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At least 217 records · Page 12Linked to original sources
PubMed1997

A new anti-infective collagen dressing containing antibiotics.

A new antibacterial dressing for infected wounds was prepared. The dressing was composed of a collagen membrane and collagen sponge; both biomaterials possess good tissue biocompatibility. An active antibacterial layer of limited hydrophobicity was placed between the membrane and the sponge and into the upper part of the sponge. The dressing contained gentamycin or amikacin at concentrations of 0.3 microgram/cm2 (loading level of the drug utilized during preparation of the dressing). Either the antibiotic or its concentration easily can be changed in the dressing by the manufacturer. The dressing was stable for several months. The antibiotic was released slowly from the dressing in in vitro experiments for 3 days. Antibacterial activity of the dressing was tested using a mouse wound model experimentally infected with Pseudomonas aeruginosa. Both dressings, containing either amikacin or gentamycin, reduced the number of living bacterial cells in the infected tissue almost to zero during the course of observation. The new dressing may be effective in the treatment of infected wounds in patients.

Amikacin↗
PubMed2003

Scanning electron microscopic examination of bacterial immobilisation in a carboxymethyl cellulose (AQUACEL) and alginate dressings.

Dressings have been applied to open wounds for centuries. Traditionally they have been absorbent, permeable materials, i.e. gauze that could adhere to desiccated wound surfaces, inducing trauma on removal. With the advent of modern wound care products many dressings are now capable of absorbing large volumes of exudate whilst still continuing to provide a moist wound healing environment. Equally important is their ability to lock exudate in the dressing (i.e. bacterial retention within the dressing matrix) such that upon removal from a wound surface bacterial dispersion is minimised. In these studies detailed scanning electron microscopy techniques have demonstrated the fluid controlling properties of alginate wound dressings and a carboxymethylated cellulose wound dressing (AQUACEL) Hydrofiber) dressing (CMCH)). It was demonstrated that following hydration of the latter wound dressing, the subsequent formation of a cohesive gel was effective in encapsulating large populations of potentially pathogenic bacteria such as Psuedomonas aeruginosa and Staphylococcus aureus under the gelled surface, as well as being immobilised within the swollen fibres. In contrast, hydrated alginate wound dressings did not form a uniform, cohesive gel structure, with the result that fewer bacteria were immobilised within the gel matrix. Many bacteria were trapped on individual, non-hydrated fibres. The unique absorbent gelling properties of the CMCH dressing appears to provide an ideal environment for immobilising bacteria.

Alginates↗
PubMed2003

Banana leaf dressing for skin graft donor areas.

Skin grafting is an integral part of burn wound management. The pain experienced at skin graft donor sites is significant. Banana leaf dressing (BLD) developed by our unit in 1996 is an excellent, non-adhesive, pain-free, cheap and easily available dressing material. We conducted a trial to compare efficacy of BLD with vaseline gauze (VG) dressing used by majority of burns centers for dressing skin graft donor areas. Thirty patients undergoing skin grafting were included in the study. BLD was applied on one half and VG on the other half of the donor area. Dressing change was done on the eighth day. Using the visual analogue scale we assessed the pain score, the dressing removal pain score and ease of dressing removal score. The advantage of early epithelisation of donor areas cannot be over stressed in burnt patients. The epithelisation status of the donor area on eight post-operative day was noted. The day of complete epithelisation was also noted. The average pain score with BLD was 1.1+0.71 while that with VG was 6.9+0.84. The average dressing removal pain score was 0.97 with BLD while that with VG it was 9.47. Ease of dressing removal score average was 1.1 with BLD while it was 9.53 with VG. In all the above scores the difference observed was statistically significant with P<0.001. The mean complete epithelisation day was 8.67 in the BLD covered areas as compared to 11.73 in the VG covered areas. This observation was highly significant with P<0.001. Our study clearly indicates that BLD is a completely non-adherent and painless dressing. We strongly recommend the use of BLD for all skin graft donor areas.

Adult↗
PubMed1999

[Differentiated local therapy of chronic wounds with modern wound dressings].

Differentiated local therapy of chronic wounds with modern wound dressings. The therapy of chronic wounds comprises besides treating the underlying disease, for instance compression therapy and phlebosurgery with venous ulcus cruris modern differentiated local therapy. Conventional wound therapy comprises primarily of colour solutions, various ointments, local antimicrobial agents, and sterile pressure bandages. Although it has been proven that conventional methods impede wound healing compared with modern wound dressings they are still widely used. In comparison the principle of moist wound healing is the basis of modern differentiated wound therapy. Therefore a vast number of modern wound dressings has been established in the last years. As not every wound dressing is suitable for every type of wound the knowledge of available modern wound dressings is essential in order to choose the wound dressing which is most suitable for the individual case. In the exudation/cleaning phase polyurethane foams, alginates and dressings containing activated charcoal are indicated. They can also be used in the granulation phase. The granulation phase is main indication for hydrokolloids and hydrogels. They are also used beside non-adhesive dressings and alginates in the epithelialisation phase. Besides the above synthetic wound dressings cytokines and biological skin equivalents are increasingly used in modern wound therapy. Biological skin equivalents comprise of epidermis equivalents, dermis substitutes and combined epidermis-dermis equivalents which are being developed at present. These will possibly be more effective on wound closure. Phase adapted use of modern wound dressings enables acute and chronic wounds to heal quickly and without complications. Present clinical studies are evaluating the importance of cytokines and new vital skin substitutes, which might offer interesting possibilities for further improvement in wound treatment.

Bandages↗
PubMedDate not supplied

Development of a new wound dressing with antimicrobial delivery capability.

A bilaminar wound dressing composed of an outer membrane and an inner three-dimensional matrix of a fabric or a sponge may be considered to constitute an ideal structure that promotes wound healing: the outer membrane prevents body fluid loss, controls water evaporation, and protects the wound surface from bacterial invasion, and the inner matrix encourages adherence by tissue growth into the matrix. Using this concept, we developed a biosynthetic wound dressing with a drug delivery capability. This medicated wound dressing is composed of a spongy sheet of a chitosane derivative and collagen mixture that is laminated to an antimicrobial-impregnated polyurethane membrane. In this study, a gentamycin sulfate-impregnated wound dressing was prepared and evaluated. The antimicrobial efficacy of this wound dressing was examined on an agar plate seeded with Pseudomonas aeruginosa. Also, the cytotoxicity of an antimicrobial released from this wound dressing was examined in an in vitro system with cultured skin substitutes. Both in vitro tests have shown that this wound dressing is capable of suppressing bacterial growth and minimizing cellular damage. In addition, in the treatment of wounds inflicted on rats and rabbits, this wound dressing was shown to be efficacious in covering full-thickness and split-thickness skin defects. Finally, the efficacy of this wound dressing was evaluated in a nonrandomized open-label study of 31 clinical cases. In 31 cases treated with this wound dressing, good or excellent wound healing was achieved.

Journal Article↗
PubMed1998

A HACCP-based approach to hygienic slaughter and dressing of lamb carcasses.

AIMS: This paper compares changes in visible and microbiological contamination on lamb carcasses dressed using one system which includes process factors previously identified as potential critical control points for HACCP-based approaches to hygienic slaughter and dressing, and another system which excludes those factors. METHODS: Longitudinal changes in microbiological and visible contamination of lamb carcasses were quantified in two slaughterhouses, one utilising clean, shorn, unwashed lambs in an inverted dressing system, the other utilising dirty, woolly, washed lambs in a traditional dressing system. Excision samples (5 cm2 each) for microbiological analyses were taken from two sites on 25 carcasses per treatment group immediately after pelting, at the completion of dressing, after overnight chilling and after boning and packaging. Visible contamination on the surface of 300 carcasses per treatment group was assessed after pelting and after overnight chilling. RESULTS: Mean aerobic plate counts and Escherichia coli counts on the leg and loin in the inverted dressing system were low after pelting (log10/cm2 1.86 and 1.71; log10/cm2 0.13 and 0.05 respectively) but generally showed statistically significant increases through to final packaging. In the conventional dressing system, there were much higher counts on the leg and loin after pelting (log10/cm2 4.66 and 2.71; log10/cm2 2.21 and 0.24 respectively), but subsequent handling of the carcass by slaughter line workers had no measurable deleterious effects. The inverted dressing system resulted in final mean aerobic plate counts on meat at packaging that were 1.38% (leg) and 48.98% (loin) of those derived from the conventional dressing system. Mean E. coli counts from the inverted system were 21.37% (leg) and 67.61% (loin) of those from the conventional system. There was an inverse relationship between the prevalence of carcasses with visible faecal contamination and their microbiological status. CONCLUSION: Significant reductions in microbiological contamination of sheep carcasses can be brought about by HACCP-based systems. Possible critical control points are pre-slaughter presentation status (including avoidance of pre-slaughter washing), inverted dressing, handling by slaughter line workers and meat inspectors, and chilling. Use of levels of visual faecal contamination as an on-line monitoring parameter for slaughter hygiene can give erroneous results. Interactions between different process steps may alter the effectiveness of the HACCP plan, and successful design and application depends on a detailed knowledge of the specific process utilised in each slaughterhouse.

Journal Article↗
PubMed2006

Dressing of cognitively impaired nursing home residents: description and analysis.

PURPOSE: Getting dressed is an activity that is of particular difficulty for many persons with dementia, given the need for hand-eye coordination, fine motor skills, and overall planning skills. Despite several studies concerning interventions to improve dressing behavior, very little is known about the dressing process as it is currently performed. The purpose of this study is to characterize the dressing activity of daily living (ADL) of nursing home residents suffering from dementia and thereby identify ways to improve the dressing process. DESIGN AND METHODS: We analyzed videotapes of dressing of 20 special care unit residents to describe the dressing process and the interaction between residents and staff members. RESULTS: Staff members completely dressed the residents in the majority of cases. Interaction between the staff members and the residents was considered insufficient in most sessions. IMPLICATIONS: The study identified possible intervention techniques, assistive devices, organizational routines, and environmental changes that may improve the dressing process. The results have implications that nursing homes may consider in their policies, care activities, staff training, and environment to facilitate safety, comfort, and satisfaction during the dressing process.

Activities of Daily Living↗
PubMed2006

Use of chlorhexidine-impregnated dressing to prevent vascular and epidural catheter colonization and infection: a meta-analysis.

OBJECTIVES: Vascular and epidural catheter-related infections cause significant morbidities and mortality in hospitalized patients. This meta-analysis assessed the effect of chlorhexidine-impregnated dressing on the risk of vascular and epidural catheter bacterial colonization and infection. METHODS: Literature search was based on MEDLINE (1966 to 1 November 2005), EMBASE and Cochrane Controlled Trials Register (2005 issue 3) databases. Only randomized controlled clinical trials comparing chlorhexidine-impregnated dressing with placebo or povidine-iodine dressing were included in this meta-analysis. Two reviewers reviewed and extracted the data independently. RESULTS: Eight studies assessing a single type of chlorhexidine-impregnated dressing were identified and subjected to meta-analysis. The chlorhexidine-impregnated dressing reduced the risk of epidural [3.6% versus 35%, odds ratio (OR) 0.07, 95% CI: 0.02-0.31, P=0.0005] and intravascular catheter or exit-site bacterial colonization (14.8% versus 26.9%, OR 0.47, 95% CI: 0.34-0.65, P<0.00001) (overall 14.3% versus 27.2%, OR 0.40, 95% CI: 0.26-0.61; P<0.0001). The use of chlorhexidine-impregnated dressing was associated with a trend towards reduction in catheter-related bloodstream or CNS infections (2.2% versus 3.8%, OR 0.58, 95% CI: 0.29-1.14, P=0.11). Local cutaneous reactions to chlorhexidine-impregnated dressing were reported in 5.6% of the patients in three studies (OR 8.17, 95% CI: 1.19-56.14, P=0.04), and 96% of these reactions occurred in neonatal patients. The number needed to prevent one episode of intravascular catheter-related bloodstream infection was 142 for an average period of catheter in situ of 10 days and a change of dressing every 5 days. The cost of preventing one vascular catheter-related bloodstream infection was estimated to be pound298 (US$532.5). CONCLUSIONS: Chlorhexidine-impregnated dressing is effective in reducing vascular and epidural catheter bacterial colonization and is also associated with a trend towards reduction in catheter-related bloodstream or CNS infections. A large randomized controlled trial is needed to confirm whether chlorhexidine-impregnated dressing is cost-effective in preventing bacterial infection related to vascular and epidural catheters.

Anti-Infective Agents, Local↗
PubMedDate not supplied

Management of skin-grafted burn wounds with Xeroform and layers of dry coarse-mesh gauze dressing results in excellent graft take and minimal nursing time.

The goals of postoperative treatment for split-thickness skin grafts (STSGs) are to maintain graft integrity, prevent graft and wound desiccation, and minimize infections. As we documented in a telephone survey of 16 burn centers, dressings for skin grafts usually consist of multiple layers of coarse-mesh gauze; the dressings receive frequent applications of aqueous solutions that contain antimicrobial agents to control bacterial growth and to maintain a moist environment at the wound surface. We prospectively studied the efficacy of our standard dressing of one layer of Xeroform (Kendall Inc., Mansfield, Mass.), which consists of fine-mesh gauze impregnated with bismuth tribromophenate, applied to the STSG surface followed by layers of dry gauze dressings wrapped in Kerlix (Kendall Inc.); the entire dressings were left intact until postoperative day 5. We evaluated 142 STSGs on 100 patients, mean age 29.2 years (range 0.3 to 79 years), with burns of 0.5% to 60% total body surface area (mean 9.1%). Meshed or sheet STSGs of 0.5% to 18% total body surface area (mean 3.14%) were placed on deep partial- or full-thickness excised wounds. Xeroform, followed by coarse-mesh gauze dressing, was applied after skin grafts were completed. The entire dressing was left intact until the initial takedown-to-graft at 5 days. Patients' grafts were evaluated on postoperative day 5 for the percentage of "take" and subgraft fluid collected; this evaluation was then repeated every other day for 10 days. On postoperative day 5 evaluations, mean skin graft take in all patients was 98.54% +/- 0.72%. Xeroform and coarse-mesh gauze dressings used to cover STSGs and left intact for 5 days until the initial dressing change, resulted in highly successful graft outcomes, with minimal postoperative nursing care compared with other dressing methods for skin grafts.

Adolescent↗
PubMed2006

Effect of different wound dressings on cell viability and proliferation.

BACKGROUND: Many new dressings have been developed since the early 1980s. Wound healing comprises cleansing, granulation/vascularization, and epithelialization phases. An optimum microenvironment and the absence of cytotoxic factors are essential for epithelialization. This study examines the effect of extracts of different wound dressings on keratinocyte survival and proliferation. METHODS: Keratinocyte cultures were exposed for 40 hours to at least three extracts of each of the following wound dressings, which were tested in octuplicate: Acticoat, Aquacel-Ag, Aquacel, Algisite M, Avance, Comfeel Plus transparent, Contreet-H, Hydrasorb, and SeaSorb. Silicone extract provided the reference material. Controls were included of cells cultured in medium that had been incubated under conditions identical to those used with the extracts. Cell survival (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide reduction) and proliferation (5-bromo-2':-deoxyuridine incorporation) were measured. RESULTS: Extracts of silver-containing dressings (Acticoat, Aquacel-Ag, Contreet-H, and Avance) were most cytotoxic. Extracts of Hydrasorb were less cytotoxic but markedly affected keratinocyte proliferation and morphology. Extracts of alginate-containing dressings (Algisite M, SeaSorb, and Contreet-H) demonstrated high calcium concentrations, markedly reduced keratinocyte proliferation, and affected keratinocyte morphology. Extracts of Aquacel and Comfeel Plus transparent induced small but significant inhibition of keratinocyte proliferation. CONCLUSIONS: The principle of minimizing harm should be applied to the choice of wound dressing. Silver-based dressings are cytotoxic and should not be used in the absence of infection. Alginate dressings with high calcium content affect keratinocyte proliferation probably by triggering terminal differentiation of keratinocytes. Such dressings should be used with caution in cases in which keratinocyte proliferation is essential. All dressings should be tested in vitro before clinical application.

Bandages↗
PubMed1997

Use of a fibrous dressing in exuding leg ulcers.

In a multicentre, prospective, randomised trial of 44 patients with exuding leg ulcers, a new hydrofibre dressing was compared with an alginate dressing in terms of dressing performance, patient comfort, safety and cost-effectiveness. The groups were well matched with regard to sex and age. A statistically significant difference between treatment groups was observed in mean wear time, with a longer wear time of four days observed in the hydrofibre dressing group compared to three days in the alginate group. The hydrofibre dressing group therefore demonstrated a significantly lower frequency of dressing changes required per week. Significantly more patients achieved a seven-day wear time with the hydrofibre dressing than with the alginate dressing. There was no difference with regard to percentage change in ulcer area. Cost-effectiveness was based on the cost of dressings, compression therapy and nursing time to achieve a healed wound. However, because of small patient numbers, it was difficult to make an accurate comparison. This study suggests that the hydrofibre dressing may have clinical benefits that merit further investigation with larger patient numbers.

Aged↗
PubMed2005

Use of a hydrocapillary dressing in the management of highly exuding ulcers: a comparative study.

OBJECTIVE: To evaluate the safety and performance of Alione Hydrocapillary dressing (Coloplast A/S) in the management of highly exuding chronic venous leg ulcers and compare it with two hydropolymer dressings,Tielle and Tielle Plus (Johnson & Johnson). METHOD: A comparative clinical trial was conducted on 97 patients with an ankle brachial pressure index > or = 0.8 and a highly exuding leg ulcer. Ulcer duration was at least four weeks. Treatment continued until healing or for a maximum of 12 months. RESULTS: There was no statistically significant difference in healing time or wound area reduction between the two treatment protocols. The test dressing (Alione Hydrocapillary) had better absorption capacity and was more comfortable for the patients than the comparator dressings (Tielle/Tielle Plus) and adhered less to the wound bed.Also, more patients preferred the test dressing to their previous treatment. Although severe leakage and maceration were observed more frequently in the comparator group compared with the test group, this was not statistically significant. CONCLUSION: Both treatment protocols were safe and effective in treating highly exuding chronic venous leg ulcers. The test dressing performed as well as or better than the comparator dressings for all study parameters and more patients preferred the test dressing to their previous dressing compared with the comparator dressings.

Adult↗
PubMed1998

[Use of an amorphous dressing in the skin care of patients after radiotherapy].

INTRODUCTION: Skin wounds caused by acute radiogen toxicity are an important side effect caused by radiotherapy treatment, therefore the prevention and immediate care is a challenge for the nursing staff. The actual traditional treatment is based on Liniment Oleocalcareo creams with Zinc Oxide as a principal agreement, but we have discovered a new alternative that at a first instance respond more effectively to the patients needs, and are classified with the terminology "amourphous dressing". MATERIAL AND METHODS: Retrospective study of the application of the amorphous dressing on 41 patients during the period between February and June 1998 in the Radiotherapy Unit of the "Hospital Universitario Sant Joan de Reus" (Tarragona). RESULTS: The application of the amorphous dressing has allowed us to evidence a slowness and decrease in the intensity of the skin damage caused by the radiation treatment. There has been a 63.86% decrease of the nursing treatment of the skin wounds as a consequence of the radiotherapy. The use of the amourphous dressing with Zinc Oxide favours the ephithelization of the moist wounds. No adverse reaction of the dressing has been observed during the time of the study, and no infections process has been detected, in none of the case was the radiotherapy treatment interrupted due to radiodermatitis, and in none of the cases an alternative dressing was needed. In some cases the amourphous dressing in combination with a tulle and a polyamide grille the healing time of the radiodermitis wound was significantly decreased. It has also been verified that the application as well as the removal of the dressing does not involve any difficulty neither for the patients nor for the nursing staff. There also has been a better level of acceptance of the new amourphous dressing as well from both patients and staff, seeing that the therapeutic results is significantly superior than that of the previously used methods. CONCLUSIONS: Having carried out the study in our Radiotherapy Unit we can assure that the new amourphous dressing, along with a strict control of the patient's evolution, increases the comfort and the quality of life of the patients. The multidisciplinary acceptance of the new treatment in a protocolized manner implies an increase in the patient quality care as well as contributing to a more efficient allocation of resources.

Adult↗
PubMed2005

[Clinical evaluation of hydrocolloidal dressing in 147 patients undergoing cardiovascular surgery].

Recent evidence has suggested that a moist environment plays an important role in wound healing. Karayahesive, one type of hydrocolloidal dressing, contains natural karaya gum as a hydrophilic gel. We applied hydrocolloidal dressing to operative wounds in 147 patients who underwent cardiovascular surgery from April 2001 through August 2002 to evaluate its clinical usefulness. The dressing was kept on the wounds for 7 days after operation, but was immediately switched to conventional dressing with gauze if there was any problem. A total of 144 patients (98%) had no wound chest infections. Good wound healing was obtained with only 1 dressing, removed 7 days after operation, in 128 patients (87%). In 19 patients (13%), the hydrocolloidal dressing was switched to conventional dressing. In 13 of these patients the hydrocolloidal dressing dissolved naturally or exudation occurred; clinically, there were no local problems; however, 3 patients had infection, 2 had fat necrosis, and 1 had burn injury caused by electrocautery. No patients had skin problems caused by this dressing. We conclude that hydrocolloidal dressing can be used safely and effectively in patients undergoing cardiovascular surgery and reduce the workload of healthcare workers.

Adult↗
PubMed1996

Comparison of central venous catheter dressings in bone marrow transplant recipients.

PURPOSE/OBJECTIVES: To determine the effect of two central venous catheter (CVC) dressing protocols on catheter-related infections in hospitalized patients with long-term tunneled catheters undergoing an autologous bone marrow transplant (BMT), to determine the prevalence of long-term CVC-related infections in this population, and to identify other factors in the study sample related to long-term CVC infection. DESIGN: Experimental. SETTING: BMT unit of a regional oncology center in a tertiary care hospital. SAMPLE: The sample consisted of 101 adult patients with cancer with long-term, tunneled CVCs inserted in the operating room on admission for autologous BMT. METHODS: Patients randomly were assigned to one of two dressing-change procedure groups. The control group received the current standard of care for patients receiving BMT--a dry, sterile gauze dressing (DSGD) changed every 24 hours. The experimental group received Opsite 3000TM (Smith + Nephew Ltd., Massilon, OH) transparent moisture vapor permeable dressings (MVPD) changed weekly. MAIN RESEARCH VARIABLES: CVC infection rates, frequency of IV tubing changes, immune status, duration of catheter use, occurrence and outcome of catheter occlusion, and use of a catheter for total parenteral nutrition. FINDINGS: Researchers determined the difference in CVC-related infections between the two groups and the impact of select variables on CVC-related infection. When all categories of CVC-related infection (i.e., suspected, sepsis, tunnel) were considered, no statistical difference was found in the likelihood of the groups remaining infection-free (p = 0.76) over time. CVC sepsis occurred in one patient in the DSGD group and five patients in the MVPD group; however, this difference was not statistically significant over time (p = 0.067). CONCLUSIONS: Development of CVC sepsis or tunnel infection in close proximity to the time of CVC surgical placement suggests that factors other than the assigned dressing were associated with the occurrence of CVC-related infection in three cases. Although the MVPD group required dressing changes more frequently than every seven days (as specified by the protocol) because of exit-site drainage and nonocclusiveness, transparent dressings were more cost-effective than daily gauze dressings in this population. IMPLICATIONS FOR NURSING PRACTICE: For adults undergoing autologous BMT, either DSGD or transparent CVC dressing can be used safely based on patient preference and skin tolerance to the dressing material.

Adult↗
PubMed2004

Dressings and topical agents for surgical wounds healing by secondary intention.

BACKGROUND: Many different wound dressings and topical applications are used to cover surgical wounds healing by secondary intention. It is not known whether these dressings heal wounds at different rates. OBJECTIVES: To assess the effectiveness of dressings and topical agents on surgical wounds healing by secondary intention SEARCH STRATEGY: We sought relevant trials from the Cochrane Central Register of Controlled Trials, Cochrane Wounds Group Specialised Trials Register, MEDLINE, EMBASE, and CINAHL databases in March 2002. SELECTION CRITERIA: All randomised controlled trials (RCTs) evaluating the effectiveness of dressings and topical agents for surgical wounds healing by secondary intention. DATA COLLECTION AND ANALYSIS: Eligibility for inclusion was confirmed by two reviewers who independently judged the methodological quality of the trials according to the Dutch Cochrane Centre list of factors relating to internal and external validity. Two reviewers summarised data from eligible studies using a data extraction sheet, any disagreements were referred to a third reviewer. MAIN RESULTS: Fourteen reports of 13 RCTs on dressings or topical agents for postoperative wounds healing by secondary intention were identified. WOUND HEALING: Whilst a single small trial of aloe vera supplementation vs gauze suggests delayed healing with aloe vera, the results of this trial are un interpretable since there was a large differential loss to follow up. A plaster cast applied to an amputation stump accelerated wound healing compared with elastic compression, WMD -25.60 days, 95% CI -49.08 to -2.12 days (1 trial). There were no statistically significant differences in healing for other dressing comparisons (e.g. gauze, foam, alginate; 11 trials). PAIN: Gauze was associated with significantly more pain for patients than other dressings (4 trials). PATIENT SATISFACTION: Patients treated with gauze were less satisfied compared with those receiving alternative dressings (3 trials). COSTS: Gauze is inexpensive but its use is associated with the use of significantly more nursing time than foam (2 trials). LENGTH OF HOSPITAL STAY: Four trials showed no difference in length of hospital stay. One trial found shorter hospital stay in people after amputation when plaster casts were applied compared with elastic compression (WMD -30.10 days; 95% CI -49.82 to -10.38). REVIEWERS' CONCLUSIONS: We found only small, poor quality trials; the evidence is therefore insufficient to determine whether the choice of dressing or topical agent affects the healing of surgical wounds healing by secondary intention. Foam is best studied as an alternative for gauze and appears to be preferable as to pain reduction, patient satisfaction and nursing time.

Bandages↗
PubMedDate not supplied

Improved long-term maintenance of central venous catheters with a new dressing technique.

Nursing procedures that may be important for maintaining in-dwelling central venous catheter sterility include the use of occlusive dressings, the frequency of dressing changes, the number and skill of nurses doing the dressing changes, the duration of catheterization, the use of antimicrobial ointment, and the extent to which sterile procedures are used during catheter placement. During a 9-month period, two different methods for applying central venous catheter dressings were compared. A new method designed to improve the stability of the dressing and to reduce tension on the catheter was found to be associated with longer maintenance of the dressings compared with a more traditional dressing; 14% fewer dressings were changed because of loss of occlusiveness. With this dressing technique and a strict protocol, including insertion and maintenance of central venous catheters by a nutritional support team, prolonged (greater than 7 days) maintenance of central venous catheters was found to be possible without an increase in the incidence of infection.

Adolescent↗
PubMed1986

Local environment of chronic wounds under synthetic dressings.

Local wound environment under oxygen-permeable and oxygen-nonpermeable dressings in patients with chronic ulcers was investigated. The oxygen tensions under both these dressings were very low or zero. Wound fluid was more acidic under the nonpermeable hydrocolloid dressing than under the oxygen-permeable polyurethane dressing. Bacterial growth studied in vitro was retarded at the more acidic pH similar to that found under the hydrocolloid dressing. Viable and functioning neutrophils were found under both the polyurethane and hydrocolloid dressings, with a greater percentage of viable cells under the polyurethane film. Our data suggest that these synthetic dressings create hypoxic conditions in which wound healing occurs whether or not the dressing is permeable to oxygen. Furthermore the local wound environment can be modified by use of synthetic dressings.

Aged↗