Closed dressings after laser skin resurfacing.
OBJECTIVE
To evaluate the safety, efficacy, and patient acceptance of closed dressings after full facial resurfacing with the carbon dioxide laser.


METHODS
Prospective cohort of men and women undergoing full facial carbon dioxide laser resurfacing.


METHODS
Ambulatory surgical center at a university hospital.


METHODS
Forty consecutive patients randomized to 1 of 4 dressing groups.


METHODS
All patients underwent full facial resurfacing with a carbon dioxide laser system. One of 5 closed dressings (single- or 3-layer composite foam, plastic mesh, hydrogel, or polymer film) was placed immediately after the procedure. Closed dressings were changed on postoperative day 2 and removed on postoperative day 4.


METHODS
Objective postoperative criteria of erythema, scarring, reepithelialization, and surface irregularities were recorded and photodocumented. Comparisons were made among the closed dressing groups as well as with a group of historical control subjects treated with open dressings. The ease of application, office time for preparation and application, and cost of the individual dressings were collected. Patient characteristics of overall acceptance, comfort, and ease of maintenance were recorded with a visual analog scale.


RESULTS
There were no complications of scarring, surface irregularities, or contact dermatitis from the application or maintenance of the closed dressings. There were no significant differences in the number of days of postoperative erythema or in the rate of facial reepithelialization among the groups. Most patients preferred not to continue with the closed dressings past 2 days. Positive features from the use of closed dressings included reduction in crust formation, decreased pruritus, decreased erythema, and decreased postoperative pain, compared with historical controls. Negative features included time in preparation and application of the dressings. Costs ranged from $9.79 to $50 per dressing change.


CONCLUSIONS
Closed dressings are safe and offer benefits noted during the first 4 postoperative days. Patients can be expected to maintain a closed dressing for at least 24 hours but no longer than 4 days. The positive features of closed dressings and patient acceptance outweigh the cost and office time involved with their application and maintenance.
Division of Otolaryngology-Head and Neck Surgery, Stanford University Hospital, Calif, USA.
J P
JP
Newman
R J
RJ
Koch
R L
RL
Goode
D000328:Adult; D000556:Ambulatory Surgical Procedures; D062109:Dermatologic Surgical Procedures; D005145:Face / Q000601:surgery*; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009779:Occlusive Dressings / Q000191:economics*; D010147:Pain Measurement; D017060:Patient Satisfaction; D011183:Postoperative Complications; D011300:Preoperative Care; D011446:Prospective Studies; D014945:Wound Healing