Effects of zinc oxide in an occlusive, adhesive dressing on granulation tissue formation.
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Acid Phosphatase↗
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Results for “OCCLUSIVE DRESSINGS”
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Topical phenytoin in diabetic foot ulcers.
OBJECTIVE: The efficacy of topical phenytoin in the treatment of diabetic foot ulcers was evaluated in a controlled inpatient study. RESEARCH DESIGN AND METHODS: Fifty patients were treated with topical phenytoin, and 50 patients matched for age, sex, and ulcer areas, depth, chronicity, and infection were dressed with dry sterile occlusive dressing. RESULTS: Both groups improved, but the ulcers treated with topical phenytoin healed more rapidly. Mean time to complete healing was 21 days with phenytoin and 45 days with control. The differences seen were statistically significant (P less than 0.05) via the chi 2 test. CONCLUSIONS: Phenytoin appears to be useful as a topical agent in promoting the healing of diabetic foot ulcers.
Adult↗
Two hydrocolloid dressings evaluated in experimental full-thickness wounds in the skin.
Hydrocolloid occlusive dressings are beneficial in wound management in many respects, although the adhesive matrix may disintegrate when in contact with wounds. The purpose of this study was to determine: (1) if material from two hydrocolloid dressings-Comfeel and Duoderm-showing differences in adhesive cohesion, can be chemically identified in granulation tissue; and (2) if the presence of this material influences cutaneous wound healing. In full-thickness skin wounds in rats, components from the two hydrocolloid dressings were phagocytosed as indicated by the presence of foam cells. Extracellular vacuoles (100-400 microns in size) occupied about 25% of the granulation tissue volume in the Duoderm group but less than 5% in the Comfeel group, a statistically significant difference (p < 0.001). The vacuoles contained hydrophobic polymers derived from the respective hydrocolloid dressing, as analyzed by Fourier Transform Infrared (FT-IR) microscopy. Wound contraction did not differ significantly between the two hydrocolloid dressings. Wounds treated with Comfeel were significantly (p < 0.05) more epithelialized (mean: 78%) than those treated with Duoderm (mean: 41%). The proliferative activity in wound epithelium, as measured immunohistochemically by bromodeoxyuridine incorporation, was similar for the two treatment groups, indicating that epithelial migration was impaired in Duoderm-treated wounds. In summary, extensive incorporation of hydrophobic dressing material from hydrocolloid dressings may render the wound bed less suitable for epithelial migration during acute secondary wound healing.
Animals↗
Preliminary observations on clotting under three hydrocolloid dressings.
Four patients with five wounds were randomly assigned to treatment with three occlusive dressings: DuoDERM, Restore and Comfeel Ulcus; the dressings were left intact for 24-48 h. When the dressings were removed, it was found that wounds that had been covered with Restore and Comfeel contained coagulated sanguinous material. Two wounds that had been covered with Comfeel and Restore, respectively, were then covered with DuoDERM, while one wound previously covered with DuoDERM was covered with Restore. Either no clotting occurred under DuoDERM or clots may have resolved. Although these preliminary data suggest that DuoDERM gel may have fibrinolytic properties, more extensive and controlled studies are needed to assess the characteristics of this dressing.
Bandages, Hydrocolloid↗
Improved long-term maintenance of central venous catheters with a new dressing technique.
Nursing procedures that may be important for maintaining in-dwelling central venous catheter sterility include the use of occlusive dressings, the frequency of dressing changes, the number and skill of nurses doing the dressing changes, the duration of catheterization, the use of antimicrobial ointment, and the extent to which sterile procedures are used during catheter placement. During a 9-month period, two different methods for applying central venous catheter dressings were compared. A new method designed to improve the stability of the dressing and to reduce tension on the catheter was found to be associated with longer maintenance of the dressings compared with a more traditional dressing; 14% fewer dressings were changed because of loss of occlusiveness. With this dressing technique and a strict protocol, including insertion and maintenance of central venous catheters by a nutritional support team, prolonged (greater than 7 days) maintenance of central venous catheters was found to be possible without an increase in the incidence of infection.
Adolescent↗
Management of radiation-induced moist skin desquamation using hydrocolloid dressing.
Moist skin desquamation has been of concern to radiation oncologists, nurses and patients since the inception of this mode of therapy. As radiation treatment machines became more sophisticated, severe reactions became less of a problem. However, with the increasing use of chemotherapy and radiation as combined modalities, moist skin reaction is occurring with greater frequency. A noncomparative study of 20 patients using a hydrocolloid occlusive dressing (Duoderm) was initiated. The purpose of the study was to determine whether moist occlusive healing would be beneficial. The dressing was evaluated on the basis of healing time, safety, wound temperature, bacterial growth, and comfort. Data were collected using photographs, bacterial cultures, temperature probes, and patient evaluations. Eighteen patients completed the study. All patients' skin reactions healed. There were no wound infections evident. Mean healing time was 12 days, with mean wound temperature relative to body core -0.8 degree C on day 1 and -1.2 degrees C on the healed site. Patient results on comfort were: 8 of 18 excellent, 7 of 18 good, 3 of 18 fair, and 0 of 18 poor. The results of this study indicate that a hydrocolloid occlusive dressing can be effective in the healing process of moist skin reaction that is due to radiation therapy.
Bandages, Hydrocolloid↗
Frequency of vaccinia virus isolation on semipermeable versus nonocclusive dressings covering smallpox vaccination sites in hospital personnel.
BACKGROUND: The Centers for Disease Control and Prevention recommends a semipermeable occlusive dressing for hospital workers who receive smallpox vaccination. OBJECTIVE: The study was designed to determine the frequency of vaccinia virus isolation from the outer surface of semipermeable dressings and to compare the prevalence of vaccinia virus on the outer surface of semipermeable dressings with its prevalence on the outer surface of nonocclusive dressings. METHODS: A prospective, observational study was conducted on hospital employees who received smallpox vaccination at a military academic medical center. Subjects were instructed to wear a semipermeable dressing if they had direct patient contact. Employees without direct patient care had the option of wearing a semipermeable dressing or a nonocclusive dressing. Prior to a programmed dressing change, the outer surface of the bandage site was swabbed and cultured for virus. Samples were considered positive when cytopathic effects were observed, with results confirmed as vaccinia by polymerase chain reaction. RESULTS: A total of 212 cultures were obtained from 93 subjects. All cultures directly obtained from active lesions were positive (13/13). Positive cultures were obtained from 7% (10/135) of the semipermeable dressings and 23% (15/64) of the nonocclusive dressings (P <.05). Ten percent (8/79) of the semipermeable dressings with purulent exudate observed underneath the bandage were culture positive, compared with 4% (2/56) of semipermeable dressings with no purulent exudate observed underneath the bandage (P=.19). CONCLUSIONS: Compared with nonocclusive dressings, the semipermeable dressing reduced, but did not eliminate, the frequency with which vaccinia virus was cultured from the surface of the dressing. Virus was present, but only rarely, on the dressing surface in the absence of purulent exudate under the semipermeable dressings.
Bandages↗
Analysis of cost of dressings in the care of burn patients.
This study aimed at analyzing the costs of material used in the occlusive dressings of burn patients. The subjects of the study were patients over the age of 18 years who were admitted to the Burns Unit of the Ribeirão Preto Medical School Clinical Hospital, University of São Paulo-Brazil, from 15 January to 11 September 1998. Data were collected concerning the costs and duration of bathing and dressing of these patients. We concluded that there was a positive relation between the real costs of the materials used and the percentage of the body surface burned. In addition, there was a positive correlation between the number of staff involved in care and the size of the burns. There was no significant difference between the cost of materials used in dressings for burns of different depths.
Adolescent↗
[Investigation of a new product (HK 183 MB) in various dermatoses].
The new trial preparation, diflucortolone valerate, was tested clinically in the form of a cream on 41 patients with weeping dermatitis. 34 cases were treated without a dressing, 5 with a dressing and 2 with an occlusive dressing. A complete cure or a distinct improvement was obtained in 100% of the cases. No undesired side effects developed.
Adrenal Cortex Hormones↗
Use of the hydrocolloidal dressing duoderm for skin donor sites for burns.
We have made a study of the use of Duoderm hydroactive sterile occlusive dressing on 10 patients for skin donor sites. Its therapeutic efficacy is evident and the dressing enhances the wound debridement and accelerates the re-epithelialization, with complete healing in 8.5 days on the average. In comparison with a conventional dressing with paraffin gauze, Duoderm allows a more rapid re-epithelialization. In addition, the new skin is softer, smoother and more homogeneous. Duoderm is also easy to use and is well tolerated by the patients.
Adult↗
Multicenter clinical evaluation of a hydrocolloid dressing for leg ulcers.
The need for a moist environment for the normal healing process led to the development of occlusive dressings. Results from this study support the contention that a moist wound environment is favorable to the healing process in humans as well as in animal models. Hydrocolloid dressings are effective in the practical daily management of chronic and even refractive ulcerations of the lower extremities and offer a time-saving treatment alternative with a high degree of patient acceptability.
Adolescent↗
Safety and efficacy of a proteolytic enzyme for enzymatic burn debridement: a preliminary report.
A prospective, non-comparative study design was used to describe our experience with a bromelain-derived debriding agent, Debridase, in 130 patients with 332 deep second degree and third degree burns treated between 1984 and 1999. Debridase was applied after saturating the burns with a moist dressing for 2-24h. Debridase was applied for a period of 4h under an occlusive dressing. Mean patient age was 18.6 +/- 19.3, 42 (32.3%) were female, and 63 (48.5%) were children under age 18. Most burns were small. Debridase was applied once in 241 (72.6%) of the 332 wounds, twice in 67 (20.18%) cases, three times in 12 (3.61%) cases, and four times in 2 (0.6%) cases. The percentage debridement by number of applications was 89 +/- 21% for a single application, 77 +/- 27% for two, and 62 +/- 27% for three Debridase applications, respectively. There were no significant adverse events. The availability of a fast acting, reliable and complication-free enzymatic debriding agent may open new horizons and provide a new treatment modality for burns.
Adolescent↗
Effect of occlusion on cell proliferation during epidermal healing.
BACKGROUND: Occlusive dressings influence epithelization of superficial wounds by some unknown mechanism(s). OBJECTIVE: The effects of occlusion on epidermal cell proliferation in two types of wounds were examined. METHODS: Partial-thickness wounds and tape-stripped skin wounds were compared. An immunohistochemical technique, employing PC10 - a monoclonal antibody against proliferating cell nuclear antigen (PCNA) - was applied to formalin-fixed, paraffin-embedded porcine tissue sections. RESULTS: The number of PC10-positive cells was low during the migratory phase, then increased to a peak of proliferation 2 to 3 days after resurfacing. An overall increased proliferative response (mean = 21%) was seen in occluded compared to control partial-thickness wounds (day 10 postoperatively); an opposite effect of occlusion on epidermal proliferation was seen in tape-stripped skin. Occlusion decreased the proliferative response (mean = 42%) compared to air-exposure. CONCLUSION: Occlusion increased epidermal cell proliferation in wounds (where the entire surface epithelium and papillary dermis was removed), whereas an opposite effect was seen in tape-stripped skin from which only the stratum corneum had been removed.
Animals↗
Occlusion following laser resurfacing promotes reepithelialization and wound healing.
One of the critical parameters that has not been examined carefully following laser skin resurfacing is the effect of eschar on the wound healing process. Because occlusive dressings minimize the occurrence of eschar, the present study was undertaken to evaluate the effect of occlusion following laser resurfacing. It is clear that CO2 lasers promote epidermal cell loss and variable amounts of dermal injury. To characterize the wound repair process after laser treatment, biopsy specimens were obtained 2 to 4 days after treatment. Specimens from 15 patients were examined; the preauricular biopsy specimens were paired such that one specimen was from skin that had been occluded and the other specimen (from the same patient) was from skin treated without occlusion. Skin specimens were examined by indirect immunofluorescence using antibodies to specific epidermal and dermal antigens. The results indicate that the keratinocytes that repopulate the epidermis migrate from the hair follicles and express keratin 17, an intermediate filament protein expressed in keratinocytes during the early stages of wound healing. The migration of keratin 17-expressing cells begins 48 hours following laser resurfacing in skin treated with occlusion, whereas cell migration from the follicles of skin treated without occlusion is delayed. In summary, occlusion promotes enhanced cell migration and diminished eschar formation, resulting in more rapid healing.
Epidermis↗
[Effect of dressing materials on wound healing].
In the early 1970s, a major revolution in the management of wounds began. Simple woven absorbents that kept the wound as dry as possible were superseded by occlusive dressings that provided moist wound healing. The wound healing process is influenced by control of moisture content, thermal properties, gaseous permeability, pH effects, and impermeability to micro-organisms. Low adherence of the dressing provides protection of the newly formed tissue and relieves the patient's pain during removal.
Bandages↗
Octyl-2-cyanoacrylate liquid bandage as a wound dressing in facial excisional surgery: results of an uncontrolled pilot study.
BACKGROUND: Although cyanoacrylate tissue adhesives are frequently used in the closure of cutaneous lacerations and excisions, only a few reports comment on their usefulness as a dressing over sutured wounds. A new formulation of octyl-2-cyanoacrylate (Liquid Bandage; BAND-AID, Johnson & Johnson) is used as an occlusive protective film over minor cuts and scrapes. OBJECTIVE: An uncontrolled pilot study to assess the safety, efficacy, and cost of Liquid Bandage as an occlusive dressing over sutured facial excisions. METHODS: Patients undergoing excision of facial neoplasms were recruited. After conventional layered repair, Liquid Bandage was applied. On suture removal, the wounds were photographed and evaluated by three dermatologists, who assigned an overall outcome rating. The average cost of Liquid Bandage and routine wound care materials was calculated based on prices from three different pharmacies. RESULTS: Of the 18 wounds available at follow-up, 17 were assigned an overall outcome rating of good or excellent by at least one of the evaluators. Eleven wounds received an excellent rating from at least two of the evaluators. One case of distal flap necrosis occurred. Liquid Bandage proved to be less expensive than routine postsurgical wound care materials. CONCLUSIONS: Liquid Bandage dressing is safe and effective over sutured facial excisions.
Adolescent↗
Compression modalities and dressings: their use in venous ulcers.
Among the standard of care for venous ulcer treatment are the use of compression therapy to reverse the effect of venous hypertension and the use of occlusive dressings to maintain a moist wound-healing environment and for treatment of abnormalities of the ulcer bed. The use of multilayered elastic bandages for compression in patients with normal arterial flow currently provides the treatment with the highest level of evidence for treatment of venous ulcers. Additionally, treatment of the ulcer bed, especially with cadexemer iodine dressings, is also supported by evidence from randomized controlled trials, whereas newer dressings provide less well proven alternative opportunities to speed the healing of venous ulcers.
Humans↗
Transparent polyurethane film as an intravenous catheter dressing. A meta-analysis of the infection risks.
OBJECTIVE: To obtain a quantitative estimate of the impact on infectious complications of using transparent dressings with intravenous catheters. DATA SOURCES: Meta-analysis of all studies published in the English literature, including abstracts, letters, and reports that examined the primary research question of infection risks associated with transparent compared with gauze dressings for use on central and peripheral venous catheters. Studies were identified by use of the MEDLINE database using the indexing terms occlusive dressings, transparent dressings, and infection and by review of referenced bibliographies. STUDY SELECTION: Seven of the 15 studies (47%) of central venous catheters and seven of 12 studies (58%) of peripheral catheters met our inclusion criteria for analysis. All studies used a prospective cohort design, utilized hospitalized patients, and reported at least one of our defined outcomes. EXTRACTION: Data for each study were abstracted independently by three investigators. At least three studies were used in the analysis of each outcome. DATA SYNTHESIS: Applying a Mantel-Haenszel chi 2 analysis, use of transparent dressings on central venous catheters was significantly associated with an elevated relative risk (RR) of catheter tip infection (RR = 1.78; 95% confidence interval [CI], 1.38 to 2.30). Catheter-related sepsis (RR = 1.69; 95% CI, 0.97 to 2.95) and bacteremia (RR = 1.63; 95% CI, 0.76 to 3.47) were both associated with an elevated RR. Use of transparent dressings on peripheral catheters was associated with an elevated RR of catheter-tip infection (RR = 1.53; 95% CI, 1.18 to 1.99) but not phlebitis (RR = 1.02; 95% CI, 0.86 to 1.20), infiltration (RR = 1.12; 95% CI, 0.92 to 1.37), or skin colonization (RR = 0.99; 95% CI, 0.90 to 1.09). CONCLUSION: The results demonstrated a significantly increased risk of catheter-tip infection with the use of transparent compared with gauze dressings when used with either central or peripheral catheters. An increased risk of bacteremia and catheter sepsis associated with the use of transparent compared with gauze dressings for use on central venous catheters was suggested.
Bacteremia↗