Occlusive vs Gauze Dressings for Local Wound Care in Surgical Patients

Abstract

Patients: Two hundred eighty-five hospitalized surgical patients with open wounds. Intervention: Patients received occlusive (ie, foams, alginates, hydrogels, hydrocolloids, hydrofibers, or films) or gauze-based dressings until their wounds were completely healed. Main Outcome Measures: Primary end points were complete wound healing, pain during dressing changes, and costs. Secondary end point was length of hospital stay. Results: Time to complete wound healing did not differ significantly between occlusive (median, 66 days; interquartile range [IQR], 29-133 days) and gauze-based dressing groups (median, 45 days; IQR, 26-106 days; log-rank P=.31). Postoperative wounds (62% of the wounds included) healed significantly (P=.02) quicker using gauze dressings (median, 45 days; IQR, 22-93 days vs median, 72 days; IQR, 36-132 days). Median pain scores were low and similar in the occlusive (0.90; IQR, 0.29-2.34) and the gauze (0.64; IQR, 0.22-1.95) groups (P=.32). Daily costs of occlusive materials were significantly higher (occlusive, €6.34 [US $9.95] vs gauze, €1.85 [US $2.90]; P Ͻ .001), but nursing time costs per day were significantly higher when gauze was used (occlusive, €1.28 [US $2.01] vs gauze, €2.41 [US $3.78]; PϽ .001). Total cost for local wound care per patient per day during hospitalization was €7.48 (US $11.74) in the occlusive group and €3.98 (US $6.25) in the gauze-based group (P=.002). Conclusions: The occlusive, moist-environment dressing principle in the clinical surgical setting does not lead to quicker wound healing or less pain than gauze dressings. The lower costs of less frequent dressing changes do not balance the higher costs of occlusive materials.

Effect of moist dressing, collagen sheet dressing and epidermal growth factor in healing of chronic wounds

“…5 Healing rates in non-adherent dressing group co-relates with the results of study by Ubbink DT et al 2008. 26 Similar were the findings in study by Dagilatis R et al 25 The present study results of collagen group are correlating with studies by Sundarrajan CR et al showing epithelization in 7-15 days. 23 Whereas Jansson K et al found complete epithelization in 7 days.…”

Evidence-Based Care of Acute Wounds: A Perspective

“…11,19 Small or superficial acute wounds may dry uncovered (WG). The dressing choice should depend on the circumstances of the patient and wound (change frequency, leakage, and pain) (WG).…”

“…Showering the wound area (for < 10 min) is allowed 24 h after surgical wound closure in a hospital, if the patient wishes to do so. 19. If there is a prosthesis beneath the wound, then showering the wound area (for < 10 min) is allowed after 48 h if there are no signs of infection and the treating surgeon agrees.…”

Possible impact of continuous drainage after minimally invasive partial nephrectomy

“…4). The early postoperative inflammatory reaction was caused mainly by neutrophils, lymphocytes, and macrophages migrating to the surgical site [9][10][11][12]. To investigate this phenomenon further, the exact numbers and increased levels of neutrophils, lymphocytes, and monocytes in the blood were measured pre-and postoperatively.…”