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PubMed1989

'Hypafix': new technique of skin graft fixation.

A new technique for split skin graft fixation using 'Hypafix' adhesive dressing is described. Ninety-three patients with burns involving less than 20% body surface area grafted at the Adelaide Children's Hospital during February 1985-May 1987 were reviewed. Comparisons were made between the results of standard fixation and Hypafix methods. The Hypafix technique showed itself to be simple and reliable, affording considerable versatility and allowing early mobilization without splintage or sedation. The adhesive is readily loosened with Ungvita ointment allowing the dressing to be removed painlessly. In this study its use has shortened both the length of inpatient stay and outpatient follow-up in the Scar Management Programme.

Burns↗

PubMed1986

Extensive subcutaneous emphysema crossing the midline after a surgical extraction: report of case.

A case of extensive subcutaneous emphysema is reported. The patient had a mandibular third molar extracted but did not experience any cervical edema until the morning after surgery. The emphysema did not appear to be caused by the surgical procedure, as emphysema caused by use of instruments becomes immediately apparent and no patient-related causes could be documented. However, a dressing of a tetracycline-steroid ointment in a petrolatum base and a hemostatic agent was placed in the tooth socket during surgery and the dressing may have allowed air into the deeper tissues. The patient was managed by hospitalization, antibiotic therapy, and rest. The tissue emphysema resolved gradually during a 5-day period.

Adult↗

PubMed2004

[Clinical study using activity-based costing to assess cost-effectiveness of a wound management system utilizing modern dressings in comparison with traditional wound care].

In recent years, the concept of cost-effectiveness, including medical delivery and health service fee systems, has become widespread in Japanese health care. In the field of pressure ulcer management, the recent introduction of penalty subtraction in the care fee system emphasizes the need for prevention and cost-effective care of pressure ulcer. Previous cost-effectiveness research on pressure ulcer management tended to focus only on "hardware" costs such as those for pharmaceuticals and medical supplies, while neglecting other cost aspects, particularly those involving the cost of labor. Thus, cost-effectiveness in pressure ulcer care has not yet been fully established. To provide true cost effectiveness data, a comparative prospective study was initiated in patients with stage II and III pressure ulcers. Considering the potential impact of the pressure reduction mattress on clinical outcome, in particular, the same type of pressure reduction mattresses are utilized in all the cases in the study. The cost analysis method used was Activity-Based Costing, which measures material and labor cost aspects on a daily basis. A reduction in the Pressure Sore Status Tool (PSST) score was used to measure clinical effectiveness. Patients were divided into three groups based on the treatment method and on the use of a consistent algorithm of wound care: 1. MC/A group, modern dressings with a treatment algorithm (control cohort). 2. TC/A group, traditional care (ointment and gauze) with a treatment algorithm. 3. TC/NA group, traditional care (ointment and gauze) without a treatment algorithm. The results revealed that MC/A is more cost-effective than both TC/A and TC/NA. This suggests that appropriate utilization of modern dressing materials and a pressure ulcer care algorithm would contribute to reducing health care costs, improved clinical results, and, ultimately, greater cost-effectiveness.

Algorithms↗

PubMed2003

Preparing the wound for healing: the effect of activated polyacrylate dressing on debridement.

Activated polyacrylate dressings facilitate wound debridement by retaining moisture while attracting and retaining proteins and bacteria. A 55-patient retrospective study was conducted to quantify the effect of this dressing on debridement of chronic wounds in clinical practice. All patients attended one of four outpatient wound clinics between June 1, 2001 and February 10, 2002 and received treatment with the polyacrylate dressing for an average of 3.9 weeks (SD 4.1). During that time, the rate of wound necrotic tissue debridement was 37.7% per week. Older patients (>80 years of age) had significantly lower rates of wound debridement (mean 18.1% per week) than those <51 years of age (mean 36% per week, P = 0.009). Other variables (age, wound type, wound duration and diagnosis of diabetes) were not found to significantly affect the rate of wound debridement. Wound debridement rates of commonly available modalities are largely unknown. However, these results suggest that activated polyacrylate dressings are an effective, atraumatic, and easy-to-use method of debriding chronic wounds.

Acrylic Resins↗

PubMed1987

Silastic foam dressing in hypospadias surgery.

Silastic foam dressing is useful after more complex types of hypospadias surgery. It immobilises and protects the penis, avoids excessive swelling and allows early mobility of the patient. Details of its application and use are described.

Humans↗

PubMed1993

[Experimental testing of hydrogel dressings POLGEL based on the basis of synthetic monomers].

In the Department of Experimental Surgery and Biomaterials Research in Wrocłow Medical Academy standard and qualifying evaluation of 5 kinds of hydrogel dressings POLGEL produced in the Institute of Physico-Chemistry and Technology of Polymers of produced in Silesian Polytechnique has been carried out. Dressings Polgel were obtained as a result of copolymerization of acrylamide and methylene-bis-acrylamide in aqueous solution. On the basis of introductory experiments for qualifying evaluation dressing Polgel M modified with glycerin in the form of foil and dressing Polgel T--in the form of jelly were chosen. Both kinds of dressings did not cause haemolytic, toxic or irritative effects. In pathomorphological experiments moderate tissues reaction was noticed what signifies good biological characteristics of the evaluated dressings. The process of healing of injuries treated with dressings Polgel M proceeded well and epidermis creating was quicker in comparison with injuries treated with traditional dressing. On the basis of the carried out experiments it was noticed that dressings Polgel M and T satisfy the requirements made for the type of materials.

Acrylamides↗

PubMed2006

[The importance of vacuum therapy in the treatment of sternal osteomyelitis from the plastic surgeons point of view].

BACKGROUND: Since its introduction in 1997 the vacuum assisted closure therapy has gained widespread and is for its indications international accepted. It is also well established in the treatment of sternal infections a dreaded complication after median sternotomy in cardiac surgery. The well known positive effects of the vacuum therapy act as a dignified cleaning procedure between debridement and plastic coverage or as a temporarily closure method if the first debridement was properly not sufficient. METHOD AND PATIENTS: Between January 2003 and December 2005 twenty eight patients with advanced sternal infection after median sternotomy were treated by radical debridement, vacuum assisted closure therapy and definitive plastic coverage by muscle flaps. In this article three patients are exemplarily introduced. RESULTS: In all patients a sufficient plastic coverage was achieved after radical debridement an vacuum assisted closure therapy. The patients received a pedicaled muscle flap. Stable wound condition with no signs of a recurrent sternal infection were observed in all patients. DISCUSSION: Vacuum assisted closure therapy acts as a link between radical Debridement and definitive plastic coverage in prolonged sternal infection after median sternotomy. Before the invention of V.A.C.(R) dressing changes were obliged every day in patients with deep sternal infection. The V.A.C.(R) therapy reduces the frequency of this painful dressing changes significantly and on this behalf makes life more comfortable for this mostly multi-morbid patients.

Aged↗

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↗

PubMedDate not supplied

Microbicidal properties of a silver-containing hydrofiber dressing against a variety of burn wound pathogens.

Partial-thickness burns are often characterized by microbial contamination and copious exudate produced during the early postburn period. Consequently, topical wound management often relies on the use of antimicrobial agents and absorbent dressings, and an AQUACEL Hydrofiber Dressing containing ionic silver has been designed to meet such needs. To assess the antimicrobial properties of the AQUACEL Hydrofiber dressing, samples were challenged with a wide variety of recognized burn wound pathogens in a simulated wound fluid model. Dressing samples were inoculated with the challenge organisms at time zero and then reinoculated on days 4 and 9 to mimic the worst-case clinical scenario. The dressing was shown to be microbicidal against aerobic and anaerobic bacteria (including antibiotic-resistant strains), yeasts, and filamentous fungi during a 14-day test period. Based on our results, the silver-containing dressing is likely to provide a barrier to infection, in addition to providing proven fluid-handling benefits of the AQUACEL Hydrofiber dressing, in the management of partial-thickness burns.

Anti-Bacterial Agents↗

PubMed2006

Efficacy of a skin-protection powder for use as a dressing for intractable ulcers.

OBJECTIVE: Stomahesive skin-protection powder has been reported to be useful as a skin-care and skin-barrier product for the management of stomas. This study aimed to evaluate its efficacy, in terms of wound healing, moisture retention and pain management, as an alternative to conventional dressing materials. Both clinical and animal studies were undertaken. METHOD: The efficacy of the Stomahesive powder was tested by measuring the thickness of granulation tissue formed in a total skin defect in a db/db mouse model. We then compared the healing process using either the skin-protection powder or a conventional film dressing material. In the clinical study 17 patients with various intractable ulcers were treated with Stomahesive powder, and healing was evaluated. RESULTS: In the mouse model, granulation tissue in the wounds treated with the powder was 2.86 times thicker than that of the wounds treated with the film dressing. In the clinical study, 16 out of 17 wounds healed completely. CONCLUSION: The Stomahesive powder could be an effective treatment modality for contact ulceration, superficial ulcers with complex contours and morphology, and superficial ulcers contaminated by liquid faeces or vaginal discharge that have not responded to conventional dressings. DECLARATION OF INTEREST: None.

Administration, Cutaneous↗

PubMed2000

[Ambulant treatment of wounds by vacuum sealing].

The treatment of chronic wounds by vacuum sealing as an outpatient procedure is a new method of wound conditioning before closing the defect. The quality of life for the patient in his usual surrounding is maintained. Financial aspects also play a role in this treatment since costs for the health care system can be reduced. Various vacuum pumps, drainages and polymere foams are available and suitable for the outpatient treatment. The most important condition is to regularly check the vacuum. This can performed by the patient, the relatives or nursing staff. The main complication consists in loss of vacuum but technical and local or systemic complications can also appear. Individually applied vacuum dressings (polyvinyl foam, drainage tube and polymere foil) are practical. The ideal pump systems for the outpatient treatment are still not trial.

Ambulatory Care↗

PubMed1990

[Does the elastic rapid wound dressing Ankerplast Spray modify wound healing?].

It had been tested if the elastic wound-dressing Ankerplast Spray reduces the risk of an infection of wounds, and if any influences could be observed on the formation of scars after spray-sealing of fresh surgical wounds. In a prospective, controlled study of 597 patients 567 could be postoperatively surveyed at all fixed terms of control up to the 56th day. The infection rate of wounds after general surgical operations amounted to a total of 7 per cent. The rate of hypertrophic scars within the control group was with 11 per cent respectively 7 per cent significantly below the rate of 34 per cent of hypertrophic scars within the Spray group. Are fresh surgical operation wounds being sealed with the elastic wound-dressing Ankerplast Spray no influence can be observed on the postoperative risk of wound infections. Hypertrophic scars must be taken in consideration in about 34 per cent.

Acrylates↗

PubMed2003

Vacuum-assisted closure of a complex pilonidal sinus.

INTRODUCTION: The annual incidence of pilonidal sinus is approximately 26 per 100,000, of which complex pilonidal sinuses are the minority. Many different approaches have been described for managing simple cases. Treatment options for complex pilonidal sinus include excision with healing by secondary intention or plastic surgical procedures to obliterate the defect. Recently, vacuum-assisted closure has been used by plastic surgeons to facilitate healing of chronic or complicated wounds with particular success in treating pressure wounds overlying the sacrum. METHODS: A patient with a complex pilonidal sinus was managed with excision and vacuum-assisted closure. RESULTS: A large tissue defect after radical excision healed relatively quickly when the subatmospheric pressure dressing was applied. The patient was discharged with the vacuum pump and change of dressings for alternate days. CONCLUSION: Vacuum-assisted closure of a complex pilonidal sinus shortened the length of hospital stay and the need for further surgery and provided a cosmetically acceptable result.

Adult↗

PubMed2006

A polyurethane dressing is beneficial for split-thickness skin-graft donor wound healing.

Few comparative studies have been performed on the various wound-dressing materials or methods proposed for use. To clarify the efficacy of wound dressing, 35 patients (17 females, aged 44.8+/-26.86 years and 18 males, aged 35.4+/-29.70) were subjected to a prospective study comparing a polyurethane dressing and a hydrogel dressing for split-thickness skin donors from the lateral thighs. We examined their clinical usefulness such as accelerated healing time, frequency of changing the dressing, degree of pain, or amount of exudates, and performed moisture meter analysis at 1 month and 1 year after re-epithelialization, which reflects the quality of the stratum corneum and subsequent scarring. The polyurethane dressing was superior to hydrogel in the wound healing time, amount of exudates, and frequency of dressing changes: the hydrogel was better for regulating the degree of pain. There was a positive correlation between transepidermal water loss and the effective contact coefficient, which indicates skin barrier function and affected by skin surface electrolytes and reflects water content, in moisture meter analysis (r(2)=0.32, p<0.01). Transepidermal water loss returned to the control level at 1 year after healing with both dressings. The effective contact coefficient of the polyurethane wound was significantly lower than that of hydrogel at 1 month (p<0.01), while both dressing wounds demonstrated significantly higher values at both 1 month and 1 year compared to the control (p<0.01). The polyurethane dressing is therefore superior both clinically and in moisture meter analysis.

Adolescent↗

PubMed2003

Assessment of a silver-coated barrier dressing for potential use with skin grafts on excised burns.

Acticoat burn dressing is a silver-coated dressing with antimicrobial activity purported to reduce infection from environmental organisms in partial and full-thickness wounds. Acticoat was tested for activity as an antimicrobial treatment and as an antimicrobial barrier dressing in three in vitro assays. It was found that a modified disc assay method gave false negative results but in an assay in which bacteria were inoculated on top of samples of Acticoat, bacterial numbers were reduced, over time, with all microorganisms tested. Acticoat served as a barrier for bacteria, inoculated onto it, from contaminating the surface of an agar plate under the Acticoat. The data show that Acticoat has: antimicrobial capabilities, but to be effective hours of contact between Acticoat and the microorganisms are required; and the capacity to serve as an antimicrobial barrier dressing. These findings support the conclusion that Acticoat has activity to reduce microbial contamination of wounds from environmental sources.

Anti-Bacterial Agents↗

PubMed2004

Effect of three wound dressings on infection, healing comfort, and cost in patients with sternotomy wounds: a randomized trial.

STUDY OBJECTIVE: To compare three dressing types in terms of their ability to protect against infection and promote healing, patient comfort, and cost-effectiveness. DESIGN: Prospective, randomized controlled trial. SETTING: Major metropolitan, academically affiliated, tertiary referral center. PATIENTS: Seven hundred thirty-seven patients were randomized to receive a dry absorbent dressing (n = 243) [Primapore; Smith & Nephew; Sydney, NSW, Australia], a hydrocolloid dressing (n = 267) [Duoderm Thin ConvaTec; Mulgrave, VIC, Australia], or a hydroactive dressing (n = 227) [Opsite; Smith & Nephew] in the operating theater on skin closure. RESULTS: There was no difference in the rate of wound infection or wound healing between treatment groups. The Primapore dressing was the most comfortable and cost-effective dressing option for the sternotomy wound. Duoderm Thin dressings were associated with increased wound exudate (p < 0.001), poor dressing integrity (p < 0.001), more frequent dressing changes (p < 0.001), more discomfort with removal (p < 0.05), and increased cost (p < 0.001). CONCLUSIONS: In the context of no additional benefit for the prevention of wound infection or the rate of wound healing for any of the three dressing products examined, dry absorbent dressings are the most comfortable and cost-effective products for sternotomy wounds following cardiac surgery.

Aged↗

PubMed1988

Biosynthetic compound dressings--management of hand burns.

To achieve optimal hand function, wound closure becomes the most important ingredient in hand burns. This study documents the use of a biosynthetic compound dressing (Biobrane) which has been fabricated as a glove for management of hand burns. The glove allowed rapid active motion and minimized the pain of open wounds. Forty-two Biobrane glove applications were evaluated with 50 per cent applied over superficial hand burns and 50 per cent over deep partial thickness or full thickness injuries. In the superficial hand burns, the patients were discharged home after a mean time of 2.8 days. With the deep burns the dressing provided a closed wound after early excision of eschar without the use of an autograft or biological dressing. Based on these studies, we conclude that the biosynthetic compound dressing glove is a useful adjunct to be added to the armamentarium for treatment of the burned hand.

Biocompatible Materials↗

PubMed2002

Sequential treatment with calcium alginate dressings and hydrocolloid dressings accelerates pressure ulcer healing in older subjects: a multicenter randomized trial of sequential versus nonsequential treatment with hydrocolloid dressings alone.

OBJECTIVES: To compare the efficacy of a sequential strategy combining calcium alginate and hydrocolloid dressings treatment of grade III or IV pressure ulcers (PUs) and the efficacy of nonsequential strategy with hydrocolloids alone. DESIGN: An open, randomized, multicenter parallel-group trial. SETTING: Twenty geriatrics hospital wards. PARTICIPANTS: One hundred ten older patients with grade III or IV PUs. INTERVENTION: The control strategy consisted of applying hydrocolloid dressings (DuodermE) for 8 weeks; the sequential strategy consisted of applying combined calcium alginate dressings (UrgoSorb) for the first 4 weeks and hydrocolloid dressings (Algoplaque) for the next 4 weeks. MEASUREMENTS: PU surface areas were measured weekly by ulcer tracing. The endpoints were the mean absolute surface area reduction (SAR) during the 8-week study period and the number of patients achieving a 40 or more SAR (SAR40). RESULTS: Fifty-seven and 53 patients were randomly allocated to sequential and control strategies respectively. Baseline patient characteristics and PU ulcer features at inclusion were similar in the two groups. Mean +/- standard deviation SAR was significantly larger in the sequential treatment group (5.4 +/- 5.7 cm2 and 7.6 +/- 7.1 cm2 at 4 and 8 weeks) than in the control group (1.6 +/- 4.9 cm2 and 3.1 +/- 7.2 cm2, P< .001). In the sequential treatment group, 68.4 of the patients reached SAR40 at 4 weeks and 75.4 at 8 weeks, proportions significantly larger than in the control group (22.6 and 58.5, respectively, P< .0001). Dressing tolerance was good in both strategies. CONCLUSIONS: In grade III or IV PUs, treatment using first calcium alginate dressings and then hydrocolloid dressings promotes faster healing than treatment with hydrocolloid dressings alone.

Aged↗