Although low cost and possessing good tensile properties, cotton gauze provides little or no moist healing because it allows rapid evaporation of moisture that results in a dry desiccated wound bed which is a significant issue with burn wounds since water loss tends to occur at a much greater rate even when covered (Samke, L. O., et al., Bums, 3: 159-165 (1977)). Alginate dressings usually require a secondary dressing for application and have little or no elasticity for stretching freely over joints. Thus, the combination of occlusion and gelation with elasticity and conformability in a single wound dressing would provide advantages over current wound dressings. A wound dressing was prepared with cotton and alginate, wherein the alginate was crosslinked and grafted through a polycarboxylic acid ester bond to the celluose of stretch cotton gauze. The resulting properties of being elastic and highly absorbent dressing when combined with targeting the pathophysiology of chronic wounds of high protease levels make this dressing attractive for commercialization. The process of research and development of the alginate-cotton dressing will be discussed.