Review of closed dressings after laser resurfacing

BACKGROUND. Laser skin resurfacing has become an accepted technique for the treatment of facial rhytides and associated solar skin damage. Achieving a successful result is directly related to proper postoperative wound care d uring the reepithelialization process. There are open and closed approaches to the treatment of the post-laser resurfacing patient with distinct advan tages and disadvantages. OBJECTIVE. To review the most commonly used closed dressings after facial l aser skin resurfacing and compare their advantages and disadvantages. To co mpare clinical findings with a group of patients treated exclusively with a n open technique. METHODS. Review of composite foams, polymer film, polymer mesh, and hydroge l products and prospective observations of clinical outcomes of patients tr eated with each dressing category after facial laser skin resurfacing. We p erform a retrospective charr review of a group of patients treated exclusiv ely with an open technique comparing crust formation, comfort, and pruritus with the prospective group of patients treated with closed dressings. RESULTS. The closed dressings available today each have unique structural c onfigurations and adhesive properties intended to maintain an occlusive wou nd environment. Patient acceptance of these dressings was favorable, with i mproved comfort compared to the open dressing group. Complications of bacte rial infections and contact dermatitis were not observed when closed dressi ngs were used with a protocol for dressing changes performed at 48 hours. R ates of reepithelialization did not vary according to dressing category. Cr ust formation and postoperative pruritus occurred less frequently when clos ed occlusive dressings were worn by patients. CONCLUSIONS. When used properly, these dressings improve patient comfort, s implify their postoperative wound care, and do not increase the risk of inf ection or contact dermatitis. Overall satisfaction was highest with perfora ted mesh and polymer dressings for full-face wounds.