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At least 19 recordsLinked to original sources
PubMed1987

Evaluation of dressing regimens for prevention of infection with peripheral intravenous catheters. Gauze, a transparent polyurethane dressing, and an iodophor-transparent dressing.

Four dressing regimens for peripheral venous catheters were studied in a prospective randomized clinical trial with 2088 Teflon catheters: (1) sterile gauze, replaced every other day, and three dressings left on for the lifetime of the catheter; (2) gauze; (3) a transparent polyurethane dressing; and (4) an iodophor-transparent dressing. The four dressings provided comparable coverage, except moisture accumulated more frequently under the transparent dressings (26% to 28% vs 20% to 21%). Cutaneous colonization under the dressing was low level and comparable with all four dressings (range, 10(0.58) to 10(0.70) colony-forming units). The rate of local catheter-related infection (greater than or equal to 15 colony-forming units) was also low and did not differ significantly (range, 4.6% to 5.9%); no catheter caused bacteremia. Stepwise logistic multivariate analysis showed cutaneous colonization of the insertion site (relative risk [RR] of infection, 3.86), contamination of the catheter hub (RR, 3.78), moisture under the dressing (RR, 2.48), and prolonged catheterization (RR, 1.75) to be significant risk factors for catheter-related infection. These data indicate that it is not cost-effective to redress peripheral venous catheters at periodic intervals; for most patients, either sterile gauze or a transparent dressing can be used and left on until the catheter is removed.

Bandages↗
PubMed2002

Sequential treatment with calcium alginate dressings and hydrocolloid dressings accelerates pressure ulcer healing in older subjects: a multicenter randomized trial of sequential versus nonsequential treatment with hydrocolloid dressings alone.

OBJECTIVES: To compare the efficacy of a sequential strategy combining calcium alginate and hydrocolloid dressings treatment of grade III or IV pressure ulcers (PUs) and the efficacy of nonsequential strategy with hydrocolloids alone. DESIGN: An open, randomized, multicenter parallel-group trial. SETTING: Twenty geriatrics hospital wards. PARTICIPANTS: One hundred ten older patients with grade III or IV PUs. INTERVENTION: The control strategy consisted of applying hydrocolloid dressings (DuodermE) for 8 weeks; the sequential strategy consisted of applying combined calcium alginate dressings (UrgoSorb) for the first 4 weeks and hydrocolloid dressings (Algoplaque) for the next 4 weeks. MEASUREMENTS: PU surface areas were measured weekly by ulcer tracing. The endpoints were the mean absolute surface area reduction (SAR) during the 8-week study period and the number of patients achieving a 40 or more SAR (SAR40). RESULTS: Fifty-seven and 53 patients were randomly allocated to sequential and control strategies respectively. Baseline patient characteristics and PU ulcer features at inclusion were similar in the two groups. Mean +/- standard deviation SAR was significantly larger in the sequential treatment group (5.4 +/- 5.7 cm2 and 7.6 +/- 7.1 cm2 at 4 and 8 weeks) than in the control group (1.6 +/- 4.9 cm2 and 3.1 +/- 7.2 cm2, P< .001). In the sequential treatment group, 68.4 of the patients reached SAR40 at 4 weeks and 75.4 at 8 weeks, proportions significantly larger than in the control group (22.6 and 58.5, respectively, P< .0001). Dressing tolerance was good in both strategies. CONCLUSIONS: In grade III or IV PUs, treatment using first calcium alginate dressings and then hydrocolloid dressings promotes faster healing than treatment with hydrocolloid dressings alone.

Aged↗
PubMed1998

A randomized trial comparing Arglaes (a transparent dressing containing silver ions) to Tegaderm (a transparent polyurethane dressing) for dressing peripheral arterial catheters and central vascular catheters.

The purpose of this trial was to prepare for a large randomized trial comparing Arglaes film dressing, a recent innovation containing silver ions, against Tegaderm, a transparent polyurethane dressing. Thirty-one patients admitted to the intensive care unit and requiring the insertion of an arterial line or central venous catheter were recruited into the study. Skin swabs were taken from the insertion sites prior to catheterization and on removal of the intravascular device to measure skin colonization rate between the two dressings. The catheter tips were also cultured on removal to establish if there was a difference between the two groups. No statistical differences were found in bacterial growth between the two dressings.

Adolescent↗
PubMed2001

Groin dressing after cardiac catheterization. Comparison between light dressing with thin transparent tape (Tegaderm) and conventional tight/pressure dressing with an elastic adhesive bandage (Tensoplast).

Post cardiac catheterization puncture site care is usually done with a tight pressure dressing by an elastic adhesive bandage (Tensoplast) due to the belief that it should prevent bleeding. The practice is uncomfortable to the patients. The authors compared a new way of dressing using light transparent tape (Tegaderm) to the conventional tight pressure one. 126 post coronary angiography patients were randomized to have their groins dressed either with Tensoplast or with Tegaderm. Patients ambulated 8 hours after the procedures. The groin was evaluated for pain, discomfort and bleeding complications. 49 per cent in the Tensoplast vs 26.9 per cent in the Tegaderm group experienced pain (p value of 0.01). 55.5 per cent in the Tensoplast group vs 11.1 per cent in the Tegaderm group reported discomfort. 4.7 per cent in the Tensoplast vs 1.6 per cent in the Tegaderm group developed bleeding or hematoma. Dressing of the puncture site after cardiac catheterization with Tegaderm was more comfortable than the conventional Tensoplast without any difference in bleeding complications.

Adhesives↗
PubMed1999

General and plastic surgery devices; classification of the nonresorbable gauze/sponge for external use, the hydrophilic wound dressing, the occlusive wound dressing, and the hydrogel wound dressing. Food and Drug Administration, HHS. Final rule.

The Food and Drug Administration (FDA) is classifying the nonresorbable gauze/sponge for external use, the hydrophilic wound dressing, the occlusive wound dressing, and the hydrogel wound dressing into class I (general controls). FDA is also exempting these devices from premarket notification procedures. This action is being taken under the Federal Food, Drug, and Cosmetic Act (the act), as amended by the Medical Device Amendments of 1976 (the 1976 amendments), the Safe Medical Devices Act of 1990 (SMDA), and the Food and Drug Administration Modernization Act of 1997 (FDAMA).

Bandages↗
PubMed1995

Split-thickness skin graft donor site management. A randomized prospective trial comparing a hydrophilic polyurethane absorbent foam dressing with a petrolatum gauze dressing.

OBJECTIVE: Traditionally, skin graft donor sites have been covered with fine-mesh gauze dressings, and a dry eschar has been allowed to form. Newer dressings that can provide a moist wound environment may facilitate reepithelialization. We compared a hydrophilic semipermeable absorbent polyurethane foam dressing that provides a moist wound environment with a petrolatum gauze dressing for donor sites. DESIGN: Prospective randomized trial; follow-up at 14 days. SETTING: Department of head and neck surgery in a tertiary care center. PATIENTS: Sixty-eight eligible patients received one of the two dressings. Harvested skin grafts were 0.375-mm (0.015-in) thick; donor site surface areas were recorded. At postoperative day 14, the dressings were removed, and wound epithelialization was scored: 1, none; 2, scattered or spotty; and 3, complete. Donor site and operative site pain intensities were assessed by a visual numeric scale: none (0) to the worst (100) experienced over the preceding 24-hour period. Pain scores were available for 58 patients. MAIN OUTCOME MEASURES: Dressings were compared based on these criteria: healing at 14 days, infection, and donor site and operative site pain. RESULTS: A healing score of 3 was seen in 37% (14/38) of patients with hydrophilic semipermeable absorbent polyurethane foam dressings and in 17% (5/30) of patients with petrolatum gauze dressings (P = .06) by day 14. Overall, however, mean healing scores were similar in both groups. Mean healing scores for the patients who received a hydrophilic semipermeable absorbent polyurethane foam dressing was 2.3 (SD = 0.6) vs 2.2 (SD = 0.6) for patients who received the petrolatum gauze dressing (P = .20). Numbers of days required for complete epithelialization in these groups were 20.6 (SD = 10.1) and 19.3 (SD = 5.1), respectively (P = .49). One infection occurred in the group who received the petrolatum gauze dressing. The mean maximum pain intensity scores were lower for those who were given the hydrophilic semipermeable absorbent polyurethane foam dressing on postoperative days 1 through 3 (P = .003, .03, and .04, respectively). Pain increased with a larger donor site surface area for the patients with the petrolatum gauze dressing but not for the patients with the hydrophilic semipermeable absorbent polyurethane foam dressing. CONCLUSIONS: The hydrophilic semipermeable absorbent polyurethane foam dressing appears to have potential advantages over the petrolatum gauze dressing; it produces less initial patient donor site discomfort and tends to produce more complete donor site healing by postoperative day 14.

Absorption↗
PubMed1994

Evaluation of three new hydrocolloid dressings: retention of dressing integrity and biodegradability of absorbent components attenuate inflammation.

Residues from hydrocolloid dressings (HCDs) that originate from matrix disintegration and nonbiodegradability of the absorbent components, may cause deep-seated, unresolved inflammation in tissue that appears otherwise healed. The purpose of this study was to evaluate three new HCDs that were formulated with the goal of attenuating the inflammatory responses that may arise from HCD therapy. Two of the HCDs (A-106 and A-107) consisted of conventional absorbents dispersed in a new maceration-resistant adhesive matrix. The same matrix, mixed with potentially biodegradable dextran microspheres, formed the third dressing (Dextran Bead Dressing [DBD]). In this pilot scale study these novel dressings were evaluated on full-thickness dermal wounds on swine. Restore (Hollister) and DuoDERM CGF (Convatec) dressings were used as controls. Wound healing was evaluated histomorphometrically. Pertinent histologic parameters were ranked from wound tissue that was harvested 18 days after wounding. Grossly visible dressing disintegration ranged from minimal (DBD) to severe (Restore). Disintegration of other dressings was moderate. The percentage of tissue sections exhibiting giant cells reflected, in parallel, the observed extent of dressing disintegration. Thirty-eight percent of wounds dressed with DBD contained giant cells; 74 and 100% of wounds treated with DuoDERM CGF and Restore, respectively, contained giant cells. DBD-dressed wounds had relatively fewer chronic inflammatory cells than other dressings. These wounds were also characterized by a well-organized collagen matrix and complete reepithelialization. The extent of wound closures was similar for all dressing types except Restore. Closure of Restore-dressed wounds was delayed compared with closure with DBD and DuoDERM CGF on all days of evaluation except one. A-106 and A-107 were comparable to DuoDERM CGF in retention of dressing integrity and the elicited inflammatory tissue response. The DBD dressing appears to possess equivalent properties of typical HCDs while causing minimal tissue reactions.

Absorption↗
PubMed2003

An evaluation of an adhesive hydrocellular foam dressing and a self-adherent soft silicone foam dressing in a nursing home setting.

To assess the performance of two wound dressings in the management of chronic wounds, a 5-year retrospective descriptive study was conducted involving 4,200 wounds in 1,891 residents of 30 nursing homes in the state of Florida. Wound and patient variables were abstracted from charts completed by the wound care clinicians providing care in the nursing homes. The chart abstraction time period was chosen to capture a change in wound dressing regimens in these nursing homes. Patient demographic and wound assessment variables, including evidence of surrounding skin stripping information, were abstracted from the database. The majority of wounds were classified as pressure ulcers (3,579 out of 3,795 [94%] hydrocellular-dressing treated wounds; 339 of 352 [96%] silicone dressing-treated wounds, and 51 of wounds managed with both dressings). The majority of wounds were classified as Stage II or III ulcers. Wounds in the hydrocellular group were larger (mean area 7.53 cm2) and took longer to heal (mean 70.1 days) than those in the silicone dressing group (mean area 5.5 cm2, 39.2 days) but the proportion of ulcers healed was the same (63%) in both groups. Skin stripping was rare with either dressing (1% to 2% of wounds). Problems with adhesion and infections occurred more frequently in the silicone dressing group than in the hydrocellular dressing group. The results of this study show that most chronic wounds managed with either dressing will heal after an average of 70 days, that differences between the two dressings are minimal, and that periwound skin stripping is uncommon. Ease of use characteristics and the ability of dressings to remain in place appeared to differ, possibly affecting infection rates and costs of care.

Adult↗
PubMedDate not supplied

A prospective comparison of a new, synthetic donor site dressing versus an impregnated gauze dressing.

Three institutions enrolled 38 patients who required bilateral skin graft donor sites into a safety and efficacy study of a new synthetic donor site dressing. Bilateral donor sites were randomized to receive either a new, synthetic donor site dressing or an impregnated gauze dressing. Wounds were assessed by time to healing, pain, and patient preference. Synthetic dressing wounds were treated 7.9 days compared with 10.2 days for gauze dressing wounds (p < 0.001), and synthetic dressing wounds were more completely epithelialized. Visual analogue pain analysis revealed significantly less donor site pain with synthetic dressing (2.94) versus gauze dressing (4.64) (p < 0.001). Synthetic dressing had fewer treatment-related adverse experiences than gauze dressing (2 vs 7) and was judged by recipients to be superior to gauze dressing in comfort, pain relief, cosmetic appeal, ease of ambulation, and overall acceptance.

Adult↗
PubMed2003

A study to compare a new self-adherent soft silicone dressing with a self-adherent polymer dressing in stage II pressure ulcers.

Pressure ulcers are common among elderly nursing home residents. To be effective in managing these wounds, a dressing should maintain a moist environment, facilitate healing, absorb exudate, remain in place for a number of days, and prevent trauma to the surrounding skin. An 8-week, open, randomized, multicenter, controlled study was conducted to compare the effects of a new self-adherent soft silicone dressing and a self-adherent hydropolymer dressing on Stage II pressure ulcers. Thirty-eight (38) residents participated in the study. Eighteen residents (mean age 83.8 years, range 74.9 to 95.1 years) were randomized to wound management with a soft silicone dressing, and the ulcers of 20 residents (mean age 82.5 years, range 66.4 to 91.9 years) were managed with a hydropolymer dressing. Wound healing, wound and surrounding skin characteristics, and ease of dressing removal were measured and documented. During the study, eight (44%) ulcers in the soft silicone group and 10 (50%) in the hydropolymer dressing group healed. Both dressings were changed approximately once a week and no differences in signs of inflammation, amount of exudate and odor, or incidence of leakage were observed. Damage to the surrounding skin, maceration, and dressing removal difficulties were less common with the soft silicone dressing. Differences in tissue damage between the two dressings were significant during weeks 1, 2, and 3 (P < 0.05). Studies with a larger sample size are needed to confirm these findings.

Aged↗
PubMed2003

Adhesive retention dressings are more comfortable than alginate dressings on split-skin-graft donor sites.

Painful split-skin-graft donor sites remain a common problem for patients. We undertook a prospective randomised trial to examine the comparative comfort and ease of care of two different donor-site dressings. One dressing is the alginate Kaltostat, the standard plastic-surgical dressing in the UK and abroad, and the other is the adhesive retention tape Mefix, a novel use of a readily available dressing. We randomised 50 patients requiring split-skin grafts to receive either alginate (Kaltostat) or retention (Mefix) donor-site dressings. Dressings were assessed by interview and questionnaire at 24, 72 h and 2 weeks, and by wound review at 2 weeks. Retention dressings were found to be more comfortable, required less nursing intervention and allowed patients easier mobility with a greater range of daily activities, especially washing, without compromising wound healing. We recommend adhesive retention dressings as cost-effective comfortable dressings, which readily conform to any donor site.

Activities of Daily Living↗
PubMed1999

A randomized clinical study comparing a hydrocellular dressing to a hydrocolloid dressing in the management of pressure ulcers.

This study compared an adhesive hydrocellular dressing with a leading hydrocolloid dressing in the management of pressure ulcers. Forty adult patients of both sexes who had Stage II or III pressure ulcers (according to the Agency for Health Care Policy and Research system) were enrolled in the study and were randomized to either the hydrocellular or hydrocolloid dressing. Dressing changes were done as required, and each ulcer was assessed on a weekly basis. Patients were followed for 8 weeks, until ulcer closure was achieved, or until the patient was withdrawn from the study, whichever occurred first. The hydrocellular dressing was found to compare favorably with the hydrocolloid dressing. In terms of ease of use, the hydrocellular dressing was found to be significantly easier to remove (P < 0.001) and quicker to change (P < 0.001) than the hydrocolloid dressing. No differences were detected between the two dressing groups regarding mean wound pain, odor, and changes in ulcer appearance and ulcer area.

Aged↗
PubMed2000

Topical agents or dressings for pain in venous leg ulcers.

BACKGROUND: Venous leg ulcers affect up to 1 per cent of people at some time in their life. These ulcers are often painful and some clinicians choose dressings to reduce the pain both during and between dressing changes. OBJECTIVES: To assess the effectiveness of dressings, local anaesthetics/analgesics for pain relief in venous leg ulceration. SEARCH STRATEGY: Cochrane Wounds Group Register and the Cochrane Collaboration Field in Complementary Medicine were searched. Cochrane Pain Palliative and Supportive Care Group and Cochrane Wounds Group strategy were combined and used. SELECTION CRITERIA: All randomised controlled trials which evaluated local interventions used to relieve venous leg ulcer pain were considered. Pain was defined as either persistent pain or pain at dressing changes or debridement. DATA COLLECTION AND ANALYSIS: Eligibility for inclusion was confirmed by two reviewers who independently assessed the all potential trials. Details of eligible studies were summarised using a data extraction sheet which was checked by the second reviewer. MAIN RESULTS: No trial evaluated interventions for persistent pain. Three trials compared a eutectic mixture of local anaesthetic (EMLA) versus placebo for pain at debridement. All 3 trials reported a significant difference in pain in favour of EMLA, however, one of the trials favoured placebo in terms of number of ulcers healed at the end of the trial and another trial noted an increased incidence of burning and itching with the use of EMLA. REVIEWER'S CONCLUSIONS: EMLA may provide pain relief for venous leg ulcer debridement however, the effect of the product on ulcer healing and the incidence of itching and burning is unclear. Research is required to address questions such as the benefits of leg ulcer debridement and the impact of EMLA on healing and the incidence of burning and itching. There were no trials addressing the treatment of persistent pain and further research is warranted.

Administration, Topical↗
PubMed1999

External compression dressing versus standard dressing after axillary lymphadenectomy.

BACKGROUND: Closed-catheter drainage after axillary lymph node dissection (ALND) for breast cancer may constitute a significant inconvenience to the recovering patient, and may also serve as portals of entry for bacteria. Any intervention that could reduce the volume and duration of postoperative drainage would be beneficial. The purpose of this study was to determine whether an external compression dressing after ALND would decrease postoperative drainage, afford earlier drain removal, and reduce subsequent seroma formation. PATIENTS AND METHODS: One hundred thirty-five women undergoing definitive surgical treatment for breast cancer were randomized to receive a compression dressing (n = 66) or standard dressing (n = 69). They were also stratified for modified radical mastectomy (MRM; n = 74) or breast conservation therapy (BCT; n = 61). All patients had ALND. The compression dressing consisted of a circumferential chest wrap of two 6-inch Ace bandages, held in place by circumferential Elastoplast bandage, and it was applied by the same nurse. This dressing remained intact until postoperative day 4. Patients in the standard dressing group (control) were fitted with a front-fastening Surgibra only. Drains were removed when the total daily amount was <50 cc. Postoperative drainage volume, total days with drain, and frequency of seroma formation were recorded for each patient. RESULTS: After 4 days, wound drainage in both groups was nearly identical (compression = 490 cc, standard = 517 cc; P = 0.48). Total days with drain were also similar (compression = 6.4 days, standard = 6.1 days; P = 0.69). The compression dressing did not reduce seroma formation. In fact, there was a statistically significant increase in the number of seroma aspirations per patient in the compression group (compression = 2.9, standard = 1.8; P <0.01). The increase in seroma aspirations was more significant in MRM patients (compression = 3.1, standard = 1.7; P <0.01) than in BCT patients (compression = 2.6, standard = 1.8; P = 0.20). CONCLUSIONS: External compression dressing fails to decrease postoperative drainage and may increase the incidence of seroma formation after drain removal. Thus, routine use of a compression dressing to reduce postoperative drainage after ALND for breast cancer is not warranted.

Axilla↗
PubMed2000

A prospective randomized trial of dressings versus no dressings for hypospadias repair.

PURPOSE: Dressings following hypospadias repair have the benefits of gentle compression for hemostasis, immobilization of the wound and formation of a "hermetic seal." Potential disadvantages include producing ischemia, infection and pain during dressing removal. We compare the success and complications of hypospadias repair with and without dressings in a prospective randomized manner. MATERIALS AND METHODS: Children with hypospadias were randomized either to receive or not receive a transparent film dressing for 2 days. A written informed consent was obtained. Hypospadias repair was performed in 100 consecutive patients. Study exclusion criteria were known coagulopathy and oozing at the end of the case. Criteria for success were a glanular meatus, single forward directed stream, unimpeded voiding, absence of penile chordee, good cosmesis and no need for any secondary procedure. All but 1 hypospadias repair preserved the integrity of the urethral plate. Statistical significance was considered at p <0.05. RESULTS: We were able to randomize between the dressed and nondressed groups based on fresh versus redo cases, position of the urethral meatus, severity of chordee, use of epinephrine, duration of surgery, type of repair and chordee correction (p >0.05). Of 49 patients 44 (90%) had successful results in the dressed and nondressed groups. Postoperative calls were more common in the undressed group (p = 0.02) but no particular complication was more common in either group (p >0.05). Mean followup was 1 year, and there was no clinical or statistical difference between the dressed and nondressed groups with regard to success of the operation (p >0.05). CONCLUSIONS: The success rate for hypospadias surgery that preserves the urethral plate is independent of dressing usage. Dressings may not be indicated for all hypospadias repairs.

Adolescent↗
PubMed2003

Advanced hemostatic dressing development program: animal model selection criteria and results of a study of nine hemostatic dressings in a model of severe large venous hemorrhage and hepatic injury in Swine.

BACKGROUND: An advanced hemostatic dressing is needed to augment current methods for the control of life-threatening hemorrhage. A systematic approach to the study of dressings is described. We studied the effects of nine hemostatic dressings on blood loss using a model of severe venous hemorrhage and hepatic injury in swine. METHODS: Swine were treated using one of nine hemostatic dressings. Dressings used the following primary active ingredients: microfibrillar collagen, oxidized cellulose, thrombin, fibrinogen, propyl gallate, aluminum sulfate, and fully acetylated poly-N-acetyl glucosamine. Standardized liver injuries were induced, dressings were applied, and resuscitation was initiated. Blood loss, hemostasis, and 60-minute survival were quantified. RESULTS: The American Red Cross hemostatic dressing (fibrinogen and thrombin) reduced (p < 0.01) posttreatment blood loss (366 mL; 95% confidence interval, 175-762 mL) and increased (p < 0.05) the percentage of animals in which hemostasis was attained (73%), compared with gauze controls (2,973 mL; 95% confidence interval, 1,414-6,102 mL and 0%, respectively). No other dressing was effective. The number of vessels lacerated was positively related to pretreatment blood loss and negatively related to hemostasis. CONCLUSION: The hemorrhage model allowed differentiation among topical hemostatic agents for severe hemorrhage. The American Red Cross hemostatic dressing was effective and warrants further development.

Animals↗