Wet Wraps No Better Than Standard Treatment for Atopic Eczema

In a small study of children with moderate to severe eczema, a type of dressing called "wet wraps" was no better than conventional therapy at improving disease severity, new research shows. Moreover, the wet wraps were more difficult to apply and were associated with more skin infections.

With wet wraps, conventional emulsifying ointments and topical steroids are applied to the affected areas and then covered with a wet tubular retention bandage, serving as an occlusive dressing.

Based on their own encouraging results with wet wraps, Dr. D. Hindley, from Fairfield General Hospital in the UK, and colleagues decided to compare them against conventional therapy, which is similar but lacks the wet outer dressing, in a randomized study of 45 children.

The conventional therapy was applied at least three times daily, whereas the wet wraps were applied once daily for 12 or more hours. The SCORing Atopic Dermatitis (SCORAD) index was used to gauge disease severity over the 4-week study period.

The researchers' findings appear in the Archives of Disease in Childhood for February.

Both treatments provided significant and similar improvements in disease severity. With wet wraps, the SCORAD score fell from 53 to 24 and with conventional therapy, it dropped from 41 to 17. Topical steroid use in each group was also comparable.

Five children treated with wet wraps received antibiotics for skin infections compared with none of the children treated with conventional therapy (P = 0.05). Nurses and others caring for the subjects agreed that the wet wraps were significantly more difficult to apply than the conventional therapy.

"Though there may be clinical situations where wet wraps are a useful option, we found no advantages of wet wraps to conventional treatment when used over a 4-week period, and some disadvantages," the investigators conclude.

Reference: Arch Dis Child. 2006;91:164-168

Authors: News Author: Anthony J. Brown, MD; CME Author: Penny Murata, MD

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