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PubMedDate not supplied

Randomized clinical trial of the effect of semi-occlusive dressings on the microflora and clinical outcome of acute facial wounds.

This study investigated whether treatment with occlusive, hydroactive polyurethane dressings affects the microflora and clinical outcome of acute wounds. A randomized, controlled trial was performed on 60 patients with acute facial lacerations. Following primary closure, patients were provided with either a dry-gauze dressing or a hydroactive polyurethane dressing (Cutinova Thin). The wounds were assessed clinically and microbiologically prior to closure, then after 5, 28 and 56 days. The dressing, which was removed at day 5, was also sent for microbiological culture. Wounds treated with the polyurethane dressing showed improved comfort and contour (p < 0.04), less erythema (p < 0.03) and less potential for scarring (p < 0.01) at day 5. At day 28 and day 56, there were no significant differences in the clinical assessment between the test and control groups (p > 0.05). A total of 518 isolates were recovered from the patients during the study. Mean number of isolates and bacterial growth density were calculated in both groups. A similar range of microorganisms were obtained from both treatment groups with no clear difference in organism colonization. This study shows the potential usefulness of facial wounds as a human model for studying acute wound healing responses and anti-scarring therapy. While short-term, clinical benefits of occlusive dressings were evident in the management of acute wounds, these data clearly show that all studies of scarring following acute wounding should extend over at least 3 months post-injury to allow for spontaneous improvement to occur.

Adolescent↗
PubMed2004

Moist exposed therapy: an effective and valid alternative to occlusive dressings for postlaser resurfacing wound care.

BACKGROUND: Laser resurfacing has now become an accepted and important component of facial rejuvenation. With the introduction of computerized scanning systems, the actual laser resurfacing technique has been greatly simplified; however, the final outcome still depends to a large extent on the efficiency of the postlaser wound care in promoting wound healing and preventing early and late complications. It has been repeatedly confirmed that a moist environment is the single most important external factor affecting the rate of re-epithelialization. Occlusive moisture-retentive dressings, however, are difficult to apply and maintain in position and may as well be complicated by serious infections. OBJECTIVE: Moist exposed burn ointment has been shown to maintain adequate moisture for optimal healing by frequent ointment application without the need for a secondary overlying dressing. It would be ideal for postoperative laser care. METHODS: Twenty-eight consecutive patients treated with coherent ultrapulse CO2 laser in Toulouse, France, were included in the trial. Moisture-retentive ointment was applied over the treated areas every 4 to 6 hours. Healing was assessed clinically and with repeated transepidermal water loss measurements. Swab cultures were taken, and pain was evaluated with a visual analog scale. Colorimetric analysis of pictures taken was statistically compared with picture analysis of 20 patients treated earlier with an occlusive dressing. RESULTS: Uneventful timely healing occurred in all patients with minimal pain and discomfort. Healing with moist exposed therapy resulted in faster recovery of cutaneous erythema, as evidenced by colorometry. CONCLUSION: Moist exposed burn ointment application can be safely considered a good and valid alternative to occlusive dressings for postoperative laser care.

Colorimetry↗
PubMed1984

A comparison of the morbidity associated with occlusive and non-occlusive dressings applied to peripheral intravenous devices.

In a non-randomized controlled study of the effects of an occlusive polymer dressing on the morbidity associated with intravenous (iv) cannulation, it was found that the polymer dressing adversely affected the rate of cannula tip colonization, but that this could not be generally related to an increased risk of thrombophlebitis. A strong association was found between Staphylococcus aureus colonization and thrombophlebitis. It is proposed that the materials, method of manufacture and the use to which the cannula is put are more important in the genesis of the minor complications of iv cannulation than the type of dressing.

Catheters, Indwelling↗
PubMed1992

Effect of occlusive dressings on the stratum corneum water holding capacity.

Occlusion of the skin is used in clinical dermatology to promote wound healing and to increase the transcutaneous penetration of topically applied drugs. These effects are related to the degree of occlusion exerted and depend on the physicochemical nature of the dressing. We have evaluated the effects of four different materials on the skin barrier and the stratum corneum water holding capacity (WHC) using the Plastic Occlusion Stress Test (POST). The following materials were compared: hydrocolloid dressing, polyurethane film, polyethylene film, and a plastic chamber. These devices were applied on the volar forearm for 24 hours in 10 healthy volunteers (mean age 32 +/- 4 years). Upon their removal, the stratum corneum WHC, measured as skin surface water loss (SSWL), was recorded continuously for 25 minutes using an Evaporimeter. SSWL decay curves showed significant differences between the occlusive materials (analysis of variance, p less than 0.01). Higher SSWL values were recorded in sites occluded with the plastic chamber, whereas the polyurethane film resulted in poor occlusive capacity. Hydrocolloid dressing and polyethylene gave similar responses with higher WHC values compared to polyurethane (p less than 0.05). The relevance of these findings to clinical dermatology in terms of wound healing and drug absorption is discussed.

Adult↗
PubMed1997

Evaluation of bacterial growth with occlusive dressing use on excoriated skin in the premature infant.

This study evaluated the effects of an occlusive (OpSite Flexigrid) dressing on bacterial growth over excoriated and the surrounding intact skin of eight premature infants. Cultures were obtained before placement and four days after dressing placement. An analysis of variance demonstrated significant increases in coagulase-negative Staphylococcus and overall total skin. No significant differences in bacterial growth occurred between intact skin underneath the dressing and that on the opposite side of the body post-dressing placement. Significant increases were found in bacterial concentrations for both intact and excoriated skin post-dressing placement. Small sample size and no between-subject design hinder generalization to the neonatal population.

Analysis of Variance↗