Background
There is no universally accepted protocol of topical wound care after cutaneous surgical procedures. The current practice is to use petrolatum‐based products, commonly containing topical antibiotics. The rise in antibiotic‐resistant bacteria and increased risk of allergic and contact dermatitis due to the use of topical antibiotics is well established.
Objective
To compare the prevalence of contact dermatitis, the infection rate and the subjective measures of healing of a novel, antibiotic‐free, film‐forming silicone‐based wound dressing to a topical triple antibiotic petrolatum‐based ointment in patients undergoing invasive dermatological interventions in two arms: (1) Mohs micrographic surgery (MMS) and (2) a combination of various routine dermatologic surgical procedures.
Design
The 231 patients were enrolled in this open‐label, randomized, single‐blinded study. Patients applied the products immediately after surgery and daily afterwards. Clinicians evaluated the surgical site for infection or contact dermatitis at all follow‐up visits. Acute wound healing progression was assessed using a rating scale against clinical experience and expected results from −4 (much worse) to +4 (much better).
Results
Contact dermatitis was significantly decreased in the wound dressing group compared to the topical antibiotic group (0 vs 15.9%,
P
< 0.001). There was no difference between the study arms (Mohs vs. non‐Mohs,
P
= 0.242). Infection rate was not significantly different between the groups (
P
> 0.05) and between the study arms (
P
> 0.05). Assessor‐rated secondary outcomes like healing time, healing quality, erythema and new tissue quality were significantly better in the wound dressing group, while comfort and perceived overall satisfaction were better in the antibiotic group. Patient‐rated outcomes did not show any difference between groups and between study arms.
Conclusion
The wound dressing used in this study is a topical silicone gel preparation and presents a viable alternative to topical antibiotics for postoperative wound care without enhancing the risk of infection.
This paper introduces a new multi-zone completion technology (MZCT) to stimulate multiple stages in a horizontal wellbore that is either cased using external packers or cemented into place. In both scenarios, a liner assembly containing specialized collars with predrilled ports that are covered by burst disks is run into the horizontal section of a wellbore. There are no restrictions on the number of collars that can be run, nor the spacing between them. After the assembly is set, coiled tubing is used to complete each interval using a cup/cup assembly that straddles each specialized collar, and then pressures up to open the burst ports. The fracture is then initiated through the coil string into the reservoir, with the coiled tubing moving along the horizontal wellbore from the toe to the heel, the process being repeating against each specialized collar.Advantages of this new system include no limits to the number of stages that can be completed, full bore diameter available following the stimulations without the cost of milling out mechanical ports, and the ability to do re-completions on the same intervals at a later date. The liner with the burst collars can be used with packers or cemented in, additional collars can be run and stimulated at a later date, and the completion is more cost effective than current alternatives. This paper discusses the application of the cemented burst collars on the Viking formation in the Redwater field of Alberta and Plato field of SW Saskatchewan. Comparisons are made between the burst collar system and previous completion systems used in the Viking. Recognized benefits include reduced downtime during operations after a screen-out and tighter spacing between fracs in a cemented liner application as opposed to perforating.
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