The objectives were to establish if a single application of a hydrocolloid dressing within a week following excisional surgeries would make any difference in the appearance of the surgical scars or surgical complications compared with reapplying petroleum ointment daily.
This study is a blinded, individual randomized controlled trial that took place at a large public university in Indiana from October 2022 through October 2023 in patients aged 18 or older undergoing standard excision or Mohs surgery with a linear bilayered repair. Patients not indicated for flaps or grafts, hair-bearing scars, hydrocolloid dressings, adhesive allergies, topical chemo at the surgical site, or those who have communication problems were not part of this study. Data analysis occurred from November 2023 through March 2025.
Of 444 screened participants, 146 patients were randomized. The mean age was 61.9 + 12.9 years, with 85 (58%) female participants and 61 (41.8%) male participants. Seventy-two received a hydrocolloid dressing once and were retained for one week, while 74 received petroleum ointment once a day. Both group variables for demographics and surgery status were equal.
The key outcome was the patient-rated scar satisfaction assessed by means of a modified Visual Analogue Scale (VAS) instrument. Secondary endpoints were VAS scores assessed by three masked Mohs surgeons, the rate of surgical complications, patient satisfaction with ease of use, and patient satisfaction with convenience.
Key Findings
Patient and surgeon assessments of the overall scar satisfaction were also equivalent between the two groups.
At 7 days, the mean difference measure on patient VAS scores regarding hydrocolloid dressing and petroleum ointment was -0.40 (95% CI: -0.70 to -0.10).
At the end of the 30th day, the difference value was -0.08 (95% CI: -0.38 to 0.23), and finally at the end of the 90th day, the value was -0.09 (95% CI: -0.41 to 0.23).
Adverse events were numerically higher in the hydrocolloid dressing group, although not significant.
Postoperative bleeding was found in 20.6% of patients with a hydrocolloid dressing compared to 8.8% in the petroleum ointment group.
Wound dehiscence was seen in 6.2% of patients with a hydrocolloid dressing, while no patients were observed in the petroleum group.
Patients experienced surgical site pain in 21.2% and 12.3%, respectively.
There were no patients in the study group who took antibiotics postoperatively.
This clinical trial shows that hydrocolloid dressing is also a good postoperative alternative for petroleum ointment because they present similar results concerning complications and scar formation after skin surgery. As cost factors and the tendency for complications after skin surgery vary between patients, the use of either hydrocolloid dressing or petroleum ointment may be preferred.
Reference:
Bell MC, Gangodawila TW, Morr CS, et al. Hydrocolloid Dressing vs Petroleum Ointment for Scar Appearance After Dermatologic Surgery: A Randomized Clinical Trial. JAMA Dermatol. 2025;161(12):1246–1251. doi:10.1001/jamadermatol.2025.4051
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