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Biomedical subjects

Peter G Shakespeare

Publications and source records attributed to Peter G Shakespeare.

6 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

How well does your ruby laser work?

The safe and effective use of cutaneous lasers is dependent upon the selection of a clinically appropriate laser energy level. Therefore, the accuracy of the stated laser output is critical. The energy output of an Aesculap ruby laser was recorded at the start of every clinical session over a 704-day period using an external energy meter. Regular review of these records enabled trends of energy output to be recognised and appropriate action to be taken prior to adverse clinical sequelae. This monitoring procedure is a quick and inexpensive method of improving quality control in the use of medical lasers.

Lasers↗
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↗
PubMed2002

International clinical recommendations on scar management.

Many techniques for management of hypertrophic scars and keloids have been proven through extensive use, but few have been supported by prospective studies with adequate control groups. Several new therapies showed good results in small-scale trials, but these have not been repeated in larger trials with long-term follow-up. This article reports a qualitative overview of the available clinical literature by an international panel of experts using standard methods of appraisal. The article provides evidence-based recommendations on prevention and treatment of abnormal scarring and, where studies are insufficient, consensus on best practice. The recommendations focus on the management of hypertrophic scars and keloids, and are internationally applicable in a range of clinical situations. These recommendations support a move to a more evidence-based approach in scar management. This approach highlights a primary role for silicone gel sheeting and intralesional corticosteroids in the management of a wide variety of abnormal scars. The authors concluded that these are the only treatments for which sufficient evidence exists to make evidence-based recommendations. A number of other therapies that are in common use have achieved acceptance by the authors as standard practice. However, it is highly desirable that many standard practices and new emerging therapies undergo large-scale studies with long-term follow-up before being recommended conclusively as alternative therapies for scar management.

Cicatrix, Hypertrophic↗
PubMedDate not supplied

The role of skin substitutes in the treatment of burn injuries.

Extensive burn wounds are difficult to manage and repair. Several engineered skin substitutes have been developed to aid in this process. These substitutes are designed with particular objectives in mind which dictate the circumstances under which they can, and should, be employed to promote healing or prepare the burn wound for final closure with autograft. This article discusses some of the rationale behind the use of skin substitutes and reviews some of the substitutes in use at the present time. Current perspectives suggest that skin substitute use is still in its infancy and that there is some way to go before their role in clinical practice becomes clear. Nevertheless the prospect of being able to supply new wound repair components and to influence the healing process to modify outcome and improve the quality of the healed burn wound will ensure a continuing high degree of interest in these potentially useful and beneficial medical devices.

Burns↗