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Two hydrocolloid dressings evaluated in experimental full-thickness wounds in the skin
1Department of Dermatology, University of Miami School of Medicine, Florida, USA.
Abstract:
Hydrocolloid occlusive dressings are beneficial in wound management in many respects, although the adhesive matrix may disintegrate when in contact with wounds. The purpose of this study was to determine: (1) if material from two hydrocolloid dressings-Comfeel and Duoderm-showing differences in adhesive cohesion, can be chemically identified in granulation tissue; and (2) if the presence of this material influences cutaneous wound healing. In full-thickness skin wounds in rats, components from the two hydrocolloid dressings were phagocytosed as indicated by the presence of foam cells. Extracellular vacuoles (100-400 microns in size) occupied about 25% of the granulation tissue volume in the Duoderm group but less than 5% in the Comfeel group, a statistically significant difference (p < 0.001). The vacuoles contained hydrophobic polymers derived from the respective hydrocolloid dressing, as analyzed by Fourier Transform Infrared (FT-IR) microscopy. Wound contraction did not differ significantly between the two hydrocolloid dressings. Wounds treated with Comfeel were significantly (p < 0.05) more epithelialized (mean: 78%) than those treated with Duoderm (mean: 41%). The proliferative activity in wound epithelium, as measured immunohistochemically by bromodeoxyuridine incorporation, was similar for the two treatment groups, indicating that epithelial migration was impaired in Duoderm-treated wounds. In summary, extensive incorporation of hydrophobic dressing material from hydrocolloid dressings may render the wound bed less suitable for epithelial migration during acute secondary wound healing.