Purchase this article with an account.
Srinivas Sai A. Kondapalli, Craig N. Czyz, Kenneth V. Cahill, Jill A. Foster, Robert H. Hill; Kaolin-impregnated Gauze In Oculoplastic Surgery. Invest. Ophthalmol. Vis. Sci. 2012;53(14):1446.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Kaolin is a naturally occurring silicate mineral derived from clay. It has been widely used and anecdotally noted to promote wound healing and reduce scar formation. In fact, some patients use china clay, a kaolin concentrated earth product, for homeopathic management of wounds. Numerous studies from trauma and emergency medicine show Kaolin impregnated gauze to be safe and effective in controlling hemorrhage in extremity and abdominal sites. Our study will look at the application of kaolin to control perioperative bleeding and promote wound healing in eyelid surgeries.
This prospective, randomized, double blinded study recruited 25 patients who underwent bilateral functional or cosmetic blepharoplasty or ptosis repair. After the initial incisions were performed, and skin was removed, a standardized size of kaolin impregnated gauze was placed on one side and cotton gauze on the other. Each gauze was left in place with gentle pressure for four and a half minutes and then removed. Individual areas of bleeding were noted, recorded, and addressed with electrocautery. Standardized postoperative photographs were obtained on day seven. The photographs were graded for edema and ecchymosis by four blinded observers. The data was analyzed using the appropriate statistical tests for data type.
A total of 25 patients underwent bilateral upper lid blepharoplasty (n=23) or bilateral lower lid blepharoplasty (n=2). Kaolin impregnated gauze did not improve intraoperative hemostasis in the eyelids. The number of bleeding sites on both treated and untreated sites was not significantly different (p=0.951) Photographic grading did not identify any significant differences in the post-operative ecchymosis or edema in the kaolin treated wounds.
The use of kaolin for hemostasis and wound healing in eyelid surgery showed no benefit to either the surgeon or the patient. Intraoperative hemostasis was not aided by kaolin impregnated gauze. There were no significant differences when evaluating postoperative edema or ecchymosis. The contrasting usefulness of kaolin in other anatomical locations highlights the importance of dedicated research on the wound healing of periocular tissues.
This PDF is available to Subscribers Only