Consider the Adhesives of Wound Dressings
Bredow et al. in their original article compare “absorbent” versus “conventional” wound dressings used postoperatively after orthopedic surgery (1). They describe that patients, nurses, and physicians were “more satisfied” with the absorbent dressings and estimated that these were “better.” Crucial points of these subjective assessments were greater wearing comfort and lower degrees of trauma when changing dressings, which are primarily due to the adhesives used, not the higher degree of absorptiveness (2). Mepilex Border Post-Op has a silicone coating; Cosmopor E uses polyacrylate adhesive. It has been shown on several occasions that the removal of silicone-coated dressings is associated with notably less pain than the removal of dressings that use other adhesives. This reduced sensation of pain does, however, directly correlate with a lower degree of adhesiveness on the skin (2). If the dressings used in this setting really remained adhesive for up to a week and did not loosen spontaneously (which is a commonly observed problem in clinical practice) then the authors are correct to conclude: “the absorbent adhesive dressing is significantly superior to today’s standard dressing.” However, a causally relevant aspect that is of central importance but was not discussed in the article, is the fact that different dressings use different adhesives. For this reason, the presented results should not be generalized just like that to other “absorbent” dressings, because commercial products feature very different adhesives (2, 3). Exudate management (4) is important after primary closure of postoperative wounds, but what is of central importance for pain, traumatization, and satisfaction of medical professionals and patients is the selection and use of the appropriate adhesive dressing.
Prof. Dr. med. Joachim Dissemond
Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie
Conflict of interest statement
Prof Dissemond received consultancy fees from Braun, Coloplast, Convatec, Lohmann&Rauscher, Mölnlycke, Hartmann, and Urgo. He received co-author payments from Lohmann&Rauscher and Hartmann.
He was reimbursed for conference delegate fees as well as travel and accommodation expenses by Lohmann&Rauscher, Coloplast, and Urgo.
He was paid for preparing scientific advanced training courses by 4M,
B. Braun, BSN, Coloplast, Engelhard, Hartmann, Lohmann&Rauscher, Mölnlycke, SastoMed, and Urgo. He received funding for clinical studies from Urgo.
|1.||Bredow J, Hoffmann K, Oppermann J, Hellmich M, Eysel P, Zarghooni K: Evaluation of absorbent versus conventional wound dressing—a randomized controlled study in orthopedic surgery. Dtsch Arztebl Int 2018; 115: 213–9 VOLLTEXT|
|2.||Klode J, Schöttler L, Stoffels I, Körber A, Schadendorf D, Dissemond J: Investigation of adhesion of modern wound dressings: a comparative analysis of 56 different wound dressings. J Eur Acad Dermatol Venereol 2011; 25: 933–9 CrossRef MEDLINE|
|3.||Dissemond J, Augustin M, Eming SA, et al.: Modern wound care—practical aspects of non-interventional topical treatment of patients with chronic wounds. J Dtsch Dermatol Ges 2014; 12: 541–54 CrossRef CrossRef MEDLINE|
|4.||Körber A, Weindorf M, Dissemond J: Exsudatmanagementkapazität moderner Wundauflagen für die Therapie des Ulcus cruris venosum unter Kompressionstherapie. Hautarzt 2008; 59: 904–11 CrossRef MEDLINE|