Prospective cohort study on surgical wounds comparing a polyhexanide-containing biocellulose dressing with a dialkyl-carbamoyl-chloride-containing hydrophobic dressing.
OBJECTIVE
Postsurgery dressing changes in diabetic foot amputation wounds and surgical wounds healing by secondary intention are often conducted in the operating room under general anesthesia. A prospective comparative cohort study was performed in 60 patients (n = 60: n = 30/n = 30) with secondary-intention surgical wounds (82% had forefoot and/or digit[s] amputations) to compare 2 different dressing types.


METHODS
Patients at the study center gave informed written consent, after which they were randomly allocated to one of the treatment groups. Group A received a biocellulose dressing with polyhexanide, and group B a hydrophobic dressing with dialkyl-carbamoyl-chloride. In both groups, gauze was used as secondary dressing and fixed with a film dressing. One day after surgery, the dressings were removed by the surgeon and patient-reported pain and dressing adherence/integrity were evaluated. The number of patients that required general anesthesia was determined during the procedure and afterward.


RESULTS
All patients (n = 60; n = 30/n = 30) were included in the intention-to-treat analysis. Pain levels in group A were significantly (t (59) = 4.026, P < .000) lower upon dressing removal, when compared with group B; in group A, n = 21 reported no pain versus n = 8 (26%) for group B. In group A, the dressing adhered in 7 subjects (23%) versus n = 27 (90%) of cases in group B (P = .000). No anesthesia was required for the patients in group A, contrary to group B, where 16% of patients received general anesthesia for dressing removal.


CONCLUSIONS
Pain levels were significantly lower and the dressing adhered significantly less in group A, compared with group B, demonstrating a better quality of life for the patients in group A.
University Center for Wound Healing, Odense University Hospital, Odense, Denmark.
Anna Marie
AM
Nielsen
Anneke
A
Andriessen
D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D001458:Bandages; D001645:Biguanides / Q000627:therapeutic use*; D001672:Biocompatible Materials / Q000627:therapeutic use*; D015331:Cohort Studies; D017719:Diabetic Foot / Q000628:therapy*; D005260:Female; D006801:Humans; D057927:Hydrophobic and Hydrophilic Interactions; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000209:etiology; D010147:Pain Measurement; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000517:prevention & control*; D014945:Wound Healing / Q000502:physiology*
D000890:Anti-Infective Agents; D001645:Biguanides; D001672:Biocompatible Materials; C031233:polihexanide