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PubMed1975

In situ production of a synthetic barrier dressing for burn wounds in rats.

We describe the in situ production of a burn wound dressing applied to eschar that completely isolates burned tissue from contamination with Pseudomonas aeruginosa. Anesthetized, adult rats were subjected to a scald burn over 10% of their body surfaces. One-half hour later a test dressing presumed to be a barrier to bacterial contamination of the wound was applied to the burned surface. Tannic acid, vaseline, ethyl linoleate, collodion, and polyhydroxethylmethacrylate (PHEMA) were evaluated. Each agent was applied directly to the burned surface. A solid film of the PHEMA was produced on the eschar by addition of solvent and a powdered form of the polymer. The surface of each synthetic dressing was contaminated 30 min after application by the addition of 10(8) P. aeruginosa. Also, a control set of rats was burned and their eschars were directly contaminated without application of the test dressing. Seven days later the contaminated muscle under the burned area in 10 control rats had P. aeruginosa counts of 10(7) to 10(8) per g of muscle (wet weight). Of the materials tested, only PHEMA consistently acted as an effective barrier dressing, reducing bacteria in the muscle to undetectable levels in 11 of 14 tests. It was also possible to treat contaminated eschar through this synthetic dressing by topical application of antibiotics to the barrier surface. The results suggest a novel clinical approach in which a barrier dressing could be used to isolate a burn eschar from environmental and subject contamination until the wound site is ready for grafting.

Acrylic Resins↗
PubMedDate not supplied

Comparing the use of hydrogel dressings to lanolin ointment with lactating mothers.

OBJECTIVE: To evaluate the use of hydrogel dressings for the prevention and treatment of nipple soreness in lactating women as compared with the common intervention of lanolin ointment. The hypothesis was as follows: Participants using hydrogel dressings as a preventive measure for nipple soreness will experience greater pain relief and a lower rate of nipple wounds as compared with the control group. The secondary hypothesis was that the reduction of nipple soreness in the treatment group would produce a longer duration of breastfeeding as compared with the control group. DESIGN: A multicentered, prospective, randomized controlled clinical trial evaluating a sample of 106 lactating mothers. SETTING: Study sites were the University of Alabama Medical Center at Birmingham (an inner-city teaching hospital) and Northeast Health System (a community hospital in Beverly, Massachusetts). PARTICIPANTS: Participants were older than age 18, fluent in English, and had an operational telephone in the residence. Other inclusion criteria were singleton, vaginal deliveries; no prior breastfeeding experience; and written informed consent. INTERVENTIONS: Participants were randomized to either the lanolin ointment or the hydrogel dressings group and received instructions specific to their assignment. All participants received breastfeeding education provided by a board-certified lactation consultant. MAIN OUTCOME MEASURES: During the initial 12 study days, participants identified pain intensity using a numeric pain intensity scale and verbal descriptor scale. Subjective data were collected via self-reported skin assessments of the bilateral breasts, nipples, and areolae. Breastfeeding duration was established by a follow-up telephone call at 2 months. RESULTS: The hydrogel dressings group had significantly greater reduction in pain score mean values at baseline, on study Day 10, and on study Day 12 in comparison to the control group. Participants using the hydrogel dressings discontinued treatment sooner than participants in the lanolin ointment group. The lanolin ointment group had eight breast infections, whereas the hydrogel dressings group had none. CONCLUSION: Hydrogel dressings are a safe, available treatment that provided more effective pain management for nipple soreness than the common intervention of lanolin ointment.

Breast Feeding↗
PubMed2002

Urgotul: a novel non-adherent lipidocolloid dressing.

Urgotul belongs to a new class of non-adherent dressings: the lipidocolloid dressings. It is composed of an open weave polyester mesh impregnated with hydrocolloid polymers dispersed within petrolatum. The first clinical trial data are presented. Efficacy and safety were evaluated in a multicentre non-comparative trial involving 92 patients treated to healing or up to 4 weeks. Adult outpatients with acute wounds (n = 34), leg ulcers (n = 24), other chronic wounds (n = 14) or with second-degree burns (n = 20) were included. Results showed 32.4% (n = 11) of the acute wounds, 12.5% (n = 3) of the leg ulcers and 14.3% (n = 2) of the other chronic wounds completely healed before 4 weeks. Surface areas decreased on average by 76.4%, 63.5% and 44.2% at study endpoint respectively. For burns, 19 patients healed (95%) within 5-19 days. A total of 771 dressing changes were performed during the course of the study. Dressing application was considered as easy or very easy in 90% or more of the changes and there was no difficulty in removing the dressing in about 95% of the cases. Safety was good with five reports of a transitory local adverse event, probably dressing-related, being observed, two patients (2.2%) prematurely stopped treatment because of moderate periwound erythema. Urgotul is a highly promising new dressing which is currently undergoing further comparative clinical evaluation.

Adult↗
PubMed1997

A comparison of two dressings in pressure sore management.

This study compared a polyurethane foam dressing with a hydrocolloid dressing for ease of application and removal, adhesion, conformability, absorbency and wear time. A randomised study was carried out, including 61 patients with stage two or three pressure sores in five centres in the UK. Dressings were applied for up to 30 days and assessments were carried out at each dressing change. The results indicated that both dressings are easy and convenient to apply; absorbency and ease of removal were significantly better with the polyurethane foam dressing than the hydrocolloid dressing; wear times were similar.

Aged↗
PubMed2005

Using Urgotul dressing for the management of epidermolysis bullosa skin lesions.

OBJECTIVE: To evaluate the acceptability, tolerance and efficacy of Urgotul wound dressing in the management of epidermolysis bullosa (EB) skin lesions. METHOD: This was an open-label uncontrolled clinical trial involving 20 patients (I I adults and nine children) with EB simplex or dystrophic EB. Patients were selected from the register of EB patients at the investigating centre and included if they presented with at least one skin lesion requiring management with a non-adherent wound dressing. Lesions were treated with the study dressing for a maximum of four weeks. All dressing changes, wound parameters, pain and effect on quality of life were recorded. RESULTS: All patients completed the trial. Nineteen out of 20 wounds healed within 8.7 +/- 8.5 days. Overall, 11 patients (55%) considered that their quality of life had improved following use of the dressing, which was also reported to be pain free and 'very easy' or 'easy' to remove at most dressing changes. Nineteen out of 20 patients stated that they would use the study dressing to manage their lesions in future. CONCLUSION: This study confirmed the very good acceptability and efficacy of Urgotul in the treatment of skin lesions in patients with EB.

Adolescent↗
PubMed1997

Two hydrocolloid dressings evaluated in experimental full-thickness wounds in the skin.

Hydrocolloid occlusive dressings are beneficial in wound management in many respects, although the adhesive matrix may disintegrate when in contact with wounds. The purpose of this study was to determine: (1) if material from two hydrocolloid dressings-Comfeel and Duoderm-showing differences in adhesive cohesion, can be chemically identified in granulation tissue; and (2) if the presence of this material influences cutaneous wound healing. In full-thickness skin wounds in rats, components from the two hydrocolloid dressings were phagocytosed as indicated by the presence of foam cells. Extracellular vacuoles (100-400 microns in size) occupied about 25% of the granulation tissue volume in the Duoderm group but less than 5% in the Comfeel group, a statistically significant difference (p < 0.001). The vacuoles contained hydrophobic polymers derived from the respective hydrocolloid dressing, as analyzed by Fourier Transform Infrared (FT-IR) microscopy. Wound contraction did not differ significantly between the two hydrocolloid dressings. Wounds treated with Comfeel were significantly (p < 0.05) more epithelialized (mean: 78%) than those treated with Duoderm (mean: 41%). The proliferative activity in wound epithelium, as measured immunohistochemically by bromodeoxyuridine incorporation, was similar for the two treatment groups, indicating that epithelial migration was impaired in Duoderm-treated wounds. In summary, extensive incorporation of hydrophobic dressing material from hydrocolloid dressings may render the wound bed less suitable for epithelial migration during acute secondary wound healing.

Animals↗
PubMed2004

Hemostatic dressings for the first responder: a review.

The military is interested in finding a hemostatic dressing that is effective in controlling hemorrhage from combat wounds, relatively inexpensive, and easy to transport. The fibrin dressing has existed for decades, but the military has been reluctant to use the dressing because it is not Food and Drug Administration approved, fairly expensive, and difficult to apply on certain wounds. Newer dressings such as the microporous polysaccharide hemosphere (TraumaDEX), mineral zeolite (QuikClot), poly-N-acetylglucosamine (HemCon), and microporous hydrogel-forming polyacrylamide (BioHemostat) dressings have addressed these deficiencies in that they are relatively inexpensive, easy to transport, and easy to apply. However, the effectiveness of these new dressings on wounds sustained in combat is still questionable according to studies and anecdotal reports from Operation Iraqi Freedom. More research is needed to draw definite conclusions about the effectiveness of these dressings in a combat setting.

Blood Coagulation↗
PubMed2000

Effects of a silicone-coated polyamide net dressing and calcium alginate on the healing of split skin graft donor sites: a prospective randomised trial.

An open randomised prospectively controlled trial was performed to assess the healing efficacy, slippage rate and degree of discomfort on removal of calcium alginate and a silicone-coated polyamide net dressing on split skin graft donor sites. Sixteen patients were randomised to the calcium alginate group and 14 to the silicone-coated group. The donor sites were assessed at days 7, 10, 14 and up to day 21. The mean time to healing in the calcium alginate group was 8.75 +/- 0.78 days (range 7 to 14 days) compared to 12 +/- 0.62 days (range 7 to 16 days) for the silicone-coated group (p < 0.01). Although more silicone-coated dressings slipped (5 versus 1), the difference was not statistically significant. Pain during the first dressing change was assessed using a visual analogue pain scale. Although no significant differences were found between the groups, it was necessary to change the dressing protocol in the silicone-coated arm of the trial after entering the first two patients. Overlaid absorbent gauze adhered to the donor site through the fenestrations in the dressing necessitating the placement of paraffin gauze between the experimental dressing and the overlying cotton gauze. There was one infection in the study, occurring in the alginate group. Based on these results we recommend calcium alginate as the dressing of choice for split skin graft donor sites.

Adult↗
PubMed1991

Faster healing and less pain in skin biopsy sites treated with an occlusive dressing.

We prospectively studied 174 patients on whom 226 unsutured parallel incisional (shave) and 3-mm punch skin biopsies were performed. Two wound-care programs, occlusive dressing therapy and conventional therapy, were compared. The biopsy sites were evaluated after 1 or 2 weeks for healing, pain, and infection. We found that healing was unrelated to the indication for biopsy or the patients' age, gender, or race. Occlusive dressing therapy-treated shave biopsy sites were 3.83 times more likely to be healed than those treated with conventional therapy. Regardless of the treatment method, a facial shave biopsy site was 3.6 times more likely to be healed than a biopsy site in other locations. No punch biopsy site had healed after 1 week. At 2 weeks, only 7% and 36% of conventional therapy- and occlusive dressing therapy-treated punch biopsy sites, respectively, had healed. Pain at the biopsy site was six times more common in both shave and punch biopsy sites treated with conventional therapy. The absence of pain with occlusive dressing therapy was significant for both types of biopsy. One punch biopsy site treated with conventional therapy became infected, and one treated with occlusive dressing therapy was suspected of being infected. Forty patients, who had biopsy sites treated with both therapies, preferred occlusive dressing therapy over conventional therapy by a ratio of 3:1 because of ease of wound care and lack of pain. We conclude that occlusive dressing therapy may be the wound management of choice for shave biopsy sites. Since punch biopsy sites do not heal readily, it may be more appropriate to suture them, at least until therapies are developed that more effectively speed their healing.

Adult↗
PubMed1984

Management of leg ulcers with hydrocolloid occlusive dressing.

Twenty-two patients with 31 leg ulcers of various causes received local wound management consisting of the application of an adhesive hydrocolloid (HC) occlusive dressing (DuoDerm). Group 1 comprised 15 patients (11 outpatients) with 19 ulcers. Approximately two thirds (12/19) of the ulcers healed when treated solely with the HC dressing; mean treatment time was 57 days. Group 2 comprised seven hospitalized patients with at least two leg ulcers of similar size and distribution. The 20 ulcers in the seven patients were treated with either mild topical antimicrobial wet dressings (Sweitzer's 1:32 solution) or HC dressings, with each patient serving as his own "control." All 20 ulcers healed; the average time to healing was 44 days with HC dressing and 42 days with wet dressing management. Most of the patients reported convenience in management and substantial relief of pain with the use of HC dressings.

Adult↗
PubMed1993

Surgical wound dressing in outpatient paediatric surgery. A randomised study.

A comparison of two different wound dressings was carried out in a series of 88 paediatric patients. The patients were randomised to either Steristrip plus Cutiplast, a conventional absorbent wound dressing, or to DuoDERM, an occlusive adhesive dressing. The study, set up to show which was the most convenient dressing for minor outpatient surgery, focused on the psychological aspects of operative treatment of infants and children. The results showed that the DuoDERM group had fewer bandage changes than the Steristrip & Cutiplast group, although this was not significant. Significantly less pain was experienced on removal of the wound dressing in the DuoDERM group. When dressed with DuoDERM, children could be bathed in the immediate postoperative period without complication. In conclusion, an occlusive wound dressing (DuoDERM) seems to minimize the physical and psychological trauma to the infant or child and reduce the disruption to the child's and the parents' daily routines.

Adolescent↗
PubMed1998

Evaluation of a novel alginate gel dressing: cytotoxicity to fibroblasts in vitro and foreign-body reaction in pig skin in vivo.

Calcium alginate dressings have beneficial effects on wound healing by providing a moist wound environment. However, cytotoxicity and the nonbiodegradable nature of calcium alginate dressings induce unresolved chronic foreign-body reaction. In this study, a novel freeze-dried alginate gel dressing (AGA-100) low in calcium ions was evaluated for cytotoxicity to L929 cells in vitro and in full-thickness pig wounds in vivo. Cytotoxicity testing on L929 cells showed the cytocompatibility of AGA-100 extracts, while extracts from Kaltostat, a well-established alginate dressing, induced cytopathic effects. In an in vivo study using pigskin, AGA-100, Kaltostat, and gauze were applied on 1-in-diameter circular full-thickness wounds on the back of pigs and the time course of wound closure was evaluated. Kaltostat and gauze dressings were used as controls. For histologic evaluation, wound tissue was harvested on day 18. AGA-100-treated wounds showed rapid wound closure compared to control wounds on day 15. Foreign-body reaction was marked in Kaltostat- and gauze-treated wounds, and differed significantly from AGA-100-treated wounds. Based on these data, AGA-100 could reduce the cytotoxicity to fibroblasts and foreign-body reaction that have been observed with currently available calcium alginate dressings; it was also found to be useful as an alginate dressing.

Alginates↗
PubMed1998

Effect of saliva dilution on the release of diacetyl and 2-heptanone from cream style dressings.

Aroma release from a cream style dressing, consisting of a thickening agent dispersed in the water phase of an oil in water (o/w) emulsion, has been studied by a purge-and-trap (PT) and a dynamic headspace mastication (DHM) model using two representative volatile compounds, viz. diacetyl and 2-heptanone. These isolations have been carried out from three systems: the dressing, the thickening agent dispersion and the o/w type of emulsion after adding different volumes of artificial saliva. Dilution of the samples with artificial saliva influences the amounts released for diacetyl and 2-heptanone differently: diacetyl decreases upon dilution of the thickening agent dispersion, emulsion and dressing. However, the amount of released 2-heptanone decreased only in the case of the thickening agent dispersion. These differences are caused by the distribution of diacetyl and 2-heptanone between the water and the oil phases. The distribution is not so important, when the DHM model is used for the release from dressings. The viscosity of the mixture of dressing and artificial saliva then plays an essential role. In general, the viscosity is considered to suppress the release of flavour. However, it has been found that the amount of volatile compounds released from the more viscous dressing was greater than from the emulsion. Most probably, the DHM model creates a large surface area by adhesion of the dressing on the wall of the sampling flask and the plunger head. This result suggests that the DHM equipment, which mimics the mouth movement, might be used to predict the real release of flavour in the mouth more precisely than other mouth models.

Diacetyl↗
PubMed1989

Need for surgical wound dressing.

The need for dressings on clean and clean contaminated surgical wounds was investigated. A total of 1202 patients with 1202 clean or clean contaminated surgical wounds were randomized into two groups: 633 wounds were covered by dressings up until the time of suture removal, and 569 wounds were treated without dressings after the first postoperative day. In the group characterized by long dressing time, the rate of postoperative wound infections was 4.9 per cent. The rate was 4.7 per cent in the group represented by short dressing time. Using short dressing time not only reduces the number of nursing hours but also limits the need for costly dressing material. In addition, both wound observation and patients' personal hygiene are made easier.

Bandages↗
PubMed1990

Cytotoxicity testing of wound dressings using normal human keratinocytes in culture.

Comparative cytotoxicity testing of 16 wound dressings of different composition show that normal human keratinocytes (NHK) growing on a fibroblastic feeder layer are as sensitive to toxic materials by direct contact as the confluent MRC5 fibroblasts used for standard cell culture cytotoxicity testing, and slightly more sensitive when extracts of the dressings were tested. After direct contact with each of the cell types, we found effects due to 12 dressing samples (75%), but the extracts of only 6 of them induced changes in cell shape or cell death on NHK, and 4 of them on MRC5 cells. In order to assess the compatibility of these dressings with a pure population of epidermal cells, the cell type responsible for reepidermization of healing wounds, we then tested the sensitivity, both to dressing samples and extracts, of normal human keratinocytes (NHK) grown in chemically defined medium and without a feeder layer: The results show epidermal cytocompatibility of 10 dressing extracts, while 6 others induced cytopathic effects. Three of these extracts specifically damaged epidermal cells and inhibited their proliferation. When comparing the sensitivities of NHK (in defined medium) and MRC5 cells, we observed complete correlation for 75% of the dressings by extract testing and in 94% of the cases after direct contact.

Bandages↗
PubMed2001

Effects of different dress styles on vitamin D levels in healthy young Jordanian women.

Jordan is a sunny Middle Eastern country where no vitamin D fortification of milk is undertaken, and where women wear dress styles that cover the body to a variable extent. This may produce variable effects on vitamin D, parathyroid hormone and bone mineralization. The aim of the present study was to evaluate the vitamin D and parathyroid hormone levels in healthy young women of child-bearing age, and to examine the effects of dress style and season, in a survey of the effects of these parameters on vitamin D metabolism, and the possible bone mineralization consequences. One hundred and forty-six subjects (22 men, 124 women) were selected, according to established inclusion criteria. Of the women, 21 wore Western-type dress styles (group 1), 80 wore dress styles covering the whole body but the sparing face and hands (group 2) and 23 wore dress styles covering the whole body including the face and hands (group 3). The study was conducted in summer and winter. All volunteers underwent initial interviews, answered a food frequency questionnaire, and underwent essential laboratory tests (serum 25-hydroxyvitamin D (25(OH)D) by radioimmunoassay, and serum parathyroid hormone (PTH) by chemiluminescent enzyme immunoassay). The 25(OH) D levels in groups 2 and 3 were significantly lower than in the men (p<0.05 in both comparisons). No significant differences were noted between women wearing different dress styles. PTH levels were in the upper limits of normal but failed to show statistical differences between study groups. The prevalence of hypovitaminosis D was 62.3% in the study groups as a whole. Dress styles covering the whole body, totally or nearly totally, have adverse effects on 25(OH)D levels and may produce a state of secondary hyperparathyroidism on the long run. Although Jordan enjoys plenty of sunshine, these data are suggestive of widespread hypovitaminosis D in Jordan.

Adolescent↗
PubMed1994

Effects of time of day on dressing behavior under the influence of ambient temperature fall from 30 degrees C to 15 degrees C.

The present paper is aimed at determining whether the dressing behavior for temperature regulation in cold is under the influences of circadian control. The half-naked subjects were instructed to dress in the garments they felt comfortable when the room temperature began to decrease from 30 degrees C to 15 degrees C in 1 h. To determine the effects of brain temperature fall on the dressing behavior, we used face cooling with cool air for 30 min before the room temperature began to decrease. We also studied the effects of wearing a hat on dressing behavior. Rectal temperature, tympanic temperature, skin temperature at seven sites, and thermal sensation were recorded. Major findings are summarized as follows: 1) the subjects dressed faster with thicker clothing in the morning than in the evening; 2) the subjects with face cooling dressed faster with thicker clothing than the subjects without face cooling; 3) the subjects without a hat dressed more rapidly with thicker, heavier clothing. These results were discussed in terms of load error between actual and set-point values in the core temperature.

Acclimatization↗
PubMed1992

Cytotoxicity testing of wound dressings using methylcellulose cell culture.

Wound dressings may induce cytotoxic effects. In this study, we check several, mostly commercially available, wound dressings for cytotoxicity. We used our previously described, newly developed and highly sensitive 7 d methylcellulose cell culture with fibroblasts as the test system. Cytotoxicity is assessed by monitoring cell growth inhibition, supported by cell morphological evaluation using light and transmission electron microscopy. We tested conventional wound dressings, polyurethane-based films, composites, hydrocolloids and a collagen-based dressing. It was shown that only 5 out of 16 wound dressings did not induce cytotoxic effects. All 5 hydrocolloids were found to inhibit cell growth (greater than 70%), while cells had strongly deviant morphologies. The remaining wound dressings showed medium cytotoxic effects, with cell growth inhibition, which varied from low (+/- 15%), medium-low (+/- 25%) to medium-high (+/- 50%). Measurable cytotoxic effects of dressings detected in vitro are likely to interfere with wound healing when applied in vivo. The results are discussed in view of the clinical uses with contaminated wounds, impaired epithelialization or hypergranulation.

Bandages↗