Hypertrophic scar formation because of
surgical procedures is associated with higher levels of
pain, a lower quality of life, and poor cosmetic outcome and requires more resources in follow-up management. An
octenidine-based
hydrogel has been shown to modulate immunological function in an in vitro
wound model, suggesting an improved
scar formation. In this prospective, randomised, observer-blinded, and intra-patient-controlled study, 45 patients who underwent
abdominoplasty or
mastectomy with transverse rectus abdominis muscle (TRAM) flap reconstruction were given both a standard postoperative
wound dressing on one
wound side and an
octenidine-based
hydrogel with transparent film dressing, covered with standard postoperative dressing on the other side. Four instances of hypertrophia were reported in the gel side versus 12 in the standard dressing side. Visual Analogue Scale (VAS)
pain scores taken during postoperative dressing changes showed reduced scores on the gel side at all time points. Vancouver
Scar Scale (VSS) scores showed improvement in the gel side at 3, 6, and 12 months postoperatively. Skin distensibility measured using a cutometer showed significantly improved measures in gel-treated
wounds, similar to measures of healthy skin. Trans-epidermal water loss (TEWL), measured using a tewameter, showed improved values on the gel side soon after surgery, with both the control and the gel side normalising after approximately 6 months. The
octenidine-based
wound dressing demonstrates improved wound healing associated with a lower incidence of
hypertrophic scar formation.