Clinical trial of occlusive plastic dressings.
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Bandages↗
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Results for “BANDAGING AND DRESSING”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
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Pinch skin grafting or porcine dermis in venous ulcers: a randomised clinical trial.
Chronic venous ulcers are common, and even with effective compression or elevation large ulcers may take months to heal. Pinch skin grafting may allow healing from epithelial islands throughout the surface area of the ulcer, and a prospective randomised trial was therefore conducted comparing this treatment with porcine dermis dressings. Most patients were treated as outpatients, 25 ulcers being randomised to treatment with pinch skin grafts and 28 to treatment with porcine dermis. Though the groups were well matched, the mean healing rate in the first week was 15 cm2 for pinch skin grafts compared with 3.5 cm2 with porcine dermis (p less than 0.02). By life table analysis 64% of ulcers treated by pinch grafts were healed at six weeks and 74% by 12 weeks compared with 29% and 46% of ulcers, respectively, treated with porcine dermis dressings (chi2 = 4.1; p less than 0.05). All ulcers that failed to heal within 12 weeks included an area posterior to the medial malleolus, where local compression may have been inadequate. Pinch skin grafting improves the rate of healing in large venous ulcers and is a simple technique that may be performed as an outpatient procedure under local anaesthesia.
Bandages↗
Necrobiosis lipoidica: treatment with porcine dressings, split-thickness skin grafts and pressure garments. A case report and review of treatment modalities.
A 39-year old nondiabetic female had severely ulcerated necrobiosis lipoidica of the legs which was refractory to medical management for 2 1/2 years. Surgical management with porcine grafting followed by autologous split-thickness skin grafts successfully healed these ulcerations. With the use of custom-fitted contoured pads and pressure gradient stockings, the grafts have remained intact for 2 1/2 years, and there has been significant improvement of the nonulcerated plaques.
Adult↗
Teratological studies on collagen wound dressing (CAS) in mice.
We subcutaneously injected collagen wound dressing (CAS) extracts equivalent to the area covering human body surface by 35 and 70%, respectively, into mouse dams from days 6 to 15 of pregnancy. No toxicity was observed in dams and no external, skeletal and visceral anomalies related to CAS treatment were observed in fetuses. It is, therefore, concluded that CAS extracts produces no teratogenesis after subcutaneous injection during organogenesis in mice.
Abnormalities, Drug-Induced↗
Human amnion in the treatment of chronic ulceration of the legs.
A prospective study to evaluate the efficacy of human amniotic membrane dressings in the treatment of chronic leg ulcers was conducted on 15 patients. Patients with two ulcers were selected. One ulcer was treated with human amnion and the other, treated with standard dressings, served as a control. The rate of healing of the two ulcers was observed and compared. Chronic ulcers of post-phlebitic, post-irradiation and post-burn origin responded to treatment with human amnion and healed more rapidly than the control ulcer. Ulcers associated with rheumatoid arthritis and vasculitis showed no improvement. It was observed that all ulcers treated with human amnion quickly became pain-free.
Aged↗
Modern dressings: what to use.
There have been significant advances in the understanding of wounds and wound management since the 1960s. The author briefly discusses these advances and provides a practical introduction to current dressing routines.
Alginates↗
Porous collagen sponge wound dressings: in vivo and in vitro studies.
Collagen-based materials can be formed into a three-dimensional sponge for use as a wound dressing and as a support for cell cultured skin components. Factors such as biocompatibility, morphological structure and addition of non-collagenous molecules to collagen are analyzed and discussed. Large pores or channels, interchannel communications and combinations of macromolecules of the connective tissue enhance wound tissue infiltration in vivo as well as cell growth in vitro into collagen sponges. The presence of such factors can be useful in patients with excised burn wounds and pressure skin ulcers.
Animals↗
Dermodress: a temporary skin substitute for coverage of exposed vital structures in the hand.
A chemically treated bovine skin, Dermodress, is presented as a new type of biological dressing for exposed tendons, bones, and nerves following extensive thermal or severe soft-tissue injuries to the hand. Its use enables the surgeon to postpone closure of defects with grafts or flaps until the presence of healthy, viable tissue is secured. The vital structures underneath the covering are kept moist, thus preventing necrosis and desiccation. Because of its adherence properties, Dermodress use also allows early mobilization and bathing, thereby accelerating rapid return of function.
Adult↗
Honey-impregnated gauze versus amniotic membrane in the treatment of burns.
A prospective randomized clinical study to compare honey-impregnated gauze with amniotic membrane dressing in partial thickness burns was carried out. Sixty-four patients were studied. Forty of them were treated with honey-impregnated gauze and 24 were treated with amniotic membrane. The burns treated with honey healed earlier as compared to the amniotic membrane (mean 9.4 vs 17.5 days) (P < 0.001). Residual scars were noted in 8 per cent of patients treated with honey-impregnated gauze and in 16.6 per cent of cases treated with amniotic membrane (P < 0.001).
Adolescent↗
Wound contraction. A quantitative interpretation.
The behavior of dressed excisional wounds in a number of species (man, rabbit, rat and mouse) has been analysed. The change in wound area with time due to contraction was found to be consistent with a constant linear rate of movement of the wound margins. The linear rate of movement of the wound margins is shown to be an appropriate parameter for the quantitative comparison of rates of contraction. This parameter can be calculated from the slope of the (area)1/2 versus time plots.
Animals↗
[Ambulatory treatment of postphlebitic ulcers of lower limbs. Physiopathological bases and clinical results].
Venous ulceration is a troublesome and disabling complication, representing one of the most difficult problems to be treated by the vascular surgeon. Venous insufficiency is a widespread condition, the prevalence of venous ulceration being 0.5 - 1 per cent in European populations. Although all venous ulcers will heal if the limb is elevated above heart level for an extended period of time, patients need a safe, effective, not disabling and quick therapy. Hence, the competent vascular surgeon must be familiar with venous pathophysiology and possess a thorough understanding of the treatment options available for a discouraged patient in need of an acceptable and effective approach. The aim of the present study was to assess the efficacy and the speed of healing of venous ulcer using an outpatient ambulatory treatment protocol. This protocol consisted of elastic compression bandage allowing deambulation, local dressing using lyophilized heterologous collagen (Condress, Gentili) and systemic profibrinolytic drugs. Exclusion criteria were coexisting arterial insufficiency, ulcer area greater than 25 cm2, coexisting disabling diseases (congestive cardiac failure, hepatic insufficiency, malignancy). From December 1990 to June 1993, 37 patients affected by venous ulcer were treated, according to the aforementioned protocol, at the Surgical Department of Montecchio Maggiore Hospital (VI). There were 16 male and 21 female patients, mean age was 66 years (range 59-91). Results show the complete healing of the venous ulcer in 94.5% of patients; mean time for ulcer healing was 128 days (range 45-91). The Authors conclude that the outpatient ambulatory treatment protocol is safe, quick, and effective for the therapy of chronic venous ulcer; once obtained the healing of the ulcer, elastic compressive bandage with elastic stockings is mandatory to prevent recurrences.
Aged↗
Skin wound healing determined by water loss.
An in vivo method of monitoring healing was tested incorporating an Evaporimeter measuring water evaporation; reepithelialization was detected through reestablishment of the water barrier. In the first study two wounds were created with a 2-mm biopsy punch on each of the backs of 15 rabbits and covered with occlusive and semiocclusive dressings. Water loss increased from a preoperative value of 6 g m-2 hr-1 to 55 g m-2 hr-1 after surgery. Water loss from the occluded site returned to baseline values in 9 days as opposed to 17 days for the semioccluded sites (P less than 0.05). The second study followed the healing of full-thickness 4 X 4-cm wounds in five rabbits treated with fine-mesh gauze and five treated with a human amnion dressing. Wound area and water loss were observed during the repair process. Visually measuring the wound area, the injuries appeared 100% healed on Day 30. The Evaporimeter continued to detect significantly increased water loss up until Day 45 when the original baseline values were reached. No differences were observed between the gauze and amnion groups. The Evaporimeter presents a simple yet accurate, noninvasive tool measuring the wound healing endpoint based on regeneration of the epidermal water barrier.
Animals↗
Preliminary clinical studies of a biological skin equivalent in burned patients.
The possibility of covering large areas of full thickness skin loss with 'living skin equivalent' produced by a modification of Bell's method was studied. Living skin equivalents, composed of a dermal equivalent (fibroblasts plus collagen) covered by epithelial cells were grafted, meshed or non-meshed, onto granulation tissue and, in one patient, onto fascia. Eight patients with full skin thickness burn wounds covering over 15 per cent of the body surface area were thus partially covered. The graft 'take' was evaluated every 48 h. In every patient grafted, an extensive lysis (60-90 per cent) of the skin equivalent graft was observed at the first dressing (48 h). In one patient only, a significant percentage of 'take' (40 per cent) was observed 14 days after grafting. These disappointing results were probably related to the presence of collagenases or proteases produced on the wound bed either by bacteria or by surrounding human cells. It appears that at the present time the biochemical nature of the dermal equivalent used is not yet completely appropriate to serve routinely as a substitute for human skin.
Bandages↗
Implications for the use of amnion and chorion in podiatric medicine and surgery.
The purpose of this article is to show the possibility of using fetal membranes as a biologic dressing for some of the pedal ulcerations that podiatrists encounter. There are as many treatment modalities for lower extremity ulcerations as there are types of ulcers. Through the following case histories, the authors demonstrate various types of ulcerations treated with amnion and chorion and the results achieved. The clinical application of fetal membranes has been under study for many years. The authors' efforts support the use of amnion and chorion by the medical community in treating some lower extremity ulcers.
Adult↗
Treatment of chronic cutaneous lesions by occlusive dressings.
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Adrenal Cortex Hormones↗
Cutaneous reactions to surgical preparations and dressings.
A prospective study of 100 surgical patients was undertaken to identify causes of contact dermatitis. Patch testing with the North American Contact Dermatitis Standard Series and additional agents used in the surgical preparation and dressing was performed in 11 patients with post-operative dermatitis or a history of tape allergy. 12 patients were diagnosed as having irritant (mechanical) contact dermatitis. One patient had allergic contact dermatitis to benzoin postoperatively; another patient with a history of an adhesive tape reaction had a positive patch test to thiuram mix, rubber accelerators formerly present in adhesive tapes. Our findings indicate that irritant contact dermatitis is a common problem in the surgical patient. Allergic contact dermatitis is less common, occurring in 2 of the 100 patients.
Adult↗
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↗