In vitro measurements of burn dressing adherence and the effect of interventions on reducing adherence.

PURPOSE: There is a paucity of research on reducing dressing adherence. This is partly due to lack of an in vitro model, recreating the clinical variability of wounds. Previously we described an in vitro gelatin model to evaluate adherence in a standardized manner. We present evaluation of strategies to reduce adherence in six dressings.

PROCEDURES: Dressing materials used were: PET (Control), fine mesh gauze coated in bismuth and petroleum jelly (BIS), nanocrystalline silver (NS), wide mesh polyester coated in polysporin ointment (WM), fine mesh cellulose acetate coated in polysporin ointment (FM), and soft silicone mesh (SIL). The dressing material was applied to gelatin and incubated for 24h. Adherence was tested using an Instron 5965 force-measurement device. Testing was repeated with various adherence reducing agents: water, surfactant, and mineral oil.

RESULTS: Adherence from least to greatest was: SIL, NS, BIS, WM, FM, PET. Water reduced adherence in all dressings; the effect increasing with exposure time. Surfactant reduced adherence of NS. Mineral oil effectively decreased adherence of BIS, and WM.

CONCLUSION: This model allows for reproducible measurement of dressing adherence. Different interventions affect various dressings. No single intervention optimally decreases adherence for all dressings.