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At least 1,315 records · Page 73Linked to original sources

Porcine collagen corneal shield treatment of persistent epithelial defects following penetrating keratoplasty.

Treatment of persistent epithelial defects following penetrating keratoplasty (PK) can be difficult. The use of a 24-hour porcine collagen corneal shield (Bausch & Lomb) to promote epithelialization of these cases was compared to the use of the hydrophilic bandage soft contact lens (Bausch & Lomb, plano O4). Twenty-three consecutive patients treated for persistent epithelial defect following PK were reviewed. Sixteen of 22 (73%) treated with a bandage soft contact lens healed completely. None of seven patients with persistent epithelial defect treated with collagen shield therapy healed. Six of these seven patients were subsequently treated with a bandage soft contact lens; five (83%) healed with this therapy. These data suggest that the 24 hour collagen corneal shield is not useful in treating persistent epithelial defect following PK and that a bandage soft contact lens is significantly more effective (P less than 0.01) in these cases.

Adult↗

[Compression treatment in venous insufficiency and lymphedema].

Ambulant therapy of varicose vein conditions is only possible with compression bandages. Doctors are often very cautious with regard to compression bandaging because they believe that it cannot be learned. The paper is intending to show that such fears are unfounded. The physical principles for the individual steps in compression bandaging are therefore described. If these principles are heeded, there are no longer any obstacles to the practical application of compression bandages.

Bandages↗

Postoperative limb compression in reduction of haemorrhage after varicose vein surgery.

In varicose vein surgery, significant postoperative morbidity results from subcutaneous haematoma formation and limb swelling after saphenous vein stripping. We investigated the effectiveness of a high-compression short-stretch adhesive bandage compared with non-adhesive crêpe in reducing haemorrhage after stripping of varicose veins. Using 99mTc-labelled red blood cells, the degree of postoperative bleeding was assessed in 10 patients with bilateral varicose veins allocated for stripping and ligation. High-compression adhesive bandaging was applied to the experimental limb and a non-adhesive bandage to the contralateral control limb. Results show that adequate compression bandaging can decrease subcutaneous haematoma formation after stripping of varicose veins.

Adult↗

A combination of plastic and plaster of Paris (Kombigips) in fracture treatment.

A new model of plaster bandage with combination of gypsum and plastics is presented and its economic use is compared with traditional technics. "Kombigips" in 12 patients was more efficient in staging of fracture healing than traditional plaster bandages, because the X-ray properties of "Kombigips" are more profitable. "Kombigips" is much more cheaper than use of pure plastic bandages and nearly as cheap as use of traditional plaster bandages.

Adolescent↗

Influence of external stabilizing devices of the ankle on sport-specific capabilities.

We compared sport-specific-skills in 23 athletes with functionally unstable ankle joints to those of 18 healthy volunteers by performing a Japan test as well as a specially designed single-leg jumping test. For external stabilization of the ankle, an Aircast brace, a Ligafix Air brace, a Malleoloc brace and a tape bandage were applied. For the Japan test in the group with uninjured ankle joints, the best results were obtained when wearing the Aircast brace, followed by tape bandage, Ligafix brace and no stabilizing device in descending order. The worst results were presented by the group with the Malleoloc brace. However, there were no significant differences among these devices. In the group with functionally unstable ankle joints, the best score was achieved with the tape bandage, followed by the Ligafix brace, Mallcoloc brace and Aircast brace. The unstabilized group showed significantly worse results compared with all other groups. In the single-leg jumping test, the stabilizing devices had no negative influence on the jumping capability in the uninjured ankle joints. Additionally, there was no significant difference among the orthoses. Volunteers with unstable ankle joints experienced a significant improvement of jumping performance with most of the devices. The best results were achieved with the Aircast brace, followed by the Malleoloc brace, Ligafix brace and tape bandage. However, there was no significant difference among these orthoses. While the reaction time of the volunteers was the same for all test situations, the time for dynamically stabilizing the ankle joint appeared to be significantly worse in those ankle joints without a brace. For athletic activities, which are dominated by movement patterns comparable to the Japan test as well as the jumping test used, these stabilizing devices seem to have no negative effect on sport-specific capabilities.

Adult↗

Face lift postoperative recovery.

The purpose of this paper is to describe what I have studied and experienced, mainly regarding the control and prediction of the postoperative edema; how to achieve an agreeable recovery and give positive support to the patient, who in turn will receive pleasant sensations that neutralize the negative consequences of the surgery.After the skin is lifted, the drainage flow to the flaps is reversed abruptly toward the medial part of the face, where the flap bases are located. The thickness and extension of the flap determines the magnitude of the post-op edema, which is also augmented by medial surgeries (blepharo, rhino) whose trauma obstruct their natural drainage, increasing the congestion and edema. To study the lymphatic drainage, the day before an extended face lift (FL) a woman was infiltrated in the cheek skin with lynfofast (solution of tecmesio) and the absorption was observed by gamma camera. Seven days after the FL she underwent the same study; we observed no absorption by the lymphatic, concluding that a week after surgery, the lymphatic network was still damaged. To study the venous return during surgery, a fine catheter was introduced into the external jugular vein up to the mandibular border to measure the peripheral pressure. Following platysma plication the pressure rose, and again after a simple bandage, but with an elastic bandage it increased even further, diminishing considerably when it was released. Hence, platysma plication and the elastic bandage on the neck augment the venous congestion of the face. There are diseases that produce and can prolong the surgical edema: cardiac, hepatic, and renal insufficiencies, hypothyroidism, malnutrition, etc. According to these factors, the post-op edema can be predicted, the surgeon can choose between a wide dissection or a medial surgery, depending on the social or employment compromises the patient has, or the patient must accept a prolonged recovery if a complex surgery is necessary. Operative measures which prevent extensive edemas are: avoiding transection of the temporal pedicle, or to realizing platysma plication too tight by using strong aspirative drainage instead of elastic bandages. In the post-op, the manual lymphatic drainage is initiated on the third or fifth day, but must be done by a trained professional, in a method contrary to that specified in the books for non-operated individuals. An aesthetician washes the hair and applies decongestive cold tea on the face the second day, and on the fifth, moisturizes the skin and cosmetically conceals any signs of bruising. The psychological support provided by the staff keeps the patient calm and relaxed. Five years experience with this protocol has enabled us to minimize post-op pain. The edema can be predicted with certain consistency (in which surgery there will be more or less edema) and the proper technique can be selected, permitting the patient to choose the best moment for a FL while the surgeon can avoid intra and postoperative measures that increase the edema. After surgery, the patient receives the daily assistance of the staff, which rapidly and efficiently improves this condition. We can predict and control the post-op recovery and the patient feels fine, unlike the past when recovery was abandoned to its natural evolution. If the patient perceived an intensive, positive support on behalf of the entire staff that kept him or her content, then we have succeeded in doing an excellent marketing. This may encourage others to undergo aesthetic surgery, especially those who are convinced that after surgery they might have to endure considerable suffering.

Edema↗

Barrier and antibacterial properties of 2-octyl cyanoacrylate-derived wound treatment films.

BACKGROUND: Besides enhancing healing, an ideal dressing should prevent invasion of pathogens and control the number of bacteria already present in the wounds. OBJECTIVE: To evaluate the barrier and antimicrobial properties of a cyanoacrylate-based bandage (LAB) against Staphylococcus aureus or Pseudomonas aeruginosa on partial thickness wounds in swine. METHODS: Barrier study: Bacteria were inoculated over test materials (LAB, standard bandage, air-exposed) that were placed over wounds. The bacteria from wounds were quantitated at 24, 48, and 72 hours postinoculation. Antimicrobial study: Wounds inoculated with bacteria were covered with LAB, standard bandage, or hydrocolloid bandage or left air-exposed. The bacteria recovered from wounds were quantitated at 24 and 72 hours after treatment. RESULTS: Barrier study: No bacteria were recovered from LAB-treated wounds. Antimicrobial study: LAB reduced the number of inoculated bacteria in comparison to all other groups. CONCLUSION: LAB is effective in protecting wounds from external bacterial invasion and reducing bacterial contamination.

Animals↗

Dosimetry and use of an immobilization system for head and neck radiotherapy treatments.

The day-to-day reproducibility of planned radiotherapy treatment is an important precondition for achieving good clinical results and reducing toxic effects. This reproducibility is difficult to achieve in the irradiation of head and neck malignancies because of the mobility of this anatomical area. This paper presents a dosimetric study and analysis of the utility of a facial mask immobilization system prepared from an orthopedic glass-fiber bandage. The dosimetric study conducted on a lucite phantom shows that the interposition of one, two, or three layers of the bandage reduces the deep absorbed dose by about 1% at 0.5 cm2, while increasing the absorbed surface dose by 12% (for a field of 15 X 15 cm2 and one layer of bandage) to 46% (for a field of 5 X 5 cm and three layers of bandage). The dosimetric study conducted on a Rando Anderson manikin shows an average increase in the skin dose of about 8% and a maximum increase of about 20%. The good dosimetric results and the practicality of this system of immobilization have persuaded us to propose it as an alternative to the systems currently on the market, which, although rather more sophisticated, are also more expensive.

Head and Neck Neoplasms↗

Paracentral rheumatoid corneal ulceration. Clinical features and cyclosporine therapy.

Six patients with rheumatoid arthritis (eight eyes) presented with small paracentral perforating corneal ulcers in otherwise quiet eyes. Initial management in five patients (seven eyes) consisted of systemic immunosuppression and therapeutic tissue adhesive with a bandage contact lens or tectonic keratoplasty. Ulceration recurred in all of these eyes, and recurrent ulcers treated with repeat tectonic keratoplasty or therapeutic tissue adhesive and a bandage contact lens all developed recurrent ulceration. The introduction of topical cyclosporine therapy in five eyes with recurrent corneal ulceration was associated with arrest of keratolysis and rapid re-epithelialization of the ulcer in all cases. One corneal ulcer was successfully treated initially with topical cyclosporine, tissue adhesive, and a bandage contact lens. In patients with rheumatoid arthritis and small paracentral corneal ulcerations or perforations, application of tissue adhesive and a bandage contact lens and introduction of topical cyclosporine may be the preferred initial treatment.

Aged↗

Role of saphenous vein surgery in the treatment of venous ulceration.

BACKGROUND: This paper describes local anaesthetic saphenous disconnection in elderly patients for the treatment of venous ulceration in legs with either saphenous venous reflux alone or in combination with deep venous reflux. METHODS: Ambulatory venous pressure was measured in 16 legs with saphenous vein reflux alone and in nine legs with combined deep and saphenous venous reflux before, immediately after and 3 months after saphenofemoral or popliteal disconnection. Ulcer area was measured by computerized planimetry before surgery and at 1 and 3 months after operation. No compression bandages or hose were applied after surgery unless the ulcers had not begun to heal after 1 month. RESULTS: In legs with saphenous reflux alone all ulcers healed without compression bandages at a median of 81 (range 14-253) days and the pressure relief index (PRI) improved significantly both after surgery and at follow-up. None of the ulcers in the nine limbs with saphenous and deep venous reflux healed without compression bandaging and the PRI was unchanged immediately following surgery and at follow-up. CONCLUSION: Saphenous vein disconnection improves venous function and heals venous ulcers without compression bandaging if the deep veins are normal. This procedure under local anaesthetic may be particularly suitable for elderly patients, but long saphenous vein stripping should be added in young patients.

Aged↗

Risk of vaccinia transfer to the hands of vaccinated persons after smallpox immunization.

Transmission of vaccinia virus after smallpox vaccination is a concern. We conducted a prospective examination of the protection afforded by vaccination-site bandages in recently vaccinated individuals. After smallpox vaccination, inoculation sites were covered with 2 occlusive dressings. Site assessment and bandage changes occurred every 3-5 days until the site was healed. At each visit, specimens from the vaccination site, outer dressing surface, and contralateral hand were obtained for vaccinia culture. For 148 vaccinated subjects, vaccinia was detected from vaccination lesions of every subject on several occasions. Only 6 (0.65%) of 918 dressing (95% CI, 0.24%-1.4%) and 2 (0.22%) of 926 hand (95% CI, 0.03%-0.78%) specimens tested positive for vaccinia. The mean number of bandage changes was 9.6 (95% CI, 9.17-10.0). Vaccinia autoinoculation did not occur. The rate of vaccinia recovery outside occlusive bandages covering smallpox vaccination sites was remarkably low, suggesting excellent protection against inadvertent transmission.

Adult↗

Ciprofloxacin interaction with silicon-based and conventional hydrogel contact lenses.

PURPOSE: Hydrogel contact lenses can be used as bandage lenses to protect the corneal surface after injury. The use of novel silicon-based hydrogel lens materials as bandage lenses has not gained widespread acceptance. As a first step toward advocating their usefulness as bandage lenses, their interaction with ocular pharmaceuticals must be understood because topical agents are often administered in conjunction with bandage lenses. METHODS: The in vitro uptake and release of ciprofloxacin from silicone-based hydrogel (SH) and conventional pHEMA-based (CH) hydrogel contact lenses was examined by spectrophotometric evaluation of the drug concentration in saline solution. RESULTS: The hydrogel contact lenses tested showed similar drug uptake (average 1800 microg/lens) but different levels of drug release. Multiphoton laser microscopy indicated that ciprofloxacin was distributed throughout the lens thickness, with higher levels of drug at the surface owing to drug precipitation. The drug adsorption onto the lenses was partially reversible. The SH lenses released a lower amount of drug than CH lenses (72 vs. 168 microg/lens). Ionic lenses released less drug than non-ionic lenses (127 vs. 151 microg/lens). CONCLUSIONS: The differences in ciprofloxacin uptake and release between SH and CH materials may not be clinically significant because the amount of drug released from all lenses would be above the MIC(90) of ciprofloxacin for common ocular pathogens. These results indicate that material properties have a significant impact on drug-lens interactions.

Adsorption↗

Maintenance of subcutaneous cavities with CO2.

UNLABELLED: Since mechanical retractors in endoscopic plastic surgery cause certain drawbacks, we developed a model in dogs, which, by insufflating CO2 into a subcutaneous cavity, we were able to maintain. We evaluated the magnitude of subcutaneous emphysema and absorption of CO2 by insufflating different pressures and the efficacy of external pressure on the skin with the purpose of limiting the subcutaneous emphysema. Sixteen dogs were divided in 3 groups, A, B, and C. We controlled the pulmonary function by using a volume-cycle ventilator. In all groups, we maintained a subcutaneous cavity by insufflating CO2. Groups A and C were insufflated at 15 mm Hg; group B, at 8 mm Hg. We placed circumferential Esmarch bandages on the thorax of groups B and C to delimit superiorly and inferiorly the surgical area. Arterial blood gas analyses (ABGA) were taken from the femoral artery 60 minutes after intubation, 60 minutes after Esmarch bandage was placed and at the end of the CO2 insufflation. Statistically, results were analyzed by Wilcoxon test. P < 0.05 was considered statistically significant. Group A showed extensive subcutaneous emphysema. Two dogs died. The systemic increase of the CO2 showed a median of 9.6 mm Hg (P < 0.05). In Group B, Esmarch bandages caused increase in CO2, with a median of 1.65 mm Hg (P < 0.028). None of these dogs showed subcutaneous emphysema during the insufflation after CO2 insufflation pressure augmented with a median of 3.7 mm Hg (P < 0.028). In Group C, chest restriction increased CO2 median of 6.1 mm Hg (P < 0.043), and subcutaneous emphysema shown was less extensive than group A. The CO2 increased after insufflation a median of 16 mm Hg (P < 0.043). CONCLUSIONS: Subcutaneous cavities can be maintained open with CO2 insufflation at 8 mm Hg, limiting perfectly the surgical area; as done with Esmarch bandages, it reduces CO2 absorption and makes this procedure safe.

Animals↗

Developing skills in leg ulcer nursing: the lessons learned.

The high treatment costs of inappropriate leg ulcer management are well referenced. Wide variations in practice have also been reported. A training programme for community nurses has been in place in Leicestershire and Rutland NHS Trust for five years. Its objective is to promote evidence-based leg ulcer management. The aim of this prospective audit was to assess and compare the effectiveness of the compression bandage systems used in the trust: the original Charing Cross system (August 1996 to September 1997) and Robinson's Ultra Four kit (October 1997 to December 1998). All patients with leg ulceration were assessed using the Leicestershire leg ulcer assessment form. This was submitted along with an audit tool to the tissue viability service in exchange for a 12-week supply of compression bandages. The audit form was resubmitted after each subsequent 12-week period until the patient either had healed or was withdrawn from the audit. Differences between the two groups in mobility, previous deep vein thrombosis, fixed ankle deformity, the male to female ratio, duration of ulcer and ulcer surface area were noted. Patients using the Ultra Four kit had faster healing times than those given the Charing Cross system, but this was not statistically significant. Cost comparisons between the previous dressing regimen and compression bandaging showed a significance difference (p < 0.001). There was also a significant reduction in nurse time (p < 0.001). The audit results showed that compression bandaging therapy was an effective method of achieving healing in patients with venous leg ulcers and that significant cost savings were made in terms of dressing cost and nurse time. Furthermore, there were potential benefits in continuing compression therapy for the group of non-healers.

Adult↗

Exsanguination of the upper limb in healthy young volunteers.

Using a scintigraphic technique based on an autologous injection of 99mTc-labelled erythrocytes, we have evaluated the efficiency of different exsanguination procedures in the upper limb of ten healthy male volunteers. The methods were elevation alone, the use of the Esmarch bandage or a gauze bandage, the Pomidor roll-cuff, the squeeze method and the Urias bag. The various procedures gave the following median percentage reductions of blood volumes: elevation for 5 seconds 44%, 15 seconds 45%, 30 seconds 46%, 60 seconds 46% and 4 minutes 42%, the Esmarch bandage 69%, a gauze bandage 63%, the Pomidor roll-cuff 66%, the squeeze method 53%, and the Urias bag 57%. With regard to elevation alone no significant differences were found. All the external methods were significantly more effective than elevation alone. Overall, the squeeze method was found to be the best method of exsanguination before inflation of a tourniquet, because it is effective, fast, practical and inexpensive.

Adult↗

A new thermoplastic casting material. A comparison between plaster of Paris and Hexelite.

Plaster of Paris and Hexelite, a new thermoplastic bandage, were compared in the treatment of 183 patients with malleolar fractures, Colles' fractures or distortions of the finger joints. There were no statistically significant differences between the two types of bandages taking into account the strength of the bandage, the amount of skin damage and the patient's opinion of the bandage. Hexelite is seven times more expensive than plaster of Paris, and, in addition, is more difficult to handle. Hence its use has been discontinued.

Adult↗

[Long-term experience with adjustable gastric banding].

Obesity is the most common multifactorial metabolic disorder defined as an increased portion of the adipose tissue in the human body. The latest WHO report mentions a pandemia of the obesity. In the Czech Republic, its prevalence is currently 25.7% in females and 22.4% in males. A conservative approach is the main treatment method in the morbid obese patients. In case it fails, a surgical treatment is yet another option. The authors have conducted bariatric surgery (the surgical management of obesity) in the 1st Surgical Clinic since 1984. In 1993 they performed the first non-adjustable gastric bandage (NGB) using laparoscopy and since 1997 they have also performed adjustable bandages (AGB) in selected patients. From 1993 to 2004 they performed 734 procedures for morbid obesity. 647 (88%) obese patients had the gastric non-adjusable bandage applied and 87 (12%) of the obese patients had the adjustable bandage applied.

Adult↗

Candida albicans infections in leg ulcers and surrounding skin after the use of ointment impregnated stockings.

Six elderly women treated with double elastic bandages for chronic venous leg ulcers presented a clinical picture beneath these bandages as seen in intertriginous candidiasis. Painful, bright red, glistening skin lesions with pustules, denuded skin and scales were seen. Cultures on Sabouraud's agar from skin erosions and toe webs confirmed the suspicion of Candida albicans infection. Treatment with topically applied clotrimazole cream resulted in relief of pain and healing of skin lesions. There is a possibility of the Candida albicans having been transmitted from the toe webs by the bandages, and that the bandages creates a microenvironment suitable for growth of the yeast.

Aged↗