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[Medical properties of the membrane dressing made of bacterial cellulose].

Review of papers devoted to medical properties of membrane dressing made of bacterial cellulose was done. These properties were determined on the basis of studies on application of this membrane to venous leg ulcer healing. Moreover, quantitative method of valuation of wound healing process efficiency which lies in calculating efficiency coefficient was described. Value of this coefficient is directly proportional to ulcer healing speed and indirectly proportional to product of initial surface and healing time.

Bacteria↗

Studies on dressings for dental surgery use. Part 1: Effect of plasticizers on gelatin gel etching rate.

For quantitative evaluation of the absorption rate of dental dressings made of gelatin, a biopharmaceutical model of etching of gelatin gels in vitro has been elaborated. For the optimum etching conditions of gelatin gel columns 900 BAEE units per ml trypsin solution was used at a temperature of 25 degrees C. It has been found, that addition of glycerol and propylene glycol insignificantly reduces the etching rate of gelatin gels, whereas the PEG 400, PEG 1500 and PVAL increase resistance of the gels against the etching action of trypsin. In the model provided well repeatable results the coefficient of variation of the average gel etching rate remained within the range of 0.45-0.57%.

Absorption↗

Using modern dressings to effect debridement.

Before sloughy or necrotic wounds can begin to heal, they must be debrided. Some of the modern wound dressings are not only extremely effective in this, but they do not damage surrounding tissue.

Bandages, Hydrocolloid↗

Tips of the trade #26. Treatment of amputation residual limb ulcers with a hydroactive dressing and continued weight bearing.

This paper discusses treatment methods for amputation residual limb (stump) ulcers and infected or failed-amputation wounds. Local wound care and abstinence from prosthetic limb use and weight bearing have been found effective in the treatment of decubitus ulcers, as has the use of occlusive hydroactive dressings such as DuoDERM (ConvaTec, Princeton, NJ). DuoDERM application and prosthetic socket modification have been found useful for the treatment of decubitus ulcers in ambulatory patients. The techniques of, and benefits obtained from, DuoDERM therapy are explored; we conclude that the relief of local wound pressure and shear forces obtained with this therapy generally enhances ambulation capacity.

Amputation Stumps↗

Treatment of psoriasis and other dermatoses with a single application of a corticosteroid left under a hydrocolloid occlusive dressing for one week.

Lotions of five different corticosteroids were applied on 3 X 4 cm areas of large infiltrated chronic psoriatic plaque in eight patients, and left occluded with a hydrocolloid dressing (Actiderm) for one week. Area treated with clobetasol, betamethasone and triamcinolone were clinically healed within one week in four patients, but slight residual erythema was observed in the other four. Hydrocortisone-treated areas showed better improvement than the non-steroid-treated control area, where infiltration and erythema remained unchanged. In 44 patients with psoriasis, lichen planus, chronic lichenified eczema, discoid lupus erythematosus and necrobiosis lipoidica, treatment with betamethasone applied 1-3 times under Actiderm once a week healed the lesions. The skin-coloured Actiderm is easy to apply and wear and does not loosen when taking a shower or hot bath.

Adolescent↗

Treatment of chronic leg ulcers with a hydrocolloid dressing.

The effects of a hydrocolloid dressing (Comfeel Ulcus) on the physical environment of chronic leg ulcers in 58 consecutive out-patients were investigated. Patients were subdivided into two groups of which Group 1 included 31 (53.4%) and Group 2, 27 (46.6%) patients. Twenty-three (39.7%) patients healed within 7 weeks (study period) and 49 (84.5%) within 1 year (follow-up period). Aerobic and anaerobic bacterial cultures as well as mycotic cultures were performed from ulcer bases of both groups of patients. In Group 1 a 3 mm punch biopsy was taken from the ulcer margins for histopathological examination. In Group 2 serum levels of iron, zinc, copper and selenium were measured and in these latter patients a mean temperature difference of 2.8 degrees C between the ulcer base and the skin surrounding the ulcer was found. There was no difference in ulcer pH in patients belonging to Group 2, independent of bacterial or fungal contamination. Low serum iron was found in 74.1% and anaemia in 40.7% of the patients in Group 2. No differences in ulcer healing were seen in these patients compared with those without iron-deficiency or anaemia. No differences were seen in serum iron, zinc, copper or selenium levels between good and poor healers. There were 22.2% ulcer relapses in Group 1 within a year of the start of the study, with no relapses in those 15 patients of Group 2 who used specially designed compression stockings.

Adult↗

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↗

Biologic dressings and skin substitutes.

Burn wounds require coverage for healing to occur. Many techniques have been utilized to achieve such a closed wound, including biologic dressings, autologous skin, and skin substitutes. These and other methods are discussed.

Bandages↗

Silastic foam dressing in hypospadias surgery.

Silastic foam dressing is useful after more complex types of hypospadias surgery. It immobilises and protects the penis, avoids excessive swelling and allows early mobility of the patient. Details of its application and use are described.

Humans↗

[Dressing technic with silastic foam following penis operations].

Silastic foam has very good properties as dressing material. After operations on the penile urethra or the corpora cavernosa the liquid foam is applied to the wound area. The foaming material avoids formation of pouches and hollow spaces. The compressive bandage prevents post surgical edemas and hematomas respectively. It can be removed without pain.

Humans↗

Immunological safety evaluation of a haemostatic agent and wound dressing made of horse collagen fibrils.

A haemostatic agent and wound dressing made of horse collagen (Tachotop) was applied to guinea-pigs in such a way that the intended use of this material in humans was simulated, and cell-mediated and humoral immune responses of the animals were investigated. In addition, immune reactions were forcefully induced in guinea-pigs in order to validate the methodical approach and quantitate the observed reactions. Cell-mediated immunity was measured as delayed-type hypersensitivity skin reactions, and antibodies were detected by an enzyme-linked immunosorbent assay (ELISA). Simulation of the intended application of this haemostyptic material did not induce immune reactions in guinea-pigs even under critical conditions. The animals could only be immunized when the antigen was administered in solution or finely dispersed and together with adjuvant. Immune reactions thus induced were specific for collagen, no reaction was obtained against possible impurities such as albumin, immunoglobulin or fibronectin. It is concluded--in accordance with clinical experience--that this material is very unlikely to induce immune reactions upon clinical application to humans.

Animals↗

Povidone-iodine in polyethylene oxide hydrogel dressing. Effect on multiplication of Staphylococcus aureus in partial-thickness wounds.

We studied the ability of a polyethylene oxide hydrogel dressing (Vigilon) containing povidone-iodine to prevent Staphylococcus aureus proliferation in partial-thickness wounds. We previously reported that a single application of povidone-iodine on wounds challenged with 2 X 10(6) S aureus was not effective in reducing the number of S aureus after 24 hours. It was therefore hypothesized that povidone-iodine might be effective if it was available continuously and applied to wounds containing a smaller number of bacteria. To test this hypothesis, we made multiple partial-thickness wounds (5 X 7 X 0.3 mm) on six domestic pigs. We then inoculated the wounds by scrubbing them with either a low concentration (log 3.5) or a high concentration (log 7) of S aureus suspension. The wounds were either treated with Vigilon or Vigilon containing povidone-iodine or left air exposed. Wounds from each of these treatment groups were cultured by the scrub technique for S aureus with a 0.5% sodium thiosulfate-polysorbate (Tween) 80 solution 5 minutes, 30 minutes, 24 hours, or 48 hours later. A significant reduction in the number of S aureus recovered from wounds treated with Vigilon containing povidone-iodine was seen with the group inoculated with a low bacterial concentration after 24 hours; but no reductions were observed when wounds were inoculated with the higher bacterial concentration of log 7. We found Vigilon containing povidone-iodine to be an effective inhibitor of S aureus in wounds over a 24-hour period when the organism was present in low numbers.

Animals↗

Porcine heterograft dressings for split-thickness graft donor sites.

As compared with previous methods of donor site care, procine heterograft dressings allow the donor site to heal faster, require less postoperative care, are associated with a lower infection rate and eliminate virtually all of the pain of the split-thickness wound. Our experience supports that of others. We believe our modifications of this technique to be superior to previous modalities of donor site care.

Bandages↗

Burn wound dressing with human amniotic membrane.

The use of amniotic membrane as a biological dressing for thermal injury is simple and cheap and has been found to be superior to allograft and xenograft. The membrane prevents heat and water loss from the wound surface and acts as a barrier against bacterial contamination, thus aiding the healing process and reducing morbidity. Another clinically significant and important property of the membrane is its ability to offer marked relief from pain. Over a period of 30 months amniotic membrane was used to treat 15 cases of burn in a small hospital, with uniformly satisfactory results. The practical aspects of this method of treatment can easily be adopted by any hospital regardless of its available facilities.

Adolescent↗

[Initial observations on the biocompatibility of a polymer used as a skin dressing].

In the development of a dressing for burn wound covers, a material is required which combines good oxygen permeability, high water content and good biocompatibility with reasonable mechanical properties. One of the most important functions of the cover is to protect the burned surfaces from drying out and to constitute the first defence against microbial invasion. In this study composite sheets crosslinked either in presence of glicerol or diacetin, obtained by reinforcing PHEMA with a tricot PET net have been implanted subacute in rabbits, to test their biocompatibility. The same composites crosslinked in presence of diacetin and grafted on a polybutadene film, have been used as a skin graft on rabbits.

Animals↗

Pigskin xenograft as biologic dressing in radical vulvectomy.

Wound infection and breakdown constitute the most common complication of radical vulvectomy and groin lymphadenectomy. The use of pigskin xenograft as biologic dressing when the skin edges cannot be closed primarily without tension after radical vulvectomy and groin lymphadenectomy is described. This technique allows for clean granulation tissue to develop early (within five to seven days) and seems to accelerate the healing process. Its use has been associated with early ambulation and rapid recovery as well as a shorter postoperative stay.

Adult↗