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PubMed1985

Drug-loaded synthetic dressings: effect on contraction, epithelialization, and collagen synthesis of deep second-degree experimental burns.

The effect of drug-loaded synthetic dressings on the contraction, epithelialization, and collagen synthesis of deep second-degree burns was followed for 21 days in 44 guinea pigs. Two symmetrical burns were inflicted on the back of each animal; the animals were then divided at random into the following test groups: Group 1 (n = 10), a prefabricated, precut, pliable, and noncracking dressing designated as Dimac (DM), versus Dimac plus 2% silver sulfadiazine (DM+); Group 2 (n = 10), Hydron loaded with 2% silver sulfadiazine (HAgS) one versus fine mesh gauze and 1% silver-sulfadiazine cream (GAgS); Group 3 (n = 12), Hydron (Hyd) versus fine mesh gauze (G); Group 4 (n = 4), fine mesh gauze versus Telfa (Tel); Group 5 (n = 6), Telfa versus Telfa; Group 6 (n = 2), gauze versus gauze. Epithelialization and contraction rates were measured at dressing changes on postburn days 6, 12, 18, and 21, with a computerized sonic digitizer. Collagen biosynthesis was measured from the wound scar on PBD 21 and expressed as relative collagen biosynthesis. Contraction on PBDs 18 to 21 was significantly lower (p less than 0.05) in the DM and DM+ treated burns. Epithelialization of the DM and DM+ treated groups on PBD 21 was significantly (p less than 0.05) higher than in the Hyd, HAgS, GAgS, and Tel treated burns, and did not differ from the G treated wounds. The relative collagen biosynthesis method was inapplicable to this burn wound model.

Animals↗
PubMed2001

Infected wound management: advanced technologies, moisture-retentive dressings, and die-hard methods.

Wound infection is a significant problem for the complicated, critically ill patient. A critical care patient's plan of care can be challenging enough without complicating it with the additional comorbidity of a wound infection. Wound infection delays wound closure, disrupts wound tensile strength; increases hospital length of stay and costs; and escalates the patient's risk of bacteremia, sepsis, multisystem organ failure, and death. The goal is to reduce and eliminate the wound infection before it leads to such drastic consequences, especially in the age of antibiotic-resistant organisms. It is paramount to identify classic and not-so-obvious signs and symptoms of wound infections, correctly collect a wound specimen, and assist in appropriate systemic and topical wound management. Techniques to prevent wound infection and reduce bioburden include nontoxic wound cleansing, debridement of necrotic tissue, proper antibiotic management, and appropriate use of moisture-retentive dressings. Advanced technologies in moisture-retentive dressings include sustained-release silver and cadexomer iodine antimicrobial dressings and negative-pressure wound therapy. Accurate wound assessment, knowledge of new technologies, and applying current wound care standards to clinical practice will assist the critical care nurse in treating and preventing wound infections.

Bandages↗
PubMedDate not supplied

Pain and anxiety during burn dressing changes: concordance between patients' and nurses' ratings and relation to medication administration and patient variables.

Few studies have examined the various factors related to pain during burn dressing changes. Patients' and nurses' ratings of pain and tension were obtained during 107 burn dressing changes among 11 burned patients. As found in previous studies, there was little concordance between nurses' and patients' ratings. Both nurses' and patients' ratings of pain were positively related to amount of analgesic medications administered, whereas amounts were inversely related to patients' reports of pain in a subsample of dressing changes in which anxiolytics were administered. However, these relationships failed to reach statistical significance. Multiple regression analyses revealed that ratings of tension during the procedure were significantly related to overall and worst pain, whereas amount of analgesics and anxiolytics given, postburn day, and total body surface area were not. Exploratory correlations suggested that ability to accurately discriminate between painful episodes, social desirability, and trait anxiety may be factors that significantly influence self-report of pain and might be worthwhile to study more systematically in the future. Implications for burn pain control and suggestions for future research are presented.

Adult↗
PubMedDate not supplied

Patients voice issues of dress and address.

Establishing a positive patient care environment is one of the most basic concepts of health care professional practice. Dress and personal address are aspects of this environment that are influenced by culture and express mutual respect within the patient-provider relationship. The Patient Sensitivity Questionnaire was administered to determine how 76 Israeli inpatients perceived forms of address and dress in their health care environment. Patients preferred that their health care providers wear formal dress and be addressed by their formal titles. Respondents did not object to being addressed by their first names. Based on these results, it would seem that this Israeli sample preferred to retain the traditional provider-patient environment.

Adolescent↗
PubMed1996

Personality characteristics and sexual functioning of 188 cross-dressing men.

The literature on cross-dressing men has been primarily limited to self-identified patients at psychiatric clinics who are in distress. To understand the personality trait characteristics and sexual functioning of nonpatient cross-dressers, 188 non-treatment-seeking male cross-dressers completed the NEO Personality Inventory (NEO-PI) and the Derogatis Sexual Functioning Inventory (DSFI). Respondents were classified as transvestites (TV; N = 83), transgenderists (TG; N = 61), or transsexuals (TS; N = 44) based on self-report and the nature of their cross-gender activities (e.g., use of female hormones, desire for sex reassignment, and amount of time spent in female role). These diagnostic groups did not differ on the five broad personality domains of the NEO-PI, but TS men scored higher than TV and TG men on the Aesthetics facet scale of Openness to Experience (O). In terms of the DSFI scales, TS men reported lower sexual drive than TV and TG men, and TS and TG men exhibited greater psychiatric symptoms and feminine gender role, and poorer body image than TV men. Upon exclusion of a group of 49 respondents who previously sought treatment for psychological problems, no significant differences emerged among the three diagnostic groups on the NEO-PI domain and facet scales. Consideration of the DSFI scales showed that TS men experienced less sexual drive, more psychiatric symptoms, and a greater feminine gender role than TV or TG men. This study suggests that cross-dressers not seen for clinical reasons are virtually indistinguishable from non-cross-dressing men using a measure of personality traits, a sexual functioning inventory, and measures of psychological distress. These results emphasize the importance of using clinical significance criteria as required by DSM-IV guidelines before diagnosing men who cross-dress with an axis I disorder.

Adult↗
PubMed1988

Therapeutic effects of silver nylon dressings with weak direct current on Pseudomonas aeruginosa-infected burn wounds.

The therapeutic and prophylactic effects of nylon dressings coated with metallic silver in a direct current circuit have been examined in a rat model of fatal burn wound sepsis. Male Sprague-Dawley rats weighing 325 +/- 25 grams with 20% full-thickness scald injuries were used. Therapeutic effects were examined at 4 or 24 hours after surface inoculation with a lethal dose of Pseudomonas aeruginosa (Strain 59-1244). When used as a surface anode with an implanted silver needle cathode, the silver nylon was therapeutic at currents between 0.4 and 40 microA when applied at either test time and continued for 5 days (p less than 0.001). When used as a cathode, silver nylon was not effective. Nylon cloth without a silver metal coating was not effective without applied current or when used as an anode. Silver nylon dressings placed at 4 hours after inoculation but without applied current showed significant effectiveness (p less than 0.01). This effect, however, was significantly less than that seen with silver nylon used as an anode (p less than 0.001). Barrier prophylactic effects were examined by placing silver nylon or uncoated nylon on burn wounds before inoculation with Pseudomonas aeruginosa. The uncoated nylon had no barrier effect. Silver nylon was found protective but applied current was not required for significant (p less than 0.001) barrier effect. These results indicate silver nylon dressings may be a valuable antimicrobial burn wound covering device.

Animals↗
PubMed1995

Enhanced survival of autoepidermal-allodermal composite grafts in allosensitized animals by use of silver-nylon dressings and direct current.

OBJECTIVE: Observe the effect of silver-nylon (SN) dressing and direct electric current on healing of meshed autoepidermal/allodermal composite skin grafts (MCSGs) in allosensitized rats. MATERIALS AND METHODS: MCSGs were placed on experimental animals 28 to 30 days after placement of sensitizing allografts. MCSGs and control allografts were covered with either Vaseline gauze (VG) or SN; direct current, 40 microA, was applied for 5 days to some of the SN-dressed wounds (SNDCs). MEASUREMENTS AND MAIN RESULTS: Second set rejection of MCSG was not observed. SN- and SNDC-treated grafts showed expansion of the meshed autoepidermis with complete epithelialization within 3 weeks. VG-covered wounds developed areas of open granulation and were not completely epithelialized at 3 months. Both SN and SNDC reduced wound contraction when compared to VG (SN versus VG p < 0.02, SNDC versus VG p < 0.008). MCSG was found to be of low alloantigenicity in that it did not induce second set rejection of subsequent skin allograft. CONCLUSIONS: SN dressings enhanced survival of meshed composite skin grafts.

Animals↗
PubMed2004

Octyl-2-cyanoacrylate as a routine dressing after open pediatric urological procedures.

PURPOSE: Octyl-2-cyanoacrylate Dermabond, Ethicon, Inc., Sommerville, New Jersey is a synthetic tissue adhesive that has recently been used for skin closure in the treatment of minor lacerations. We assess its effectiveness as a sole dressing after open pediatric urological procedures. MATERIALS AND METHODS: Between February and August 2003 we prospectively evaluated patients undergoing extragenital open and laparoscopic pediatric urological procedures at our institution. All open incisions were closed in layers using a final layer of self-absorbing subcuticular stitches for the skin before applying Dermabond only at the skin level. In laparoscopic cases Dermabond alone was applied to port sites (3 mm or less) and instrument sites without any sutures beneath the skin. No adjuvant occlusive dressings were applied to any of these wounds. All patients were allowed to bathe and return to activity immediately postoperatively. RESULTS: During the study period 146 patients with 200 incisions were identified (open 146, laparoscopy 54). Of these children 103 (142 incisions) returned for followup during the period of study with only 1 complication identified. This 6-month-old child presented the evening of surgery with omental prolapse through the umbilical port (3 mm port) requiring urgent closure. In no case was there an appreciable healing problem on surgeon or parental examination and no wound infections occurred. CONCLUSIONS: Dermabond alone provides a simple coverage for a myriad of pediatric urological surgical wounds. Early bathing and return to activity do not appear to impact negatively on wound healing when a simple skin barrier is used in place of standard dressings.

Adolescent↗
PubMed2006

Use of negative-pressure dressings and split-thickness skin grafts following penile shaft reduction and reduction scrotoplasty in the management of penoscrotal elephantiasis.

From 1988 to 2005, 8 men who presented with penoscrotal elephantiasis underwent penile shaft degloving and reduction scrotoplasty, followed by transplantation of a split-thickness skin graft (STSG) to the penile shaft. The etiology of elephantiasis in these patients included self-injection of viscous fluid and postsurgical obstructive lymphedema. In the 6 most recent cases, negative-pressure dressings were applied over the STSG to promote graft take, and STSG take rate was 100%. The results of our series corroborate those of a previous report, which showed circumferential negative-pressure dressings to be safe and efficacious in bolstering STSGs to the penile shaft. Furthermore, these results suggest that the use of negative-pressure dressings may improve graft take in this patient population.

Bandages↗
PubMed2006

A new useful and renewable tie-over dressing method using package bands and bra hooks.

The purposes of the tie-over dressing are to secure a skin graft toward the wound bed to avoid complications such as fluid or blood accumulation and to prevent graft movements over the wound bed. When there is a concern of uneventful graft take because of infection or blood accumulation underneath the graft, it is necessary to check the status of the graft at the postoperative first and subsequent days. Therefore, an ideal tie-over dressing method should not only ensure adequate immobilization and pressure but also be able to be renewed simply and quickly. We developed a new tie-over dressing method by using bra hooks and packing rubber bands to solve these problematic issues.

Bandages↗
PubMed2006

Management of enterocutaneous fistulas using negative-pressure dressings.

Fifteen patients with enterocutaneous fistulas (ECFs) not amenable to surgical treatment were treated with negative-pressure dressings over the abdominal wound and ECF. Closure of the ECF and time to closure were examined. In 11 patients who had no visible intestinal mucosa on examination, the closure rate was 100%, with a mean time to closure of 14 days. In 4 patients who did have grossly visible intestinal mucosa, no closure occurred. This represents an overall closure rate of 73%. Fistula output rate did not have a significant effect on outcome. These results confirm the efficacy of negative-pressure dressings in the closure of ECFs. Presence or absence of visible intestinal mucosa is the single most important clinical factor when considering the use of a negative-pressure dressing in the management of a patient with ECF.

Adult↗
PubMed2002

Dressing effects on elastic collisions in dusty plasmas.

Elastic collisions between two dressed grains charged with the same sign in dusty plasmas are investigated using the first- and second-order eikonal method. An interaction potential model taking into account the cross terms of shield effects is applied to describe the interaction potential between dressed dust grains in dusty plasmas. The impact parameter method is applied to investigate the variation of the eikonal phase and elastic cross section as functions of dust charge, Debye length, and collision energy. The result shows that the potential well in the interaction potential plays an important role in the elastic cross section as well as in the eikonal phase. It is also found that the dressing effects significantly increase the elastic cross section and change the sign of the eikonal phase. It is also found that the second-order eikonal phase is caused by the pure plasma screening effects.

Journal Article↗
PubMed2003

Skin graft fixation with negative-pressure dressings.

The tie-over bolster dressing is the most commonly used method for securing skin grafts. However, it requires surgical skill and experience to make a skin graft adhere closely to a grafting site when the site has a complicatedly curved surface. The lack of appropriate tension and pressure on the skin graft may produce hematoma, dislocation, or wrinkles in the graft. The grafting site for the dorsum of a hand is particularly complicated and irregular and requires delicate changes in pressure when the tie-over bolster dressing is used for sites supported and not supported by bones. We have obtained a high survival rate at such difficult sites by managing skin grafts with negative-pressure dressings. This paper describes the details of the technique with case reports. We have used this technique for skin graft fixation in 10 patients and confirmed its high utility as evidenced by a survival rate of 95% or higher of the grafted areas. Unlike existing techniques that apply pressure on skin grafts, this technique applies a negative pressure to the space between the skin graft and the grafting site to remove hematomas and pull the whole skin graft onto the grafting site with uniform force for adhesion.

Adult↗
PubMed1990

Microbiological evaluation of clindamycin as a root canal dressing in teeth with apical periodontitis.

The present investigation was designed to study the effect of clindamycin on root canal infection when placed as an intracanal dressing. Twenty-five teeth with necrotic pulps and periapical radiolucencies were included. Following initial bacteriological sampling and routine instrumentation, clindamycin powder mixed to a paste with saline was applied for 14 days. The presence or absence of bacteria was determined in samples taken immediately after removal of the dressing, and after a period of 7 days during which the canals were filled with sampling fluid. Bacteria were recovered from four and six teeth respectively. The results indicated that clindamycin offered no advantage over conventional root canal dressings, such as calcium hydroxide, and it is therefore not recommended for use in routine endodontic therapy.

Clindamycin↗
PubMed1985

The disinfection of silicone-foam dressings.

The efficiency of four commonly used antiseptics, chlorhexidine, povidone-iodine, cetrimide and sodium hypochlorite was compared in the disinfection of silicone-foam dressing used in the management of open granulating wounds. An in vitro model was first used to determine the minimum effective concentration of each antiseptic in killing a standard culture of Pseudomonas. The appropriate concentrations were then compared in comparative studies of clinical wounds. Chlorhexidine proved to be the most effective antiseptic, povidone-iodine and cetrimide were moderately successful, but sodium hypochlorite gave poor results. A subsidiary study looked at the problem of wound irritation by carry-over of the antiseptic. A rinse of the dressing after disinfection prevented irritation by chlorhexidine without compromising its antibacterial effect, but this procedure sometimes failed to prevent irritation when using the other antiseptic agents. It is concluded that chlorhexidine is the preferred cleansing agent in the management of silicone-foam dressings on both grounds of bacteriological efficiency and lack of wound irritation. It should be noted that Hibitane concentrate used in this work contains non-ionic detergent and a stabilizing agent. Pure preparations of chlorhexidine may not behave similarly.

Anti-Infective Agents, Local↗
PubMed1992

Lymphedema treated by microwave and elastic dressing.

For lymphedema, surgical treatment is contraindicated and other conservative treatments including oral medicine are not sufficient. Treatment with microwave and elastic dressing has been evaluated in 30 cases of lymphedema with 11 control patients who received only one of the two treatments. Twenty-four patients were effectively treated. In six, edema was not decreased as compared with reduction due to daily physical activity. It was observed that the earlier the patient was treated after onset of edema, the better the results. Six of 10 control patients who received only elastic dressing showed slight decrease in edema. A patient who received only microwave did not show any improvement. There was no recurrence in half of the treated patients. Treatment of lymphedema by microwave and elastic dressing appears satisfactory, particularly when given at an early stage of the disease.

Adult↗
PubMed1990

Circumcision--which dressing?

Three methods of circumcision dressing were compared in a prospective trial. The results showed that dressings containing tincture of benzoin adversely affected wound healing in children. Dressing the wound with greasy tulle gave better results; the addition of soframycin did not produce better results than those achieved with ordinary paraffin tulle.

Anti-Bacterial Agents↗
PubMed1982

Perioral contact urticaria from sorbic acid and benzoic acid in a salad dressing.

Contact urticaria was observed in a kindergarten in 18 of 20 children following the intake and accidental perioral application of a mayonnaise salad cream. In healthy adult controls, stinging tests and closed 20 minute patch test with the salad dressing were positive in 9 out of 12 and 4 out of 10 cases respectively. Twenty minute patch tests with the different components of the salad dressing were positive only so sorbic acid (SA) and benzoic acid (BA). Urticaria was provoked by inunction of the salad dressing periorally in two healthy boys. Serial 20 minute closed patch testing with varying concentrations of SA in 91 patients and BA in 41 patients gave almost identical results: positive reactions in two thirds of the patients with the highest concentrations. The response was only partially blocked by antihistamine applied locally before testing. Non-immunologic mechanisms are probably responsible for the transient reaction, and no restriction in the extensive use of SA or BA as preservatives in food should be considered.

Adolescent↗