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R. Sonia Batra, MD, MSc, MPH; Richard J. Ort, MD; Carolyn Jacob, MD; Lori Hobbs, MD; Kenneth A. Arndt, MD; Jeffrey S. Dover, MD, FRCPC

Arch Dermatol. 2001;137:1317-1321.

Background  Closed dressings are thought to promote postoperative wound healing after laser skin resurfacing; however, quantitative data are lacking.

Objective  To compare postoperative healing after combination carbon dioxide and erbium:YAG full-face laser skin resurfacing in patients who were treated with a silicone occlusive dressing (Silon-TSR; Bio Med Sciences, Inc, Bethlehem, Pa) vs open-wound care consisting of soaks and ointment application.

Design  Thirty-five patients with closed dressings compared retrospectively with 35 control subjects with open-wound care. In a prospective evaluation, 27 patients with closed dressings were then compared with 27 historical controls matched by age, sex, skin type, and treatment technique. Erythema, crusting, swelling, pain, pruritus, purpura, long-term complications, and dressing comfort were evaluated.

Setting  Referral-based academic practice.

Results  Prospectively, closed-dressing and open-wound care groups differed significantly in maximum erythema severity (1.8 vs 2.0 on a scale of 0-3; P = .03), noticeable erythema duration (15.4 vs 31.1 days; P = .04), and time until complete erythema resolution (41.8 vs 96.1 days; P = .02). Swelling resolution was more rapid in the dressing group (12.1 vs 29.5 days; P = .02). Crusting was limited to uncovered areas in the dressing group, and crusting duration was shorter (5.0 vs 9.1 days; P<.001). Pain was more likely to be reported prospectively, but severity was mild, in the closed-dressing group. Other short- and long-term complications did not differ significantly. Subjective patient attitudes toward the dressing were positive.

Conclusions  Occlusive silicone dressing application decreases immediate postoperative morbidity with significantly reduced severity and duration of erythema and decreased duration of swelling and crusting. Long-term results and complication rates remain unchanged.

From the SkinCare Physicians of Chestnut Hill, Boston, Mass (Drs Batra, Ort, Jacob, Hobbs, Arndt, and Dover); the Division of Dermatology, Department of Medicine, Dartmouth Medical School, Hanover, NH (Drs Arndt and Dover); and the Department of Dermatology, Harvard Medical School, Boston (Dr Arndt). Dr Batra is now with the Department of Medicine, Stanford University Medical Center, Stanford, Calif.

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