Use of a Bioelectric, Antimicrobial Dressing in the Healing of an Eyelid Wound, following Micrographic (MOHS) Surgery

1.  Statement of Clinical Problem:  Management of wounds involving the eyelid is difficult due to the limited area for the application and securing of dressings. The application of an antibiotic ointment or other gel products is common.  This 65 year old patient, following the diagnosis of basal cell carcinoma of the left lower eyelid, underwent a micrographic (MOHS) surgical procedure, resulting in a gaping, 0.8 cm wound. 

2.  Description of Past Management:  The repair included a mucosal graft from the upper eyelid to the lower lid surgical site, resulting in 8 weeks of eye closure.  The usual wound care is daily application of antibiotic ointment and cool compresses for two days. This treatment was implemented by the patient for 24 hours, with resulting edema, discoloration, and bruising of the eyelids and orbital area.

3.  Current Clinical Approach:  After 24 hours, with increasing edema and discomfort, the patient began application of a bioelectric, antimicrobial dressing, moistened with normal saline, held in place with a moistened eye pad, secured by the patient’s eyeglasses. The dressing was easily applied and secured by the patient, without assistance. The bioelectric, antimicrobial dressing generates a sustained electrical microcurrent simulating physiologic current of injury which is necessary to induce, enhance, and accelerate wound healing. (1,2) It is activated when moistened.

4.  Patient Outcomes:  The patient was able to easily manage the dressing and moisture application.  There was accelerated decrease in edema and bruising, with no pain medications required.  No adverse events were observed or reported.  

5.  Conclusions:  The patient and the surgeon reported successful healing, success of graft, and positive cosmetic outcomes.  These clinical implications are limited to this single case study, without generalization to the general population.