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At least 1,405 records · Page 78Linked to original sources
PubMed2005

Hemostatic efficacy of hydrophilic wound dressing after transradial catheterization.

Here, we evaluate the efficacy of the Clo-Sur PAD nonwoven hydrophilic wound dressing (HWD) on hemostasis in an arterial-access site after transradial percutaneous coronary angiography compared with the RadiStop compression device (CD). Eighty patients who had undergone transradial coronary angiography with or without intravascular ultrasound were randomly assigned to the HWD or CD group. The time required to achieve hemostasis was measured, and the incidence of vascular complications was assessed. No significant differences in clinical and procedural characteristics were observed between the HWD group (n = 40) and the CD group (n = 40). A significant reduction in the time required to achieve hemostasis (58.7 +/- 32.6 minutes versus 131.3 +/- 59.1 minutes; p < 0.001) was associated with the use of HWD. The incidence of vascular complications was similar in both groups (5% for HWD versus 2.5% for CD; p = 0.500). No major complications, such as large hematoma or acute radial occlusion, occurred in the HWD group. In conclusion, HWD represents a safe alternative to the compression method. Hemostasis can be achieved more quickly using HWD, with no increase in access site complications, as compared to CD.

Bandages, Hydrocolloid↗
PubMed2006

Reduced cellular toxicity of a new silver-containing antimicrobial dressing and clinical performance in non-healing wounds.

Bacterial colonisation of wounds may delay wound healing. Modern silver-containing dressings are antimicrobial, yet cellular toxicity is a serious side-effect. We provide data for a newly formulated silver-containing ointment dressing, Atrauman Ag, for antimicrobial activity and cytotoxicity. Atrauman Ag effectively killed a panel of commensal skin as well as pathogenic bacterial strains while cytotoxicity for HaCaT keratinocytes was only around 10%. With these favourable in vitro tests, Atrauman Ag was analysed in 86 patients with traumatic and non-healing wounds of different aetiologies. The wound state was evaluated for 3 subsequent dressing changes. The slough score was reduced from 59.2 to 35.8%, granulation tissue increased from 27 to 40% and epithelialisation went up from 12.1 to 24%. We conclude that Atrauman Ag has a superior profile of antimicrobial activity over cellular toxicity and the low silver ion release rate may prevent interference with wound-healing mechanisms.

Aged↗
PubMed2002

[Treatment of skin lesions combining hydrofiber and extra-fine hydrochloride dressings].

Multicentric trial to test the efficacy of the combined use of two hydrocolloid dressings (AQUACEL + Varihesive Extra Fino) or a hydrocolloid dressing and gauze in the treatment of different aetiology lesions. Includes 1,805 patients with lesions that can be treated with the cure system under study, without wound dimensions or severity restrictions. At the end of the trial period, 78.3% of the lesions reached healing or a significant improvement of their condition, resulting in an increase of patients' quality of life. 90% of patients confirmed their willingness to continue the treatment with AQUACEL.

Bandages, Hydrocolloid↗
PubMed1995

Lower extremity burns and Unna paste: can we decrease health care costs without compromising patient care?

OBJECTIVE: To compare an alternative treatment for lower extremity burns with the standard in-hospital treatment, in an attempt to shorten hospital stay. DESIGN: A case-control series. SETTING: A university-affiliated hospital. PATIENTS: All patients with a burn isolated to a lower extremity were treated over an 8-month period with split-thickness skin grafting (STSG), Unna paste dressing, immediate mobilization and early discharge. This group was compared with matched controls from the preceding 8 years treated with STSG, occlusive burn gauze dressing, bed rest and hospitalization. MAIN OUTCOME MEASURES: Duration of hospital stay and graft viability. RESULTS: Thirteen patients with an average wound size of 131 cm2 were treated with Unna paste and had a graft viability of greater than 95% and a burn-scar rating equivalent to that of patients treated with the earlier regimen. The duration of hospital stay decreased from a mean of 12.9 days to 1.4 days, with no complications. This translated into a saving of $10,350 per patient. CONCLUSIONS: This alternative treatment is safe, inexpensive and effective and is recommended as the treatment of choice for uncomplicated, noncircumferential lower extremity burns.

Adolescent↗
PubMed1993

A study of hydrogen peroxide generation by, and antioxidant activity of, Granuflex (DuoDERM) Hydrocolloid Granules and some other hydrogel/hydrocolloid wound management materials.

The effect of Granuflex Hydrocolloid Granules (0.01-0.50% w/v) on the rate of proliferation of murine (L929) fibroblasts was examined. The dose-response curve showed a significant (P < 0.02) pro-proliferant effect at 0.05%, and a significant (P < 0.02) antiproliferant effect at 0.50%, mirroring the dose-response curve produced by hydrogen peroxide in the concentration range 10(-9) - 10(-4) mol/l. The antiproliferant effect at 0.20% w/v was abolished by catalase, suggesting that the biological activity of Granuflex was mediated by the in situ generation of hydrogen peroxide. Formation of hydrogen peroxide by Granuflex was confirmed by performing the scopoletin-horseradish peroxidase assay in the presence and absence of catalase. The total concentration of hydrogen peroxide detected was about 8 x 10(-6) mol/l (using 0.5% w/v Granuflex) after 48 h at 37 degrees C. In contrast, when hydrogen peroxide itself was added to L929 cultures, a similar antiproliferant activity was observed at concentrations between 10(-4) and 10(-5) mol/l. These results suggested that Granuflex was undergoing autoxidation in the culture medium, and hence that it might possess antioxidant activity. In assays for antioxidant activity using 1,1-diphenyl-2-picrylhydrazyl (DPPH), Granuflex, and two other hydrocolloid dressings (Comfeel Powder and Bard Absorption Dressing) showed significant ability to reduce DPPH to DPPH2. These three dressings also displayed superoxide scavenging activity in a nitroblue tetrazolium reduction assay. We conclude that, in addition to providing a moist wound-healing environment, Granuflex and certain other hydrocolloids might contribute to the establishment and maintenance of the reducing environment necessary for energy production and hence cell division.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMedDate not supplied

[Hydro-cellular dressing and silver sulfadiazine. Evaluation of its combination in the treatment of infected skin ulcers].

The authors carried out an observational, descriptive, prospective and multi-centric study on 49 infected lesions which had clinical signs of local infection as well as infection from a positive sprinkler method culture. These lesions were treated over a three week period with argentic sulfadiazine and a semi-permeable dressing; afterward, treatment continued for seven weeks more based on cures in a humid environment by means of a semi-permeable dressing. After three weeks of treatment, two-thirds of these lesions showed a negative exudative culture, the number of strains present in the rest of the cultures diminished to at least half of those present at the start of this study. 15 of these lesions completely closed over during the period of study (mean = 46.73 +/- 22.74 days) and the absolute cicatrisation surface area varied, on average, from 23.46 square cm at the start to 12.39 square cm at the end of this study. In relation to the relative cicatrisation an average reduction of 76.5% (IC 95= (66.85% - 86.2%)) occurred. Variance analysis (ANOVA) over repeated measurements established significant differences (p = 0.001) having a tendency toward a lineal decrease. The authors also found statistically significant differences regarding the mean relative cicatrisation in the subgroup having lesions which stopped being infected during the third week of treatment when compared to those lesions which continued being infected. In conclusion, the authors state the topical treatment using argentic sulfadiazine in combination with a semi-permeable dressing has been favorable in treating two of every three lesions which stopped being infected in the third week of treatment, furthermore, this treatment produced a reduction in the size of these lesions, both in terms of the absolute mean cicatrisation area as in the relative mean cicatrisation area cicatrisation area for the lesion group in this study.

Adult↗
PubMed1980

Clinical evaluation of the Hydron burn dressing.

Hydron, a synthetic barrier dressing composed of polyhydroxyethyl methacrylate (PHEMA) and polyethylene glycol (PEG), was applied to the burn wounds of 15 hospitalized patients. Application of the dressing was found to be time-consuming to the doctor and tedious for the patient. Dressing integrity was frequently broken by cracking, peeling, or ineffectual drying. Burn-wound colonization occurred beneath Hydron no more frequently than observed in other patients whose wounds had been treated with topical antibacterial agents. In general, the application of Hydron caused a reduction in burn-wound pain. In its present form, Hydron did not produce results superior to those observed in our other hospitalized burn patients. Due to technical difficulties, it is no longer being used in our unit.

Adolescent↗
PubMed1994

Histologic evaluation of chronic human wounds treated with hydrocolloid and nonhydrocolloid dressings.

BACKGROUND: Studies of acute surgical wounds in pigs have shown granulomatous tissue reactions induced by hydrocolloid dressings. OBJECTIVE: We examined biopsy specimens from chronic wounds in humans treated with hydrocolloid or nonhydrocolloid dressings to determine whether such reactions occurred. METHODS: A blinded retrospective analysis of 22 chronic ulcer biopsy specimens from 22 patients was performed by two dermatopathologists independently. RESULTS: No differences were seen between hydrocolloid-treated and non-hydrocolloid-treated wounds. Granulation tissue was seen in all specimens. No cavities, eosinophilic inclusions, polarizable material, or multinucleated giant cells were identified. CONCLUSION: There are no significant histologic differences between hydrocolloid-treated and non-hydrocolloid-treated wounds in humans.

Biopsy↗
PubMed1987

Biosynthetic skin substitute versus frozen human cadaver allograft for temporary coverage of excised burn wounds.

During the past 2 years a multicenter study was performed comparing Biobrane (Woodroof) and frozen cadaver allograft as temporary dressings on freshly excised full-thickness burns before the application of autograft. Each biologic dressing was evaluated with respect to the other on the same patient. Seventy-one patients were evaluated. The mean burn size was 35 +/- 20% with a mean full-thickness burn of 28 +/- 20%. Mean patient age was 34 +/- 21 years. Overall survival was 82%. The mean time of wound coverage was 10.2 +/- 6.7 days. There was no significant difference in the number of dressing changes, area changed, purulence, autograft take, and final results between allograft- and Biobrane-covered sites. There were no complications following use of either Biobrane or allograft. We conclude that Biobrane is as effective as frozen human cadaver allograft for the temporary coverage of freshly excised full-thickness burn wounds before autografting.

Adult↗
PubMed2002

An infection-preventing bilayered collagen membrane containing antibiotic-loaded hyaluronan microparticles: physical and biological properties.

An infection-preventing bilayered membrane consisting of a dense and porous collagen membrane has been developed. The membrane was fabricated using a combined freeze-drying/air-drying method. Hyaluronan (HA) microparticles containing silver sulfadiazine (AgSD) were fabricated by gelling an HA solution with calcium chloride and were incorporated into collagen layers to allow the sustained release of AgSD. In vitro biodegradability of the membrane and the release of AgSD from the membrane could be controlled by cross-linking the membrane with ultraviolet (UV) irradiation. In a cytotoxicity test, cellular damage was minimized by the sustained release of AgSD from dressings. The antibacterial capacity of the material against Pseudomonas aeruginosa was investigated using the Bauer-Kirby disk diffusion test, and bacterial growth was found to be inhibited for 4 days. In vivo tests showed that the bilayered membrane was associated with greater tissue regeneration than a polymeric membrane and with no infection-related biological signs.

Analysis of Variance↗
PubMed2006

Can sutures get wet? Prospective randomised controlled trial of wound management in general practice.

OBJECTIVE: To compare standard management of keeping wounds dry and covered with allowing wounds to be uncovered and wet in the first 48 hours after minor skin excision. DESIGN: Prospective, randomised controlled, multicentre trial testing for equivalence of infection rates. SETTING: Primary care in regional centre, Queensland, Australia. PARTICIPANTS: 857 patients randomised to either keep their wound dry and covered (n = 442) or remove the dressing and wet the wound (n = 415). RESULTS: The incidence of infection in the intervention group (8.4%) was not inferior to the incidence in the control group (8.9%) (P < 0.05). The one sided 95% confidence interval for the difference of infection rates was infinity to 0.028. CONCLUSION: These results indicate that wounds can be uncovered and allowed to get wet in the first 48 hours after minor skin excision without increasing the incidence of infection.

Adult↗
PubMed1975

Management of chylous fistulas;.

Chylous fistula following radical neck dissection is a disturbing and potentially serious complication. Meticulous surgical technique in the areas of the thoracic duct on the left and the lymphatic ducts on the right will usually prevent the occurrence of a chylous leak. If one should develop, however, a pressure dressing alone is usually not sufficient to tamponade the leaking vessel. The patient should be returned to the operating room where the leak is identified and ligated. Loss of chyle from the body will rapidly deplete the body stores of fluid, proteins, and electrolytes. Careful monitoring of serum electrolytes and proteins and accurate replacement of these substances is essential. The anatomy, physiology, surgical technique, and treatment of the lymphatics and chylous fistulas at the base of the neck are considered herein.

Chyle↗
PubMed2002

Mepore Ultra and Alldress: primary and secondary dressings.

Expenditure on wound care continues to rise in the UK as new products and innovations are introduced. Nurse specialists in tissue viability are at the forefront of many of these advances and therefore it is vital that they consider both the clinical and economic benefits of each new treatment. In this article, the authors use a case study methodology to evaluate primary and secondary wound dressings. The aim was to focus on the opportunity for reducing overall costs in wound management without compromising clinical outcomes. Given the initial results observed there appears to be ample scope for a debate within the tissue viability specialty with regard to achieving best value for money in wound care. The authors suggest that the time has come to consider this area in greater detail and depth.

Adult↗
PubMed1998

A silicone-coated nylon dressing reduces healing time in burned paediatric patients in comparison with standard sulfadiazine treatment: a prospective randomized trial.

Mepitel is a new grid like silicone coated nylon dressing containing no additional biological compounds. We describe a prospective randomized pilot study comparing Mepitel to the standard silver sulfadiazine cream (Flamazine) dressing for the topical treatment of paediatric burns. Seventy-six children presenting within 24 h of injury with a non previously treated burn were randomly assigned to Mepitel treatment (group M) or Flamazine treatment (group F). Age, sex, surface area of burn and causal agent were noted at admission. The depth of the burn, cumulative number of dressings, presence or absence of a complete epithelial cover, infection, bleeding and allergy were noted at each dressing change. There were 41 children in group M and 35 children in group F. Five children were subsequently withdrawn from each group because they required skin grafting. Analysis of the above mentioned criteria showed no statistical difference between the two groups except for the healing time (group M: 7.58+/-3.12, group F: 11.26+/-6.02, p < 0.01) and the number of dressings (group M: 3.64+/-1.5, group F: 5.13+/-2.9, p < 0.05). Mepitel has proved to be an easy-to-remove dressing, adhering only to intact skin. The faster healing time found in the Mepitel group may be related to a direct effect of silicone on epithelial growth or to a decrease in surface-cell damage compared to the silver sulfadiazine group. This attractive product will be further assessed on a larger scale trial to confirm our observations.

Adolescent↗
PubMedDate not supplied

Arglaes controlled release dressing in the control of bacteria.

It has been known for many years that silver has antimicrobial properties. Arglaes is a film dressing that provides a continuous and controlled release of silver ions and is produced by Maersk Medical. The name is derived from argentum, which is Latin for silver, and Ag, the chemical symbol for silver. Since the emergence of resistant organisms, topical antibiotics are best avoided. Arglaes has been developed in the light of this and appears to control the bacteria in wounds and prevent bacterial contamination. Arglaes also provides a moist environment for the healing process and is suitable for many wound types.

Anti-Infective Agents, Local↗
PubMed2000

The evaluation of subatmospheric pressure and hyperbaric oxygen in ischemic full-thickness wound healing.

We evaluated the efficacy of subatmospheric pressure and hyperbaric oxygen (HBO) as adjuncts in the treatment of hypoxic full-thickness wounds in a rabbit model. We hypothesized that subatmospheric pressure and HBO independently are effective in improving wound healing in the ischemic wound model and that when they are used in combination there is an increased positive effect on wound healing. Using a standard ischemic wound model four full-thickness wounds were created on each ear of 41 male New Zealand white rabbits (N = 82 ears). On each rabbit one ear was dressed with the vacuum-assisted closure (VAC) device and connected to suction; the other was dressed identically without the suction and suction tubing. Twenty rabbits were treated with HBO daily for 10 days at 2.0 atmospheres absolute for 90 minutes plus descent and ascent times. Necropsy on all rabbits was performed on postoperative day 10. Four ischemic wound treatment groups were evaluated: Group 1 (N = 21) VAC dressing alone; Group 2 (N = 20) VAC dressing plus HBO; Group 3 (N = 21) VAC dressing to suction alone; and Group 4 (N = 20) VAC dressing to suction and HBO. Using light microscopy a veterinary pathologist blinded to treatment groups quantified peak granulation tissue, granulation tissue gap, and epithelialization tissue gap. Data were analyzed by analysis of variance with significance indicated by P < 0.05. Statistical significance was found in a comparison of VAC dressing to suction and VAC dressing alone for peak granulation tissue and granulation tissue gap both with and without use of HBO. VAC device use appears to increase the rate of healing in a rabbit ischemic wound model. HBO therapy did not significantly affect the rate of healing in this model.

Analysis of Variance↗
PubMed1975

Case report: Chylous fistula following right radical neck dissection.

Two unusual cases of chylous fistulae following right radical neck dissection are presented. Treatment in the second case consisted of pressure dressing and replacing the regular blended tube feeding diet with one containing medium chain triglycerides to replace ordinary lipids (long chain triglycerides). Caloric intake was supplemented with parenteral protein and fat infusions. This resulted in prompt cessation of the leak. Other methods of controlling fistulae such as re-operation and oversewing the area or using muscle flaps, or direct packing of the wound often lead to other complications and frequently require considerable time to control the leak.

Chyle↗
PubMed1975

[Healing of the donor area after transplantation of splitted grafts].

The healing of wounds in the donor area of splitted grafts was observed. The transplants served to graft an already existing wound which had not healed spontaneously. 120 wounds sustained by 95 patients were examined either histologically or by Rebuck's method of skin fenestration. 30 wounds were dressed with ointment and tulle, in 55 cases the wound was covered with perforated cellophane and an Allen-Koch compression bandage. These patients also received 1500 mg Complain in 500 ml physiological saline solution daily, by continuous drip infusion, for three days postoperatively. In 35 patients the wounds were only covered with perforated cellophane, but without additional medication. The application of Complamin shortened the healing process to seven to ten days in contrast to the control group where the wounds took 15 to 17 days to heal.

Aged↗