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In this paper we present our positive experience with use of Aquaplast thermoplastic as a tie-down dressing for securing and maintaining skin grafts in good position against their nutrient recipient beds. This unique polymer is safe to use, simple to apply, and maintains uniform pressure across the entire surface of the skin graft, no matter how contoured the shape of the anatomical region.
Teaching nursing diagnoses to beginning students who have no clinical experiences challenges educators to use their creative energies in developing strategies that facilitate students' critical-thinking skills. Dressing Up Nursing Diagnoses is a fun and creative classroom teaching strategy you can use during the Halloween season to help beginning students formulate nursing diagnoses. Two nurse educators describe their successful experiences with this unique teaching strategy.
A simple method is described of using a commercial drape or sheet of polyethylene to keep dressings moist prior to the application of delayed skin grafts.
We describe the use of a tie-over dressing to compress and eliminate the dead space in an ear after evacuation of a hematoma. This method seems to produce effective local pressure in the precise area where it is needed.
The measurement of adherence is a function of pulling force and velocity. The machine described measures and records adherence accurately and precisely. In both engineering and clinical laboratory tests, it has shown the ability to be used as standard equipment for quantitatively evaluating dressings and grafts. It is adapted for both laboratory and patient studies.
Using adhesive drapes and a disposable suction drain, a new method for the dressing of free skin grafts has been devised. The graft is compressed by pressure that is equivalent to the negative pressure of the suction drain. This method can apply uniform and constant pressure on the graft. Moreover, the graft can be observed through a transparent drape so that the existence of hematomas can be detected easily.
BACKGROUND: With a substantial rise in the incidence of skin cancer, skin surgery has become an increasingly large part of dermatology. Skin surgery is best performed by dermatologists. This demands effective training in dermatologic surgery, including flap surgery. OBJECTIVE: To find a modern alternative to traditional training on pig's feet skin in teaching flap surgery to residents in dermatology. MATERIALS AND METHODS: A face with expression lines printed on a nonadhesive hydrocellular polyurethane dressing (Allevyn, #66007638, 20 x 20 cm, Smith & Nephew Medical Limited, Hull, England). Tumors were marked in suitable locations, necessitating the use of transposition, advancement, and rotation flaps. Twenty-two residents were trained in flap construction, excision, and closure. RESULTS: Training on Allevyn was rated high by participants. CONCLUSION: Allevyn has unlimited storing qualities and skinlike qualities when incised, extended, and sutured. Sutures stay tight without the help of an assistant. Training on Allevyn gives students a good understanding of the mechanics of skin flaps, including transposition, advancement, and rotational flaps. The Allevyn is kept by the student after the course and can be studied afterward. Skin surgery training on Allevyn is superior to traditional training in pig's feet skin.
Acticoat (Smith and Nephew, Istanbul, Turkey), chlorhexidine acetate 0.5%, and silver sulfadiazine 1% were compared to assess the antibacterial effect of their application on experimental burn wounds in contaminated with Pseudomonas aeruginosa in rats. All treatment modalities were effective against P. aeruginosa because there were significant differences between treatment groups and control groups. The mean eschar concentrations did not differ significantly between Acticoat and chlorhexidine acetate groups, but there were significant differences between the silver sulfadiazine group and the other treatment groups, indicating that silver sulfadiazine significantly eliminated P. aeruginosa more effectively in the tissues than did the other two agents. All treatment modalities were sufficient to prevent the P. aeruginosa from invading to the muscle and from causing systemic infection. In conclusion, silver sulfadiazine is the most effective agent in the treatment of the P. aeruginosa-contaminated burn wounds; Acticoat can be considered as a treatment choice because of its peculiar ability of limiting the frequency of replacing wound dressings.
We present a case of compartment syndrome of the thigh due to blunt injury in a Division I American football player managed with fasciotomy and vacuum-assisted wound closure. This case report discusses the vacuum-assisted wound closure dressing as an alternative to more traditional closure techniques such as suture retention devices and split-thickness skin grafting. We feel that any surgeon involved in performing fasciotomies should be familiar with this increasingly used closure device and its potential complications.
This study evaluated the predominant microbiota of infected necrotic pulps and the effects of calcium hydroxide therapy on these microorganisms by the checkerboard DNA-DNA hybridization technique. Conventional endodontic therapy associated with calcium hydroxide as intracanal dressing was performed in 12 single-rooted teeth with pulp necrosis and periradicular bone lesion. Samples were collected from the canal at baseline and 14 days after therapy, and the presence of 44 bacterial species was determined by the checkerboard method. Significant differences in the microbiota from baseline to post-therapy were sought by the paired-samples t test. The most prevalent species included F. nucleatum ss. vincentii, C. sputigena, C. ochracea, S. constellatus, V. parvula, P. gingivalis, P. melaninogenica, and S. sanguis. Most of the microorganisms were reduced after treatment, particularly A. gerencseriae, A. israelii, A. naeslundii, C. gingivalis, C. ochracea, P. gingivalis, S. noxia, S. sanguis, and S. oralis (p < 0.05). Conversely, A. actinomycetemcomitans, C. sputigena, and E. corrodens increased in numbers after therapy. These results indicate that conventional endodontic therapy with calcium hydroxide results in the reduction of pathogenic species associated with pulp necrosis. However, its use is limited, because it did not eliminate the whole spectrum of microorganisms.
This is a clinical review of current techniques in wound bed preparation found to be effective in assisting the wound-healing process. The process begins with the identification of a correct diagnosis of the wound's etiology and continues with optimizing the patient's medical condition, including blood flow to the wound site. Débridement as the basis of most wound-healing strategies is then emphasized. Various débridement techniques, including surgery, topical agents, and biosurgery, are thoroughly discussed and illustrated. Wound dressings, including the use of negative pressure wound therapy, are then reviewed. To properly determine the timing of advance therapeutic intervention, the wound-healing progress needs to be monitored carefully with weekly measurements. A reduction in wound area of 10 to 15 percent per week represents normal healing and does not mandate a change in the current wound-healing strategy. However, if this level of wound area reduction is not met consistently on a weekly basis, then alternative healing interventions should be considered. There is a growing body of evidence that can provide guidance on the appropriate use of such adjuvants in the problem wound. Several adjuvants are discussed, including growth factor, bioengineered tissues, and hyperbaric medicine.
This paper presents 4 consecutive cases using negative-pressure dressings (VAC) to bolster skin grafts in male genital reconstruction. In this series reconstruction followed 1 case of tumor ablation and 3 cases of debridement of abscesses or Fornier's gangrene. The VAC was applied circumferentially to the penis to secure skin grafts either directly to the penile shaft or to facilitate skin grafting to the scrotum. Graft areas ranged from 75 to 250 cm. All cases resulted in successful genital wound coverage; minor complications are described. Three practical points are brought forth. First, the VAC facilitates skin grafting to the complex contour of male genitalia. Second, the VAC can be applied circumferentially to the penis without the need for perfusion monitoring or fears of avascular necrosis. Third, with the use of the VAC, bolster use can likely be discontinued as early as 72 hours with good graft adherence and survival.
BACKGROUND: The Rapid Deployment Hemostat (RDH) Bandage was developed for the rapid control of bleeding caused by trauma. METHODS: An extremity wound involving skin, muscle, bone, and femoral arterial injury and a 1-cm vertical incision in the abdominal aorta in swine were studied to compare the RDH Bandage, a fibrin sealant dressing and gauze to restore hemostasis. The total blood loss was determined and the survival of animals was measured. RESULTS: In the extremity injury model, the RDH Bandage reduced blood loss by 63% compared with the gauze control. In the aorta arterial incision model, the RDH Bandage required a significantly lower compression time to control bleeding compared with gauze and TachoComb. The RDH Bandage was able to stop bleeding from this injury in 100% of the tests. CONCLUSION: The RDH Bandage was superior to a commercially available fibrin bandage in controlling hemorrhage, decreasing blood loss, and increasing survival.
We present an exact analytic solution of a nonlinear Schrodinger field interacting with a moving potential (obstacle) at supersonic speed. We discover conditions under which the field can form a stable shape-invariant structure localized around the obstacle-a dressing effect that protects the field against excitations by the obstacle. Such an effect demonstrates the existence of frictionless motion beyond the conventionally defined critical velocity.
We consider a two-component atomic gas illumined by two intersecting laser beams which induce Raman coupling between the components. This spatially periodic coupling modifies the dispersion relation of the gas. Properties of a Bose-Einstein condensate of such a gas are strongly affected by this modification. Using the quasiparticle excitation spectrum derived from a Bogoliubov transformation, the Landau critical velocity is found to be anisotropic and can be widely tuned by varying properties of the dressing laser beams.
The first reported measurements of single attosecond pulses use laser dressed single-photon extreme ultraviolet (XUV) ionization of gas atoms. The determination of XUV pulse duration from the electron spectrum is based on a classical theory. Although classical models are known to give a qualitatively correct description of strong laser atom interaction, the validity must be scrutinized by a quantum-mechanical analysis. We establish a theoretical framework for the accurate temporal characterization of attosecond XUV pulses. Our analysis reveals an improved scheme that allows for direct experimental discrimination between single and multiple attosecond pulses.
In the context of the averaging problem in relativistic cosmology, we provide a key to the interpretation of cosmological parameters by taking into account the actual inhomogeneous geometry of the Universe. We discuss the relation between "bare" cosmological parameters determining the cosmological model and the parameters interpreted by observers with a "Friedmannian bias," which are "dressed" by the smoothed-out geometrical inhomogeneities of the surveyed spatial region.
We discuss radiative corrections to an atomic two-level system subject to an intense driving laser field. It is shown that the Lamb shift of the laser-dressed states, which are the natural state basis of the combined atom-laser system, cannot be explained in terms of the Lamb shift received by the atomic bare states which is usually observed in spectroscopic experiments. In the final part, we propose an experimental scheme to measure these corrections based on the incoherent resonance fluorescence spectrum of the driven atom.