SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
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.
The use of moisture-retentive dressings (dressings that are capable of maintaining a warm moist environment) has been shown to provide the optimal environment for wound healing, accelerating the healing process and promoting tissue growth. TenderWet, produced by Paul Hartmann, is an innovative dressing that not only provides a moist warm environment but also incorporates the unique properties of Ringer's solution which actively cleanses (debrides) the wound.
OBJECTIVE: To provide family physicians with an approach to managing skin ulcers in older patients. SOURCES OF INFORMATION: Clinical practice guidelines and best practice guidelines were summarized to describe an evidence-based approach. MAIN MESSAGE; Preventing ulcers is important in frail older patients. Using guidelines can help prevent ulcers in institutions. Clarifying the cause and contributing factors is the first step in management. Pressure and venous ulcers are common in elderly people. Poor nutrition, edema, arterial insufficiency, and anemia often impair wound healing. Adequate debridement is important to decrease risk of infection and to promote healing. There are guidelines for cleaning ulcers. Choice of dressings depends on the circumstances of each wound, but dressings should provide a moist environment. Options for dressings are summarized. CONCLUSION: Family physicians can manage skin ulcers effectively by applying basic principles and using readily available guidelines.
A simple tie-over dressing using a silicone gel sheet gives firm fixation and allows direct inspection of the underlying grafted skin. Moreover, if haematoma or any complication is recognised, the sheet can be easily removed and reapplied.
The performances of hydrocolloid and alginate dressing materials have been compared in a study of 65 split skin graft donor areas. The donor areas were randomised between the two dressing materials. The rates of epithelialisation, the discomfort experienced by the patients and the convenience of the dressings in clinical use were compared. At the time of the first dressing change 87% of the donor areas dressed with the hydrocolloid and 86% of the donor areas dressed with the alginate were found to be more than 90% healed. The mean time from operation to the observation of complete healing was 10.0 days for the donor areas dressed with the hydrocolloid and 15.5 days for the donor areas dressed with the alginate: this difference was found to be statistically significant. The discomfort experienced by the two groups of patients was comparable. The rapid healing associated with the hydrocolloid dressing was thought to be of greatest benefit to inpatients; alginate dressings were thought to be more suitable for outpatients, as they proved to be simpler to use.
A synthetic dressing (IP-758) consisting of a silicone membrane with a laminated layer of nylon fabric was evaluated in patients as a substitute for biological materials to cover excised areas of burn wounds. During a 3-day interval, the tissue developed a tightly adherent bond to the synthetic dressing. The IP-758 conformed to irregularly-shaped regions and stretched with the movements of the wound surface. Seventeen burned children from 3 to 12 years of age and 1 adult are included in this study. In 12 cases, the mean area covered with the synthetic ranged from approximately 39 to 118 cm2. The average dressing remained in place for 3 days and was replaced once. Microbiological sampling (wet swab technique) of the area under the IP-758 after application of second dressing was compared with open control sites treated with topical antibiotics. The results with Staphylococcus aureus, a frequent contaminant, were similar for the two test areas. The IP-758 site in 6 patients contained an average of 10 3 S. aureus per swab test. Immediately following removal of the adherent IP-758 and control of local bleeding, the wounds in most patients provided excellent sites for autografts. The IP-758 dressing is well-tolerated, elastic and adherent to the burn wound permitting maturation of the wound to readily accept autografts.
Wound care following lower limb arthroplasty has not been subject to in-depth clinical research, primarily because such wounds usually heal without complication. However, when prosthetic implants are used, serious wound problems can be disastrous (Whitehouse et al. Infect Control Hosp Epidemiol 2002;23:183-9; Lindwell OM. Clin Orthop Relat Res 1986;211:91-103). We report the results of a prospective, randomised, controlled trial comparing a hydrofibre (Aquacel) and central pad (Mepore) dressing in the management of acute wounds following primary total hip or knee arthroplasty left to heal by primary intention. Dressing performance was measured in 61 patients receiving total hip or knee replacements. There was a significant reduction in the requirement for dressing changes before five postoperative days in the hydrofibre group (43% compared with 77% in the central pad group), and there were fewer blisters amongst patients in the hydrofibre group (13% compared with 26% in the central pad group). We conclude that there is a potential role for hydrofibre dressing in the management of arthroplasty wounds.
Nipple soreness and nipple trauma have long been associated with breastfeeding, and persist despite the many clinical advancements in the field of lactation. Management of nipple wounds has been approached in a variety of ways over the years in an attempt to treat and resolve this problem. Incorporating the scientific principles of modern wound care management can provide additional effective treatment options. Wounds are characterized by depth and extent of tissue destruction, regardless of their location on the body. Current wound treatment methods employ the use of moisture to aid healing. A moist environment is critical for epithelization, the proliferation and migration of epithelial cells across the surface of a wound during healing. Nipple wounds also heal by this process. Using a particular type of wound dressing, a hydrogel sheet wound covering, on a nipple wound offers several advantages. These dressings help maintain a moist environment, decrease the chance of bacterial infection, are easy to use, and provide immediate pain relief.
Urgotul belongs to a new class of non-adherent dressings: the lipidocolloid dressings. It is composed of an open weave polyester mesh impregnated with hydrocolloid polymers dispersed within petrolatum. The first clinical trial data are presented. Efficacy and safety were evaluated in a multicentre non-comparative trial involving 92 patients treated to healing or up to 4 weeks. Adult outpatients with acute wounds (n = 34), leg ulcers (n = 24), other chronic wounds (n = 14) or with second-degree burns (n = 20) were included. Results showed 32.4% (n = 11) of the acute wounds, 12.5% (n = 3) of the leg ulcers and 14.3% (n = 2) of the other chronic wounds completely healed before 4 weeks. Surface areas decreased on average by 76.4%, 63.5% and 44.2% at study endpoint respectively. For burns, 19 patients healed (95%) within 5-19 days. A total of 771 dressing changes were performed during the course of the study. Dressing application was considered as easy or very easy in 90% or more of the changes and there was no difficulty in removing the dressing in about 95% of the cases. Safety was good with five reports of a transitory local adverse event, probably dressing-related, being observed, two patients (2.2%) prematurely stopped treatment because of moderate periwound erythema. Urgotul is a highly promising new dressing which is currently undergoing further comparative clinical evaluation.
OBJECTIVE: The majority of leg ulcer patients in Sweden are managed by primary health care personnel. To compare, in a primary care setting, the healing results and the expenses of two commonly used wound dressings for leg ulcers. DESIGN: Thirty patients with leg ulcers of venous or mixed venous/arterial aetiology were randomized to treatment with saline-soaked gauze or with the hydrocolloidal dressing [HCD: DuoDERM (ConvaTec, A Bristol-Myers Squibb Company, Princeton)]. All patients were bandaged with the same compression of low-stretch-type [Comprilan (Beiersdorf AG, Hamburg)]. SETTING: Vårdcentralen Marieberg, Primary Health Care Centre, Motala, Sweden. OUTCOME MEASURES: Healing/reduction of ulcer area, pain, costs for material, nursing time, kilometres driven were registered during a six-week period. RESULTS: Two patients dropped out of the study, one in the gauze-group due to erysipelas, and one in the HCD-group for social reasons. A total of 1234 dressing changes were analysed. Costs for material were similar in the two groups. When the total care including nursing- and travelling time and kilometres driven were analysed, the mean cost for treatment with gauze dressings was 4126 Swedish Kronor (SEK), and with HCD, 1565 SEK. Seven patients in the HCD-group and two in the gauze-group healed during the study. The reduction of the ulcer area was 19% in the gauze-group and 51% in the HCD-group (p < 0.16). CONCLUSION: The total care, analysed in an authentic clinical setting, must be considered when different wound-care methods are discussed. In this study the use of HCD showed lower costs than use of gauze-dressings. As regards healing there was a tendency to improved healing with HCD, but no significant difference. Patients in the HCD-group reported significantly less pain at dressing changes (p < 0.003) than patients in the gauze-group.
Presently, gauze is the dressing of choice for exit site care. This article evaluates a different type of exit site dressing called Blisterfilm, a unique polyurethane adhesive film that has greater oxygen permeability, decreases the amount of pressure exerted on the catheter and exit site, and is easily removed.
The purpose of this research utilization project was to determine if a sufficient research base was present to support the use of gauze rather than transparent dressings for peripheral intravenous catheter sites. The research articles reviewed in this article do not support a relationship between dressing type and complications of peripheral intravenous catheters.
OBJECTIVE: To evaluate the safety, efficacy, and patient acceptance of closed dressings after full facial resurfacing with the carbon dioxide laser. DESIGN: Prospective cohort of men and women undergoing full facial carbon dioxide laser resurfacing. SETTING: Ambulatory surgical center at a university hospital. PATIENTS: Forty consecutive patients randomized to 1 of 4 dressing groups. INTERVENTIONS: All patients underwent full facial resurfacing with a carbon dioxide laser system. One of 5 closed dressings (single- or 3-layer composite foam, plastic mesh, hydrogel, or polymer film) was placed immediately after the procedure. Closed dressings were changed on postoperative day 2 and removed on postoperative day 4. OUTCOME MEASURES: Objective postoperative criteria of erythema, scarring, reepithelialization, and surface irregularities were recorded and photodocumented. Comparisons were made among the closed dressing groups as well as with a group of historical control subjects treated with open dressings. The ease of application, office time for preparation and application, and cost of the individual dressings were collected. Patient characteristics of overall acceptance, comfort, and ease of maintenance were recorded with a visual analog scale. RESULTS: There were no complications of scarring, surface irregularities, or contact dermatitis from the application or maintenance of the closed dressings. There were no significant differences in the number of days of postoperative erythema or in the rate of facial reepithelialization among the groups. Most patients preferred not to continue with the closed dressings past 2 days. Positive features from the use of closed dressings included reduction in crust formation, decreased pruritus, decreased erythema, and decreased postoperative pain, compared with historical controls. Negative features included time in preparation and application of the dressings. Costs ranged from $9.79 to $50 per dressing change. CONCLUSIONS: Closed dressings are safe and offer benefits noted during the first 4 postoperative days. Patients can be expected to maintain a closed dressing for at least 24 hours but no longer than 4 days. The positive features of closed dressings and patient acceptance outweigh the cost and office time involved with their application and maintenance.
Explore the source record for details and available documents.
Epi-Lock, a 1-mm-thick semipermeable sheet of modified polyurethane dressing material, was compared with silver sulfadiazene cream (Silvadene) in a prospective, randomized, cross-over-controlled study in which 50 patients alternated changing antibiotic cream daily with leaving the polyurethane sheet in place for a week. Overall, patient and physician preference for Epi-Lock was statistically significant (P less than 0.004), based on less pain, easier care, and faster healing. The collection of fluid under the polyurethane dressing and the necessity of leaving the wound covered for a week were less well accepted. Epi-Lock represents a major advance in wound dressing materials and should eventually gain wide application in outpatient treatment of partial thickness burns and abrasions.
INTRODUCTION: The management of patients with a laparostoma due to peritonitis is a challenge for every surgeon and intensivist. The goal of this study was to compare the different treatment strategies for the open abdomen: Abdominal Dressing (AD), the classic V.A.C. therapy (CV) and conventional open therapy (CT). METHODS: Between 2001 and 2005 we identified 62 patients in 4 surgical departments in Austria who had to be treated with a laparostoma due to peritonitis. 27 patients were conventionally treated, 16 with the Classic V.A.C. therapy and 19 patients with V.A.C. abdominal dressing. RESULTS: The mortality was 3/16 (14 %) in the AD group vs. 4/12 (21 %) patients in the CV group and 18/9 (59 %) in conventional therapy. There was no significant difference for survivors in the length of ICU stay: 26.6 +/- 23.0 days in the CT group, 34.6 +/- 30.2 days in the CV group and 38.9 +/- 27.2 days in the AD group. Apache II Score and Mannheimer Peritonitis Score showed no difference between the groups. CONCLUSION: We found a reduction of mortality in the V.A.C. Abdominal Dressing group by approximately 40 % (AD: 14 %, CT: 59 %). Although we could identify a difference in age in our retrospective study we believe that V.A.C. Abdominal Dressing is the important factor for the different clinical outcome. These first results indicate the need for further prospective evaluation of the V.A.C. Abdominal Dressing therapy, to prove if a new standard in the therapy of the open abdomen is created.
The cost of care plays an increasing role in treatment decisions. As the costs of wound care are largely driven by the costs associated with nurse visits to change patients' dressings, attempts to reduce the number of dressings used and thus the frequency of nurse visits should be welcomed. The acquisition cost of the dressing alone is a poor indicator of the total cost of care. Other factors--especially factors influencing the frequency of nurse visits, such as wear time--need to be considered when making treatment and formulary decisions. This paper assesses the theoretical wear time of a number of dressings based on laboratory data on their fluid-handling capacities. The monthly treatment cost associated with each dressing is based on the theoretical wear time. The results suggest that the superior fluid-handling capacity of TIELLE Plus hydropolymer adhesive dressing can reduce the costs associated with wound care.
This article discusses the use of OpSite Plus (formerly known as OpSite Post-Op) in the community setting. This semipermeable film dressing with an absorbent pad was evaluated by the community hospital and by practice and district nurses within Plymouth's NHS Primary Care Trust.