Saturday, August 27, 2016
Kaolin and eyelid surgery
Using kaolin-impregnated gauze offers limited benefit for blepharoplasty patients. The mineral, which has been shown to help control hemorrhage when combined with gauze and applied to wounds, showed no quantifiable change in intraoperative hemostasis among cosmetic eyelid surgery patients.
Postoperatively, the limited positive effects on lid edema and ecchymosis were noted in the later healing stages by surgeons but not by patients, according to a new study.
Investigators reported on a prospective, randomized, double-blind study of 46 eyelid surgery patients. After making skin incisions, they placed kaolin-impregnated gauze in one eyelid wound bed and cotton gauze in the other.
They removed the gauze and took postoperative pictures on days one, four and seven. Blinded observers graded the photos for edema and ecchymosis, and patients completed a survey at each visit, asking them which side had more bruising, swelling and pain.
Researchers noted no notable difference in the number of intraoperative bleeding sites for kaolin compared to plain gauze. The blinded observers didn’t see differences in postoperative edema between lids photographed.
But while they didn’t see immediate effects from the treated gauze, there appeared to be limited postoperative benefit — a statistically significant difference in ecchymosis at days four and seven. Patients, however, didn’t note this or any differences in perceived edema, ecchymosis or pain between the lids.
While this study doesn’t show a clear benefit associated with using kaolin-impregnated gauze for blepharoplasty patients, considering the time and cost, other research suggests the gauze might be of more benefit with repeated applications, according to the authors.
Cherry Hill, N.J., plastic surgeon Steven L. Davis, M.D., does not use kaolin-impregnated gauze for eyelid surgery patients.
“…the additional cost does not seem beneficial,” he says. “I use 1% lidocaine with epinephrine on a gauze topically after incision.”