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At least 577 records · Page 32Linked to original sources
PubMed1994

The effect of semirigid dressings on below-knee amputations.

BACKGROUND AND PURPOSE: The effect of using semirigid dressings (SRDs) on the residual limb of individuals who have had below-knee amputations as a consequence of peripheral vascular disease was investigated, with the primary question being: Does the time to readiness for prosthetic fitting for patients treated with the SRDs differ from that of patients treated with soft dressings? SUBJECTS: Forty patients entered the study and were alternately assigned to one of two groups. Nineteen patients were assigned to the SRD group, and 21 patients were assigned to the soft dressing group. METHODS: The time from surgery to readiness for prosthetic fitting was recorded for each patient. Kaplan-Meier survival curves were generated for each group, and the results were analyzed with the log-rank test. RESULTS: There was a difference between the two curves, and an examination of the curves suggests that the expected time to readiness for prosthetic fitting for patients treated with the SRDs would be less than half that of patients treated with soft dressings. CONCLUSION AND DISCUSSION: The results suggest that a patient may be ready for prosthetic fitting sooner if treated with SRDs instead of soft dressings.

Aged↗
PubMed1986

A dressing system providing fluid supply and suction drainage used for continuous or intermittent irrigation.

In this article a dressing system is described that is capable of providing continuous or intermittent wound irrigation. It is based on a felt dressing provided with an adhesive cover and ports for fluid supply and suction drainage. At continuous irrigation (approximate rate, 70 ml/h), a 1-L fluid bag and a siphon about 30 cm in height are used; at intermittent irrigation (approximate rate, 60 ml/min), a 60-ml fluid bag and a suction balloon are used. In an experimental set-up it was shown that the supplied fluid diffused throughout the dressing felt and that the felt was partly saturated both during continuous and after intermittent irrigation, the effect of gravity being counteracted by capillary force and suction. The suction pressure at the drainage port and within the occlusively applied felt showed a linear relationship. The drainage of particles, while relatively impeded at low flow rates, was satisfactory at rates recommended for clinical use. The dressing felt was inert to adherence of bacteria and white blood cells. This dressing system would seem to provide access to the whole wound surface for active therapy through fluid supply and suction drainage.

Bandages↗
PubMed1994

Influence of occlusive and impregnated gauze dressings on incisional healing: a prospective, randomized, controlled study.

After elective surgery, 28 patients with 40 wounds were enrolled in a controlled clinical study to assess the effects of two different dressings on incisional healing. Patients served as their own control with one-half of each incision covered with an impregnated gauze (Xeroform) and the other half of the incision covered with a thin occlusive hydrocolloid dressing (DuoDerm Extra Thin CGF). All wounds were evaluated 2 to 3 days, 7 to 10 days, 4 weeks, and 7 months postoperatively. None of the incisions segments showed any evidence of infection. At the time of suture removal, the hydrocolloid dressing's ability to contain exudate, protect the wound, and facilitate mobility and personal hygiene were rated higher compared with the gauze-type dressing (p < 0.001, for all variables). At the 4-week visit, both the patient and the surgeon rated the scar segments covered with the hydrocolloid dressing better with respect to color, evenness, and suppleness (p < or = 0.04, for all variables). These differences were no longer apparent 7 months after surgery.

Adolescent↗
PubMed2001

Which dressing for split-thickness skin graft donor sites?

There are a variety of methods used for the postoperative management of the donor site created after harvesting a split-thickness skin graft. The authors compare three major groups of dressings-open, semiopen, and closed-performed on 60 patients divided into three groups. These different dressings were compared based on healing time, quality of the regenerated skin, and patient comfort. Biopsy specimens were obtained from the donor sites of each group for the assessment of healing quality and stage. An ideal donor site dressing method is one that affords protection from dehydration and prevention of wound and infection while also achieving rapid and painless healing of the donor site. The closed-dressing group had the shortest healing time, shown both clinically and histologically, and superior patient comfort was also documented in this group. The closed-dressing group showed qualitatively superior healing when compared with open and semiopen donor sites. This was attributed to protection from dehydration and mechanical trauma, and avoidance of exogenous contamination.

Adolescent↗
PubMed2003

Effect of a chitosan-based hemostatic dressing on blood loss and survival in a model of severe venous hemorrhage and hepatic injury in swine.

BACKGROUND: Hemorrhage is a leading cause of death from trauma. An advanced hemostatic dressing could augment available hemostatic methods. We studied the effects of a new chitosan dressing on blood loss, survival, and fluid use after severe hepatic injury in swine. METHODS: Swine received chitosan dressings or gauze sponges. Standardized, severe liver injuries were induced. After 30 seconds, dressings were applied and resuscitation initiated. Blood loss, hemostasis, resuscitation volume, and 60-minute survival were quantified. RESULTS: Posttreatment blood loss was reduced ( p< 0.01) in the chitosan group (264 mL; 95% confidence interval [CI], 82-852 mL) compared with the gauze group (2,879 mL; 95% CI, 788-10,513 mL). Fluid use was reduced ( p= 0.03) in the chitosan group (1,793 mL; 95% CI, 749-4,291) compared with the gauze group (6,614 mL; 95% CI, 2,519-17,363 mL). Survival was seven of eight and two of even in the chitosan and gauze groups ( p= 0.04), respectively. Hemostasis was improved in the chitosan group ( p= 0.03). CONCLUSION: A chitosan dressing reduced hemorrhage and improved survival after severe liver injury in swine. Further studies are warranted.

Animals↗
PubMedDate not supplied

Subatmospheric pressure dressings in the temporary treatment of soft tissue injuries associated with type III open tibial shaft fractures in children.

PURPOSE: This study was designed to evaluate the use of subatmospheric pressure dressings on high-energy open tibial shaft fractures in children. We hypothesized that the use of a negative-pressure dressing in these fractures would result in a decreased incidence of infection and decreased need for pedicled muscle flaps and free tissue transfer. METHODS: A retrospective case series of 15 consecutive pediatric patients with 16 type III open tibial shaft fractures (8 type IIIA, 7 type IIIB, and 1 type IIIC). The patients' age ranged from 2 to 17 years. All patients underwent a standard protocol of serial irrigation and debridement of the open wound with bony stabilization. Temporary coverage of the open wound was obtained with the use of a subatmospheric pressure dressing until definitive wound coverage or closure. RESULTS: Infection occurred in 5 of 16 fractures, 2 requiring antibiotics alone (1 type IIIA and 1 type IIIB) and 3 requiring surgical intervention (2 type IIIB and 1 type IIIC). Seven of 16 (3 type IIIA, 3 type IIIB, and 1 type IIIC) fractures required repeat surgical intervention to facilitate bony healing. Only 3 patients required free tissue transfers or rotational muscle flaps for coverage, a 50% decrease compared with the initial classification. CONCLUSIONS: Compared with other described methods, the use of subatmospheric pressure dressings in the temporary treatment of soft tissue wounds associated with high-energy open tibial shaft may reduce the need for major soft tissue coverage procedures. Its effect on infection and fracture healing rates requires further study. SIGNIFICANCE: A reduction in the need for major soft tissue coverage procedures with the use of negative-pressure dressings in this setting should result in decreased morbidity for these patients and in decreased social and financial costs.

Adolescent↗
PubMed2004

Topical negative pressure using a drainage pouch without foam dressing for the treatment of undermined pressure ulcers.

UNLABELLED: Topical negative pressure is gaining popularity as an acute and chronic wound management technique. In general, foam dressing is applied to the wound surface to maintain negative pressure. Due to the potential for clogging by the foam dressing, topical negative pressure cannot be used when there is a high volume of necrotic tissue or massive infection present. In this study, topical negative pressure was applied using a drainage pouch without any dressing. Topical negative pressure was applied to 8 patients with 9 pressure ulcers complicated by undermining. This approach was effective in the treatment of all 9 ulcers and allowed the wounds to be visualized while maintaining negative pressure. Since this technique can be performed without foam dressing, it can be used to treat early-stage infectious pressure ulcers in which there is a lot of necrotic tissue. CONCLUSION: Topical negative pressure without dressing is an extremely effective treatment of pressure ulcers complicated by undermining.

Adult↗
PubMedDate not supplied

Comparison of in vitro disc diffusion and time kill-kinetic assays for the evaluation of antimicrobial wound dressing efficacy.

There is a plethora of new silver-containing dressings on the market today. Various manufacturers attempt to show that their dressings are the most efficacious and therefore should be preferentially employed by health care workers based on the results of their in vitro tests. However, there have been no studies that clearly identify which tests are appropriate for comparison purposes. The purpose of this study was to determine which in vitro test is most appropriate for evaluating the antimicrobial efficacy of silver-containing dressings. This was done by testing seven silver-containing dressings and two non-silver-containing topical agents against 17 clinically relevant microorganisms using zone of inhibition assays and time-kill kinetic assays in complex media. The results for the two assays were then correlated to determine whether the methods generated similar results. It was determined that the two methods do not correlate at all. This is most likely a result of the silver interacting with the media in the zone of inhibition test, thus invalidating the results of this test. We therefore conclude that zone of inhibition data generated for silver-containing dressings is of little value when assessing antimicrobial efficacy and that time-kill assays are of greater use.

Administration, Topical↗
PubMed2006

Efficacy and safety of 'wet-wrap' dressings as an intervention treatment in children with severe and/or refractory atopic dermatitis: a critical review of the literature.

BACKGROUND: During the last two decades wet-wrap treatment (WWT) has been advocated as a relatively safe and effective treatment modality in children with severe and/or refractory atopic dermatitis (AD). Unfortunately, there are still many unsolved issues concerning the use of wet-wrap dressings in patients with AD. OBJECTIVES: To make an inventory of the different methodologies and to evaluate the currently available evidence for the use of WWT as an intervention treatment in children with severe and/or refractory AD. METHODS: We performed a search of the literature via the online PubMed database. Reference lists from relevant articles were scanned for additional publications. Publications describing a treatment modality for children with severe and/or refractory AD, which included the application of wet dressings, were collected and evaluated using the guidelines of the NHS Centre for Reviews and Dissemination, University of York. RESULTS: Twenty-four publications were included for evaluation. Eleven of the publications detailed original clinical studies (study design level 2-4), while 13 revealed expert opinions (study design level 5). Evidence levels did not exceed level 4. CONCLUSIONS: Large prospective studies evaluating the efficacy and safety profile of WWT are lacking. We were able to formulate the following conclusions with a grade C of recommendation. (i) WWT using cream or ointment and a double layer of cotton bandages, with a moist first layer and a dry second layer, is an efficacious short-term intervention treatment in children with severe and/or refractory AD. (ii) The use of wet-wrap dressings with diluted topical corticosteroids is a more efficacious short-term intervention treatment in children with severe and/or refractory AD than wet-wrap dressings with emollients only. (iii) The use of wet-wrap dressings with diluted topical corticosteroids for up to 14 days is a safe intervention treatment in children with severe and/or refractory AD, with temporary systemic bioactivity of the corticosteroids as the only reported serious side-effect. (iv) Lowering the absolute amount of applied topical corticosteroid to once daily application and further dilution of the product can reduce the risk of systemic bioactivity.

Adolescent↗
PubMed1996

The hygienic efficiency of conventional and inverted lamb dressing systems.

Aerobic plate counts (APC 37 degrees C and APC 25 degrees C) and Escherichia coli enumerations (Petrifilm) were used to determine sources of bacterial contamination during sheep dressing, determine the hygienic efficacy of hand wash and knife 'sterilization' procedures and compare the hygiene efficiency of conventional and inverted sheep dressing systems. The major slaughterline sources of microbial contamination were: fleece > workers' hands > faecal pellets > knife blades. Aerobic plate counts (APC 37 degrees C) exceeding log 4.4 cfu cm-2 were considered indicative of direct fleece contact, whereas E. coli numbers exceeding log 3.3 cfu cm-2 were considered indicative of direct faecal contact. A 44 degrees C water hand rinse removed 90% of the microbial contamination from workers' hands, but rinsed hands, particularly those contacting the fleece, still carried a microbial population exceeding log 4.0 cfu cm-2. A 44 degrees C rinse followed by an 82 degrees C water dip reduced the contamination on knife blades to less than log 3.0 cfu cm-2. Inverted dressing systems produced carcasses with a lower contamination level than conventional systems. With both systems little increase in contamination occurred after pelt removal. The areas of highest contamination were the forequarter region with inverted dressing and the hindquarter with conventional dressing. In both cases these regions are the sites where cuts are made through the skin. With both systems contamination around these cuts was entirely consistent with direct fleece contact resulting from 'rollback'.

Animals↗
PubMed1995

Ischemic complications of tubular gauze dressings.

BACKGROUND: Ischemic pressure complications associated with tubular gauze digital dressings have been occasionally reported in the medical literature. Previous authors have implicated specific mechanisms. We report a 10th case of this type of complication and hypothesize that a "Chinese finger trap" mechanism was responsible. OBJECTIVE: To compare pressures generated using different application techniques of tubular gauze digital dressings. METHODS: A simple device to measure dressing pressure was constructed. Comparative pressure measurements using different application techniques were obtained. RESULTS: Too many layers, excess longitudinal traction during application, using more than a 90 degrees twist during application, and rolled proximal dressing edges all increased measured pressures significantly. CONCLUSIONS: Physicians and other health care providers involved in the application of these dressings should be aware of their correct application and the mechanisms that may produce complications.

Bandages↗
PubMedDate not supplied

Self adhesive dressing pouch for the protection of catheters.

This paper is about a new model of dressing, used for the protection of all types of temporary and permanent catheters. Those who developed this dressing realised the practical difficulties during the placement and removal of traditional dressings, used in haemodialysis units. They also realised that it this was unpleasant for the patients, and there was a risk to the catheters when removing the dressings because of the use of scissors and other cutting instruments. This new dressing solves these previously mentioned problems and at the same time contributes to the comfort of the patients. The model has been registered as a standard using model, and therefore it is protected by law and its copyright (Intellectual Property).

Adhesives↗
PubMed2003

A genipin-crosslinked gelatin membrane as wound-dressing material: in vitro and in vivo studies.

A naturally occurring crosslinking agent (genipin) was used in this study to crosslink gelatin hydrogel to develop a wound-dressing membrane. The study was to investigate the in vitro characteristics of the genipin-crosslinked gelatin membrane. The glutaraldehyde-crosslinked counterpart, at a similar crosslinking degree, was used as control. Additionally, an in vivo experiment was undertaken to study the wound healings covered with the glutaraldehyde- and genipin-crosslinked dressings in a rat model. The in vitro results obtained suggested that crosslinking of gelatin membranes with glutaraldehyde or genipin may produce distinct crosslinking structures. The differences in crosslinking structure can significantly affect the mechanical property, water-vapor-transmission rate, swelling ratio, degradation against enzyme and cellular compatibility of the crosslinked membranes. In the in vivo study, it was found that the degree of inflammatory reaction for the wound treated with the genipin-crosslinked dressing was significantly less severe than that covered with the glutaraldehyde-crosslinked dressing throughout the entire course of the study. Additionally, the healing rate for the wound treated with the genipin-crosslinked dressing was notably faster than its glutaraldehyde-crosslinked counterpart.

Animals↗
PubMed1992

The effects of different central venous line dressing changes on bacterial growth in a pediatric oncology population.

Central venous lines are now common in children who need a permanent form of intravenous access. These lines frequently become infected. This study compared the effects of different antiseptics (Hibiclens [chlorhexadine 4%; Stuart Pharmaceutical, Wilmington, DE] and Betadine [povidone-iodine, Clini Pad Corp, Guilford, CT]) used to clean the skin as well as the dressings used to cover the exit site (Tegaderm [3-M Medical-Surgical Division, St Paul, MN] and gauze) on microorganism growth on the skin in a pediatric oncology population. Sixty subjects were recruited from the oncology and bone marrow transplant units of Children's Hospital in Boston, MA. The subjects were randomly assigned to one of four dressing groups. These included: 1, Betadine and Tegaderm; 2, Betadine and gauze; 3, Hibiclens and Tegaderm; and 4, Hibiclens and gauze. Dressings were done on a Monday-Wednesday-Friday basis. Quantitative cultures were obtained before the first and after the fifth dressing changes. There were no significant differences in incidence of bacterial growth between dressing groups (F = 1.05, P = .377). Redness (F = 3.01, P = .037) and swelling (F = 2.75, P = .051) were more frequently seen in Betadine groups. Boys were more often infected than girls. (Chi 2 = 4.075, P = .044).

Adolescent↗
PubMed2006

The effectiveness of using a lipido-colloid dressing for patients with traumatic digital wounds.

This study compares the effect of a daily gauze dressing with that of a lipido-colloid dressing on the time taken to make up the dressing and efficacy of the management of traumatic digital wounds. This is a randomized controlled trial of 28 patients (16 experimental and 12 control) with injuries to their fingers and loss of tissue. The patients in the experimental and control groups were given a lipido-colloid dressing and a daily gauze dressing, respectively. The patients'wounds were assessed in terms of the size of the wound and the time it took for the wound to heal. The findings showed that patients in the experimental group had a faster recovery time from the healing of their wound than the control group (p= .024). The findings can help to establish an evidence-based practice in the management of traumatic digital wounds in clinical settings.

Adult↗
PubMed1994

Semipermeable dressings improve epidermal barrier function in premature infants.

Infants of less than 32 wk gestation have a defective epidermal barrier, with increased skin permeability and transepidermal water loss (TEWL). We studied the effect of a nonadhesive semipermeable dressing on the epidermal barrier of premature infants and on fetal skin transplanted to nude mice. Fifteen infants with a mean estimated gestational age of 27.7 wk and 16 human fetal skin grafts (estimated gestational age, 23-26 wk) transplanted to eight nude mice were studied. One lower leg (or skin graft) was treated and the other left untreated as a control. In the infants, TEWL was measured on control skin and treated skin (both through the dressing and after temporary dressing removal) on d 0, 1, 2, 4, and 7. Bacterial and fungal cultures were also performed. In the mice, TEWL and skin blood flow were measured on d 0, 2, and 4. Biopsies were obtained on d 4 for a cell proliferation assay, histology, and electron microscopy. Treated infant skin showed a consistently lower bacterial number and a significantly decreased TEWL (measured through the dressing). There was also a significantly lower TEWL on the treated side, measured after temporary dressing removal, on d 1, 2, 4, and 7, documenting improved epidermal barrier function. The animal study revealed decreased TEWL and a nearly 2-fold greater d-4 keratinocyte proliferation (p = 0.01) in treated skin and decreased blood flow on d 4 in control skin (p = 0.01). There was no significant difference in the volume density of membrane coating granules or the morphology of intercorneocyte spaces.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2004

Evaluation of a honey-impregnated tulle dressing in primary care.

Honey has been used for its healing properties for centuries and has been used to dress wounds with favourable results. The emergence of antibiotic resistance and growing interest in "natural" or "complementary" therapies has led to an interest in honey dressings. Much of the research to date has been related to honey's antibacterial properties. However, the healing properties claimed for honey also include stimulating new tissue growth, moist wound healing, fluid handling and promoting epithelialization. Until recently, honey had not been developed as a wound management product and was not a certified pharmaceutical device. Activon Tulle is a sterile, non-adherent dressing impregnated with Leptospermum scoparium hone. The claimed properties of honey dressings would make this a valuable addition to the dressing currently available in the primary care setting. An evaluation was undertaken involving 20 patients with a variety of wounds. A conclusion is drawn that while further research is needed, medical grade honey does appear to be a valuable addition to the wound management formulary.

Aged↗
PubMedDate not supplied

Drawtex: a unique dressing that can be tailor-made to fit wounds.

Drawtex is a new and innovative dressing using dispersion technology which works on capillary action. This promotes moist wound healing and provides the optimum environment at the wound interface. This dressing has the ability to absorb exudate 30 times it own weight. The unique capillary action draws the exudate away from the wound bed and into the core of the dressing from where it disperses into a second layer of Drawtex. The practitioner tailors the Drawtex to conform to the wound bed. Drawtex's non-adherence reduces the frequency of dressing change after the first week. This is not the only benefit as it is also very cost-effective at half the price of other modern dressing products.

Absorption↗