A combine pad is a specialized, highly absorbent wound dressing designed primarily to manage wounds producing significant amounts of fluid, known as exudate. Frequently called an ABD pad due to its common use on abdominal wounds, this dressing is engineered to soak up and hold large volumes of drainage away from the wound site. This provides superior absorption capacity, reducing the frequency of dressing changes and maintaining a clean environment to promote healing. Combine pads are distinguished from standard gauze by their thick, multi-layered structure and considerably larger size.
Defining the Combine Pad
A combine pad is constructed with a distinct, multi-layered design that dictates its function and high absorbency. The dressing consists of a thick, inner core made of super-absorbent materials like cellulose fibers or cotton fleece. This fluffy inner material is responsible for absorbing and dispersing fluids laterally to prevent pooling and reduce the risk of maceration on the surrounding skin.
The inner core is fully encased by an outer layer, typically a soft, non-woven fabric that faces the wound. This non-adherent layer wicks moisture quickly away from the skin and into the absorbent core. The reverse side of the pad often features a moisture-repellent or hydrophobic backing to protect against “strike-through,” which is when fluid soaks all the way through the pad. The edges of the pad are usually sealed to prevent linting or shedding fibers into the wound, ensuring a cleaner application.
Primary Use Cases
The primary function of a combine pad is managing wounds with medium to heavy levels of exudate. Its high absorption capacity makes it particularly useful for heavily draining post-operative incisions, such as those following abdominal surgery, which earned it the common “ABD pad” nickname. The pads can be used as a primary dressing directly on a wound or as a secondary dressing placed over a smaller contact layer.
Beyond absorbing discharge, the pad’s thickness provides significant cushioning and protection for the wound site. This bulky layer helps shield the injured area from external trauma or friction, which is beneficial for large surface wounds or those located on areas prone to bumping. In first aid and trauma situations, the pad’s size and absorbency make it suitable for managing severe wounds, including deep lacerations or abrasions, where immediate control of heavy bleeding is necessary. The pad can also be used to apply mild, uniform pressure to the wound when secured with a wrap, assisting in initial hemorrhage control.
Step-by-Step Application
Proper application begins by ensuring the wound is cleaned according to medical guidelines and that a sterile pad is used. After preparing the wound, the pad must be oriented correctly, placing the soft, non-woven side directly against the wound surface. If the pad features a visible stripe, such as a blue line, this mark typically indicates the moisture-resistant backing and should face away from the skin, often remembered as “blue to the sky.”
The pad must be large enough to completely cover the wound and extend past its edges to ensure all drainage is captured. Since combine pads do not have an adhesive backing, they must be secured firmly using medical tape, rolled gauze, or a cohesive wrap. The securing material should hold the pad in place without wrapping so tightly that it restricts circulation. The dressing should be monitored for saturation, and it is time to change the pad when the drainage reaches the edges or strike-through is observed on the moisture-repellent side.