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PubMedDate not supplied

[Venous ulcers of the lower limbs in the aged. Indications for bandages].

BACKGROUND: There are many causes of ulcer of the lower limb. In the elderly, venous ulcers and arteriosclerosis often coexist; for this reason pressure bandages might be contraindicated for the risk of precipitating a potentially critical arterial flow. In this work, the conditions which allow a safely treatment with pressure bandage in the elderly are evaluated. MATERIAL AND METHOD: Eleven self-sufficient elderly, with venous ulcerations to one leg only, and ankle pressure/omeral pressure between 0.92 and 0.86 were treated with elastic bandaging of the leg. RESULTS: All patients completed the treatment, with healing of the ulcer obtained in 3-8 months time. So far none of them relapsed. CONCLUSIONS: In the elderly, in selected cases, when Pc/Po > 0.86, pressure bandages can be safely applied to heal the ulcer, without running the risk of endangering arterial circulation.

Age Factors↗
PubMed1993

Delivery of growth factor to wounds using a genetically engineered biological bandage.

Increasing the rate of wound healing of acute wounds and promoting the closure of chronic ulcers is an important goal in wound therapy. Growth factors have been shown to facilitate this process; however, the systems described for growth factor delivery are not ideal. In the present report we demonstrate the feasibility of a new method of delivering growth factors to the wound site using a genetically engineered biological bandage. The bandage consists of keratinocytes (SCC-13 cells) that are engineered by gene transfer to produce high levels of bovine growth hormone (bGH). bGH was selected for these studies because it can be easily distinguished from rat and human growth hormone in wound fluids and culture medium. The bGH-producing cells are contained and maintained in serum-free medium inside an envelope composed of a low protein binding, 0.2 micron pore size, polysulfone membrane. The genetically engineered cells cannot escape from the bandage, but the bGH is freely released into the surrounding culture medium. When placed onto a full-thickness, surgically generated wound on rats, the cells within the bandage continue to produce and release bGH into the wound for at least 3 days. This system is a safe and reliable way of providing real-time delivery of any desired biomolecule into the wound site.

Animals↗
PubMed1987

Ontogeny of immobility reactions elicited by clamping, bandaging, and maternal transports in rats.

Wistar neonate rats assume a characteristic posture when being transported by the mother. This carrying posture is normally elicited by the pressure given by the mother's teeth on the pup's neck. By clamping or bandaging the neck and head an immobility reflex with flexion of body and limbs resembling the carrying posture is elicited when pups are in a supine position. On the contrary, by bandaging or by lightly clamping the pups in a prone position, a dorsiflexion with extension of forelimbs is elicited. Both clamping or bandaging inhibits contact and air righting. After a period of immobility bursts of activity follow. The characteristics of all the reactions described above depend on the age of the developing pups. It seems that the immobility reflex with ventroflexion of the body is a behavior used initially by pups to facilitate carrying by the mother, and by both pups and adults as a defense against predators. The posture adopted by the pups bandaged in the neck in a prone position is very similar to the posture they adopt while suckling from the mother. It is postulated that the weight of the mother when lying over the pups plus the pressure on the paws caused by their prone position, could be the stimulus that normally produces the suckling posture.

Aging↗
PubMed2000

Bandage soft contact lens barrier function: a clinical research note.

Corneal thickness pre- and post-operatively was measured on 18 volunteer subjects within the context of a clinical investigation of laser refractive surgery. All measurements were taken with regard for time of day, in order to counter any complicating diurnal influence on data accuracy. Of the 18 subjects, six lost or had accidently displaced their overnight bandage soft contact lenses the first night immediately after surgery, and 12 retained theirs. The individuals with lost bandage lenses exhibited uniformly thick, swollen corneas. In contrast, the other 12 subjects, with retained lenses, exhibited a stable corneal thickness map, displaying the characteristic relatively thick periphery that transitions to a thinner central region. Moreover, in the six affected subjects, application of a new overnight bandage lens resulted in recovery of the normal thickness pattern on day 2, as opposed to the uniform swelling or oedema of the previous day. In combination, these findings indicate a fluid barrier function on behalf of the bandage soft contact lenses, which allowed the corneal endothelial pump mechanism to counteract any extreme swelling or fluid accumulation. This previously unreported phenomenon helps explain the historical effectiveness of this treatment regimen for corneal bullous, or excessive fluid-retention, conditions.

Journal Article↗
PubMed1999

Intraoperative use of the absorbable fibrin adhesive bandage: long term effects.

PURPOSE: The absorbable fibrin adhesive bandage (AFAB) reduces acute blood loss in experimental trauma models, but the effects on wound healing and subsequent function have heretofore not been investigated. Retropubic prostatectomy was selected to evaluate short and long term effects of using the AFAB intraoperatively. MATERIALS AND METHODS: Dogs undergoing prostatectomy were randomly assigned to one of four treatments: CONTROL- sponges and manual pressure were applied after transecting the prostatic pedicles. Sponges were removed when the prostate was delivered. Vessels were isolated and ligated if bleeding continued after removal. AFAB- hemostatically active bandages were applied to the prostatic bed prior to sponges and pressure. Additional bandages were applied at the urethrovesical junction after completing the anastomosis. PLACEBO- visually identical (hemostatically inert) bandages were applied in an identical fashion. LIQUID SEALANT- concentrated thrombin and fibrinogen solution was applied to the vessels prior to sponges and pressure. Additional sealant solution was applied around the anastomosis. RESULTS: Blood loss and time to achieve hemostasis were significantly less in the AFAB group compared with the other treatments. There were no differences in days to anastomotic integrity, continence, or intra-abdominal adhesions at necropsy six weeks later. CONCLUSIONS: The AFAB can reduce surgery time and blood loss, with no decrement in wound healing or subsequent function.

Animals↗
PubMed2002

Early and late removal of the pressure bandage in brown snake envenomation: a report of two cases.

Two cases of brown snake envenomation are presented where the duration of bandage application in one patient was prolonged compared with the other patient and was associated with a reduction in the total amount of antivenom required. One patient had the bandage removed 2 hours and twenty minutes after application and required 25 units of brown snake antivenom to neutralise the defibrination coagulopathy and manage an upper gastrointestinal haemorrhage. This patient also sustained an urticarial reaction during administration of the final 5 vials of antivenom. The other patient had the bandage released more than 22 hours after its application and only required a total of 6 units of brown snake antivenom to neutralise the defibrination coagulopathy. In the latter case, there was no reaction to any of the vials of antivenom These cases suggest that bandage release could be delayed well beyond the usual recommended time to effect a reduction in peak and cumulative venom levels and antivenom requirements.

Journal Article↗
PubMed1986

Experimental study on thermal burns caused by plaster bandage.

Plaster bandage is frequently used in the field of orthopaedic surgery. Little is known however of thermal burns caused by plaster bandage. Experience has shown that heat producing levels differ depending on application conditions, i.e., water temperature into which plaster of Paris is dipped, thickness of the plaster cast, kind of plaster, etc. We made a series of experiments to find out what factors are related to elevation of the skin temperature in a plaster splint applied to a human forearm. The highest skin temperature of 47.7 degrees C was obtained upon application of a plaster bandage made of 30 layers of plaster with short setting time, dipped in water at 42 degrees C. In this condition the examinee had a first degree burn on the skin surface. Thus, care must be taken in applying a plaster bandage to assure that it does not cause a serious burn to the skin.

Burns↗
PubMed1963

The Velpeau bandage.

Many varieties of swaddling bandages for injuries of the shoulder are in use and are called Velpeau bandages. Velpeau's original description has been consulted. The injured arm is placed across the chest and turns of bandage are made from beneath the sound axilla, over the injured shoulder, in front of the injured arm, and beneath the elbow, to pass again to the sound axilla. It is completed by transverse turns. Velpeau, a blacksmith's son, was born in 1795, became professor of surgery in Paris, and died in 1867 after a distinguished career.

Axilla↗
PubMed2002

[Reconstruction of shoulder-girdle symmetry after midclavicular fractures. Stable, elastic intramedullary pinning versus rucksack bandage].

The aim of this study was to compare the results achieved in two groups of 20 patients treated for midclavicular fracture. The first group (mean age 36 years) was treated non-operatively with a rucksack bandage, whereas the second group (mean age 37 years) underwent intramedullary fixation with a titanium pin using a minimally invasive, unreamed technique. At follow-up, which averaged 3.1+/-0.9 years in group 1 and 2.9+/-0.7 years in group 2, the result of treatment, as indicated by the Constant score, functional outcome and cosmetic outcome, was significantly better in the group undergoing operative treatment. Clavicle shortening was significantly ( P=0.027) higher in patients treated with a rucksack bandage. The absolute Constant score averaged 78+/-23 in group 1 and 97+/-4 in group 2 ( P=0.001). The Constant rating scale showed a significant difference between patients with clavicle shortening of less than 1 cm and 1 cm shortening or more. There were two non-unions in group 1 but none in group 2. Refractures were not observed in either group. According to these results, intramedullary fixation with a titanium pin seems to be more advantageous in midclavicular fractures than non-operative treatment. As the operation is well received by the patients, it should be offered to them as an alternative treatment to the rucksack bandage.

Adolescent↗
PubMed1997

[Proprioceptive capacities of patients with retropatellar knee pain with special reference to effectiveness of an elastic knee bandage].

In the presented study, knee joint proprioception of 43 patients with a patellar pain syndrome of the knee joint was evaluated. In a control group, the proprioception of 30 healthy volunteers with clinical and an-amnestic inconspicous knee joints was examined. We tested the proprioceptive capability of the subjects with a passive angle reproduction test. Additionally, all knee joints were measured with and without an elastic knee bandage. The patient group showed significant deterioration of angle reproduction capability (13.2 degrees +/- 6.1 degrees) compared to the control group (7.8 degrees +/- 2.8 degrees). After applying an elastic knee bandage, the angle reproduction capability significantly improved to 9.2 degrees +/- 4.5 degrees. Proprioception of the contralateral, noninvolved knee joint in the patients (11.6 degrees +/- 6.3 degrees) was worse compared to the control group. Applying an elastic knee bandage did not significantly improve the proprioception of the uninjured knee joint.

Adult↗
PubMed2001

Cryotherapy compared with Robert Jones bandage after total knee replacement: a prospective randomized trial.

Sixty patients undergoing total knee replacement were randomized to receive either a cold compression dressing (Cryo/Cuff, Aircast, UK) or a modified Robert Jones bandage immediately after surgery. The cold compression dressing was used for a minimum of 6 h per day throughout the hospital stay, and the modified Robert Jones bandage remained in place for 48 h from the time of operation. The 2 groups of patients were compared during their hospital stay for blood loss, range of movement, pain scores and need for analgesia. No difference was found between the 2 groups except for less blood loss in the surgical drains in the cold compression group (P < 0.05). Postoperative complications were seen in both groups, but no complication was associated with either the cold compression dressing or the modified Robert Jones bandage.

Aged↗
PubMed2001

Elastic bandaging facilitates primary closure of large ventral hernias due to giant omphaloceles.

Large ventral hernias (VH) following conservative treatment of a giant omphalocele are a major challenge for pediatric surgeons. Although primary closure is accepted as the ideal procedure, these defects often require multi-staged operations, prosthetic support, and postoperative mechanical ventilation. Between 1990 and 2000, 34 patients with omphaloceles were admitted to our unit and 6 of them (17.6%) who had giant omphaloceles were treated conservatively. In the same period, a 5-year-old girl was admitted with a huge VH following application of subcutaneous tissue expanders in another center. In these 7 patients (6 girls, 1 boy, average age 20 months) we used preoperative elastic bandaging for facilitating primary closure. In all cases primary closure was successful following 3 to 6 weeks of bandaging. We did not use prosthetic material or postoperative mechanical ventilation in any case. Follow-up periods ranged from 2 to 10 years, and there were no recurrences or other problems. Out limited experience reveals that preoperative elastic bandaging is a safe and effective procedure for facilitating primary closure of the large VHs.

Bandages↗
PubMed1983

Bandages for backslabs: an experimental study.

Five types of bandage commonly used to support plaster backslabs were subject to static and dynamic performance tests. Dry and wet samples were studied. The performance of wet bandage is inferior. Attention is drawn to possible hazards caused by the shrinkage exhibited by 2 types of wet bandage.

Bandages↗
PubMedDate not supplied

Early mobilization after diagnostic cardiac catheterization with the use of a hemostatic bandage containing thrombin.

The aim of the present study was to assess the efficacy and safety of a thrombin-containing bandage for local hemostasis after femoral sheath removal in patients undergoing diagnostic cardiac catheterization. Forty-one patients undergoing diagnostic coronary angiography using a 6-F femoral sheath were included. The sheath was removed immediately after the procedure using the bandage according to a prespecified protocol. Mean compression time was 7.3+/-1.7 min and mean time from sheath removal to mobilization was 132+/-34 min. None of the patients suffered recurrent bleeding or any in-hospital and 7-day vascular complications. We conclude that in patients undergoing femoral-access diagnostic cardiac catheterization, the use of a hemostatic bandage containing thrombin was associated with short time to hemostasis with the ability for early patient mobilization without vascular complications.

Bandages↗
PubMed2000

Which venous leg ulcers will heal with limb compression bandages?

PURPOSE: To develop a simple prediction rule to identify patients in whom a venous leg ulcer will heal using a limb compression bandage (eg, Unna's boot). SUBJECTS AND METHODS: We performed a retrospective cohort study of patients with venous leg ulcers who received a limb compression bandage applied weekly. Prognostic factors were assessed from the patient's history before the start of treatment. The outcome of interest was a healed wound within 24 weeks of treatment. The final model was validated in another data set. RESULTS: Several accurate prognostic models were developed. The simplest model summed the size and duration of the wound before treatment, with 1 point given for a wound with an area >5 cm(2) and another if the wound was >6 months old. In the development data set, ulcers healed in 93% (110 of 118) of patients with a score of 0, but in only 13% (9 of 67) of those with a score of 2. In the validation data set, ulcers healed in 95% (19 of 20) of patients with a score of 0, and 37% (44 of 120) of those with a score of 2. CONCLUSIONS: This simple prognostic model can be used to discriminate between patients with a venous leg ulcer that will or will not heal within 24 weeks of care with a limb compression bandage. The model may be useful in determining which patients to treat with a limb compression, and which patients should be referred or considered for alternative treatments.

Aged↗
PubMed2003

Erosive pustular dermatosis of the leg associated with compression bandaging and fungal infection.

BACKGROUND: Erosive pustular dermatosis of the leg (EPDL) has been described in association with venous insufficiency and atrophy of the skin of the lower leg. Like erosive pustular dermatosis of the scalp, this disease has also been reported to be a non-infective condition. OBJECTIVES: To investigate the clinicopathological features and, where possible, the aetiology of clinical EPDL. METHODS: We identified a group of patients undergoing continuous compression bandaging for venous dermatitis of the legs and/or predominantly venous leg ulceration with clinical features described in patients with EPDL. They were investigated by skin biopsy, patch testing and microbiological tests for the presence of bacteria and fungi. RESULTS: Twenty-four of 400 (6%) patients were noted to have pustules on the leg(s). There was laboratory evidence of fungal infection in 13 of 24 patients (54%), with complete and sustained resolution of pustules after antifungal treatment. Pustulation in the other 11 patients (46%) was unresponsive to antibiotics for confirmed bacterial infection; some improvement was seen with potent topical corticosteroids but full clearance was achieved only after a switch from continuous four-layer compression bandaging to the use of intermittent long stretch compression. CONCLUSIONS: EPDL is a fairly common clinical picture seen in patients undergoing continuous compression bandaging. It may be produced by opportunistic, particularly fungal, infection. In almost half an infective aetiology cannot be demonstrated and a pyoderma gangrenosum-like process may be implicated.

Aged↗
PubMed1999

Venous ulcer healing by four-layer compression bandaging is not influenced by the pattern of venous incompetence.

BACKGROUND: Previous studies have related deep venous incompetence to reduced venous ulcer healing rates. The aim of this study was to determine the relationship between the pattern of venous incompetence and ulcer healing. METHODS: A total of 198 legs with venous ulceration were investigated with colour venous duplex imaging to determine the presence and site of venous incompetence. All were treated initially with the four-layer bandage technique. RESULTS: At 6 months, 74 per cent of the venous ulcers had healed using the four-layer bandage technique. There was no significant correlation between the pattern of incompetence and the healing rate of the ulcer. Previous deep vein thrombosis (DVT), increased size of the ulcer and previous episodes of ulceration were associated with a poor healing rate. CONCLUSION: The four-layer bandage technique achieved an ulcer healing rate of 74 per cent after 6 months, irrespective of the pattern of venous incompetence. Patients with a large ulcer, previous DVT or previous episodes of ulceration had delayed healing, supporting the previous literature.

Adult↗
PubMed2000

Intermittent pump versus compression bandages in the treatment of venous leg ulcers.

BACKGROUND: The purpose of the present paper was to compare healing rate and leg swelling with an intermittent compression pump versus compression bandages in the treatment of venous leg ulcers, and to also compare patient compliance and satisfaction with the two techniques. METHODS: A randomized cross-over study of patients attending an outpatient wound clinic (n = 16) was undertaken. A regular monthly follow-up with measurement of ulcer size and leg volume was carried out, as well as completion of a questionnaire. RESULTS: Assessment was possible in 11 of the 16 patients. There was no significant difference between treatment types with regards to ulcer healing rates or control of leg oedema. The survey revealed that patients found the pump easier and more comfortable to use, with a trend towards increased compliance. CONCLUSIONS: Although the present study was too small for generalizable conclusions, compression pumps and bandages are comparable in efficacy for the healing of venous leg ulcers. The compression pump is reported as being easier and more comfortable to use than bandages.

Aged↗