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PubMedDate not supplied

Unna's boot dressings facilitate outpatient skin grafting of hands.

Present day economics have challenged health care providers to minimize the length of hospitalization without sacrificing quality of care. Within this context, the purpose of this study was to determine whether supporting the hand and wrist with an Unna's boot dressing (Medicopaste bandage; Graham-Field, Inc., Hauppauge, N.Y.) and splint, and covering the skin graft donor site with calcium alginate (Kaltostat; Calgon Vestal, St. Louis, Mo.), would allow successful outpatient skin grafting of burns to the upper extremity. Twelve patients with burns underwent debridement and split-thickness skin grafting on a total of 16 upper extremities with this method. Only patients who were otherwise healthy, had adequate home environments, and had burns limited to distal to the elbow were included for this initial trial. All skin graft donor sites were obtained from either the upper thigh or buttocks. Patients were discharged to home after 4 to 6 hours of observation and given amoxicillin for 5 days after surgery. Patients returned to the burn unit on the fifth postgrafting day for removal of the Unna's boot dressing, initiation of occupational therapy to the hands, and reapplication of a new calcium alginate dressing if needed. This and subsequent follow-up visits revealed a 95% or more take on all skin grafts, without any infectious complications. These results demonstrate the efficacy of Unna's boot support and calcium alginate dressings of donor sites in limited skin graft procedures. Furthermore, these results suggest that more extensive surgical debridements and skin graftings may be successfully shifted to outpatient procedures with use of these adjuvants.

Adolescent↗
PubMed2001

The effect of the biopatch, a chlorhexidine impregnated dressing, on bacterial colonization of epidural catheter exit sites.

We performed a prospective, randomized study in 55 ASA I to 3 women undergoing elective gynaecological surgery followed by postoperative epidural analgesia. We compared the incidence of bacterial colonization at the epidural exit site following catheter removal between a control group and an experimental group who received a chlorhexidine impregnated dressing (Biopatch, Johnson and Johnson, Arlington, TX, U.S.A.). Positive culture results were found in 11 of 27 (40.1%) patients in the control group compared with one of 29 (3.4%) patients whose epidural catheters were dressed with the Biopatch. We concluded that the Biopatch was effective in reducing bacterial colonization of the epidural catheter exit site.

Adult↗
PubMed1985

A comparison of the in vivo antibacterial effects of 'OpSite', 'Tegaderm' and 'Ensure' dressings.

Three semi-permeable polyurethane dressings, 'Ensure', 'OpSite' and 'Tegaderm', were tested for their ability to prevent the increase in bacterial population under naturally hydrated, occluded volar forearm skin. Only 'OpSite' inhibited the bacterial multiplication in these tests. It is concluded that in the practical situation, 'OpSite' could well confer a greater margin of safety.

Bandages↗
PubMed1993

Full-thickness pressure ulcers: patient and wound healing characteristics.

To investigate the patient and healing characteristics related to full-thickness pressure ulcers, 119 consecutive patients admitted with ulcers in three acute care, four longterm care, and one rehabilitation agency were studied. Of the 119 patients with 153 pressure ulcers, only 48 (40%) had full-thickness ulcers. Compared to patients with partial-thickness ulcers, patients with full-thickness ulcers were more likely to have multiple ulcers, occasional incontinence of urine and feces, a compromised overall skin condition, and a less than optimal nutritional status at baseline. Full-thickness ulcers treated with a hydrocolloid dressing (DuoDERM Hydroactive) did not develop adverse reactions; clinicians perceived the dressing to be efficacious. Ulcers that healed during the study decreased 47% in area in two weeks. This distinguished ulcers that healed from those that did not heal. The findings suggest that ulcers that do not decrease in size within two weeks should be reevaluated for additional or alternate treatments.

Aged↗
PubMedDate not supplied

Serratia rubidaea isolated from a silastic foam dressing.

A pigment-producing strain of Serratia rubidaea was isolated from two consecutive cultures from a sponge of silastic foam used as a dressing for chronic crural ulcers. The bacterium caused a red discolouration of the sponge and the surrounding part of the leg. The silastic sponge creates a new type of environment for microorganisms. The growth of previously rare bacteria such as S. rubidaea may be favoured by conditions within the sponge.

Female↗
PubMed2002

Unique management of stage 4S neuroblastoma complicated by massive hepatomegaly: case report and review of the literature.

Stage 4S neuroblastoma is an unusual malignancy that has an excellent prognosis, except in young infants. A 2-month-old with 4S neuroblastoma complicated by massive hepatomegaly, managed by abdominal decompression surgery and a negative-pressure dressing system is presented. Diffuse alveolar hemorrhage also developed, which was treated with high-dose corticosteroids.

Abdominal Muscles↗
PubMed1995

Management of lacerations in sports: use of a biosynthetic dressing during competitive wrestling.

Lacerations occur commonly during competitive contact sports. Such injuries often limit the ability of the athlete to continue competition because of concerns about further trauma to the site and risks of infection. We describe herein the use of a biosynthetic dressing, Duoderm Thin, to protect lacerations received during competitive wrestling. The dressing was able to support the skin, protect the laceration from further injury, shield the wound from exposure to infectious agents, and prevent transmission of blood or serum to other wrestlers. Such protection enabled two wrestlers to continue competition and/or practice without adverse effects.

Adolescent↗
PubMed1976

[Lyophilized split pigskin for biological wound dressings (author's transl)].

Experimental and clinical investigations of an unviable split pigskin preserve, produced by a fairly simple industrial process, outline the following results: The skin preserve protects a wound surface against infection and prevents loss of fluid. The reaction of the wound surface is very restricted even after repeated application, whilst the viable pigskin releases a more intense host reaction.

Animals↗
PubMed2004

["Abdominal dressing" - a new method of treatment for open abdomen following secondary peritonitis].

INTRODUCTION: Treatment of open abdomen following secondary peritonitis is a challenge for surgery and intensive care units (ICU). The aim of this study was to compare three different concurrent treatment strategies. METHODS: Patients suffering an open abdomen following surgery for secondary peritonitis at the Department of General Surgery from 01/01 to 12/03 were investigated. Factor studied: duration of open abdomen, incidence of multi-organ failure, need for surgical revisions, length of stay (LOS) in ICU, nursing requirements (change of dressing/day), survival and integrity of abdominal wall after discharge. Treatment strategies included: open packing (OP), classic vacuum assisted (V.A.C.(R))-therapy with silicone net protection for the intestine (CV) and V.A.C.(R)-therapy with "abdominal dressing" a newly developed meshed polyvinyl wrap (AD). RESULTS: 21 patients were studied: 5 patients were treated with OP, 8 patients with CV and 8 patients with AD. Mean LOS was 65 (OP) vs. 53 (CV) vs. 42 (AD) days (NS), peritonitis related death was 3 (OP) vs. 1 (CV) vs. 0 (AD) (p < 0.05 Chisquare test). Median nursing effort was 4 dressings/day (OP), 0.5 (CV) and 0.5 (AD) (p < 0.005 OP vs CV, AD Kruskal-Wallis test). CONCLUSION: The "abdominal dressing"-therapy seems to be a more efficient treatment option in patients suffering from open abdomen following secondary peritonitis. A trend towards shorter ICU-LOS, lower mortality rates and reduced nursing requirements support our hypothesis.

Critical Care↗
PubMedDate not supplied

Flushing due to solitary cutaneous mastocytoma can be prevented by hydrocolloid dressings.

Solitary mastocytomas occur commonly and can occasionally be associated with troublesome flushing related to rubbing. We report a child with a solitary mastocytoma who repeatedly and reproducibly caused flushing only with rubbing and scratching. Conventional treatment with antihistamines was not completely effective and caused sedation. A trial application of double-layer hydrocolloid dressing led to complete abolition of flushing episodes until the child reached an age where he could peel off the dressings. This treatment is particularly suited to very young children with solitary mastocytomas whose parents do not feel comfortable with antihistamine treatment, topical or intralesional corticosteroids, or surgical interventions. This treatment may be used alone or in conjunction with conventional therapy where there has been a failure to achieve complete control of flushing and/or blistering.

Colloids↗
PubMed1994

Evaluation of cytokines in donor site wound fluids.

The aim of the study was to measure concentrations of cytokines in wound fluid from donor sites. A film dressing was applied to the donor sites (mean size 10 x 15 cm) immediately after a split skin graft had been taken. Five days later the film was punctured with a needle and 2-3 ml of the fluid accumulated under the film dressing was withdrawn into a syringe. The fluid was snap frozen and stored immediately at -70 degrees C. The fluid was examined for epidermal growth factor (EGF), basic fibroblast growth factor (bFGF), transforming growth factor (TGF) alpha, TGF beta, interleukin (IL)-1 alpha and IL-1 beta. The results showed that the fluid accumulated under the film dressing contained growth factors and cytokines that are thought to promote healing. The fluid was rich in TGF alpha but contained no EGF or bFGF, which indicates that TGF alpha plays a major part for promoting local wound healing.

Adult↗
PubMed2003

Outcomes of hyaluronan therapy in diabetic foot wounds.

The purpose of this study was to evaluate outcomes of persons with neuropathic diabetic foot wounds treated with a hyaluronan-containing dressing. Data were abstracted for 36 patients with diabetes, 72.2% male, aged 60.0+/-10.7 years and a mean glycated hemoglobin (HbA(1c)) of 9.5+/-2.5% presenting for care at two large, multidisciplinary wound care centers. All patients received surgical debridement for their diabetic foot wounds and were placed on therapy consisting of hyaluronan dressing (Hyalofill, Convatec, USA) with dressing changes taking place every other day. Outcomes evaluated included time to complete wound closure and proportion of patients achieving wound closure in 20 weeks. Hyalofill therapy was used until the wound bed achieved 100% granulation tissue. Therapy was then followed by a moisture-retentive dressing until complete epithelialization. In total, 75.0% of wounds measuring a mean 2.2+/-2.2 cm(2) healed in the 20-week evaluation period. Of those that healed in this period, healing took place in a mean 10.0+/-4.8 weeks. The average duration of Hyalofill therapy in all patients was 8.6+/-4.2 weeks. Deeper (UT Grade 2A) wounds were over 15 times less likely to heal than superficial (1A) wounds (94.7 vs. 52.9%, Odds Ratio=15.9, 95% Confidence Interval=1.7-142.8, P=0.006). We conclude that a regimen consisting of moist wound healing using hyaluronan-containing dressings may be a useful adjunct to appropriate diabetic foot ulcer care. We await the completion of a multicenter randomized controlled trial in this area to either support or refute this initial assessment.

Adjuvants, Immunologic↗
PubMed2000

Comparison of equine amnion and a nonadherent wound dressing material for bandaging pinch-grafted wounds in ponies.

OBJECTIVE: To evaluate healing of pinch-grafted wounds on the distal aspect of the limbs of ponies bandaged with equine amnion or a standard nonadherent wound dressing material. ANIMALS: 6 ponies. PROCEDURE: A 2.5x2.5-cm full-thickness section of skin was removed from the dorsal aspect of each limb at the midpoint of the metacarpus or metatarsus. Six days later, wounds were grafted with partial-thickness pinch grafts. Half the wounds were bandaged with amnion, and the other half were bandaged with a nonadherent dressing. Bandages were changed every 3 days until wound healing was complete. At each bandage change, numbers of grafts lost were recorded, and wounds were measured. RESULTS: Percentage of grafts lost from wounds bandaged with amnion was not significantly different from percentage lost from wounds bandaged with the nonadherent dressing. Median healing time for wounds bandaged with amnion (30 days) was significantly less than median healing time for wounds bandaged with the nonadherent dressing (39 days). All wounds were healed by day 45. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that amnion can be used for bandaging pinch-grafted wounds on the distal aspect of the limbs of ponies.

Amnion↗
PubMed1995

Management of difficult wounds with Biobrane.

Nine patients with open wounds are reviewed. All wounds were debrided prior to application of Biobrane. Silver sulfadiazine was applied twice daily. All healed uneventfully after closure. Biobrane is recommended for treatment of difficult and large open wounds; its use reduces evaporative loss and bacterial proliferation, enabling development of a healthy wound base suitable for grafting or delayed closure. This approach can prevent the necessity for flap repair and reduce pain during wound dressing. Wounds such as lower extremity ulcers are often resistant to therapy. Repeated debridements may result in further desiccation without progression of wound healing. Biobrane-treated wounds develop a healthy granulating base which can be grafted or closed.

Adult↗
PubMed2002

Weekly transparent dressing changes linked to increased bacteremia rates.

BACKGROUND: In 2000, the rate of primary bloodstream infections (BSIs) was double that in 1999 for intensive care unit (ICU) patients with triple lumen catheters, pulmonary artery catheters, or both. In December 1999, changes in products and practices related to site care were implemented as a cost-saving initiative. OBJECTIVE: To determine the factors contributing to an increase of BSIs after cost-saving measures for site care had been introduced. DESIGN: Epidemiologic study involving prospective identification of infection. SETTING: A community teaching hospital. PARTICIPANTS: Patients in a 20-bed, medical-surgical ICU identified as having triple lumen catheters, pulmonary artery catheters, or both and a primary BSI during 2000 and 2001. METHODS: Alcohol swab sticks were reintroduced and the frequency of transparent dressing changes and site care was increased. Inservice presentations were conducted on aseptic technique and posters were placed reviewing site care protocol for physicians and nurses. RESULTS: The incidence of primary BSIs decreased significantly (P = .003) during a 3-month intervention and this decrease was sustained through the following 12 months. CONCLUSIONS: Prolonging the interval between the change of transparent dressings from 3 times weekly to once weekly and switching from alcohol swab sticks to pads was associated with an increase in BSIs, which was controlled after returning to the original policy.

Acute Disease↗
PubMed2000

Low-level laser therapy for wound healing: feasibility of wound dressing transillumination.

OBJECTIVE: The purpose of this study was to assess the feasibility of exposing wounds during low-level laser therapy (LLLT) by transillumination of the wound dressings. BACKGROUND DATA: LLLT has been associated with accelerated wound healing in chronic ulcers. The usual approach is to remove wound dressings prior to exposure and to treat three to five times weekly. Frequent change of wound dressings is time consuming and costly; it disrupts the healing process, increases the risk of wound infection, and may be traumatic for the patient. METHODS: A double integrating sphere setup was employed to quantify the diffuse transmittance and reflectance of various wound dressings. Differences in transmittance for large area sources and point sources were demonstrated through the use of a diode laser and an incoherent light source. RESULTS: There were a number of gels and membrane style wound dressings with diffuse transmittance of more than 50%. Hence, for these dressings the prescribed radiant exposure to the wound surface could be achieved by increasing the exposure duration, while maintaining reasonable overall treatment times. CONCLUSIONS: Although LLLT by transillumination of wound dressings is feasible for a variety of wound dressings without significant commitments in additional treatment time, the specific transmission of products not included in this study needs to be determined at the intended treatment wavelength. A transillumination approach may facilitate a faster rate of wound healing than LLLT applied to exposed wounds by reducing trauma and the risk of infection.

Absorption↗