Hydrophilic Polymer, Potassium Ferrate 'WoundSeal' is Effective Alternative to Suturing in Punch Biopsies

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A recent study, presented in a poster at the 2024 Society for Pediatric Dermatology Annual Meeting in Toronto, ON, reported that the use of a hydrophilic polymer and potassium ferrate- containing product known as WoundSeal offered significantly fewer, if any, observed infection or bleeding in punch biopsies performed in pediatric patients.¹

According to poster authors Fo et al, punch biopsy procedures are not without risks, including infection, postoperative bleeding, scarring, and damage to surrounding skin. Traditionally, sutures are used to close punch biopsy sites, yet they can lead to complications and require a follow-up visit for removal.²

Background and Methods

The study proposed the use of WoundSeal, a product containing a hydrophilic polymer and potassium ferrate, as an alternative to sutures for closing punch biopsy sites in pediatric patients.

WoundSeal creates an instant scab, which could be particularly beneficial for patients with known bleeding risks, such as those with lower platelet counts or biopsies performed outside the anatomical trunk. The study aims to compare the efficacy and safety of WoundSeal versus traditional suturing in terms of recovery, prognosis, and adverse effects.

Researchers conducted a retrospective chart review of patients aged 0-21 years who underwent a punch biopsy at the University of New Mexico Dermatology Clinic between January 2020 and March 2024. Data recorded included the location and size of the biopsy site, closure method (suture or WoundSeal), and any complications occurring within 2 weeks post-procedure.

The inclusion criteria were met by 137 patients, with a slight gender balance (69 males and 68 females). Of these, 87 patients had their biopsy sites closed with sutures, while 50 utilized WoundSeal. Biopsy lesion sizes ranged from 3 mm to 6 mm, with WoundSeal being used on lesions up to 5 mm.

Findings

The study found that complications were slightly more frequent in patients who underwent suturing (n=8) compared to those treated with WoundSeal (n=7). Notably, suturing resulted in one case of procedural bleeding, whereas WoundSeal showed no such complication. Additionally, there were no infections or significant adverse events reported in either group.

Conclusions

The use of WoundSeal in pediatric punch biopsies offers several advantages over traditional suturing.

"WoundSeal does not require the need for suture removal, making it more convenient for both the provider and patient," wrote Fo et al.

This study's findings suggest that WoundSeal could be a viable option for pediatric patients undergoing punch biopsies, particularly for those at higher risk of bleeding or when suture removal is logistically challenging. However, poster authors noted that larger studies are warranted to further evaluate the effectiveness and long-term outcomes associated with WoundSeal.

References

1. Fo RF, Jun MS, White K, Smidt AC, Durkin JR. The effectiveness of hydrophilic polymer and potassium ferrate in pediatric punch biopsies: A retrospective study. Poster presented at the 2024 Society for Pediatric Dermatology Annual Meeting, July 11-14; Toronto, ON.
2. Yasui Y, Kato H, Oda T, Nakamura M, Morita A. Complications and risk factors of punch biopsy: A retrospective large-scale study. J Dermatol. 2023;50(1):98-101. doi:10.1111/1346-8138.16585