Qualitative Evaluation of ‘BIPP Dressing’ for Intraoral Mucosal Defect

Abstract

Introduction: Various biologic and non biologic graft materials are considered in the past as Intraoral wound dressing material. While autografts have issues related to donor site morbidity, allografts like collagen have limited intraoral usage due to allergenicity and ease of adaptability to the mucosal defect. Bismuth sub-nitrate Iodoform Paraffin Paste (BIPP) dressing is prepared by impregnating sterile gauze with a paste containing one part bismuth sub-nitrate, two parts iodoform, one part sterile liquid paraffin by weight. BIPP is well known for its antiseptic and astringent properties, henceforth serves as a good wound dressing material preventing infection and wound contractures. Its use in intraoral mucosal defects though widely acknowledged has rarely been evaluated. Aim: The aim of this study was to assess the qualitative properties of BIPPs as an intraoral wound dressing material. Materials and Methods: A total of 10 patients with oral precancerous lesions of the oral mucosa were included in this study. After excision of the oral lesions, BIPP pack was used to cover the defects that were too large to close primarily. Before use, sterile BIPP gauze was cut into a suitable shape of the defect and was placed directly on the wound and stabilised using vicryl sutures. The dressing was removed after two weeks of the operation. The effectiveness and usefulness of the BIPP dressing was evaluated by scoring the following parameters in the intraoperative and postoperative periods: operability, haemostatic status, pain relief, feeding situation, epithelialisation, scar contracture, and safety. Results: Out of the 10 patients, in six patients BIPP was used for the buccal mucosal defect, in two patients for labial mucosal defect and in one patient each for tongue and palatal defect. In all the patients the raw wound post resection were covered with BIPP pack and stabilised with vicryl sutures. Postoperatively there was no adverse event, there was no discomfort and all the patients tolerated the BIPP dressing. Conclusion: BIPP use in covering the defect, post soft tissue resection of the intraoral precancerous lesion has given a satisfactory result in the present study.

Keywords

• collagen dressing
• mucosal allograft substitutes
• precancerous conditions