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PubMed1967

Wound dressings.

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Bandages↗
PubMed1994

[Local therapy of ulcus cruris].

The primary step of local ulcer therapy consists in debridement. Cleaning the ulcers from necrotic tissue can be achieved by surgical, mechanical, osmotic, autolytic and enzymatic means. The introduction of (semi-)occlusive wound dressings for moist wound healing has significantly improved ulcer treatment, since critical steps of wound healing, such as fibroblast proliferation, angiogenesis and epithelialisation are markedly accelerated. In contrast, topical antimicrobial therapy and traditional local treatment with "wound ointments" are of diminishing value because of frequent side effects such as inhibition of granulation tissue or allergic sensitization.

Anti-Infective Agents, Local↗
PubMed2003

[Vacuum--a novel method for treating chronic wounds].

Chronic wounds represent a major health burden and drain on resources. In spite of advances in our understanding of chronic wound biology and the development of new treatments, there is no one form of treatment suitable for all wounds and patients. Many factors can impair healing--local and systemic. The current treatments include different ways of debridement, occlusive hydrocolloid dressings, topical growth factors, hyperbaric oxygen, bioengineered skin equivalents and more. In the last decade there is an increment in the use of negative pressure dressing (VAC--vacuum assisted closure system) in the treatment of chronic wounds from different etiologies--diabetic, venous and pressure sores. Our experience demonstrated good results in the treatment of diabetic and venous insufficiency ulcers, and disappointing results in the treatment of pressure sores. Promising results were demonstrated in the treatment of acute injuries, lowering the need for microvascular reconstruction. Prospective researches examining the efficacy and cost effectiveness of this treatment in comparison to other methods are crucial for wise and extensive use of the VAC system.

Humans↗
PubMed1991

Hyaluronate derivatives and their application to wound healing: preliminary observations.

Hyaluronic acid and its derivatives show promise as biomaterials in wound healing applications. Studies of cutaneous wound repair were carried out in two animal models to compare the biological effects of hyaluronic acid and hyaluronic acid ethyl ester, a new semisynthetic derivative. The two compounds were tested in partial-thickness excisional wounds in 40-kg pigs and full-thickness excisional wounds in the rabbit ear as 0.2% (w/w) formulations in a neutral Na alginate vehicle. All compounds were administered daily under an occlusive, polyurethane dressing. Neither hyaluronic acid nor the hyaluronic acid ethyl ester showed toxic or inflammatory influences over the observation period of about 2 weeks. Morphometric analysis of porcine wounds revealed small differences among treatment groups which may have been masked by the effect of the vehicle. The rabbit ear model data suggested a very slight inhibition of wound closure. Biochemical analysis of ear wounds showed this injury model to be a sensitive system for evaluation of vulnerary agents. The hyaluronate-treated wounds tended to accumulate collagen more slowly, which may reflect the capacity of these compounds to modify the scarring process. Given the ability to fabricate hyaluronate esters into films and fibers, these data suggest that such biomaterials will not, by themselves, exert a negative influence on the repair process and may improve healing, either alone or in combination with other soluble agents.

Animals↗
PubMed2003

Soluble E-selectin and soluble ICAM-1 levels as markers of the activity of atopic dermatitis in children.

The expression of adhesion molecules is up-regulated in the skin of atopic dermatitis (AD) patients, and the levels of the soluble adhesion molecules sE-selectin and sICAM-1 have been reported to reflect the endothelial activation in the skin of AD patients. The objective of the study was to investigate the relationship between symptom score and levels of sE-selectin, sICAM-1 and sVCAM-1 before and after 2 weeks of treatment. Eighteen children with an exacerbation of AD were admitted and treated with corticosteroid dilutions under occlusive wet dressings (wet-wrap treatment). Symptom score (objective SCORAD) and levels of sE-selectin, sICAM-1, and sVCAM-1 were assessed before and after 2 weeks of treatment. A significant correlation between the objective SCORAD before treatment and the level of sE-selectin (p < 0.05), but not the level of sICAM-1 (p = 0.7) or sVCAM-1 (p = 0.5) was observed. The treatment resulted in a high degree of remission, which was reflected by a significant decrease in the level of sICAM-1 (p < 0.01), whereas there was only a trend in the level of sE-selectin to decrease (p = 0.08). The level of sE-selectin after 2 weeks of treatment still correlated significantly with the objective SCORAD before treatment (p < 0.005). Soluble E-selectin is a relative objective marker for the severity of AD. SCORAD is a treatment-sensitive symptom of AD, whereas E-selectin may be a more stable underlying systemic representation of AD.

Administration, Inhalation↗
PubMedDate not supplied

[Results of vacuum sealing therapy in joint infections].

AIM: At present the vacuum sealing technique is acknowledged as a therapy for acute and chronic wounds. An acceleration of the healing process, due to the vacuum suction with occlusive wound dressing, leads to the shortening of a cost-effective medical treatment. This can be applied to wound treatment and infections of soft tissues, but even today there is only sparse information in this context about joint infections. METHOD: The results of therapy with the vacuum sealing technique in 68 patients with infections of the joints of an extremity or the trunk were analysed in a retrospective study without a control group. The importance of several patient-related factors for the medical treatment have been analysed. RESULTS: An adequate treatment of joint infections can be achieved even in the presence of endoprostheses or osteosynthetic material. The following factors have been found to be of significance for a prolonged medical treatment: diabetes mellitus (p=0.0052), obesity (BMI>25) (p=0.0458) and a preceding trauma (p=0.0457). CONCLUSION: The results confirm the value of the vacuum sealing technique following surgical debridement in combination with resistance tested antibiotic treatment, as a sufficient therapy for joint infections, even in patients with an endoprosthesis. This procedure leads to a safe treatment of the joint infection, combined with a good function of the treated joint, good patient comfort and a short duration of the therapy.

Abscess↗
PubMedDate not supplied

Wound coverage: is there a difference?

Many different wound-covering materials, making various claims regarding wound healing effectiveness, are currently available. However, no controlled, comparison trials have been performed to document these claims. This prospective, randomized study was undertaken to compare wound healing among several synthetic burn dressings. Micrografts were placed on 20 New Zealand white rabbits, then randomly covered with four commonly used synthetic burn dressings, to evaluate the impact on wound healing. No statistically significant difference in wound healing was observed among the dressings. With equal wound healing, the choice of wound coverage should be based on other factors such as availability, cost, and handling properties of the dressing.

Analysis of Variance↗
PubMed2002

Management of acute and chronic open wounds: the importance of moist environment in optimal wound healing.

The history of wound care and management closely parallels that of military surgery which has laid down the principles and dictated the practices of wound cleansing, debridement and coverage. From a treatment standpoint, there are essentially two types of wounds: those characterized by loss of tissue and those in which no tissue has been lost. In the event of tissue loss it is critical to determine whether vital structures such as bone, tendons, nerves and vessels have been exposed. It is also important to determine the amount of soft tissue contusion and contamination. In any case primary wound healing by early closure either primarily or with the help of grafts or flaps is preferred to secondary healing and wound contraction with subsequent contractures which interfere with range of motion and function. Whether the wound is acute or chronic, essential principles of wound care must be observed in order to avoid wound sepsis and achieve rapid and optimal wound healing. - Tissues must be handled gently. - Caustic solutions capable of sterilizing the skin should never be applied to the wound. It is desirable never to put anything in the wound that cannot be tolerated comfortably in the conjunctival sac. - All devitalized tissues must be debrided either hydrodynamically, chemically, mechanically or surgically. - All dead space must be obliterated. - Exposed vital structures must be covered by well vascularized tissues. An essential part of any wound management protocol is wound dressing. It cannot be too strongly emphasized that a wound dressing may have a profound influence on healing particularly of secondary type healing, a critical feature being the extent to which such dressing restricts the evaporation of water from the wound surface. A review of available dressing materials is reported with emphasis on the newly developed concept of moist environment for optimal healing. a practical guide for dressing selection is also proposed.

Acute Disease↗