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Dressing the exenterated orbital cavity is difficult and time consuming for staff, traumatic to the healing wound, and painful for the patient, particularly when the wound is being left to granulate. We report the use of a silastic foam dressing which offers a number of advantages in this clinical situation.
Nurses must take care that the wide range of wound dressings now available does not distract them from patients' holistic needs. Dressings must be applied to suit individual requirements.
Despite the fact that they speed up the healing process, many nurses find the array of leg ulcer dressings bewildering, and tend to rely on 'old favourites' instead. A booklet has been developed to assist in choosing the right modern dressing at each stage in an ulcer's healing.
Is there a difference in the numbers of tape injuries, hematomas, and recurrent bleeding episodes associated with the postarteriographic wound between the standard pressure dressing and the pelvic-girdle-type pressure dressing? The answers to these questions can be important to critical care nursing practices.
The dressing change core procedure has proven advantageous to our clinical staff. It has enhanced the quality of wound care because it is comprehensive, eliminating the need to look up several procedures. Wound care strategies involving new products are readily incorporated as addendums to the core procedure. Additionally, staff and students with varying levels of education and experience can understand the core procedure and apply it to their clinical practice settings. The "core" concept has made the dressing procedure one of the highlights of our skin care program.
The objective of the present study was to determine the effects of a fibrin sealant (Tisseel) on wound healing. The sealant tested is produced from human plasma. This study involved 12 adult beagle dogs, all of which underwent creation of full-thickness palatal wounds. Six animals received immediate application of a fibrin sealant as a wound dressing. Polaroid photographs were taken immediately after creation of the palatal wounds and at regular intervals during the healing period. Six measurements were obtained from these photographs. Longitudinal comparisons of the profile of the mean curves for the relative changes during the 38-day study period indicated that the six parameters investigated have similar curve profiles in both the fibrin-sealant treated wounds and the untreated control wounds. The overall direction of healing was not significantly different in the two groups. However, comparisons of the curve magnitudes indicated that there was a significantly greater reduction in wound size in the fibrin sealant treated group. Cross-sectional comparisons (analysis of variance General Linear Models procedure) indicated that in the first 2 weeks there was a relatively greater reduction in wound width in the fibrin sealant treated group of animals. No significant differences were present at the end of the experimental period. The findings of this study indicated that the fibrin sealant when used as a dressing on palatal wounds of adult beagle dogs resulted in greater wound contraction in the early stages of wound healing.
To demonstrate the effect of a two-layered polyurethane foam wound dressing (Lyomousse) on the healing of venous leg ulcers a comparative study in 41 patients (24 treated, 17 controls) was performed. For a quantification of the process of healing a computer-assisted morphometric procedure was used. This method is based on a Polaroid-photograph of the ulceration which is transferred in digital form by means of a digitizing equipment. From the digital data the primary variables area, perimeter and maximal diameter of the ulceration are calculated. For quantitative comparison the relative changes as well as the rate of the changes of the primary variables were used. The statistical comparison of the treated group and the control group showed a highly significant (p less than 0.001) promotion of wound healing for the therapy with the synthetic foam dressing using the relative changes as an indicator, and a significant (p less than 0.05) increase in the rates of changes, indicating an acceleration of healing. This therapeutical advantage can be drawn back to specific characteristics of the synthetic material, assuring a water vapour saturated micro-environment at the surface of the wound and reducing this way the detrimental effect of heat loss due to evaporation onto the healing process.
Activated-charcoal cloth and dressings product based upon this material were applied for covering burn wounds. As a control served a gauze dressings with greases and solution topical drugs. The healing of deep thermal burns of 3rd degree on rabbits studied by a histological method was differed by a rapid decreasing of inflammation reaction, active epithelialization and soft scar formation. A clinical use in 15 burned patients was shown that in combination with enzymatic and antimicrobial drug solutions these materials accelerate healing and epithelialization of superficial burn wounds and improve treatment of deep burn wounds before autodermoplasty.
A survey of the quality of bifocal glass and polycarbonate dress lenses was conducted to determine how well these lenses conform to the ANSI (American National Standards Institute) Z80.1 standard and to identify processing operations that need improvement. Eight different prescriptions were filled with polycarbonate and glass dress lenses by different laboratories. Conformance to the ANSI Z80.1 standard was determined for seven characteristics of individual lenses and one characteristic (vertical prism imbalance) of the pairs of lenses in prescriptions. The results show that 78% of the glass lenses and 43% of the polycarbonate lenses conformed to ANSI Z80.1 for the seven characteristics of individual lenses. For pairs of lenses, 88% of the glass pairs and 71% of the polycarbonate pairs have acceptable vertical prism imbalance. Glass lenses that did not conform failed for a variety of reasons, none of which dominated. Incorrect add power and excessive prism were the major causes of polycarbonate lenses not conforming.
Chronic leg ulcers in sickle cell anemia occur mainly around the ankles. The prevalence is up to 75% in adults. These ulcers are painful and debilitating, yet medical treatment is unsuccessful. Surgical treatment consists of repeated skin grafting procedures, which eventually deplete the patient's available donor sites. Thus, in vitro generation of human epidermal autograft for potential treatment of leg ulcers in sickle cell anemia was initiated. However, because epidermal cells need a supporting matrix in order to be applied to the ulcer, the authors decided to assess the independent effect of a collagen matrix alone in promoting healing of sickle cell leg ulcers. Collistat (Hellistex, Inc) dressing was applied directly to the ulcers. The ulcers were reviewed every 2 weeks, and the dressing reapplied every 4 weeks. Collagen matrix caused the chronic ulcers to heal completely in fewer than 3 months. This encouraging performance of collagen alone should be greatly enhanced by the in vitro epidermal autograft.
The use of a rapid method of teaching a severely brain injured patient to wash and dress is described. The patient, who was injured in an automobile accident eight months earlier, remained dependent in self-care after five months in an acute rehabilitation unit. He was then transferred to a Transitional Living Facility where the program was performed. The patient's physical and cognitive status remained unchanged during the program which lasted for 12 treatment days, but he did become independent in washing and dressing. Independence was maintained at six-month follow-up. Issues relating to the individual's severe memory impairment are discussed in terms of the relevance of such impairments to outcome of training techniques.
A simple, easy and effective woundclosure following dermabrasion was carried out by fixation of Transite over the Epidermal-cutaneous defect and Allevyn over this Mesh-Graft-Like biologic dressing. Transite shows very little aderence to the wound surface. It is not damaging the wound at removal. The dressing removal is painless.
To assess the effect of the catgut dressing in trophic ulcers of the lower extremities upon the dynamics of non-specific immunological reactivity the authors defined the complementary activity of the serum, concentration of the serumal lysozyme and contents of thermolabile inhibitors of the serum. The clinical and laboratory findings prove that the use of the cargut dressing in trophic ulcers of the lower extremities increases the level of non-specific immunological reactivity of an organism. The use of catgut for the therapeutic purposes stimulates the condition of natural immunity which constitutes one of the causes contributing to a favourable course of the healing processes.
A new technique of dressing using Silastic-foam which up to now has not been introduced to ORC is presented. This type of foam dressing is characterized by good adaption to the wound, high flexibility, avoidance of wound irritation and by supporting wound granulation. Several possibilities of application are described.
Twenty-seven players with superficial wounds (abrasions, turf burns, and blisters) were treated with a new Hydroactive dressing. We conclude that this dressing provides an excellent alternative to other forms of treatment since it is easy to use, comfortable, hypoallergenic, and provides impressive healing results.
Right hemisphere brain-damaged stroke patients demonstrate a variety of neurologic deficits which seem to impair their ability to regain self-care independence. Visual perceptual and visual search disorders have been implicated with persistent functional deficits. The objective of this study was to measure the extent to which defects of optokinetic nystagmus (OKN), an ocular movement reflex, may be associated with inability to regain independent function. Eighteen right hemisphere brain-damaged stroke patients suffering similar sensory-motor deficits were followed up from admission as they underwent self-care training in a comprehensive stroke rehabilitation center. Ten subjects demonstrated unilateral absence of OKN and eight subjects demonstrated bilaterally intact responses upon admission. Upper extremity (UE) dressing independence was used as an indicator of functional skill level at admission, during treatment, and at discharge. Subjects with unilateral loss of OKN were significantly less independent at admission and at discharge when compared to subjects with intact OKN. Although both groups of patients made statistically significant gains in UE dressing, those with defective OKN had a 40% greater inpatient length of stay and were more likely to be discharged to a nursing home or needed care by a significant other after rehabilitation.
Opsite, a sterile, occlusive, adherent, polyurethane film has been used in a prospective study involving 150 cases of partial thickness burns. All cases were admitted to the Department of Plastic Surgery, Singapore General Hospital. The patients' ages ranged from infants to the elderly. All sites of the body were tried on Opsite except the head and face and total burns areas applied with opsite varied from less than 5% to 25%. 80% of cases did well, 20% had to have the dressing discontinued for various reasons, the most common being infection. The advantages were in the ease of wound observation, patient comfort, early mobilisation and relative economy. Opsite is a suitable burns dressing for the partial thickness burns especially of the trunk and limbs and is very useful in children. The complications are relatively few and minor.
The below-the-knee removable rigid dressing is a below-the-knee plaster cast held by a suspension stockinette to a supracondylar plastic cuff. It has proved to be an effective method for postoperative, pre-prosthetic, and prosthetic care of below-the-knee amputees. Being removable, it permits frequent observation and progressive shrinkage of the stump (by adding socks), and eliminates the need of elastic stump bandaging. In addition, it still maintains the advantages of immobilization of soft tissue (to reduce pain and facilitate wound healing) and prevention of trauma to the stump as does the conventional rigid dressing. It has significantly reduced the incidence of pre-tibial skin breakdown and distal edema, produced fast stump shrinkage, and shortened time to ambulatory discharge with a temporary prosthesis by ninety days.