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Biomedical subjects

K G Harding

Publications and source records attributed to K G Harding.

At least 91 records · Page 5Linked to original sources
PubMed1987

Staphylococcal infection of open granulating wounds.

The significance of staphylococcal infection has been studied prospectively in 250 wounds healing by open granulation. In a series of 50 axillary skin excisions, 17 became infected with Staphylococcus aureus with consequent pain and delay in healing. The infections responded well to Fucidin ointment. Nasal carriers of the organism may be especially liable to this complication. In contrast, although S. aureus was not infrequently found in deep granulating wounds, there was no clear evidence of harm resulting in the 50 laparotomy wounds and 150 pilonidal sinus excisions studied. The susceptibility of superficial wounds to the infection is ascribed to friction from dressings. Deep granulating wounds are occasionally affected similarly when the cavity has filled.

Axilla↗
PubMed1985

Pilonidal sinus excision--healing by open granulation.

A prospective study is reported of 100 pilonidal sinus excisions healing by open granulation. Delays in healing appeared to be due to infection, particularly by anaerobic bacteria. Comparisons are made between three groups studied consecutively - 30 wounds not treated with antibiotics, 20 given a fixed two-week course of metronidazole and 50 managed flexibly. In this last group, wound management was determined by clinical appearance; 24 wounds were clinically healthy throughout and received no antibiotic while 26 looked unhealthy initially or after an interval and were treated with metronidazole, supplemented in some cases with erythromycin. The best results were obtained in the group managed flexibly. It is considered that the problems of delayed healing are due to excisions which leave a wound of a shape ill-designed to maintain good drainage. Unhealthy wounds should be re-shaped if possible and treated early with a combination of metronidazole and erythromycin.

Bacteria, Anaerobic↗
PubMed1985

The disinfection of silicone-foam dressings.

The efficiency of four commonly used antiseptics, chlorhexidine, povidone-iodine, cetrimide and sodium hypochlorite was compared in the disinfection of silicone-foam dressing used in the management of open granulating wounds. An in vitro model was first used to determine the minimum effective concentration of each antiseptic in killing a standard culture of Pseudomonas. The appropriate concentrations were then compared in comparative studies of clinical wounds. Chlorhexidine proved to be the most effective antiseptic, povidone-iodine and cetrimide were moderately successful, but sodium hypochlorite gave poor results. A subsidiary study looked at the problem of wound irritation by carry-over of the antiseptic. A rinse of the dressing after disinfection prevented irritation by chlorhexidine without compromising its antibacterial effect, but this procedure sometimes failed to prevent irritation when using the other antiseptic agents. It is concluded that chlorhexidine is the preferred cleansing agent in the management of silicone-foam dressings on both grounds of bacteriological efficiency and lack of wound irritation. It should be noted that Hibitane concentrate used in this work contains non-ionic detergent and a stabilizing agent. Pure preparations of chlorhexidine may not behave similarly.

Anti-Infective Agents, Local↗
PubMed1983

A comparison of skin grafting and healing by granulation, following axillary excision for hidradenitis suppurativa.

The treatment of established hidradenitis suppurativa demands complete excision of the apocrine glands in the affected area. Ten patients undergoing bilateral excision of the axillary skin, had one axilla grafted and the other allowed to heal by granulation utilising Silastic foam dressing, in order to compare the two methods. Split skin grafting resulted in more rapid healing of the excised area than healing by secondary intention. However, Silastic foam dressing resulted in certain healing with a good cosmetic result and avoided the need for immobilisation and a painful donor site. Most patients in this series preferred Silastic foam dressing to skin grafting.

Axilla↗
PubMed1981

Postanal sinus.

Explore the source record for details and available documents.

Humans↗
PubMed1980

The use of silastic foam dressing in the treatment of advanced hidradenitis suppurativa.

We describe our experience in the use of a Silastic foam dressing in 17 patients undergoing radical excision of hidradenitis suppurativa whose wounds were allowed to heal by granulation. Axillary excisions were carried out in 9 patients and perineal excisions in 8 patients. The technique permits adequate excision of the disease and results in a cosmetically acceptable scar, superior to that obtained by skin grafting and with little limitation of movement. It avoids the pain of conventional management of granulating wounds by gauze packing. It is considered that this method of management is superior in most respects to other techniques used to manage the defect resulting from adequate excision of hidradenitis.

Adolescent↗
PubMedDate not supplied

Topical treatment: which dressing to choose.

Wounds have existed since the beginning of time. The interest in this subject has been stimulated in the main by conflict and war that have necessitated the development of new ways of managing wounds. In the 1960s the development of new materials that maintained a moist environment in the wound area encouraged a number of commercial companies to produce a wide variety of new materials with physical and chemical properties that might provide a moist environment. However the data to support the use of such materials are limited if one requires evidence that they have produced more rapid healing in chronic wounds kept moist as to those kept dry. Is this due to a problem with the outcome measure rather than a problem with the materials themselves? Rather than seeing this as justification for not using such materials, it should instead lead clinicians to question the validity of endpoint studies in wound healing experiments. There is a lack of evidence regarding the ability of such materials to improve the speed of healing in chronic wounds. Nevertheless considerable clinical experience, obtained from treating many patients, has indicated that not only are such new treatments cost effective, but that they are also proving to be extremely beneficial and acceptable to patients, on account of their ability to reduce pain, odour or leakage from a wound.

Animals↗
PubMedDate not supplied

A new approach to monitoring trace element concentrations and speciation in wounds and wound fluids.

Combined application of potentiometric stripping analysis (PSA) and computer simulation of speciation analysis has been used to determine the total element concentrations and the proportions of the different chemical species of copper, manganese and zinc present in human would fluids. With samples of 0.5 to 1 cm3 the coefficient of variation lies in the range of 5-10%. In eight patients the concentrations of Cu and Zn were greater than those expected in blood plasma, but for Mn the observed concentrations lay with the range expected for plasma.

Cholecystectomy↗
PubMedDate not supplied

Use of molecular techniques to study microbial diversity in the skin: chronic wounds reevaluated.

The skin is colonized by an array of microorganisms which form its natural microflora. Disruption to the normal barrier function of the skin (due to trauma or disease) may result in invasion of the dermis by opportunistic bacteria. To date, these organisms, which may contribute to the chronicity of skin wounds, have been analyzed solely by culture methods. It is increasingly realized that standard culture methods of analysis do not accurately reflect the full diversity of complex microflora. This review discusses the limitations of traditional culture approaches and reviews recent advances in molecular microbiological techniques which facilitate a more comprehensive characterization of the microflora within clinical samples. The currently available technologies and techniques are described, as is their use in clinical practice and their potential for diagnostic screening. Chronic venous ulceration of the lower limbs is an important skin disorder in which the microflora invading the dermal tissues contribute to the observed delayed healing. Using chronic leg ulcers as a working example, we show how strict culture and molecular microbiological techniques may be employed, for the first time in combination, to definitively characterize the invading microbial community of the dermis.

Chronic Disease↗
PubMedDate not supplied

Psychological factors and delayed healing in chronic wounds.

OBJECTIVE: Studies have shown that stress can delay the healing of experimental punch biopsy wounds. This study examined the relationship between the healing of natural wounds and anxiety and depression. METHODS: Fifty-three subjects (31 women and 22 men) were studied. Wound healing was rated using a five-point Likert scale. Anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HAD), a well-validated psychometric questionnaire. Psychological and clinical wound assessments were each conducted with raters and subjects blinded to the results of the other assessment. RESULTS: Delayed healing was associated with a higher mean HAD score (p = .0348). Higher HAD anxiety and depression scores (indicating "caseness") were also associated with delayed healing (p = .0476 and p = .0311, respectively). Patients scoring in the top 50% of total HAD scores were four times more likely to have delayed healing than those scoring in the bottom 50% (confidence interval = 1.06-15.08). CONCLUSIONS: The relationship between healing of chronic wounds and anxiety and depression as measured by the HAD was statistically significant. Further research in the form of a longitudinal study and/or an interventional study is proposed.

Adult↗
PubMedDate not supplied

Comparing hydrocolloid dressings in management of exuding wounds.

Hydrocolloid dressings have been widely used since the late 1970s. This article compares two hydrocolloid dressings--3M Tegasorb dressing and ConvaTec's Granuflex (E)--and highlights their similarities and differences when used in the clinical situation. Both hydrocolloids were reported to perform favourably by users in most situations. 3M Tegasorb dressing becomes transparent in use and this function was rated highly by users compared to the opaque Granuflex (E). In addition, 3M Tegasorb showed better adherence. One limitation of the study was the small number of patients studied. Weekly assessments yielded 90 data sets in total.

Adult↗