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PubMed2006

The effect of treating infected skin grafts with Acticoat on immune cells.

A study was conducted to determine the effect of Acticoat placed on an infected skin graft on parameters of immunity. Two partial thickness wounds (2 cm x 4 cm) were created on the dorsal midline of Hartley guinea pigs (n=28). Wounds were covered with autologous skin graft and maintained either aseptically (Noninoculated, n=8), inoculated with Staphylococcus aureus (Surgery-Inoculated, n=8) with or without Acticoat bandage (Surgery-Inoculated-Acticoat, n=6). Five days later, splenocytes and blood were collected to estimate natural killer cell (NK) cytotoxicity, proliferative response to T and B cell mitogens and neutrophil oxidative burst. Animals that did not undergo surgery were included as a nonsurgery control group. [(3)H]-thymidine incorporation in response to a variety of T and B cell mitogens was significantly lower for all groups undergoing surgery compared to the nonsurgery control group (p<0.0001) and no additional effect was observed on this immune measure by applying the Acticoat bandage. The Surgery-Inoculated-Acticoat group exhibited greater NK cytotoxic activity (as assessed as the ability to lyse K562 tumor cells) compared to the Surgery-Inoculated group (p<0.006). The Surgery-Inoculated-Acticoat group had higher neutrophil oxidative burst at 5 min post stimulation, but was not different from controls after 15 min. In conclusion, the application of an Acticoat bandage to an inoculated surgery wound did not alter the low cell-mediated immune response that followed surgery, but appeared to increase parameters (NK cytotoxic activity and neutrophil function) of innate immunity.

Animals↗
PubMed2000

Successful treatment of severe wrinkled corneal flap after laser in situ keratomileusis with deionized water.

PURPOSE: To investigate a case of severe wrinkled corneal flap after laser in situ keratomileusis (LASIK) successfully treated by hydrating the flap with deionized water and applying a bandage contact lens. METHODS: A 39-year-old woman presented with corneal flap wrinkles 24 hours after undergoing LASIK in her left eye. Under the operating microscope the flap was refloated and hydrated with sterile deionized water for 2 minutes without stretching or ironing the flap. A bandage contact lens was then applied for 24 hours. Sterile deionized water was used topically every 2 hours for 1 day. RESULTS: Twenty-four hours after treatment with sterile deionized water and a bandage contact lens, the cornea was smooth and wrinkle free. CONCLUSIONS: Hydration with deionized water may offer advantages over isotonic solutions in treating a wrinkled corneal flap after LASIK.

Adult↗
PubMed1989

Management of exuberant granulation tissue.

Exuberant granulation tissue is common in large, lower limb wounds of horses, particularly horses of large body size. Methods of control include chemical cautery, cryogenic surgery, and surgical resection. Surgical resection is preferred because it is easy to perform, provides tissue for histologic evaluation, and preserves the epithelial margin. Effective treatments to prevent the formation of granulation tissue include leaving granulating wounds open to the air or, possibly, bandaging with topical steroids. Bandaging or casting may promote exuberant granulation tissue in wounds in which it has already formed, but bandaging and casting are still important in the early management of lower limb or hock wounds in horses. The use of skin grafts or delayed secondary wound closure is frequently necessary to prevent the recurrence of exuberant granulation tissue.

Animals↗
PubMed1995

A corneal lens/shield system to promote postoperative corneal epithelial healing.

We used a disposable bandage soft contact lens piggybacked onto a medicated, 12-hour corneal collagen shield to promote postoperative corneal epithelial healing and to provide sustained delivery of high levels of medications after corneal surgery in patients known to have poor corneal epithelial wound healing characteristics. Our experience with three patients indicates that the collagen shield dissolves completely by the first postoperative day and that the bandage lens remains in place with good mobility until it is removed when epithelialization is complete. This system eliminates the need for painful manipulation and placement of a bandage soft contact lens in an edematous, inflamed eye during the immediate postoperative period.

Biological Dressings↗
PubMed1999

Vascular surgical society of great britain and ireland: role of superficial vein surgery in treatment of venous ulceration

BACKGROUND: Recent colour duplex studies of patients presenting with venous ulceration in the community have shown that between 55 and 60 per cent have isolated superficial venous insufficiency. Previous studies of the role of superficial surgery in the treatment of venous ulceration have applied postoperative compression bandaging and therefore it has not been possible to determine the role of superficial surgery in promoting ulcer healing. The purpose of this prospective study was, therefore, to examine the healing rate after superficial surgery in patients with isolated superficial venous incompetence and venous ulceration who did not undergo postoperative compression bandaging. METHODS: Patients with isolated superficial venous incompetence, as demonstrated by colour duplex scanning and an ankle : brachial pressure index greater than 0.8, underwent saphenofemoral or saphenopopliteal disconnection under local anaesthesia, or a high tie and strip under general anaesthesia. Compression bandaging was not applied after operation. Patients were followed regularly after surgery and the endpoint was ulcer healing. RESULTS: Between May 1994 and July 1997, 122 legs with venous ulceration and isolated superficial venous incompetence underwent superficial surgery. Ninety-three (76 per cent) had long saphenous incompetence alone, 13 (11 per cent) had short saphenous incompetence alone and 16 (13 per cent) had combined long and short saphenous incompetence. The median (range) patient age was 72 (28-94) years and the median duration of ulceration was 32 weeks (range 2 weeks to 32 years). The median (range) ulcer area was 9 (1-500) cm2. Ninety patients (74 per cent) had a local anaesthetic procedure while 32 (26 per cent) had general anaesthesia. Of patients who had long saphenous surgery, 69 had high ligation only and 24 had high ligation and strip. The healing rate by life-table analysis was 58 per cent at 6 months, 73 per cent at 1 year and 82 per cent at 18 months. Clinical review and colour duplex examination of patients with ulcers that had failed to heal (n = 18) showed that two had recurrent superficial to deep connections; the remainder had fixed ankle joints or severe osteoarthritis of the hip and knee. CONCLUSION: Superficial venous surgery in patients with isolated superficial venous incompetence and venous ulceration can achieve a very high healing rate in the absence of postoperative compression.

Journal Article↗
PubMed2001

Effect of external ocular surgery and mode of post-operative care on plasminogen, plasmin, angiostatins and alpha(2)-macroglobulin in tears.

PURPOSE: To determine whether corneal surgery and the mode of post-surgical treatment influence the distribution of plasminogen, plasmin, angiostatins and alpha(2)-macrogobulin in tear fluid. METHODS: Subjects underwent either photorefractive keratectomy (PRK), insertion of intra-stromal corneal rings (ICR), or cataract ablation followed by insertion of an intra-ocular lens (IOL). Post-surgical treatment consisted of prophylactic use of antibiotic and anti-inflammatory agents followed either by patching for 24 hours, or covering the wounded cornea with a bandage soft contact lens. Open eye tear fluid (OTF) was obtained prior to surgery and 10 minutes after patch removal or 24 hours after surgery and thereafter with the bandage lens still in place. After centrifugation, supernatants and controls were western blot analyzed using a protocol designed to allow the simultaneous semi- quantitative detection of alpha2-macroglobulin, plasminogen, plasmin, angiostatins and interleukin-8 (IL-8). RESULTS: No obvious differences were apparent in OTF recovered from contralateral control eyes compared to the surgical eyes in individuals who underwent PRK surgery and whose eyes were covered with a bandage contact lens. In contrast, OTF samples recovered 10 minutes after patch removal from all individuals contained elevated levels of alpha2-macroglobulin and a diverse mixture of elevated levels of plasminogen/plasmin, angiostatins and possibly a plasmin-a1-antiplasmin complex. All of these changes were seen, albeit to a lesser extent, in the patched control OTF samples. IL-8 could not be detected in any sample. The composition of the tear film returned to near normal on subsequent sampling 24 hours after patch removal. CONCLUSIONS: Patching results in a marked increase in the concentration of various proteins which could modulate inflammation and wound healing.

Angiostatins↗
PubMedDate not supplied

Techniques to maintain a bloodless field in lower extremity surgery.

PURPOSE: Most surgeons and podiatrists prefer to operate on toes and feet with a bloodless operating field. This can be achieved with a pneumatic tourniquet applied to the thigh after exsanguination of the limb with a rubber bandage or with an Esmark bandage alone, placed below the knee. A pneumatic tourniquet requires the use of general anesthesia with associated increased risks. The purpose of this study was to describe the differences in the complications in patients who have had foot surgery with either a thigh pneumatic tourniquet or a lower-leg Esmark bandage. SAMPLE: 120 patients underwent foot surgery at a 350-bed tertiary care facility in Central Texas. DESIGN: A retrospective, descriptive study of the postoperative complications after foot surgery. RESULTS: Based on limb assessment in the operating room and in day surgery, there were no adverse effects at the site of placement of the Esmark or the pneumatic tourniquets or unexpected postoperative problems at the surgical site. No patient expressed any problems at the site of placement of the Esmark or the pneumatic tourniquet. CONCLUSIONS: A calf ankle Esmark with adequate padding is a safe and effective method to achieve a bloodless surgical field for foot and ankle surgery.

Adolescent↗
PubMed1999

The influence of systemic growth hormone administration on the healing time of skin graft donor sites in a pig model.

A more rapid healing of skin graft donor sites has often been observed during ultimoratio therapies with growth hormone in adults who have suffered extremely severe burns. The purpose of this animal experimental study was to examine the influence of systemic growth hormone administration on the healing time of skin graft donor sites under standardized conditions in pigs. The animals were 14 (7 experimental and 7 control) male, sexually mature, German domestic pigs, in which 30 skin graft donor sites 8 cm x 4 cm and 0.6 mm deep were created. Fifteen each of the skin graft donor sites were bandaged with the same material [hydrocolloid bandage (Varihaesive E) and PVP-iodine gauze (Braunovidon Gaze)]. The test period was 15 days for each pig, whereby recombinant growth hormone (0.5 IU/kg body weight per day) was applied subcutaneously in the experimental group. The bandages were changed under brief narcosis every 2 days, during which one skin-punch biopsy was taken per skin graft donor site, and blood samples were drawn for determination of the serum IGF-1 values. Photographic documentation was also recorded. The biopsies were examined histologically (hematoxylin and eosin stain) and immunohistochemically (collagen IV and VII, and laminin), whereby histologically the start of keratinization was assessed as a healing criterion. The serum IGF-1 values in the growth hormone group were statistically significantly higher than in the control group. Immunohistochemically, a complete basal membrane was observed in both the experimental and the control group after the 7th or 8th day. A clearly elevated serum IGF-1 level correlated in the growth hormone group with the skin graft donor sites healing. It could thus be demonstrated both clinically and histologically that systemic application of growth hormone results in a statistically significantly more rapid healing of the skin graft donor sites by 2 days earlier than in the control group.

Animals↗
PubMed2005

Amniotic membrane transplantation in refractory neurotrophic corneal ulcers: a randomized, controlled clinical trial.

PURPOSE: This study was designed to compare and evaluate the efficacy of amniotic membrane transplantation with the conventional management (tarsorrhaphy and bandage contact lens) in eyes with refractory neurotrophic corneal ulcers. METHODS: Thirty eyes of 30 patients (14 females and 16 males) with neurotrophic corneal ulcers refractory to medical management were included and divided randomly into group 1 (n = 15), who received conventional management with a tarsorrhaphy (n = 11) or bandage contact lens (n = 4), and group 2 (n = 15), who underwent Amniotic Membrane Transplantation. The outcome parameters evaluated were epithelialization time, duration of healing of corneal ulcers, and improvement in best corrected visual acuity. RESULTS: The mean age in our study was 37 +/- 14.71 years. At the end of 3 months follow-up, 10 of 15 patients (66.67%) in group 1 showed complete epithelialization and subsequent healing and 11 of 15 patients (73.33%) in group 2 showed complete epithelialization and healing (P > 0.05). The median time for complete epithelialization was 21 days in both groups. Both groups showed an improvement in the best-corrected visual acuity. CONCLUSIONS: Both amniotic membrane transplantation and conventional management (tarsorrhaphy or bandage contact lens) are effective treatment modalities for refractory neurotrophic corneal ulcers.

Adolescent↗
PubMedDate not supplied

Feline onychectomy at a teaching institution: a retrospective study of 163 cases.

One hundred sixty-three cats underwent onychectomy from January 1985 to November 1992. Onychectomy was performed with guillotine-type nail shears (62%), surgical blade (24.5%), or both (8.6%), and wound closure consisted of bandages alone (61.3%), bandages after suture closure (26.4%), or tissue adhesive application (9.2%). The duration of surgery was significantly longer when onychectomy was performed with a blade or when suture closure was used instead of bandages alone (P < .05). Fifty percent of the cats had one or more complications immediately after surgery. Early postoperative complications included pain (38.1%), hemorrhage (31.9%), lameness (26.9%), swelling (6.3%), or non-weight-bearing (5.6%), and were observed more frequently after blade onychectomy (P < .001). Follow-up was available in 121 cats; 19.8% developed complications after release. Late postoperative complications included infection (11.6%), regrowth (7.4%), P2 protrusion (1.7%), palmagrade stance (1.7%), and prolonged, intermittent lameness (0.8%). Late postoperative complications were observed more frequently after shears onychectomy (P = .018). Use of tissue adhesive was associated with more postoperative lameness (P < .02) and, when used after shears onychectomy, with more infections (P = .049).

Animals↗
PubMed2000

The effect of a new tissue-adhesive wound dressing on the healing of traumatic abrasions.

BACKGROUND: Octylcyanoacrylate is a new medical-grade adhesive with antimicrobial properties. It forms a thin, flexible, occlusive bandage. OBJECTIVE: To determine the gross and histological effects of the spray bandage when treating abrasions. METHODS: Abrasions were produced on the flanks of 18 albino guinea pigs and randomized to treatment with a control (Biobrane) or octylcyanoacrylate dressing. The wounds were assessed with digital photography using a previously validated method. Histopathological analysis was done on day 14. RESULTS: There were no differences in the mean wound-healing ratios on days 1 (1.25 vs. 1.23, p = 0.61), 7 (1.15 vs. 1.13, p = 0. 14) and 14 (1.03 vs. 1.02, p = 0.63) for tissue adhesive and Biobrane, respectively. There were no differences found on histopathological analysis either. CONCLUSIONS: This external spray bandage was well tolerated and did not show any signs of histotoxicity or adverse wound healing.

Animals↗
PubMed2006

Attempted transmission of Candidatus Mycoplasma haemominutum and Mycoplasma haemofelis by feeding cats infected Ctenocephalides felis.

OBJECTIVE: To determine whether Mycoplasma haemofelis (Mhf) and Candidatus Mycoplasma haemominutum (Mhm) can be transmitted by ingestion of Mycoplasma-infected Ctenocephalides felis and by-products (feces, larvae, and eggs). ANIMALS: 10 cats. PROCEDURE: 3 cats were carriers of Mhf, and 1 was a carrier of Mhm. Six cats had negative results of PCR assay for Mhf and Mhm DNA. A chamber containing 100 C felis was bandaged to 2 Mhf carrier cats. Five days later, fleas and by-products were analyzed for Mycoplasma spp DNA. The remaining fleas and a sample of by-products were fed to 2 Mycoplasma-naïve cats. A chamber containing 200 C felis was bandaged to the Mhm carrier cat. Five days later, fleas and by-products were analyzed for Mycoplasma spp DNA. The remaining fleas and a sample of by-products were fed to 2 Mycoplasma-naïve cats. A chamber containing 200 C felis was bandaged to an Mhf carrier cat and Mhm-carrier cat. Three days later, fleas and by-products were analyzed for Mycoplasma spp DNA. The remaining fleas and a random sample of by products were fed to 4 Mycoplasma-naïve cats. All cats were monitored for infection for >or=7 weeks. RESULTS: Uptake of Mhf and Mhm DNA into fleas and by-products was detected. None of the naïve cats became infected. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that ingestion of Mycoplasma-infected C felis or by-products is not an important means of transmission for Mhf or Mhm.

Animals↗
PubMedDate not supplied

Anterior stromal puncture in the treatment of loose epithelium after LASIK.

PURPOSE: To describe anterior stromal puncture, with or without a bandage contact lens, as a means to treat LASIK epithelial defects and potentially reduce the likelihood of secondary diffuse lamellar keratitis (DLK). METHODS: Six eyes of five LASIK patients had their microkeratome pass complicated by loose epithelium, central in one case. After repositioning the flap, a 25-gauge needle on a tuberculin syringe was used to puncture the anterior corneal stroma to just beneath Bowman's layer in the affected area of irregular epithelium. A bandage contact lens was placed on two eyes, including the one with loose epithelium centrally. RESULTS: Normal appearance of the corneal epithelium was noted by postoperative day 1; no eye developed DLK or significant epithelial ingrowth postoperatively. All eyes achieved > or = 20/20 vision. CONCLUSIONS: By obviating, in select cases, the need for bandage contact lenses, anterior stromal puncture could increase patient comfort and remove a potential source of infection.

Adult↗
PubMed2004

[Monolayered amniotic membrane transplantation as a palliative treatment for bullous keratopathy].

PURPOSE: To determine the efficacy of monolayered amniotic membrane transplantation for short and medium-term symptomatic improvement in those cases of bullous keratopathy where a penetrating keratoplasty is not indicated. METHODS: Amniotic membrane transplantation was performed in five patients with symptomatic bullous keratopathy in which penetrating keratoplasty was not indicated. Data about bandage contact lens need before and after surgery, existence of ocular pain, occurrence and extension of bullae, epithelial defects, and persistence of amniotic membrane, were obtained at days 4 and 14, and months 1, 2, 4 and 6 after surgery. RESULTS: No pain, bullae or epithelial defects were present at day 14 in any patient. However, progressive dissolvement of the amniotic membrane was accompanied with more bullae and pain. At 6th month, 4 of 5 patients required bandage contact lens. CONCLUSION: Amniotic membrane transplantation alleviates short-term symptomatic bullous keratopathy and preserves corneal anatomy. Six months after surgery, anatomical and symptomatic improvement does not avoid the need of bandage contact lens.

Amnion↗
PubMedDate not supplied

Semirigid external fixation for repair of fractures in young animals.

An alternative method for external coaptation of fractures in young animals utilizes tongue depressors incorporated in a bandage consisting of a thick layer of cotton padding, gauze bandaging, and adhesive tape. This method was used in 13 cases with fractures of the tibia or the radius and ulna, some of which were open. Five cases (four dogs and a cat) had displaced fractures, and eight cases had either nondisplaced or only mildly displaced fractures. Size of the animal was not considered a limiting factor. Bandages were examined periodically. All fractures healed uneventfully, and the splints were removed 21-to-44 days after application. This method of external coaptation proved to be easy to apply and modify during the healing process and was applicable to a wide variety of fractures with good results.

Animals↗
PubMed1999

[CBO-guideline for diagnosis and treatment of the acute ankle injury. National organization for quality assurance in hospitals].

Following an acute ankle inversion trauma, the aim of the diagnostic strategy is to rule out a fracture and/or lateral ankle ligament rupture. Plain X-rays are indicated when weightbearing is impossible (the patient cannot take at least four steps) and/or if there is pain on palpation on the posterior aspect of the lateral or medial malleolus. This applies to the period directly following the trauma as well as 4-5 days later. In the first forty-eight hours after trauma, physical examination cannot distinguish between a distortion and a lateral ligament rupture. In a patient with a painful swollen ankle after an acute inversion trauma, a compression bandage is applied and the patient is advised to elevate the leg and to perform ankle movements, notably dorsal extension. Weightbearing on the extremity may be allowed as soon as the pain allows. A few days later, when pain and swelling have subsided, delayed physical examination for detection of a lateral ligament rupture is performed. Delayed physical examination four to five days after inversion trauma has good interobserver agreement. Additional diagnostics such as radiography, arthrography, ultrasound investigation and MRI are expensive and give no further information. In a patient with a simple distortion an elastic bandage for a few days can be applied. The patient is instructed to resume normal walking as soon as possible. Functional treatment with inelastic tape bandage or a brace application for five to six weeks is the treatment of choice for an acute lateral ankle ligament rupture. The aim of treatment is restoration of a normal range of motion within two weeks and a stable ankle at long term follow-up.

Ankle Injuries↗
PubMed2000

[Microwave effect on immunological response of chronic limb lymphedema].

OBJECTIVE: To observe the character of local and systemic immune responses in chronic limb lymphedema, and to investigate the effect of microwave on immunological response. METHODS: From November 1996 to February 1998, 27 patients with chronic limb lymphedema were adopted in this study. Among them, there were 11 males and 16 females, the average age was 36.6 years. These patients were classified as the experimental group and 10 healthy volunteers as the control group. Before and after microwave heating and bandaging treatment, T and B lymphocyte in peripheral blood and skin infiltrating cells in the patients and volunteers were detected and phenotyped with alkaline phosphatase-anti-alkaline phosphatase(APAAP) and avidin biotin peroxidase complex (ABC) immunohistochemical methods respectively. RESULTS: There were decreases of CD4+ T lymphocyte and the ratio of CD4+/CD8+ in peripheral blood and predominant dermal perivascular T lymphocyte infiltration in chronic limb lymphedema patients. After two courses of microwave heating and bandaging treatment, it was found that the number of CD4+ T lymphocytes increased and the ratio of CD4+/CD8+ was restored to normal levels, and dermal perivascular T lymphocyte infiltration decreased greatly. CONCLUSION: Microwave heating and bandaging treatment can modulate the systemic and local immunological imbalance of chronic limb lymphedema.

Adolescent↗
PubMed2002

[Results of conservative treatment of midclavicular fractures].

BACKGROUND: ln this study, we compare the outcome of conservative management by closed reduction and figure of eight bandage in cases of midclavicular fractures with previously published results of other treatment methods. METHODS: In our department between 1997-2002, 37 cases ofmidclavicular fractures having undergone conservative treatment were evaluated. RESULTS: 26 patients (70.2%) were male and the remaining 11 (29.8%) female. The average age was 34.3 years (range; 9 to 65). The claviclefractures were classified according to the Allman classification and all fractures were in group 1. After reduction, a figure of eight bandage was applied. The mean follow-up period was 29.8 months (range; 6 to 48). All the fractures showed a complete union but one case (2.7%). 1n 16.2% of the cases minor cosmetic problems were observed. CONCLUSIONS: We conclude that conservative treatment is the preferred method of treatment in cases of mid-clavicular fractures, unless there is an absolute indication for surgical therapy. This approach is easily applicable, cost effective and has fewer complications. Key Words: Midclavicular fracture, conservative treatment, closed reduction,figure of eight bandage.

Adolescent↗