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PubMedDate not supplied

An investigation of the benefits of Aquacel Hydrofibre wound dressing.

Aquacel wound dressing, produced by ConvaTec, uses the main ingredient of the hydrocolloid dressing in a new way to produce a hydrofibre dressing. Aquacel is designed for use in moderate to heavily exuding wounds as it absorbs exudate directly into its fibres. It has been shown to be effective in pressure sores, leg ulcers and surgical wounds, producing warm, moist, local wound conditions for optimum wound healing. Aquacel can lock exudate away thus protecting the surrounding skin.

Bandages, Hydrocolloid↗
PubMed2001

Using a new foam dressing in the care of fungating wounds.

Fungating wounds may present with a number of unpleasant symptoms such as malodour, high levels of exudate and pain. The cosmetic appearance of the wound, along with these associated symptoms, can be a significant cause of distress to patients. As a result of the fact that fungating wounds rarely heal, their management is based on symptom control, promoting comfort and maintaining or improving the patient's quality of life. The treatment of these wounds is generally palliative in nature and often involves the use of dressings or other topical products to control symptoms. This case study details the use of a new hydropolymer foam dressing (Tielle Plus) in the management of a large fungating breast wound. The dressing was clinically and cost effective, nursing staff found it easy to use, and the patient found it very comfortable and less noticeable under her clothing.

Aged↗
PubMedDate not supplied

The use of a hydrofibre dressing in fulminating necrotizing fasciitis.

This article describes a case of necrotizing fasciitis in a 52-year-old man with previously undiagnosed diabetes. Treatment involved massive debridement and subsequent dressing of the open surgical wound. A modern hydrofibre dressing (Aquacel) was inserted intraoperatively and subsequently continued postoperatively. Wound healing occurred over 3 months and the patient was discharged with no disability. The dressing managed the exudate level and kept the wound moist. It also was well tolerated by the patient, was comfortable and easy for the nurses to remove and apply.

Carboxymethylcellulose Sodium↗
PubMed2004

Evaluation of a wound dressing using different research methods.

This article examines different methods of assessing wound progress in order to better inform future research designs and thus produce a more credible and valid bank of knowledge. Data collected in a study of Vacutex, a capillary action dressing, were reassessed using four different mechanisms: non-blind assessment by a research nurse; two different scoring systems based on wound size and appearance; and a blind randomized assessment using initial and final images of wounds.Non-blind assessment indicated that the Vacutex dressing was superior to standard dressings by +40.8% (P=0.022); assessment by wound area and overall appearance indicated +11.2% superiority (P is not significant); and the blind randomized image-based assessment indicated a +20.6% difference (P is not significant). Assessment by wound area and description did not allow a percentage superiority to be identified and the conclusion of this method was that there was no significant difference by rank sum testing. The different assessment techniques resulted in significantly different conclusions about the effectiveness of Vacutex. On balance, the blind, randomized, image-based assessment may miss some finer nuances of wound progress but is probably the most unbiased option because those assessing the wounds are not aware of which images are taken before or after wounds have been treated.

Bandages↗
PubMedDate not supplied

Sustained silver-releasing dressing in the treatment of diabetic foot ulcers.

This study investigated the clinical performance and safety of a sustained silver-releasing foam dressing, Contreet Foam, in the treatment of diabetic foot ulcers. Twenty-seven patients with diabetic foot ulcers of grade I or II (Wagner's classification) were followed for six weeks: one week run-in using Biatain dressings, four weeks' treatment with Contreet dressings. Four ulcers healed during the four-week treatment with Contreet 56% in average. Contreet Foam showed good exudate management properties and was considered easy to use. Only two infections occurred showed that all six of the non-study ulcers developed an infection during the study. All ulcers (study ulcers as well as non-study ulcers) were treated according to good practice of diabetic wound care. There were no directions for the treatment of secondary wounds. No device-related adverse events were observed. This study demonstrated that Contreet Foam is safe and easy to use and effectively supports healing and good wound progress of diabetic foot ulcers.

Adult↗
PubMedDate not supplied

Films or fabrics: is it time to re-appraise postoperative dressings?

Post-operative wounds healing by primary intention are often seen as the simplest areas of modern wound care. However, have we overlooked the problems that can exist and are we really looking at postoperative dressing selection with the same vigour we attach to other areas of wound care? This article outlines the development of modern post operative dressings, both fabric and film-based and raises the question 'if postoperative wound infection is a problem should we consider more effective barrier dressings?'

Bandages↗
PubMed1995

Nurses' assessment and management of pain at wound dressing changes.

This case study examined the methods used by nurses to assess, manage and document pain at wound dressing changes. The sample consisted of four registered nurses working in acute surgical wards and the dermatology outpatient clinic at a large hospital. A theoretical framework was used to structure and focus the study. Data were collected through non-participant observation, semi-structured interviews and nursing documentation. Findings included the failure of nurses to assess patients' pain verbally or to use pain assessment tools. Reliance on nursing experience and non-verbal patient indicators of pain suggested inadequate assessment. Pharmacological agents were advocated to manage pain but were not used. Information was given to patients but no control over their pain was facilitated. Neither assessment nor management of pain at dressing changes was documented. Recommendations are suggested, including teaching strategies to develop a more sensitive approach which would include patient involvement in pain assessment before dressing changes, documented pain assessments and wider availability of nitrous oxide and oxygen (Entonox).

Adult↗
PubMed1997

The cytocompatibility of hydrocolloid dressings.

The purpose of this study was to evaluate the effect on fibroblast proliferation of hydrophilic particles isolated from six commercial hydrocolloid dressings. The hydrophobic adhesive matrix of six hydrocolloid dressings was removed using a reflux extraction method with an organic solvent (xylene). The remaining hydrophilic particles were dissolved in complete cell growth medium containing 10% (v/v) foetal calf serum and added to confluent human dermal fibroblasts grown in monolayer in final concentrations of 0.1 and 0.01% (w/v). Control cells received growth medium alone. The fibroblasts were incubated with the hydrophilic particles and the thymidine analogue 5-bromo-2'-deoxyuridine (BrdU) for 24 hours. The incorporation of BrdU into DNA was used as a measure of cell proliferation and determined using an ELISA kit. The results were expressed in percentage of control-treated wells and analysed using analysis of variance. Apart from Comfeel Plus, the hydrophilic particles of hydrocolloid dressings significantly inhibited fibroblast proliferation at 0.1% compared to control-treated fibroblasts (p < 0.05).

Analysis of Variance↗
PubMed1998

Odour-absorbing dressings.

This study uses an objective test system that compares the ability of different dressings to prevent the passage of a volatile amine when applied to a wound model under simulated 'in-use' conditions. Five dressings containing activated charcoal were tested by this method, and a low-adherent absorbent dressing was used as a control. Results demonstrate clear differences in the ability of the products to contain the test solution and prevent the loss of the volatile diethylamine into the surrounding air. Products which combine a physical absorbent with a charcoal component show enhanced performance.

Administration, Cutaneous↗
PubMed2001

Malignant wound management: what dressings do nurses use?

This paper reports on the findings from the first part of a three-phase project that aimed to identify nursing strategies used in the management of malignant wounds. The difficulties relating to the management of these wounds and the significant physical and psychological impact on patients are described. A quantitative postal survey aiming to identify the types of dressing used in the care of malignant wounds was sent to specialist nurses working in oncology and palliative care in New South Wales, Australia. Additional qualitative data showed that the major issues were coping with odour and meeting the financial costs of the dressing products. The long list of products compiled for this research demonstrates the complexities nurses face when selecting dressings for the management of malignant wounds. Furthermore, there are no clear recommendations to guide nursing practice. This study provides a framework for subsequent phases of the project and will hopefully lead to the development of guidelines for best practice in malignant wound management.

Bandages↗
PubMed2003

Pain at first dressing change after toenail avulsion: the experience of nurses, patients and an observer: 1.

OBJECTIVE: Ingrowing toenails are often treated surgically by nail avulsion, with paraffin tulle gauze applied to the toenail bed afterwards. In one large city's primary care trusts, community nurses reported that patients felt pain when the gauze was removed postoperatively. This study looked at patients' general pain experience, and their pain during the first dressing change after toenail avulsion. Patients' perceptions of their pain were investigated, along with nurses' experience of redressing toenail beds, their technique and their interaction with patients, especially in relation to pain prevention. METHOD: First an extensive literature review was conducted. Then a collective instrumental case study design was used. This allowed triangulation of data sources using patient and nurse interviews, and non-participant observation, from six cases recruited from the city's primary care trusts. Data were subjected to thematic content analysis, with two main categories identified. These were 'setting up of expectations' and 'a painful experience: but for whom?' RESULTS AND CONCLUSION: This study provides a unique description of the type of pain patients experience. It raises serious issues about the adequacy of nurses' management of pain, including assessment, documentation and advice on pain-relief strategies. It supports discontinuing the use of paraffin tulle gauze as the postoperative dressing, and raises ethical issues about changing treatments and lack of communication with secondary care. Finally, it identifies a gap in knowledge of the most suitable dressing product to apply immediately after surgery. A randomised controlled trial is needed to clarify these preliminary findings.

Adult↗
PubMed2004

A small study in healing rates and symptom control using a new sheet hydrogel dressing.

OBJECTIVE: This study set out to investigate the pain control and absorptive properties of a new sheet hydrogel dressing (ActiFormCool, Activa). METHOD: This was a simple evaluation involving 20 wounds. Compression was used when appropriate, although each patient receiving compression had used short-stretch bandages before entering the study. RESULTS: Pain was reduced from an average of 8.65 to an average of 3.75, where 10 represents the worst pain possible and one represents no pain. Exudate reduction was assessed by the number of dressing changes required each week. The dressing-change rate reduced from an average of 2.8 times weekly to an average of 1.3 times weekly. Skin condition improved in all three cases in which the surrounding skin had been a problem before the study. Over a four-week period, two wounds healed, four healed by 90% and two by 80%, with an overall average healing rate of 46%. CONCLUSION: ActiFormCool provides an optimum wound-healing environment, reduces pain and absorbs fluid, making it an excellent alternative to loose hydrogels.

Bandages, Hydrocolloid↗
PubMed1991

Burn dressings: a critical indicator for patient care classification in burn units.

Nursing services consume approximately 60% of a hospital personnel budget, requiring justification for staffing levels and manpower expenses. The lack of an adequate level of nursing care affects the operation of the entire health care team. The purpose of this descriptive study is to establish the mean tasking time to apply burn dressings. The number of nursing staff required to complete a burn dressing application is dependent on the location of injury and the ability of the patient to cooperate. Establishing the essential mean tasking time for routine post-operative dressing assists in the production of accurate reporting of nursing manpower requirements.

Adolescent↗
PubMed2002

Use of hylan B gel as a wound dressing after endoscopic sinus surgery.

Although serious sequelae of endoscopic sinus surgery are infrequent, more commonplace surgical management often involves the control of mucosal bleeding. This study was conducted to assess the efficacy of an elastoviscous hylan gel as a postsurgical wound dressing for promotion of hemostasis. Twenty patients with a diagnosis of chronic sinusitis were evaluated. In randomized fashion, the gel dressing was placed into one operated cavity while the contralateral side served as the control. The results indicated that hylan gel was effective in stilling postsurgical bleeding, particularly in the fulminant polyposis cases who had a larger and more exposed cavity. These early results indicate a potential benefit of a gel dressing for hemostasis when used at the conclusion of the operative procedure. In addition, other parameters were evaluated in this study, including prevention of postoperative adhesions and the effect on mucosal healing. These parameters showed a positive result compared with the control group.

Cellulose↗
PubMed1998

Effects of cold and compression dressings on early postoperative outcomes for the arthroscopic anterior cruciate ligament reconstruction patient.

Efforts to minimize the morbidity of anterior cruciate ligament (ACL) reconstruction include the use of cryotherapy and/or compressive dressings in the immediate postoperative period. We undertook the present study to determine if the alleged benefits of the Cryo/Cuff, which combines these modalities, are more attributable to its compressive effect rather than cold application. Seventy-eight patients admitted for primary endoscopic ACL reconstruction using a bone-patella tendon-bone autograft were randomized to receive Cryo/Cuff compressive dressings postoperatively. Forty subjects (Group 1) had the cuff applied with continuous circulating ice water using the Autochill device, while 38 others (Group 2) received the cuff with room temperature water. Cases were performed as inpatients and all subjects were administered intravenous morphine postoperatively via a patient-controlled infusion pump for the first 24 postoperative hours. At baseline, the groups were well matched in age, sex, duration of symptoms, operative time, and associated meniscal surgery. No significant difference between groups was detected with respect to length of hospitalization, Hemovac knee drainage, oral and intravenous narcotic requirement, or subjective pain as measured by a visual analog scale. No apparent complications related to the use of the Cryo/Cuff dressings were noted. The clinical effect of the Cryo/Cuff in this study was not influenced by the use of continuous ice water vs. room temperature water. Further study should focus on variations in compression to evaluate the clinical impact of this device.

Adult↗
PubMed1976

In vitro studies of antimicrobial effects of biological dressings. A comparison of the effect of human cadaver split skin grafts; irradiated and deep frozen porcine split skin; and fresh split skin from living humans and pigs.

The in-vitro antimicrobial effect of certain biological dressings was analysed. Glass basins lined with inverted human or pig skin treated and stored in various ways were inoculated with Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli. Glass basins served as controls. Human split skin from cadavers or living donors, deep frozen or preserved in Histocon and fresh-frozen pig had marked inhibitory activity. Heated skin and beta-irradiated pig skin did not have this effect. The antimicrobial effect was not observed during the first 2 hours of incubation but was present after 24 and 48 hours. It was not dependent on serum factors, It is concluded that when a biological dressings is used, advantage should be taken of its bactericidal activity, as infection is often a problem in sound dressing.

Animals↗