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PubMed2004

Using a new lipidocolloid dressing in paediatric wounds: results of French and German clinical studies.

OBJECTIVE: To evaluate the efficacy, tolerance and acceptability of a lipidocolloid dressing, Urgotul (Laboratoires Urgo), in the local treatment of acute and chronic paediatric wounds. METHOD: Two non-comparative multicentre prospective clinical studies were conducted using the same protocol in France and Germany. A total of 100 patients were recruited from 16 centres (11 in France and five in Germany), and followed up for four weeks. Seventy wounds (55 burns and 15 other wounds) from France and 30 from Germany (22 burns and eight other wounds) were evaluated by nursing staff at every dressing change and by the medical investigator on a weekly basis. RESULTS: In the French study population, 86% of the burns (superficial and deep partial-thickness) and 53% of the other wounds healed completely within the four weeks. Figures for the German study population were 100% and 88% respectively. Pain was evaluated using pain scales adapted to the patient's age (objective pain scale, faces scale for pain and a visual analogue scale) at each dressing change. Dressing removal was non-traumatic, inducing very limited pain. Minor local adverse events were reported in four children. CONCLUSION: Urgotul is not only efficacious, but also well-tolerated and accepted by children with acute and chronic wounds. The dressing, therefore, might be an appropriate and highly promising alternative to conventional dressings.

Bandages, Hydrocolloid↗
PubMed1998

[Case report about the combined use of 2 moist wound dressings in the treatment of a chronic diabetic foot ulcer].

INTRODUCTION: Approximately 4.5% of the Spanish population suffer from Diabetes Mellitus (that means around 1.8 million people). Currently, the main problem that diabetes treatment presents is controlling its chronic complications, being the diabetic foot one of them, which can end up causing an amputation. Prevalence of ulceration varies according to sex, age and population characteristics, oscillating between 2.4% and 5.6%. In Catalonia, in a community case study, the prevalence was of 7.9%. In the same way, it has been calculated that at least 15% of diabetics will suffer from foot ulcerations during their lives. MATERIAL AND METHODS: A clinical case regarding a diabetic neuropathic chronic ulcer highly exuding was made to analyze the effect of this new dressing in the daily clinical practice. CombiDERM is an absorbent dressing with an external polyurethane plate and a central part with absorbent hydroparticles, indicated for the management of the exudate and the protection of the surrounding skin. 64-year-old woman, who suffered from Diabetes Mellitus type I to 28 years evolution with Retinopathy grade II, Artropathy of Charcott and a neuropathic ulcer of 4 years evolution. She was admitted in the Vascular Surgery Service the 6th of May of 1995 presenting an ulcer with signs of local infection in the sole of her left foot. Different local treatments were established and improvement periods were alternated with non-improvement periods, giving as a result an unfavorable evolution of the wound. The treatment with CombiDERM was established, using AQUACEL Ribbon (Hydrofiber dressing) as filling material. To evaluate the continuation of the treatment photos and acetates were taken, and data was registered in a Case Report Form. RESULTS: At the beginning the ulcer presented a high level of exudate, no signs of infection, light pain and the skin surrounding the ulcer was lightly macerated. After nine days of treatment an improvement of the ulcer could be observed, with the presence of granulating tissue. On the twenty-fourth day, granulation in the bed of the wound was completed and the quantity of exudate had reduced significantly. Application and removal of the dressing was easy and without pain. The evolution of the lesion was very good, without signs of infection, and with a graded epithelization until the ulcer was completely healed, at the eleventh week of the treatment with the new dressing. (The surface of the ulcer decreased from 557.67 mm2 to 0 mm2). CONCLUSION: Having in mind the good evolution of this ulcer and the characteristics of CombiDERM, the new dressing is an optimal alternative in the treatment of highly exuding diabetic neuropathy ulcers.

Diabetic Foot↗
PubMed1991

Comparison between Eusol and Silastic foam dressing in the postoperative management of pilonidal sinus.

Seventy-five consecutive patients with pilonidal sinus disease were randomized to receive either Eusol dressings or Silastic foam dressings. Patients were divided into those with pilonidal sinus and pilonidal abscess. There was no significant difference between time to hospital discharge or time to full healing in either group. The cost benefits and simplicity of Silastic foam dressing are discussed.

Abscess↗
PubMed1987

The newer surgical dressings and wound healing.

In summary, there are a variety of new synthetic surgical dressing materials available today. Although individual physician preferences and differences in the type of injury may determine which of these membranes is utilized in a given clinical situation, they all serve to speed the rate of epithelialization, to decrease motion within the healing wound, to decrease postoperative pain, and to minimize the potential for bleeding and infection. For all of these reasons, a complete knowledge of these dressings and their uses will greatly enhance the surgeon's ability to care more satisfactorily for the patient with a cutaneous wound.

Bandages↗
PubMedDate not supplied

[Report of an update on products used in the treatment of ulcers].

We have studied some of the new products either at experiment stage, or else already on the market, used in the treatment of leg-ulcers. In terms of the way in which they act we draw a distinction between: synthetic powders with adsorbent power (Bard and Iodosorb); synthetic dressings with a semi-adsorbent power (Aloxan and Silastic); and synthetic dressings with no adsorbent power (Synthaderm). We give a personal impression of each of them, together with their indications, advantages, and disadvantages.

Humans↗
PubMed1997

Bacteriostatic and biological stimulation effect of Mepitel on experimental burns on the skin of rats.

This study was conducted on 200 white Wistar rats weighing about 200 g each. The animals were divided into two equal groups--an experimental one, with Mepitel (SCA Mölnlycke) dressings, and a control group with cotton gauze dressings. Microbiological and histological examinations and measurements of the wounds made on the 3rd, 7th, 14th, 21st and 28th days after the 3rd-degree heat burn was inflicted using the standard method. The observations included burns with the spontaneous elimination of necroses and healing; wounds after operative total necrectomy of the burnt skin and spontaneous healing; and burns followed by total surgical necrectomy and grafting with allotransplants. The quantitative results reveal statistically reliable bacteriostatic activity above and under the Mepitel dressing. The histological examination reveals considerable biological activity in the tissues under the Mepitel. This manifests itself as an acceleration in the healing process in the wounds caused by burns and after necrectomy of the burnt skin. Mepitel on the allotransplant on the wound, which was left following the necrectomy of the burnt skin provokes the rapid and early rejection of the allograft. Mepitel's biological activity has also been confirmed by the statistically-reliable data relating to the dynamic changes in the length and breadth of the wounds. The authors came to the conclusion that, when applied immediately to a burn or a wound left following the necrectomy of skin burns, Mepitel suppresses the development of the microbiological flora and stimulates the normal healing process. Mepitel is not suitable for dressing allotransplants because of the rapid acceleration of their rejection.

Animals↗
PubMed1998

The effects of cadexomer iodine paste in the treatment of venous leg ulcers compared with hydrocolloid dressing and paraffin gauze dressing. Cadexomer Iodine Study Group.

BACKGROUND: The aim was to examine cadexomer iodine paste in a comparative clinical trial. METHODS: A 12-week, randomized, open, controlled, multicenter, multinational trial in patients with exudating, venous leg ulcers of cadexomer iodine paste (Iodosorb/Iodoflex), hydrocolloid dressing (Duoderm E, Granuflex E), or paraffin gauze dressing (Jelonet) was carried out. All patients used short-stretch compression bandages (Comprilan) throughout the study. The primary efficacy variable was a reduction in ulcer size (%), and the secondary end-point was the time taken to stop exudation, when the patient had completed the study according to the protocol. A total of 153 patients entered the study and were treated for 12 weeks or until cessation of exudation. RESULTS: The mean reduction in ulcer size in all patients was 62% with cadexomer iodine vs. 41% and 24% for hydrocolloid and paraffin gauze (ns). Of those treated for 12 weeks (n = 51), ulcer area reduction was 66% for cadexomer iodine and 18% for hydrocolloid (p = 0.0127). For the whole material, the rate of healing (ulcer area reduction per week) was significantly higher for cadexomer iodine than for paraffin gauze (0.64 cm2/week vs. 0.19 cm2/week, p = 0.0353). The treatment costs were similar in all groups; however, when the costs were correlated with healing over a 12-week period, cadexomer iodine paste was found to be more cost effective than hydrocolloid dressing or paraffin gauze dressing. CONCLUSIONS: This study shows that cadexomer iodine paste is an efficient, cost-effective and safe alternative to hydrocolloid dressing and paraffin gauze dressing for the treatment of venous leg ulcers.

Adult↗
PubMed2000

Effect of hydrocolloid dressings on healing by second intention after excision of pilonidal sinus.

OBJECTIVE: To assess the efficacy of hydrocolloid dressings in wound management after excision of pilonidal sinus. DESIGN: Prospective randomised trial. SETTING: District hospital, Spain. PATIENTS: 38 patients with chronic pilonidal sinus. INTERVENTIONS: Open excision with healing by second intention. Divided into three groups: conventional gauze dressing (control, n = 15), Comfeel (n = 12) and Varihesive (n = 11). MAIN OUTCOME MEASURES: Median healing time, infection rate, intolerance, pain, comfort, ease of management, leakage, and recurrence. RESULTS: Median healing time was 68 days (range 33-168) in the control group, compared with 65 days (range 40-137) in the two hydrocolloid groups combined. There were no differences between the hydrocolloid groups. There were no recurrences during the 74 months of follow-up. A third of the postoperative cultures in the control group grew pathogens compared with 1/23 of the patients treated with hydrocolloid dressings (p = 0.03). This was of no clinical relevance. 14/23 in the hydrocolloid group developed leaks. Pain was significantly less in the first four postoperative weeks among the patients in the hydrocolloid group than in the control group (p < 0.05). CONCLUSIONS: Hydrocolloid dressings lessen pain and increase comfort for patients after excision of pilonidal sinus, though time to healing is no shorten than when a conventional gauze dressing is used.

Adolescent↗
PubMedDate not supplied

Use of Biobrane in wound management.

Biologic dressings remain the gold standard for temporary wound coverage and closure and as a skin substitute. However, increasing interest has resulted in numerous synthetic wound dressings and skin substitutes modeled after biologic dressings. In 1979 Biobrane was introduced for commercial use in the treatment of burn wounds and donor sites. Biobrane is a biosynthetic wound dressing constructed of a silicone film with a nylon fabric partially embedded into the film. Collagen is incorporated in both the silicone and nylon components. The purpose of this conference is to evaluate the effectiveness of Biobrane as a wound dressing with the 15 years of clinical experience used to define the best indications for its present use.

Biocompatible Materials↗
PubMed2004

Comparison of bacteria-retaining ability of absorbent wound dressings.

Fibrous materials in some modern absorbent wound dressings have the ability to sequester and retain bacteria; however, this ability varies according to the nature of the fibres. We studied the bacterial retention capacity of alginate and carboxymethylcellulose dressings, using an infected skin ulcer model on the backs of rats. Wound surfaces were inoculated with either Staphylococcus aureus or Pseudomonas aeruginosa at a concentration of 1.5 x 10(6) colony-forming units per wound. AQUACEL; Hydrofiber;, Kaltostat; or Sorbsan; were applied to the contaminated wounds for 12 h. Each dressing was then divided into two pieces. Total viable bacterial count within the dressing was calculated using one piece, and bacterial count released from the dressing into physiological saline was determined using the other piece, enabling bacterial retention rate to be calculated. Bacterial counts in tissue were also determined. Each dressing was tested on each of 10 wounds contaminated with each bacterium. Statistical analyses were performed using one-way analysis of variance (ANOVA) for replicated measures combined with Duncan's multiple comparison test. AQUACEL; Hydrofiber; dressing was most effective in its ability to retain both Staphylococcus aureus and Pseudomonas aeruginosa (p < 0.05). Bacterial counts in tissue showed no significant change with respect to pathogen or the type of dressing used. It can be concluded that the bacterial retaining ability of AQUACEL; Hydrofiber; dressing was found to be significantly higher than that of alginate dressings in an infected animal wound model.

Absorption↗
PubMed2004

Comparison of four different dressings on donor site wounds.

Following nursing observation of the difficulties of healing of donor site wounds, including trauma and pain on removal of dressings, a blind randomized study was undertaken to determine which of four dressings provided the greatest comfort, had the fastest healing time and could be removed without trauma. Forty patients had one of four dressings applied in theatre: paraffin gauze, alginate alone, alginate with film cover or film alone. An observer was present who was unaware of the dressing used and recorded patient observations and nursing records for information. The study revealed that the dressing that caused patients most discomfort and trauma on removal was paraffin gauze. Alginate with film dressing was found to be most successful in treating these patients.

Adolescent↗
PubMed1998

Costs of dressings in the community.

This study compares the costs of dressings used in the treatment of patients with a variety of wound aetiologies. The two dressings investigated were a hydrocolloid dressing and a hydrocellular dressing. Secondary objectives included a comparison of dressing durability, time to complete healing, ease of wound cleansing and dressing removal. The study was an open prospective single-centre randomised parallel group trial involving 100 patients, treated in the community, who were randomised to the two dressing groups. For all aetiologies except pressure sores, the costs of the hydrocolloid dressing were less than the costs of the hydrocellular dressings. Similar healing rates were observed in the leg ulcer and 'other wound' groups. There were, however, significant differences in the number of healed wounds observed in patients with pressure sores treated with the hydrocellular dressing.

Aged↗
PubMed1995

A new silicone rubber dressing used as a temporary dressing before delayed split skin grafting. A prospective randomised study.

In cases of split skin grafting after wide local excision of malignant melanoma or other tumours, the graft is often delayed for one or two days to reduce bleeding underneath it. Paraffin gauze and an absorbent dressing may be used as a temporary dressing before the application of the skin graft. Paraffin gauze, however, has the disadvantage that it often adheres to the wound bed making removal time-consuming and causing pain and bleeding. A new, fine-mesh polyamide netting covered with silicone (Mepitel, Mölnlycke) was therefore tested in a randomised prospective study with paraffin gauze as the control. There were significant differences between the two groups in terms of the adherence of the dressing, the time needed to remove the dressing, pain, and bleeding. Mepitel was superior to paraffin gauze because it adhered less to the wound bed, the time needed to remove the dressing was shorter, and it caused less pain and less bleeding.

Adult↗
PubMedDate not supplied

[Experimental and clinical use of various forms of immobilized proteinases and their inhibitors].

Analysis of the data obtained in experimental (971 animals) and clinical (250 patients) studies with various immobilized proteinases and their inhibitors showed that this approach to enzymotherapy is a perspective one. Immobilized enzymes and inhibitors exceeded distinctly the native preparations in therapeutic efficiency and were devoid of their disadvantages (low stability and autolysis of proteinases, inactivation by inhibitors, occurring in blood and tissues, rapid elimination of the inhibitors from the organism). Wide use of immobilized enzymes and inhibitors in medical practice offered new possibilities in surgery, shortened distinctly the duration of patients treatment and enabled to decrease the doses of drugs and consumption of dressing materials.

Acute Disease↗
PubMed1996

Application of benzyl hyaluronate membranes as potential wound dressings: evaluation of water vapour and gas permeabilities.

Membranes of 75% and 100% benzyl hyaluronate esters (percentage of total carboxylate groups esterified) were prepared and their water vapour, oxygen and carbon dioxide transmission rates determined. The values of these properties were compared with the values obtained for several commercial wound dressings under the same conditions. The benzyl hyaluronate membranes showed water vapour transmission rates (2157-2327 gm-2 per day) comparable to those from commercial skin dressings (426-2047 gm-2 per day). In the dry state, the benzyl hyaluronate membranes showed lower oxygen and carbon dioxide transmission rates. Taking into account the biocompatibility of the hyaluronic acid esters, and the possibility that therapeutic agents could be incorporated into these membranes, the results indicate that the benzyl hyaluronate membranes have potential wound dressing applications.

Biocompatible Materials↗