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At least 865 records · Page 48Linked to original sources
PubMed2000

Tacky but refined: a "slick" technique for dressings that hold better.

For decades benzoin has been used to enhance the "stickiness" of the skin for improved adherence complementing the protective and functional aspects of well-constructed surgical bandages/dressings. The fully adherent and longer-lasting pressure dressing is both aesthetically pleasing to the patient (and surgeon) and, at the same time, functions to decrease seroma or hematoma formation, enhances antisepsis by blocking transient bacterial contamination, and inhibits traumatic sabotage of surgical wounds due to patient overactivity or inadvertent collision with a door jam, car door, table leg, or grandchild, etc. Also, when the bandage looks good, the patient realizes the operation was a success (at least aesthetically). Although simple, our additional steps of deoiling the skin with acetone, followed by multiple compress/release cycles of gauze to the Mastisol area reaps benefits to the patient and surgeon both in function (adherence) and in the production of a truly "dressy" beautiful and long-lasting dressing. In this way, the dressing "bed" is not only more receptive to one's aesthetically pleasing bandage, but is more tacky, yet refined. This same technique can be utilized prior to application of adhesive strips to healing wounds after sutures have been removed, allowing them to "stay on" longer with potentially better cosmesis and less spreading of the scar.

Adhesiveness↗
PubMed2000

Occlusive dressing versus oxygen mist therapy following CO2 laser resurfacing.

BACKGROUND: Oxygen is an essential element for collagen synthesis and reepithelialization. The use of topical oxygen after CO2 laser resurfacing has not been studied. OBJECTIVE: To compare the rate and quality of healing in wounds treated with an oxygen mist to those treated with occlusive dressing following CO2 laser resurfacing. METHODS: Three patients underwent CO2 laser resurfacing to each half of the face 3 weeks apart. Postoperatively, half of the face was treated with an oxygen mist protocol for 5 days, while the other half was treated with occlusive dressing for 4 days. RESULTS: At postoperative day 5, significantly less crusting was observed on the half of the face treated with the oxygen mist protocol (p < 0.05). CONCLUSION: The oxygen mist postoperative protocol may offer patients similar overall healing rates and significantly less crusting compared to occlusive dressing.

Aged↗
PubMed2001

Moist wound healing with occlusive dressings: a clinical focus.

The concept of moist wound healing, which is facilitated by the application of occlusive dressings, dates back to 1615 BC, and the technique is currently supported by a relatively large volume of data. It is clear that occlusive dressings are in many cases associated with more rapid reepithelialization, a reduced risk of infection, and more rapid wound healing than the alternatives. Nevertheless, many clinicians have been slow to accept this therapeutic technique. This article traces the history of moist wound healing from its earliest inception, examines the theoretical mechanisms of its effect, and explores its advantages and disadvantages. It also reviews the literature supporting the use of occlusive dressings in a variety of wound settings and examines the possible reasons behind the apparent reluctance on the part of the medical community to accept a potentially valuable therapy.

Animals↗
PubMedDate not supplied

Modified cotton gauze dressings that selectively absorb neutrophil elastase activity in solution.

Dressings for chronic human wounds have been aimed at protection, removal of exudate, and improved appearance. However since the time of ancient Greece wound care and dressing strategies have primarily relied on empiricism. Recent studies have shown that chronic wounds contain high levels of tissue and cytokine destroying proteases including collagenase and neutrophil elastase. Therefore we sought to develop an effective wound dressing that could absorb elastase through affinity sequestration. Cotton gauze was modified by oxidation, phosphorylation, and sulfonation to enhance elastase affinity by ionic or active site uptake. Type VII absorbent cotton gauze was oxidized to dialdehyde cotton which was subsequently converted in part to the bisulfite addition product. Gauze preparations were also phosphorylated and carboxymethylated. Modified cotton gauzes were compared with untreated gauze for reduction of elastase activity in buffered saline. Solutions of elastase that were soaked in oxidized, sulfonated, and phosphorylated cotton gauze showed reduced elastase activity. The initial velocities (v(o)) and turnover rates of elastase showed significant decreases compared with solutions taken from untreated gauze. The reduction in enzyme activity with dialdehyde cotton gauze was confirmed in solution by determining elastase inhibition with dialdehyde starch. The dialdehyde cotton gauze also decreased elastase activity in human wound fluid in a dose response relation based on weight of gauze per volume of wound fluid. Absorbency, pH, air permeability and strength properties of the modified gauze were also compared with untreated cotton gauze. This report shows the effect of reducing elastase activity in solution with cotton containing aldehydic or negatively charged cellulose fibers that may be applicable to treatment modalities in chronic wounds.

Absorption↗
PubMed2000

Healing at skin graft donor sites dressed with chitosan.

Chitosan is a derivative of chitin, extracted from the exoskeleton of lobsters, crabs and shrimps. As a semi-permeable biological dressing, it maintains a sterile wound exudate beneath a dry scab, preventing dehydration and contamination of the wound to optimise conditions for healing. In this study, evaluation of healing at split skin graft donor sites, dressed half with chitosan and half with a conventional dressing, showed that chitosan facilitated rapid wound re-epithelialisation and the regeneration of nerves within a vascular dermis. In addition, digital colour separation analysis of donor site scars demonstrated an earlier return to normal skin colour at chitosan-treated areas.

Adolescent↗
PubMed1992

Effect of occlusive dressings on the stratum corneum water holding capacity.

Occlusion of the skin is used in clinical dermatology to promote wound healing and to increase the transcutaneous penetration of topically applied drugs. These effects are related to the degree of occlusion exerted and depend on the physicochemical nature of the dressing. We have evaluated the effects of four different materials on the skin barrier and the stratum corneum water holding capacity (WHC) using the Plastic Occlusion Stress Test (POST). The following materials were compared: hydrocolloid dressing, polyurethane film, polyethylene film, and a plastic chamber. These devices were applied on the volar forearm for 24 hours in 10 healthy volunteers (mean age 32 +/- 4 years). Upon their removal, the stratum corneum WHC, measured as skin surface water loss (SSWL), was recorded continuously for 25 minutes using an Evaporimeter. SSWL decay curves showed significant differences between the occlusive materials (analysis of variance, p less than 0.01). Higher SSWL values were recorded in sites occluded with the plastic chamber, whereas the polyurethane film resulted in poor occlusive capacity. Hydrocolloid dressing and polyethylene gave similar responses with higher WHC values compared to polyurethane (p less than 0.05). The relevance of these findings to clinical dermatology in terms of wound healing and drug absorption is discussed.

Adult↗
PubMed1998

Negative-pressure dressings as a bolster for skin grafts.

Contoured wounds needing closure with skin grafts are often located in complex anatomic regions or are in unusual positions, which make conventional skin graft stabilization techniques cumbersome and ineffective. Often after 72 hours, a skin graft covered with a bolstered dressing has poor take secondary to shear stresses, as well as hematoma formation or serum collection, negating the effectiveness of the stabilizing dressing. The Food and Drug Administration has recently approved vacuum-assisted closure (V.A.C.), an innovative technique using negative pressure, for closure of chronic wounds. This reportedly leads to enhanced granulation tissue formation and consequently more rapid reepithelialization of wounds compared with conventional packing with saline-moistened gauze. Experimental studies have demonstrated increased oxygen tension, decreased bacterial counts, and increased granulation formation occurring under negative-pressure systems. Extending the use of this concept, we have coupled skin grafting with negative-pressure dressings for closure of large, complex open wounds. Our results indicate greater than 95% graft take in all patients in this study. This technique is extremely efficacious, with increased graft take due to total immobilization of the graft, thereby limiting shear forces, elimination of fluid collections, bridging of the graft, and decreased bacterial contamination. Moreover we have noted decreased edema in rotated muscle flaps, improved contour conformity, and shortened hospitalizations.

Aged↗
PubMedDate not supplied

Pilot study of a unique film dressing for the treatment of donor site wounds.

The clinical benefits of using the VENTEX Wound Dressing System (VWDS) (The Kendall Co.) in the management of donor site wounds were evaluated in this pilot study involving 10 informed and consenting patients. The study was a prospective, randomized, controlled study in which one donor site wound was managed with VWDS, and the other donor site wound on the same patient was managed by our standard of care, which involved the use of Xeroform gauze (The Kendall Co.). Each donor site wound was independently assessed daily for pain, rate of reepithelialization, adverse reactions, and ease of dressing use while patients were hospitalized. Quality of scar was assessed during regularly scheduled follow-up visits. The use of VWDS eliminated donor site pain and accelerated reepithelialization compared with Xeroform gauze. There were no adverse reactions associated with the use of VWDS. In contrast, there were two cases of suspected infection at the donor sites treated with Xeroform gauze. The VWDS was more complicated to apply and use compared with Xeroform gauze. There were no differences observed in scar quality of donor sites treated with these dressings.

Adolescent↗
PubMed1999

Effect of dry fibrin sealant dressings versus gauze packing on blood loss in grade V liver injuries in resuscitated swine.

BACKGROUND: We conducted this study to determine whether the dry fibrin sealant dressing (DFSD) would stop bleeding from a grade V liver injury and to evaluate the effects of leaving the absorbable DFSD in survival animals. METHODS: Twenty-four swine (40+/-3.0 kg) received a uniform grade V liver injury and were randomized to one of four 1-hour treatment groups: (1) gauze packing, (2) DFSD, (3) immunoglobulin G placebo dressing, and (4) no treatment. All animals were resuscitated with lactated Ringer's solution. Total blood loss (TBL), mean arterial pressure, resuscitation volume, and laboratory data were monitored for 1 hour after injury. Four swine were treated with the DFSD after grade V injury and allowed to survive for 7 or 14 days. RESULTS: The TBL was 1,104+/-264 mL (mean +/- SEM), 544+/-104 mL, 4,223+/-1,555 mL, and 6,026+/-1,020 mL for groups 1, 2, 3, and 4 respectively. TBL in DFSD animals was less than that in animals treated with gauze packing (p = 0.06). Grade V injuries were uniform among the 1-hour groups, and no evidence of intrahepatic abscess, unusual adhesions, or hepatic vein, vena caval, or pulmonary thromboses were noted in the long-term survival animals. CONCLUSION: In this model of grade V liver injury, blood loss with the DFSD was 51% of that observed with standard gauze packing (not statistically different). Initial survival data revealed no complications attributable to the fibrin dressing. DFSD may provide simple, rapid, and definitive hemorrhage control in life-threatening liver injuries without the need for reoperation.

Animals↗
PubMedDate not supplied

Glycosaminoglycan hydrogels as supplemental wound dressings for donor sites.

Chemically crosslinked glycosaminoglycan (GAG) hydrogel films were evaluated as biointeractive dressings in a porcine model for donor-site autograft wounds. Multiple 5 x 5 x 0.03 cm wounds were created on the dorsum of pigs. Half of the wounds were treated with a GAG film plus an occlusive dressing (Tegaderm), whereas the other half were treated with Tegaderm alone. At 3, 5, or 7 days after surgery, the partially healed wounds were excised and evaluated histologically for three animals at each time point. By day 3, epithelial cells had proliferated and migrated from wound edges and from epithelial islands associated with residual hair follicles to begin to cover the wound bed. A statistically significant increase in coverage was observed for GAG + Tegaderm-dressed wounds than for those with Tegaderm alone at day 3 and day 5 post-surgery. By day 7, all treatment groups were completely healed. Thus, GAG hydrogels accelerated wound healing by enhancing re-epithelialization.

Animals↗
PubMedDate not supplied

Comparing the Vancouver Scar Scale with the cutometer in the assessment of donor site wounds treated with various dressings in a randomized trial.

Cutaneous scarring observed in wounds is, to a significant degree, dependent upon the time it takes for the wounds to heal. Various topical dressings are proposed to influence healing time in donor sites. In this prospective randomized study, we examined the effect of Vaseline gauze (VD; Branolind, Paul Hartmann AG, Germany), Biobrane (BD; Bertek Pharmaceuticals, Inc., Morgantown, WV), an occlusive film dressing Barrier Flex (OD; Moelnlycke Health Care GmbH, Germany), and an equine collagen foil, Tissu Foil E (CD; Baxter, Heidelberg, Germany), on re-epithelialization and scarring in standardized donor site wounds. At 6 months after surgery, donor site scars and normal uninjured mirror sided skin were evaluated in 33 patients using both the Vancouver Scar Scale (VSS) and the cutometer SEM 575 (Courage and Khazaka). The median healing time for OD was 14 days, BD 16 days, CD 19 days, and VD 19 days. The single parameter pliability of the VSS was not significantly different from uninjured skin when all donor site scars were pooled. No difference was found between the four groups. Viscoelastic analysis of all pooled patient data showed a significant difference for Uf (total deformation), Ua (total recovery), Ur (immediate retraction), Ue (immediate distension), Ur/Ue, and Ur/Uf, indicating that donor sites significantly differed from normal uninjured skin. No significant correlation between objective viscoelastic measurements and the subjective pliability assessment of the VSS was found. Viscoelastic differences were greatest in the VD and BD groups. Viscolelastic differences did not significantly correlate with healing time. Various wound dressings had minimal yet significant influence on healing time and scarring. In contrast to the VSS, viscoelastic measurements of skin pliability can objectify scarring when few differences are anticipated.

Bandages↗
PubMed1990

Inhibition of connective tissue formation in dermal wounds covered with synthetic, moisture vapor-permeable dressings and its reversal by transforming growth factor-beta.

An investigation of synthetic, adherent, moisture vapor-permeable dressings (SAM) on dermal wounds healing by secondary intent has yielded the novel observation that SAM dressings severely inhibited the deposition of granulation tissue and subsequent collagenous tissue when compared with air-exposed wounds in mouse and guinea pig systems. Repair tissue was quantitated histomorphometrically in full-thickness wounds covered with SAM or left air-exposed for periods up to 3 weeks. Early in healing, mouse wounds left open to the atmosphere formed a scab which overlay a large volume of granulation tissue derived from two sources, one lateral, and the other deep and centrally located. In contrast, SAM-covered wounds contained only a small amount of granulation tissue which was derived solely from lateral sources. Granulation tissue was replaced by fibrous connective tissue over time, and this was always less in SAM-covered wounds. Deposition of large amounts of connective tissue in air-exposed wounds was associated with significant polymorphonuclear and mononuclear cell infiltrates, while the lack of granulation tissue formation in SAM-covered sites was associated with reduced inflammation. Dressing-induced inhibition of connective tissue could be partially reversed by treatment with transforming growth factor-beta form 1 or 2. Deposition of granulation tissue in large lenticular wounds in guinea pig skin, but not in 6-mm punch wounds, was also inhibited when the wounds were covered with SAM, and the morphology of air-exposed and SAM-covered wounds was similar to that in mice. SAM-covered wounds in mice and guinea pigs may be useful as models of chronic non-healing wounds.

Animals↗
PubMed2005

Prevention of amputation caused by rheumatic diseases following a novel therapy of exposing bone marrow, occlusive dressing and subsequent epidermal grafting.

BACKGROUND: Wounds with exposed bones caused by rheumatic diseases commonly result in amputation despite progress in our understanding of wound-healing mechanisms. OBJECTIVES: To determine whether an experimental therapy of bone marrow exposure, an occlusive dressing and subsequent grafting of epidermal sheets accelerates healing and reduces the need for amputation in patients with rheumatic diseases. METHODS: Fifteen patients, including those with rheumatoid arthritis or systemic sclerosis, who had wounds with exposed bones were treated either with the standard procedure, consisting of local wound care, debridement with a scalpel, bed rest and parenteral antibiotics (n = 8), or with a newly developed experimental procedure (n = 7). In that new procedure, the affected bone was initially exposed by debridement with a scalpel, followed by partial excision with a bone scraper until bleeding was observed from the exposed bone. The lesions were immediately covered with an occlusive dressing, and were eventually treated with epidermal grafts obtained from suction blisters. RESULTS: A comparison with standard therapy demonstrated that the time needed for wound healing was similar, but that the newly developed combination therapy reduced the risk of amputation (P = 0.020). No skin ulcers or erosions were observed for at least 1 year in five of seven patients (72%) due to the adoption of stable palmoplantar-type characteristics in grafts derived from the trunk epidermis. CONCLUSIONS: Our study indicates that exposure of bone marrow cells plus an occlusive dressing accelerates the healing of skin ulcers at least partly through the preparation of a healthy well-granulated wound bed and that subsequent epidermal grafting achieves site-specific differentiation through epithelial-mesenchymal interactions.

Adult↗
PubMed2004

Use of biosynthetic dressings in paraneoplastic pemphigus.

A 77-year-old woman with paraneoplastic pemphigus and non-Hodgkin's lymphoma was treated with supportive therapy and oral prednisone. Biobrane, a biosynthetic dressing, was later applied to the extensive areas of erosion to assist in pain management and to provide a temporary barrier function. She reported an improvement in the pain associated with the areas of erosion. The use of biosynthetic dressings in blistering disorders has not been previously reported. Standard dressings such as silver sulfadiazine are messy and can cause discomfort with frequent changing. We feel that this is an area that warrants further evaluation as it may contribute to the overall treatment and comfort cares of these patients.

Aged↗
PubMed1986

Nobecutane spray as a temporary dressing of skin graft donor sites.

Various methods have been used for managing split-thickness skin graft donor sites. Open and closed techniques have been suggested by various authors with the purpose of achieving smooth and rapid healing of the wound. There is growing evidence to suggest that the site and quality of the healing is improved when the wound is protected from dehydration and further mechanical trauma. A recent method is the spraying of Nobecutane Spray on the donor site. Nobecutane sprayed on a wound forms a plastic film which serves as a dressing material. It contains specially modified acrylic resin in an organic solvent (ethyl acetate) and TMTD (tetramethylthiuram disulphide) which is strongly bactericidal and fungicidal. We employed this method on 50 patients and found it to be effective in achieving rapid and painless healing. The dressing is transparent, permits easy follow-up of healing in the donor site, protects the wound against infection, and does not inconvenience the patient. The treatment is simple, economical, and does not require special skills. The dressing peels off spontaneously after epidermal regeneration of the wound is completed. No complications or allergic reaction were observed with this treatment.

Acrylic Resins↗
PubMed1987

Dressings for dermabrasion: new aspects.

Occlusive dressings reduce healing time by up to 50% over air-exposed wounds. Biobrane (Woodroof, Santa Ana, CA), a biosynthetic wound dressing which is maintenance free, shortens wound healing, and results in less erythema and milia formation, appears to be the wound dressing best suited for dermabrasion.

Biocompatible Materials↗
PubMed2005

Octyl-2-cyanoacrylate liquid bandage as a wound dressing in facial excisional surgery: results of an uncontrolled pilot study.

BACKGROUND: Although cyanoacrylate tissue adhesives are frequently used in the closure of cutaneous lacerations and excisions, only a few reports comment on their usefulness as a dressing over sutured wounds. A new formulation of octyl-2-cyanoacrylate (Liquid Bandage; BAND-AID, Johnson & Johnson) is used as an occlusive protective film over minor cuts and scrapes. OBJECTIVE: An uncontrolled pilot study to assess the safety, efficacy, and cost of Liquid Bandage as an occlusive dressing over sutured facial excisions. METHODS: Patients undergoing excision of facial neoplasms were recruited. After conventional layered repair, Liquid Bandage was applied. On suture removal, the wounds were photographed and evaluated by three dermatologists, who assigned an overall outcome rating. The average cost of Liquid Bandage and routine wound care materials was calculated based on prices from three different pharmacies. RESULTS: Of the 18 wounds available at follow-up, 17 were assigned an overall outcome rating of good or excellent by at least one of the evaluators. Eleven wounds received an excellent rating from at least two of the evaluators. One case of distal flap necrosis occurred. Liquid Bandage proved to be less expensive than routine postsurgical wound care materials. CONCLUSIONS: Liquid Bandage dressing is safe and effective over sutured facial excisions.

Adolescent↗
PubMed1982

Collagen film for burn wound dressings reconstituted from animal intestines.

Collagen was isolated and purified from sheep intestines and cast into a film. The collagen film was cross-linked with ultraviolet light and reinforced by imbedding a nylon mesh. The collagen membrane was evaluated as a wound dressing for second- and third-degree burns in rats. Histopathological studies of the burns with and without the collagen dressings were made. The study showed the burn wounds dressed with collagen membrane exhibited rapid epithelialization with little inflammatory change and dense fibrous tissue ingrowth in the subdermal layers.

Amino Acids↗