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The 4-layer bandage was originally designed to provide sustained leg compression to patients with venous leg ulcers. Since then, the practice of 4-layer bandaging has become widespread in the United Kingdom. Ulcer healing rates vary for a number of reasons. This review, by a member of the original design team, seeks to discuss reasons of varying success and offers advice for its appropriate usage.
Soft contact lenses have been used as therapeutic bandages to aid epithelial healing following pentrating keratoplasty. Often the hydrogel lenses are used in conjunction with topical medications such as gentamicin. A reported complication is the persistence of infectious ulcers even though the eye is being treated with topical antibiotics. The purpose of this study was to measure the gentamicin diffusion coefficients for some hydrogel bandage lenses and to design a kinetic model to estimate the drug distribution on an eye covered with a hydrogel contact lens. The model includes the hydrogel diffusion coefficients and literature values for tear production, tear exchange per blink around the edge of a lens, fit, etc. From the computer generated data, it can be shown that the permeability of gentamicin sulfate through the Saulfon-80 hydrogel lens on a normal eye was only 0.002% of the amount of the drug under the contact lens after 10 minute intervals of topical drug application. The important drug distribution pathway was around the edge of the lens.
From 1984 in N.N. Burdenko Surgical clinic of I.M. Sechenov MMA more than 500 horizontal gastroplasties (HGP) were performed for the treatment of patients with extreme degree of alimentary-constitutional obesity. In 1996 for the first time in our country HGP was performed, including laparoscopic method, with use of regulated silicon bandage "Lap-Band" (LB) made by "Bioenterics", USA. Laparoscopic HGP was performed in 29 patients (7 males, 22 females), aged from 23 to 60 years, mean age was 34.2 +/- 10 years. Minimal body weight was 85 kg, maximal--180 kg, mean--131 +/- 27.2 kg. Mean body mass index was 47 +/- 9.9 kg/m2. Open operations were performed in 14 cases, laparoscopic operations--in 15 cases. 11 laparoscopies were performed in initial stages in very stout patients and in the absence of laparoscopic equipment. In 3 cases the conversion from laparoscopic to open operation was necessary: in 1st case because of hemorrhage from lesser omentum's vessels, when hemostasis cannot be performed by laparoscopy; in 2nd case as a result of bronchospasm associated with tense pneumoperitoneum in the patient with bronchial asthma; in 3rd case because of significant enlargement and rigidity of liver left lobe, which didn't permit to create the space for manipulations in cardial portion of the stomach. The mean bed day turnover after traditional HGP with LB and after laparoscopic HGP was 12.2 and 5.4 respectively. Intraoperative complication was observed in one case--hemorrhage from lesser omentum's vessels. One complication was observed in immediate postoperative period, on the 6th day after traditional HGP: the eventration as a result of hard diarrhea due to antibacterial treatment was diagnosed. One more complication was observed in a year after traditional HGP: small stomach evacuatory function disorders as a result of its significant dilatation. These disorders occurred because of gastric mucosa inflammatory edema, decrease of anastomosis diameter and frequent vomiting due to aspirin taking. In this case the repeated operation--bandage's reposition was performed. There were no other complications. The rate of repeated operations was 4% which agrees with literature data.
We present a case of primary (localised non-familial) conjunctival amyloidosis, which is an uncommon condition, characterised by amyloid deposition within the substantia propria of the conjunctiva. Soft bandage contact lenses were fitted in order to protect the cornea from the mechanical abrasion of the irregular surface of the palpebral conjunctiva. We used non-ionic high water content (70%) soft bandage lenses from Filcon 4A with a Dk of 40. The lenses were well tolerated and gave significant relief of the symptoms.
The efficiency of a topical anesthetic occluded with Orahesive Oral Bandage was investigated. Experimental pain was provoked by needle insertions into two palatal test areas in 20 healthy subjects. Pain, estimated on a 100-mm visual analogue scale (VAS), decreased significantly from 23.5 mm to 10.5 mm at the greater palatine foramen and from 51.5 mm to 35.0 mm at the incisive foramen after application of a eutectic mixture of local anesthetics (EMLA). No significant change in pain perception was obtained after placebo application. The EMLA cream and the Orahesive Oral Bandages were well accepted by the subjects, as only two out of 20 subjects experienced slight gagging reflexes and only three considered the taste unpleasant. No other adverse reactions were observed. Occlusion of topical anesthetics seems to be a useful technique for achieving superficial mucosal anesthesia.
The article deals with the comparative evaluation of the immobilizing properties of the "boot" plaster bandage after manual and apparatus reposition of the malleoli. It was revealed by means of the EMED and F P/10 apparatus (FGR) that the immobilizing property of the "boot" plaster bandage is higher in apparatus than in manual reposition.
A new treatment of impotence by venous leakage is reported. It consists of tying the dorsal and lateral aspects of the cavernous body with a bandage of synthetic material. The bandage, inserted on the bulbo-cavernous muscles, restores a "carter effect" and prevents venous leakage during erection. This technique has been used in 20 patients, with satisfactory results in 10 who were followed up for more than 4 months.
Bandage lenses, a complete tarsorrhaphy, chloramphenicol 0.5%, and sodium chloride 2% were tested for their effect on corneal epithelial wound healing in rabbits. The healing rate was decreased with bandage lenses and increased by tarsorrhaphy. There was no significant effect on healing rate with either chloramphenicol or hypertonic saline.
The danger of pressure damage due to bandages is considerable. Plaster casts are incorrect immediately after accidents, repositioning of and operations on limbs. Complaints of circulatory disturbances and pains are to be taken very seriously. Pressure damage may occur not only after plaster casts, but also with elastic bandages. The urgent need to pay attention to undisturbed blood flow to the extremities after accidents and operations is emphasized with reference to 11 cases of various kinds.
The compressive bandaging of limbs as a supportive therapy in venous insufficiency and lymphedema is neither difficult, nor a mystery. The compressive therapy is to be applied exclusively to walking patients. The principles of some types of compressive bandages are explained.
BACKGROUND: Venous leg ulceration is a chronic debilitating condition which negatively impacts on patients' quality of life. Despite the application of gold standard treatment a number of patients suffer from 'slow to heal' ulcers, which can require treatment for years. AIMS: The aim of this study was to compare the effects of four-layer compression bandaging (4LB) for treating venous leg ulcers with other available treatments on health-related quality of life duringtreatment. METHODS: In this pragmatic trial, 200 patients with venous leg ulceration were randomised either to 4LB (intervention group; n = 100) or to continue their usual system of care (control group; n = 100). Analysis was by intention to treat; quality of life measurements were taken at randomisation and after six weeks of treatment. RESULTS: 4LB provided greater quality of life benefits than the control group particularly in the area of physical activity and social functioning. CONCLUSION: Due to the long-term nature of treatment for many of these patients, the effects on quality of life should be considered when prescribing treatment. This study has shown that 4LB significantly improves the quality of life of patients during treatment for venous leg ulceration.
BACKGROUND: The treatment of persistent epithelial defects (PED) with autologous serum eye drops is often combined with conventional medication such as artificial tears and topical antibiotics, but until now no report exists on the use of a bandage contact lens (BCL) in combination with autologous serum eye drops in the treatment of PEDs. We report six eyes (five patients) which were all treated with autologous serum eye drops in combination with an FDA group IV hydrogel contact lens. METHODS: Five patients aged 36-88 years, were suffering from six PEDs for 73.5+/-46.9 days due to rheumatoid sterile corneal ulcer (n=1), neurotrophic keratopathy (n=3) or partial limbal stem cell deficiency (n=1). All patients had been unsuccessfully treated with conventional therapy before. Three of them had already had an amniotic membrane transplantation and two had undergone a keratoplasty; however, the epithelial defect persisted or recurred. In all cases, an FDA group IV hydrogel contact lens (Biomedics 55, ocufilcon D, 55% water content) was fitted and serum eye drops applied 8 times a day. RESULTS: The PED healed in five of six eyes after a treatment period of 14.2+/-8.9 days. In one eye the PED became smaller, but it took 90 days until the lesion healed completely. In three eyes (two patients) white deposits appeared on the surface of the BCL during the treatment after 12.3+/-5.1 days. Because no signs of inflammation were observed and since the epithelial defect improved, a new identical lens was applied and the medication continued unaltered. The surface of contaminated and non-contaminated BCLs were analyzed by scanning electron microscopy and SDS gel-electrophoresis. The scanning electron microscopic examination presented a coating of amorphous material with a wrinkled appearance and many corpuscular deposits. There was no indication of bacterial colonisation. The SDS gel-electrophoresis showed a small band at 65 kDa, probably albumin. CONCLUSION: These findings suggest that the combination of a therapeutic contact lens and serum eye drops can be successfully used in the treatment of persistent epithelial defects. Deposition of albumin may occur on the surface of the contact lenses, which, in the small group presented here, caused no unwanted effects.
A prospective trial of mallet-finger injuries treated conservatively by elastic double-finger bandage showed no disadvantages compared to other kinds of conservative treatment. The method is agreeable for the patient, being hygienic and causing no kind of skin irritation.
A prospective trial of dislocations of the interphalangeal joints of fingers treated by elastic double-finger bandage showed good final results with an almost normal range of motion. The method is found pleasant by the patient, being hygienic and causing no kind of skin reaction.
The use of potato peels as a dressing for burn wounds has been reported previously. A technique of preparing bandage rolls with boiled potato peels is now presented, which makes dressing of a burn wound more convenient.
Control of burn-scar hypertrophy remains a priority in the care of the burn patient. However, because of the problems associated with traditional compression therapy methods a study of the clinical utility of a tubular compressive bandage (TCB) was initiated. The clinical effectiveness of TCB was determined by studying 210 separate anatomic burn sites in 88 burn patients with a mean age of 25 years and a mean burn size of 21 per cent of the total body surface area (TBSA). To facilitate analysis of the results the patients were divided into two groups, the first group consisted of 71 patients who received prophylactic pressure therapy and a second group of 17 patients who received therapeutic pressure therapy after the establishment of hypertrophic scars. Mean follow-up of the entire group of patients was 11 months. The anatomic area involved by the burn was the most important factor in determining the effectiveness of TCB in this study. Failures primarily occurred at sites of mobility where pressure could not be consistently delivered or maintained, including the digits of the hand, axilla, groin and the head/neck regions. Overall, 85 per cent of the anatomic sites treated had good or satisfactory results. Based on the results of this study, we use TCB on all burn patients, who are at risk of developing burn-scar hypertrophy, immediately after the burn wound has healed or been surgically closed.
A technique is described to prevent the shift in position of dressing materials by applying a double-sided adhesive tape between the skin and the elastic bandage. This technique also prevents a shift in position of a pressure garment, especially when applied around joints on the extremities.
The use and aims of various wound dressings are discussed. Application and indications in the horse vary according to the type and location of the wound as well as the nature and availability of the dressing material. Coaptation and immobilization are essential to promote healing in certain locations. Techniques used for bandage application in horses are described, with special emphasis on problem areas.