title: Faster healing and less pain in skin biopsy sites treated with an occlusive dressing.
abstract: We prospectively studied 174 patients on whom 226 unsutured parallel incisional (shave) and 3-mm punch skin biopsies were performed. Two wound-care programs, occlusive dressing therapy and conventional therapy, were compared. The biopsy sites were evaluated after 1 or 2 weeks for healing, pain, and infection. We found that healing was unrelated to the indication for biopsy or the patients' age, gender, or race. Occlusive dressing therapy-treated shave biopsy sites were 3.83 times more likely to be healed than those treated with conventional therapy. Regardless of the treatment method, a facial shave biopsy site was 3.6 times more likely to be healed than a biopsy site in other locations. No punch biopsy site had healed after 1 week. At 2 weeks, only 7% and 36% of conventional therapy- and occlusive dressing therapy-treated punch biopsy sites, respectively, had healed. Pain at the biopsy site was six times more common in both shave and punch biopsy sites treated with conventional therapy. The absence of pain with occlusive dressing therapy was significant for both types of biopsy. One punch biopsy site treated with conventional therapy became infected, and one treated with occlusive dressing therapy was suspected of being infected. Forty patients, who had biopsy sites treated with both therapies, preferred occlusive dressing therapy over conventional therapy by a ratio of 3:1 because of ease of wound care and lack of pain. We conclude that occlusive dressing therapy may be the wound management of choice for shave biopsy sites. Since punch biopsy sites do not heal readily, it may be more appropriate to suture them, at least until therapies are developed that more effectively speed their healing.
authors.affiliation: Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, FL 33101.
authors.forename: A J
authors.initials: AJ
authors.lastname: Nemeth
authors.forename: W H
authors.initials: WH
authors.lastname: Eaglstein
authors.forename: J R
authors.initials: JR
authors.lastname: Taylor
authors.forename: L J
authors.initials: LJ
authors.lastname: Peerson
authors.forename: V
authors.initials: V
authors.lastname: Falanga
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009779:Occlusive Dressings; D016017:Odds Ratio; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D017060:Patient Satisfaction; D011446:Prospective Studies; D012867:Skin / Q000473:pathology*; D013997:Time Factors; D014945:Wound Healing