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

Teng Guo, Chong Wu, Xinhe JIAO

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.