Cover wound dressings are regarded as important postoperative care following surgical intervention. Opinions differ on whether the cleft lip repair wound should be routinely covered by dressings or not. Therefore, a well designed randomized controlled trial is required to determine if routine cover dressing offers a better outcome.
Aim
The aim of this study was to compare the outcome of wound and cosmetic appearance of cleft lip repair in a randomized controlled trial between cover wound and no wound dressing groups.
Materials and methods
Forty consecutive patients requiring cleft lip repair were randomized prospectively to receive the traditional wound dressing cover (n = 20) or had the wound left exposed without any dressing cover (n = 20), after the completion of cleft wound closure. The main outcome measures were wound infection and dehiscence rates in the two groups, in addition to the scar cosmetic outcomes.
Result
The two groups were comparable in terms of age and sex. The incidence of wound infection was 0% (0/20) in cover dressing group as compared to 5% (1/20) in no cover dressing group (p = 0.31). No statistical significant differences in the wound dehiscence rate between the wounds that received dressing (15%) and those with no dressing (20%) were observed. The mean diameter of scar at the 5th to 8th week review appointments was almost similar between the group with dressing (3.29 ± 1.26 mm) and no dressing (3.62 ± 1.28 mm). The patient reported outcome in relation to the cosmetic appearance of the scar after repair was similar in the two groups.
Conclusion
There was no difference in the main outcome measures between the group that had cover dressing and those with exposed wound after cleft lip repair surgery. This study demonstrates that dressing of cleft repair wound may be unnecessary.
How to cite this article
Gbolahan OO, Ogunmuyiwa SA, Osinaike BB, Alabi A. Randomized Controlled Trial comparing Dressing and No Dressing of Surgical Wound after Cleft Lip Repair. J Contemp Dent Pract 2015;16(7):554-558.
British National Formulary 61 In. London: The Society; 2011. p. 1036.
Systematic review and meta-analysis of wound dressings in the prevention of surgical-site infections in surgical wounds healing by primary intention. Br J Surg 2012;99(9):1185-1194.
Exposure of the wound—a safe economy in the NHS. Postgrad Med J 1987;63(735):27-28.
InConverse JM (Ed), Reconstructive plastic surgery. Philadelphia Saunders, 1964. Pp. 1360-1388 accessed at http://premaks.tripod.com/ENT/Converse/conv43.pdf on 13-03-2015. In.; 2015.
Surgical wound infection: a comparison between dressed and undressed wounds. J Trop Med Hyg 1977 Sep;80(9):192-196.
An improved technique for repair of bilateral cleft lip deformities through extensive muscle dissection in one stage surgery. Egypt J Plast Reconstr Surg 2006;30(2):131-137.
Moist wound healing with occlusive dressings: a clinical review. Dermatol Surg 1995;21(7): 583-590.
Patient-oriented evidence that matters: POEMS. EJHP 2004;11(42):56-57.
Center for diseare control definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Infect Control Hosp Epidemiol 1992;13(10):606-608.
Studies in the management of the contaminated wound. Am J Surg 1971;122(1):74-77.
Human fluid from acute wounds stimulates fibroblast and endothelial cell growth. J Am Acad Dermatol 1991;25(1):1054-1058.
Faster healing and less pain in skin biopsy sites treated with an occlusive dressing. Arch Dermatol 1991;127(11):1679-1683.
Prospective evaluation of occlusive hydrocolloid dressing regarding the healing effect after abdominal operations: randomized controlled trial. Asian J Surg 2008;31(1):1-5.
Eur J Surg 1998;164(3):179-183.
An overview of surgical site infections: aetiology, incidence and risk factors. EWMA J 2005;5(2):11-15.
Surgical wound infection rates by wound class, operative procedure, and patient risk index. National Nosocomial Infections Surveillance System. Am J Med 1991;91(3B):152S-157S.
