EFFECTS OF OCCLUSIVE AND CONVENTIONAL GAUZE DRESSINGS ON INCISIONAL HEALING AFTER ABDOMINAL OPERATIONS

Objective: To compare the effect of occlusive (Comfeel) and convention al (Mepore) dressings on the healing of incisional wounds after abdomi nal operations. Design: Prospective randomised study. Setting: Laborat ory and teaching hospital, Denmark. Subjects: 73 patients who underwen t clean operations requiring incisions longer than 5 cm between August 1993 and August 1995 were randomised to have their wounds dressed wit h either Comfeel or Mepore. Interventions: Comfeel was left on until t he sutures were removed, and Mepore was removed 2 days postoperatively . Main outcome measures: Infection, adherence, leakage, and cosmetic a ppearance three months later. Results: 36 patients were randomised to have Comfeel and 37 to have Mepore. 29 patients were withdrawn from th e study (20 having Mepore and 9 having Comfed) leaving 26, and 17 for analysis, respectively. Wound infections developed in 1 patient in the Comfeel group and 5 in the Mepores group (p = 0.2). There were no dif ferences between the groups regarding the need for dressings to be cha nged, the incidence of leakage, or loosening of the dressing from the skin. Comfeel adhered securely to the skin and remained more or less t ransparent until sutures were removed. It remained totally transparent in 23 (64%), and no dressing became totally opaque. There were no dif ferences in cosmetic appearance after three months. We had the impress ion that patients who had Comfeel were more comfortable and found it e asier to mobilise and carry out their daily activities. Conclusion: Oc clusive dressings stay in place and stay transparent, and do not incre ase the risk of wound infection. They may even be more comfortable. th ey are a reasonable alternative to conventional dressings.