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PubMed2005

Bacterial and fungal absorption properties of a hydrogel dressing with a superabsorbent polymer core.

OBJECTIVE: To study in vitro the micro-organism absorption properties of a hydrogel wound dressing, TenderWet. METHOD: Microbial films on agar plates and suspensions with common wound bacteria (Staphylococcus aureus, Staphylococcus epidermidis and Pseudomonas aeruginosa) and a fungal strain (Candida albicans) were studied. RESULTS: The hydrogel dressing reduced the number of micro-organisms significantly, both on the agar plate and in suspension. The in vitro data show that the hydrogel dressing absorbed the micro-organisms from the environment. Electron microscopic imaging clearly demonstrated that the germs were attached to the surface of the dressing's superabsorbent polymer core. CONCLUSION: In vitro data show that the hydrogel dressing TenderWet attracts and retains micro-organisms and reduces the number of viable germs. Clinical experience underlines this fast cleansing and debriding effect of the hydrogel wound dressing.

Absorption↗
PubMed2004

Effects of periodontal dressings on fibroblasts and gingival wound healing in dogs.

In the present study the effects of different commercially available periodontal dressings (Peripac, Barricaid, Fittydent, Reso-Pack and Myzotect-tincture) on fibroblast (V-79-379A) proliferation and survival were tested in vitro. Barricaid, Fittydent and Reso-Pack periodontal dressings have only small inhibitory effects on cell proliferation (83.3 +/- 9%, 71.6 +/- 8.7% and 87.3 +/- 4.5% of control after 48 h, respectively) in comparison with the great inhibitory effect of Myzotect-tincture (2.9 +/- 0.1%) and Peripac (33.7 +/- 11.4%) (p < 0.001). Barricaid was the only dressing where 41% of cells survived after exposure, while the other four dressings killed all the cells in 6 days. In addition, the healing of artificially created gingival wounds covered by Barricaid and Reso-Pack was followed for 7 days in 12 Beagle dogs. Histological evaluation of gingival tissue demonstrated that wounds covered by Reso-Pack showed the best epithelisation and vascularity and the least inflammatory reaction in first 4 days. Later the observed parameters were similar with those of wounds covered by Barricaid or without pack. The present results indicate that Peripac periodontal dressing and Myzotect-tincture showed the highest cytotoxicity to fibroblasts in vitro. From the histological observations in Beagle dogs Reso-Pack has been found to be the most suitable dressing, followed by Barricaid.

Adhesives↗
PubMed1975

A chlorhexidine-containing methacrylic gel as a periodontal dressing.

The modification of a methacrylic gel for use as a periodontal dressing was attempted. The increased adhesion and rigidity of the resultant material appeared consistent with the clinical findings. Satisfactory retention of the dressing was found in 85% of those placed on a group of patients attending for periodontal surgery. The potential value of the methacrylic gel for carrying and releasing pharmacological agents useful in the management of lesions of the oral mucosa was assessed by incorporating chlorhexidine acetate into the dressing. In vitro and in vivo studies demonstrated effective release of the chlorhexidine from the dressing throughout the period of time a periodontal dressing is normally in situ. In conclusion the results suggested that the modified methacrylic gel fulfills the requirements of a periodontal dressing. Study to assess further the potential for this material to carry other pharmacological agents used in the topical treatment of lesions of the oral mucosa is indicated.

Acrylates↗
PubMed1983

Comparison of results following modified Widman flap surgery with and without surgical dressing.

The clinical effects of a periodontal dressing after modified Widman flap surgery were studied. A total of thirty surgical sites in 13 patients were included in the study. Half of the sites were not covered by a periodontal dressing while the other half were. To effect a blind evaluation, the dressings were placed and removed by someone other than the examiner. Gingival crevicular fluid flow and gingival inflammation were measured prior to surgery, 2 weeks, 1 month and 2 months after surgery. Clinical attachment level and pocket depth were measured prior to surgery, 1 month and 2 months after surgery. All patients were instructed in oral hygiene procedures and received rubber cup prophylaxes and flossing at 1 week, 2 weeks, 1 month and 2 months postoperatively. At the conclusion of the study, a questionnaire was administered to each patient. No significant differences were found between dressed and undressed segments regarding changes in clinical attachment levels, pocket depth, or gingival inflammation. The omission of a dressing did not result in a greater incidence of discomfort. More patients stated preference for no dressing.

Adult↗
PubMed1984

Current status of periodontal dressings.

A comprehensive review of periodontal dressings is presented. The rationale for the application of dressings, their advantages and disadvantages are described. Tissue reactions to dressings and the therapeutic and adverse effects of antimicrobial agents used in dressings are discussed. The present status and value of a surgical dressing is critically assessed in view of recent studies which indicate that the routine use of dressings in postsurgical care may be either unnecessary or undesirable.

Animals↗
PubMed1994

Occlusivity and effects of two occlusive dressings on normal human skin.

Two occlusive, adhesive dressings--one hydrocolloid (absorptive) and one zinc-medicated (non-absorptive)--were studied regarding their occlusivity and effects when applied to normal human skin for 48 h. Both dressings reduced normal transepidermal water loss by about 70%. As documented by a 7-fold increase in the water loss beneath the dressings compared to untreated skin, water was retained in the stratum corneum by both dressings. No appreciable influence of either dressing on skin temperature was found. The skin surface pH decreased beneath the hydrocolloid while it increased beneath the zinc dressing.

Adult↗
PubMed1989

The effect of chlorhexidine supplementation in a periodontal dressing.

Most commercial periodontal dressings claiming antibacterial activity lose this activity shortly after application. Chlorhexidine (CH) is an antibacterial agent with long-term activity in the oral cavity owing to its substantiveness and slow-release properties. In a double-blind split-mouth-designed clinical trial the effect of incorporating CH acetate in periodontal dressing was tested on wound healing after gingivectomy. Eleven patients, each needing at least two gingivectomies, constituted the test panel. Wound healing, as assessed by bleeding tendency after removal of dressing 7 days postoperatively was significantly delayed when control dressings were applied as compared with test dressings. Variables with regard to patient comfort also yielded results in favor of the test pack. Incorporation of antibacterial agents with high retention and slow release properties in the mouth in surgical dressings seems advantageous.

Adult↗
PubMed1998

[Case report about the combined use of 2 moist wound dressings in the treatment of a chronic diabetic foot ulcer].

INTRODUCTION: Approximately 4.5% of the Spanish population suffer from Diabetes Mellitus (that means around 1.8 million people). Currently, the main problem that diabetes treatment presents is controlling its chronic complications, being the diabetic foot one of them, which can end up causing an amputation. Prevalence of ulceration varies according to sex, age and population characteristics, oscillating between 2.4% and 5.6%. In Catalonia, in a community case study, the prevalence was of 7.9%. In the same way, it has been calculated that at least 15% of diabetics will suffer from foot ulcerations during their lives. MATERIAL AND METHODS: A clinical case regarding a diabetic neuropathic chronic ulcer highly exuding was made to analyze the effect of this new dressing in the daily clinical practice. CombiDERM is an absorbent dressing with an external polyurethane plate and a central part with absorbent hydroparticles, indicated for the management of the exudate and the protection of the surrounding skin. 64-year-old woman, who suffered from Diabetes Mellitus type I to 28 years evolution with Retinopathy grade II, Artropathy of Charcott and a neuropathic ulcer of 4 years evolution. She was admitted in the Vascular Surgery Service the 6th of May of 1995 presenting an ulcer with signs of local infection in the sole of her left foot. Different local treatments were established and improvement periods were alternated with non-improvement periods, giving as a result an unfavorable evolution of the wound. The treatment with CombiDERM was established, using AQUACEL Ribbon (Hydrofiber dressing) as filling material. To evaluate the continuation of the treatment photos and acetates were taken, and data was registered in a Case Report Form. RESULTS: At the beginning the ulcer presented a high level of exudate, no signs of infection, light pain and the skin surrounding the ulcer was lightly macerated. After nine days of treatment an improvement of the ulcer could be observed, with the presence of granulating tissue. On the twenty-fourth day, granulation in the bed of the wound was completed and the quantity of exudate had reduced significantly. Application and removal of the dressing was easy and without pain. The evolution of the lesion was very good, without signs of infection, and with a graded epithelization until the ulcer was completely healed, at the eleventh week of the treatment with the new dressing. (The surface of the ulcer decreased from 557.67 mm2 to 0 mm2). CONCLUSION: Having in mind the good evolution of this ulcer and the characteristics of CombiDERM, the new dressing is an optimal alternative in the treatment of highly exuding diabetic neuropathy ulcers.

Diabetic Foot↗
PubMed2002

Evaluating the effectiveness of a dressing for use in malodorous, exuding wounds.

Malodorous, exuding wounds can cause problems for patients in terms of discomfort and social isolation. A prospective, noncomparative, multicenter study was conducted to evaluate the effectiveness of an odor-controlling dressing in the management of patients with chronic and acute exuding, malodorous wounds. Forty-six patients with various malodorous wounds (mean duration prior to study entry of 231.6 weeks) participated in the study. The majority of the patients were > 65 years of age (mean 70.7 years). Wound characteristics, odor, and dressing exudate absorption were assessed at baseline and at every dressing change (total: 348 dressing changes). Overall assessment of the dressing's ability was rated as good or excellent for odor control (91% of patients), exudate management (82%), and overall comfort (86%). Patient and nurse perception of odor were similar. While appropriate treatment to address the cause of exudate and wound odor remains a priority, the results of this study suggest that discomfort and isolation may be reduced through the use of odor-control dressings.

Aged↗
PubMedDate not supplied

Using film dressings.

Film dressings were one of the first modern wound-dressing products. They are extremely flexible, transparent and adhesive. They have no capacity to absorb fluid but are able to 'breathe off' small amounts of fluid by a process known as moisture vapour transpiration (MVT). The rate of MVT varies between brands but is, at best, minimal. This means that such dressings are not suitable for wounds that produce anything more than a minimal amount of exudate. Film dressings should not be used interchangeably with film products designed for intravenous cannula retention. Intravenous cannula dressings are designed to keep the cannula site dry and have a much higher MVT rate, whereas film dressings are designed to keep the wound moist.

Humans↗
PubMedDate not supplied

Inhibition of plaque accumulation under periodontal dressing by sustained-release varnish of chlorhexidine.

Slow-release varnish containing chlorhexidine was applied prior to the application of a periodontal dressing. The ability of the slow-release varnish to inhibit accumulation of dental plaque under the dressing was compared to a placebo varnish. Seven volunteers were fitted with periodontal dressing on the lower and upper jaws. One jaw was pre-coated with slow-release varnish containing chlorhexidine, while the other was coated with a placebo. A week later the dressings were removed and the plaque under the dressing was scored. Significantly less plaque was found on teeth pre-coated with the slow-release varnish containing chlorhexidine as compared to the control. An increase in the amount of gingival fluid was observed in both the control and experimental groups after removing the periodontal dressing.

Adult↗
PubMed1992

Occlusive versus semi-open dressings in the management of skin graft donor sites.

In a prospective, randomised study we compared the efficacy of a new occlusive dressing (Granuflex-E) with a semi-open dressing (tulle gras) in the management of skin-graft donor sites. The study examined 10 patients with burns, each with two donor sites. Each patient acted as his or her own control. The donor sites were mirror images of each other, the anterior surface of the thighs. One donor site was dressed with Granuflex-E and the other with tulle gras. The sites dressed with the occlusive dressing healed significantly faster and were more comfortable than the sites with the semi-open dressing.

Bandages↗
PubMed1986

[The search for an "ideal" surgical dressing].

Trials of a new occlusive dressing, Op-site (Smith Nephew), were conducted on a group of patients. Op-site is a fine, transparent, elastic, self-adhesive polyurethan film. Although non-porous and therefore water- and bacteria-proof, it is permeable to gases. The existing dressings fulfil only a few of the criteria of an "ideal" dressing and in some cases actually interfere with the healthy process. The main disadvantages are: the disturbance of newly formed epithelium, when many dressings are removed, their fibres become embedded in the new tissues and cause inflammation and delayed healing. Few dressings are true bacterial barriers and the hazard of infection of the wound is always present. Recent studies of the mechanism of wound healing have indicated that a moist, not dry surrounding provides the optimum conditions for wound repair. Healing under Op-site is said to be quicker because the serous exudate permits unhindered migration of new cells across the wound bed and prevents cellular dehydration. In contrast, under dry conditions healing is delayed because the new skin cells must first cleave a path through dehydrated dermis before migrating across the wound. The Op-site wound dressing can be readily applied over the joints and allows complete freedom of movement. The skin remains dry and the wound moist, providing the ideal environment for rapid healing. The film does not adhere to the moist wound and can therefore be removed without damage to the newly formed epidermis. The adhesive is low allergic. Finally, the wound can be assessed without removing the transparent Op-site.(ABSTRACT TRUNCATED AT 250 WORDS)

Amputation, Surgical↗
PubMed1996

Hydroactive dressings and serum proteins: an in vitro study.

An in vitro approach was used to obtain information about the compatibility of hydroactive dressing materials with the serum proteins which are thought to be relevant to wound healing. Artificial wound fluid was incubated with different hydroactive dressings (Cutinova hydro, Varihesive E, Comfeel Ulcer Dressing and Allevyn), and concentrations of total protein, albumin, immunoglobulin and growth factors were measured after one day of incubation. Cutinova hydro and Allevyn absorbed considerable amounts of fluid. Fluid uptake was lower for the hydrocolloid dressings. An unexpected finding was that Cutinova hydro showed an approximately two-fold increase over control values in the concentration of all proteins tested, indicating a selective absorption of water by this dressing. For the other dressings tested, zero or very low absorption of proteins was found, indicating a basically satisfactory protein compatibility.

Absorption↗
PubMed2026

Electrospun Nanofiber Dressings for Diabetic Wounds: From Single-Layer to Intelligent Composite Systems.

Diabetic chronic wounds have become a major challenge for clinical treatment due to their complex pathological microenvironment, including persistent inflammatory response, angiogenesis disorder, excessive oxidative stress, and susceptible infection. Traditional dressings as a passive barrier have difficulty meeting the above multiple treatment needs. Electrospinning technology, with its ability to mimic the fibrous network structure of the natural extracellular matrix (ECM), offers a high specific surface area, controllable porosity, and excellent drug-loading capacity, making it an ideal platform for developing a new generation of multifunctional wound dressings. This article provides a systematic review of the research progress on electrospun nanofiber dressings in the treatment of diabetic wounds, focusing on the design evolution from basic single-layer structures to advanced complex structures and elucidating the mechanisms of action and quantifiable effects of each structural type in addressing specific pathological challenges. We also compared the current status of clinical translation for electrospun dressings with that of other advanced wound care platforms and proposed a standardized preclinical evaluation framework. A large number of research data show that these advanced designs can effectively improve the quality of healing. Finally, this paper points out the challenges faced by this field, such as scalable fabrication, in vivo reliability of smart systems, and long-term biosafety, and provides theoretical basis and technical reference for the design of efficient and intelligent electrostatic spinning diabetic wound dressings.

Nanofibers↗
PubMed2005

Systematic review of dressings and topical agents for surgical wounds healing by secondary intention.

BACKGROUND: The best dressing for postoperative wounds healing by secondary intention is unknown. METHODS: A systematic review was conducted to assess the effectiveness of dressings and topical agents on such wounds. Main endpoints were wound healing, pain, patient satisfaction, costs and hospital stay. Systematic methodological appraisal and data extraction were performed by independent reviewers. RESULTS: Fourteen reports of 13 randomized clinical trials on dressings or topical agents (gauze, foam, bead, alginate and hydrocolloid dressing) for postoperative wounds healing by secondary intention were identified; they were of weak methodological quality. In general, no statistically significant differences in wound healing were found for various dressing comparisons (11 of 13 trials). Patients experienced significantly more pain (four of six trials) and were less satisfied when gauze was used (three of six trials). Gauze was inexpensive, but its use was associated with significantly more nursing time than dressing with foam (two of three trials). No substantial differences in hospital stay were found (four of five trials). CONCLUSIONS: Only small, poor-quality trials exist, rendering the evidence insufficient. Foam is best studied as an alternative to gauze and appears to be preferable in terms of pain reduction, patient satisfaction and nursing time.

Administration, Topical↗
PubMed1986

An evaluation of Aquaphor Gauze dressing in burned children.

Aquaphor Gauze was evaluated as a dressing for skin graft donor sites, for partial thickness burn injuries and for split thickness skin grafts. Control dressings consisted of: fine mesh gauze for skin graft donor sites. silver sulphadiazine (Silvadene) on coarse mesh gauze for the partial thickness burns, and nitrofurazone cream (Furacin) on fine mesh gauze for the skin grafts. The Aquaphor Gauze was found to be inferior to the fine mesh gauze for donor site dressings. No statistically significant difference was identified between Aquaphor Gauze and controls for the treatment of partial thickness burns. As a dressing for skin grafts the Aquaphor Gauze was significantly superior to the control dressing as measured by graft take and reduced patient pain. We would recommend that Aquaphor Gauze be used as a dressing for skin grafts where the risk of infection is not excessive.

Adolescent↗
PubMed1995

Acemannan-containing wound dressing gel reduces radiation-induced skin reactions in C3H mice.

PURPOSE: To determine (a) whether a wound dressing gel that contains acemannan extracted from aloe leaves affects the severity of radiation-induced acute skin reactions in C3H mice; (b) if so, whether other commercially available gels such as a personal lubricating jelly and a healing ointment have similar effects; and (c) when the wound dressing gel should be applied for maximum effect. METHODS AND MATERIALS: Male C3H mice received graded single doses of gamma radiation ranging from 30 to 47.5 Gy to the right leg. In most experiments, the gel was applied daily beginning immediately after irradiation. To determine timing of application for best effect, gel was applied beginning on day -7, 0, or +7 relative to the day of irradiation (day 0) and continuing for 1, 2, 3, 4, or 5 weeks. The right inner thigh of each mouse was scored on a scale of 0 to 3.5 for severity of radiation reaction from the seventh to the 35th day after irradiation. Dose-response curves were obtained by plotting the percentage of mice that reached or exceeded a given peak skin reaction as a function of dose. Curves were fitted by logit analysis and ED50 values, and 95% confidence limits were obtained. RESULTS: The average peak skin reactions of the wound dressing gel-treated mice were lower than those of the untreated mice at all radiation doses tested. The ED50 values for skin reactions of 2.0-2.75 were approximately 7 Gy higher in the wound dressing gel-treated mice. The average peak skin reactions and the ED50 values for mice treated with personal lubricating jelly or healing ointment were similar to irradiated control values. Reduction in the percentage of mice with skin reactions of 2.5 or more was greatest in the groups that received wound dressing gel for at least 2 weeks beginning immediately after irradiation. There was no effect if gel was applied only before irradiation or beginning 1 week after irradiation. CONCLUSION: Wound dressing gel, but not personal lubricating jelly or healing ointment, reduces acute radiation-induced skin reactions in C3H mice if applied daily for at least 2 weeks beginning immediately after irradiation.

Aloe↗