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PubMed1988

A study to compare the overall performance of two hydrocolloid dressings on partial thickness wounds.

This study was conducted to compare the overall performance of a test dressing (RestoreTM Wound Care Dressing, Hollister Incorporated), because it is newer to the market, to a control dressing (Duoderm, Convatec, A Squibb Company) a product that is more established in the market. The study was random, unblinded, controlled and utilized a sample of subjects with non-infected dermal ulcers and partial-thickness wounds. Compared to the control dressing, the test dressing was more absorbent, easier to use and wore twice as long. This dressing was also more flexible, conformable, adhesive and durable. Significantly less barrier residue remained on the wound bed and/or periwound area with the test dressing, and significantly more wounds were evaluated as healed or improved. The clinical data strongly established the superior performance of the test dressing over the control occlusive dressing.

Equipment Design↗
PubMed1981

Comparison of newer synthetic and biological wound dressings.

In 18 piglets, weighing 10-15 kg, third-degree burns or full-thickness skin excisions of 4 X 4 cm were inflicted. The effect of five dressing materials on adhesiveness to the wounds, appearance, conformability, wound contraction, bacterial count, and morphology of the wound was studied at the end of the seventh and fourteenth days without dressing changes. In 11 piglets with a burn wound, the most adherent dressing was collagen sponge(CS), followed by polyurethane sponge (PU), pigskin xenograph (PS), and xeroform. CS more effectively debrided the wound from coagulated necrotic tissue than the other dressings. Wound contraction was maximal with CS dressing (52%), followed by PU (44%), xeroform (32%), and PS (27%). In another seven piglets with full-thickness excised wounds, a velour dressing made of polytetrafluoroethylene (PTFE) or PU adhered significantly more than CS or PS. Wound contraction was greater with CS (37%) or PTFE (35%) than with PS (23%) or PU (18%). The bacterial counts were similar in wounds dressed with CS, PU, or PTFE. PS dressing showed significantly higher bacterial counts. The results of this study support those of a previous report on the effect of similar dressing materials on rabbit second-degree burns (8).

Animals↗
PubMed1993

[Experimental testing of hydrogel dressings POLGEL based on the basis of synthetic monomers].

In the Department of Experimental Surgery and Biomaterials Research in Wrocłow Medical Academy standard and qualifying evaluation of 5 kinds of hydrogel dressings POLGEL produced in the Institute of Physico-Chemistry and Technology of Polymers of produced in Silesian Polytechnique has been carried out. Dressings Polgel were obtained as a result of copolymerization of acrylamide and methylene-bis-acrylamide in aqueous solution. On the basis of introductory experiments for qualifying evaluation dressing Polgel M modified with glycerin in the form of foil and dressing Polgel T--in the form of jelly were chosen. Both kinds of dressings did not cause haemolytic, toxic or irritative effects. In pathomorphological experiments moderate tissues reaction was noticed what signifies good biological characteristics of the evaluated dressings. The process of healing of injuries treated with dressings Polgel M proceeded well and epidermis creating was quicker in comparison with injuries treated with traditional dressing. On the basis of the carried out experiments it was noticed that dressings Polgel M and T satisfy the requirements made for the type of materials.

Acrylamides↗
PubMed1999

In vivo evaluation of a novel alginate dressing.

Alginate dressings are currently used in the management of epidermal and dermal wounds, and provide a moist environment that leads to rapid granulation and reepithelialization. However, a cytotoxic effect on proliferation of fibroblasts and residual material with inflammation in healing wounds have been reported recently. We have developed a new alginate dressing (AGA-100), which does not have an inhibitory effect on proliferation of fibroblasts. The purpose of this study was to evaluate the new alginate dressing with respect to wound healing in full- and partial-thickness pig wounds and with respect to biodegradation following implantation into rabbit muscle. Kaltostat and Sorbsan, both well-established commercial dressings, were used as control. The closure rate of full-thickness wounds treated with AGA-100 was significantly higher on day 15 compared with that with Kaltostat and Sorbsan. Reepithelialization rate of partial-thickness wounds treated with Sorbsan was statistically significantly lower on day 3 than those with the other two dressings. As to dressing debris remained in the healing wound, a large amount of foreign debris was noted in all the full-thickness wounds treated with Kaltostat or Sorbsan, while only about one-third of wounds treated with AGA-100 showed a little dressing debris. AGA-100 implanted into the muscle of rabbits was bioresorbed completely within 3 months. Therefore, dressing residue in AGA-100-treated full-thickness wounds might be fully absorbed in a few months. In conclusion, it is shown that our newly developed AGA-100 possesses superior properties compared with typical alginate dressings.

Alginates↗
PubMed1994

Dressings and wound infection.

Wounds will readily acquire bacteria, unless protective measures are taken. The bacterial protection afforded by conventional absorbent cellulose dressings has been shown to be limited, particularly in the presence of serous exudate that may compromise dressing integrity. In addition, dressings may shed particles that remain in the wound. By contrast, many modern dressings are impermeable to bacteria, are removed completely, have been found to optimize reepithelialization rates and reduce the incidence of wound sepsis. Recently, it has been found that they could also play a role in preventing cross-contamination. Removing conventional cellulosic dressings from bacterially colonized wounds liberates wound bacteria into the air, and the numbers are slow to decline. However, using an in vitro wound model, use of the hydrocolloid dressing Granuflex (ConvaTec, Skillman, NJ) on experimentally colonized wounds resulted in significantly fewer numbers of airborne bacteria. Dispersal from wet conventional dressings was lower than from dry dressings; nevertheless, the numbers of bacteria per liter of air following removal of the hydrocolloid dressing were approximately 20% of those observed for gauze. These findings have also been confirmed in the clinic. To reduce the incidence of complications, wound care in general, and infection control procedures in particular, requires carefully disciplined team work.

Bandages↗
PubMed1994

Dressings for surgical wounds.

Abdominal incisions typically are covered with conventional gauze or not dressed at all, since it is commonly believed that dressings do not influence the healing process. Also, patient personal hygiene is not facilitated when gauze type dressings are used, and frequent changes are time consuming and sometimes painful. Following creation of an adjacent enteral stoma, dressings frequently become wet or soiled and sometimes interfere with management of the stoma. These problems did not occur in 89% of 340 patients whose wounds were dressed with a hydrocolloid dressing following colorectal surgery and creation of a stoma. Also, no wound infections occurred in 92% of patients studied. Our findings confirm those reported by others, i.e., the rate of wound infections is not increased when occlusive dressings are used following surgery. At the same time, patients are able to move freely and take showers, and nursing time spent on changing post-operative dressings is greatly reduced. Finally, occlusive dressings have also been found to reduce inflammation and subsequent scarring.

Abdomen↗
PubMed1986

Pressure ulcer management in home health care: efficacy and cost effectiveness of moisture vapor permeable dressing.

This prospective randomized study was conducted in the home care setting to compare healing rates and costs of two different dressings for pressure ulcers: the gauze and tape dressing and the transparent moisture vapor permeable dressing (MVP). Demographic variables, healing rates, and cost of treatment were statistically analyzed for 77 pressure ulcers (48 patients). Each wound was randomly assigned to either a gauze dressing or a MVP dressing. Initial ulcer grade (Shea criteria) and measurements were determined at the start of treatment and weekly for an eight-week period. Photographs of the wound were taken at the beginning and end of treatment. The same protocol for irrigating the wound and relieving pressure was followed for both dressing groups. The median improvement for the grade II group was 100% for the MVP (n = 22) and 52% for gauze (n = 12), p less than 0.05 (Wilcoxon rank sum test). The healing rates for grade III ulcers were not significantly different in the two dressing groups. The mean (eight-week) labor and supply cost per ulcer using the MVP was $845, while that for gauze treatments was $1359, p less than 0.05 (Wilcoxon rank sum test). The cost difference for grade III ulcers was not significant in the two dressing groups. The MVP improved the healing rate and was more cost effective for grade II ulcers. Both gauze and MVP dressings proved effective for the treatment of grade III ulcers.

Bandages↗
PubMed2006

Evaluation of a bi-layer wound dressing for burn care. II. In vitro and in vivo bactericidal properties.

We have recently designed a medicated bi-layer wound dressing to address the key requirements for treating external, contaminated war wounds. This study assessed the in vitro and in vivo bactericidal efficacies of the DRDC hydrogel/polyurethane wound dressing. Chloramphenicol- and chlorhexidine-loaded DRDC dressings produced significantly larger zones of inhibition against Pseudomonas aeruginosa than the other medicated dressings for 4 d. Chlorhexidine-loaded Allevyn and Hydrasorb remained bactericidal for 48 h only. Chloramphenicol-loaded Hydrasorb and Allevyn remained bactericidal for 1 and 3 d, respectively. Ps. aeruginosa and Staphylococcus epidermidis counts in wounds treated with chlorhexidine- and chloramphenicol-loaded DRDC dressings for 24 h were 1-3-log lower than those of control wounds. While Ps. aeruginosa counts in the wounds on day 4 were comparable following daily changes of either antiseptic-loaded dressings, chlorhexidine showed a 75% greater bactericidal efficacy against Staph. epidermidis than chloramphenicol. Though increasing the frequency of dressing changes led to a greater reduction in the wound bacterial load, the contamination levels of all antiseptic-treated wounds remained below 10(5) CFU/g of wound. Cerium nitrate-loaded dressings did not exert any bactericidal effect, irrespective of the experimental conditions. These data show that the DRDC dressing is effective in delivering medications, such as an antimicrobial agent, to the wound bed.

Animals↗
PubMed2006

A systematic review of randomized controlled trials of wound dressings for chronic venous ulcer.

OBJECTIVE: To determine whether more "modern" complex wound dressings further improve the healing of venous ulcers over that with simple wound dressings, we conducted a systematic review of randomized controlled trials (RCTs) of wound dressing trials that were published from October 1, 1997, through September 1, 2005. METHODS: We searched MEDLINE, CINAHL, and the Cochrane Controlled Trials Registry Database to identify RCTs. Criteria for ultimate selection included treatment with compression and an objective outcome describing the proportion of wounds healed. Twenty RCTs were identified that satisfied these criteria and were classified into three wound dressing classes: semiocclusive/occlusive group (n = 8), growth factor group (n = 7), and human skin equivalent group (n = 5). RESULTS: Assessment of study design quality for the 20 RCTs showed a low percentage (<49%) of RCTs that incorporated at least 3 of 7 indicators of trial quality, but it seemed better in the 5 RCTs that showed significance for ulcer healing; 4 of the studies used at least 6 of the 7 characteristics of adequate study design. Five (25%) of the 20 RCTs had a statistically significantly improved proportion of ulcers healed in the experimental dressing group over control values: zinc oxide paste bandage (79% vs 56%) and Tegasorb (59% vs 15%) in the semiocclusive/occlusive group and perilesional injection of granulocyte-macrophage colony-stimulating factor (57% vs 19%) and porcine collagen derived from small-intestine submucosa (Oasis; 55% vs 34%) in the growth factor group. In the sole significant RCT from the human skin equivalent group, Apligraf (63%) was superior to Tegapore (48%). Four of these five studies also showed an improved time to complete healing by Kaplan-Meier estimate. CONCLUSIONS: Certain wound dressings can improve both the proportion of ulcers healed and the time to healing over that achieved with adequate compression and a simple wound dressing. The selection of a specific dressing, however, will depend on the dressing characteristics for ease of application, patient comfort, wound drainage absorption, and expense.

Bandages↗
PubMed1996

Healing of full-thickness wounds in pigs: effects of occlusive and non-occlusive dressings associated with a gel vehicle.

This study, based upon a pig model, was conducted to investigate the effects of moist and dry healing conditions on wound closure (epithelialization, granulation tissue, contraction) of full-thickness wounds. Thirty-two full-thickness square wounds (3 cm x 3 cm) covered with either an occlusive polyurethane dressing (Tegaderm) or a non-occlusive dressing (Melolin) were evaluated. The effect of the presence or the absence of a gel (3% Idroramnosan) was also investigated with both dressings. The dressings were renewed twice a week. The time required for wound closure was 19.2 +/- 1.6 days for Tegaderm and 26.6 +/- 3.0 days (means +/- SD) for Melolin, respectively. The healing time of the full-thickness porcine wounds was significantly (P < 0.001) reduced by the occlusive dressing. Equivalent results were found with the 3% gel, indicating that the gel can be used as a neutral vehicle. The healing rate, calculated according to Gilman's method, was also significantly (P < 0.001) enhanced by the occlusive dressing. This progression was 0.073 +/- 0.004 cm/day and 0.050 +/- 0.009 cm/day (means +/- SD) for Tegaderm and Melolin, respectively. The contribution of contraction to wound closure was similar in all wounds, indicating that the occlusive dressing did not have an effect on wound contraction. Histological evaluation was performed on full-thickness skin biopsies of whole wound harvested from the time of wound closure to 3 months after. At any time point, no significant histological variations were observed between the different treated wounds. This study demonstrates in a porcine model that for full-thickness wounds, as for split-thickness wounds, occlusive dressing enhances healing rate and shortens the time for wound repair. The shortened healing time is a function primarily of the effect of occlusive dressing on epithelialization, especially the third phase of wound resurfacing.

Animals↗
PubMed2005

Comparison of two wound dressings after laser skin resurfacing.

BACKGROUND: It has been reported that the final outcome of laser resurfacing still depends to a large degree on the efficiency of the post laser resurfacing wound care in promoting wound healing and preventing early and late complications. OBJECTIVE: The objective of this study was to evaluate and compare a new hydrocolloid dressing, H2460, with Flexzan(TM) for healing of an acute wound after laser skin resurfacing (LSR). METHODS: Ten volunteers received LSR of the peri-orbital area with an erbium:YAG laser. Identical parameters were used on both sides: 2 J, 5 mm spot, 8 Hz, 300 micros pulse, two passes on the upper eyelids, four passes on the lower eyelids and six passes on the crow's feet area. Soon after the LSR, one side was covered with Flexzan dressing and the other side was covered with a new hydrocolloid dressing -- H2460. The side of the dressing was randomized by alternating both dressings. All volunteers were evaluated and digitally photographed every day for a week and at 1 month after LSR. The degree of erythema, swelling, bleeding, oozing, crusting, pigmentary changes, scarring, discomfort, itching, burning, ease of application of dressings, initial adhesion, overall adhesion, leakage of fluid, maceration of surrounding skin, ease of removal and adhesive residue upon removal were documented. RESULTS: In all volunteer and investigator's evaluations, the new dressing, H2460, achieved far better results than Flexzan in each category. After a 1-week follow-up all volunteers and the investigator evaluated the H2460 side as: healed better, simple to use, and caused less discomfort in 10 out of 10 volunteers. The blinded observer's assessment showed that the Flexzan side healed better in one volunteer. CONCLUSION: The new dressing, H2460, is a better and suitable alternative to Flexzan as a post LSR dressing.

Bandages, Hydrocolloid↗
PubMedDate not supplied

Prospective clinical study of Hydron, a synthetic dressing, in delivery of an antimicrobial drug to second-degree burns.

This clinical trial prospectively evaluates the potential beneficial effects of antimicrobial drug delivery from a synthetic dressing (Hydron-AgSD) formed on second-degree burn wounds. A paste composed of polyethylene glycol-400, poly 2-OH ethylmethacrylate, and silver sulfadiazine (AgSD 1%-3%) matured within one hour to form a solid dressing. In 27 patients, comparable areas of second-degree wounds on the same patient were selected at random for test and control (silver sulfadiazine 1% only) sites. The mean total time of the synthetic dressing application per patient was about nine days, and each dressing remained in place for nearly four days. During this interval the control sites required four dressings changes. In 17 tests for infections, the control areas were contaminated but no bacteria were detected under the synthetic dressing; in three tests, the controls had no bacteria, whereas the synthetic dressing did. Healing of burns was similar under both types of dressing. Benefits of Hydron treatment included increased patient comfort because of the reduced number of dressing changes and, in some cases, greater freedom from contaminating bacteria.

Adolescent↗
PubMedDate not supplied

A matched-pair, randomized study evaluating the efficacy and safety of Acticoat silver-coated dressing for the treatment of burn wounds.

A new silver-coating technology was developed to prevent wound adhesion, limit nosocomial infection, control bacterial growth, and facilitate burn wound care through a silver-coated dressing material. For the purposes of this article, Acticoat (Westaim Biomedical Inc, Fort Saskatchawan, Alberta, Canada) silver-coated dressing was used. After in vitro and in vivo studies, a randomized, prospective clinical study was performed to assess the efficacy and ease of use of Acticoat dressing as compared with the efficacy and ease of our institution's standard burn wound care. Thirty burn patients with symmetric wounds were randomized to be treated with either 0.5% silver nitrate solution or Acticoat silver-coated dressing. The dressing was evaluated on the basis of overall patient comfort, ease of use for the wound care provider, and level of antimicrobial effectiveness. Wound pain was rated by the patient using a visual analog scale during dressing removal, application, and 2 hours after application. Ease of use was rated by the nurse providing wound care. Antimicrobial effectiveness was evaluated by quantitative burn wound biopsies performed before and at the end of treatment. Patients found dressing removal less painful with Acticoat than with silver nitrate, but they found the pain to be comparable during application and 2 hours after application. According to the nurses, there was no statistically significant difference in the ease of use. The frequency of burn wound sepsis (> 10(5) organisms per gram of tissue) was less in Acticoat-treated wounds than in those treated with silver nitrate (5 vs 16). Secondary bacteremias arising from infected burn wounds were also less frequent with Acticoat than with silver nitrate-treated wounds (1 vs 5). Acticoat dressing offers a new form of dressing for the burn wound, but it requires further investigation with greater numbers of patients in a larger number of centers and in different phases of burn wound care.

Adolescent↗
PubMedDate not supplied

Clinical benefit of a hydrocolloid dressing in closed surgical wounds.

A prospective, multicenter trial evaluated the clinical benefits of a new hydrocolloid wound dressing material (DuoDERM Extrathin; ConvaTec International, Skillman, N.J.) in a postoperative setting. Criteria assessed were patient quality of life (adherence of the dressing, showering or bathing possibilities, aspects of dressing changes), safety (incidence of infection), effectiveness (healing time), and clinical utility (ease of application and removal, ease of inspecting the wound through the dressing). Ninety-five patients with 102 sutured wounds were enrolled in the study during a period of 18 months. Forty-three wounds were in anatomic areas considered difficult to dress with such conventional materials as gauze and tape. The overall incidence of infection was 2%; the dressing was found not to be a causal factor. In five wounds, treatment had to be stopped before scheduled. Comfort rating by the patients and the investigators were "good" and "very good" in 95% and 92% of cases, respectively. A mean of 1.56 dressings per wound was used until removal of the sutures. Because of the reduction in the necessary number of dressing changes, hydrocolloid dressing may help in reducing treatment costs.

Adolescent↗
PubMed1986

Spandra: a sustained release battlefield wound dressing.

In 1981, our laboratories developed a family of elastomers which could be cured by ultraviolet (UV) radiation. Curing by UV radiation was a significant advance in chemistry, since it allowed ultra-fast curing of elastomers in a matter of seconds, as compared to several hours at 110 degrees C for conventional heat curing. We applied for a patent based on this technology, and the patent was allowed in mid-1984 [29]. Based on this technology, Thermedics submitted a proposal to the US Army for the development of a sustained-release battlefield wound dressing containing antibiotics and coagulants. The drugs were evenly distributed in the oligomer matrix, and subsequently cured in seconds under UV illumination, without the use of heat, organic solvents or water. Because delicate drugs are not subjected to heat, organic solvents or water, the pharmacological activity of the drugs is insured. Therefore, theoretically any drug may be incorporated into our dressing. Sustained release dressings were first developed at Thermedics in 1983, spurred by a contract from the US Army Medical Research and Development Command. Under this contract, the Company developed a new type of wound dressing capable of accelerating the healing process, retarding infection, and minimizing pain. Based on our TECOFLEX materials technology, the dressing performs like temporary artificial skin. Its transmission properties for oxygen, carbon dioxide, and water vapor are similar to those of intact skin. Thus, while excluding bacteria from the wound site, the dressing maintains an optimal moist environment for the promotion of rapid healing. The new drawing shown in Figure 10 minimizes pain during healing by preventing dehydration and shrinkage in the wound. Patient comfort is also enhanced by the incorporation of a special fabric which imparts flex properties to the bandage that are almost identical to those of human skin, with greater stretch in one direction than in another. This also facilitates application to complex body contours by only one attendant, an important feature in both hospital and emergency situations. Materials currently in use in hospitals are difficult to handle, requiring two or three nurses to apply large dressings. Thermedics' military wound dressing not only has the significant advantage of ease of application, but this dressing can also be used for delivery of drugs to a specific site.(ABSTRACT TRUNCATED AT 400 WORDS)

Administration, Cutaneous↗
PubMed2000

Nurses' views about pain and trauma at dressing changes: results of a national survey.

Research findings and professional concerns that patients still experience pain and tissue trauma at dressing changes led specialist nurses to develop a postal questionnaire to elicit the views of 1000 nurses with an interest in wound management. The questionnaire asked practitioners to identify the primary considerations underpinning their approach to pain and tissue trauma at dressing changes, the strategies they adopted, and the factors which determined their treatment choices. The higher than anticipated response rate (37%) illustrates the importance nurses attach to this aspect of practice. The practitioners' main considerations during dressing changes were the need to prevent trauma to the wound (47%) and to avoid causing the patient pain (34%). Significantly, 81% noticed that patients experienced most pain when dressing products were removed, highlighting the need to re-emphasise the principles of moist wound healing. A total of 225 respondents (60%) were aware of dressings specifically designed to prevent pain and trauma during dressing changes. Practitioners also had the freedom to use the product of choice all (61%) or most (36%) of the time. However, respondents also demonstrated confusion about the properties and availability of many dressings. Recommendations for practice include reviewing the number of dressings currently available, together with ongoing education and update on all wound management dressing products and related issues.

Bandages↗
PubMed2001

Evaluating a superabsorbent hydropolymer dressing for exuding venous leg ulcers.

A new hydropolymer dressing was compared with an alginate dressing in a multicentre, prospective, controlled, randomised, stratified, open label trial of 113 patients with exuding venous leg ulcers. The study aimed to evaluate the performance of the dressings in terms of their ability to handle exudate, patient and user acceptability and cost-effectiveness. Patients were stratified according to volume of wound exudate (moderate/heavy) and randomised to the hydropolymer dressing or the alginate plus a secondary dressing. A statistically significant difference between treatment groups was observed in mean wear time, with a longer wear time observed in the hydropolymer group (3.91 days) compared with the alginate group (3.09 days, p = 0.001). In terms of patient and user acceptability, all 10 overall evaluations made by both patient and investigator were markedly in favour of the hydropolymer dressing (p < 0.001 to p = 0.020). The use of the hydropolymer dressing for patients with moderate to heavily exuding venous leg ulcers has statistically significant advantages over the alginate dressing in terms of wear time and investigator and patient acceptability. It is anticipated that this reduction in dressing frequency will translate into a cost-effective wound treatment.

Adult↗
PubMed2004

The importance of pain reduction through dressing selection in routine wound management: the MAPP study.

OBJECTIVE: To discover the incidence of pain in patients with acute or chronic wounds of various causes during dressing removal, and the effect of switching to a non-adherent dressing. METHOD: A total of 656 primary care physicians reported the relevant details of all acute or chronic wounds observed during routine visits throughout the study period. The pain experienced during dressing changes was systematically evaluated. In patients with moderate to severe pain, a more extensive evaluation was performed and they were invited to complete a self-evaluation questionnaire. If the patients were seen at a subsequent visit, a new evaluation was performed. RESULTS: In total 5850 patients were seen: 2914 with acute wounds and 2936 with chronic wounds. During dressing changes, a similar number of patients with acute and chronic wounds reported 'moderate to severe' pain during the medical screening visit (79.9% and 79.7%) and 'very severe' pain in their self-evaluation questionnaire completed at home (47% and 59% respectively). Dressing removal was most painful when there was adherence to the wound bed. Switching to a new, non-adherent dressing reduced pain during dressing changes in 88% of patients with chronic wounds and 95% of patients with acute wounds. CONCLUSION: This study demonstrates that similar problems with patient acceptability arise irrespective of wound aetiology. Pain is a major problem and is most often related to dressing selection. Selecting a suitable, non-adherent dressing improves patient acceptability.

Acute Disease↗