Bordered Silicone Foam Dressing Shows Effective Post-Graft Management in Complex Foot Wounds

Key Takeaways

• Complex foot wounds post-graft (SAWC Spring 2026, US): Case series (n=8) after debridement, antibiotic-loaded cement, and amniotic/dermal grafts; bordered silicone foam (n=4) vs dry sterile dressing (n=4).
• Outcomes (6 weeks): Fewer dressing changes with silicone foam (0.63 vs 1.54/week); less periwound maceration (1 vs 4 cases); infections (1 vs 2); no graft failures, systemic complications, or amputations.
• Clinical relevance: Silicone foam showed improved moisture control, stability, and reduced strike-through, supporting graft environment preservation and fewer unplanned dressing changes, particularly relevant in high-motion foot wounds and limited-resource settings

Bordered silicone foam dressings resulted in fewer dressing changes, reduced maceration, and improved moisture control compared to traditional dry sterile dressings in patients with complex foot wounds, according to a poster presented at the Symposium on Advanced Wound Care (SAWC) Spring.¹

Eight patients received surgical debridement, followed by antibiotic-loaded resorbable cement and amniotic and dermal grafts secured with staples, according to the poster.¹ The authors noted surgeons applied a silver-impregnated non-adherent contact layer before patients received postoperative dressing. Four patients received standard dry sterile dressings, while 4 received bordered silicone foam dressings.

At 6-week follow-up, patients in the bordered silicone foam dressing group required fewer dressing changes (0.63 vs. 1.54 per week), with authors noting patients demonstrated improved stability and reduced strike-through.¹ Periwound maceration occurred in 1 patient in the bordered foam silicone dressing group compared with 4 instances in the standard of care group, according to the poster. One bordered silicone foam patient experienced partial graft-edge lift that required staple reinforcement, while localized infections occurred in 1 bordered silicone foam dressing patient and 2 standard of care patients. Authors noted no graft failures, systemic complications, or amputations occurred and overall, bordered foam silicone dressings demonstrated favorable trends in moisture control and dressing performance.

Consistency is one of the biggest advantages poster author Arthur Evensen, DPM, CWSP, DABPM, FACPM, has seen with bordered silicone foam dressings.

“In complex foot wounds, especially following graft placement, the difference between success and setback often comes down to how stable the wound environment remains between visits,” says Dr. Evensen. “What stood out in our series was not just moisture control, but the ability of the dressing to maintain that balance without frequent disruption. We saw fewer unplanned dressing changes, less maceration, and overall better preservation of the graft environment compared to traditional dry sterile dressings. In a high-motion, anatomically challenging area like the foot, that stability matters.”

Dr. Evensen notes a broader shift in how DPMs approach postoperative wound care. He says there is a tendency to focus heavily on the graft or biologic itself, but the dressing is what ultimately “protects or jeopardizes” that investment. He says a conformable silicone foam that can adapt to irregular surfaces, manage exudate dynamically, and remain securely in place without constant adjustment is a therapeutic strategy, not just a cover dressing.

Dr. Evensen cites additional advantages of a bordered silicone dressing in rural settings, saying simplicity and durability are critical when patients do not have reliable access to home health services, and when dressing changes fall on the patient or family. He says a system that reduces the need for frequent changes not only improves convenience but reduces opportunities for error, contamination, and loss of local antimicrobial effects, adding that fewer interventions may translate into better outcomes.

“In our view, the value here is not just performance, but reliability,” says Dr. Evensen. “In complex wound care, especially in resource-limited settings, reliability is often what drives success.”

Reference

1. Evensen A, Moore J, Miller G, Mulloy B. Innovative use of bordered silicone foam for post-graft management in complex foot wounds: a case series. Poster presented at the Symposium on Advanced Wound Care (SAWC) Spring, Charlotte, NC, April 8–12, 2026.