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The authors recommend a calcium alginate sterile bandage SORBALGON, its advantage being that it has a haemostatic action, does not irritate tissues, is non-toxic, is easily changed and promotes healing. It is suited for covering extensive and deep wounds with ample secretion.
In 2004 the Leg Ulcer Forum issued a consensus statement, which stipulated that health care assistants should not apply compression bandaging. Because concerns have been raised about the role of unqualified staff in general wound management, the forum's executive has reissued the statement.
Blood flow in subcutaneous tissue of the lower leg decreased by 45% on changing from recumbency to the sitting position in patients suffering from chronic venous insufficiency. When walking, blood flow increased significantly to values near those measured during resting recumbency. A conventional elastic compression bandage (Weromedium) had no effect on these parameters, indicating that therapeutic gain through compression is not mediated by an improvement in subcutaneous blood flow.
We report on a patient who developed necrotizing contact dermatitis after a single topical application of tincture of benzoin and a pressure bandage following enucleation of an eye. The toxicity manifested in this case was more severe than any documented previously in the ophthalmic literature.
In 49 consecutive leg ulcer patients fungal cultures were taken from 4 different locations: the ulcer; the ulcer edge; 10 cm below the knee; and the toe-web. The patients had been treated with ACO Medicated Stockings in half of the cases, and the others were treated with several different bandages. Sera were analysed for antibodies against Candida albicans with the indirect immunofluorescence technique (IIF). The mean antibody titer was 434 in the patients with C. albicans in their ulcers, 123 in control patients with negative cultures in their ulcers and 258 in control patients with basalioma or actinic keratoses. Seven patients were culture positive for C. albicans, two patients had C. parapsilosis and one had growth of Trichophyton rubrum in their ulcers. Nine out of 10 patients with positive cultures had been treated with ACO Medicated Stockings (p less than 0.05). Covering a large area of the leg with an ointment impregnated stocking without preservatives seems to increase the risk for fungal infections.
A 57-year-old man with Shy-Drager syndrome underwent plastic surgery for decubitus on the buttocks under general anesthesia. Before induction of anesthesia, an elastic bandage was applied to the legs, and its effects were examined by raising the upper body. The fall in mean blood pressure decreased from 49% to 39%, and the symptoms of cerebral hypoxia disappeared. However, the induction of anesthesia with 5 mg diazepam, 0.05 mg fentanyl, and 100 mg thiamylal reduced blood pressure abruptly from 150/88 mmHg to 95/68 mmHg. Continuous infusion of phenylephrine was then started, and blood pressure became stable at around 150/90 mmHg. In this state, IPPV did not reduce the blood pressure in the supine position, and did not intensify its fall when the upper body was raised. Anesthesia was maintained with nitrous oxide 70% in oxygen, fentanyl and pancuronium. During the surgery, ventilation was controlled, and phenylephrine was infused at the rate of 5-15 micrograms.min-1 to maintain systolic blood pressure above 100 mmHg. Phenylephrine was infused during the two postoperative days, because blood pressure fell whenever the patient's posture was changed to prevent pressure on the operative site.
A case is presented in which inappropriate application of extensible tubed net bandage to a finger caused local skin necrosis. Only one comparable complication of this dressing material has been reported previously.
The protrusion of the peritoneal dialysis catheter from the skin is a technological and biological problem insufficiently solved in CAPD-patients. Infections in this area may demand the removal of the indwelling catheter. A decrease of the infection rate as well as a significant increase of the comfort for the patients is possible by the new bandaging method demonstrated, in which colostomy bags usual in trade are used.
Immobilization by means of a femoral plaster-cast box cannot always cope with the wide variety and severity of the injuries and diseases in the knee-joint region. To achieve best possible rehabilitation, several alternative and subsequent methods of surgical bandaging are described, including indications, technique and pros and cons.
The authors, on the basis of the clinico-radiographic revieping of 45 patients suffering from clavicle fracture and treated through "O"-shaped soft bandage, state the results obtained: they particularly point out the advantages of such method in the fractures of clavicle 3rd medium, with single rima in patients aged between 10 and 70.
169 legs with primary varicose veins suitable for sclerotherapy were entered into the trial. At the time of injection they were randomly allocated to be bandaged for three or six weeks; patients allocated to the six-week group had their legs rebandaged after the first three week. Patients were subsequently assessed blind at three months and thereafter at yearly intervals.
One of the most common problems following otoplasty is that the bandage applied at the time of surgery slips prematurely, falling over the patient's eyes and thereby requiring replacement. We present a simple technique which prevents this from occurring.
Both taping and bracing can be applied in the early functional treatment of ankle sprains. In this study the long-term (2.3 +/- 0.5 years) results of functional treatment with two types of bandages were compared. Out of 165 patients treated, 112 were available for interview, 60 of whom had been treated with adhesive, non-elastic tape and 52, with a confection brace. In 93 of these patients (47 in the tape group), the ankle was examined and stabilometry was performed. The distance (D) and area (A) covered by each patient's centre of gravity while he/she stood on one leg for 30 s were measured. The following symptoms were found on the total population: pain on movement in 5%, swelling in 8% and functional instability (recurrent sprain or a feeling of giving way) in 38%. Mechanical instability was found in 34%. Pain on palpation of the lateral ligaments was the only symptom whose frequency differed significantly (P < 0.05) between the tape group (47%) and the brace group (20%). Stabilometric measurements revealed no substantial difference between the tape group (D: 436 +/- 100 mm; A: 192 +/- 87 mm2) and the brace group (D: 459 +/- 111 mm; A: 206 +/- 92 mm2). Nor was any difference in stability observed between the injured and the non-injured ankle, between the stable and the unstable ankle, or between the unstable ankle with and without brace application. Stabilometry is thus not an appropriate means of quantifying the symptoms of ankle instability.(ABSTRACT TRUNCATED AT 250 WORDS)
Layered compression therapy for venous leg ulcers and ulcers associated with chronic leg edema has been shown to be an effective treatment in patients with adequate arterial circulation. However, no study has looked specifically at compression therapy in the diabetic population. This clinical case review examines outcomes in two groups of diabetic patients with edema and either venous ulcers or preulcerative conditions. Patients in Group 1 had clinically adequate arterial circulation and were treated with a four-layer compression bandage system. The highly elastic third layer was eliminated in the Group 2 patients, who had compromised peripheral arterial circulation. Healing occurred in 81% of patients in Group 1 and 67% of patients in Group 2. There was no acute progression of lower limb ischemia. Layered compression therapy was an effective and safe treatment in this diabetic population with adequate arterial circulation. Reduced compression also can be helpful in some patients with arterial compromise.
Proprioception of the knee joint was tested in 30 healthy volunteers with clinically inconspicuous knee joints. To examine proprioception, an angle reproduction test was performed. We could not document any differences between the left and the right knee joint or between men and women. At the mid-range, proprioception was worse compared with the end range of motion. In addition, 25 patients with an isolated rupture of the anterior cruciate ligament were evaluated, 14 before and 11 after operative anterior cruciate ligament (ACL) reconstruction. Preoperatively, there was a significant deterioration of proprioception compared with the control group. We were able to show a positive influence of a knee bandage on the proprioception of the injured knee. Patients after ACL reconstruction showed no significantly better proprioception compared with the preoperative group.
Fibrin sealants have become increasingly popular in nearly all surgical specialties. The absorbable fibrin adhesive bandage (AFAB) is a novel, potentially revolutionary product made from dried fibrinogen and thrombin. The AFAB appears to have excellent efficacy in producing rapid hemostasis in a variety of experimental major renal trauma models. The AFAB also appears to enhance healing of the urinary collecting system. Further study is essential to explore new urologic applications of this exciting technology.
PURPOSE: To determine the feasibility and side effect profile of 2-octyl cyanoacrylate with parabens (Liquid Bandage) as an adjunct wound sealant and barrier against the inflow of ocular surface fluid after clear corneal cataract surgery. DESIGN: Prospective interventional case series. PARTICIPANTS: Fifty-one eyes of 51 patients undergoing clear corneal cataract surgery. METHODS: Fifty-one eyes of 51 patients who underwent cataract surgery by one surgeon (RSK) were enrolled. A 2.75-mm clear corneal, triplanar, temporal incision was used in each case, followed by routine phacoemulsification. At the conclusion of each case, the wound was dried with a cellulose sponge. A modified microsponge with 1 to 2 drops of 2-octyl cyanoacrylate with parabens was then applied in a smooth layer to the wound. All wounds were rechecked for leakage with a cellulose sponge applied at the wound lip. The following criteria were evaluated on the first 2 postoperative visits: (1) visual acuity; (2) patient complaints; (3) wound integrity; (4) presence of tissue adhesive; and (5) any adverse events, including abnormal increase in local tissue reaction to the adhesive. MAIN OUTCOME MEASURES: Side effect profile and clinical course of 2-octyl cyanoacrylate with parabens applied to clear corneal wounds. RESULTS: All 51 eyes demonstrated intraoperative watertight wound closure after the application of 2-octyl cyanoacrylate with parabens. Forty-five eyes (88%) had tissue adhesive still completely covering the wound on postoperative day 1. Two eyes (4%) had tissue adhesive over portions of their wound, and 4 eyes (8%) had no adhesive noted on their wound. All wounds were watertight on all postoperative visits. Thirty-one of 51 patients (61%) complained of mild transient foreign body sensation on postoperative day 1. Twenty-six patients (51%) had trace diffuse bulbar conjunctival hyperemia. Five patients had trace focal conjunctival hyperemia adjacent to the wound. Nine patients (18%) had remnants of the adhesive remaining on the second postoperative visit. CONCLUSIONS: Our study demonstrates the ease of use and applicability and low side effect profile of 2-octyl cyanoacrylate with parabens as a temporary wound barrier in clear corneal cataract surgery.
PURPOSE: To evaluate benefits and side effects of bandage soft contact lens (BSCL) insertion after LASIK in relation to patients' characteristics. DESIGN: Prospective, randomized, bicenter comparative investigational trial. PARTICIPANTS: One hundred patients (200 eyes) with myopia and/or myopic astigmatism. METHODS: Each patient underwent consecutive (Marburg, Germany) or simultaneous (Mainz, Germany) bilateral LASIK. At the end of the procedure, the first treated eye received a drop of ofloxacin and dexamethasone, patch, and transparent protective shield for 2 to 4 hours. The fellow eye received in addition a BSCL, soaked in the same eyedrops for 20 to 24 hours. MAIN OUTCOME MEASURES: Schirmer II test results, first-day uncorrected visual acuity (UCVA), and tolerance of contact lens wear (poor, moderate, good) were recorded. Patients' subjective preference for the BSCL on the first postoperative day was graded as more comfortable than fellow eye, no difference, or less comfortable. Three months after surgery, the corneal flap was photographed in retroillumination for objective evaluation of microstriae. Statistical significance was determined using the Kruskal-Wallis 1-way analysis of variance on ranks test. RESULTS: Fifty-four percent of patients felt discomfort in the eye that had the BSCL (contra-BSCL subgroup), whereas 27% enjoyed having a BSCL (pro-BSCL subgroup). The remaining 19% felt no difference. The average Schirmer II value was 16.6 mm (+/-7.7) in the pro-BSCL subgroup, 14.9 mm (+/-6.4) in the no difference subgroup, and 12.3 mm (+/-7.7) in the contra-BSCL subgroup. There was a female preponderance in the contra-BSCL (39:15) and no difference (15:6) subgroups. A preoperative history of poor contact lens tolerance was recorded in 50% of the contra-BSCL subgroup patients; 41%, no difference; and 33%, pro-BSCL. Postoperative parameters such as first-day UCVA, number of eyes with microstriae, folds requiring stretching, or cases of diffuse lamellar keratitis did not differ significantly. Eyes with flap microstriae had a significantly deeper mean ablation (114.5 microm [range, 52-146 microm]) than eyes without any flap abnormalities (75.4 microm [39-120 microm]). No significant differences were found between the consecutive and simultaneous groups. CONCLUSION: The majority of patients did not experience better postoperative comfort from the application of a BSCL. Only 27% of patients reported more comfort from postoperative BSCL use. The latter have better tear film characteristics and a history of less difficulty with contact lenses preoperatively. A BSCL does not protect from the occurrence of microstriae.