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June 1988, Vol 124, No. 6 >
Article | June 1988

Occlusive Wound Dressings: Title and subTitle BreakWhy, When, Which?

Vincent Falanga, MD
[+] Author Affiliations

Accepted for publication March 9, 1988.

Reprints not available.


From the Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine.


Arch Dermatol. 1988;124(6):872-877. doi:10.1001/archderm.1988.01670060018009
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For more than a century, the practice of dressing a wound has had as one of its major rationales the prevention of infection. Dressings can theoretically protect the wound from gross microbial contamination and help to prevent the spread of infection to other patients on the surgical ward. In this setting, one thinks of dressings as a barrier between the wound and the outside world. It is a relatively novel idea that the composition and properties of the dressing itself can play a major role in modifying the wound microenvironment. In the span of a decade, three key observations have helped physicians think of dressings as pharmacologic agents. Odland1 first observed in 1958 that a blister healed faster if left unbroken. Then, in a 1962 landmark article, Winter2 showed that occlusion of wounds with a polyethylene film (Polythene) more than doubled wound epithelialization in domestic pigs. Finally, Hinman

REFERENCES

1 +
Odland G:  The fine structure of the interrelationship of cells in the human epidermis . J Biophys Biochem Cytol 1958;;4:529-535.
2 +
Winter GD:  Formation of scab and the rate of epithelialization of superficial wounds in the skin of the young domestic pig . Nature 1962;;193:293-294.
3 +
Hinman CD, Maibach H:  Effect of air exposure and occlusion on experimental human skin wounds . Nature 1963;;200:377-378.
4 +
Eaglstein WH, Mertz PM, Falanga V:  Occlusive dressings . Am Fam Physician 1987;;35:211-216.
5 +
Eaglstein WH, Mertz PM:  New method for assessing epidermal wound healing: The effects of triamcinolone acetonide and polyethelene film occlusion . J Invest Dermatol 1978;;71:382-384.
6 +
Rovee DT:  Effect of local wound environment on epidermal healing , in Maibach HL, Rovee DT (eds): Epidermal Wound Healing . Chicago, Year Book Medical Publishers Inc, 1972;, pp 159-181.
7 +
Barnett A, Berkowitz RL, Mills R, et al:  Comparison of synthetic adhesive moisture vapor permeable and fine mesh gauze dressings for split-thickness skin graft donor sites . Am J Surg 1983;;145:379-381.
8 +
Mandy SH:  A new primary wound dressing made of polyethylene oxide gel . J Dermatol Surg Oncol 1983;;9:153-155.
9 +
Linsky CB, Rovee DT, Dow T:  Effect of dressing on wound inflammation and scar tissue , in Dineen P, Hildick-Smith G (eds): The Surgical Wound . Philadelphia, Lea & Febiger, 1981;, pp 191-206.
10 +
Winter GD:  Epidermal regeneration studied in the domestic pig , in Maibach HL, Rovee DT (eds): Epidermal Wound Healing . Chicago, Year Book Medical Publishers Inc, 1972;, pp 71-112.
11 +
Alvarez OM, Mertz PM, Eaglstein WH:  The effect of occlusive dressings on collagen synthesis and re-epithelialization in superficial wounds . J Surg Res 1983;;35:142-148.
12 +
Leipziger LS, Glushko V, DiBernardo B, et al:  Dermal wound repair: Role of collagen matrix implants and synthetic polymer dressings . J Am Acad Dermatol 1985;;12:409-419.
13 +
Douglas DM:  Factors affecting the gain of tensile strength in healing wounds , in Illingworth C (ed): Wound Healing . Boston, Little Brown & Co Inc, 1966;, pp 233-241.
14 +
Eaton AC:  A controlled trial to evaluate and compare a sutureless skin closure technique (Op-Site skin closure) with conventional skin suturing and clipping in abdominal surgery . Br J Surg 1980;;67:857-860.
15 +
Buchan IA, Andrews JK, Lang SM:  Laboratory investigation of the composition and properties of pigskin wound exudate under Op-Site . Burns 1981;;8:39-46.
16 +
Nemeth AJ, Hebda PA, Eaglstein WH:  Stimulatory effect of human wound fluid on epidermal outgrowth from porcine skin explant cultures, abstracted . J Invest Dermatol 1986;;86:497.
17 +
Mertz PM, Eaglstein WH:  The effect of a semiocclusive dressing on the microbial population in superficial wounds . Arch Surg 1984;;119:287-289.
18 +
Katz S, McGinley K, Leyden JJ:  Semipermeable occlusive dressings . Arch Dermatol 1986;;122:58-62.
19 +
Eaglstein WH:  Experiences with biosynthetic dressings . J Am Acad Dermatol 1985;;12:434-440.
20 +
May SR:  Physiology, immunology, and clinical efficacy of an adherent polyurethane wound dressing: Op-Site , in Wise DL (ed): Burn Wound Coverings . Boca Raton, Fla, CRC Press, 1984;, pp 53-78.
21 +
Holland KT, Davis W, Ingham E, et al:  A comparison of the in vitro antibacterial and complement activating effect of Op-Site and Tegaderm dressings . J Hosp Infect 1984;;5:323-328.
22 +
Mertz PM, Marshall DA, Eaglstein WH:  Occlusive wound dressings to prevent bacterial invasion and wound infection . J Am Acad Dermatol 1985;;12:662-668.
23 +
Jaffe LF, Vanable JW:  Electric fields and wound healing , in Eaglstein WH (ed): Clinics in Dermatology: Wound Healing . Philadelphia, JB Lippincott, 1984;, pp 34-44.
24 +
Falanga V, Bourguignon GJ, Bourguignon LYW:  Electrical stimulation increases the expression of fibroblast receptors for transforming growth factor-beta, abstracted . J Invest Dermatol 1987;;88:488.
25 +
Eaglstein WH, Davis SC, Mehle AL, et al:  Optimal use of an occlusive dressing to enhance healing: Effect of delayed application and early removal on wound healing . Arch Dermatol 1988;;124:392-395.
26 +
Alper JC, Tibbetts LL, Sarazen AA:  The in vitro response of fibroblasts to the fluid that accumulates under a vapor-permeable membrane . J Invest Dermatol 1985;;84:513-515.
27 +
Friedman SJ, Su WPD:  Management of leg ulcers with hydrocolloid occlusive dressing . Arch Dermatol 1984;;120:1329-1336.
28 +
Alper JC, Welch EA, Ginsberg M, et al:  Moist wound healing under a vapor permeable membrane . J Am Acad Dermatol 1983;;8:347-353.
29 +
Angermeier MC, Alper JC, Urbaniak HS:  Vapor-permeable membrane therapy for ulcers of osteomyelitis . J Dermatol Surg Oncol 1984;;10:384-388.
30 +
Gorse GJ, Messner RL:  Improved pressure sore healing with hydrocolloid dressings . Arch Dermatol 1987;;123:766-771.
31 +
Mallory SB:  Adjunctive therapy for epidermolysis bullosa . J Am Acad Dermatol 1982;;6:951-952.
32 +
Eisenberg M:  The effect of occlusive dressings on reepithelializations of wounds in children with epidermolysis bullosa . J Pediatr Surg 1986;;21:892-894.
33 +
Alper JC, Welch EA, Maguire P:  Use of the vapor permeable membrane for cutaneous ulcers: Details of application and side effects . J Am Acad Dermatol 1984;;11:858-866.
34 +
Zitelli JA:  Delayed wound healing with adhesive wound dressings . J Dermatol Surg Oncol 1984;;10:709-710.
35 +
Varghese MC, Balin AK, Carter DM, et al:  Local environment of chronic wounds under synthetic dressings . Arch Dermatol 1986;;122:52-57.
36 +
Gilmore WA, Wheeland RG:  Treatment of ulcers on legs by pinch grafts and a supportive dressing of polyurethane . J Dermatol Surg Oncol 1982;;8:177-183.
37 +
Mertz PM, Marshall DA, Kuglar MA:  Povidone-iodine in polyethylene oxide hydrogel dressing . Arch Dermatol 1986;; 122:1133-1138.
38 +
Richmond JD, Sutherland AB:  A new approach to the problems encountered with Op-Site as a donor site dressing: Systemic ethamsylate . Br J Plast Surg 1986;;39:516-518.

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1 +
Odland G:  The fine structure of the interrelationship of cells in the human epidermis . J Biophys Biochem Cytol 1958;;4:529-535.
2 +
Winter GD:  Formation of scab and the rate of epithelialization of superficial wounds in the skin of the young domestic pig . Nature 1962;;193:293-294.
3 +
Hinman CD, Maibach H:  Effect of air exposure and occlusion on experimental human skin wounds . Nature 1963;;200:377-378.
4 +
Eaglstein WH, Mertz PM, Falanga V:  Occlusive dressings . Am Fam Physician 1987;;35:211-216.
5 +
Eaglstein WH, Mertz PM:  New method for assessing epidermal wound healing: The effects of triamcinolone acetonide and polyethelene film occlusion . J Invest Dermatol 1978;;71:382-384.
6 +
Rovee DT:  Effect of local wound environment on epidermal healing , in Maibach HL, Rovee DT (eds): Epidermal Wound Healing . Chicago, Year Book Medical Publishers Inc, 1972;, pp 159-181.
7 +
Barnett A, Berkowitz RL, Mills R, et al:  Comparison of synthetic adhesive moisture vapor permeable and fine mesh gauze dressings for split-thickness skin graft donor sites . Am J Surg 1983;;145:379-381.
8 +
Mandy SH:  A new primary wound dressing made of polyethylene oxide gel . J Dermatol Surg Oncol 1983;;9:153-155.
9 +
Linsky CB, Rovee DT, Dow T:  Effect of dressing on wound inflammation and scar tissue , in Dineen P, Hildick-Smith G (eds): The Surgical Wound . Philadelphia, Lea & Febiger, 1981;, pp 191-206.
10 +
Winter GD:  Epidermal regeneration studied in the domestic pig , in Maibach HL, Rovee DT (eds): Epidermal Wound Healing . Chicago, Year Book Medical Publishers Inc, 1972;, pp 71-112.
11 +
Alvarez OM, Mertz PM, Eaglstein WH:  The effect of occlusive dressings on collagen synthesis and re-epithelialization in superficial wounds . J Surg Res 1983;;35:142-148.
12 +
Leipziger LS, Glushko V, DiBernardo B, et al:  Dermal wound repair: Role of collagen matrix implants and synthetic polymer dressings . J Am Acad Dermatol 1985;;12:409-419.
13 +
Douglas DM:  Factors affecting the gain of tensile strength in healing wounds , in Illingworth C (ed): Wound Healing . Boston, Little Brown & Co Inc, 1966;, pp 233-241.
14 +
Eaton AC:  A controlled trial to evaluate and compare a sutureless skin closure technique (Op-Site skin closure) with conventional skin suturing and clipping in abdominal surgery . Br J Surg 1980;;67:857-860.
15 +
Buchan IA, Andrews JK, Lang SM:  Laboratory investigation of the composition and properties of pigskin wound exudate under Op-Site . Burns 1981;;8:39-46.
16 +
Nemeth AJ, Hebda PA, Eaglstein WH:  Stimulatory effect of human wound fluid on epidermal outgrowth from porcine skin explant cultures, abstracted . J Invest Dermatol 1986;;86:497.
17 +
Mertz PM, Eaglstein WH:  The effect of a semiocclusive dressing on the microbial population in superficial wounds . Arch Surg 1984;;119:287-289.
18 +
Katz S, McGinley K, Leyden JJ:  Semipermeable occlusive dressings . Arch Dermatol 1986;;122:58-62.
19 +
Eaglstein WH:  Experiences with biosynthetic dressings . J Am Acad Dermatol 1985;;12:434-440.
20 +
May SR:  Physiology, immunology, and clinical efficacy of an adherent polyurethane wound dressing: Op-Site , in Wise DL (ed): Burn Wound Coverings . Boca Raton, Fla, CRC Press, 1984;, pp 53-78.
21 +
Holland KT, Davis W, Ingham E, et al:  A comparison of the in vitro antibacterial and complement activating effect of Op-Site and Tegaderm dressings . J Hosp Infect 1984;;5:323-328.
22 +
Mertz PM, Marshall DA, Eaglstein WH:  Occlusive wound dressings to prevent bacterial invasion and wound infection . J Am Acad Dermatol 1985;;12:662-668.
23 +
Jaffe LF, Vanable JW:  Electric fields and wound healing , in Eaglstein WH (ed): Clinics in Dermatology: Wound Healing . Philadelphia, JB Lippincott, 1984;, pp 34-44.
24 +
Falanga V, Bourguignon GJ, Bourguignon LYW:  Electrical stimulation increases the expression of fibroblast receptors for transforming growth factor-beta, abstracted . J Invest Dermatol 1987;;88:488.
25 +
Eaglstein WH, Davis SC, Mehle AL, et al:  Optimal use of an occlusive dressing to enhance healing: Effect of delayed application and early removal on wound healing . Arch Dermatol 1988;;124:392-395.
26 +
Alper JC, Tibbetts LL, Sarazen AA:  The in vitro response of fibroblasts to the fluid that accumulates under a vapor-permeable membrane . J Invest Dermatol 1985;;84:513-515.
27 +
Friedman SJ, Su WPD:  Management of leg ulcers with hydrocolloid occlusive dressing . Arch Dermatol 1984;;120:1329-1336.
28 +
Alper JC, Welch EA, Ginsberg M, et al:  Moist wound healing under a vapor permeable membrane . J Am Acad Dermatol 1983;;8:347-353.
29 +
Angermeier MC, Alper JC, Urbaniak HS:  Vapor-permeable membrane therapy for ulcers of osteomyelitis . J Dermatol Surg Oncol 1984;;10:384-388.
30 +
Gorse GJ, Messner RL:  Improved pressure sore healing with hydrocolloid dressings . Arch Dermatol 1987;;123:766-771.
31 +
Mallory SB:  Adjunctive therapy for epidermolysis bullosa . J Am Acad Dermatol 1982;;6:951-952.
32 +
Eisenberg M:  The effect of occlusive dressings on reepithelializations of wounds in children with epidermolysis bullosa . J Pediatr Surg 1986;;21:892-894.
33 +
Alper JC, Welch EA, Maguire P:  Use of the vapor permeable membrane for cutaneous ulcers: Details of application and side effects . J Am Acad Dermatol 1984;;11:858-866.
34 +
Zitelli JA:  Delayed wound healing with adhesive wound dressings . J Dermatol Surg Oncol 1984;;10:709-710.
35 +
Varghese MC, Balin AK, Carter DM, et al:  Local environment of chronic wounds under synthetic dressings . Arch Dermatol 1986;;122:52-57.
36 +
Gilmore WA, Wheeland RG:  Treatment of ulcers on legs by pinch grafts and a supportive dressing of polyurethane . J Dermatol Surg Oncol 1982;;8:177-183.
37 +
Mertz PM, Marshall DA, Kuglar MA:  Povidone-iodine in polyethylene oxide hydrogel dressing . Arch Dermatol 1986;; 122:1133-1138.
38 +
Richmond JD, Sutherland AB:  A new approach to the problems encountered with Op-Site as a donor site dressing: Systemic ethamsylate . Br J Plast Surg 1986;;39:516-518.

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