Impact of modified SSD soft brace on surgical outcomes and wound healing duration following hand scar contracture release in RDEB patients.

OBJECTIVE

To investigate the clinical efficacy of a modified soft brace incorporating a Silver Sulfadiazine (SSD) oil-based dressing in improving wound healing and home care quality following hand scar contracture release surgery in patients with RDEB.

METHODS

Thirty-five RDEB patients (aged 8-21 years) who underwent hand contracture release between 2017 and 2023 were assigned to Traditional (Vaseline gauze + brace, n = 17) or Modified (SSD dressing + brace, n = 18) groups. Perioperative outcomes, wound healing duration, compliance (RHCS), and recurrence-free survival were compared.

RESULTS

Baseline characteristics were comparable. Compared to the Traditional Group, the Modified Group had significantly fewer dressing changes (2.33 ± 0.49 vs. 4.18 ± 0.73, P < 0.001), shorter healing duration (23.33 ± 3.40 vs. 36.24 ± 5.09 days, P < 0.001), lower epithelial stripping rate (11.1% vs. 64.7%, P = 1.6E-3), and no refractory wounds. The Modified Group also showed higher RHCS total scores (84.94 ± 9.62 vs. 46.12 ± 19.12, P < 0.001) and fewer spontaneous nocturnal blisters (11.1% vs. 64.7%). Univariable Cox regression indicated the modified regimen was associated with delayed recurrence. Kaplan-Meier analysis showed delayed recurrence in the Modified Group by log-rank test (P = 0.03), and univariable Cox analysis yielded HR 0.39, 95% CI 0.16-0.95, albeit with wide confidence intervals and limited late-term power.

CONCLUSION

In this retrospective cohort, the SSD-containing non-adherent dressing used with a soft brace was associated with fewer dressing changes, less dressing-related trauma, and better reported tolerance. Prospective controlled studies with validated functional and compliance outcomes are required.