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PubMed1989

Preliminary observations on clotting under three hydrocolloid dressings.

Four patients with five wounds were randomly assigned to treatment with three occlusive dressings: DuoDERM, Restore and Comfeel Ulcus; the dressings were left intact for 24-48 h. When the dressings were removed, it was found that wounds that had been covered with Restore and Comfeel contained coagulated sanguinous material. Two wounds that had been covered with Comfeel and Restore, respectively, were then covered with DuoDERM, while one wound previously covered with DuoDERM was covered with Restore. Either no clotting occurred under DuoDERM or clots may have resolved. Although these preliminary data suggest that DuoDERM gel may have fibrinolytic properties, more extensive and controlled studies are needed to assess the characteristics of this dressing.

Bandages, Hydrocolloid↗

PubMed1977

Ambulatory treatment of psoriasis: combined use of occlusive dressings with locacorten tar at night and 'open' treatment with locasalen during the day.

Fifty patients with refractory psoriasis were treated with a combined method consisting in the application of occlusive dressings with Locacorten Tar ointment at night and of 'open' treatment (without occlusive dressings) with Locasalen ointment during the day. The aim of this trial was to obtain the benefit of the occlusive-dressing method without having to hospitalize the patients. The mean time required for the eradication of psoriatic scales was 3.46 days, while that needed for complete recovery was 14 days. The results clearly indicated that this combined approach has all the advantages of occlusives dressings but allows the patient greater freedom during the day. The very good effect of the treatment is also attributable to the triple action obtained with this combination: the anti-epidermoplastic effect of flumethasone pivalate, the squamolytic effect of salicylic acid, and the keratoplastic action of the tar compound.

Adolescent↗

PubMed1997

A comparison of two dressings in the management of chronic wounds.

A hydropolymer dressing (Tielle) and a hydrocolloid dressing (Granuflex) were compared in a randomised controlled clinical study involving 100 patients with leg ulcers and 99 patients with pressure sores in the community. Statistically significant differences in favour of the hydropolymer dressing were detected for dressing leakage and odour production, but no statistically significant differences were recorded in the number of patients with either leg ulcers or pressure sores who healed in each treatment group.

Aged↗

PubMed2004

A silver sulphadiazine-impregnated lipidocolloid wound dressing to treat second-degree burns.

OBJECTIVE: To evaluate the efficacy and tolerance of Urgotul SSD dressing (Laboratoires Urgo) in the treatment of second-degree burns. METHOD: This was a national multicentre phase III non-comparative open-label prospective study involving 10 burns units. The 41 subjects were non-immunosuppressed adults with second-degree thermal burn(s), which were clinically non-infected, less than 24 hours old, had a surface area less than 500 cm2 and warranted the local use of silver sulphadiazine. For four weeks, subjects were followed up weekly with a clinical assessment, bacteriological swabs and photographic recording. RESULTS: Of the 41 patients, 24 healed within a mean of 10.8 days and 13 had a skin graft on the study burn within a mean of 11.5 days. There were four premature study withdrawals. The total number of cumulative treatment days was 445, and 298 treatments were performed (including 257 dressing changes). Mean dressing wear time was 1.73 days. None of the subjects acquired a secondary infection. Researchers took 121 bacteriological samples, and wound colonisation with Staphylococcus aureus was found in only one patient. At follow-up nursing staff reported that dressing acceptability was good. CONCLUSION: Use of Urgotul SSD led to a good wound outcome--wounds healed or were grafted.

Adult↗

PubMed2005

Silver absorption and antibacterial efficacy of silver dressings.

OBJECTIVE: To evaluate the patterns of silver release from selected sustained silver-release dressings and the protective role of proteins in wound exudate and wound scale. The bactericidal action of silver in chronic wound therapy is also examined. METHOD: Sequential microbiological examination of wound swabs from seven patients with chronic wounds and sampling of wound exudate and wound scale. Silver content was measured using atomic absorption spectrometry. The ability of Contreet Foam to absorb exudate and release silver was studied in punch biopsy wounds in a rodent model. RESULTS: Silver accumulation in wound exudate correlated well with its viscosity and protein content. Silver bound to wound scale and debris was approximately proportional to the silver ion release from dressings. Bacterial burden was controlled, but not eliminated, following chronic silver therapy. CONCLUSION: Silver dressings (Acticoat-7, Actisorb Silver, Contreet Foam, Aquacel Ag and Flamazine) were found to be safe for use in chronic wound therapy. Excess silver ion is bound by wound exudate and wound scale as a protective mechanism. Silver-release dressings are not likely to result in germ-free wounds. Further studies are needed to examine potential silver resistance.

Aged↗

PubMed2006

An evaluation of polyvinylidene film dressing for treatment of pressure ulcers in older people.

OBJECTIVE: To compare the effectiveness of polyvinylidene (PVL) food wrap as a dressing material versus conventional ointments and gauze dressings for pressure ulcers in patients aged 60 years or over. METHODS: A prospective open controlled trial was conducted. The severity of pressure ulcers in both groups was evaluated using the DESIGN system. Scores were compared at baseline, four, eight and 12 weeks. RESULTS: Twenty-five patients were treated with the PVL film (test) dressings and 24 with the conventional treatment (control). The test group showed greater improvement in DESIGN scores than the control group throughout the observation period, and the difference reached statistical significance at 12 weeks (p < 0.05). The incidences of local wound infection in the two groups were not statistically different (p > 0.999). CONCLUSION: The PVL film dressing was more effective than conventional treatment in the management of severe pressure ulcers.

Aged↗

PubMed2006

Efficacy of a skin-protection powder for use as a dressing for intractable ulcers.

OBJECTIVE: Stomahesive skin-protection powder has been reported to be useful as a skin-care and skin-barrier product for the management of stomas. This study aimed to evaluate its efficacy, in terms of wound healing, moisture retention and pain management, as an alternative to conventional dressing materials. Both clinical and animal studies were undertaken. METHOD: The efficacy of the Stomahesive powder was tested by measuring the thickness of granulation tissue formed in a total skin defect in a db/db mouse model. We then compared the healing process using either the skin-protection powder or a conventional film dressing material. In the clinical study 17 patients with various intractable ulcers were treated with Stomahesive powder, and healing was evaluated. RESULTS: In the mouse model, granulation tissue in the wounds treated with the powder was 2.86 times thicker than that of the wounds treated with the film dressing. In the clinical study, 16 out of 17 wounds healed completely. CONCLUSION: The Stomahesive powder could be an effective treatment modality for contact ulceration, superficial ulcers with complex contours and morphology, and superficial ulcers contaminated by liquid faeces or vaginal discharge that have not responded to conventional dressings. DECLARATION OF INTEREST: None.

Administration, Cutaneous↗

PubMed1975

Antibacterial properties of periodontal dressings.

The relationship between the build-up of bacterial plaque at the dento-gingival junction and the development of gingivitis is well established. The susceptibility of patients requiring periodontal surgery to the pathogenic potential of plaque would seem to necessitate the protection of the surgically treated area by a periodontal dressing until adequate plaque control by the patient is possible. In the light of clinical experience, an investigation was undertaken into the antibacterial properties of certain proprietary periodontal dressings and a zinc oxide/eugenol material. None of these materials showed any marked degree of antibacterial activity. One of these materials, Coe-Pak, had been used alone or combined with Cross Pack for all the patients in the clinical survey with very satisfactory results, and it is concluded that this material is successful because of its physical properties and not its antibacterial ones. Careful attention to asepsis, gentle and controlled tissue handling, correct technique, and thorough removal of plaque and calculus are the prerequisites for successful periodontal surgery. The protection of the surgical wound by a dressing of adequate physical properties aids in ensuring uneventful healing. The use of potent antibacterial agents in the dressing is not necessary; a physical barrier to salivary/bacterial contamination and food impaction may be the most important factor.

Anti-Infective Agents, Local↗

PubMed1979

Comparison of healing following periodontal surgery with and without dressings in humans.

Seven patients with chronic moderate to severe generalized periodontitis requiring periodontal flap surgery were selected for study. Internally beveled full thickness, apically positioned flaps with osseous recontouring were performed in 20 quadrants. Half the quadrants received a noneugenol dressing, and the other half were left undressed. Fluid Index, Gingival Index, inflammatory index, pocket depth and patient comfort were studied up to 16 weeks postoperatively. Results showed no difference in these parameters between quadrants where periodontal dressings were or were not used following surgery. The patients reported more pain and discomfort and the pain and discomfort was more severe postoperatively when the dressing was used. The results of this study suggest that a surgical dressing serves no useful purpose when periodontal flap surgery is performed.

Adult↗

PubMed1993

Postoperative pain and discomfort with and without periodontal dressing in conjunction with 0.2% chlorhexidine mouthwash after apically positioned flap procedure.

The purpose of this study was to evaluate patient postoperative pain experience and discomfort with and without the use of a periodontal dressing in combination with a 0.2% chlorhexidine mouthwash after internal bevelled, full thickness, apically positioned flap procedure. Twenty-four patients requiring comparable bilateral flap procedures were selected. Using a split-mouth design, one site received a periodontal dressing while the other site did not. A 0.2% chlorhexidine mouthwash (10 ml for 1 minute twice daily) was prescribed postoperatively for all patients. Pain assessment was made according to a structured, categorized scale (0 = no pain; 1 = mild pain; 2 = moderate pain; and 3 = severe pain). Analgesic drug consumption was recorded during the first postoperative week. After at least a one-month period, the second flap procedure was performed using the alternate postoperative treatment. At the conclusion of the trial, a self-administered questionnaire on postoperative experience was administered. Results indicated a similar trend for mean pain scores as assessed by patients for both dressed and undressed sides during the 7-day postoperative period. Statistical analysis revealed no significant differences between treatment groups with respect to frequency distribution of patients who did or did not take analgesics or the daily and total consumption of analgesic drops. Although patients with dressing frequently experienced eating difficulty, most stated a psychological feeling of protection and well-being with its use.

Adult↗

PubMed1994

Weekly treatment of psoriasis with a hydrocolloid dressing in combination with triamcinolone acetonide. A controlled comparative study.

In a within subject comparison, the efficacy and the tolerability of topical treatment with triamcinolone acetonide under a hydrocolloid dressing were compared with triamcinolone acetonide monotherapy, monotherapy with hydrocolloid dressing and triamcinolone acetonide under plastic occlusion. The clinical efficacy of hydrocolloid dressing as a monotherapy and the pronounced clinical efficacy of this occlusive in combination with triamcinolone acetonide were confirmed. Comparing the hydrocolloid dressing (Duoderm E) and the plastic semi-occlusive (Opsite IV 3000), we concluded that the tolerability of both approaches was similar. However, Duoderm E in conjunction with triamcinolone acetonide was highly effective, whereas Opsite IV 3000 in combination with this steroid only had an inconspicuous antipsoriatic potential.

Adult↗

PubMed2000

Comparison of equine amnion and a nonadherent wound dressing material for bandaging pinch-grafted wounds in ponies.

OBJECTIVE: To evaluate healing of pinch-grafted wounds on the distal aspect of the limbs of ponies bandaged with equine amnion or a standard nonadherent wound dressing material. ANIMALS: 6 ponies. PROCEDURE: A 2.5x2.5-cm full-thickness section of skin was removed from the dorsal aspect of each limb at the midpoint of the metacarpus or metatarsus. Six days later, wounds were grafted with partial-thickness pinch grafts. Half the wounds were bandaged with amnion, and the other half were bandaged with a nonadherent dressing. Bandages were changed every 3 days until wound healing was complete. At each bandage change, numbers of grafts lost were recorded, and wounds were measured. RESULTS: Percentage of grafts lost from wounds bandaged with amnion was not significantly different from percentage lost from wounds bandaged with the nonadherent dressing. Median healing time for wounds bandaged with amnion (30 days) was significantly less than median healing time for wounds bandaged with the nonadherent dressing (39 days). All wounds were healed by day 45. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that amnion can be used for bandaging pinch-grafted wounds on the distal aspect of the limbs of ponies.

Amnion↗

PubMed1980

The effect of periodontal dressings on intact mucous membrane and on wound healing. A methodological study.

Biological screening of dental materials which are intended for use in contact with the oral mucosa comprises a mucous membrane irritation test. The aim of the present investigation was to study the effect of 3 periodontal dressings on intact oral mucosa and to assess their effect on the epithelial proliferation during wound healing. A total of 87 rats were used, 24 for studying reactions in intact mucosa and 63 for a wound healing study. A wound was inflicted on each animal in the palate behind the incisors. The dressing covered the wound area and the surrounding mucosa and was secured by an appliance fixed to the maxillary incisors. 3H-labelled thymidine was injected prior to sacrifice after observation periods of 1, 3 and 5 days. Histological assessment and autoradiographic evaluation of mitotic activity were performed. The dressings caused no reaction in the intact mucosa. In the wound healing study the mitotic activity at day 1 was lower in test than in control animals indicating a toxic effect of all materials. No differences between the 3 dressings were found. After 5 days, all wounds were covered by epithelium. Neither at 3 nor at 5 days were any differences between test and control animals seen.

Animals↗

PubMed1976

The use of collagen film (Cutycol) as a dressing for donor areas in split skin grafting.

In this investigation sterile collagen film has been used as a dressing for 55 donor areas. The two aims of our study were to find out whether this film could be used as a dressing and whether the film which was applied at the time of surgery could be used as the only dressing before complete healing was achieved. The results were good in 56% of the cases and fair in 20%. It was noted that local pre-treatment with epinephrine gave better results. If only small or medium sized donor areas were included the results were even better. This is probably because the film in larger donor areas could slip away leaving the donor site more or less exposed. The results are encouraging in two important aspects: The donor sites were not painful and the nursing staff could reduce or eliminate time-consuming work with frequent dressings.

Adolescent↗

PubMed1977

Antibacterial effect of biological dressings in the treatment of infected wounds.

Human cadaver split skin preserved in a special transport medium (Histocon; Histo-Lab. Ltd., Göteborg, Sweden) and porcine split skin (Skintec; Genetic Lab. Inc., Minneapolis, USA), were used in thirteen patients with infected wounds. Cadaver skin made it possible to reduce applications of wound dressing to two or three times a week without aggravation of infection and made the wound bed suitable for autografting. Skintec was less reliable in these respects. The two biological dressings had equal pain reducing properties. Leukocyte agglutinins, attributable to the treatment with cadaver skin did not appear. Because of retained histological and histochemical characteristics in the preserved cadaver skin it was preferred to Skintec. A regimen consisting of initial wound toilet, antibiotic treatment, skin changing every second or third day finally made permanent skin grafting possible. Secondary gains were a reduce in nursing and dressing routine as compared to saline dressings.

Adult↗

PubMed2001

Wound dressings.

Each child, wound and wound site is unique and these factors will impact on the type of dressing the nurse decides to use. Wound dressings broadly fall into a number of classes, depending on the material they are made of. The nurse should be aware of the particular characteristics of each class of dressing and the impact these can have on wound healing. Modern wound dressings are designed to do one or more of three things: protect, debride and absorb excess exudate. With this knowledge the nurse can make the most appropriate selections and provide explanations to parents and child about the choices available.

Bandages↗

PubMed1990

A randomized trial of two occlusive dressings in the treatment of leg ulcers.

Two occlusive dressings--one zinc oxide medicated (Mezinc) and one hydrocolloid (Duoderm)--were compared in a prospective, randomized trial over a period of 8 weeks to determine their healing ability and effect on pain for venous and arterial leg ulcers. All patients were patch-tested before the study and colophony allergy was an exclusion criterion. Of the 43 outpatients included, 31 completed the trial and 6 patients randomized to each treatment group were withdrawn. The initial ulcer areas decreased after 8 weeks of treatment with Mezinc by 64% and by 48% after treatment with Duoderm. Ulcer pain was relieved in 50% of the patients--with a similar analgesic effect for the two dressings. Mezinc treatment was discontinued in 2 cases due to sensitization to colophony (one ingredient of Mezinc) which indicated a risk of contact allergy to colophony due to Mezinc treatment. 1103 consecutive eczema patients were patch-tested on the back with Mezinc and colophony 20% in petrolatum simultaneously. It was found that 42 (4%) of the patients showed allergic skin reactions to colophony and 19 (2%) to Mezinc. Both dressings were well tolerated by leg ulcer patients and there appeared to be no major differences in the efficacy of the two occlusive dressings.

Aged↗

PubMed2002

[Allergic contact dermatitis to the Comfeel hydrocolloid dressing].

INTRODUCTION: Allergic contact dermatitis is frequent in patients with chronic leg ulcers. However, it rarely occurs with modern wound dressings and is exceptional with hydrocolloids. CASE REPORT: A 66-year-old woman was treated for a leg ulcer with the Comfeel plus(R) transparent hydrocolloid dressing for two months. She developed a pruriginous, erythematous and vesiculous dermatitis under the hydrocolloid plaques. Patch tests for the Comfeel plus(R) transparent hydrocolloid, the Comfeel plus(R) hydrocolloid, balsam of Peru and epoxy resin were positive. Only the positive test for the Comfeel plus(R) transparent hydrocolloid was clinically pertinent. The histological examination of the positive test was suggestive of eczema. DISCUSSION: To our knowledge, allergic contact dermatitis to Comfeel plus(R) hydrocolloid dressings has not been reported. Most previous studies which included systematic patch-testings in patients with leg ulcers showed high sensitization rates for various allergens, but no allergy to hydrocolloids. Only isolated cases of allergic contact dermatitis to another hydrocolloid (Duoderm E(R)) have been reported. Our case report shows that allergic contact dermatitis is a possible side-effect of Comfeel plus(R) hydrocolloid dressings. However, it seems exceptional. Since the patch-tests failed to identify the constituent responsible for this allergy in our observation, comprehensive allergologic investigations should be repeated in further cases.

Aged↗