Effect of delayed primary closure on the healing of ischemic wounds

The influence of occlusive dressing and hyperbaric oxygen on flap survival and the healing of ischaemic wounds

The effect of dressing with Duoderm (hydrocolloid) and treatment with hyperbaric oxygen was investigated on the healing of ischaemic incisional wounds and on flap survival in rats. After 10 days, Duoderm dressing of ischaemic wounds decreased all strength parameters (load*S, stress*S) by 41%-44% and the improvement of ischaemic wound healing by hyperbaric oxygen treatment shown in our previous study was not seen. After removal of Duoderm on day 10 the biomechanical properties had improved but not returned to normal on day 20. In the dressed animals the shrinkage of ischaemic wounds and the extension of necrosis on the ischaemic flaps were reduced. Dressing may be useful clinically in preventing superficial dermal necroses. One must, however, be aware of the impairment of the wound strength of the incisional wounds.