A randomized clinical trial published in JAMA Dermatology found long-term scar appearance in patients using hydrocolloid dressing or daily petroleum ointment application was comparable in the long term. The study authors noted that while patient-reported scar appearance at 1 week after surgery was slightly more favorable in the hydrocolloid dressing arm, differences did not persist at the 30- and 90-day marks.

Hydrocolloid dressings (HCDs) are engineered to promote optimal wound healing because they are applied over the surgery site for 7 days, while petroleum ointment requires daily reapplication. Therefore, HCDs may be a viable option for patients who would prefer to avoid daily wound care while maintaining similar scar appearance.

The effectiveness of HCDs and petroleum ointment were compared in a cohort of 146 adult patients who had undergone standard excision or Mohs micrographic surgery with linear bilayered repair. Patients were randomized between HCD (72 patients) and petroleum ointment (74 patients) . The primary outcome was patient-reported scar appearance for which they used a modified visual analogue scale (VAS) to report at the 7-, 30-, and 90- day marks. Secondary outcomes included blinded surgeon VAS assessments, rates of surgical complications, and patient ratings of comfort and convenience.

After 7 days, the mean difference in patient-reported VAS between HCD and petroleum groups was –0.40, favoring HCD. However at 30 days, the gap shrunk to –0.08, and at 90 days it was -0.09. In the HCD arm, nearly 87% of patients rated the dressing as convenient or extremely convenient and approximately 74% reported comfort or extreme comfort. Meanwhile in the petroleum ointment arm, about 47% and 48% of patients reported convenience and comfort, respectively. Differences in surgeon VAS assessments were not statistically significant, according to the authors.

The HCD group had a higher, but not statistically significant, rate of adverse events:

• postoperative bleeding in the HCD arm was about 21% vs 9% in the petroleum arm

• wound dehiscence was approximately 6% for HCD vs 0 for petroleum

• surgical site pain was 21% vs 12%.

No patients in either arm required postoperative antibiotics. The study's single-center design may have limited its generalizability and external validity, along with inclusion being limited to linear closures. Scar evaluation being performed remotely rather than in-person was also a limitation.

The study authors concluded that HCD was a viable option for scar care after dermatologic surgery. They encouraged practitioners to consider cost, as well as patients’ preferences and their individual risk of complications.

 The authors reported no conflicts of interest.

Source: JAMA Dermatology