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At least 793 records · Page 44Linked to original sources
PubMed2004

The prevention of heel pressure ulcers using a hydropolymer dressing in surgical patients.

OBJECTIVE: A trial of a self-adhesive hydropolymer foam dressing (Tielle, Johnson & Johnson) demonstrated that it prevented the development of friction-generated pressure ulcers on the heels of ICU patients. Following the trial, use of the foam dressing became a standard preventive measure in the ICU and the prevalence of heel ulcers decreased by 72% in two years. This follow-up study evaluated the foam's effectiveness in preventing heel pressure ulcers in surgical patients. METHOD: A total of 140 surgical patients were screened over a four-month period. They were assigned to one of two groups, depending on their pressure ulcer risk score and the anticipated length of the surgical procedure. The foam dressing was used as a barrier on the heels, depending on the patient's risk status, which was assessed using a modified Norton scale, and the duration of their surgery. Heels were inspected on a daily basis for up to 10 days. All 23 patients in the group whose surgery lasted less than 90 minutes dropped out of the study as they were discharged with insufficient data. RESULTS: A 76.7% reduction in heel pressure ulcers was achieved with this preventive measure. CONCLUSION: Use of an adhesive foam dressing on surgical patients can prevent heel ulcers. Research is needed on the effects of friction on the heel during the transfer and movement of surgical patients. DECLARATION OF INTEREST: This study was sponsored by Johnson & Johnson Medical.

Bandages, Hydrocolloid↗
PubMed2006

Effect of a new silver dressing on chronic venous leg ulcers with signs of critical colonisation.

OBJECTIVE: To investigate the clinical performance and safety of a new silver-containing wound-contact layer, Physiotulle -Ag (Coloplast), in the treatment of chronic venous leg ulcers with delayed healing and signs of critical colonisation. METHOD: This was an open prospective non-comparative multicentre clinical study. Patients were treated for four weeks with Physiotulle -Ag, which was covered by Alione Hydrocapillary Dressing (Coloplast). RESULTS: Thirty patients were recruited into the study. One ulcer healed after three weeks of treatment. The mean relative ulcer area reduced by 55% after four weeks. Over the study period the mean amount of healthy granulation tissue increased from 26% to 62%, and the mean amount of fibrin decreased from 63% to 32%. The ratio of malodorous wounds was 50% at inclusion, 20% after one week and 3% after four weeks. The dressing was considered easy or very easy to apply in 100% and easy to remove in 89% of dressing evaluations. The dressing combination showed good exudate-management properties. Incidence and severity of maceration, erythema and eczema decreased during the study and no device-related adverse events were recorded. CONCLUSION: Physiotulle -Ag is safe and easy to use in chronic venous leg ulcers in which healing is delayed and with signs of critical colonisation.

Aged↗
PubMed2005

[Prospective, randomized and controlled trial on the dwell time of peripheral intravenous catheters in children, according to three dressing regimens].

This prospective, randomized and controlled study verified the influence of three dressing regimens on the dwell time of peripheral intravenous catheters (PIC) in children. The study groups were composed of dressings with sterile gauze (EG 1), with sterile transparent film (EG 2) and with hypoallergenic adhesive tape (CG). Variables were selected to control for variables related to children, professionals and intravenous therapy characteristics. The 150 PIC that composed the sample were inserted in 68 children, predominantly of preschool age, male, with brown skin color, eutrophic and with gastrointestinal system diseases. The majority of the PIC was installed by nursing auxiliaries in veins of the dorsal arch of the hand. The type of dressing exerted a significant influence (p = 0.022) on the average dwell time of the studied PIC: EG 1 (46.12 hours), EG 2 (29.53 hours) and CG (38.18 hours), concluding that the dressing with sterile gauze maintained the catheter inserted for a longer time.

Bandages↗
PubMed2001

Economic evaluation of collagenase-containing ointment and hydrocolloid dressing in the treatment of pressure ulcers.

OBJECTIVE: To evaluate the efficacy and cost effectiveness of two treatments of pressure sores on the heel: a collagenase-containing ointment and a hydrocolloid dressing. DESIGN: Study and cost data were collected prospectively in a randomised clinical trial in The Netherlands by counting the resource use for each patient until wound healing occurred. STUDY PARTICIPANTS: All 24 female study participants were inpatients from the same hospital with grade IV pressure sores on the heel following orthopaedic surgery. INTERVENTIONS: Two different treatment strategies were analysed: a collagenase-containing ointment (Novuxol) and a hydrocolloid dressing (Duoderm). PERSPECTIVE: Hospital perspective. MAIN OUTCOME MEASURES AND RESULTS: The average costs per patient for treatment with the hydrocolloid dressing were about 5% higher than those with the collagenase-containing ointment. The treatment costs were similarly distributed within both groups, with 34% for materials and 66% for personnel. The cost-effectiveness analysis revealed that cost savings of 899 Dutch guilders (1998 values) per successfully treated patient could be expected using the collagenase-containing ointment instead of the hydrocolloid dressing. In addition, wound healing was achieved, on average, within a shorter time period with the collagenase treatment (10 weeks) compared with the hydrocolloid treatment (14 weeks). The robustness of the results were also tested using sensitivity analyses. These analyses served to confirm that collagenase treatment provides a better cost-effectiveness ratio than hydrocolloid treatment. CONCLUSIONS: With regard to overall costs and costs per successfully treated patient, this study showed collagenase treatment to be more cost effective than the hydrocolloid treatment in patients with grade IV pressure sores on the heel and that the amount of time needed for wound healing was shorter.

Aged↗
PubMed2006

[The effects of the ulmus root-bark dressing in tissue regeneration of induced pressure ulcers in rats].

PURPOSE: The purpose of this study was to examine the effects of the ulmus root-bark dressing on tissue regeneration in experimentally-induced pressure ulcers in rats. METHOD: A randomized pretest/post-test control group time-series study design was used. Thirty-three male Sprague-Dawley rats were used in this study. The rats were anesthetized with 100 mg/kg of ketamine. Pressure ulcers were induced at 140 mmHg for three hours using a personally-designed pressing apparatus. For four weeks, the ulmus root-bark dressing was applied every other day in the experimental group (n=18) and a wet gauze dressing in the control group (n=15). For data analysis, the statistical program SPSS WIN 12 was used. The wounds were examined by light microscopy and electron microscopy. RESULT: There were significant statistical differences in the size of the pressure ulcers as time went by (p=0.006). It should be noted that there were no significant statistical differences in the number of capillaries. Using light microscopy the inflammatory infiltration and neovascularization in the dermis in the experimental group emerged densely in the early stages, but recovered rapidly at the latter stages. In addition, the reepithelization of the epidermis occurred earlier than in the control group. By electron microscopy, the cell organelles of the capillary endothelial cells and the basal lamina of capillaries in the experimental group showed a more rapid maturation during the latter stages, compared with the control group. CONCLUSION: According to this study, it can be concluded that the ulmus root-bark dressing is effective regarding the healing of pressure ulcers.

Animals↗
PubMed2002

Identification of tetrodotoxin and fish species in a dried dressed fish fillet implicated in food poisoning.

There were five victims of neurotoxic food poisoning from a dried dressed fish fillet in Changhua County, Taiwan, in February 2000. The toxicity of the dried dressed fish fillets was 243 mouse units per g according to a tetrodotoxin bioassay. The partially purified toxin was identified as tetrodotoxin and anhydrotetrodotoxin. The sequence of the 376-nucleotide region in the cytochrome b gene of the mitochondrial DNA exhibited the same genotype as that of the toxic puffer fish Lagocephalus lunaris. The same single restriction site for Hinfl was found in the polymerase chain reaction (PCR) products from the dried dressed fish fillet and the muscle of L. lunaris, yielding two DNA fragments of 170 and 206 bp. However, no restriction site for Hinfl was found in the PCR products from other toxic puffer fishes, including Takifugu niphobles, Takifugu oblongus, and Takifugu rubripes. Therefore, the species of the dried dressed fish fillet was identified as L. lunaris and its causative agent was identified as tetrodotoxin.

Anesthetics, Local↗
PubMed2003

Combination of hydrocolloid dressing and medical compression stockings versus Unna's boot for the treatment of venous leg ulcers.

BACKGROUND: Various therapeutic approaches have been developed to manage venous ulcers. In this study the effectiveness of a hydrocolloid dressing (Comfeel Ulcer Dressing) in comparison to the Unna boot, the prototype of rigid bandages, was evaluated. METHODS DESIGN: Prospective, comparative study. SETTING: University hospital. PATIENTS: Sixty patients diagnosed with post-thrombotic chronic venous insufficiency with venous ulcers were randomly assigned to two groups of 30 patients. INTERVENTIONS: In group A, the Unna boot, and in group B, hydrocolloid dressing in addition to the elastic compression were used. MEASURES: The two groups were compared in terms of 1) complete healing, 2) weekly wound surface reduction, 3) time to complete healing, 4) performance characteristics (ease-of-use score), 5) pain during application and at home, 6) application time. RESULTS: The duration of the ulcers was 16.6 +/- 5.8 weeks in group A and 16.9 +/- 6.2 in group B (p >0.05). Previous ulcer recurrence was 74% (20/27 patients) in group A and 73% (19/26 patients) in group B (p >0.05). The initial ulcer size was 6.38 +/- 1.2 cm2 in group A and 6.19 +/- 0.8 cm2 in group B (p >0.05). The complete healing rates were 74.07% (20/27) in group A and 80. 76% (21/26) in group B (p >0.05). The weekly wound surface reductions were 1.28 +/- 0.72 cm2/week and 1.16 +/- 0.38 cm2/week in groups A and B, respectively (p >0.05). The ulcer healing time was 6.85 +/- 3.60 weeks in group A, whereas it was 6.65 +/- 3.31 weeks in group B (p >0.05). Ease-of-use score was 9.04 +/- 2.38 in group A and 17.27 +/- 3.27 in group B and the difference was significant (p <0.0001). A higher degree of pain was reported by the patients who were treated with the Unna boot, both during application (group A 3.69 +/- 1.35, group B 1.88 +/- 1.48, p <0.0001) and at home (group A, 3.27 +/- 1.08, group B, 1.88 +/- 1.11, p <0.0001). The average time spent on Unna boot changes was 150.59 +/- 34.73 min, compared to 134.54 +/- 43.39 min in group B (p >0.05). CONCLUSIONS: These results demonstrate the superiority of hydrocolloid dressing plus elastic compression treatment in terms of patient convenience.

Adult↗
PubMed1997

A consecutive series of adults with brain injury treated with a washing and dressing retraining program.

OBJECTIVES: Single-case reports indicate that behavioral methods can assist persons with brain injury to redevelop self-care skills. However, the proportion of patients who could benefit from these interventions is unknown. The present study used a specific retraining protocol to treat all patients admitted to a single facility over a 3-year period who were unable to wash and dress independently. METHOD: Four patients out of 48 met the study criteria and were treated with the washing and dressing protocol. Three had traumatic brain injury, and one had brain injury after cerebral bleed. The training program involved behavioral observation, task analysis, consistent practice, and cue fading. The Adaptive Behavior Scale was used to measure behavior change. RESULTS: Three subjects achieved rapid independence in washing and dressing (20 days, 37 days, and 11 days of treatment), and one did not show significant clinical improvement. CONCLUSION: All patients admitted to the facility during a 3-year period who required washing and dressing retraining were treated with the same protocol. The consecutive series design prevented researchers from selecting patients who they believed were good treatment candidates; therefore, the findings support the general applicability of the training program.

Activities of Daily Living↗
PubMed1998

How occupational therapists teach older patients to use bathing and dressing devices in rehabilitation.

OBJECTIVE: This article describes the methods occupational therapists use to teach bathing and dressing device use to older patients in rehabilitation programs. The relationship of three patient characteristics to five aspects of assistive device instruction was examined. METHOD: The study sample included 86 patients and 19 occupational therapists who provided the assistive device training. Patients were 55 years of age or older and in rehabilitation for an orthopedic deficit, cerebrovascular accident, or lower limb amputation. Therapists recorded information on teaching methods, perceptions of patient knowledge, and expectations for future device use after each treatment session. RESULTS: Patients received an average of three dressing and two bathing devices for home use. Therapists devoted an average of two and a half sessions (10 min average duration) to teach dressing device use and an average of one session (9 min average duration) to teach bathing device use. Teaching occurred mostly in the clinic setting through oral instruction and demonstration. At discharge, patients who evaluated devices positively and were evaluated as having a positive affect were perceived by the therapists as "having greater knowledge of device use." More time was spent teaching those patients with lower Functional Independence Measure scores, less positive evaluations of devices, and lower affect scores. Family caregivers were involved in one or more dressing sessions for 26% of patients and one or more bathing sessions for 36% of patients. CONCLUSION: Assistive device training in rehabilitation centers consists largely of simulated sessions in the occupational therapy clinic, and patients in the study described the instruction they received as "satisfactory." More research is needed to study the long-term effectiveness of assistive device training after patients return home.

Activities of Daily Living↗
PubMed2006

Control of traumatic wound bleeding by compression with a compact elastic adhesive dressing.

OBJECTIVE: Compression dressing has been assumed effective, but never formally examined in the field. METHODS: A prospective interventional trial examined efficacy and feasibility of an elastic adhesive dressing compression device in the arena of the traumatic incident. The primary variable examined was the bleeding rate from wounds compared before and after dressing. RESULTS: Sixty-two consecutive bleeding wounds resulting from penetrating trauma were treated. Bleeding intensity was profuse in 58%, moderate 23%, and mild in 19%. Full control of bleeding was achieved in 87%, a significantly diminished rate in 11%, and, in 1 case, the technique had no influence on the bleeding rate. The Wilcoxon test for variables comparing bleeding rates before and after the procedure obtained significant difference (Z = -6.9, p < 0.01). No significant complications were observed. Caregivers were highly satisfied in 90% of cases. CONCLUSION: Elastic adhesive dressing was observed as an effective and reliable technique, demonstrating a high rate of success without complications.

Adhesives↗
PubMed1998

Improved healing with a collagen-alginate dressing in the chemical matricectomy.

A prospective clinical trial was conducted to evaluate the efficacy of a collagen-alginate wound dressing in the postoperative management of chemical matricectomies. The study involved 20 patients and 23 separate procedures. The collagen-alginate-dressing treatment group had an average healing time of 24.4 days, compared with 35.8 days for the control group, which received treatment consisting of soaks and daily dressing changes (P < .05). The authors suggest that using a collagen-alginate wound dressing in the postoperative management of chemical matricectomies will shorten healing time, thus reducing infection rates and increasing patient compliance and satisfaction.

Adolescent↗
PubMedDate not supplied

Mixing and matching dressing products.

The reality of wound management in clinical practice leaves a lot to be desired in relation to dressing selection and use. Maureen Benbow highlights some of the problems currently being encountered in relation to good wound management practice and illustrates good practice with a particularly difficult case study. A basic understanding of patient assessment, wound assessment, dressing properties and their appropriateness at different stages of healing and for differing clinical appearances is essential to achieving success in wound and patient management. The author uses an unusual case study to illustrate the thinking and informed decision-making behind the choice of dressings used in combination. The issues to be addressed in relation to the management of wounds generally reflect the professional accountability of nurses and how they try to avoid harming the patient, the cost implications of dressings, their efficacy and clinical effectiveness and how practice can be improved.

Aged↗
PubMed1975

Mafenide acetate solution dressings: an adjunct in burn wound care.

A continuation of the study of 5% aqueous Sulfamylon solution dressings in burned patients was analyzed in 150 consecutive cases. The rate of invasive infection and mortality was not excessive. Dressings were used as an adjunct to other topical chemotherapeutic agents as well as homo/heterograft skin in the overall burn care program. Sulfamylon soaks were shown to be effective for debridement, granulation tissue protection and preparation, and bacterial control. The dressings were comfortable when in place and the wounds appeared clean. Epithelialization was not hampered so that the dressings could be utilized in partial thickness wounds as well as for mesh autografts on extensive burn surfaces=

Adolescent↗
PubMed2001

Screening evaluation of an ionized nanocrystalline silver dressing in chronic wound care.

The successful topical treatment of chronic wounds requires adequate debridement, bacterial balance, and moisture balance. An ionized nanocrystalline silver dressing was evaluated through an uncontrolled, prospective study of a case series of 29 patients with a variety of chronic nonhealing wounds. The four arms of the study included nine patients with foot ulcers, six patients with venous stasis ulcers, two patients with pressure ulcers, and 12 patients with miscellaneous wounds. All wounds were assessed for the usual signs of clinical infection, with most of these parameters being measured and recorded. Microbiologically, bacterial load was determined via quantitative biopsies and semi-quantitative swabs. In general, the results showed a marked clinical improvement for the majority of wounds treated with the dressing. Among improved parameters included decreased exudate and decreased purulence. The quantitative bacterial biopsies did not show any decrease in organism numbers, although the semi-quantitative swabs indicated a decrease in the wound surface bacterial loading. This was indicative of the dressing's ability to reduce surface bacteria and achieve an element of bacterial balance in the superficial dermal compartment. The proposed mechanism of action for this ionized nanocrystalline based dressing is through bacterial and moisture balance within the superficial wound space compartment.

Algorithms↗
PubMed2002

Outcomes of subatmospheric pressure dressing therapy on wounds of the diabetic foot.

The purpose of this retrospective study was to evaluate outcomes of people with large diabetic foot wounds treated with subatmospheric pressure dressing therapy immediately following surgical wound debridement. Data were abstracted from the medical records of 31 consecutive patients with diabetes, 77.4% male (n = 24), aged 56.1 +/- 11.7 years, presenting for care at two large multidisciplinary wound care centers. All patients received surgical debridement for indolent diabetic foot wounds and were subsequently started on a regimen of subatmospheric pressure dressing therapy delivered using a vacuum-assisted closure device for a mean of 4.7 +/- 4.2 weeks (mode = 2 weeks) using a protocol that called for cessation of therapy when the wound bed approached 100% coverage with granulation tissue with no exposed tendon, joint capsule, or bone. Outcomes evaluated included time to complete wound closure, proportion of patients achieving wound healing at the level of initial debridement, and complications associated with use of the device. The mean duration of wounds before therapy was 25.4 +/- 23.8 weeks. In patients treated with subatmospheric pressure dressing therapy, 90.3% (n = 28) of wounds healed at the level of debridement without the need for further bony resection in a mean 8.1 +/- 5.5 weeks. The remaining 9.7% (n = 3) went on to higher level amputation (below knee amputation = 3.2%, [n = 1] and transmetatarsal amputation = 6.5% [n = 2]). Complications included periwound maceration (19.4% [n = 6]), periwound cellulitis (3.2% [n = 1]), and deep space infection (3.2% [n = 1]). The authors concluded that appropriate use of subatmospheric pressure dressing therapy to achieve a rapid granular bed in diabetic foot wounds may have promise in treatment of this population at high risk for amputation and that a large, randomized trial is now indicated.

Atmospheric Pressure↗
PubMed1992

[The modern approach to dressing wounds].

The author evaluates from the pathophysiological aspect the impact of various dressings applied to wounds with regard to the permeability of secretions, gases, maintenance of a stable temperature and preservation of an optimum pH as well as with regard to preventing penetration of toxic substances, bacteria and foreign bodies. The author also pays attention to the important condition of non-adhesiveness of the dressing to the surface of the healing wound. From this aspect he evaluates cotton, paraffin, hydrocolloid, porous and silicon dressings. Based on the study of extensive literature and his own experiments, the author reaches the conclusion that it is essential to provide optimal mechanical and thermal protection of the wound and that for every type and stage of wound healing an appropriate dressing must be selected.

Bandages↗
PubMed2004

[The therapeutic effect of nanometer silver impregnated dressing on gunshot wounds after being immersed in brine and tapwater in rabbits].

OBJECTIVE: To investigate the therapeutic effect of nanometer silver impregnated dressing on gunshot wounds after being immersed in brine and tapwater in rabbits. METHODS: Rabbits were randomly divided into two groups after receiving gunshot wounds in both lower limbs. In group 1, the wounded limbs on the experimental side were immersed in brine for 5 h; in group 2, the wounded limbs on experimental side were immersed in tapwater for 5 h. All the wounds were treated with nanometer silver impregnated dressing on the experimental sides, while those of the control sides were treated with vaseline dressing. Biopsy was done after 30 min and 1, 2, 3, 4, 5 h, respectively. RESULTS: In group 1, the onset of inflammation around the wounds of the experimental sides was delayed, the inflammatory response was less serious, and the wounds were dry with less exudation compared to the controls. The mean healing time of the entry wounds on experimental and control sides was (29.4 +/- 6.6) d and (36.3 +/- 6.0) d (P < 0.01), respectively, and that of the exit wounds on experimental and control sides was (20.1 +/- 6.0) d and (27.3 +/- 5.7) d (P < 0.01), respectively. In group 2, only one of the experimental wounds showed mild inflammation, while all of the control wounds showed serious inflammation with much exudation. The mean healing time of the entry wounds on experimentsides was (13.0 +/- 1.52) d, while that on control sides was (16.0 +/- 3.10) d (P < 0.01). The mean healing time of exit wounds on experimental sides was (11.0 +/- 2.75) d, and those of the control sides was (15.6 +/- 2.85) d (P < 0.01). CONCLUSION: The nanometer silver impregnated dressing can control infection and accelerate healing in gunshot wounds in rabbits.

Animals↗
PubMedDate not supplied

[Treatment of infected wounds and abscesses in bovine limbs with Ligasano-polyurethane-soft foam dressing material].

The objective of this report is to present the most important indications for the use of Ligasano-polyurethane-soft-foam dressing material in the treatment of infected wounds in cattle. For this study, 28 cattle were selected, which were treated at the clinic (2000-2003) for infected cut, puncture and laceration wounds on the limbs, purulent tarsal hygromas, large abscesses in the tarsal, crural and thigh regions, and purulent tenosynovitis of the digital flexor tendon sheath caused by penetrating puncture wounds. After routine wound cleansing, debridement or adequate surgery with wound lavage, Ligasano-polyurethane-soft-foam (Ligamed Medical Produkte, Cadolzburg-Wachendorf, Germany) was applied as a primary wound dressing instead of the conventional cotton gauze swabs or as drainage material in all these wounds. The porous surface structure of this material caused subtle wound debridement and mechanical stimulation of the wound surface increasing exudation and decreasing fibrinous adhesions. The pores ensured good drainage, reduced infection, avoided the accumulation of exudate and the following destruction of the wound surface. In all these indications, except abscesses and purulent hygromas, no or only slight purulent exudation of the treated wounds was observed. Especially in the treatment of purulent tenosynovitis of the digital flexor tendon sheath with tendon resection a rapid healing of these large surgical wounds--often within 2 weeks--was found. The therapeutic effect of Ligasano-polyurethane-soft-foam as a primary wound dressing was so convincing in these bovine patients, that it is now used exclusively as primary wound dressing material for treatment of infected wounds.

Abscess↗