Composite dressings for improved granulation and reduced maceration with negative-pressure treatment

1. A dressing for treating a tissue site with negative pressure, the dressing comprising:

a sealing layer including apertures disposed through a periphery and an interior portion of the sealing layer;

a first film adjacent to the sealing layer and comprising a non-porous material and a plurality of fluid restrictions, wherein one or more of the fluid restrictions is registered with at least one of the apertures in the interior portion, wherein the fluid restrictions extend entirely across the first film;

a first manifold layer adjacent to the first film and opposite the sealing layer, the first manifold layer comprising a second film of a transparent material having a manifold area comprising blisters and apertures, wherein the apertures in the second film are configured to allow fluid transfer through the second film;

a second manifold layer adjacent to the first manifold layer, the second manifold layer comprising foam having a contact area that is less than the manifold area; and

a cover configured to be positioned over the first manifold layer and in contact with at least a portion of the first manifold layer.

2. The dressing of claim 1 , wherein at least the first film is configured to be positioned in a stacked relationship between the second manifold layer and the tissue site.

3. The dressing of claim 1 , wherein:

the manifold area has a first shape;

the contact area has a second shape;

the first shape is analogous to the second shape; and

the manifold area comprises a border area around the contact area.

4. The dressing of claim 1 , wherein the contact area comprises porous appendages adjacent to the manifold area.

5. The dressing of claim 4 , wherein the porous appendages comprise at least three radial appendages adjacent to the manifold area.

6. The dressing of claim 1 , wherein the contact area comprises:

a central region; and

at least three porous appendages coupled to the central region.

7. The dressing of claim 1 , wherein the contact area comprises:

a central region; and

at least three porous appendages coupled to the central region and extending to an edge of the manifold area.

8. The dressing of claim 1 , wherein the transparent material comprises polyurethane or polyethylene.

9. The dressing of claim 1 , wherein the foam is a hydrophobic polymer foam.

10. The dressing of claim 1 , wherein the foam is reticulated open-celled foam.

11. The dressing of claim 1 , wherein the foam is reticulated polyurethane ether foam.

12. The dressing claim 1 , wherein the foam is porous and has an average pore size in a range of 400-600 microns.

13. The dressing of claim 1 , wherein the foam has a thickness in a range of 2 millimeters to 7 millimeters.

14. The dressing of claim 1 , wherein the blisters are spaced about 2 millimeters apart.

15. The dressing of claim 1 , wherein the blisters have a height of about 0.5 millimeters to about 2 millimeters.

16. The dressing of claim 1 , wherein the blisters have a width of about 1 millimeter to about 3 millimeters.

17. The dressing of claim 1 , wherein the second manifold layer is substantially opaque.

18. The dressing of claim 1 , wherein:

the blisters are spaced about 2 millimeters apart;

the blisters have a height of about 1.5 millimeters; and

the blisters have a diameter of about 1.5 millimeters.

19. A method for treating a tissue site, comprising:

positioning a dressing on the tissue site, the dressing comprising:

a sealing layer including apertures disposed through a periphery and an interior portion of the sealing layer,

a first film adjacent to the sealing layer and comprising a non-porous material and a plurality of fluid restrictions, wherein the fluid restrictions extend entirely across the first film,

a first manifold layer adjacent to the first film and opposite the sealing layer, the first manifold layer comprising a second film of a transparent material having a manifold area comprising blisters and apertures, and

a second manifold layer adjacent to the first manifold layer, the second manifold layer comprising foam having a contact area that is less than the manifold area;

inspecting the position of the dressing against areas of the tissue site by visualizing the areas of the tissue site through at least a border area around the contact area; and

adjusting the position of the dressing so that the manifold area of the dressing substantially corresponds to areas of the tissue site within borders of the tissue site.

20. The method of claim 19 , further comprising applying negative pressure to the dressing.

21. The method of claim 19 , wherein at least the first film is positioned in a stacked relationship between the second manifold layer and the tissue site.

22. The method of claim 19 , wherein the manifold area comprises the border area around the contact area.

23. The method of claim 19 , wherein the contact area comprises at least three appendages adjacent to the manifold area.

24. The method of claim 19 , wherein the transparent material comprises polyurethane or polyethylene.

25. The method of claim 19 , wherein the foam has a thickness in a range of 4 millimeters to 10 millimeters.

26. The method of claim 19 , wherein the blisters have a height of about 0.5 millimeters to about 2 millimeters.

27. The dressing of claim 1 , wherein the interior portion of the sealing layer corresponds to a surface area of the first film.

28. The dressing of claim 1 , wherein the sealing layer is coupled to the cover.