacement interval: just know this

• How many days should DuoDerm stay on? Complete guide to replacement intervals