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At least 1,117 records · Page 62Linked to original sources
PubMed2003

So-called biological dressing effects of cultured epidermal sheets are mediated by the production of EGF family, TGF-beta and VEGF.

BACKGROUND: Cultured epidermal sheet (CES) grafts accelerate wound healing as a result of so-called biological dressing effect, which is thought to be mediated by various growth factors. However, the profile of growth factor expression in CESs is unclear. OBJECTIVE: To investigate whether CESs produce growth factors along with stratification we investigated the production of growth factors and their regulation in CESs. METHODS: CESs conditioned medium was harvested and the concentration of TGF-alpha, TGF-beta1, TGF-beta2, and VEGF was measured using ELISA. The mRNA of EGF family, TGF-beta family and VEGF was detected by Northern blot or RNase protection assay. RESULTS: The concentration of TGF-alpha was 100 pg/ml in the monolayer culture, but dramatically increased to 600 pg/ml 2 days after stratification. It decreased to baseline, and then gradually increased to 300 pg/ml in the presence of EGF and remained at that level until day 20. TGF-beta1 increased from 50 to 400 pg/ml after stratification, and remained at that level day 20. TGF-beta2 was undetectable in the monolayer culture, but dramatically increased to 200 pg/ml 2 days after stratification. Unlike TGF-beta1, TGF-beta2 gradually increased over time after stratification. VEGF increased with stratification from 500 to 1500 pg/ml. The addition of EGF upregulated EGF family, TGF-beta, and VEGF production in CESs, as confirmed by ELISA, Northern blot, and RNase protection assay. CONCLUSION: These results indicate that so-called biological dressing effect of CESs is mediated by production of the EGF family, TGF-beta, and VEGF. Our results also demonstrate the ability of EGF to enhance growth factor production in CESs.

Biological Dressings↗
PubMed1999

Techniques for applying subatmospheric pressure dressing to wounds in difficult regions of anatomy.

Subatmospheric pressure dressing (SPD) has been commercially available in the United States since 1995 as the vacuum-assisted closure (VAC) device. SPD increases local blood flow, decreases edema and bacterial count, and promotes the formation of granulation tissue. Despite recent clinical successes with the use of SPD in a variety of wound types, problems may occur with application of VAC system in certain areas of the body. The main limitation occurs when attempting to maintain an airtight seal over irregular surfaces surrounding a wound. For example, application of the adhesive drape and creation of a seal are particularly difficulty in the hip and perineum. In addition, wounds of the lower extremity can occur in multiple sites, posing the problem of providing a vacuum dressing to more than one wound from one suction pump machine. To address these challenging clinical wounds, we have developed techniques to allow the successful application of SPD to sacral pressure ulcers near the anus, and to multiple large lower extremity ulcers.

Adhesives↗
PubMed2000

Efficacy and safety of wet-wrap dressings in children with severe atopic dermatitis: influence of corticosteroid dilution.

BACKGROUND: The wet-wrap treatment involves emollients or corticosteroid dilutions under occlusive wet dressings, and has been reported to be highly effective in severe refractory atopic dermatitis (AD). OBJECTIVES: To investigate the influence of different corticosteroid dilutions on the efficacy and hypothalamic-pituitary-adrenal (HPA) axis suppression in children with severe refractory AD having wet-wrap dressings. METHODS: Eighteen children were treated with a 50% dilution of fluticasone propionate (FP) 0.05% cream for 2 weeks. In another five children a side-to-side comparison was conducted with 10%, 25% and 50% dilutions of FP cream under wet wrap. A third group of eight children was treated with 0% (= emollient), 5%, 10% or 25% dilutions of FP cream applied on the whole body under wet wrap. RESULTS: After 1 week, a major improvement averaging 74% was observed, without apparent differences between 5%, 10% or 25% dilutions of FP cream under wet wrap, with less improvement in the second week of treatment. The first and second group of children showed HPA axis suppression in only three of 23 children using measurements of 09.00 h serum cortisol after 2 weeks. The third group of children showed HPA axis suppression, as indicated by 06.00 h serum cortisol levels, which was related to the absolute amount of FP applied. CONCLUSIONS: This suggests that weaker corticosteroid dilutions had comparable high efficacy, but lower risk of HPA axis suppression.

Administration, Topical↗
PubMed2000

Bifonazole (Mycospor cream) in the treatment of moccasin-type tinea pedis. Comparison between combination therapy of bifonazole cream + 10% urea ointment (Urepearl) and occlusive dressing therapy with the same agents.

Moccasin-type tinea pedis(MTTP) is a hardly curable superficial dermatomycosis primarily characterized by hyperkeratosis of the sole. In this study, we compared the usefulness of combination therapy of bifonazole (Mycospor cream) + 10% urea ointment (Urepearl) (overlapping application group = group I) with occlusive dressing therapy with the same agents (group II) in the treatment of MTTP, and obtained the following results. (1) The clinical improvement rate (percentage of "marked improvement" and "moderate improvement") was 60.4% in group I and 83.3% in group II. (2) The mycological eradication rate was 48.7% in group I and 82.1% in group II after 4 weeks of treatment and 90.9 and 96.9%, after 12 weeks of treatment, respectively. (3) The clinical utility rate (percentage of "very beneficial" and "beneficial") was 83.3% in group I and 93.8% in group II. These results indicate the superiority of both combination therapy of bifonazole + 10% urea ointment (overlapping application group) and occlusive dressing therapy with the same agents in terms of efficacy and safety for the treatment of MTTP, and suggest that they can be recommended for treatment of patients for whom it is difficult to use oral antimycotic agents or for patients who fail to respond to oral medications alone.

Administration, Topical↗
PubMed2000

Wound care following CO2 laser resurfacing using Kaltostat, Duoderm, and Telfa for dressings.

BACKGROUND: There are a variety of dressings available for wound care following CO2 laser resurfacing. OBJECTIVE: To share the experience of using Kaltostat and Duoderm for wound care following laser resurfacing. METHODS: A total of 27 patients underwent laser resurfacing, including 12 for wrinkles and 15 for acne scars. Kaltostat pads and Duoderm sheets were cut into appropriate shapes to cover the laser-treated areas. The patients' families changed the dressings when the exudate accumulating under Duoderm began to leak. Kaltostat pads were used only for the first 2-3 days when the amount of discharge was profuse. Telfa pads were used rather than Kaltostat in two cases. Duoderm alone was used thereafter to the day of complete reepithelialization. Patients returned to the hospital on days 4, 7, and 10. RESULTS: Complete reepithelialization occurred by day 7 in patients with wrinkles and day 10 in patients with acne scars. The degree of postoperative erythema was mild to moderate. CONCLUSIONS: Duoderm worked well for postresurfacing wound healing. Kaltostat fibers were difficult to remove totally. Telfa pads can be used instead of Kaltostat.

Alginates↗
PubMedDate not supplied

Effects of nitric oxide releasing poly(vinyl alcohol) hydrogel dressings on dermal wound healing in diabetic mice.

Healing of chronic wounds such as diabetic foot ulcers is a significant clinical problem. Methods of accelerating healing in these difficult lower extremity sites include use of growth factor-loaded gels, hyperbaric oxygen, grafts, and artificial skin replacements. Nitric oxide (NO) has been proposed as a possible active agent for enhancing wound healing. This study examines the in vitro and in vivo responses to a novel hydrogel that produces therapeutic levels of NO. A hydrogel wound dressing was fabricated using ultraviolet light-initiated polymerization from poly(vinyl alcohol) with a NO donor covalently coupled to the polymer backbone. NO release from the NO-modified hydrogel was shown to occur over a time period of up to 48 hours, and there was no associated decrease in fibroblast growth or viability in vitro associated with NO hydrogels. Fibroblasts in culture with NO hydrogels had an increased production of extracellular matrix compared with cells cultured without the NO hydrogels. Preliminary animal studies in a diabetic mouse, impaired wound healing model were conducted comparing low (0.5 mM) and high (5 mM) doses of NO. Time to complete closure was similar in control wounds and NO-treated wounds; however, at 8 days control wounds were significantly smaller than NO-treated wounds. By days 10 to 13 this delay was no longer apparent. Granulation tissue thickness within the wounds at days 8 and 15 and scar tissue thickness after wound closure were increased in animals exposed to higher dose NO hydrogels. The results of this study suggest that exogenous NO released from a hydrogel wound dressing has potential to modulate wound healing.

Animals↗
PubMed2000

Clinical experience with the negative pressure wound dressing.

Between 1997 and 1999, more than 300 patients have been treated using negative pressure wound dressings. The technique has been used successfully to prepare various acute, chronic or infected wounds to accept a skin graft or flap, and to promote graft take at difficult donor sites. The advantages include rapid healing by secondary intention, reduced time to skin grafting, an increase in the rate of graft take and a reduction in donor site complications. The dressing can be applied quickly and easily and there have been no serious complications.

Humans↗
PubMed2004

["Abdominal dressing" - a new method of treatment for open abdomen following secondary peritonitis].

INTRODUCTION: Treatment of open abdomen following secondary peritonitis is a challenge for surgery and intensive care units (ICU). The aim of this study was to compare three different concurrent treatment strategies. METHODS: Patients suffering an open abdomen following surgery for secondary peritonitis at the Department of General Surgery from 01/01 to 12/03 were investigated. Factor studied: duration of open abdomen, incidence of multi-organ failure, need for surgical revisions, length of stay (LOS) in ICU, nursing requirements (change of dressing/day), survival and integrity of abdominal wall after discharge. Treatment strategies included: open packing (OP), classic vacuum assisted (V.A.C.(R))-therapy with silicone net protection for the intestine (CV) and V.A.C.(R)-therapy with "abdominal dressing" a newly developed meshed polyvinyl wrap (AD). RESULTS: 21 patients were studied: 5 patients were treated with OP, 8 patients with CV and 8 patients with AD. Mean LOS was 65 (OP) vs. 53 (CV) vs. 42 (AD) days (NS), peritonitis related death was 3 (OP) vs. 1 (CV) vs. 0 (AD) (p < 0.05 Chisquare test). Median nursing effort was 4 dressings/day (OP), 0.5 (CV) and 0.5 (AD) (p < 0.005 OP vs CV, AD Kruskal-Wallis test). CONCLUSION: The "abdominal dressing"-therapy seems to be a more efficient treatment option in patients suffering from open abdomen following secondary peritonitis. A trend towards shorter ICU-LOS, lower mortality rates and reduced nursing requirements support our hypothesis.

Critical Care↗
PubMed2001

Remission and relapse of chronic plaque psoriasis treated once a week with clobetasol propionate occluded with a hydrocolloid dressing versus twice daily treatment with clobetasol propionate alone.

BACKGROUND: Many studies have shown the clinical efficiency of occlusion therapy for psoriasis, particularly corticosteroids used under hydrocolloid dressings. However, there are no data from comparative clinical studies evaluating the remission and relapse characteristics of such occlusion therapy compared with orthodox topical steroid monotherapy. METHODS: In a randomised, open-label, parallel group study from three centres, the remission and relapse characteristics were investigated for the use of a hydrocolloid dressing (HCD) over clobetasol propionate 0.05% lotion once a week compared with the same steroid in ointment formulation used unoccluded twice a day in 61 patients with stable chronic plaque psoriasis. RESULTS: There was a pronounced treatment difference in favour of the HCD + clobetasol propionate lotion group with respect to time to clearance, but there was little evidence for a difference with respect to time to relapse. CONCLUSION: The combination of the HCD + clobetasol propionate lotion provides a fast and highly effective remission induction.

Administration, Topical↗
PubMed2002

Weekly transparent dressing changes linked to increased bacteremia rates.

BACKGROUND: In 2000, the rate of primary bloodstream infections (BSIs) was double that in 1999 for intensive care unit (ICU) patients with triple lumen catheters, pulmonary artery catheters, or both. In December 1999, changes in products and practices related to site care were implemented as a cost-saving initiative. OBJECTIVE: To determine the factors contributing to an increase of BSIs after cost-saving measures for site care had been introduced. DESIGN: Epidemiologic study involving prospective identification of infection. SETTING: A community teaching hospital. PARTICIPANTS: Patients in a 20-bed, medical-surgical ICU identified as having triple lumen catheters, pulmonary artery catheters, or both and a primary BSI during 2000 and 2001. METHODS: Alcohol swab sticks were reintroduced and the frequency of transparent dressing changes and site care was increased. Inservice presentations were conducted on aseptic technique and posters were placed reviewing site care protocol for physicians and nurses. RESULTS: The incidence of primary BSIs decreased significantly (P = .003) during a 3-month intervention and this decrease was sustained through the following 12 months. CONCLUSIONS: Prolonging the interval between the change of transparent dressings from 3 times weekly to once weekly and switching from alcohol swab sticks to pads was associated with an increase in BSIs, which was controlled after returning to the original policy.

Acute Disease↗
PubMed2006

Update on tissue-engineered biological dressings.

Tissue-engineered biological dressings offer promise in the treatment of burns, chronic ulcers, donor site and other surgical wounds, and a variety of blistering and desquamating dermatologic conditions. For example, the prevalence of diabetic foot ulcers ranges from 4.4% to 10.5% of diabetics, resulting in 82,000 lower extremity amputations annually; venous leg ulcers affect 0.18% to 1.35% of the population; and pressure ulcers are found in 5.0% to 8.8% of institutionalized patients and 14.8% of patients in acute care facilities. Despite the large number of potential beneficiaries, cellular tissue-engineered products have suffered setbacks in recent years and have garnered considerably lower market share than commercial promoters anticipated. The mechanism of action of these products is not universally agreed upon, but delivery of growth factors and extracellular matrix components to the wound is thought to be important; graft "take" is not usually considered to occur. These "engineered" products do not specifically match a treatment modality to an underlying pathology. Clinical effect is often modest, and sometimes not justi- fiable from a cost-benefit perspective. Nevertheless, clinical reports in the literature of uses of tissueengineered biological dressings continue to mount, indicating that these products are finding niche applications where clinical utility is high and the cost can be defended. Despite commercial setbacks, the first-approved products, Dermagraft, Apligraf, and Cultured Epidermal Autograft (Epicel) are still being marketed, and new ones, such as OrCel, continue to be developed. The major indications for these products are summarized and a brief review of the available clinical literature is offered.

Biological Dressings↗
PubMed1980

Biological dressings in burns--a review.

A history of the development of the various biological dressings is presented. Substances currently in use--homografts, heterografts (including amniotic membranes), collagen-based dressings, and synthetic films--are reviewed in terms of their indications for use, method of application, future, and advantages and disadvantages.

Amnion↗
PubMed1981

Monitoring, banking, and clinical use of amnion as a burn wound dressing.

The preparation of human amniotic membrane obtained from cesarean delivery placentas for use in the treatment of acutely burned pediatric patients is presented. The technique of membrane harvesting and cleansing, bacteriological monitoring during various phases of preparation, and a method of ultracold long-term banking are described. A total of 187 membranes were stripped under aseptic conditions, cultured, treated in 0.025% sodium hypochlorite (NaOCl) for one minute and recultured. Fourteen organisms were recovered prior to NaOC1 treatment, and only 8 organisms after treatment. Amnions that grew any organism after hypochlorite treatment (23%) were deemed unsuitable for clinical use. Clinical experience with amniotic membranes in 36 acutely burned patients suggests that amnion is a cost-effective biological dressing, acceptable as an immediate dressing on superficial second-degree burns. It is also acceptable as an adjunct to meshed autograft over fascia, and as a temporary covering on recently excised wounds prior to autografting.

Adolescent↗
PubMed1985

A simple dressing to keep secreting wounds dry.

A simple method to dress secreting wounds using readily available materials is described. The dressing allows secretions and blood to pass freely through, leaving the wound clean and dry.

Bandages↗
PubMed2003

Tegaderm transparent dressing (3M) for the treatment of chronic exposure keratopathy.

We report an effective alternative treatment of profound chronic exposure keratopathy in a proptotic eye due to intraorbital extension of basal cell carcinoma. The corneal surface gradually reepithelialized in a 6-week period after the first application of Tegaderm transparent dressing (3M, St. Paul, MN, U.S.A.) with instillation of antibiotic ointment on the ocular surface. The patient has been comfortable with an intact epithelial surface, a vascularized cornea, and nonirritated surrounding skin after changing the Tegaderm dressing daily for 15 months. There was no evidence of recurrent corneal ulceration or infiltrations. We conclude that Tegaderm represents a useful treatment of exposure keratopathy due to chronic proptosis.

Aged↗
PubMedDate not supplied

Healing characteristics of expanded autografts on wounds covered with homograft and Biobrane temporary wound dressing.

This study compared the healing characteristics of expanded autografts on wounds with interstices that were closed with cryopreserved cadaver homograft split-thickness skin and wounds with interstices that were closed with the synthetic skin substitute, Biobrane temporary wound dressing. Nine paired wounds in four patients with large burns were used in this study. When Biobrane temporary wound dressing adhered to a wound, epithelial migration did not proceed until it was removed. Although wounds covered with homograft immediately had the appearance of healed wounds, biopsy specimens showed evidence of a delay in epithelial migration. Although these results indicate impaired epithelial migration with the use of both materials, we concluded that homograft offered an advantage because the wounds that were covered with it remained closed during the entire reepithelialization process.

Adult↗
PubMedDate not supplied

Meshed Biobrane: a dressing for difficult topography.

Biobrane temporary biosynthetic skin substitute has been well demonstrated in the treatment of superficial and deep wounds. We have used this product nearly 1000 times. It has previously been shown to be ineffective for use in areas with convex or concave topographies or in areas along joint surfaces. The following study covers an attempt to adapt this dressing for use in these difficult areas. Ninety-eight applications of meshed Biobrane temporary wound dressing were placed in anatomic locations, which ranged from the head to the foot, with an 86% success rate.

Biocompatible Materials↗