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We describe a simple tubular elastic gauze dressing for surgical wounds of the penis. The amount of pressure placed on the penis is consistent and reproducible. The material is elastic enough to avoid vascular occlusion and is easily applied with a plastic tube. The dressing stays in place, can be used with stents or catheters, and is easily removed by the patients at home.
Dissolution of soft tissues on the uninstrumented root canal wall by an intracanal dressing of calcium hydroxide paste was examined by scanning electron microscopy (SEM). The roots of human extracted teeth were split longitudinally into halves, and the pulp tissue was removed by forceps. Then, the halves were divided randomly into three groups. Specimens in the control group were given no treatment. Specimens of the 1-wk group were stored for 7 days in calcium hydroxide-saline paste under the condition of 100% humidity and 37 degrees C. Specimens of the 4-wk group were stored for 28 days in the same manner, but washed and replaced into new paste every week. Root canal walls of these specimens were compared under a scanning electron microscope. A layer of odontoblasts was observed in the control group, whereas it had disappeared completely in the 1- and 4-wk groups. However, the predentin remained almost intact in the 1-wk group, and although the surface was eroded, in the 4-wk group. It was found that calcium hydroxide paste dressing could dissolve the odontoblastic cell layer, but had little effect on predentin.
The purpose of this study was to evaluate Ca2+ and OH- diffusion properties through root dentin by using different calcium hydroxide (CH) dressing materials. Twenty-eight single-rooted teeth were instrumented and external defects were created on the root surface. 17% EDTA was used to eliminate the smear layer. All surfaces except the external defects were sealed, and the teeth were placed in normal saline. Ca2+ concentrations and the pH in the saline were determined for 3 days as the control period. After removing the teeth from normal saline, they were filled with: (i) DT Temporary Dressing CH; (ii) CH powder and normal saline; (iii) TempCanal; and (iv) CH points. The teeth were then placed in normal saline, and Ca2+ concentrations and pH values were measured at 1, 3, 7, 14, and 28 days. Nonsetting CH pastes gradually released Ca2+, whereas this increase was absent from CH points. None of the test materials induced a pH increase in the media during the observation period. This study demonstrated that, when nonsetting CH pastes are applied to the root canal, diffusion of Ca2+ without an increase in pH to the surrounding media occurs. This implies that these type of material are more suitable than CH points for treatment of external root resorption.
Periapical tissue response was evaluated histologically in teeth of 6-month-old dogs with incomplete root formation and periapical lesions in order to compare the effects of two calcium hydroxide-containing pastes prepared with different vehicles on induced root apex formation and repair of the periapical region. A group of teeth with no root canal dressing was used as control. After induction of the periapical lesion, the root canals were instrumented and filled with one of the two pastes (Calen and Calasept), which were renewed monthly for 90 days. At the end of the follow-up period (3 months), the animals were killed. Block sections from the actual areas were dissected free and prepared for histopathological analysis. Both calcium hydroxide pastes helped induce apical sealing and repair of the region, but the Calen paste yielded better results than Calasept. The induced mineralized tissue was predominantly of the cementoid type after the use of both pastes, but the inflammatory infiltrate was significantly less intense with the use of the Calen paste. In the control group, the absence of a root canal dressing impaired the process of periapical repair and yielded no apical root closure in any of the cases analyzed.
To determine the presence of p-monochlorophenol in the calcium hydroxide (Calen) + p-monochlorophenol combination after its use as intracanal dressing, periapical lesions were induced in 60 root canals of upper and lower premolars of four dogs. After biomechanical preparation, the root canals received the intracanal medication, which was removed from the apical third after 2, 4, 7, and 14 days for chemical analysis by spectrophotometry. The results showed a p-monochlorophenol loss of approximately 50.0% in the dressing after 48 h, with no further significant loss after longer periods of times. p-Monochlorophenol was still present in the medication after 14 days.
The aim of this study was to investigate whether differences in the composition of calcium hydroxide (Ca(OH)2) preparations influence the removal efficiency of irrigation solutions used in combination with filing of the canal. Three Ca(OH)2 preparations were used: Calxyl, Pulpdent paste, and chemically pure Ca(OH)2 mixed with distilled water. Fifty-one single-rooted extracted human teeth were prepared with a step-back technique and divided into groups A, B, and C. In each group, 15 teeth were assigned to each Ca(OH)2 preparation while the remaining two served as positive and negative controls. Each group of treated teeth was divided into three subgroups of five teeth each: subgroup I--canals were irrigated with saline, filed with a #25 file, and finally flushed with saline; subgroup II--canals were irrigated with NaOCl, filed with a #25 file, and finally flushed with NaOCl; and subgroup III--canals were irrigated with NaOCl, filed with a #25 file, and finally flushed with tetrasodium EDTA. Canal sections were then photographed, and the percentage ratios of Ca(OH)2 coated area to the total canal surface area were calculated by image processing analysis. Results revealed: (a) none of the methods efficiently removed all dressing from the walls, and (b) concentration of the paste used had little effect on the efficacy of the methods applied for the removal of the dressing. Excipients (i.e. methylcellulose contained in Pulpdent) possibly effect retention of Ca(OH)2.
In order to develop a novel unique wound dressing, a combination of self-adhesive Eudragit E film with antibacterial drug-loaded poly (N-isopropyl-acrylamide) (PNIPAAm) microgel beads was designed. The result indicates that the tack property of Eudragit E film increased with an increase of the PNIPAAm microgel beads added, but there was no significant difference between the dried PNIPAAm microgel beads with or without adsorbing drug. In addition, the peel strength of Eudragit E film initially decreased with the addition of PNIPAAm microgel beads, but increased to a maximum value when PNIPAAm microgel beads were added from 4% to 7.6%. then decreased again after 7.6%. The optimal concentration of PNIPAAm microgel beads was 7.6% (w/v) which had better tack and peel adhesive properties. The water uptake ratio of Eudragit E film containing PNIPAAm microgel beads was found to be temperature-dependent, suggesting that the Eudragit E film containing PNIPAAm microgel beads enabled to absorb the wound fluid. Eudragit E film containing PNIPAAm microgel beads with or without adsorbing drug had significantly reduced peel strength after 12 h-immersion in solution. All these results suggest that a novel drug-loaded wound dressing has been developed by binding a self-adhesive Eudragit E film with an antibacterial drug-loaded PNIPAAm microgel beads to achieve thermo-responsive, adhesive, absorptive and easy peeling functions.
Chemically-crosslinked glycosaminoglycan (GAG) hydrogel films were prepared and evaluated as bio-interactive wound dressings. Hyaluronan (HA) and chondroitin sulfate (CS) were first converted to the adipic dihydrazide derivatives and then crosslinked with poly(ethylene glycol) propiondialdehyde to give a polymer network. The crosslinking occurred at neutral pH in minutes at room temperature to give clear, soft hydrogels. After gelation, a solvent-casting method was used to obtain a GAG hydrogel film. A mouse model was used to evaluate the efficacy of these GAG films in facilitating wound healing. Full-thickness wounds were created on the dorsal side of Balb/c mice and were dressed with a GAG film plus Tegaderm' or TegadermT' alone. A significant increase in re-epithelialization was observed on day 5 (p < 0.001) and day 7 (p < 0.05) for wounds treated with a GAG film plus Tegaderm versus those treated with Tegaderm alone. While no significant differences in wound contraction or inflammatory response were found, wounds treated with either HA or CS films showed more fibro-vascular tissue by day 10. The GAG hydrogel films provide a highly hydrated, peri-cellular environment in which assembly of other matrix components. presentation of growth and differentiation factors, and cell migration can readily occur.
The hygienic performances of the processes for the production of cooled carcasses at eight pork packing plants were assessed from small sets of microbiological data. At each plant, a single sample was obtained from a randomly selected site on each of 25 randomly selected carcasses at each of three stages of processing, which were after polishing, after washing at the end of the dressing process, and after cooling. The aerobic bacteria, coliforms and Escherichia coli recovered from each sample were enumerated. When bacteria of one type were recovered from > or = 20 of 25 samples, the log mean number of those bacteria on the population of carcasses undergoing processing was estimated on the assumption that the set of counts was normally distributed. The log of the total number recovered from 25 samples was calculated for each set of counts. The log mean numbers of total aerobic bacteria recovered from the polished carcasses at different plants ranged from about 1.9 to 3.8 log cfu cm(-2). At six of the plants, the log mean numbers of total aerobes on the cooled carcasses did not differ substantially from the log mean numbers on the polished carcasses, but the log mean numbers on the cooled carcasses were substantially higher at one plant and substantially lower at another than on the polished carcasses. Coliforms and E. coli were recovered from too few samples in most sets from cooled carcasses for estimation of their log mean numbers. However, the log total numbers of coliforms and E. coli recovered indicated that substantial numbers of those organisms were added to carcasses during the dressing processes at four of the plants, and that the numbers on the carcasses were substantially reduced by the processes for cooling without spraying at two of the plants. At seven of the plants, the total numbers of coliforms and E. coli recovered from cooled carcasses were <3.1 and <2.2 log cfu 2500 cm(-2), respectively. The findings indicate that production processes for pig carcasses can be operated to give cooled carcasses with log mean numbers of total aerobes < 2 cm(-2), and log total numbers of coliforms and E. coli each < 1 2500 cm(-2).
OBJECTIVES: We sought to determine the efficacy of MeroGel, an absorbable hyaluronic acid nasal dressing (HA) in reducing synechia after functional endoscopic sinus surgery (FESS) compared with Merocel, a nonabsorbable packing (NAP) requiring removal. METHODS: We conducted a blinded, randomized, controlled trial of 37 patients requiring bilateral FESS for chronic sinusitis. Patients were randomized to placement of HA within the right or left middle meatus and NAP on the other side. Patients were evaluated at 2, 4, 6, and 8 weeks postoperatively. RESULTS: Blinded evaluation revealed 5 patients (14%) with synechia at last follow-up: 3 sides (8%) with HA and 3 (8%) with NAP. Thirteen patients (35%) had synechia at any visit, 10 sides (27%) with HA and 9 (24%) with NAP. Seven patients (19%) required lysis of synechia, 5 sides (14%) with HA and 3 (8%) with NAP. CONCLUSION: We found no statistically significant difference between HA and NAP dressings.
Epi-Lock, a new semiocclusive, semipermeable dressing, was evaluated against standard therapy for three common emergency department wounds: partial thickness burns, deep abrasions, and selected lacerations. Comparison was made of quality of wound healing; rate of wound healing; level of pain experienced, postdressing, by the patient; and ease of use by the staff. One hundred patients in each group (standard treatment versus Epi-Lock) included approximately 40 burns, 35 abrasions, and 25 lacerations in each subgroup. The results of this study showed a statistically significant difference (P less than .01) in all categories for Epi-Lock versus standard therapy. Epi-Lock may be a useful new dressing for all types of wounds presenting to the emergency department.
To compare the opinions of patients and physicians regarding physician dress and demeanor in the emergency department, we conducted a cross-sectional survey of 190 ED patients and 129 medical specialists, family practitioners, surgeons, and emergency physicians in a community hospital. Seventy-three percent of physicians and 43% of patients thought that physical appearance influenced patient opinion of medical care. Forty-nine percent of patients believed emergency physicians should wear white coats, but only 18% disliked scrub suits. Patients were more tolerant of casual dress than were physicians. Both groups disliked excessive jewelry, prominent ruffles or ribbons, long fingernails, blue jeans, and sandals. Opinions and practices of emergency physicians were similar to those of other medical specialists. Most physicians (96%) addressed patients by surname or title, but 43% of patients preferred being called by their first names. The age, gender, income, and education of patients did not influence how they wished to be addressed. Larger studies are needed to assess the influence of age, sex, race, and depth of feeling regarding first-name address and physician attire in the ED.
Cognitive impairment can profoundly affect the skills required for activities of daily living (ADL). Most cognitive screening measures assess cognitive status rather than the cognitive functions that underlie ADL tasks. The dressing assessment guide (DAG) assesses the cognitive and functional abilities in dressing of patients with dementia. The DAG evaluates everyday and overlearned tasks and uses cues to provide a context for action. Nurses can easily administer the guide, and the resulting data provide the basis for nursing interventions.
Twenty-four patients were studied after the application of plasticized polyvinyl chloride (PVC) film as a temporary burns dressing. The burns were assessed as being partial thickness (nine patients) and full thickness (15 patients) in depth and involving 2 per cent to 35 per cent of the body surface area. Microbiological cultures were performed on the exudate beneath the plasticized PVC film and then at each dressing change until the burn was healed. Bacterial isolates showed no unexpected organisms and there was no predominant organism to suggest contamination from the plasticized PVC film. Indeed, bacteria were only rarely isolated from the initial exudate (three of 37 burn wounds), and subsequent bacterial cultures did not differ from those normally found in burn wounds. In addition, incorporation of the plasticized PVC film into nutrient broth and agar with Staph, aureus and Ps. aeruginosa did not influence the recovery of these organisms, indicating that plasticized PVC film does not exert any antibacterial effect.
This study compares a moisture-vapour-permeable film (MVPF) with silver sulphadiazine in a randomized prospective manner for the treatment of outpatient burns. The two treatment groups were closely matched in age, sex, per cent of BSA burned, and in burn severity and locations. The MVPF group demonstrated a 39.0 per cent greater reduction in pain after application of the dressing over the silver sulphadiazine group. Patients in the MVPF film group also reported significantly less difficulty in wound care and in dressing interference with their daily functions. The clinical infection rate and time to healing were similar in both groups. In the management of outpatient burns, MVPF was found to be superior to silver sulphadiazine.
A patient with mycosis fungoides illustrates the problem of pain management during wound care and suggests the utility of a novel treatment, gabapentin. Skin lesions, be they induced through necrosis of tumor, therapy (e.g., radiotherapy), or by pressure ulceration, are often the cause of continuous pain or acute wound dressing pain. Optimizing the analgesic treatment in those patients is thus of major importance. Anti-inflammatory drugs and opioids are the cornerstones in the treatment of cancer pain but are rarely sufficient to control wound pain. Different adjuvant techniques can be used, including topical analgesics, psychological distraction techniques, anxiolytics, and co-analgesics. There is growing evidence that anticonvulsants, and sodium channel blockers in particular, are effective not only in neuropathic but also in inflammatory pain. Gabapentin, a voltage sensitive sodium and calcium channel blocker, was used as a co-analgesic to supplement morphine in this case of cancer wound dressing pain.
Skin temperature of the hands of 12 volunteers was monitored. The hands were placed in bulky dressings and treated with a standard ice bag (group I) or a new cooling blanket (group II). The contralateral hands served as controls. The mean difference in skin temperatures between group I and controls was 1.5 degrees F, while the difference between group II and controls was 13 degrees F. Temperatures of the controls did not decrease with time. Newer cooling devices appear to be more efficacious than standard ice bags in accurately and significantly lowering skin temperature when used with traditional bulky hand dressings.
A brief review of the literature concerning the wound healing process is presented. A synopsis of the physical and physiologic factors that can affect the rate of this process is provided. The authors discuss the importance of the wound dressing in maintaining an optimal environment for wound healing. Modern dressings have specific indications and are frequently comprised of more than one layer. The authors define the contact layers as the layer that comes into intimate contact with the wound surface and has the greatest influence on healing. A description of some of the common products used as the contact layer is presented.