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PubMed1983

Comparison of synthetic adhesive moisture vapor permeable and fine mesh gauze dressings for split-thickness skin graft donor sites.

SAM and fine mesh gauze dressings were compared on 60 consecutive skin graft donor sites. SAM dressings are significantly better than fine mesh gauze dressings for healing of split-thickness skin graft donor sites; healing occurs much more rapidly with much less pain. In patients known to be colonized with Pseudomonas, care should be taken when using SAM dressings, although it is not an absolute contraindication. There were no clinically significant differences between Tegaderm and Op-Site.

Adolescent↗
PubMed2006

Development and in vitro evaluation of chitosan-polysaccharides composite wound dressings.

This study focuses on the design and evaluation of chitosan-based films intended for wound dressing application. Films of chitosan and their blends with cornstarch and dextran were developed to improve the films' physical strength. Polypropylene glycol at concentrations of 0.5, 1.0 and 1.5% (w/v) was added to improve the films' flexibility. Some properties required for successful wound dressing, such as liquid adsorption, vapor and oxygen penetration, bioadhesiveness, and film elasticity, were examined. Chitosan films showed the highest liquid adsorption and the adsorption tended to decrease with addition of cornstarch and dextran. Moisture vapor and oxygen were found to be able to penetrate through all film formulations, and those films with cornstarch and dextran showed increased penetration rates through the films. The bioadhesiveness test using a pig gut model did not show significantly different bioadhesive properties with the addition of cornstarch and dextran. The film elasticity of the formulation containing only chitosan exhibited the lowest elongation of the film at a force of 2N, but increased with the addition of cornstarch and dextran, respectively. In conclusion, the design and development of chitosan as a wound dressing can be improved by the addition of cornstarch or dextran, and propylene glycol to obtain the films with optimal properties for wound management.

Adhesiveness↗
PubMed2001

A study to evaluate primary dressings for the application of cultured keratinocytes.

Despite the recent improvements in cell culture and dermal regeneration methods, tissue engineering of skin has yet to receive widespread acceptance in the management of burn injuries. The reasons for this are complex and include not only the inherent costs of (particularly) setting up and running such a system but also the continuing difficulties in achieving successful engraftment of the neoepidermis. The latter has previously been addressed in a number of ways, including improving the recipient bed and using pre-confluent delivery systems to allow earlier application of cells to that wound bed. One area that has received little attention is that of the optimal wound dressing to use with this technology; the cells are very poorly attached at early time points, and, in this context, the traditional dressing of paraffin gauze has never been formally assessed in comparison with newer materials. Using a porcine acute wound chamber model, we performed a prospective randomised trial to assess four different wound dressings with reference to the amount of epidermal cover gained and the histological quality of the regenerated skin after 3 weeks. Out of the four materials tested, polyurethane foam (Allevyn) was superior histologically (although equal in take rate with paraffin gauze), whilst polythene sheet (Opsite) and silicone sheet were substantially inferior. We conclude that the traditional dressing used with this technology should be compared with polyurethane foam in a clinical trial. In the future, novel dressings should be formally tested against traditional methods before being adopted.

Animals↗
PubMedDate not supplied

Descriptive evaluation of Alione hydrocapillary dressing.

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.

Aged↗
PubMed1998

Temporary wound covering with a silicon sheet for the soft tissue defect following open fasciotomy. Technical note.

OBJECTIVE: Temporary covering of a defect of the soft tissues with a silicon sheet after fasciotomy in the treatment of compartment syndrome. DESIGN: Retrospective study. SETTING: University Hospital, Tübingen. PATIENTS: From January 1991 to June 1996, open fasciotomy was performed a total of 18 times on 17 patients with compartment syndrome. In 17 of the 18 cases acute vascular ischemia was the cause of the compartment syndrome. INTERVENTIONS: For the 18 necessary fasciotomies, a silicon sheet was temporarily used to cover the defect of the soft tissue temporarily a total of 9 times. The silicon sheet was gradually drawn together and the wound was finally closed with a secondary suture. RESULTS: In 6 of the 9 cases a secondary suture could be performed without any difficulties after the swelling had subsided, and a meshgraft covering was not necessary. Only one patient suffered from wound infection because the silicon sheet had not been sutured correctly. In the other cases there was no sign of infection. The wound dressing was changed painlessly and furthermore, an improved cosmetic result was observed. CONCLUSIONS: There are considerable advantages in the use of a silicon sheet as a temporary covering for the defect of the soft tissues in the treatment of compartment syndrome: lower costs because of shorter hospitalisation and the dressing change is practically painless. A reduced risk of infection and improved cosmetic results are further advantages of this method.

Aged↗
PubMed2003

Dressings and topical agents for arterial leg ulcers.

BACKGROUND: It is estimated that people in industrialised countries have a 1% chance of suffering from a leg ulcer at some time in their life. The majority of leg ulcers are associated with circulation problems; poor blood return in the veins causes venous ulcers (around 70% of ulcers) and poor blood supply to the legs causes arterial ulcers (around 25% of ulcers). Treatment of arterial leg ulcers is directed towards correcting the poor arterial blood supply, for example, by surgically correcting arterial blockages, and by supporting ulcer healing using topical agents (medicines in cream/ointment) and wound dressings. There are a large number of topical agents and wound dressings available and it is unclear what impact these have on ulcer healing. OBJECTIVES: To determine whether topical agents and wound dressings affect the rate of healing in arterial ulcers. To compare healing rates, costs and patient-centred outcomes between wound dressings and topical agents. SEARCH STRATEGY: Publications describing (or potentially describing) randomised controlled trials (RCTs), or controlled clinical trials (CCTs) of dressings and topical agents for arterial leg ulcers were sought through the Specialised Trials Registers of the Cochrane Wounds Group (last searched January 2002) and the Cochrane Peripheral Vascular Diseases Group (last searched April 2002). SELECTION CRITERIA: RCTs or CCTs (trials with non-randomised concurrent comparison groups) were eligible for inclusion. The participants had to have ulcers that were described as arterial, and the time to healing, proportion completely healed, or rate of reduction in ulcer area had to be reported. All wound dressings and topical agents were eligible for inclusion in this review. DATA COLLECTION AND ANALYSIS: Information on the participants' characteristics, the interventions, and outcomes, as well as data on the trial methods, such as blinding of patients and clinicians, and allocation concealment were extracted using a standardised data extraction form. MAIN RESULTS: One trial met the inclusion criteria. This small trial compared ketanserin ointment with vehicle alone, changed twice a day. The trial was too small and for too short a follow-up period to be able to determine whether there was any difference in healing rates. REVIEWER'S CONCLUSIONS: There is insufficient evidence to determine whether the choice of topical agent or dressing affects the healing of arterial leg ulcers. Inadequate description of the people in the one included trial means that the results cannot be easily applied to other clinical populations.

Administration, Topical↗
PubMed2003

Gauze and tape and transparent polyurethane dressings for central venous catheters.

BACKGROUND: Central venous catheters facilitate venous access, allowing the intravenous administration of complex drug treatments, blood products and nutritional support, without the trauma associated with repeated venepuncture. However, central venous catheters are associated with a risk of infection. Some studies have indicated that the type of dressing used for central venous catheters may affect the risk of infection. Gauze and tape or transparent polyurethane film dressings such as Tegaderm, Opsite or Opsite IV3000 are the most common types of dressing used to secure central venous catheters. Currently, it is not clear which type of dressing is the most appropriate. OBJECTIVES: To compare gauze and tape and transparent polyurethane central venous catheter dressings in terms of catheter related infection, catheter security, tolerance to dressing material and dressing condition in hospitalised adults and children. SEARCH STRATEGY: The Cochrane Wounds Group Specialised Trials Register (October 2002), the Cochrane Controlled Trials Register (4th Quarter 2002) and the databases; MEDLINE (1966-December 2002, CINAHL (1982-October 2002) and EMBASE (1980-December 2002) were searched to identify any randomised controlled trials comparing the effects of gauze and tape and/or transparent polyurethane dressings for central venous catheter sites. Additional references were identified from bibliographies of published literature and were also sought from other sources. SELECTION CRITERIA: All randomised controlled trials evaluating the effects of dressing type (i.e. gauze and tape and/or transparent polyurethane dressings) on central venous catheter related infection, catheter security, tolerance to dressing material and dressing condition in hospitalised patients. DATA COLLECTION AND ANALYSIS: Twenty-three studies were reviewed. Data was extracted from each paper by two members of the review team independently and results then compared. Differences were resolved either by consensus or by referral to a third member of the review team. Authors were contacted for missing information. MAIN RESULTS: Of the 23 studies reviewed, 14 were excluded. Nine studies were included. Data was only available for meta-analysis from six of the nine included studies. Of the six included studies with available data, two compared gauze and tape with Opsite IV3000, two compared Opsite with Opsite IV3000, one compared gauze and tape with Tegaderm, and one compared Tegaderm with Opsite. There was no evidence of any difference in the incidence of infectious complications between any of the dressing types compared in this review. Each of these comparisons was based on no more than two studies and all of these studies reported data from a small patient sample. Therefore it is probable that the finding of no difference between dressing types is due to the lack of adequate data. REVIEWER'S CONCLUSIONS: There is a high level of uncertainty regarding the risk of infection with the central venous catheter dressings identified in this review. Therefore, at this stage it appears that the choice of dressing for central venous catheters can be based on patient preference. To identify the most appropriate central venous catheter dressings, further research is necessary. It is paramount that any future studies investigating this issue must be rigorously performed randomised controlled trials.

Bacterial Infections↗
PubMed2005

[Topical therapy of ulcers].

Therapy of ulcers includes both treating the ulcer itself and the underlying disease. Local or surgical wound therapy depends on the phase of the wound healing. Physiological wound healing can be divided into three phases: the cleansing phase, the granulation phase and the epithelialization phase. The choice of the optimal therapy also depends on degree of secretion, bacterial contamination and anatomical location, as well as size and depth of the wound. While dry wound therapy was performed years ago, moist wound therapy is well-established today. There are a large number of modern wound dressings for local, phase-dependent or phase-independent ulcer therapy, making the optimal treatment of each kind of chronic wound possible.

Animals↗
PubMed2003

A prospective randomized evaluation of negative-pressure wound dressings for diabetic foot wounds.

Optimal treatment for large diabetic foot wounds is ill defined. The purpose of this study was to compare the rate of wound healing with the Vacuum Assisted Closure device trade mark (VAC) to conventional moist dressings in the treatment of large diabetic foot wounds. Diabetics with significant soft tissue defects of the foot were considered for enrollment. Patients were randomized to receive either moist gauze dressings or VAC treatments for 2 weeks, after which they were treated with the alternative dressing for an additional 2 weeks. Wounds were photographed weekly and wound dimensions calculated in a blinded fashion with spatial analysis software. Percent change in wound dimensions were calculated and compared for each weekly assessment and over 2 weeks of therapy with each dressing type. Ten patients were enrolled in the trial, but two were lost to follow-up and two were withdrawn. Complete data were available for analysis on seven wounds in six patients. Average length, width, and depth of the wounds at initiation of the trial was 7.7, 3.5, and 3.1 cm, respectively. Only the wound depth was significantly decreased over the weeks of the trial to 1.2 cm ( p < 0.05). VAC dressings decreased the wound volume and depth significantly more than moist gauze dressings (59% vs. 0% and 49% vs. 8%, respectively). VAC dressings were associated with a decrease in all wound dimensions while wound length and width increased with moist dressings. In summary, over the first several weeks of therapy, VAC dressings decreased wound depth and volume more effectively than moist gauze dressings. Negative-pressure wound treatment may accelerate closure of large foot wounds in the diabetic patient.

Cross-Over Studies↗
PubMed1990

Bipp: a case of toxicity?

Ribbon gauze impregnated with bismuth iodoform paraffin paste is a dressing used in both oral and ENT surgery. A case is presented in which it was implicated in increased postoperative morbidity highly suggestive of a toxic state.

Aged↗
PubMedDate not supplied

Opsite spray: its use for fixation of meshed skin grafts. Simple and low tech.

The fixation of skin grafts often poses a problem, particularly in patients who have undergone tangential excision and grafting for burns. Sutures, staples, fibrin glue and other adhesives have been used for graft fixation. We present the use of Opsite spray as a simple method for graft fixation and stabilization. Opsite markedly reduced pain and discomfort at the time of first graft dressing and obviated the necessity for an anaesthetic which is often required for the removal of staples.

Acrylic Resins↗
PubMed2004

[Pressure conditions under VVS-foams - an experimental in-vitro- and in-vivo-analysis].

The aim of this study was to determine the pressure conditions in the tissue beneath and on the surface of wounds. This was done in vitro both on a plain surface and on a bovine muscle. In comparison we measured the pressure of the anterior tibial muscle of a patient with compartment syndrome. Besides, we applied negative pressure using just one drape connector and measured the pressure in different distances to look if the pressure is constant in large V.A.C.(R) dressings. Both polyurethane and polyvinyl alcohol foams were used.

Animals↗
PubMed2002

Debridement of necrotic tissue and eschar using a capillary dressing and semi-permeable film dressing.

Mrs S presented with necrotic pressure damage to her right heel following hospitalization for cardiovascular accident. Mrs H, who had a history of dementia and self-neglect, was found to have a necrotic haematoma on her sacrum. Both presented with leathery necrotic eschar that did not respond to hydrogel or hydrocolloid dressings. Using Vacutex capillary dressing and Tegaderm vapour-permeable film as a secondary dressing, the wound margins showed signs of demarcation within a few days, and within one week I was able to sharp debride the wound, which prepared the wound for healing.

Aged↗
PubMed1975

Physical characteristics and performance of synthetic wound dressings.

From these studies it is concluded that: 1) Physical characteristics of wound dressings can be quantified and evaluated for their contribution to in vivo performance. 2) A total performance scoring system can be reliably used to quantitatively separate series of wound dressings by their in vivo performances. 3) The physical characteristics most determinate of good perfprmance in these 5 series of dressings were undersurface texture and water vapor transmission.

Animals↗
PubMed2004

Comparing a foam composite to a hydrocellular foam dressing in the management of venous leg ulcers: a controlled clinical study.

Venous leg ulcers are the most prevalent form of chronic wounds in the Western world. The principles of moist wound healing coupled with the use of graduated compression bandaging have become the cornerstone of treatment for venous leg ulcers but not all moist dressings are alike. To compare the attributes of a foam composite dressing with those of a hydrocellular foam dressing in the management of venous leg ulcers, a prospective, randomized, comparative 12-week study was conducted in 15 centers in the US, Canada, France, Germany, and the UK. Dressings were changed and compression bandages applied per manufacturer recommendations and dressing performance was assessed at every dressing change and at the final evaluation. Patients with venous ulcers were randomized to treatment for 12 weeks with either hydrocellular foam (n = 52) or foam composite (n = 55) dressing. Healing differences between the groups were not statistically significant, with 36% of patients using foam composite dressing healed in a mean of 66 days and 39% of patients using hydrocellular foam dressing healed in a mean of 73 days. However, the foam composite dressing performed significantly better than the hydrocellular foam dressing with regard to condition of the periwound skin - 55% of patients in the foam composite group having healed or markedly improved surrounding skin compared to 37% of patients using hydrocellular foam (P = 0.03). The foam composite dressing was rated significantly better than the hydrocellular foam dressing ("very good" to "excellent") in level of satisfaction with conformability (87% and 75%, respectively, P = 0.05); being non-sensitizing (73% and 52%, respectively, P = 0.02); and ease of application (93% and 81%, respectively, P = 0.01). The findings reported in this study suggest that the foam composite dressing offers significant improvements in the quality of life of patients with venous leg ulcers as well as for their caregivers.

Adult↗
PubMed2004

[Possible interventions in impaired wound healing].

Chronic wounds are long-term results of various diseases. Evaluation and therapy of the underlying disorder must be the first goal of a comprehensive wound care protocol. Treatment of local (i.e. wound infection, necrosis, or foreign body) or systemic (i.e. diabetes, immunosuppression, or patient compliance) disturbing factors is the second major step for appropriate wound care. The third major point is wound bed preparation (i.e. debridement, moist wound dressings, or VAC therapy), and wound stimulation. After appropriate wound bed preparation, wounds can be closed by plastic surgery or wound stimulation through various agents (i.e. protease inhibitors, growth factors, or tissue engineering).

Debridement↗
PubMed1998

Leg ulceration in the sickle cell patient.

BACKGROUND: The purpose of this study was to determine cost of care for leg ulcers in sickle cell patients and suggest an improved modality in ulcer care. STUDY DESIGN: We performed a retrospective study of a group of sickle cell disease patients with leg ulcers. RESULTS: Eighteen patients with a leg ulcer (duration: mean, 53.7 months), sickle cell disease, and a mean of 20.7 years of age had various modalities of treatment with the only consistency in healing being a commercial moist-wound dressing. CONCLUSIONS: There is no consistency in the treatment of the sickle cell patient with a leg ulcer. Treatment with a moist dressing had the best results.

Adolescent↗