Abstract
OBJECTIVES: This study aimed to determine and compare the effectiveness of silk fibroin dressing and normal saline dressing in terms of wound healing time, as assessed by Dr Kamal's Adaptive Wound Healing Score (KAWHS). METHODS: A single-blinded, randomised controlled trial was conducted at a tertiary hospital from November 2022 to November 2023. A total of 142 patients with superficial surgical site infections (SSIs) post-laparotomy were randomised into two groups: silk fibroin dressing (n = 71) and saline dressing (n = 71). The primary outcome, wound healing, was assessed using KAWHS on days 5, 10, and 15. Secondary outcomes included exudate amount (measured by gauze weight), length of hospital stay, and scar characteristics assessed at three months using the Vancouver Scar Scale (VSS). RESULTS: The silk fibroin group demonstrated significantly faster wound healing, with a mean duration of 13.92 ± 2.38 days (95% confidence interval [CI]: 13.36-14.48) compared to 17.41 ± 2.73 days (95% CI: 16.76-18.06) in the saline dressing group (P <0.01). Median KAWHS scores on day 10 were 7 (interquartile range [IQR]: 5-8) versus 9 (IQR: 8-10), and on day 15 were 5 (IQR: 5-5) versus 7 (IQR: 5-8), both favouring silk fibroin (P <0.01). A significant reduction in wound exudate was also observed in the silk fibroin group on days 10 and 15 (P <0.01). No statistically significant differences were found in hospital stay duration (P = 0.32) or scar characteristics at three-month follow-up (P = 0.46). CONCLUSIONS: Silk fibroin dressing was more effective than saline dressing in accelerating wound healing and reducing exudate in patients with superficial SSIs following laparotomy. Short-term benefits were evident, whereas long-term outcomes such as scar formation appeared comparable.