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This article describes the potential risks to patients' skin from the use of wound dressings and how to minimise those risks. Guidance is provided on the steps to be taken once an allergic reaction is suspected.
Technology in the field of wound management is constantly progressing as researchers search for the ideal wound dressing. The regulatory situation for wound-care products can be confusing because in some cases they are considered to be pharmaceuticals and in others they are deemed to be medical devices. In addition, the situation has not been assisted by the system of risk classification in the Medical Device Directive. This article highlights the issues and provides an update on the latest position.
Hydrogel polymers are hydrophilic resins that display excellent biocompatibility, which has allowed their application in diverse fields of surgery and medicine. The original hydrogel polymer, a copolymer of 2-hydroxyethyl methacrylate and ethylene dimethacrylate, was developed by Wichterle and Lim in 1954. The development of the first soft hydrogel contact lenses by Wichterle in 1961 represented the first successful clinical application of hydrogel polymers and remains one of the most important uses of hydrogels today. The biocompatibility of hydrogel polymers may be adapted to diverse tissue types by small variations in the makeup of the polymer, including varying the type and amount of monomers and differing the amounts and characteristics of the cross-linking agents used to create the polymer chains. Hydrogels have been successfully developed for use as coatings, soft contact lenses, wound dressings, and drug delivery systems.
The poor standard of dressing provision in the crucial role of community nursing is discussed by Roy Lukacs, assistant district finance officer, Aylesbury and Milton Keynes Health District and Mike Dormer, product manager, patient care division, Johnson and Johnson. They ask why the drug tariff system is still common to many districts.
Local circumstances dictated that the supply of sterile dressing packs for the District be the subject of competitive tendering in August, 1984. This article shares the experience of conducting this task which involved developing a methodology in advance of detailed DHSS or Regional guidelines on this service.
With an increasing number of elderly clients now being accepted onto our haemodialysis programme, Permcath (Quinton Instrument Co., Seattle, WA, USA) catheters have become the chosen form of long term vascular access in many of these people. With this has come the need not only to adapt, but where necessary change the previous format of covering dressings at the exit site of these catheters.
In 1971-72, a large outbreak of poisoning caused by the consumption of seed dressed with organomercury compound occurred in Iraq. International assistance was requested by the Government of Iraq in investigating this outbreak. The results of the investigations to date were presented at the Conference on Intoxication due to Alkylmercury Treated Seed, held in Baghdad, Iraq on 9-13 November 1974. This paper summarizes the main findings and recommendations of the Conference.
PURPOSE: To investigate the suitability of chitosan films prepared using two different solvents, acetic acid (Chitosan-AA) and lactic acid (Chitosan-LA), for wound dressing, in comparison with a commercial preparation, Omiderm. METHODS: The mechanical and in-vitro bioadhesive strength properties of Chitosan-AA, Chitosan-LA, and Omiderm were investigated using texture analyzer equipment. The vapour permeability of chitosan films was determined using a method for evaluation of moisture permeability of containers and packaging material described in USP XXII. In addition, the biological evaluations were performed via primary skin irritation, intracutaneous, and systemic injection tests. RESULTS: The three preparations differed significantly in terms of the mechanical and bioadhesive strength properties. Chitosan-LA exhibited a lower tensile strength, but more flexible and bioadhesive than Chitosan-AA. Chitosan film was found to be permeable to water vapour. Chitosan-LA and Omiderm were non-irritant and did not cause any skin allergic reaction. In contrast, Chitosan-AA films inflicted adverse skin reactions. Nevertheless, no gross sign of toxicity was encountered from the systemic injection of the extracts of the three preparations. CONCLUSION: Chitosan films demonstrated significantly different mechanical and bioadhesive strength properties from Omiderm. Chitosan-LA was more soft, flexible, pliable and bioadhesive when compared to Chitosan-AA films. Furthermore, Chitosan-LA did not cause erythema, edema and systemic toxicity. Hence, Chitosan-LA film is suitable to be used in the management of wound healing and skin burn.
Silver isn't justfor jewelry. A wound care dressing that uses ionic silver to kill organisms is drawing increasing clinical attention because of its potential to keep wounds clean and perhaps treat existing infections. The product intrigues clinicians as an alternative to antibiotics, a boon in an age of increasing antibiotic resistanc.
Drug Rash with Eosinophilia and Systemic Symptoms (DRESS syndrome) or the drug hypersensitivity syndrome is a delayed and serious skin disease. It is manifest by a severe skin reaction associated with a severe visceral attack (adenopathy, hepatitis, nephritis, interstitial pneumopathy...) and haematological anomalies (raised hypereosinophilia...). The severe visceral attack is the main cause of death, which is estimated at around 10%. The principal drugs responsible are the aromatic anti-convulsants, sulphamides and minocycline. A large number of cases have been described with phenytoin, more rarely with carbamazepine and phenobarbitone.
This report describes the use of clear plastic bags on vinyl chloride-vinylidine chloride copolymer (also known as S Film) for the postoperative management of amputation stumps. The bags are shrunk to the stump by the application of heat and act as a primary dressing. Their use has been effective in controlling postoperative oedema and infection as well as giving the surgeon direct visual access to the stump without disturbing the wound. A case of a below-knee amputation managed by this method is described.
Completely independent application of lower extremity prostheses and clothing is essential but often difficult to accomplish in optimal rehabilitation of the bilateral above-knee amputee. This paper suggests an occupational therapy treatment plan for above-knee amputations, discusses reasons for dependency and decreased use of lower extremity prostheses and clothing, and describes a bilateral lower extremity dressing frame designed for independent application of prostheses and lower extremity clothing. The cost of rehabilitation can be justified once independence in application of prostheses and clothing is accomplished and functional ambulation is achieved.
Tight-lacing of the female body has been practised at various periods in the history of costume. During the romantic age of the nineteenth century the ideal women had to be pale, weak and often pathologically thin. She was supposed to be of a humble disposition and subservient to her husband (according to the doctrine of subordination). Women laced themselves so tightly that their bodies became deformed, with physical injuries and damage to the internal organs as a consequence. Competition for suitable husbands was keen, since marriage was the only honourable way for a woman to ensure that she would be provided for. It was also in the nineteenth century that doctors were beginning to fight against endemic disease and to argue for a more hygienic way of life. They maintained that women were slaves to fashion and that they dressed in an unhygienic way. Above all, they campaigned against the use of tight-laced corsets. Swedish doctors, such as Anton Nyström, Truls Johan Harterlius and Karolina Widerström headed the fight against the use of laced corsetes, on both medical and social grounds. An improved and "informed" costume was introduced which was meant to allow women greater freedom of movement, thus enabling them to live a more natural life. It was, however, not until 1910 that the tightly-laced corset was abandoned. The conclusion of this is that the history of costume is "the history of absurd follies".
Chronic wounds in patients with multiple systemic factors present a significant clinical challenge for clinicians. Oasis Wound Dressing is derived from porcine small intestine which, when placed in a non-infected wound, stimulates new tissue and an absorbable, natural template for the growth of new tissue. Emerging evidence suggests that it is beneficial for patients with chronic, non-healing wounds complicated by multiple systemic factors.
Twelve kinds of adhesive tapes and dressing materials produced by Beiersdorf were evaluated using laboratory, experimental and clinical tests. There were performed examinations of physical, physico-mechanical and bacteriostatic properties. Tests for supradermal and intradermal reactivity were performed in experimental animals. Moreover, different clinical tests of these materials were made.
Staff nurses have a key role in ensuring that practice is evidenced-based. This article discusses the application of a model for evidence-based practice change by staff nurses in an acute care setting who examined the practice of using sterile gloves for postoperative wound dressing changes. This initiative was in response to the challenge that it was unnecessary to use sterile instead of nonsterile gloves. Extensive literature search revealed insufficient evidence to justify a practice change to nonsterile gloves.
An HPLC method for the determination of brucine in seed dressing agents was investigated. The sample solution was separated on a Spherisorb C18 column(4.6 mm i.d. x 200 mm, 5 microns) with CH3OH-H2O-CTAB (88:12:0.04, m/m) as the mobile phase and detected at 254 nm. Calibration curve of brucine was obtained for the concentration range of 0.01 g/L-0.25 g/L. The linear regression equation was A = 11,485,814 rho + 21,229, r = 0.9997. The RSD was 1.2%(n = 11). The results show that this method is simple, specific and accurate.
The properties of polyvinyl alcohol (PVA), such as the ability to form membranes, good relative bioadhesiveness, the ability to mix with other polymers, biodegradability, swelling in water, lead to an assumption that the polymer may be used effectively as a carrier of the active substance onto the mucous membranes, what has led us to undertake present studies [1-4]. They revealed that depending on the degree of polyalcohol hydrolysis, the dressings made on the basis of PVA and methylcellulose (MC) with the addition of hydrophilic substances were characterised by distinct rheological properties and released the active substance in various ways. The studies on the kinetics of the release of a locally applied antiseptic, chlorhexidine digluconate, in biopharmaceutical model provided evidence of close to rectilinear relationship between the amount of released substance and the time of release for selected formulations.