Evaluation of the effectiveness of silicone-coated dressings in pediatric surgery

BACKGROUND: Skin injuries associated with the adhesive components of medical dressings compromise the barrier function of the skin, delay wound healing, increase the risk of infection, and may cause pain and stress in patients. Evaluation of such injuries is important due to the frequent use of these dressings in clinical practice. AIM: To compare the use of dressings with silicone wound contact layer and medical adhesive dressings in pediatric surgery. MATERIALS AND METHODS: The study included 100 pediatric patients aged 5 to 17 years who underwent surgery for uncomplicated acute appendicitis. Dressings were applied to wounds following minimally invasive laparoscopic access. The study was designed as a prospective, single-center, randomized trial. Patients were randomly assigned using the sealed envelope method into two groups. Group 1 (main group, n=50; mean age, 10.9±2.9 years) received a silicone-based dressing (Cosmopor® Silicone, Paul Hartmann, Germany), whereas group 2 (control group, n=50; mean age, 8.6±3.1 years) received a dressing with medical adhesive (Cosmopor® E Steril, Paul Hartmann, Germany). Skin integrity was assessed both macroscopically and via dermatoscopy at four sites daily over a 7-day period. Skin damage severity was quantified using a mathematical model that accounted for the number of adhesive removals and the surface area of damaged skin. RESULTS: By postoperative day 7, the incidence of skin damage in group 2 was nine times higher than in the group treated with silicone-coated dressings (36% vs 4%, p =0.001). The average pain score in the control group was 6 points. Dressing changes in the main group were associated with significantly lower pain scores, averaging 1.7 points—3.5 times lower than in the control group (p 0.001). Pre-dressing anxiety levels in group 2 remained high (8.5–6.9 points) throughout hospitalization, while in group 1 they did not exceed 3 points from postoperative day 4 onward. CONCLUSIONS: The use of silicone-based dressings significantly reduced skin trauma in the postoperative wound area. Pain intensity was 3.5 times lower with silicone dressings compared to adhesive dressings, which also helped minimize pre-procedural anxiety.