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    Critical factors in healing acute wounds

    Base decisions on well-done clinical trials to provide best patient care

     

    Getting moisture on sutures doesn’t matter

    Dermatologists and other doctors might instruct patients not to get their sutures wet. But researchers have shown that people who get their sutures wet with normal bathing have no increased infection risk, according to Dr. Kirsner.

    Cutaneous sutures don’t matter

    The general thinking in medicine is that cutaneous suturing may lead to better cosmetic results. But researchers, according to Dr. Kirsner, have found no significant difference in cosmetic results after closing with deep with buried sutures, whether Steri-Strips (3M) or cutaneous sutures were used. They’ve also studied (and found no differences) when after placing deep buried sutures, whether Steri Strips versus not closing the wound on the epidermis at all.

    “So, when you close the wound, you may not need to put superficial stitches in at all, but it is important to apply an occlusive dressing,” Dr. Kirsner says.

    Everting the wound? Matters not.

    “People ask: What about everting the wound, and do you need cutaneous stitches to evert the wound? One study showed no difference in wound eversion versus no wound eversion at three months follow up,” Dr. Kirsner says. “It’s something that we’re taught, but it may not be important to evert the wound at the time of wound closure.”  

    Ointment beneath occlusive dressing doesn’t matter

    Some providers put an ointment underneath the occlusive dressing—a practice researchers have found makes no difference in wound healing.

    “…it made no difference with regard to infection if you put an antibiotic ointment, no ointment or a Vaseline ointment as long as you put an occlusive dressing on.  After that you don’t need to add additional occlusion with an ointment,” Dr. Kirsner says.

    Keeping up with the latest findings in wound care matters, according to Dr. Kirsner.

    “I think that in order to make sure that we’re giving the state-of-the-art or standard of care to our patients, we want to keep abreast of the literature,” he says. “We shouldn’t only rely on what we were taught in residency and what our teachers did, but rather base on decisions from well done clinical trials.”  

    Disclosure: Dr. Kirsner reports no relevant disclosures.

    Lisette Hilton
    Lisette Hilton is president of Words Come Alive, based in Boca Raton, Florida.

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