Occlusive vs Gauze Dressings for Local Wound Care in Surgical Patients: A Randomized Clinical Trial

OBJECTIVE To compare effectiveness and costs of gauze-based vs occlusive, moist-environment dressing principles. DESIGN Randomized clinical trial. SETTING Academic Medical Center, Amsterdam, the Netherlands. PATIENTS Two hundred eighty-five hospitalized surgical patients with open wounds. INTERVENTION Patients received occlusive (ie, foams, alginates, hydrogels, hydrocolloids, hydrofibers, or films) or gauze-based dressings until their wounds were completely healed. MAIN OUTCOME MEASURES Primary end points were complete wound healing, pain during dressing changes, and costs. Secondary end point was length of hospital stay. RESULTS Time to complete wound healing did not differ significantly between occlusive (median, 66 days; interquartile range [IQR], 29-133 days) and gauze-based dressing groups (median, 45 days; IQR, 26-106 days; log-rank P = .31). Postoperative wounds (62% of the wounds included) healed significantly (P = .02) quicker using gauze dressings (median, 45 days; IQR, 22-93 days vs median, 72 days; IQR, 36-132 days). Median pain scores were low and similar in the occlusive (0.90; IQR, 0.29-2.34) and the gauze (0.64; IQR, 0.22-1.95) groups (P = .32). Daily costs of occlusive materials were significantly higher (occlusive, €6.34 [US $9.95] vs gauze, €1.85 [US $2.90]; P