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Results for “OCCLUSIVE DRESSINGS”

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At least 991 records · Page 55Linked to original sources
PubMed1994

Development of a temporary living skin replacement composed of human neonatal fibroblasts cultured in Biobrane, a synthetic dressing material.

BACKGROUND: Preferred coverings for excised burn wounds when sufficient autograft skin is not available are fresh or cryopreserved cadaveric skin. Problems with supply, preservation, immune rejection, and potential infection transmission accompanying the use of allograft skin underscore the need for effective alternative temporary skin replacements. METHODS: We cultured human neonatal fibroblasts (HF) for 4 to 6 weeks in nylon mesh of Biobrane, a synthetic dressing consisting of a thin layer of silicone bonded to nylon mesh. Secreted matrix proteins were identified by immunostaining and quantitated, and growth factor-specific messenger RNAs were identified by reverse transcription-polymerase chain reaction. Living grafts (Biobrane/HF) were sutured to full-thickness, excised wounds on athymic mice; control animals received Biobrane alone. Wounds were observed and biopsy specimens were obtained at intervals during the subsequent 40 days. RESULTS: After 3 to 6 weeks of culture in Biobrane the HF proliferated and secreted matrix proteins including type I collagen, fibronectin, and decorin, as well as messenger RNA for several growth factors (acidic fibroblast growth factor, basic fibroblast growth factor, and keratinocyte growth factor). Biobrane/HF grafts were transferred to full-thickness wounds, resulting in rapid fibrovascular ingrowth from the wound and effective wound closure for up to 40 days with minimal inflammatory responses. Biobrane control grafts adhered initially to wounds, but within several days many grafts developed subgraft exudates; histologic sections revealed marked inflammatory responses in these wounds. By 20 days, most BB grafts were separating from the underlying wounds that were closing by epithelialization and contraction. CONCLUSIONS: The Biobrane/HF living skin replacement provides long-term biologic coverage of full-thickness wound defects in mice with rapid incorporation of a living tissue matrix into the wound bed. Because HF have been found to be relatively nonantigenic when transferred to allogeneic hosts, Biobrane/HF grafts could replace the use of cadaveric allograft skin for achieving temporary wound closure after burn wound excision. Biobrane/HF grafts may persist on human wounds for weeks or months, with long-term persistence perhaps primarily dependent on durability of the silicone rubber layer.

Animals↗
PubMed1996

A comparative study of silicone net dressing and paraffin gauze dressing in skin-grafted sites.

This prospective randomized study has compared paraffin gauze dressing (n = 19) with silicone net dressing (Mepitel, n = 19) applied as the first layer to newly grafted burn wounds. At the first postoperative dressing visual analogue pain scores were greater in the paraffin gauze group (mean 4.4) than in the silicone net group (mean 1.4, P < 0.01). All patients in the paraffin gauze group experienced some degree of pain on dressing removal, whereas 53 per cent of patients in the silicone net group experienced no pain. Overall graft take was similar in both groups, (silicone net mean 95.7 per cent; paraffin gauze mean 94.3 per cent). Dressings were harder to remove in the paraffin gauze group as assessed by a simple scoring system (P < 0.001). In conclusion silicone net dressing confers advantages over conventional paraffin gauze, especially in reducing patient discomfort during dressing changes.

Adolescent↗
PubMed2004

Effectiveness of microporous polysaccharide hemospheres for achieving hemostasis in mohs micrographic surgery.

BACKGROUND: Microporous polysaccharide hemospheres consist of controlled-porosity spherical particles manufactured from bioinert plant polysaccharide. Microporous polysaccharide hemospheres facilitate hemostasis by rapidly absorbing the fluid component of blood, concentrating platelets and clotting factors to accelerate blood clotting. OBJECTIVE: The objective was to compare a microporous polysaccharide hemosphere bandage and electrocautery in achieving hemostasis. METHODS: Twenty-four patients with a total of 48 stages of Mohs micrographic surgery were included. Patients were stratified by whether or not they were taking anticoagulant medications. Within each group, patients were randomized to receive either the microporous polysaccharide hemosphere bandage or electrocautery. Outcomes included bleeding through the dressing (early time point) and active bleeding upon dressing removal (late time point). RESULTS: Nineteen patients not taking anticoagulants had 40 stages, of which 18 received the study bandage and 22 received electrocautery. The remaining 5 patients on anticoagulants had 8 stages, of which 4 received the study bandage and 4 received electrocautery. In both total and subgroup analysis, there was a higher incidence of bleeding through the dressing with the study bandage (p<0.05), but no increase in the incidence of active bleeding upon dressing removal (p>0.05). CONCLUSION: The microporous polysaccharide hemosphere study bandage had an increased incidence of bleeding through the dressing compared to electrocautery, but did not have an increased incidence of active bleeding upon dressing removal.

Aged↗
PubMed1998

Understanding dressings.

Currently our understanding of chronic wound pathophysiology is deficient in knowing what specifically is lacking during arrested wound healing. Autologous or allogenic keratinocytes have been used successfully to treat chronic wounds, as have composites containing diverse substances such as allogenic dermis, polyglycolic acid, or collagen mesh combined with keratinocytes or fibroblasts (Table 6). In spite of great technological advances and increased understanding, there is much work to be done. We look forward to the day when our knowledge of wound healing has progressed to the point when specific deficiencies can be supplemented by dressing contents, and when "smart" dressings can adapt to the changing wound as it progresses through the phases of healing.

Humans↗
PubMed1998

Efficacy of a dry fibrin sealant dressing for hemorrhage control after ballistic injury.

OBJECTIVE: To determine if a dry fibrin sealant dressing (DFSD) will provide superior hemostasis when compared with regular gauze in a ballistic injury animal model. DESIGN: A nonsurvival randomized goat study. SETTING: A federal biomedical research institute. SUBJECTS: Eighteen anesthetized Angora goats. INTERVENTIONS: Uncontrolled hemorrhage was induced by a complex ballistic extremity injury. Control of hemorrhage was achieved by applying and holding pressure with the DFSD or regular gauze for 2 minutes. The dressings were left in place for 1 hour. MAIN OUTCOME MEASURES: Total blood loss, mean arterial pressure, ballistic injury, and mortality were recorded after 1 hour. RESULTS: The injuries were equivalent for the 2 groups. No animal mortality was seen. After 1 hour, the mean (+/-SEM) blood loss was 124+/-64 mL in the DFSD-treated group and 377+/-64 mL in the gauze dressings-treated group (P=.01). Twenty minutes after injury, the mean arterial pressure was 95.0 mm Hg (+/-SEM, +/-4.7 mm Hg) in the DFSD-treated group and 70.0+/-5.0 mm Hg in the gauze dressings-treated group. The difference persisted for the remainder of the study (P=.01). CONCLUSION: The DFSD was superior to gauze in decreasing blood loss and maintaining blood pressure while retaining the simplicity of standard dressing application.

Animals↗