Report of a prospective trial of dextranomer beads (Debrisan) and silicone foam elastomer (Silastic) dressings in surgical wounds. A comparison of dressings in the management of surgical abdominal wounds. [Silastic foam dressing compared with mèche-treatment in open management following excision of a pilonidal cyst]. Dressings for treating cavity wounds. The cost effectiveness of dextranomer and eusol in the treatment of infected surgical wounds. Effect of hydrocolloid dressings on healing by second intention after excision of pilonidal sinus.
A prospective randomized controller trial of dextranomer beads (Debrisan) and silicone foam elastomer (Silastic) dressings in open infected surgical wounds has been performed. The results indicate that the healing time for wounds treated by Debrisan (n = 25) and elastomer (n = 25) is similar, being 40.92 +/- 3.98 and 36.90 +/- 3.18 days respectively. The time taken for wounds to become pain-free was similar in both treatment groups, as was the persistence of signs in the wounds of erythema, oedema and slough. Comparison of cost reveals the elastomer dressing to be considerably cheaper than Debrisan. This prospective randomised trial compared the performance of three dressing protocols in the management of 36 dehisced surgical abdominal wounds: a standard alginate; a gauze moistened with sodium hypochlorite (0.05%); and a combine dressing pad. Outcomes assessed were: healing time (cm2 per day and cm3 per day), patient comfort (pain and satisfaction) and cost. There were no statistically significant differences in healing rates between the three groups but there was a trend for the combine dressing pad protocol to produce a greater reduction in wound area. The combine dressing pad protocol performed well when compared with the calcium alginate in terms of healing time, patient comfort and cost. Maximum pain was significantly greater (p = 0.011) and satisfaction significantly lower among patients who received the sodium hypochlorite protocol. Costs during the in-patient phase were also substantially higher for the sodium hypochlorite protocol. Trial results support the view that sodium hypochlorite dressing protocols for surgical wounds should be abandoned. nan Two treatment protocols for the management of patients with non-infected cavity wounds were studied, using data obtained from both the community and the outpatients clinic. Patients were treated with either a polyurethane foam hydrophilic dressing (Allevyn) or a calcium sodium alginate dressing (Kaltostat). Although alginate fibres were found to be incorporated in tissue, both dressing regimes were found to be easy to use, effective and acceptable to patients and clinicians. nan To assess the efficacy of hydrocolloid dressings in wound management after excision of pilonidal sinus.
                Prospective randomised trial.
                District hospital, Spain.
                38 patients with chronic pilonidal sinus.
                Open excision with healing by second intention. Divided into three groups: conventional gauze dressing (control, n = 15), Comfeel (n = 12) and Varihesive (n = 11).
                Median healing time, infection rate, intolerance, pain, comfort, ease of management, leakage, and recurrence.
                Median healing time was 68 days (range 33-168) in the control group, compared with 65 days (range 40-137) in the two hydrocolloid groups combined. There were no differences between the hydrocolloid groups. There were no recurrences during the 74 months of follow-up. A third of the postoperative cultures in the control group grew pathogens compared with 1/23 of the patients treated with hydrocolloid dressings (p = 0.03). This was of no clinical relevance. 14/23 in the hydrocolloid group developed leaks. Pain was significantly less in the first four postoperative weeks among the patients in the hydrocolloid group than in the control group (p < 0.05).
                Hydrocolloid dressings lessen pain and increase comfort for patients after excision of pilonidal sinus, though time to healing is no shorten than when a conventional gauze dressing is used.
We found only small, poor quality trials; the evidence is therefore insufficient to determine whether the choice of dressing or topical agent affects the healing of surgical wounds healing by secondary intention. Foam is best studied as an alternative for gauze and appears to be preferable as to pain reduction, patient satisfaction and nursing time.