Faster healing and less pain in skin biopsy sites treated with an occlusive dressing
A. J. Nemeth, W. H. Eaglstein, J. R. Taylor, L. J. Peerson and V. Falanga
Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, FL 33101.
We prospectively studied 174 patients on whom 226 unsutured parallel
incisional (shave) and 3-mm punch skin biopsies were performed. Two
wound-care programs, occlusive dressing therapy and conventional therapy,
were compared. The biopsy sites were evaluated after 1 or 2 weeks for
healing, pain, and infection. We found that healing was unrelated to the
indication for biopsy or the patients' age, gender, or race. Occlusive
dressing therapy-treated shave biopsy sites were 3.83 times more likely to
be healed than those treated with conventional therapy. Regardless of the
treatment method, a facial shave biopsy site was 3.6 times more likely to
be healed than a biopsy site in other locations. No punch biopsy site had
healed after 1 week. At 2 weeks, only 7% and 36% of conventional therapy-
and occlusive dressing therapy-treated punch biopsy sites, respectively,
had healed. Pain at the biopsy site was six times more common in both shave
and punch biopsy sites treated with conventional therapy. The absence of
pain with occlusive dressing therapy was significant for both types of
biopsy. One punch biopsy site treated with conventional therapy became
infected, and one treated with occlusive dressing therapy was suspected of
being infected. Forty patients, who had biopsy sites treated with both
therapies, preferred occlusive dressing therapy over conventional therapy
by a ratio of 3:1 because of ease of wound care and lack of pain. We
conclude that occlusive dressing therapy may be the wound management of
choice for shave biopsy sites. Since punch biopsy sites do not heal
readily, it may be more appropriate to suture them, at least until
therapies are developed that more effectively speed their healing.
