How to get the dressing right

If your are seriously wounded in an accident, your chances of a quick recovery may depend on which brand of dressing your surgeon happens to find in the cupboard.

Until now, there has been little research into the efficacy of different wound dressings, says Vivien Sieber, of the University of East London, who is determined to reverse this trend.

Surgeons have tended to go by past experience. "It's partly habit. They go to the cupboard and pull out what there is," she said.

She has recently completed a study using "skin equivalent" materials to compare various commercially-available dressings. These materials were originally developed as alternatives to skin grafts, and are sometimes used after the removal of tattoos.

Dr Sieber found, together with William Otto of the Imperial Cancer Research Fund, that the same type of dressing (of polyurethane film) from 3M performed markedly better than that from Smith and Nephew.

She said: "I don't think anyone realised the difference. I was very surprised."

This study is the first to be able to measure the rate of healing in the laboratory.

Dr Sieber measured the rate of DNA synthesis to determine how quickly the skin was growing back.

She said: "That's the first way of quantifying it. Surgeons (in the past) have had to rely on empirical experience." The dressing from 3M actually increased the rate of skin growth.

"Whether enhancing DNA synthesis is a good thing, I don't know," added Dr Sieber.

The method used by the British Standard Institute for testing dressings simply involves assessing the effects of an extract of dressing on a single layer of cells.

Dr Sieber's methods improve on the BSI's because the skin equivalents that she uses are much more like skin.

She said: "It's a very simple model for human skin, but it is better able to assess the complex physical, chemical and biological factors that may influence wound healing".

But Dr Sieber keeps her research in perspective.

"I always avoid using a plaster myself, if I possibly can," she concluded.