Systematic review of dressings and topical agents for surgical wounds healing by secondary intention.
BACKGROUND
The best dressing for postoperative wounds healing by secondary intention is unknown.


METHODS
A systematic review was conducted to assess the effectiveness of dressings and topical agents on such wounds. Main endpoints were wound healing, pain, patient satisfaction, costs and hospital stay. Systematic methodological appraisal and data extraction were performed by independent reviewers.


RESULTS
Fourteen reports of 13 randomized clinical trials on dressings or topical agents (gauze, foam, bead, alginate and hydrocolloid dressing) for postoperative wounds healing by secondary intention were identified; they were of weak methodological quality. In general, no statistically significant differences in wound healing were found for various dressing comparisons (11 of 13 trials). Patients experienced significantly more pain (four of six trials) and were less satisfied when gauze was used (three of six trials). Gauze was inexpensive, but its use was associated with significantly more nursing time than dressing with foam (two of three trials). No substantial differences in hospital stay were found (four of five trials).


CONCLUSIONS
Only small, poor-quality trials exist, rendering the evidence insufficient. Foam is best studied as an alternative to gauze and appears to be preferable in terms of pain reduction, patient satisfaction and nursing time.
Vermeulen
H
H
Department of Surgery, Academic Medical Centre, Amsterdam, The Netherlands. H.Vermeulen@amc.uva.nl <H.Vermeulen@amc.uva.nl>
Ubbink
D T
DT
Goossens
A
A
de Vos
R
R
Legemate
D A
DA
D000287:Administration, Topical; D001458:Bandages; D003362:Cost-Benefit Analysis; D006801:Humans; D007902:Length of Stay; D009732:Nursing Care; D010149:Postoperative Pain / Q000209:etiology; D017060:Patient Satisfaction; D011182:Postoperative Care / Q000191:economics / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing