Randomised clinical trial of Hydrofiber dressing with silver versus povidone-iodine gauze in the management of open surgical and traumatic wounds

Abstract

This prospective, randomised clinical trial compared pain, comfort, exudate management, wound healing and safety with Hydrofiber dressing with ionic silver (Hydrofiber Ag dressing) and with povidone-iodine gauze for the treatment of open surgical and traumatic wounds. Patients were treated with Hydrofiber Ag dressing or povidone-iodine gauze for up to 2 weeks. Pain severity was measured with a 10-cm visual analogue scale (VAS). Other parameters were assessed clinically with various scales. Pain VAS scores decreased during dressing removal in both groups, and decreased while the dressing was in place in the Hydrofiber Ag dressing group (n = 35) but not in the povidone-iodine gauze group (n = 32). Pain VAS scores were similar between treatment groups. At final evaluation, Hydrofiber Ag dressing was significantly better than povidone-iodine gauze for overall ability to manage pain (P < 0.001), overall comfort (P < or = 0.001), wound trauma on dressing removal (P = 0.001), exudate handling (P < 0.001) and ease of use (P < or = 0.001). Rates of complete healing at study completion were 23% for Hydrofiber Ag dressing and 9% for povidone-iodine gauze (P = ns). No adverse events were reported with Hydrofiber Ag dressing; one subject discontinued povidone-iodine gauze due to adverse skin reaction. Hydrofiber Ag dressing supported wound healing and reduced overall pain compared with povidone-iodine gauze in the treatment of open surgical wounds requiring an antimicrobial dressing.

Figure 1

Subject disposition.

Figure 2

Mean pain scores on a 10‐cm visual analogue scale with the prestudy dressing and the study dressing in the Hydrofiber dressing with ionic silver group (solid line) and the povidone–iodine gauze group (dashed line).

Figure 3

Overall ability of the study dressing to manage wound pain.

Figure 4

Comfort and trauma scores at the final visit. (A) Comfort with the study dressing in place. (B) Comfort during removal of the study dressing. (C) Wound trauma during removal of the study dressing.

Figure 5

Ease‐of‐use scores. (A) Ease of application during 38 dressing changes in the Hydrofiber dressing with ionic silver (Hydrofiber Ag dressing) group and 24 dressing changes in the povidone–iodine gauze group. (B) Ease of removal during 40 dressing changes in the Hydrofiber Ag dressing group and 36 dressing changes in the povidone–iodine gauze group.