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A detailed review of periodontal dressings is presented, covering physical, chemical and biological aspects. Areas requiring further research are outlined, particularly in the physico-chemical sphere; and some contra-indications to particular substances are described. It is concluded that there is a definite place for dressings, but that more knowledge is required before optimal properties can be developed.
Adhesion to enamel is an important aspect of periodontal dressing retention. Details of tensile and shear bond strengths are presented for three dressing materials and a positive polycarboxylate control, and the data are discussed with regard to optimum levels of retention. A level of 2 MN/m2 is suggested for shear bond strength, and 1 MN/m2 for tensile bond strength, under the test conditions employed.
Corethium 2 has been known to be a valuable biological dressing which encourages re-epithelization in cases of tissue loss, especially in varicose ulcers. It ensures a superior quality of healed tissue even in difficult chronic cases. It also reduces the overall treatment time and can be used as an out-patient dressing.
BACKGROUND: The use of silicone oil in the treatment of hypertrophic scars has recently been much discussed. Silicone gel and silicone cream containing 20% silicone oil have been demonstrated to effectively treat hypertrophic scars. However, the results in treating keloid are variable. OBJECTIVE: The purpose of this study was to evaluate the clinical efficacy of silicone cream with occlusive dressing in the treatment of keloid. METHODS: An open study was performed in 15 Chinese patients with single or multiple keloids. Nineteen keloids were randomly selected and treated with silicone cream occlusive dressing (SCOD). The effectiveness was assessed using a scoring system involving elevation, redness, hardness, itching and tenderness or pain of the lesions. RESULTS: Fifteen out of 19 keloids (79%) showed significant improvement after using SCOD for 6 months. None of the keloids progressed. CONCLUSIONS: We conclude that SCOD is easy to apply, noninvasive, painless, almost free of side effects. It is especially useful in children and those who cannot tolerate the pain or inconvenience of other treatment procedures. The action mechanism of SCOD is still unclear, though hydration and occlusion rather than silicone itself may play an important role.
The linear dimensional changes of three commercial periodontal dressings were measured during 24 hours. The dressings revealed different degrees of dimensional changes, which may indicate that exhibit variations in adaptation to wound surfaces.
The cytotoxicity of three periodontal dressings was evaluated by two in vitro cell culture techniques. Fresh and stored materials were found to be cytotoxic by both techniques and it appeared that the mechanism of cytotoxicity was different for the three dressing materials tested.
We performed a prospective, randomized study in 55 ASA I to 3 women undergoing elective gynaecological surgery followed by postoperative epidural analgesia. We compared the incidence of bacterial colonization at the epidural exit site following catheter removal between a control group and an experimental group who received a chlorhexidine impregnated dressing (Biopatch, Johnson and Johnson, Arlington, TX, U.S.A.). Positive culture results were found in 11 of 27 (40.1%) patients in the control group compared with one of 29 (3.4%) patients whose epidural catheters were dressed with the Biopatch. We concluded that the Biopatch was effective in reducing bacterial colonization of the epidural catheter exit site.
BACKGROUND: Pressure sores are important and common complications of spinal cord injury. Many preventive and therapeutic approaches have been tried and new trials are evolving. One relatively recent method is application of a hydrocolloid dressing (HD). In this study we compared the therapeutic effects of HD on pressure ulcer healing with two other topical applications, phenytoin cream (PC) and simple dressing (SD). METHODS: Ninety-one stage I and stage II pressure ulcers of 83 paraplegic male victims of the Iran-Iraq war were randomly allocated to three treatment groups. Mean age and weight of the participants were 36.64 +/- 6.04 years and 61.12 +/- 5.08 kg, respectively. All the patients were managed in long term care units or in their homes for 8 weeks by a team of general practitioners and nurses, and the ulcer status was recorded as "Complete healing", "Partial healing", "Without improvement" and "Worsening". RESULTS: Complete healing of ulcers, regardless of location and stage, was better in the HD group than the PC [23/31(74.19%) vs 12/30(40%); difference: 34.19%, 95% CI = 10.85-57.52, (P < 0.01)] or the SD [23/31(74.19%) vs 8/30(26.66%); difference: 47.53%, 95% CI = 25.45-69.61, (P < 0.005)] groups. Complete healing of stage I ulcers in the HD group [11/13(85%)] was better than in the SD [5/11(45%); difference: 40%, 95% CI = 4.7-75.22, (P < 0.05)] or PC [2/9 (22%); difference: 63%, 95% CI = 29.69-96.3, (P < 0.005)] groups. Complete healing of stage II ulcer in the HD group [12/18 (67%)] was better than in the SD group [3/19(16%); difference: 51%, 95% CI = 23.73-78.26, (P < 0.005)], but not significantly different from the PC group [10/21 (48%); difference: 19%, 95% CI = -11.47-49.47, (P > 0.05)]. We performed a second analysis considering only one ulcer per patient (i.e. 83 ulcers in 83 patients). This "per patient" analysis showed that complete ulcer healing in the HD group was better than in the PC [20/28(71.4%) vs 11/28 (39.3%); difference: 32.1%, 95% CI = 7.4-56.7, (P < 0.01)] or SD [20/28(71.4%) vs 8/27 (29.6%); difference: 41.8%, 95% CI = 17.7-65.8, (P < 0.005)] groups. CONCLUSION: We deduced that HD is the most effective method investigated for treating stage I and II pressure ulcers in young paraplegic men.
The Tielle family (Johnson & Johnson Medical) is a range of dressings that come in a variety of shapes and sizes, designed to fit the different types and locations of wounds that occur in practice. There are three types--Tielle, Tielle Lite and Tielle Plus--and the choice of dressing should be based on the degree of exudate that the wound is producing. This product focus aims to give an overview of the range and provides research-based evidence for application in clinical practice.
This article discusses the use of transparent film dressing in wound management. It focuses on one particular product, C-View (Maersk Medical), determining its efficacy through multiple case study review. C-View was found to be easy to use and cost-effective, both as a primary and secondary wound dressing.
This article describes a novel dressing product that was developed from existing technology: hydrocolloid. The main benefits of Urgotul relate to the fact that it does not adhere to the wound surface, so both wound trauma on removal and the build up of moisture under the dressing are avoided.
The Tielle trade mark family (Johnson and Johnson Medical) is a range of hydropolymer foam dressings that come in a variety of shapes and sizes, and are designed to fit the different types and locations of wounds that occur in practice. There are three types: Tielle, Tielle Lite and Tielle Plus. Each can be based on the characteristics of the primary dressing, if any, and on the degree of exudate that the wound is producing. This article aims to give an overview of the range and a summary of research-based clinical and scientific evidence to support clinical practice.
It is widely recognized that a moist wound environment enhances epithelial migration and resurfacing, as well as promoting autolytic debridement of necrotic tissue, reducing pain, infection and scarring (Russell, 2002). However, an imbalance in the level of moisture can lead to delayed healing, or even wound extension (Kindlen and Morison, 1999). The type of wound itself can be influential in relation to the level of exudate produced. With such a diverse array of wound management products now available, the healthcare professional faces a constant dilemma in deciding what dressing is suitable for maintaining an optimal level of humidity in the wound environment. Alione, a new hydrocapillary dressing, manufactured by Coloplast, appears to overcome this impasse by being sufficiently versatile to manage varying levels of exudate in all types of wounds.
Acute surgical wounds left to heal by secondary intention are often routinely managed with gauze fabric dressings. This paper reviews research that suggests newer, modern dressings are more cost-effective and cause less pain on removal.
The effects of three periodontal dressings (Coe-Pak, PPC, Perio Putty) upon subcutaneous tissues in 26 Sprague-Dawley rats were investigated. The three dressings, and a control (Teflon), were placed into polyethylene tubes. Two tubes per animal were implanted on either side of the dorsal midline area. After 14 days the specimens were retrieved and prepared for histological examination. Three methods of scoring were utilized for evaluation. First, a system evaluating the overall number of inflammatory cells, connective tissue capsule thickness, and the vascular changes produced; second, an inflammatory cell count, the Inflammatory Index (I.I), computing the inflammatory cells in a particular field of view for each material; and third, a Reaction Spread Index (R.S.I.) comparing the distance of the spread of the inflammatory reaction into the connective tissues. Statistical analysis of the data was carried out utilizing the Chi-square test and analysis of variance. While the three scoring systems utilized did result in some comparative variation in reactions, the overall order of decreasing severity was always PPC, Coe-Pak, Perio Putty, and Teflon.
Single administration of collagen wound dressing (CAS) made from bovine derm in the form of finely ground powders was given to mice and rats via i.p., s.c. and p.o. routes and via i.v. route in the form of physiological saline extracts and it was continuously injected into mice for 28 days via s.c. route to study its acute and subacute toxicity. Examinations were made of on general conditions, body weight, food and water consumption, hematology, serum biochemistry, organ weight, and gross and microscopic findings. Results showed no marked toxicity except for local irritation which was seen only after parenteral administration. We concluded on the basis of these animal experiments that there should be no problem in regard to safety after somewhat more extensive therapeutic application of CAS as a wound dressing in clinical practice.
Three different methods were used to determine working and setting times of periodontal dressings. The Gillmore needle and the rheometer employed were not suitable for recording setting reactions. A penetration test was found applicable for determination of working and setting times for all three dressings although they exhibited different setting characteristics.
The effects on the healing of full-thickness excisional wounds treated with either of two occlusive dressings (Mezinc or Duoderm) were compared with the effects of gauze soaked in saline. The wounds were made on 86 rats and were examined clinically, histologically and biochemically four, eight and twelve days after wounding. Four days postoperatively the Duoderm-treated wounds differed significantly from the other two groups. Clinically, an adherent discolored gelatinous mass remained after removal of the firm part of the Duoderm dressing. Histologically it corresponded to a superficial exudate containing polymorphonuclear leukocytes (PMNs), macrophages and condensed foreign material. There was also a more extensive inflammatory reaction in the underlying tissues compared with gauze or Mezinc treatment and debris was seen in vesicles extracellularly and in foamy macrophages. Foamy macrophages were only seen in the Duoderm-treated wounds. These macrophages were mainly confined to the granulation tissue, which was about twice as thick as in the other two treatment groups twelve days after excision.