What Is an Alternative to Xeroform? Understanding Wound Dressing Options

October 8, 2025 •

4 min read

While Xeroform is a cost-effective and popular option for many wounds, patients with a sensitivity to its bismuth tribromophenate ingredient or specific wound needs often require an alternative. For those asking, 'What is an alternative to Xeroform?', the answer depends on the wound type, exudate level, and desired dressing properties, with numerous options available for effective healing.

Quick Summary

This guide examines various wound dressing alternatives to Xeroform, such as petrolatum gauze, silicone contact layers, hydrogels, and antimicrobial products. It explains the purpose of each alternative based on wound characteristics like exudate levels, pain sensitivity, and infection risk.

Key Points

Plain Petrolatum Gauze: A direct, non-medicated alternative to Xeroform, offering moisture and non-adherence without the bismuth component.
Silicone Contact Layers: Options like Mepitel offer gentle, non-adherent protection ideal for fragile skin and surgical sites.
Hydrogels for Pain Relief: Water-based hydrogel dressings provide a cooling sensation and hydrate dry wounds, which is particularly beneficial for minor burns.
High-Absorbency Options: For wounds with moderate to heavy drainage, dressings like foams and alginates are more appropriate than Xeroform.
Specialized Antimicrobials: Silver-impregnated and medical-grade honey dressings are effective for infected wounds or those at risk of infection.
Consider Patient Sensitivities: Allergies to bismuth tribromophenate are a key reason to seek an alternative to Xeroform.
Match Dressing to Wound Type: The best alternative depends on the specific wound's characteristics, including exudate level and skin fragility.

Understanding Xeroform's Role in Wound Care

Xeroform is a sterile, non-adherent wound dressing made from a fine-mesh gauze impregnated with a blend of petrolatum and 3% bismuth tribromophenate. This unique combination serves several purposes: the petrolatum creates a moist healing environment and prevents the dressing from sticking to the wound bed, while the bismuth tribromophenate acts as a mild antiseptic and deodorizer. It is commonly used for minor burns, lacerations, skin graft sites, and other non-draining or lightly draining wounds. However, Xeroform is not suitable for all wound types, particularly those with heavy exudate, and can cause irritation in patients with a bismuth sensitivity. For these reasons, exploring suitable alternatives is crucial for effective and comfortable wound management.

Non-Medicated Non-Adherent Alternatives

For patients who need the non-adherent properties of Xeroform without the medicinal additive, several non-medicated options are available.

Plain Petrolatum Gauze

This is the simplest and most direct alternative. It consists of a fine-mesh gauze impregnated with sterile white petrolatum, providing a moist, non-adherent layer for the wound.

Key uses: Ideal for non-draining wounds, skin grafts, and donor sites where the primary goal is to prevent the dressing from sticking.
Advantage over Xeroform: Eliminates the risk of irritation from bismuth tribromophenate for sensitive patients.
Limitation: Lacks the mild deodorizing and antibacterial action of Xeroform. It can also dry out over several days.

Silicone Wound Contact Layers

Dressings with a soft silicone contact layer, such as Mepitel or Adaptic Touch, are excellent for fragile or sensitive skin.

Key uses: Skin tears, surgical incisions, and burns.
Advantages: Very gentle on the skin, causing minimal trauma upon removal. The mesh structure allows exudate to pass through to a secondary absorbent dressing. Some studies indicate lower infection rates in surgical sites treated with silicone dressings compared to Xeroform.
Limitation: Often more expensive than petrolatum gauze. A secondary dressing is always required to absorb fluid.

Advanced Dressings for Specific Wound Needs

For wounds that are not a good fit for simple impregnated gauze, more advanced dressings offer specialized properties.

Hydrogel Dressings for Dry Wounds and Pain Relief

Hydrogels are water-based dressings that provide hydration to dry or necrotic wounds, helping to facilitate autolytic debridement (the body's process of breaking down dead tissue).

Key uses: Dry wounds, partial-thickness burns, and radiation-damaged skin.
Advantages: Creates a moist healing environment and offers a soothing, cooling effect that can reduce wound pain.
Limitations: Low absorbency, making them unsuitable for heavily draining wounds. A secondary dressing is needed.

Hydrocolloid Dressings for Mild Exudate

Hydrocolloids are self-adhesive, gel-forming dressings that are both occlusive and absorbent.

Key uses: Pressure ulcers, minor burns, and superficial wounds with light to moderate drainage.
Advantages: Creates a moist environment, waterproof, and can remain in place for several days.
Limitation: Not recommended for infected or heavily draining wounds.

Absorbent Dressings (Foam and Alginates)

These are used for wounds with moderate to heavy exudate, which are contraindicated for Xeroform.

Foam Dressings: Made of polyurethane, foams are highly absorbent and provide cushioning.
Alginate Dressings: Derived from seaweed, they form a gel upon contact with wound exudate and are highly absorbent. They are excellent for packing cavity wounds and controlling bleeding.

Antimicrobial Alternatives

For wounds at risk of infection, specialized dressings can provide antibacterial action without relying on bismuth.

Silver-Impregnated Dressings

Dressings containing ionic silver, like Aquacel Ag or Mepilex Ag, provide broad-spectrum antimicrobial activity.

Key uses: Infected wounds, chronic wounds, and burns.
Advantages: Effective against many types of bacteria and can be worn for several days.
Limitations: Can be more expensive than other options. Not suitable for patients with silver sensitivity.

Medical-Grade Honey Dressings

Manuka honey-based products (e.g., MediHoney) offer antimicrobial, anti-inflammatory, and osmotic debriding properties.

Key uses: Chronic and infected wounds, burns.
Advantages: Excellent for combating bacterial infection and provides gentle debridement.
Limitation: Not for patients with honey allergies and can be costly.

How to Choose the Right Xeroform Alternative

Choosing the best alternative to Xeroform requires a careful evaluation of the wound's specific characteristics, such as exudate level, the need for antimicrobial properties, and the patient's skin sensitivity. Below is a comparison table to help guide your decision:


Dressing Type	Primary Function	Absorbency	Non-Adherent	Best for	Considerations
Plain Petrolatum Gauze	Moist environment	Low	Yes	Minor burns, skin grafts	Lacks antimicrobial properties
Silicone Contact Layer (e.g., Mepitel)	Gentle protection	Low (requires secondary)	Yes	Fragile skin, skin tears	Requires secondary dressing
Hydrogel	Hydration, pain relief	Low	Yes	Dry wounds, burns	Not for high exudate
Hydrocolloid	Moist environment, exudate mgmt	Moderate	Yes	Pressure ulcers, light drainage	Not for heavy exudate or infected wounds
Foam	Absorption, cushioning	High	Yes (can be bordered)	Moderate to heavy exudate	Requires secondary securement (if non-bordered)
Alginate	High absorption	Very High	Yes (forms gel)	Heavy drainage, bleeding wounds	Not for dry wounds
Silver Dressing (e.g., Aquacel Ag)	Antimicrobial	Varies	Varies	Infected wounds, burns	Higher cost, patient allergies
Medical-Grade Honey	Antimicrobial, debridement	Varies	Varies	Infected, chronic wounds	Cost, patient allergies

Conclusion

While Xeroform is a long-standing tool in wound care, a wide variety of advanced and equally effective alternatives are available for patients who cannot use it or have wound needs that it cannot meet. Options range from simple non-medicated petrolatum gauze for basic non-adherence to sophisticated silicone and hydrogel dressings for sensitive skin and pain relief. For more complex wounds involving infection or heavy drainage, specialized silver, honey, foam, or alginate dressings provide targeted treatment. By assessing the specific requirements of the wound, healthcare providers can select the optimal dressing to promote healing and patient comfort. For deeper insights into wound management practices, the National Institutes of Health provides numerous resources for clinical research and studies on wound dressings.

Frequently Asked Questions

Reasons to seek an alternative include a known hypersensitivity or allergy to bismuth tribromophenate, a patient's need for a higher absorbency dressing for heavily draining wounds, or simply exploring more advanced and potentially more effective wound care technologies.

Yes, plain petrolatum gauze is an excellent substitute if the goal is to maintain a moist, non-adherent environment for a wound. However, it lacks the mild antiseptic and deodorizing properties of the bismuth compound found in Xeroform.

For superficial partial-thickness burns, both non-medicated petrolatum gauze and hydrogel dressings are good options. Hydrogels provide a cooling, pain-relieving effect. For more severe burns, specialized antimicrobial dressings like silver-impregnated products may be used under medical supervision.

Xeroform is not intended for use on heavily draining wounds. For these, highly absorbent options such as foam dressings or alginate dressings are the best alternatives to manage exudate effectively.

Silicone wound contact layers (e.g., Mepitel) are a very gentle, non-adherent alternative that minimizes trauma during dressing changes, making them ideal for patients with sensitive or fragile skin.

Yes, medical-grade honey dressings, such as MediHoney, have demonstrated antimicrobial, anti-inflammatory, and antioxidant properties. The high sugar concentration also provides osmotic debridement for wound cleansing.

One study found that a low-cost, handmade bismuth-petrolatum dressing could be a viable alternative to commercial Xeroform in low-resource settings. However, this is not a recommended practice for general use due to issues with ensuring sterility and correct ingredient ratios. It is always best to use commercially produced, sterile wound care products or consult a healthcare provider for recommendations.