Hydrocoloidal dressings in surgical wounds healing by second intention
Keywords:
HYDROCOLOIDAL SALES, OCCLUSIVE DRESSINGS, WOUND HEALINGAbstract
Introduction: in certain cases it is impossible or technically difficult to close surgical wounds using simple methods or local skin flaps, so options to reconstruct the area are limited to using a loose skin graft or healing by second intention.
Objective: to assess healing by second intention using hydrocoloidal dressings.
Methods: a therapeutic trial was carried out with twelve patients between 14 and 74 years old (average age 47), who presented wounds with medical surgery indication and that, due to their nature or topography were technically difficult, or even at times impossible to close using simple methods or with plasty local flap closure. In all cases patients received treatment with hydrocoloidal dressings to promote healing by second intention.
Results: all patients evidenced reepitelization of the surgical defect. Reepitelization occurred within 20 to 90 days (average time was 31 days. No infections in the wound were detected in any case. Two patients reported slight pain, other two slight discomfort and two more were not satisfied with the esthetic results. 80% of patients declared no pain or discomfort at all, and concluded esthetic results were good.
Conclusions: this therapeutic trial carried out with a few patients proved hydrocoloidal dressings appear to be a promising option for wounds caused in dermathological surgeries, healing by second intention.
References
(2) Eaglstein W. Moist wound healing with occlusive dressings: a clinical focus. Dermatol Surg 2001; 27(2): 175-81.
(3) Vermeulen H, Ubbink DT, Goossens A, de Vos R, Legemate DA. Systematic review of dressings and topical agents for surgical wounds healing by secondary intention. Br J Surg 2005; 92(6): 665-72.
(4) Bouza C, Muñoz A, Amate JM. Efficacy of modern dressings in the treatment of leg ulcers: a systematic review. Wound Repair Regen 2005; 13(3): 218-29.
(5) Mulder GD, Altmann M, Seeley JE, Tintle T. Prospective randomized study of the efficacy of hydrogel, hydrocolloid, and saline solution-moistened dressings on the management of pressure ulcers. Wound Repair Regen 1993; 1(4): 213-8.
(6) Moreno-Arias GA, Izento-Menezes CM, Carrasco MA, Camps-Fresneda A. Second intention healing after Mohs micrographic surgery. J Eur Acad Dermatol Venereol 2000; 14(3):159-65.
(7) Hultén L. Dressings for surgical wounds. Am J Surg 2004; 167(1A): 42S-45S.
(8) Hormbrey E, Pandya A, Giele H. Adhesive retention dressings are more comfortable than alginate dressings on split-skin-graft donor sites. Br J Plast Surg 2003; 56(3): 498-550.
(9) Viciano V, Castera JE, Medrano J, Aquiló J, Torro J, Botella MG, et al. Effect of hydrocolloid dressings on healing by second intention after excision of pilonidal sinus. Eur J Surg 2000; 166(3): 229-32.
(10) Foley GB, Allen J. Wound healing after toenail avulsion. A comparison of Kaltostat and Melolin as postoperative dressings. The Foot 1994; 4: 88-91
(11) Glenn MJ, Bennett RG, Kelly AP. Acne keloidalis nuchae: treatment with excision and second-intention healing. J Am Acad Dermatol 1995; 33(2 Pt. 1): 243-6.
(12) Kittelberger K, LeBel A, Borsook D. Valoración del dolor. En: Borsook D, LeBel A, Mc Peek B, eds. Massachusets General Hospital tratamiento del dolor. Madrid: Marban, 1999: 26-43.
(13) Goetze S, Ziemer M, Kaatz M, Lipman RD, Elsner P. Treatment of superficial surgical wounds after removal of seborrheic keratoses: a single-blinded randomized-controlled clinical study. Dermatol Surg 2006; 32(5): 661-8.