Where is the evidence that superficial wounds must be kept moist for faster healing?

Where is the evidence that superficial wounds must be kept moist for faster healing?

Many prominent medical organizations have been promoting a treatment for wounds that has not been shown to have scientific merit. After minor cuts, scrapes and skin biopsy many physicians and medical organizations promote “keeping the wound moist for faster healing”. A brief list of some of the more notable organization websites are: Mayo Clinic, Stanford Medicine, Cleveland Clinic, and the American Academy of Dermatology which writes, “apply petroleum jelly. This will help keep the wound moist for faster healing.”

The American Family Physician article, “Common questions about Wound Care” states: https://www.aafp.org/pubs/afp/issues/2015/0115/p86.html
“Should Wounds Be Occluded?
Current wound care practices recommend maintaining a moist wound bed to aid in healing.7,8 Wounds should be occluded with an appropriate dressing and reassessed periodically for optimal moisture levels.
EVIDENCE SUMMARY

Dressings protect the wound by acting as a barrier to infection and absorbing wound fluid. A moist wound bed stimulates epithelial cells to migrate across the wound bed and resurface the wound.8 A dry environment leads to cell desiccation and causes scab formation, which delays wound healing. Older studies in animals and humans suggest that moist wounds had faster rates of re-epithelialization compared with dry wounds.9–11”



Common Questions About Wound Care

Below are the references for the American Family Physician article:
# 7 Sibbald RG, Goodman L, Woo KY, et al. Special considerations in wound bed preparation 2011: an update. Adv Skin Wound Care. 2011;24(9):415-436.
# 8 Okan D, Woo K, Ayello EA, Sibbald G. The role of moisture balance in wound healing. Adv Skin Wound Care. 2007;20(1):39-53.
# 9 Winter GD. Formation of the scab and the rate of epithelization of superficial wounds in the skin of the young domestic pig. Nature. 1962;193:293-294.
# 10 Hinman CD, Maibach H. Effect of air exposure and occlusion on experimental human skin wounds. Nature. 1963;200:377-378.
#11 Agren MS, Karlsmark T, Hansen JB, Rygaard J. Occlusion versus air exposure on full-thickness

A meticulous examination of all references above reveals the following:
#7 concerns only chronic and non healing wounds
#8 is a review and discussion, no new scientific evidence or studies is presented and references #9, and #10
#9 is an experiment on a young domestic pig.
#10 is one poorly designed study involving only seven individuals comparing moist occluded and dry wounds. The article concludes: “ No difference was observed by the seventh day, as both wounds were 100 percent epithilialized at this time.”
#11 states, ”moisture benefits dressings are not documented in humans.”

There is little to no evidence that superficial wounds heal faster under moist conditions. It appears that evolution has given humans the scab, which as of this moment has not been surpassed.
Dr. Nayvin Gordon 1/8/25

Gordon has written for Scientific American, The Journal of Family Practice, American Family Physician and The Journal of the American Geriatrics Society among other publications. He may be reached at gordonnayvin [at] yahoo.com

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