A dressing for treating a tissue site with negative pressure may comprise a cover having an adhesive, a manifold, a perforated polymer film, and a perforated silicone gel having a treatment aperture. The cover, the manifold, the perforated polymer film, and the perforated silicone gel may be assembled in a stacked relationship with the cover and the perforated silicone gel enclosing the manifold. The perforated polymer film may be at least partially exposed through the treatment aperture, and at least some of the adhesive may be exposed through the perforated silicone around the treatment aperture.