Gauze is often used as a generic term to cover a wide range of dressing products. However, gauze products have numerous subcategories that differ according to fabric construction or material composition. The two major groups are referred to as (i) woven or (ii) non-woven. It is important that practitioners differentiate between these subcategories as product characteristics, and performance will differ within each group .

Non-woven gauze dressings are generally made of rayon or synthetic fibre blends. Not to be confused with woven gauze, these dressings were introduced to replace woven products as they have a lower adherence to the wound bed and are less likely to release lint.

Woven products, often referred to as absorbent gauze, are generally made of 100% natural cotton yarns and have been manufactured the same way for centuries. It is this type of gauze that has the potential to cause more problems than any other, as it will shed fibres when cut and is prone to linting with fibres remaining in the wound after dressing removal. Woven gauze is the oldest dressing still in use and dates as far back as the Ancient Egyptians who used it to wrap bodies prior to burial.

Prior to the 1960s, gauze was used for all wound types and was especially useful for the extensive injuries inflicted on soldiers during combat. Used in large quantities, woven gauze dressings were able to absorb wound exudate and provide the type of environment that would allow the wound to form an eschar.

Although there was little else available, it was viewed as an acceptable dressing as, at that time, it was assumed a dry wound environment would facilitate the death of bacteria.

This drying process was also seen to aid debridement of the wound, because as the gauze dried the non-viable tissue would adhere to and be removed when the dressing was taken off.

Before the advent of moisture-retentive cavity dressings, packing of a cavity wound with gauze, both perioperatively and postoperatively, was also a common practice. Ribbon gauze was moistened with antiseptics such as EUSOL, Proflavin and Chlorhexadine and packed tightly into the wound cavity. Although never substantiated, the theory was that this would keep the wound margins apart, allowing the wound to granulate from the base upwards.

Research carried out on the effect of antiseptics began a crusade in United Kingdom (UK) nursing journals that led to a ban on their use in wound management. This movement was predominately based on the work carried out by Brennan and Leaper, as they demonstrated that certain antiseptics appeared, at least in vivo, would delay healing.

The focus was taken away from the use of gauze as a potentially harmful dressing material, to the solution in which it was soaked and nurses began to replace antiseptics with physiological saline. This failed to address the issues regarding the use of gauze, with practitioners believing that they were now using a harmless solution, that is saline on the wound surface.

Saline is an isotonic solution, but as water evaporates from the saline dressing, it becomes hypertonic and draws fluid from the wound into the gauze. Unless the gauze is re-moistened, the packing quickly dries out, becoming a hard ball. Subsequent removal will be painful for the patient and may even require a further visit to the operating theatre. However, these problems were often ignored or diminished as attention was drawn towards the antiseptic debate. It remains questionable whether the use of antiseptics was the real cause for concern, as solutions were generally never in contact with the wound in sufficient quantities or long enough to do the patient harm.