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PubMed1991

Pain during burn dressing change in children: relationship to burn area, depth and analgesic regimens.

To determine the level of pain that acutely burned children experience, we obtained pain scores before, during and after burn dressing change (BDC). Pain scores were higher during the BDC, consistent with severe pain during this procedure. A positive correlation between pain scores and the body surface area (BSA) burned suggests that pain increases with the size of the burn. Contrary to widely held beliefs, comparison of mean pain scores and the percent of 3rd degree burn revealed that the larger the area of full-thickness injury, the greater the pain. Regardless of wide variations in patient characteristics, fixed doses of oral narcotics were usually prescribed for pain. Patients with BSA greater than 70% experienced severe pain during BDC despite the type, dose or route of opioids. These findings suggest the need for (a) education to correct the myth that 'third-degree burns don't hurt'; (b) revision of analgesic prescribing patterns in the burned child; and (c) research to determine the mechanisms (e.g., tolerance or deafferentation) underlying the opioid-resistant nature of pain after large burns.

Acetaminophen↗
PubMed1984

The coat burn wound dressing.

A simple and reliable technique to protect experimental burn wounds in guinea pigs is described. This method significantly reduced the accidental removal of dressings, as well as autocannibalism and contamination.

Animals↗
PubMed1984

Tulle-gras dressings.

Tulle-gras backed with a soluble polyvinyl alcohol film has been compared with standard tulle-gras to treat patients with minor burns. The new material although less comformable to body contours offered the advantages of decreased dressing time and improved patient comfort. No adverse effects were observed on wound flora or healing rate.

Adolescent↗
PubMed1991

Evaluation of boiled potato peel as a wound dressing.

In a series of experiments full thickness skin defects in 68 rats were covered with dressings made of boiled potato peels according to the method developed in Bombay. The wounds closed within 14 days and histologically complete repair of epidermis was found. The cork layer of the potato peel prevents dehydration of the wound and protects against exogenous agents. Experiments with homogenates revealed that a complete structure of the peel is necessary. Steroidal glycosides may have contributed to the favourable results.

Alkaloids↗
PubMed1992

Prevention of dressing slippage under an elastic bandage.

A technique is described to prevent the shift in position of dressing materials by applying a double-sided adhesive tape between the skin and the elastic bandage. This technique also prevents a shift in position of a pressure garment, especially when applied around joints on the extremities.

Adhesives↗
PubMed1992

Propofol for repeated burns dressings in a child: a case report.

The use of propofol for repeated burns dressings in a severely psychologically disturbed child is described. The benefits of using this method rather than the traditionally used ketamine are discussed. The lack of adverse side-effects and rapid restarting of feeding were found to be advantageous.

Adolescent↗
PubMed1996

The use of calcium alginate dressings in deep hand burns.

Deep burns of the hand are a common serious surgical problem with major occupational and economic implications. Control of haemorrhage during excision and grafting is difficult and postoperative haematoma may reduce graft take. Following excision, important deep structures such as extensor tendons or joints may be exposed. Such tissues do not take free skin grafts satisfactorily. We have found calcium alginate dressings can be of immense help in minimizing these technical problems. We describe our experience in one patient; three other patients have been treated with equal success.

Adolescent↗
PubMed1994

Examining equipment for wound care: the use of forceps and cotton wool in dressing packs.

Wound care experts have, over recent years, questioned the routine use of forceps and cotton wool balls in packs used for cleansing and dressing wounds. Despite relevant research supporting this view, these items still appear in wound care packs in some hospitals and the basis for this practice, at times, does not seem to have been questioned. A project to explore the effect of introducing a new pack (substituting gloves and non-woven gauze for cotton wool and forceps) was undertaken at St James's University Hospital in the summer of 1993. Nurses' opinions regarding satisfaction with the new pack were explored along with whether they would prefer to use forceps. Results showed that the majority of nurses were satisfied with the new packs and found them an appropriate, acceptable alternative. The Accident and Emergency findings are reported with a discussion of the implications for practice.

Attitude of Health Personnel↗
PubMed2005

Impact of heat on nanocrystalline silver dressings. Part II: Physical properties.

This work explores the effects of elevated temperature on the physical and chemical properties of nanocrystalline silver, and relates it to previously observed thermally induced changes in biological activity [Taylor PL et al. Biomaterials, in press, doi:10.1016/j.biomaterials.2005.05.040]. Microstructural evolution of nanocrystalline silver dressings, heat-treated for 24 h at temperatures from 23 to 110 degrees C, was studied in detail using X-ray diffraction (XRD), scanning electron microscopy (SEM), and X-ray photoelectron spectroscopy (XPS). These analyses indicated that silver nanocrystalline coatings undergo significant changes in structure when exposed to elevated temperature. XRD analysis showed a rapid increase in crystallite size above 75 degrees C along with decomposition of crystalline silver oxide (Ag2O) at the onset of crystallite growth. SEM imaging showed a loss of fine features and sintering of the structure at elevated temperatures. The XPS data indicated that silver-oxygen bonds disappeared completely, with the initial decomposition occurring between 23 and 37 degrees C, and total oxygen in the coating decreased from 16-17% to 6.5% over the temperature range of 75-110 degrees C. A comparison of these results to the data of Taylor et al. [Biomaterials, in press, doi:10.1016/j.biomaterials.2005.05.040] indicates that the unique biological properties of nanocrystalline silver are related to its nanostructure. This should guide future development of therapeutic nanocrystalline silver delivery systems.

Anti-Bacterial Agents↗
PubMed2005

Comparison of silver-coated dressing (Acticoat), chlorhexidine acetate 0.5% (Bactigrass), and fusidic acid 2% (Fucidin) for topical antibacterial effect in methicillin-resistant Staphylococci-contaminated, full-skin thickness rat burn wounds.

Acticoat, chlorhexidine acetate 0.5%, and fusidic acid 2% were compared to assess the antibacterial effect of an application on experimental 15% BSA, full-thickness burn wounds in rats swabbed 24 h earlier with a 10(8) standard strain of methicillin-resistant Staphylococci. The swabbed organism was recovered from the eschar of all groups except the fusidic acid group. While there were significant differences between treatment groups and control group, the mean eschar concentrations did not differ significantly between the Acticoat and chlorhexidine acetate groups, but there were significant differences between the fusidic acid group and the other treatment groups. There were no statistically significant differences between treatment groups, and between control group and the chlorhexidine acetate group regarding recovery of the seeded organism from muscle, but there were significant differences between the control group and Acticoat group, and between control the group and the fusidic acid group. While no systemic spread was seen in the treatment groups, it was seen in six animals in the control group. The animal data suggest that fusidic acid is the most effective agent in the treatment of methicillin-resistant Staphylococcus aureus-contaminated burn wounds, and Acticoat is a choice of treatment with the particular advantage of limiting the frequency of replacement of the dressing.

Administration, Topical↗
PubMed2005

Using national microbiological data to set meaningful performance criteria for slaughter and dressing of animals at Australian export abattoirs.

Slaughter establishments in Australia that export meat to the USA are required by the controlling authority, the Australian Quarantine and Inspection Service (AQIS), to test carcases under the Escherichia coli and Salmonella monitoring (ESAM) program and to use statistical process control techniques to ensure meat is produced hygienically. However, analysing the ESAM database for E. coli using standard statistical techniques proved difficult because of inter-plant variability and because the vast majority of results were below the limits of detection. As well, it is likely that, in slaughter and dressing, higher than normal microbiological counts can often be random events, for which there is neither logical explanation nor obvious management reaction. One approach to statistical process control is to set performance criteria so that a high proportion of establishments are likely to pass, while prompting individual plants to improve the process if they cannot meet the criteria. A spreadsheet-based tool was developed in Visual Basic in order to interrogate the ESAM database and to identify those plants with microbiological performance significantly different from the norm. The present paper describes how performance criteria for cattle, sheep, pigs and goats and for sub-categories within a species (e.g. sheep/lambs, cows/bulls) were established.

Abattoirs↗
PubMed2006

The effects on the microbiological condition of product of carcass dressing, cooling, and portioning processes at a poultry packing plant.

The log mean numbers of aerobes, coliforms, Escherichia coli and presumptive staphylococci plus listerias on chicken carcasses and carcass portions at various stages of processing at a poultry packing plant were estimated from the numbers of those bacteria recovered from groups of 25 randomly selected product units. The fractions of listerias in the presumptive staphylococci plus listerias groups of organisms were also estimated. Samples were obtained from carcasses by excising a strip of skin measuring approximately 5 x 2 cm(2) from a randomly selected site on each selected carcass, or by rinsing each selected carcass portion. The log mean numbers of aerobes, coliforms, E. coli and presumptive staphylococci plus listerias on carcasses after scalding at 58 degrees C and plucking were about 4.4, 2.5, 2.2 and 1.4 log cfu/cm(2), respectively. The numbers of bacteria on eviscerated carcasses were similar. After the series of operations for removing the crop, lungs, kidneys and neck, the numbers of aerobes were about 1 log unit less than on eviscerated carcasses, but the numbers of the other bacteria were not substantially reduced. After cooling in water, the numbers of coliforms and E. coli were about 1 log unit less and the numbers of presumptive staphylococci plus listerias were about 0.5 log unit less than the numbers on dressed carcasses, but the numbers of aerobes were not reduced. The numbers of aerobes were 1 log unit more on boneless breasts, and 0.5 log units more on skin-on thighs and breasts that had been tumbled with brine than on cooled carcasses; and presumptive staphylococci plus listerias were 0.5 log unit more on thighs than on cooled carcasses. Otherwise the numbers of bacteria on the product were not substantially affected by processing. Listerias were <20% of the presumptive staphylococci plus listerias group of organisms recovered from product at each point in the process except after breasts were tumbled with brine, when >40% of the organisms were listerias.

Animals↗
PubMed2004

In vitro inhibition of human neutrophil elastase by oleic acid albumin formulations from derivatized cotton wound dressings.

Human neutrophil elastase (HNE) is elevated in chronic wounds. Oleic acid albumin formulations that inhibit HNE may be applicable to treatment modalities for chronic wounds. Oleic acid/albumin formulations with mole ratios of 100:1, 50:1, and 25:1 (oleic acid to albumin) were prepared and found to have dose response inhibition properties against HNE. The IC50 values for inhibition of HNE with oleic acid/albumin formulations were 0.029-0.049 microM. Oleic acid/albumin (BSA) formulations were bound to positively and negatively charged cotton wound dressings and assessed for elastase inhibition using a fiber bound formulation in an assay designed to mimic HNE inhibition in the wound. Cotton derivatized with both carboxylate and amine functional groups were combined with oleic acid/albumin formulations at a maximum loading of 0.030 mg oleic acid + 0.14 mg BSA/mg fiber. The IC50 values for inhibition of HNE with oleic acid/albumin formulations bound to derivatized cotton were 0.26-0.42 microM. Release of the oleic acid/albumin formulation from the fiber was measured by measuring oleic acid levels with quantitative GC analysis. Approximately, 35-50% of the fiber bound formulation was released into solution within the first 15 min of incubation. Albumin was found to enhance the rate of elastase hydrolysis of the substrate within a concentration range of 0.3-50 g/L. The acceleration of HNE substrate hydrolysis by albumin required increased concentration of inhibitor in the formulation to obtain complete inhibition of HNE. Oleic acid formulations prepared with albumin enable transport, solubility and promote dose response inhibition of HNE from derivatized cotton fibers under aqueous conditions mimicking the chronic wound.

Animals↗
PubMed2004

Silver leaf nylon dressing to prevent radiation dermatitis in patients undergoing chemotherapy and external beam radiotherapy to the perineum.

PURPOSE: Silver-leaf nylon dressing (SLND) has been shown to have effective antimicrobial activity and to enhance healing in burns and skin grafts. The purpose of this study was to evaluate the value of SLND in preventing radiation dermatitis in patients undergoing radiotherapy to target volumes that included the perineum and concurrent chemotherapy. METHODS AND MATERIALS: Fifteen consecutive patients with either anal canal or gynecologic cancer were offered the SLND as a preventive intervention. The evaluation was based on standardized photographs taken at the end of treatment. A historical control group of 15 patients with the same neoplasms who received standard skin care was assessed in the same fashion. Ten observers unaware of the treatment intervention were enrolled in the evaluation of the skin changes. The Mann-Whitney U test was used to assess the statistical significance of the differences in the dermatitis scores between the two patient groups. RESULTS: The mean dermatitis score for controls was 2.62 (standard deviation, 0.48). The mean score for the SLND group was significantly lower at 1.16 (standard deviation, 0.40; p <0.0001). CONCLUSION: The results of this study suggest that SLND is effective in reducing radiation dermatitis, apparently because of its antibacterial properties.

Adult↗
PubMedDate not supplied

Expression of matrix metalloproteinases and growth factors in diabetic foot wounds treated with a protease absorbent dressing.

UNLABELLED: Wound healing in diabetes is impaired, and nonhealing ulceration represent clinically relevant complications. Persistently high levels of matrix metalloproteases (MMPs) contribute to wound chronicity. Thus, the topical use of protease inhibitors might influence wound healing and promote transition from a chronic to an acute wound. METHODS: In this study, 33 patients with chronic diabetic foot lesions (stage 2a of the University of Texas Wound Classification system) were included. Fifteen patients received redundant "good standard wound care." In addition, 18 patients were treated with a protease inhibitory modulating matrix (the OCR/collagen Promogran matrix, Ethicon) with dressings changed on a daily basis. Prior to treatment and at 4 and 8 days after treatment, two 3-mm punch biopsies were taken from the center of the wounds and analyzed using ELISA techniques for MMPs, tissue inhibitor of MMP-2 (TIMP-2), and interleukin-1beta (IL-1beta) levels. In addition, mRNA levels of MMPs as well as IL-1beta and TNF-alpha were detected using quantitative real-time polymerase chain reaction (TaqMan, Applied Biosystems, Weiterstadt, Germany). RESULTS: No differences were detected between both groups and at the three time points for the mRNA levels of MMPs as well as of IL-1beta and TNF-alpha. In addition, MMP levels in wound tissue (analyzed by ELISA) were also not significantly different between both groups. However, IL-1beta was increased on day 8 in the treatment group (P=.01) only. Interestingly, we found a significant reduction of the MMP-9/TIMP-2 ratio in the group being treated with the ORC/collagen. These wounds exhibited a more rapid healing rate when treated with the ORC/collagen matrix. CONCLUSIONS: The local treatment with a protease inhibitor has a beneficial effect on wound healing. In contrast to the data on wound fluid, our study demonstrated for the first time the unaltered mRNA levels of MMPs during treatment with a protease inhibitory modulating matrix. At the cellular level, MMPs were also not statistically different. However, the more relevant ratio of MMP-9/TIMP-2 was decreased in the treatment group. An equally important finding was that we did not detect a compensatory increase in the MMP-RNA expression even though wound size was clearly reduced.

Absorbent Pads↗
PubMed2004

Evaluation of pH levels and calcium ion release in various calcium hydroxide endodontic dressings.

OBJECTIVE: The purpose of this study was to evaluate Ca(2+) release and pH of 3 calcium hydroxide-based products used routinely as intracanal dressings, as well as the new gutta-percha points with calcium hydroxide. STUDY DESIGN: The pH and Ca(2+) release were assessed using Calen with camphorated paramonochlorophenol, saline calcium hydroxide paste, LC paste (Lopes and Costa paste-calcium hydroxide with olive oil), and calcium hydroxide containing gutta-percha points. The materials were inserted in polyethylene tubes and immersed in deionized water. The pH variation and Ca(2+) release were monitored periodically for 4 weeks. RESULTS: After 72 hours, materials 1 and 2 raise the pH from 9.6 and 8.2 to 11.4 and 11.3, respectively, while a small change was observed for materials 3 and 4. The calcium concentration released from materials 1, 2, 3, and 4 after 72 hours was 6.54, 4.98, 1.31, and 1.74 mg/dL, respectively. CONCLUSION: Calen plus camphorated paramonochlorophenol and saline calcium hydroxide paste exhibited the highest calcium release and pH levels.

Analysis of Variance↗
PubMed2005

Investigation of pH at different dentinal sites after placement of calcium hydroxide dressing by two methods.

OBJECTIVE: The dentin pH at different sites following placement of calcium hydroxide paste using 2 different methods was evaluated. STUDY DESIGN: One hundred twenty Extracted teeth were instrumented and randomly divided into 6 different groups. Then they were dressed with calcium hydroxide by 2 different methods using paper points or Lentulo spiral, according to their respective groups, and stored. After the experimental period of time, half of the samples were cut transversally into slices and the other half split longitudinally and rinsed with distilled water. The dentin pH of cervical, middle, and apical thirds was measured from the root canal wall surface and 1 mm away from the root canal lumen in the inner dentin. The results were compared and statistically analyzed. RESULTS: The highest pH values were obtained on the root canal walls when the calcium hydroxide was placed with Lentulo spiral filler (P > .05). There was a significant reduction in pH values in the inner dentin. When the cross sections of teeth were compared at 7 days, the Lentulo group was statistically different only in the apical third. CONCLUSIONS: Placement of the calcium hydroxide paste with a Lentulo spiral with subsequent compaction with the blunt end of a sterile paper point obtained a higher pH value on the canal walls and in the inner dentin than paper points only.

Analysis of Variance↗