When Should You Not Use Xeroform? Contraindications Guide
When should you not use Xeroform?
The Quick Answer
Avoid Xeroform for **heavily exuding wounds** (causes maceration), **dry/eschar-covered wounds** (requires moisture-donating dressings first), **known bismuth allergy**, or **third-degree burns** (requires specialized antimicrobial dressings). Not ideal for actively infected wounds needing aggressive debridement—use absorptive antimicrobial dressings until infection controlled.
Why We Ask This
Well-intentioned use of Xeroform on inappropriate wounds (e.g., highly exudative venous ulcers) worsens outcomes through maceration—clinicians and patients unaware that dressing selection must match wound exudate levels and tissue type for optimal healing.
The Practical Science
Xeroform's semi-occlusive nature traps excess fluid against skin, elevating skin pH and activating proteases that degrade extracellular matrix. Contraindications align with wound moisture balance principles: absorptive dressings for high exudate, hydrogels for dry wounds.
In Clinical Practice
A heavily draining leg ulcer develops periwound maceration with Xeroform—switching to calcium alginate dressing absorbs 20x its weight in fluid while maintaining moist wound bed, resolving maceration within 48 hours and enabling progression to healing.
References & Context
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