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Accelerated Healing of Full-Thickness Skin Wounds in a Wet Environment

Svensjö, Tor; Pomahac, Bohdan M.D.; Yao, Feng Ph.D.; Slama, Jaromir M.D.; Eriksson, Elof M.D., Ph.D.

Plastic and Reconstructive Surgery: September 2000 - Volume 106 - Issue 3 - p 602-612

Full-thickness skin wounds are preferably allowed to heal under controlled hydration dressings such as hydrocolloids. It was hypothesized that a wet (liquid) environment rather than a dry or moist one would accelerate the wound healing process. We compared skin repair by secondary intention in full-thickness skin wounds in wet (saline), moist (hydrocolloid), and dry (gauze) conditions in an established porcine wound healing model. The study included three animals with a total of 70 wounds layered in a standardized fashion on the back of young Yorkshire pigs. Twelve days after wounding, 0 percent of dry, 20 percent of moist, and 86 percent of saline-treated wounds were completely reepithelialized (p values = 0.0046 and 0.027 for saline wounds compared with dry and moist wounds, respectively). The accelerated healing was caused at least in part by faster contraction in wet wounds (p value < 0.005 compared with that of other groups 9 and 12 days after wounding). Development of granulation tissue was faster in moist conditions than it was for dry and wet wounds. The thickness and number of cell layers of the newly formed epidermis were greater in dry and wet wounds than in moist ones. It was concluded that these full-thickness porcine skin wounds healed faster in a wet environment than in a moist one. Dry wounds healed more slowly than moist wounds.

The basic mechanisms of skin wound repair were influenced by the treatment modality as demonstrated by the observed differences in granulation tissue formation, reepithelialization, and rate of wound contraction. (Plast. Reconstr. Surg. 106: 602, 2000.)

Boston, Mass., and Malmö, Sweden

From the Laboratory of Tissue Repair and Gene Transfer, Division of Plastic Surgery, Brigham and Women’s Hospital, Harvard Medical School; and the Department of Plastic and Reconstructive Surgery, Malmö University Hospital.

Received for publication November 12, 1998;

revised December 1, 1999.

Elof Eriksson, M.D., Ph.D. Division of Plastic Surgery Brigham and Women’s Hospital 75 Francis Street Boston, Mass. 02115

Presented at the Annual Clinical Congress of the American College of Surgeons, in Chicago, Illinois, October 12 through 17, 1997.

©2000American Society of Plastic Surgeons