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.”
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