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Biomedical subjects

Paul E Banwell

Publications and source records attributed to Paul E Banwell.

9 recordsLinked to original sources
PubMed2005

Interface dressings influence the delivery of topical negative-pressure therapy.

BACKGROUND: Topical negative-pressure therapy is a widely used wound management system that generates a negative pressure at the wound surface through a foam pad, which aids in wound stimulation through mechanical forces on the wound bed. System guidelines state that the foam dressing should be placed in direct apposition with the wound surface; however, an interface dressing is often inserted at this point to promote comfort at dressing changes. METHODS: Topical negative-pressure dressings were applied to 40 healthy volunteers. Pressures at the skin surface under the dressing were recorded and compared with those measured by a topical negative-pressure machine using the Therapeutic Regulated Accurate Care pad system. These were repeated, inserting different types of interface dressings: petroleum jelly (Vaseline)-impregnated gauze, nonadherent silicone dressing, and mylar polyester film dressing. RESULTS: Pressures recorded at the skin interface with no interface dressing were close to those set on the topical negative-pressure machine (mean pressure change, -5.11 +/- 0.55 mmHg). Interposition of dressings at the skin/foam interface affected pressure transmission through the foam, and some caused significant decreases in pressures recorded at the skin surface (e.g., Vaseline-impregnated gauze: mean pressure change, -11.76 mmHg; maximum pressure change, -41 mmHg). CONCLUSION: The loss in negative pressure means that pressures designated by the machine cannot be relied on as a measure of wound pressure when certain dressings are used at the interface. This could be important in determining the outcome of some wounds under topical negative-pressure therapy treatment.

Bandages↗
PubMed2005

Radiotherapy and wound healing.

Radiotherapy is an invaluable weapon when treating cancer. However, the deleterious effects of radiation, both immediate and long-term, may have a significant effect on local tissues. Problematic wound healing in radiation-damaged tissue constitutes a major problem that is frequently overlooked during the management of patients who require radiotherapy, or have had radiotherapy in the past. Poor wound healing may lead to chronic ulceration, pain, secondary infection and psychological distress and compromise the outcome of general or reconstructive surgery. We discuss the pathophysiology of poor wound healing following radiotherapy, specific problems for radiation-damaged tissue and potential treatments to improve wound healing of irradiated tissues.

Humans↗
PubMed2004

Topical negative pressure therapy: mechanisms and indications.

Topical negative pressure (TNP) therapy has emerged as a high-technology, microprocessor-controlled physical wound-healing modality. Complex effects at the wound-dressing interface following application of a controlled vacuum force have been documented. These include changes on a microscopic, molecular level and on a macroscopic, tissue level: interstitial fluid flow and exudate management, oedema reduction, effects on wound perfusion, protease profiles, growth factor and cytokine expression and cellular activity, all leading to enhanced granulation tissue formation and improved wound-healing parameters. Primary indications for clinical use have been documented and include traumatic wounds, open abdominal wounds, infected sternotomy wounds, wound bed preparation, complex diabetic wounds and skin-graft fixation. Whilst this therapy now forms an essential part of the wound healing armamentarium, extensive clinical trials are recommended to confirm efficacy and delineate its optimum use.

Bandages, Hydrocolloid↗
PubMed2004

Necrotising fasciitis: a new management algorithm based on clinical classification.

Necrotising fasciitis is a rare infection of the subcutaneous tissues. If untreated, it is invariably fatal, and thus a high index of suspicion for the diagnosis is required. The disease's manifestation can range from a fulminant presentation to a subtle and insidious development. The priority in every case is to proceed to radical surgical debridement. On review of the literature and based on our clinical experience, we propose a new classification based on clinical presentation and suggest an algorithm to facilitate the management of this devastating condition. Increasing awareness should be given to the management of the large wounds resulting from the surgical debridement of necrotising fasciitis.

Abdominal Muscles↗
PubMed2004

Telemedicine in wound healing.

Better care for patients and improved health care depends on the availability of good information which is accessible when and where it is needed. The development of technology, more specifically the Internet, has expanded the means whereby information can be acquired and transmitted over large distances enabling the concept of telemedicine to become a reality. Telemedicine, defined as the practise of medicine at a distance, encompasses diagnosis, education and treatment. It is a technology that many thought would expand rapidly and change the face of medicine. However, this has not happened and during the last decade although certain telemedicine applications, such as video-consulting and teleradiology, have matured to become essential health care services in some countries, others, such as telepathology, remain the subject of intensive research effort. Telemedicine can be used in almost any medical specialty although the specialties best suited are those with a high visual component. Wound healing and wound management is thus a prime candidate for telemedicine. Development of a suitable telemedical system in this field could have a significant effect on wound care in the community, tertiary referral patterns and hospital admission rates.

Computer Communication Networks↗
PubMed2004

Topical radiant heating in wound healing: an experimental study in a donor site wound model*.

The importance of temperature in the wound-healing process is rapidly being recognised as a novel way in which to manipulate the wound-healing environment. In this study, we aimed to investigate the direct effect of topical radiant heating (TRH), using a novel bandaging system (Warm-Up, Arizant Health care Inc., Eden Prairie MN, USA; Augustine Medical, USA), on wound healing at a physiological and cellular level. Experimental bandages were positioned over split-thickness skin graft donor site wounds of 12 patients undergoing graft harvesting from the anterior thigh. The experimental group (n=6) underwent intermittent heating for 5 hours (three 1-hour heating cycles at 38 degrees C, separated by two 1-hour rest periods), whilst the control group (n=6) received no radiant heating. Physiological blood-flow recordings both in the control group and the topical radiant heat cohort were undertaken using Laser Doppler Imaging (LDI). Skin biopsies were obtained at identical time points, and immunohistochemical analysis was undertaken using antibodies against neutrophils (NP57), lymphocytes (CD3) and macrophages (CD68). We found that TRH significantly increased local dermal blood flow (P<0.001) by up to 100% in both injured and intact skin. Furthermore, this increase in flow was associated with a significant (P<0.05) increase in CD3 immunoreactivity on day 1 postoperatively. This study demonstrates that TRH increases local blood flow and lymphocyte (CD3) extravasation, and we postulate that these changes may enhance local innate immunity within the healing wound environment.

Biopsy, Needle↗