PubMed · 9117821
This article examines some of the issues involved in the management and control of MRSA colonisation and infection in wounds.
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T Young. 1996. Methicillin-resistant Staphylococcus aureus.. https://pubmed.ncbi.nlm.nih.gov/9117821/
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Wound repair-stimulatory activities of various cytokines and growth factors depend on successful delivery of these factors to the injured sites. Here were present the design and preparation of the new collagen- and polyurethane-based dressings containing the recombinant human cytokines-rhG-CSF, rhGM-CSF or rhEGF. To test the efficacy of the retrieval of the incorporated cytokines, their controlled release from the dressings was carried out over three consecutive days using polyurethane sponge as a collector of the extracts. The maximum quantities of the released rhG-CSF, rhGM-CSF and rhEGF reached approximately 25, 50, and 10%, respectively, of the total cytokine contents of the dressings, as assessed by the specific ELISA tests. These data indicate that collagen- and polyurethane dressings containing rhGM-CSF and rhG/CSF may serve as effective tools for the topical delivery of cytokines to wounded tissues.
The cause of a leg ulcer should be determined before a course of treatment is undertaken, and this often can be accomplished through history taking, physical examination, and use of simple noninvasive testing. Most leg ulcers are caused by venous disease, arterial insufficiency, neuropathy, or a combination of these factors. Complete management should address the patient's general health as well as specific findings, and treatment of any underlying cause is paramount. In venous ulcers, compression is the cornerstone of treatment, and a variety of effective stockings and other compression devices are available. Arterial ulcers usually require reestablishment of an adequate vascular supply, often through surgery. Neuropathic ulcers need thorough debridement to allow good granulation and epithelialization. Five types of occlusive dressings are available that achieve debridement less painfully but also more slowly than the surgical approach. Several adjunctive methods are now available that facilitate successful therapy in these ulcers, which have often been considered nonhealing wounds.
Compression therapy is the principal treatment for leg ulcers associated with venous disease. The efficacy of compression therapy can be variable, which may in part be owing to the degree of compression applied. However, if the mechanism of action of this treatment could be better understood, it might be possible to improve its efficacy. It is not clear whether assessment of the degree of compression should be made under static or dynamic conditions, or both. A review of methods used previously suggests the need for a new method of assessment allowing continuous monitoring, even during movement. A system for continuous static and dynamic measurements of compression is described. Using an air chamber and manometer to test the system, agreement within +/- 3 mmHg is observed. The system is applied to investigate changes in forces, expressed as pressure, under bandages and compression stockings. Application of five bandage systems by experienced nurses to a volunteer shows a marked variation in applied pressure. During short periods of walking, rapid changes in pressure under compression stockings are observed, including some transients of less than 0.25 s. The method is simple to apply and may help to understand further the mechanism of action of compression therapy.