Stage 2 Pressure Injury Dressings: A Singapore Caregiver's Guide

Transparency note: This guide is written by EMIS+, which sells wound care products and provides wound care nurse home visits in Singapore. We carry products from 3M, Smith & Nephew, Coloplast, Convatec, and other manufacturers. We do not favour one brand.

Last reviewed: 17 October 2026 by the EMIS+ Clinical Team (Singapore Nursing Board registered nurses with post-registration wound care qualifications).

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Quick Answer

A stage 2 pressure injury is partial-thickness skin loss with exposed dermis. The wound bed is pink or red, moist, and may appear as an intact or ruptured serum-filled blister. It does not involve fat, muscle, or bone, and does not have slough, eschar, or granulation tissue. Treatment focuses on pressure relief, a moist wound environment, and skin protection. Common dressing choices include foam, hydrocolloid, and transparent film. No single dressing is proven superior. If the wound shows no improvement after 2 weeks, reassess the cause and seek professional wound care.

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What Is a Stage 2 Pressure Injury?

The National Pressure Injury Advisory Panel (NPIAP) defines a stage 2 pressure injury as:

Partial-thickness loss of skin with exposed dermis. The wound bed is viable, pink or red, moist, and may also present as an intact or ruptured serum-filled blister.

Key characteristics:

• Involves the epidermis and part of the dermis
• No fat, muscle, or bone visible
• No slough (yellow/white tissue) or eschar (black/brown dead tissue)
• No granulation tissue (that appears in deeper wounds)
• Often painful because nerve endings are exposed
• Common over bony prominences: sacrum, heels, hips, elbows, shoulder blades

Stage 2 injuries are often caused by pressure combined with shear, friction, or moisture. They are common in bedbound or wheelchair-bound individuals, but can also occur in anyone with reduced mobility or sensation.

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Treatment Principles

1. Pressure Relief (Most Important)

The single most important treatment is removing pressure from the affected area. No dressing will heal a pressure injury if pressure continues.

• Bedbound patients: Reposition at least every 2 hours while in bed, or more frequently if the skin reddens. Use a pressure-relieving mattress or overlay.
• Wheelchair users: Perform weight shifts every 15 to 30 minutes AND use a pressure-relieving cushion. A cushion does not replace weight shifts. Limit sitting time when the injury is on a sitting surface (sacrum, ischium, coccyx).
• Heels: Float the heels off the bed using a pillow under the calves, not directly under the heels.
• Avoid donut-type cushions, which can increase pressure around the wound edge.

Repositioning frequency should be individualised based on the patient's skin condition, mobility, and comfort. "Every 2 hours" is a common starting point, not a fixed rule.

2. Cleanse Gently

• Cleanse with normal saline or a gentle wound cleanser at each dressing change
• Do not use antiseptics (hydrogen peroxide, povidone-iodine, chlorhexidine) on a routine basis, as they can damage healthy tissue
• If antiseptic use is considered for a critically colonised or infected wound, it should be time-limited and supervised by a healthcare professional, per the International Wound Infection Institute (IWII) guidance

3. Maintain a Moist Environment

A moist wound bed supports healing. The dressing should:

• Keep the wound bed moist
• Absorb excess exudate without drying out the wound
• Protect the surrounding skin from maceration
• Be comfortable and easy to change

4. Protect Surrounding Skin

• Use a skin barrier film or ointment around the wound to protect from moisture and adhesive
• Ensure incontinence is managed promptly (urine and stool irritate skin)
• Avoid tape on fragile skin; use silicone-based adhesives when possible

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Dressing Options for Stage 2 Pressure Injuries

No single dressing has been proven superior for stage 2 pressure injuries. A Cochrane network meta-analysis (39 trials, 2,127 participants) could not identify a dressing or topical treatment that was clearly better than others. The choice depends on exudate level, wound location, patient comfort, and cost.

Foam Dressings

Best for: Moderate exudate, painful wounds, areas subject to pressure

• Absorbent, cushioned, and comfortable
• Available in adhesive and non-adhesive forms
• Can be left in place for 3 to 5 days
• Examples: 3M Tegaderm Foam, Smith & Nephew Allevyn, Coloplast Biatain
• Good for sacral and heel pressure injuries

Hydrocolloid Dressings

Best for: Low to moderate exudate, superficial wounds, areas with minimal movement

• Creates a moist environment by interacting with wound fluid
• Self-adhesive and waterproof
• Can be left in place for 3 to 5 days
• Examples: 3M Tegaderm Hydrocolloid, Convatec DuoDERM
• Not suitable for heavily exuding wounds or infected wounds

Transparent Film Dressings

Best for: Very low exudate, superficial abrasions, as a secondary dressing

• Thin, transparent, and flexible
• Allows visual monitoring without removal
• Does not absorb exudate
• Examples: 3M Tegaderm Film
• Not suitable for moderate to heavy exudate

Hydrogel Dressings

Best for: Dry or minimally exuding wounds, painful wounds requiring cooling

• Provides moisture to dry wounds
• Has a cooling effect that can reduce pain
• Available as sheet, amorphous gel, or impregnated gauze
• Examples: Smith & Nephew SoloSite (hydrogel wound gel), 3M Tegagel
• Note: Stage 2 wounds are typically moist, so hydrogel is only needed if the wound is dry. It is not for necrotic tissue (which does not occur in stage 2).

Silicone Dressings

Best for: Fragile skin, painful dressing changes, patients at risk for skin tears

• Gentle on removal, reducing trauma to surrounding skin
• Good for elderly patients or those with thin skin
• Examples: Mepilex (Mölnlycke), 3M Tegaderm Silicone

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What to Avoid

• Massaging the area around the wound. This can damage fragile tissue and does not improve circulation.
• Using antiseptic creams routinely. Hydrogen peroxide, povidone-iodine, and chlorhexidine can damage healthy cells.
• Applying harsh soaps or alcohol to the wound.
• Using donut cushions. They increase pressure around the wound edge.
• Leaving a wet dressing on too long. Maceration (softening of skin from moisture) can enlarge the wound.
• Ignoring the cause. If pressure continues, the wound will not heal and may progress.

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Healing Timeline

Stage 2 pressure injuries typically show signs of improvement within 1 to 2 weeks of appropriate care, but healing time varies by individual, wound size, overall health, and whether pressure is consistently relieved. If there is no improvement after 2 weeks of consistent pressure relief and appropriate dressing, reassess:

• Is pressure truly being relieved?
• Is the dressing appropriate for the exudate level?
• Is there undiagnosed infection?
• Does the patient have underlying conditions (diabetes, poor circulation, malnutrition) that slow healing?
• Should the wound be reassessed for staging (could it be deeper than initially thought)?

Seek professional wound care if the wound worsens, shows signs of infection, or does not improve.

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Signs of Infection

Seek medical attention if you notice:

• Increasing redness, warmth, or swelling around the wound
• Pus or foul-smelling discharge
• Increasing pain
• Red streaks spreading from the wound
• Fever
• The wound becoming deeper or larger

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Prevention: Stopping Recurrence

Skin Care

• Inspect skin daily, especially over bony prominences
• Keep skin clean and dry
• Use moisturiser on dry, intact skin (not on open wounds)
• Change wet or soiled clothing and bedding promptly

Support Surfaces

• Use a pressure-relieving mattress overlay for bedbound patients
• Use a pressure-relieving cushion for wheelchair users (in addition to weight shifts)
• Use heel protectors or pillows to float heels
• Evidence for prophylactic dressings is strongest for multilayer silicone foam on the sacrum and heels, not for film or hydrocolloid on at-risk skin

Nutrition

• Ensure adequate protein intake (1.2 to 1.5g per kg of body weight per day, or as advised by a dietitian)
• Maintain adequate hydration
• Consider vitamin and mineral supplementation if deficient (consult a doctor or dietitian)

Mobility

• Encourage movement and repositioning
• Use lift sheets or transfer aids to reduce shear and friction
• Avoid dragging the patient across sheets

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Singapore-Specific Resources

Financial Assistance

Singapore citizens and PRs aged 60 and above who are using a Community Care service may be eligible for AIC's Seniors' Mobility and Enabling Fund (SMF), which subsidises home healthcare items including wound dressings, with up to 80% subsidy. Eligibility is means-tested. Check the AIC website for current criteria and per-capita income caps, as these are subject to review.

Home Nursing

• AIC-subsidised home nursing is available for eligible seniors through approved service providers
• EMIS+ offers private wound care nurse home visits by Singapore Nursing Board registered nurses with wound care qualifications
• Polyclinic and hospital referrals can help navigate subsidised care options

Emergency Contacts

• 995 for emergency ambulance
• 1777 for non-emergency ambulance
• Your nearest polyclinic or GP for non-urgent wound concerns

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Frequently Asked Questions

Can I use antiseptic cream on a stage 2 pressure injury?

Routine use of antiseptic creams (hydrogen peroxide, povidone-iodine, chlorhexidine) is not recommended, as they can damage healthy tissue. If a wound shows signs of critical colonisation or infection, a healthcare professional may recommend a time-limited course of antiseptic, per IWII guidance.

How often should I change the dressing?

It depends on the dressing type and exudate level. Foam and hydrocolloid dressings are typically changed every 3 to 5 days. Change sooner if the dressing is saturated, leaking, or causing discomfort.

Can a stage 2 pressure injury heal on its own?

With consistent pressure relief and good skin care, many stage 2 injuries heal. However, if pressure continues or the wound is not properly cared for, it can progress to stage 3 or 4. Professional assessment is recommended if there is no improvement in 2 weeks.

Is a stage 2 pressure injury the same as a bed sore?

"Bed sore" is a common term for pressure injuries. Stage 2 is one of four stages (stage 1 being intact red skin, stage 3 and 4 being deeper tissue loss).

Should I use a donut cushion?

No. Donut cushions increase pressure around the wound edge and can reduce blood flow. Use a properly designed pressure-relieving cushion instead, and perform regular weight shifts.

Can I use hydrocolloid on a heavily exuding wound?

No. Hydrocolloid is best for low to moderate exudate. For heavy exudate, use a foam or alginate dressing and seek professional advice.

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Getting Professional Wound Care

If you or a loved one has a pressure injury that is not improving, EMIS+ offers wound care nurse home visits. A Singapore Nursing Board registered nurse with wound care qualifications will assess the wound, recommend appropriate dressings, provide caregiver training, and monitor healing. EMIS+ stocks a range of wound care products from 3M, Smith & Nephew, Coloplast, and Convatec.

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Medical Disclaimer

This article is for informational purposes only and does not constitute medical advice. Wound care should be individualised based on a healthcare professional's assessment. If a wound worsens, shows signs of infection, or does not improve, consult a doctor or qualified wound care nurse.

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Sources

• National Pressure Injury Advisory Panel (NPIAP). Pressure Injury Stages. https://www.npiap.com
• International Wound Infection Institute (IWII). Wound Infection in Clinical Practice, 4th edition, 2026.
• Cochrane Database of Systematic Reviews. Dressings and topical agents for treating pressure ulcers (CD011947).
• Agency for Integrated Care (AIC). Seniors' Mobility and Enabling Fund (SMF). https://www.aic.sg/financial-assistance/home-healthcare-items/
• Ministry of Health, Singapore. Nursing Clinical Practice Guideline on Pressure Ulcer Prevention.
• Smith & Nephew. SoloSite Wound Gel product documentation.
• 3M. Tegaderm Foam and Hydrocolloid product documentation.
• Coloplast. Biatain foam dressing product documentation.