Delayed healing in full-thickness wounds treated with aluminum chloride solution. A histologic study with evaporimetry correlation.

Optimizing wound healing parameters seems to be the utmost importance in the present age of sophisticated wound care and dressings. We studied the effect of two hemostatics: 30% aluminum chloride and ferric subsulfate (Monsel's solution) on the rate of wound healing in Yucatan miniature hairless pigs. Wound healing was examined in occluded and nonoccluded full-thickness 3-mm punch biopsy wounds. Wounds were treated either with 30% aluminum chloride solution or ferric subsulfate solution or were allowed to clot with minimal pressure from a gauze pad. The course of wound healing was followed utilizing evaporimetry readings from the wound sites in addition to periodic histologic examination in an attempt to correlate the evaporimetry readings with corresponding histology. Delay in reepithelialization was noted histologically both in wounds treated with aluminum chloride and in those treated with ferric subsulfate compared to controls. Presumably this delay was the result of tissue necrosis caused by these hemostatic agents, resulting in slightly larger and less cosmetically acceptable scars. Plots of evaporimetry data revealed a biphasic pattern of water loss during healing, with an initial rapid decline in water loss followed by a much slower decline. Histologic reepithelialization seemed to correlate best with the point on the evaporimery curve where the slope changed from the phase of rapid water loss to a slower rate.