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At least 343 records · Page 19Linked to original sources
PubMedDate not supplied

EMLA cream provides rapid pain relief for the curettage of molluscum contagiosum in children with atopic dermatitis without causing serious application-site reactions.

Twenty-nine children with atopic dermatitis, 4 to 9 years of age, were included in an open study of the analgesic efficacy and the application-site reactions produced by EMLA cream 5% at a maximum dose of 10 g applied for 30 minutes under occlusion prior to the curettage of molluscum contagiosum. Molluscum areas with and without eczema were treated. The overall magnitude of pain was assessed first by the child and then by the physician on a four-step verbal rating scale immediately after completion of the curettage. Prior to the surgical treatment, the application site was examined for local skin reactions. Eighty-three percent of the children rated the pain from the surgical procedure as none or mild, while the physicians rated the pain as none or mild in 86% of the children. The application-site reactions were pallor, redness, and edema. These reactions were transient and required no clinical attention. Their incidence or severity did not differ significantly between areas with and without eczema. In conclusion, EMLA cream 5% applied for 30 minutes under an occlusive dressing provides effective local analgesia without serious application-site reactions for the curettage of molluscum contagiosum in children with atopic dermatitis.

Anesthetics, Combined↗
PubMed1997

Rupioid psoriasis associated with arthropathy.

We reported a rare case of rupioid psoriasis associated with arthropathy. A 28-year-old male had suffered from severe arthritis for 6 months and had limpet-like, cone-shaped skin lesions on the extremities for 3 months. The histopathology revealed remarkable Munro's and Kogoj microabscesses, intense dermal edema, and moderate inflammatory cell infiltration. The radiological examination showed bilateral sacroilitis. The skin lesions and arthritis responded dramatically in three weeks to i.m. methotrexate combined with topical steroids and emollients and occlusive dressing technique. There was no recurrence of such skin lesions during the two year follow-up period.

Abscess↗
PubMed1991

Pressure ulcers: critical considerations in prevention and management.

Pressure ulcer development is a serious problem occurring predominately among elderly persons, who are confined to bed or chair. Factors associated with pressure ulcer development include: cerebrovascular accident, impaired nutritional intake, fecal incontinence, lymphocytopenia and a high comorbidity score. Implementation of preventative measures, such as: in-depth assessment for mobility, a pressure relieving device combined with adequate repositioning, thorough evaluation for nutritional status and urinary incontinence, significantly reduce pressure ulcer incidence. If the pressure ulcer is a partial thickness (Stage II) wound, the causative factors are probably friction and/or moisture. If the ulcer is full thickness (Stage III, IV) it is secondary to pressure and/or shearing forces. The development of wound infection is the most common complication. Osteomyelitis is not an uncommon occurrence and must be initially ruled out in all full thickness pressure ulcers. Surgical debridement of necrotic tissue is necessary prior to further treatment and /or assessments. Cultures and antibiotic therapy are indicated only upon evidence of infection (erythema, edema, cellulitis, osteomyelitis, leukocytosis, bandemia or fever). Topical pharmacologic agents may be used to prevent or treat infection but must be carefully controlled to avoid such adverse effects as toxicity to the wound, allergic reaction and development of resistant pathogens. Proper use of occlusive dressings increase patient comfort, enhance healing, decrease the possibility of infection, save time and reduce costs. A patient presenting an ulcer which fails to improve, or due to its size will take a great deal of time to heal, should be evaluated for surgical closure.

Aged↗
PubMed1988

Pyoderma pathophysiology and management.

Cutaneous infections with Staphylococcus aureus, Streptococcus pyogenes, and Pseudomonas aeruginosa are major complications of epidermolysis bullosa. Application of impermeable occlusive dressings over denuded skin colonized with these bacteria results in rapid multiplication and the hazard of severe pyoderma. Approaches to the prophylactic treatment of these infections during the long-term management of epidermolysis bullosa are considered.

Administration, Cutaneous↗
PubMedDate not supplied

Iatrogenic injury in childhood staphylococcal scalded skin syndrome.

Staphylococcal scalded skin syndrome (SSSS) may cause significant morbidity in children. It is common practice for adhesive occlusive dressings to be used to apply topical local anaesthetic prior to venepuncture. We report two cases in which removal of these dressings from children with SSSS caused injury and discomfort in areas previously free from blistering. We recommend that an alternative method of topical anaesthetic application is used to minimize skin trauma in these patients.

Administration, Topical↗
PubMed1997

[The author's own method of local anesthesia for skin incision around implants during limb lengthening].

Infection around implants is the most frequently described problem during limb lengthening. Fast elimination of the inflammatory response is crucial for intensive mobilization and weight bearing of the extremity being elongated. Prior to the unloading incision of the skin stretched around the implant EMLA ointment was used repeatedly in 12 children. EMLA was applied 1-2 hours prior to the procedure and covered with an occlusive dressing. All skin incisions, also within inflamed areas were painless. The management described eliminates the need for general anesthesia and thus for hospitalization, lowers treatment costs and limits child's anxiety.

Adolescent↗
PubMed1990

Studies on zinc in wound healing.

Topical zinc is widely used in wound treatment although the beneficial effect of zinc has only been documented in zinc-deficient patients who were given zinc orally. The main purpose of this study was to investigate the effect of topically applied zinc on leg ulcer healing and examine its effect on some mechanisms in wound healing using standardized animal models. Additionally, absorption of zinc into wounds and intact skin treated topically with zinc was studied. In a double-blind trial involving 37 leg ulcer patients with low serum zinc levels, topical zinc oxide promoted cleansing and re-epithelialization. Infections and deteriorations of ulcers were less common in zinc oxide treated patients. Re-epithelialization, an important mechanism in the closure of leg ulcers, was enhanced with zinc oxide applied topically on partial-thickness wounds in pigs with normal zinc status. Zinc sulfate at three different concentrations did not, however, result in this beneficial effect on the resurfacing of wounds. The inflammatory reaction was diminished in zinc treated wounds except when a high zinc sulfate concentration was applied. Bacterial growth and concomitant diseases such as diabetes can complicate wound healing. In normal rats, bacterial growth in full-thickness wounds was reduced with topical zinc oxide but not in hyperglycemic diabetic rats. The anti-bacterial mechanism of zinc oxide seemed to be more indirect and to be mediated via local defense systems rather than being directly toxic to the bacteria. Healing of 21-day-old skin incisions was impaired in zinc deficiency, as measured by a significantly decreased wound breaking strength in zinc-deficient rats compared with that of pair-fed controls. The decreased breaking strength did not seem to be due to differences in collagen concentration of the wounds. Zinc oxide was slowly but continuously solubilized when applied on open wounds in rats. On the other hand, with zinc sulfate, the zinc concentrations, either locally or systemically, did not maintain a constant level for the 48-hour post-operative treatment period as they did with zinc oxide. Zinc absorption in and through normal human forearm skin was demonstrated after treatment with a zinc oxide medicated occlusive dressing by increased zinc levels in epidermis, interstitial fluid and dermis compared with the non-zinc control dressing. In conclusion, topical zinc may stimulate leg ulcer healing by enhancing re-epithelialization, decreasing inflammation and bacterial growth. When zinc is applied on wounds it not only corrects a local zinc deficit but also acts pharmacologically.(ABSTRACT TRUNCATED AT 400 WORDS)

Administration, Topical↗
PubMed1982

A double-blind trial of budesonide and betamethasone- 17,21-dipropionate in psoriasis.

A double-blind trial was carried out to compare the effectiveness of budesonide, a non-halogenated steroid, and betamethasone-17,21-dipropionate in the treatment of psoriasis. One group of 40 hospitalized patients was treated with both preparations under occlusive dressings. The evaluation was done as a left-right comparison within each patient. These patients were treated for 1 week, with evaluations on Days 3 and 7. Another series of 79 out-patients was divided into two groups, either group being treated with one of the two preparations. These were treated for 2 weeks, with evaluations after 1 and 2 weeks. Itching, scaling, erythema and induration were recorded on a 5-point scale. A preference was stated for the best result. Statistically significant results favouring the budesonide ointment were obtained, both with and without occlusion.

Adolescent↗
PubMed1988

[Antipsoriatic effect of (tape) occlusion].

Occlusive dressing may lead to a significant reduction of the induration and desquamation of psoriatic lesions. Our lectin-histochemical findings suggest that this effect is unlikely to be caused by a normalization of abnormal keratinocyte differentiation. Since epidermal cells rich in calmodulin can immunohistologically be detected, we conclude that the egress from the stratum basale is at least partially inhibited.

Adult↗
PubMed1975

An explanation for the 'placebo' effect of bland ointment bases.

Bland topical applications, containing no pharmacologically active ingredients, were found to have an antimitotic effect on the epidermis of the stripped dorsal skin of hairless mice. White soft paraffin, cetomacrogol cream A (B.P.), starch paste, and emulsifying ointment (B.P.) were applied for 24 h periods under occlusive dressing to the backs of mice. The antimitotic effect was present at the time of removal of the dressings and up to 72 h after removal. White soft paraffin had the maximal antimitotic activity and epidermis of mice treated with it showed only 23% of the number of mitoses of control animals having no such treatment. Emulsifying ointment had the least activity and in some circumstances actually seemed stimulatory to mitotic activity.

Animals↗
PubMed2001

Re-epithelialization of the skin following CO2 laser resurfacing.

Wound healing following CO(2) laser resurfacing of the face is a complex process which must involve a rapid replacement of the ablated epidermis to protect the underlying structures in the skin from desiccation and deeper injury. The majority of cells that regenerate the epidermis come from the hair follicles, and cell movement out of the follicles is monitored using immunofluorescence with antibodies to keratin 17, an intermediate filament protein expressed in the migrating front of cells. This migration is enhanced with occlusive dressings used immediately after the resurfacing procedure. Skin biopsies have been examined at multiple time points following resurfacing, and re-epithelialization begins by 48 h in skin that has been occluded. Skin that has been left open with no treatment forms an eschar and has no keratinocyte migration at 48 h, thus displaying delayed wound healing.

Carbon Dioxide↗
PubMed1989

[The use of a heparin ointment in combination with dimexide in treating psoriasis].

Thirty-five male patients with psoriasis en plaques, persisting for 2-5 years, resistant to routine therapy, were treated with official heparin ointment with 15% dimexide under an occlusion dressing. Positive results were achieved in 41.2 +/- 5.9 days of the ointment application. Complete resolution of the rash was observed in 19 (54.3%) patients, partial regression in 14 (40%), no effect in 2 (5.7%) patients. This ointment is recommended for active therapy of patients with local psoriatic plaques with a stable course of the condition, torpid to routine antipsoriatic therapy.

Adult↗
PubMed2001

An octyl-2-cyanoacrylate formulation speeds healing of partial-thickness wounds.

BACKGROUND: Occlusive dressings have been known to accelerate the rate of healing. Every year new dressings are being introduced in the marketplace. OBJECTIVE: The purpose of this study was to evaluate the effect of a new octyl-2-cyanoacrylate liquid dressing as compared to two over-the-counter bandages on partial-thickness wounds. Performance parameters were epithelialization, erythema, scab formation, material adherence, hemostasis, and infection. METHOD: Eight pigs with a total of 645 partial-thickness wounds were assigned to one of the following treatments: liquid dressing, standard bandage, hydrocolloid bandage, or untreated air exposed. RESULT: The liquid bandage enhanced the rate of epithelialization and was the only treatment to provide complete hemostasis, reduced scab formation, and did not induce an irritant response (erythema) or infection. CONCLUSION: The liquid bandage is an easy to use material that stops bleeding (instantaneous hemostasis) while enhancing healing of partial-thickness wounds.

Animals↗
PubMed2002

What really affects the incidence of central venous catheter-related infections for short-term catheterization?

Central venous catheterization is one of the important sepsis reasons in surgical patients. In this randomized controlled study, the effect of the frequency and type of catheter site care, as well as age, coexisting malignancy or diabetes mellitus, total parenteral nutrition administration and antibiotics use, on central venous catheter infection was investigated. Seventy-two single-lumen polyurethane catheters were included. In group I (n: 33), a transparent occlusive dressing was applied to the insertion site and not removed for 7 days unless there were signs of local infection. In group II (n: 39), daily site care was done with povidone-iodine 10% solution and a new sterile gauze was applied. Chi-square, linear correlation and multiple regression tests were used for statistical analysis. Mean duration of catheters was 8 +/- 4 days. There was no catheter-related sepsis. Ten (13.9%) patients had positive catheter tip cultures of whom three had site infection as well. The incidence of site and tip infections were not significantly different in group I and II (p > 0.05). Site infection and age younger than 60 years significantly increased the rate of tip infection (p: 0.004 and p: 0.02 respectively). Total parenteral nutrition administration was associated with higher rate of tip infection (p: 0.06). Coexisting malignancy or diabetes mellitus, duration of catheter and antibiotics use did not have any significant effect on the rate of central venous catheter infections (p > 0.05). In conclusion, we observed that the frequency of insertion site care and the type of dressing applied to the site had no significant effect on the rate of CVC infection. Insertion site infection was the most significant factor increasing the incidence of catheter tip infection. The use of the CVC for total parenteral nutrition facilitated tip infection as well.

Adult↗
PubMed2003

[Vacuum assisted closure--a new method for wound control and treatment].

UNLABELLED: Despite the numerous advances in wound healing research, the treatment of chronic non-healing wounds still presents a challenge. Vacuum assisted closure is a new technique for wound treatment using negative pressure. The method can be used for the treatment of a wide variety of wounds, including pressure sores, diabetic ulcers, venous ulcers, surgical traumatic wounds and radiated wounds. With the aid of this method pressure is distributed on the wound by using a foam with a specific pore size. The foam is placed over the wound and the wound is covered with an adherent, occlusive dressing thus converting the open wound to a controlled closed wound. The mechanism that stands for the positive effect of the negative pressure dressing is obtained by removing the third space fluids from the area immediately adjacent to the wounds, thus decreasing the pressure on small vessels and improving the blood supply to the wound with positive consequences for this increment. CONCLUSIONS AND RECOMMENDATIONS: A new method is presented for the treatment of chronic wounds using negative pressure. The application of the negative pressure to wounds can promote the healing of a variety of chronic non-healing wounds with significant increase in granulation tissue formation.

Humans↗
PubMed1994

Audit of infection in continuous ambulatory peritoneal dialysis.

The major cause of failure of continuous ambulatory peritoneal dialysis is peritoneal or exit site infection with Staphylococcus aureus. From 1989-1992, eradication of nasal and perineal carriage, continued use of an occlusive dressing to the exit site, improved aseptic technique for dressing changes by the patient and avoidance of wetting of the dressing were used in an attempt to reduce staphylococcal infections. By comparison with the 3-year period prior to intervention, a significant increase in the life of the catheters was achieved (removed at 1 year, 13 vs. 28%, P < 0.001) with a reduction in episodes of peritonitis due to S. aureus. The study was not prospectively controlled but there did not appear to be any other factor to account for the sudden and consistent improvement observed.

Catheterization↗
PubMed1984

[Hand burns in children. Retrospective study of 137 cases from 1973-1982 representing 177 hands].

One hundred and seventy seven burnt hands observed in children during the last ten years were reviewed at our hospital. One third were severely injured with burns deeper than 2nd degree. The infrequent greasy occlusive dressing was performed under general anesthesia in 87% of the burnt hands as the primary treatment. Out of 19 cases, five necessitated a secondary procedure one year or more later. Excision followed by full thickness skin grafts or flaps was used initially in 11%. Besides the common sequelae of burnt hands, we found some proper to children: clinodactyly, inhibition of longitudinal growth following epiphyseal plate destruction. The annual increase in the observed number of cases which doubled in ten years, shows the importance of prevention.

Adolescent↗
PubMed1993

[Transdermal application of 10% lidocaine-gel for management of pain associated with herpes zoster].

We have developed transdermally applicable 10% lidocaine aqueous gel containing an absorption promoter and applied it for 15 patients suffering from severe pain in acute or subacute phase of herpes zoster. The patients, consisting of 7 males and 8 females with a mean age 58.5 +/- 13.0 (SD) yrs, had skin eruptions of herpes zoster for the past 2 months. Lidocaine-gel was applied locally to the diseased skin with or without an occlusive dressing. In 14 of the 15 patients (93%), a remarkable reduction of pain (below 10% of pretreatment level) was obtained after 9.9 +/- 5.6 (SD) times of lidocaine-gel treatments. There was no adverse systemic reactions or local skin damages. None of them developed post-herpetic neuralgia. The lidocaine-gel treatment appears to be very useful for reduction of pain associated with acute or subacute phase of herpes zoster.

Administration, Cutaneous↗