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PubMed1976

Evaluation of use of the rigid dressing in amputation of the lower extremity.

Twenty-seven arteriosclerotic amputees were evaluated to determine the value of the rigid dressing technique for amputation wound management. Results were compared with those for patients having conventional stump wound management. The two groups were similar in number, age and incidence of diabetes. All the patients treated with the rigid dressing had primary healing of the amputation wound, while 13 patients treated with the conventional dressing had primary healing. Long term rehabilitation to the use of a prosthesis was not improved by the application of a rigid dressing on the amputation wound. Our current preference is use of the rigid dressing applied in the operating room at the time of amputation. If the wound is satisfactory and the general condition of the patient is such that he can use a temporary pylon, it is attached to the cast at the first change, about two weeks after operation.

Aged↗

PubMed2001

Hanging wet-to-dry dressings out to dry.

Wet-to-dry dressings have been standard procedure for home care wound care patients although research indicates gauze dressings are not an optimal wound care modality for the patient, the clinician, or the healthcare system. Gauze dressings do not effectively support optimal healing and are more labor intensive to use than advanced dressings such as films, foams, hydrocolloids, and hydrogels. This article provides clinicians with the rationale and evidence needed to collaborate with physicians in choosing the most cost-effective wound care products to achieve positive patient outcomes.

Bandages↗

PubMed1995

Clinical application of new bovine collagen membranes as a partial-thickness burn wound dressing.

New bovine collagen membranes were applied for covering of partial-thickness burn wounds to compare with porcine skin used as biological dressing. Forty four of investigated patients had superficial (2a degree), and forty four of them had deep (2b degree) partial thickness burn wounds. When nonperforated collagen membranes or porcine skin were used for dressing of superficial (2a degree) burn wounds, time of healing was established as 11 +/- 3.4 (mean + or - sd) and 12+/- 4.9 days, respectively (n=12). For perforated version of the dressings the time of healing was 9 +/- 3.5 and 10 +/- 3.2, respectively (n=10). The differences were nonsignificant in both cases. When nonperforated collagen membranes or porcine skin were used for treatment of deep (2b degree) burn wounds, the time of healing was established as 29 + or - 6.1 and 30 +/- 5.4 days, respectively ( n=10). The differences were nonsignificant as well. We can conclude from our study that new collagen membranes can be considered as biological dressings and can be recommended for partial-thickness burn wound care. Perforated version of the collagen membranes was better than nonperforated.

Adolescent↗

PubMed1986

Semipermeable occlusive dressings. Effects on growth of pathogenic bacteria and reepithelialization of superficial wounds.

Six commercially available semiocclusive dressings were tested for their effect on the growth of resident and pathogenic bacteria and the reepithelialization of experimentally induced wounds in human volunteers. Scarification and abrasion-type wounds inoculated with Staphylococcus epidermidis, Staphylococcus aureus, Streptococcus pyogenes, and Pseudomonas aeruginosa were quantitatively cultured at different times after being covered with the dressings. Reepithelialization was assessed by serial stereomicrographs. None of the dressings was able to prevent clinical infection. All dressings provided microenvironments that were conducive to the growth of resident and pathogenic bacteria. There was no difference in the rates of reepithelialization.

Adult↗

PubMed1998

Sore nipples in breast-feeding women: a clinical trial of wound dressings vs conventional care.

BACKGROUND: Sore nipples in breast-feeding mothers are a common cause of premature weaning, and are difficult to treat owing to recurrent trauma and exposure to the infant's oral flora. OBJECTIVE: To compare the safety and efficacy of a hydrogel moist wound dressing (Elasto-gel, Southwest Technologies Inc, Baltimore, Md) with the use of breast shells and lanolin cream in the treatment of maternal sore nipples associated with breast-feeding. DESIGN: Randomized controlled trial comparing the above treatments for sore nipples. Patients were seen for a maximum of 3 follow-up visits within 10 days, or until the resolution of symptoms. SETTING: The Maternal-Infant Lactation Center at the Mercy Hospital of Pittsburgh, Pittsburgh, Pa, a tertiary care teaching hospital in inner-city Pittsburgh. PATIENTS: A referred sample of 42 breast-feeding women who presented to the Maternal-Infant Lactation Center for the treatment of sore nipples. All patients with breast infection or chronic unrelated pain conditions were excluded from the study. INTERVENTION: After informed consent, patients were randomized to receive either a hydrogel wound dressing or breast shells and lanolin. All patients underwent a history, physical examination of the infant and the mother's breasts, assessment of breast-feeding technique, and breast-feeding instruction. MAIN OUTCOME MEASURES: The degree of pain on self-report questionnaires and the change in scores for physical examination, breast-feeding technique, and pain behaviors during breast-feeding. RESULTS: Although both treatments, in association with instruction in breast-feeding technique, were effective, greater improvement was seen in the group using breast shells and lanolin. This reached statistical significance for physician-rated healing (P<.01) and self-reported pain (P<.05). There were significantly more infections in the dressing group (P<.05), which resulted in early discontinuation of the study. CONCLUSIONS: Prevention of sore nipples by teaching proper technique on the initiation of breast-feeding should be instituted. For those cases in which sore nipples do develop, breast shells and lanolin in association with instruction in breast-feeding technique are more effective than moist wound dressings. Lanolin and shells should remain first-line therapy.

Adult↗

PubMed1984

Characteristics and uses of biologic dressings and skin substitutes.

Biologic dressings used for temporary coverage of open wounds exert both mechanical and physiologic effects by protecting the wound, maintaining microbial control, and hastening wound maturation. Synthetic wound dressings modeled after the biologic dressings have been evaluated by several investigators. Those studies have shown unilaminate synthetic membranes to be ineffective when applied to full-thickness wounds and have identified a bilaminate construction as being necessary for membranes to serve as effective skin substitutes. The desirable properties of skin substitutes have been identified and incorporated in the design of recently developed membranes. Recent studies in this and other laboratories have resulted in the development of collagen-synthetic bilaminates, a totally synthetic biologically inert bilaminate, and tissue culture-derived membranes. The characteristics and limitations of each skin substitute determine the optimum usage of these composite membranes and define the modifications needed to improve the effectiveness of such dressings.

Animals↗

PubMed1993

Pilot study analysis of the histologic and bacteriologic effects of occlusive dressings in chemosurgical peel using a minipig model.

The histologic changes associated with chemosurgery are well documented, but the data concerning the effects of occlusive dressings (adhesive tape, gauze, or ointments) is largely anecdotal. Wide differences of opinion exist as to the best method of phenol application and postpeel wound care regimen. Using a Yucatan minipig as our animal model, we studied the histologic and bacteriologic differences that various commonly used occlusive dressings have upon the initial burn depth and the subsequent healing of peeled skin. We also compared chemical peel with dermabrasion and chemabrasion. Our results showed to statistical difference in peel depth between "wet" versus "moist" phenol application or between occluded versus nonoccluded dressings. Based upon this animal model, we recommend that phenol solutions be applied moist rather than wet and that an occlusive dressing other than adhesive tape be used and maintained for a minimum of four days.

Animals↗

PubMed1983

Comparison of synthetic adhesive moisture vapor permeable and fine mesh gauze dressings for split-thickness skin graft donor sites.

SAM and fine mesh gauze dressings were compared on 60 consecutive skin graft donor sites. SAM dressings are significantly better than fine mesh gauze dressings for healing of split-thickness skin graft donor sites; healing occurs much more rapidly with much less pain. In patients known to be colonized with Pseudomonas, care should be taken when using SAM dressings, although it is not an absolute contraindication. There were no clinically significant differences between Tegaderm and Op-Site.

Adolescent↗

PubMed1991

Treatment of excoriations with a transparent hydrocolloid dressing: a prospective study.

A transparent hydrocolloid dressing (THCD) was compared with a traditional paraffin gauze dressing (PGD) in the treatment of excoriations with special focus on patient acceptability. A series of 12 emergency ward patients with 16 traumatic excoriations were included in the study. There were 9 women and 3 men. Average age was 26 years (range 12-66 years). Seven wounds were dressed with THCD and nine with PGD. Patients treated with THCD felt less pain than those treated with PGD. A significantly higher number of patients treated with PGD than THCD complained of wound or bandage sticking to their clothes (P = 0.0007). No infection was seen. We conclude that THCD is suitable for dressing acute excoriations. And the level of comfort is better than in traditional treatment with PGD.

Adolescent↗

PubMed1994

Alginate fiber dressing for oral mucosal wounds.

The aim of this study was to evaluate the effect on hemostasis and wound healing of a proprietary alginate fiber dressing when applied to a wound of the buccal mucosa of approximately 2 mm depth. The study showed a significant reduction in the number of residual bleeding points in shallow wounds when the alginate fiber dressing was applied for 5 minutes as compared with the use of non-alginate-impregnated surgical gauze. There was no significant difference in the rate of epithelial repair of the test and control sites nor in the area of the resulting mucosal scar. In addition, there was no significant difference in the numbers of tissue components in the submucosa. It is concluded that the alginate fiber dressing material evaluated in this study may be effective as a hemostatic mucosal dressing in shallow wounds, but it does not accelerate mucosal wound healing.

Alginates↗

PubMed1996

Water vapour transmission rates in burns and chronic leg ulcers: influence of wound dressings and comparison with in vitro evaluation.

One of the main functions of wound dressings is to control water vapour transmission rate (WVTR) from wounded skin. In this paper, the influence of hydrocolloid, knitted viscose and gauze dressings was evaluated through in vivo measurement of WVTR in burns and chronic leg ulcers utilizing an evaporimeter. The results suggest that the evaporative water vapour loss from exposed skin wounds depends mainly on the wound depth, and that chronic leg ulcers have the same level of the WVTR as full thickness burns. Compared with the knitted viscose and gauze dressings, hydrocolloid dressing has a greater effect on reducing evaporative water loss, with WVTR being 20-30% of that of exposed wounds under the conditions used in this study. This result is in agreement with that obtained in an in vitro evaluation.

Adult↗

PubMed1988

Antimicrobial properties of antiseptic-impregnated biological dressings.

Three antiseptics--chlorhexidine acetate, silver nitrate and povidone-iodine--were incorporated into biological dressings (human skin and amnio-chorion) and evaluated in vitro against disparate micro-organisms. Results indicated that antimicrobial levels of chlorhexidine and silver were released from the dressings over a clinically relevant time period, whereas povidone-iodine was ineffective. Chlorhexidine dressings demonstrated broad-spectrum activity, whereas silver dressings were most effective against Pseudomonas aeruginosa.

Anti-Infective Agents, Local↗

PubMed1988

Biosynthetic compound dressings--management of hand burns.

To achieve optimal hand function, wound closure becomes the most important ingredient in hand burns. This study documents the use of a biosynthetic compound dressing (Biobrane) which has been fabricated as a glove for management of hand burns. The glove allowed rapid active motion and minimized the pain of open wounds. Forty-two Biobrane glove applications were evaluated with 50 per cent applied over superficial hand burns and 50 per cent over deep partial thickness or full thickness injuries. In the superficial hand burns, the patients were discharged home after a mean time of 2.8 days. With the deep burns the dressing provided a closed wound after early excision of eschar without the use of an autograft or biological dressing. Based on these studies, we conclude that the biosynthetic compound dressing glove is a useful adjunct to be added to the armamentarium for treatment of the burned hand.

Biocompatible Materials↗

PubMed1991

Cellophane--a dressing for split-thickness skin graft donor sites.

Cellophane paper has been used as a dressing for split-thickness skin graft donor sites in 251 patients between October 1985 and December 1989. Twelve donor sites in 10 patients were observed in detail to assess the usefulness of this material. The results of the study are presented and the merits and disadvantages of this dressing material have been discussed. In the opinion of the authors the cellophane paper dressing was found to be most satisfactory. It is also cheaper than the newly available dressing materials for the skin donor area.

Burns↗

PubMed1986

The effect of occlusive dressings on re-epithelializations of wounds in children with epidermolysis bullosa.

Hydrocolloid dressing (HCD), a new oxygen impermeable occlusive dressing, was studied in a controlled clinical trial of three pediatric patients with dystrophic epidermolysis bullosa (RDEB). Advantages of this material over such dressings as paraffin gauze (PG) or the perforated plastic film (TELFA), include considerably faster re-epithelialization, pain free movement of the injured part and fewer dressing changes. The most significant advantage of HCD for RDEB patients has been in the reduction of scar tissue formation, because in this disease, wounds heal with scarring that causes mutilating deformities.

Child↗

PubMed1989

Effects of occlusive and semiocclusive dressings on the return of barrier function to transepidermal water loss in standardized human wounds.

Clinical observation and histologic examination of excised wounds have confirmed that occlusive dressings promote rapid wound reepithelialization. However, normalization of barrier function has not been routinely assessed in studies of occlusive dressing effects on wound healing. We examined the effects of occlusive dressings on the reestablishment of the cutaneous barrier to transepidermal water loss (TEWL) after standardized skin wounds were produced in human subjects. We confirmed previous observations that occlusive dressings augment reepithelialization. No significant improvement in the rate of reestablishment of the barrier to TEWL was measured between the covered test or uncovered control sites in each subject, however. TEWL declined in an exponential fashion after wounding. Measurements of TEWL were over twice that of adjacent normal skin when epithelialization was judged to be overtly complete and did not return to normal until 4 weeks after wounds were produced.

Adult↗

PubMed2003

Assessment of a silver-coated barrier dressing for potential use with skin grafts on excised burns.

Acticoat burn dressing is a silver-coated dressing with antimicrobial activity purported to reduce infection from environmental organisms in partial and full-thickness wounds. Acticoat was tested for activity as an antimicrobial treatment and as an antimicrobial barrier dressing in three in vitro assays. It was found that a modified disc assay method gave false negative results but in an assay in which bacteria were inoculated on top of samples of Acticoat, bacterial numbers were reduced, over time, with all microorganisms tested. Acticoat served as a barrier for bacteria, inoculated onto it, from contaminating the surface of an agar plate under the Acticoat. The data show that Acticoat has: antimicrobial capabilities, but to be effective hours of contact between Acticoat and the microorganisms are required; and the capacity to serve as an antimicrobial barrier dressing. These findings support the conclusion that Acticoat has activity to reduce microbial contamination of wounds from environmental sources.

Anti-Bacterial Agents↗

PubMed2006

Observational study of bone-anchored hearing aid infection rates using different post-operative dressings.

INTRODUCTION: Avoidance of infection at the implant site is a crucial element to the success of bone-anchored hearing aid (BAHA) implantation. However, little evidence exists to suggest the best post-operative wound dressing to use. MATERIAL AND METHODS: We report our experience with 160 consecutive BAHA patients, using four types of post-operative BAHA wound dressing (Tri-adcortyl, Mepitel, Allevyn, and Acticoat 7 with Allevyn). Patients were reviewed at week one and week two post-operatively. Infection was defined as a positive wound swab culture or evidence of cellulitis at the BAHA site. RESULTS: Post-operative BAHA infection rates were 16 per cent, 50 per cent, 10 per cent and 5 per cent, for each of the four dressings respectively, and the mean number of additional visits to wound care clinic were 1.5, 3.7, one and 0.4, respectively. DISCUSSION: Acticoat 7 with Allevyn produced the lowest infection rate and thus became the dressing of choice for our BAHA programme.

Adult↗