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We describe a simple, inexpensive pressure dressing which supplements manual pressure and may be applied quickly and easily following femoral arterial puncture for angiography. This technique has been used on several thousand patients without complications.
Earlier studies show that neutrophils are virtually unable to kill Staphylococcus aureus in vitro. However, upon addition of 10 mM N-acetylcysteine (NAC) or reduced glutathione (GSH) the neutrophil bacterial killing ability becomes excellent. We want to exploit this phenomenon to develop a wound dressing material that will improve neutrophil function. To study the mechanisms behind the downregulation of neutrophil elimination of bacteria, we used different markers for neutrophil function on surface-adhering neutrophils in contact with S. aureus with or without addition of the antioxidants NAC or GSH. Analysis by scanning electron microscopy showed cell shrinkage and numerous cytoplasmic processes on surface-adhering neutrophils exposed to S. aureus. In cells exposed to S. aureus and GSH, the cells were of normal size and the cytoplasm was spread as in normal attachment. Staining for intracellular GSH, a hallmark of oxidative stress, showed little difference between the experimental groups, indicating that the cells were not damaged by traditional oxidative stress. The H(2)O(2) production of neutrophils, measured by Amplex red, was correlated to bacterial exposure and was not affected by the addition of scavengers. The intracellular and extracellular production of ROS was measured by luminol-amplified chemiluminescence. The apparent ROS-production was mostly intracellular and decreased in the presence of scavengers. However, extracellular production of ROS was not affected by the addition of NAC. The production of nitric oxide (NO) was measured spectrophotometrically as the production of nitrate apparently decreased in the presence of scavengers, probably as a result of interference with the reagents in the test system. In conclusion, differences between leukocytes that were able to eliminate S. aureus and those that were not were mainly seen in the morphology of the cells and in cell viability. The morphological findings point to a difference in NO signaling in the absence and presence of ROS scavengers.
An improved wound dressing with a long-term drug diffusion-efficacy has been developed by UV-radiation technique. It involves incorporation of ciprofloxacin (CIP), at the concentration of 0.5-2.0% (w/v), into a water mixture of 2-hydroxymethacrylate (HEMA) monomer, benzoin isobutyl ether (BIE) initiator and different content of ethylene glycol dimethacrylate (EGDMA) cross-linker. Increasing the concentration of EGDMA would reduce the releasing ratio of CIP from pHEMA. T1/2 is increased from 2.64 to 45.67 h when the EGDMA is added from 1 to 8%. In the ranges of 0< or = F < or = 0.6, the n value of 1%CIP-pHEMA membranes is increased from 0.48 to 0.81. It indicates that the mechanism of drug release falls between the Fickian and Case II diffusion model. The antibacterial activity of the drug impregnated into the membrane was evaluated by in vitro drug kinetic agar plate method. Higher concentration of EGDMA, up to 8% of the cross-linker, extends the drug release. Comparison with the drug-soaked membranes, the newly synthesized 1% CIP-pHEMA membrane (cross-linked with 4% EGDMA) sustains the release of the entrapped drug and maintains the antibacterial activity up to 12 days.
Hyiodine (high molecular weight hyaluronan combined with KI3 complex) is a new non-adhesive wound dressing which significantly improves the healing process. The aim of the study was to investigate the effects of Hyoidine on functional properties of isolated human keratinocytes and leukocytes, and on those of U937 and HL60 cell lines. While KI3 complex inhibited the viability and proliferation of the cells tested, Hyiodine did not have any significant effect. The expression of CD11b, CD62L and CD69 on PMNL, monocytes and lymphocytes, as well as the oxidative burst of blood neutrophils, were not changed. On the contrary, Hyiodine inhibited the PMA-activated oxidative burst and significantly increased the production of IL-6 and TNF-alpha by lymphocytes. It was concluded that hyaluronan content of Hyiodine reduces the toxic effect of KI3 complex on cells and speeds up the wound healing process by increasing the production of inflammatory cytokines.
Aluminium foil has been found to be an extremely useful and painless way of dressing wounds prior to delayed skin grafting. However, it is not recommended for use on skin-graft donor sites as it delays epithelial healing.
The "tie-over" dressing is commonly used in plastic surgical practice. A simple, cheap and effective refinement of this established technique is described. This consists of a flanged disc over which can be slipped a "neoprene" sealing ring. The advantages of the device include the ease and speed of application: the facility to tighten and adjust the tie-over sutures once they are in place and the possibility of removing and replacing the device if early inspection of the graft is desired.
This paper describes a simple modification of the conventional tie-over dressing used in skin grafting. A plastic bead is used to gather together the tie-over threads and an aluminium collar provides a rapid method of securing the tie.
A prospective trial was performed to ascertain the value of padded head dressings following the correction of prominent ears. Twenty consecutive adults and 20 consecutive children were included. The results are discussed and certain recommendations suggested.
A single layer of surgical gauze applied with adhesive provides a simple and inexpensive dressing for use following hypospadias repair. It splints the penis to the abdomen, supports the wound and secures the catheter while permitting observation and wound care.
A method of securing a dressing on scalp wounds, using silastic foam, is described. This method has the advantage of leaving the rest of the scalp uncovered and is particularly effective in the unco-operative patient.
About 0.05 mg Cd l-1 was found in the irrigation water contaminated by the wastewater discharged from tungsten ore dressing plants, and about 1 mg Cd kg-1 was found in irrigated acid soils. The main sources of cadmium intake by residents of the polluted areas are agricultural products. The average intake of cadmium was 367-382 micrograms day-1, and for smokers 417 micrograms day-1. Among the residents who have been exposed to cadmium for more than 25 years, cadmium absorption (urinary cadmium greater than or equal to 10 micrograms g-1 creatine) was 60% and an early effect on the target organ (urinary cadmium greater than or equal to 15 micrograms g-1 creatinine and urinary beta 2-microglobulin greater than 500 micrograms g-1 creatinine) was detected in 17% of the sample of 433 persons. Levels of urinary cadmium and blood cadmium exceeded the critical value in the exposed group. The concentrations of urinary calcium, beta 2-microglobulin and N-acetyl-beta-D-glucosaminidase were significantly higher in residents of contaminated areas than in those of control areas. Case-control study of the residents shows that many have suffered from a nephropathy with tubulo-interstitial abnormalities. Owing to the combined cadmium effect, the cases with fractional beta 2-microglobulin excretion greater than 0.10 were 46% in the exposed population, and were much higher than that in the control group (20.3%).
This report outlines the successful application of Sorbsan-calcium alginate fibre dressings in footcare. This biomaterial has been found in clinical trials to have quite outstanding merit and can be used for sinus drainage and in the treatment of fissures, hypergranulation tissue, interdigital maceration, heloma molle and other lesions. Sorbsan bonds with and aids natural healing scabs and effects drainage of moist sites thus assisting in creating an environment conducive to the healing process. Similar promise has been demonstrated for this material in ongoing trials in hospitals in Sunderland where Sorbsan has been used effectively in the treatment of diabetic and trophic ulcers.
This highly absorbent, biodegradable dressing derived from seaweed can be successfully applied to cleanse a wide variety of secreting lesions. The high absorption of exudate is achieved via strong hydrophilic gel formation and this serves to control wound secretion levels and to minimize bacterial contamination. Alginate fibres trapped in a wound are readily biodegraded and do not have to be removed thus avoiding disturbance of granulation tissue formation. Additional features are odour remission, conformability and ready removal of tissue adherent material.
An overview is presented of the use of hydrogel composites as biomaterials. These range from laminates or coatings (in which a homogeneous hydrogel is used in conjunction with a more mechanically stable substrate), through blends of hydrogels with synthetic hydrophobic polymers, to the use of two-component systems in which water enhances the compatibility of two structurally different polymers. Although synthetic hydrogels provide an ideal basis for materials of these types, naturally occurring hydrophilic polymers with their unique properties have a major contribution to make. It is in the clinical and patent literature, rather than journals dealing with polymers per se, that the vast majority of examples of the use of hydrogel composites are found. This review collects and comments on examples based on synthetic developments in this field during the last decade, particularly in relation to the development of wound dressings and implant materials.
The present study deals with the effect of the type and chemical character of incorporated polyester (polyether blocks) on the hydrolytic stability of different types of polyurethane medical adhesive dressings. Diffusion parameters of the investigated polyurethane adhesives, giving information concerning the chemical changes taking place in water or physiological solution, have also been determined.
A histological comparison was undertaken of the tissue response to a new sodium calcium alginate material (Kaltostat) and an oxidized regenerated cellulose wound dressing (Surgicel) when implanted between bone and periosteum in the jaws at intervals of up to 24 wk. Both biomaterials caused a foreign body reaction, persisting up to 12 wk after surgery. New bone formation occurred along the surface of the mandible in some specimens, but was not apparently related to the implants. It was concluded that the implantation of Kaltostat or Surgicel between bone and periosteum in the jaws caused a delay in wound healing, and had no effect on bone induction.
One hundred Gram-positive, catalase-positive strains were isolated from freshly dressed lamb carcasses. They were randomly selected from a non-selective medium and tested for 75 characters. Only nine cultures could be identified by conventional methods. A numerical taxonomic study was conducted on the whole population and 25 reference strains. At the 80% similarity level (Ssm), ten clusters were formed. Five of them were entirely composed of reference strains. Phena V and VIII contained seven isolates and two reference strains of Micrococcus. Phena VI (six unidentified isolates), VII (nine staphylococci) and IX (69 unidentified isolates) were more related to M. kristinae than to the remaining reference strains. Properties with possible implications in meat spoilage were: strong lipolytic activity (76%), anaerobic growth (85%), tolerance to 15% (w/v) NaCl (95%) and ability to grow at 15 degrees C (95%) and 4 degrees C (26%).
Two, identical multiple-baseline-across-subjects designs were used to compare the effects of single instance and general case instruction on the generalized dressing of youth and adults with severe mental retardation. Performance across eight nontrained, probe shirts was used to assess generalization of the skill "putting on pullover shirts." Following training with a single shirt, subjects exhibited limited success with the eight nontrained shirts. Only after training with a set of shirts that sampled the range of stimulus and response variation for "putting on pullover shirts" was successful generalization observed. Results suggest that the response variations taught during general case instruction played a major role in improved performance across the nontrained shirts. Implications of the results are discussed for instruction in applied settings, and for research methodology in the analysis of generalization.