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PubMedDate not supplied

Use of a noncontact radiant heat bandage and Staphylococcus aureus dermal infections in an ovine model.

Diabetic foot wounds are difficult to manage due to relative tissue ischemia and high rates of soft tissue infection. One potential treatment modality is the application of local radiant heat to promote wound healing and control infection. However, there are concerns that local heat will spread rather than control infection. We determined in this study the effect of a noncontact radiant heat bandage in controlling an ischemic soft tissue infection. Bilateral 10 x 15 cm dermal flaps were created in 15 adult range sheep. The flaps were inoculated intradermally with 107 Staphylococcus aureus in 3 separate areas. The control flap was left open to air, while the treatment flap was covered with a noncontact radiant heat bandage and heated to 38 degrees C for three 1-hour periods separated by two 1-hour nonheating periods daily. After 10 days, both dermal flaps were harvested and sent for quantitative bacteriology. Due to operative complications, 12 of 15 sheep completed the study. The heated flap temperature was significantly higher 39.2 +/- 0.5 degrees C (+/- SE) vs. the control flap 36.1 +/- 0.1 degrees C (p < 0.00001) and bacterial counts were significantly smaller in the heated flap (median 1.0 x 107 colony-forming units per gm tissue) when compared to the control flap (median 7.5 x 107) (p = 0.001). This study shows the use of a noncontact radiant heat bandage controls ischemic soft tissue infections in an ovine model.

Animals↗
PubMedDate not supplied

[Blood transfusion in total hip endoprosthesis operations in relation to Redon drainage and pressure bandages. An innovation in surgical method].

PROBLEM: There is a difference in the use of redon drainage following hip arthroplasty worldwide. The aim of the study was to find the best version. METHOD: In a prospective randomized study including 158 patients with coxarthrosis we implanted cementless Alloclassic hip-endoprostheses and registered consumption of blood, blood loss, hemoglobin level, subcutaneuos hematoma, swelling of the proximal thigh, bleeding and exsudation of the wound in four groups supplied with three, two (subcutaneously and subfascial) and one (subcutaneously or subfascial) drainage with compression bandage and one group with two redons (subcutaneously and subfascial) without compression bandage. For prophylaxis of deep vein thrombosis we used low dose heparin. RESULT: We could demonstrate, that the application of two redons one subcutaneously and one subfascial gave the best result. Compared to the conventional procedure with three redons we achieved a reduction of 47% of blood units, a significant reduction of exsudation and bleeding out of the wound, subcutaneous hematomas and a reduced swelling of the proximal leg in addition to better clinical conditions of the patients. The reason is a more accelerated stop of the bleeding out of the spongy bone. The application of one drain subcutaneously or subfascial showed no further reduction of blood loss, but an increase of wound exsudation and bleeding out the wound and an increase of subcutaneous hematomas. Sufficient external compression of the area of operation by a compression bandage is very important. Disadvantages as a result of changing the way of drainage have not been detected. CONCLUSION: The use of two Redons one subcutaneously and one subfascial showed an obvious benefit without any clinical disadvantage compared to 3 redons or no drainage.

Arthroplasty, Replacement, Hip↗
PubMed2005

Early treatment of trans-tibial amputees: retrospective analysis of early fitting and elastic bandaging.

This study investigates the effects of early fitting in trans-tibial amputees. The assumption is that compared to elastic bandaging, the use of a rigid dressing in early fitting will result in quicker wound healing and earlier ambulation. A retrospective file search was carried out in three different hospitals, analysing the time to first prosthesis, the incidence of local and general complications and the functional outcome after discharge from hospital. Each of the hospitals used a different method of postoperative care: elastic bandaging, immediate postoperative application of the plaster cast or delayed application of the plaster cast within one week post amputation. In comparison to the elastic bandaging method (N=52), the use of a rigid dressing in the early fitting method (immediate and delayed, N=97) resulted in a statistically significant shorter period from amputation to the delivery of a first regular prosthesis (110 days vs 50 days) and a decreased risk of knee flexion contracture. Although, differences in local complications were not observed, the risk of pressure sores in other places than the stump was increased in early fitting. Instead of further reducing the time to first prosthesis by immediate fitting, the use of delayed fitting resulted in a statistically significant shorter period from amputation to the delivery of a first regular prosthesis (56 vs 40 days). However, delayed fitting was associated with an increased risk for reamputation. In conclusion, this study indicates that early fitting by use of a rigid dressing after trans-tibial amputation is the treatment of choice. If it is possible to apply a plaster cast in the operating room, the authors would prefer the immediate fitting method.

Aged↗
PubMed1982

Comparison of removable rigid dressings and elastic bandages in preprosthetic management of patients with below-knee amputations.

The purpose of this study was to determine if the removable rigid dressing is more effective in preprosthetic management than the conventional support dressing with elastic bandages. Residual limb circumference, independent application of the dressing, tendency of the dressing to remain secure, development of pressure areas, and presence of pain were evaluated in two groups of below-knee amputees. Subjects were randomly assigned to use either removable rigid dressings or conventional elastic bandages. Residual limb circumference was measured three times a week, and the other variables were measured weekly. The results indicated that the removable rigid dressing is more effective in preprosthetic management than the elastic bandage.

Aged↗
PubMed2000

Does the absorbable fibrin adhesive bandage facilitate partial nephrectomy?

PURPOSE: To evaluate the ability of the absorbable fibrin adhesive bandage (AFAB), a prototype product comprising lyophilized fibrinogen and thrombin on a VicrylTM mesh backing, to seal the collecting system and control bleeding after partial nephrectomy. MATERIALS AND METHODS: Growing female pigs (n = 18) underwent left nephrectomy and a 40% (by length) right lower pole partial nephrectomy. One of three treatments was immediately applied: Conventional-closure of the collecting system, ligation of visible segmental vessels, application of SurgicelTM with bolstering sutures to the renal capsule; AFAB-application of up to two 4 x 4-inch AFABs held under pressure for 60 seconds; Placebo-application of a hemostatically inert VicrylTM bandage, visually identical to the AFAB. Blood loss and ischemic and total operative times were recorded, and abdominal computerized tomography (CT) was performed on postoperative day 6. Animals were sacrificed at 6 weeks to evaluate the remaining renal mass histologically. RESULTS: Compared with conventional therapy, use of the AFAB resulted in significantly less bleeding (13 versus 68 ml., p <0.001) and lower operative (7.2 versus 16.3 minutes, p <0.001) and ischemic times (3.4 versus 7.8 minutes, p <0.001). Estimated blood loss in the placebo bandage group was dramatically higher (357 ml., p <0.001). Postoperative CT and histological sectioning suggested that the AFAB produces a stable, durable clot and that healing is at least as successful as with conventional treatment. CONCLUSION: Use of the AFAB facilitated performance of partial nephrectomy by reducing blood loss and ischemic and total operative times. The AFAB appears equivalent to conventional surgery in its ability to seal the collecting system.

Absorbable Implants↗
PubMedDate not supplied

A randomized, controlled trial comparing compression bandaging and cold therapy in postoperative total knee replacement surgery.

PURPOSE: To examine the difference between compression bandaging and cold therapy after total knee arthroplasty. SAMPLE: Eighty-four postoperative, unilateral, total knee replacement, surgical clients. PROCEDURE: Clients were randomized into two groups: those receiving compression bandaging, and those receiving cryo-pad technology. Subjects were assessed for total length of stay, blood loss, blood transfusion, swelling, flexion, pain, and opiate use. FINDINGS: Unlike other studies, the results of these data showed no significant differences between groups on the measured outcomes. A simple cost benefit analysis shows that the compression bandage is cheaper and more labor efficient than the cold therapy as delivered by cryo-pad technology.

Arthroplasty, Replacement, Knee↗
PubMed2003

Modified rapid deployment hemostat bandage reduces blood loss and mortality in coagulopathic pigs with severe liver injury.

BACKGROUND: Hemostasis can be difficult to achieve after blunt abdominal trauma, especially if the patient is coagulopathic. The U.S. Food and Drug Administration has recently approved a hemostatic dressing for treating bleeding after extremity trauma (RDH bandage; Marine Polymer Technologies, Cambridge, MA). It has not been evaluated for internal bleeding after trauma. We redesigned this dressing for internal use, and then tested whether this modified bandage (Miami-modified Rapid Deployment Hemostat) could achieve hemostasis when used as an adjunct to standard laparotomy pad packing in a pig model of severe liver injury with coagulopathy. METHODS: Anesthetized swine (35-45 kg) received an isovolemic 45% blood volume replacement with refrigerated Hextend (6% hetastarch). Core body temperature was maintained at 33-34 degrees C with intra-abdominal ice packs. A coagulopathic condition was documented by thromboelastography. At this point a severe liver injury was induced by the avulsion of the left lateral hepatic lobe, then the pigs were randomized to treatment with either standard abdominal packing (control) or packing plus Miami-modified Rapid Deployment Hemostat. Two series of experiments were conducted. In series one (n = 14), the abdomen was closed and the animals were observed with no resuscitation. After one hour, the abdomen was opened, the packing was removed and the presence of bleeding was noted. In series two (n = 10), the abdomen was closed and the animal resuscitated with one unit of blood plus as much lactated Ringers intravenous fluid (IVF) as required to maintain a mean arterial pressure (MAP) > 70 mm Hg. After one hour, the packing was removed, the abdomen closed, and data were collected for an additional two hours. RESULTS: Series one: 6/7 animals in the control group had continued bleeding at one hour; 1/7 animals in the treatment group had active bleeding (p = 0.0291). Series two: With control vs. Miami-modified Rapid Deployment Hemostat, the three-hour survival was zero vs. 80% (p = 0.0476). The total blood loss was 1.2 +/- 0.1 vs. 0.3 +/- 0.1 mL/kg/min (p = 0.001) and the IVF requirement was 1.6 +/- 0.3 vs. 0.6 +/- 0.3 mL/kg/min (p = 0.026). CONCLUSIONS: The Miami-modified Rapid Deployment Hemostat bandage significantly reduced mortality, blood loss, and fluid requirements when used as an adjunct to standard abdominal packing following severe liver injury in coagulopathic pigs [corrected].

Animals↗
PubMed1993

Alterations in pressure under elastic bandages: experimental and clinical evaluation.

Clinical and experimental studies of pressure under elastic bandages are performed in order to assess their effectiveness in compressing wounds to prevent edema in burn wounds. In experimental studies, pressure decreased slowly over a day when applied with a tension of 250 grams to a limb model without a pad. However, pressure decreased a little more rapidly when applied using a pad, especially when the pad became wet. In clinical studies among patients, the pressure under the elastic bandage decreased more rapidly over time than it did in the experimental studies. From those findings, although harmful side effects such as circulatory disturbances will not occur when an elastic bandage is applied on the limb with a tension of 250 grams, it is very difficult to maintain the initial level of pressure correctly and control the pressure for even the duration of a single day clinically.

Adolescent↗
PubMed1997

Comparison of bandaging and elevation of the claw for the treatment of foot lameness in dairy cows.

OBJECTIVE: To compare the effectiveness of three treatments for sole injuries in dairy cows and to evaluate the ease and speed of applying the treatments. DESIGN: A randomised clinical trial. PROCEDURE: The three forms of treatment were elevating the affected claw of a lame cow with a wooden block glued to the unaffected claw (39 cows), elevating the affected claw with a rubberised shoe glued to the unaffected claw (42 cows) or applying a padded bandage to the whole foot of a lame cow (31 cows). RESULTS: The percentages of cows that recovered from lameness at 3 and 7 days after treatment were significantly higher for cows treated with wooden blocks (P = 0.013 and P = 0.008) or rubberised shoes (P = 0.026 and P = 0.0003) than padded bandages. Cows treated with blocks had a recovery rate of 48.7% at day three and 65.8% at day seven, and cows treated with rubberised shoes, rates of 45.2% and 76.2%, respectively. Cows which had a bandage applied to the foot had recovery rates of 19.4% at day three and 32.3% at day seven. However, by day 14, there was no significant difference in recovery rate between the three treatments. Rubberised shoes were shown to offer a number of advantages over wooden blocks. The shoes were significantly quicker to attach than blocks (median of 9.5 minutes compared with 14.0 minutes, P < 0.0001) and remained on the claw longer (57.1% of rubberised shoes remained at 30 days compared to 30.8% of blocks, P = 0.025). The rubberised shoes also offered an advantage over wooden blocks for operator safety and health by reducing contact between the potentially hazardous adhesive used to attach both devices and the skin of the person applying the device. CONCLUSIONS: Rubberised shoes are a superior method of elevating an affected claw in conditions of lameness likely to respond to removal of weightbearing forces.

Animals↗
PubMed1993

Effectiveness of functional ankle taping for judo athletes: a comparison between judo bandaging and taping.

This study was conducted to compare the effectiveness of the traditional method of ankle bandaging and the new method of ankle taping for judo athletes in Japan, and to introduce a functionally effective taping method for judo players. Four university judo athletes with ankle instability were selected to undertake radiography of the ankles before and after exercise, with bandaging at one time and taping at the other. Talar tilt (TT) angles were measured in order to compare the ankle-supporting effects. The results showed that the old ankle bandaging method had no role in eliminating the talar tilt during judo practice. In contrast, the new taping method was more effective in eliminating the talar tilt and supporting the involved ankles both mechanically and functionally.

Ankle Injuries↗
PubMed1976

Control of distension of varicose veins achieved by leg bandages, as used after injection sclerotherapy.

A study was performed to determine whether the pressures routinely produced by bandaging for compression sclerotherapy of varicose veins are adequate to maintain the superfical veins almost empty of blood. The results suggest that well-applied bandages can provide sufficient support to combat the high distending pressures found in varicose veins. The large variation among different surgeons, however, indicates that any clinical assessment of compression sclerotherapy should include measurement of the pressure at which the bandages are applied.

Bandages↗
PubMed1999

Bandage distraction technique for ankle arthroscopy.

In ankle arthroscopy, the joint space of the talocrural joint is often too narrow for insertion of the scope and instruments. Various distraction devices for this procedure have been used to widen the joint space. Bandage distraction is effective and noninvasive, but it is difficult to extend the posterior joint space sufficiently for insertion of the scope. Here we describe a new bandage distraction method that can extend the posterior joint space adequately. Using our method, the anterior and posterior joint spaces on direct lateral radiographs were measured after adding the distraction force in nine healthy volunteers (18 ankles; three men and 6 women). This was compared to a previously reported method. The posterior joint space was widened a greater amount when our new bandage distraction technique was used.

Ankle Joint↗
PubMedDate not supplied

Venous leg ulcers: short-stretch bandage compression therapy.

Graduated compression therapy is rapidly becoming the treatment of choice for venous leg ulcers; it is cost-effective and offers faster healing rates than without compression. Holistic assessment of the patient along with education of the practitioner leads to the safe application of compression bandages. This article looks at the assessment of venous ulcers and how application of short-stretch bandages can achieve graduated compression, leading to rapid healing. As with any new skill, compression bandaging requires the practitioner to have received research-based education and practice and to have a clear understanding of how the technique achieves the objective.

Bandages↗
PubMedDate not supplied

The four-layer bandage system from a nursing perspective.

This article describes an evaluation that took place in 20 health centres, community clinics and hospitals throughout the UK. The aim was to explore nurses' opinions of three different four-layer bandage systems: kit A (System 4); kit B (Charing Cross); and kit C (Profore). Fifty-seven pairs of nurses were involved; within each pair, one was the applier and one the wearer. Each nurse was asked to complete a questionnaire which highlighted their opinions relating to ease of application, conformability, comfort and preferred bandage length. Responses were analysed using simple frequency counts, means, standard errors, Fisher's exact test and Kruskal-Wallis' one-way analysis of variance. The nurses involved were regular users of either the Charing Cross or Profore systems. Kit A was significantly easier to apply than kit B for layer 1 (P < 0.001), layer 2 (P < 0.05) and layer 3 (P < 0.01). There was no significant difference in relation to layer 4. With regard to ease of application there were no statistically significant differences between kits A and C or B and C. Layer 1 of kit A was significantly more conformable than layer 1 of kit B (P < 0.001). There were no significant differences between kits B and C, or A and C or in relation to comfort for all bandage kits. Overall preference by the applier was: 25 for kit A, nine for kit B and 15 for kit C. Overall preference by the wearer was: 23 for kit A, 10 for kit B and 14 for kit C.

Attitude of Health Personnel↗
PubMedDate not supplied

A new cohesive short-stretch bandage and its application.

The undisputed optimum treatment for venous leg ulcers is compression therapy, where an external appliance (multilayer, short-stretch bandaging and compression hosiery) promotes venous return through graduated compression of the tissues and capillaries. However, this is not always acceptable to the patient, particularly when the patient's social life is affected with malodour and pain associated with venous leg ulcers, thereby reducing quality of life. There is a psychosocial consideration when the bandaging system is bulky, hot and difficulty is found with the fitting of shoes. An alternative and clinically effective solution is essential if the wound is to heal. In this case study, the patient was provided with a cohesive and short-stretch compression bandage (Actico), which allowed her to continue her social life while effectively treating her ulcer.

Aged↗
PubMed2003

Why patients do not comply with compression bandaging.

The aim of this study was to explore the perceptions of patients presenting with venous leg ulceration who were labelled as 'non-compliant' with compression bandaging by district nurses. A hermeneutic approach was taken and 14 patients with chronic venous leg ulceration were interviewed. Six themes emerged from the data: (1) lay perceptions of the cause and healing of leg ulceration, (2) concurrent problems of leg ulceration, (3) dilemmas of treatment, (4) perceptions of healthcare professionals, (5) the need for health education, (6) what it is like living with a leg ulcer. Patients did not have a clear understanding of their condition or treatment regimes. Concurrent problems associated with compression bandaging included pain, leakage of exudate and skin irritation, and these symptoms adversely affected patients' lifestyles and contributed to 'non-compliance'. Patients acknowledged that acceptable care was given in the community. However, they said that healthcare professionals misunderstood how their physical and psychological problems affected them, which in turn led to disagreements and disempowerment. Finally, it was apparent that patients were lacking in information relating to their condition and treatment. This study identified that many aspects of patients' perceptions of their condition and treatments influenced their ability to tolerate compression bandages. Non-compliance is a multivariant concept in which both physical and psychological determinants play a key role. Nurses need to gain a clear understanding of patients' concurrent physical problems and perceptions of their health beliefs.

Aged↗
PubMed1996

High-compression bandages.

This report describes the results of a programme of tests carried out on a new high-compression bandage, with two application aids designed to produce specific pressures on normal-size and oedematous limbs. The product was tested to examine its performance in relation to the specified criteria of a Type 3c compression bandage and other pre-defined features. The results show that, with the use of both application aids, the bandage can provide the target pressure of 40 mmHg +/- 10% on ankles ranging from 21-26 cm and 27-33 cm in circumference. Ankles with circumferences between 26 and 27 cm will fall marginally outside the design criteria (40 +/- 6 mmHg).

Bandages↗
PubMed1997

Trial of two bandaging systems for chronic venous leg ulcers.

A four-layer bandaging system developed at Charing Cross Hospital has been found to be effective in healing chronic venous ulcers but is not available on the Drug Tariff. An alternative system was devised from bandages available on the Drug Tariff and a community-based randomised controlled trial was undertaken to compare the two systems. Twenty-nine patients with a total of 35 ulcerated legs were recruited. Equal numbers of ulcerated legs healed using the two compression systems. Nineteen ulcerated legs did not heal, of which six were withdrawn from the trial-two in the trial system and four in the Charing Cross system. Of the 13 remaining ulcerated legs, for which treatment was completed, the mean reduction in ulcer area was 34% with the trial system and 39% with the Charing Cross system. The change in ulcer area was not statistically significant. However, a much larger trial is required in order to demonstrate definitively that the two bandaging systems are equivalent.

Bandages↗