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PubMedDate not supplied

Growth peptide release from biologic dressings: a comparison.

Biologic dressings are believed to stimulate wound healing in a variety of wound types. Cryopreserved allograft skin (CAS) is used as a biologic dressing for excised wounds, partial-thickness wounds, and meshed split-thickness skin grafts, and the use of allogenic or autologous cultured epithelial sheets (CES) has been reported to enhance healing of skin ulcers and deep partial-thickness wounds. However, limitations of allograft skin include bacteriologic and viral safety, limited availability, cost, and ease of handling. Previously we have reported the successful use of human keratinocytes cultured to single-layer confluence on Hydroderm polyurethane membranes (HD/HK) for grafting of full-thickness wounds. In this study we evaluated the release of five different growth peptides (transforming growth factors alpha and beta (TGF-alpha, TGF-beta), interleukin-6, interleukin-8, and melanoma growth stimulatory activity from CAS, CES, and HD/HK grafts. Highest levels of TGF-alpha were found for HD/HK (728 +/- 115 pg/10 cm2 of membrane) followed by CES (491 +/- 137 pg/10 cm2; NS). No TGF-alpha was detectable for CAS, and 3.7-fold, and 25-fold higher levels of interleukin-6 were found for CES (257 +/- 12.7 U/10 cm2) compared with HD/HK and CAS, respectively. Interleukin-8 had similar levels for CES (0.65 +/- 0.7 ng/10 cm2) and HD/HK (0.88 +/- 0.12 ng/10 cm2), whereas melanoma growth stimulatory activity was elevated in CES (2314 +/- 97 pg/10 cm2) compared with HD/HK (1071 +/- 55 pg/10 cm2). TGF-beta was barely detectable for CES and HD/HK. Cryopreserved allograft showed high levels of TGF-beta (5.2 +/- 1.6 ng/10 cm2). Overall mitogenic activity of the supernatants on keratinocyte cultures was assessed. Highest proliferation was seen for CES supernatants followed by HD/HK (NS). Supernatants from CAS had an antiproliferative effect on keratinocytes. We conclude that a single layer of keratinocytes cultured on a polyurethane membrane facilitates keratinocyte proliferation similar to CES, whereas cryopreserved allograft has no mitogenic effect on keratinocytes.

Analysis of Variance↗
PubMedDate not supplied

Treatment-resistant pain and distress during pediatric burn-dressing changes.

Recent research has suggested some efficacy for the use of hypnosis in the control of pain and distress in a pediatric population undergoing painful medical procedures. Here, we study a sample (N=23) of pediatric subjects undergoing burn-dressing changes and receiving either an imagery-based or control (social-support) treatment. Subjects' levels of distress were assessed with the Observational Scale of Behavioral Distress. Results indicated that distress behaviors in this population can be measured reliably using this scale. However, no support was found for the main hypothesis that imagery treatment would be superior to control treatment in the alleviation of distress, nor were these treatments effective in comparison to baseline conditions. We discuss the formidable problem that burn and dressing-change pain presents, as well as the reasons why this treatment attempt might have failed to have the predicted effects. We also discuss important developmental considerations regarding the adequate assessment of pain and distress.

Burns↗
PubMed1989

Comparison of an occlusive and a semi-occlusive dressing and the effect of the wound exudate upon keratinocyte proliferation.

Three consecutive studies were performed in 58 patients evaluating the effect of occlusion on the healing of partial-thickness wounds. Mirror-image donor sites were covered with the occlusive hydrocolloid dressing (HCD) (DuoDerm) and compared to fine mesh gauze, and the HCD was subsequently compared to a semi-occlusive dressing of polyurethane film, (Op-site). In addition, partial-thickness burn wounds were covered with the HCD and the remaining burn wound was treated with silver sulfadiazine. The donor sites and burn wounds treated with HCD healed significantly faster than those covered with fine mesh gauze or silver sulfadiazine (p less than 0.001) and with less pain. The HCD and polyurethane film were equivalent. There were no clinical infections with the wounds that were occluded. The exudate collected beneath the DuoDerm and Op-site on donor sites was added to the tissue culture system and resulted in a modest increase in keratinocyte proliferation. However, the exudate from burn wounds under HCD resulted in a marked increase in cell proliferation (p less than 0.001).

Adolescent↗
PubMed2000

Accelerated healing with a mesh autograft/allodermal composite skin graft treated with silver nylon dressings with and without direct current in rats.

PURPOSE: Evaluation of the healing and persistence of a meshed composite skin graft applied without immunosuppression. METHODS: The contraction of wounds grafted with 9:1 split-thickness autograft/1.5:1 allodermal mesh composite skin grafts (auto/allo MCSGs) was investigated. No immunosuppressive agent was applied. Male ACI rats and female Lewis rats reciprocally served as allodermis graft donors and recipients. Autograft/dermal autograft and allograft/dermal allograft MCSGs were the controls. RESULTS: AT 3 months after grafting, when epithelized auto/allo MCSG wounds were measured by computerized morphometric analysis, the silver nylon (SN) dressing group displayed less contraction than the Vaseline (petroleum jelly) dressing group (p < 0.003), and direct current treatment (SNDC) was more effective than SN (p < 0.005). The histologic structures of the hair follicles appear to confine the rejection process to the allogeneic follicles of the graft. The focal nature of the rejection process and the relatively low antigenicity of the dermal matrix allowed the survival of the allodermis layer. Although direct current significantly enhanced MCSG healing, SN and SNDC were not the immunosuppressive agents that were confirmed. CONCLUSION: This type of MCSG can heal without immunosuppressive treatment.

Animals↗
PubMed1981

Use of semipermeable polyurethane membrane for skin graft dressings.

The use of semipermeable polyurethane membrane (Op-site) for skin graft donor-site dressings is now well-accepted. We have used Op-site for skin graft coverage in 25 patients with good results. The dressing modality is not only easy to do, even in anatomically difficult areas, but it also maintains a moist environment, allows daily graft observation, and provides a barrier for exogenous bacteria.

Humans↗
PubMed1982

A comparative study of glycerinized and lyophilized porcine skin in dressings for third-degree burns.

A comparative study of local treatment with lyophilized and glycerinized porcine skin was performed on 100 patients with third-degree burns. We compared the efficiency, simplicity, and cost of preparation of dehydrated, sterile porcine skin for ready use in temporary dressings for burn victims. We conclude that this is a simple, efficient, and safe method, which, because of its low cost, will permit greater use of porcine skin as a temporary substitute in dressings for third-degree burns.

Animals↗
PubMed2003

Dressing for alveolopalatal wounds after alveolar bone grafting.

Cotton gauze with alpha cyanoacrylate was used for alveolopalatal wound dressing after alveolar bone grafting to treat 93 alveolar clefts in 74 cleft patients to reduce mechanical injuries, tension for wound dehiscence, and adhesion of food remnants. T-shaped cotton gauze was put on the gingivoperiosteal flaps and was impregnated with cyanoacrylate. The procedure required no preoperative preparation and its intraoperative execution took less than 5 minutes. The gauze with cyanoacrylate was removed approximately 1 week after surgery. No infection was observed at any of the operational sites, but tiny fistulas developed at four of them. The mean bone graft score was 1.4 point. No complications such as thermal injury resulted from the use of cyanoacrylate. Gauze impregnated with cyanoacrylate proved to be a convenient and dependable dressing for alveolopalatal wounds resulting from gingivoperiosteoplasty for alveolar bone grafting.

Adolescent↗
PubMedDate not supplied

Flushing due to solitary cutaneous mastocytoma can be prevented by hydrocolloid dressings.

Solitary mastocytomas occur commonly and can occasionally be associated with troublesome flushing related to rubbing. We report a child with a solitary mastocytoma who repeatedly and reproducibly caused flushing only with rubbing and scratching. Conventional treatment with antihistamines was not completely effective and caused sedation. A trial application of double-layer hydrocolloid dressing led to complete abolition of flushing episodes until the child reached an age where he could peel off the dressings. This treatment is particularly suited to very young children with solitary mastocytomas whose parents do not feel comfortable with antihistamine treatment, topical or intralesional corticosteroids, or surgical interventions. This treatment may be used alone or in conjunction with conventional therapy where there has been a failure to achieve complete control of flushing and/or blistering.

Colloids↗
PubMed1989

The bacteriology of chronic venous ulcers treated with occlusive hydrocolloid dressings.

The bacterial flora of chronic venous ulcers treated with an occlusive hydrocolloid dressing were studied over a period of 8 weeks. A novel exudate sampling method was used in an attempt to isolate anaerobic bacteria. The flora was generally stable. Once a species was present, it remained with the exception of Pseudomonas, which appeared to be inhibited by the dressing. Twelve out of 20 ulcers contained anaerobic bacteria and healing did not appear to be impaired by the presence of any particular species of bacteria.

Aged↗
PubMed1983

Initial physical tests of aluminoborate cements in the context of periodontal dressing development.

A new glass ionomer cement system (aluminoborate) is under consideration for dental applications, including the possibility of a periodontal dressing material. Following the development of pertinent adhesive and rheological tests, two experimental formulations were selected by a simple screening procedure and subjected to appropriate adhesive tests. One formulation proved satisfactory and was subjected to a rheological test in addition. The possible role of aluminoborates as periodontal dressing materials is discussed.

Adhesiveness↗
PubMed1988

Occlusive hydrocolloid dressings applied to chronic neuropathic ulcers. A study of efficacy in patients at a rural South Indian Hospital.

The response of 47 chronic ulcers (41 neuropathic [leprosy], 3 stasis, 1 traumatic, and 2 of unknown etiology) to hydrocolloid occlusive dressings was evaluated at a rural south Indian hospital. The response to treatment was objectively evaluated by photographic estimation of the surface areas of the ulcers. Eight ulcers healed over the 2 months of the study, and all but one ulcer improved. This type of dressing may have a valuable role in the management of chronic ulcers in the tropics, particularly those due to leprosy.

Adolescent↗
PubMed1992

The effects of occlusive dressings on the recruitment of mononuclear cells by endothelial binding into acute wounds.

Mononuclear cell infiltration is a characteristic feature of wounds and may play an important role in the healing process. We have previously shown that the recruitment of peripheral blood mononuclear cells into wounded skin is an active, dynamic, and regulated process mediated at least in part by specific interactions between mononuclear leukocytes and specialized dermal microvascular endothelial cells in the wounded skin. The purpose of this study was to investigate the capacity of dermal microvascular endothelial cells in wounds exposed to air or covered with occlusive dressings to promote the adhesion of monocytes and lymphocytes. The results showed that dermal microvascular endothelial cells in both air-exposed and occluded wounds were capable of supporting peripheral blood mononuclear cell and monocyte adherence. However, in comparison with air exposed wounds, the level of peripheral blood mononuclear cell binding was significantly higher in occluded biopsies obtained at 0 to 9, 12, 15, and 21 days after wounding. In addition, monocyte and peripheral blood mononuclear cells binding to occluded wounds peaked earlier than peripheral blood mononuclear cell binding to air exposed wounds. These studies provide evidence that differences in the kinetics and magnitude of mononuclear cell adherence may account at least in part for the beneficial effects of occlusive dressing on wound healing.

Animals↗
PubMed1996

A randomized controlled trial of hydrocolloid dressing in the treatment of hypertrophic scars and keloids.

BACKGROUND: Silicone gel sheeting has been investigated for use in the treatments of keloids and hypertrophic scars. Its mechanism of action may be related to scar hydration. OBJECTIVE: The purpose of the present study was to evaluate a hydrocolloid occlusive dressing that also acts by promoting a moist environment. METHODS: In a randomized controlled prospective study, patients were allocated to receive hydrocolloid dressing or moisturizer to keloids or hypertrophic scars. Scar size and volume, color, patient symptoms, and transcutaneous oxygen measurements were taken. RESULTS: There was significantly reduced itching (P < 0.03), somewhat reduced pain (P < 0.08) and increased pliability (10%) for both treatments over 2 months. CONCLUSION: Hydration of the scar for 2 months resulted in symptomatic improvement, but no change in physical parameters.

Adult↗
PubMed1994

Local treatment of pressure sores in the elderly: amino acid copolymer membrane versus hydrocolloid dressing.

OBJECTIVE: To compare the clinical effectiveness and wound management properties of a copolymer membrane, Inerpan (Synthélabo), and a hydrocolloid dressing, Comfeel (Coloplast), in the treatment of decubitus ulcers in the elderly. DESIGN: Open, randomized, multicentric French study, with two parallel groups of patients. PATIENTS: 168 in-patients aged more 65 years (mean age: 82 years) suffering from grade II to grade IV (in the Shea classification) pressure sores. TRIAL PERIOD: Either 8 weeks or until the ulcer healed, whichever occurred first. MEASUREMENTS: In addition to a complete physical examination, patients were evaluated at baseline for nutritional status and risk factors. The wounds were described, their depth scored, and the areas traced at Weeks 0, 1, 2, 4, 6, and 8. The number of dressings used was recorded. RESULTS: Thirty-one Inerpan-treated patients and 23 Comfeel-treated patients achieved healing (P = 0.089), with respective median healing times of 32 and 38 days. Healing times were compared using survival curves (in the whole population) adjusted for ulcer depth effect and showed a significant difference in favor of Inerpan (P = 0.044 and 0.014). Progress of healing (percentage of ulcer healed) was calculated in the two groups. Clinically assessed the treatment performance scored at the completion of the study showed better results with Inerpan (P < 0.05). Both groups were similar in terms of granulation/exudation scores, surrounding skin, and ease of care. CONCLUSION: It is concluded that Inerpan is easy to use, safeguards the healing process, and is of particular value in the management of pressure sores.

Age Factors↗
PubMed1976

The use of chlorhexidine mouthwash compared with a periodontal dressing following the gingivectomy procedure.

The clinical results achieved were compared when a group of 21 patients requiring gingivectomies in comparable bilateral segments received a dressing or a chlorhexidine mouthwash during the first post-operative week. Initial pre-operative conditions were comparable. In each of the two treatments highly significant reductions in pocket depths were achieved; the sizes of the reductions were of clinical significance (greater than 1.5 mm). The observed difference (0.16 mm) between the two treatments in favour of the mouthwash, although significant at the conventional 5% level, was clinically unimportant. More patients preferred the dressing as a post-operative treatment, and the clinical implications of the patients' preferences are discussed.

Adult↗
PubMed1977

Some antibacterial properties of periodontal dressings.

Three commercial periodontal dressings were tested for antibacterial activity against salivary microorganisms after having been stored dry or in liquid for 1 and 2 days. Inhibition of growth of mixed salivary flora was evaluated on blood agar dishes. Also, the ability of Strep. mutans to colonize the surface of the dressings was tested. The surface contact test indicated antibacterial activity against salivary microorganisms by freshly made Coe-pak and Wondrpak. Some activity could also be observed after 2 days' storage in about half the experiments. The initial bacteriostatic effect of Peripac was limited to the setting phase. The plaque accumulation test revealed single cells only on the surfaces of Coe-pak and Wondrpak whereas Peripac seemed to be colonized by the test bacteria.

Bacteriological Techniques↗