Novel bilayer wound dressing based on electrospun gelatin/keratin nanofibrous mats for skin wound repair.

PubMed

Yao, Chun-Hsu; Lee, Chia-Yu; Huang, Chiung-Hua; Chen, Yueh-Sheng; Chen, Kuo-Yu

2017-10-01

A bilayer membrane (GKU) with a commercial polyurethane wound dressing as an outer layer and electrospun gelatin/keratin nanofibrous mat as an inner layer was fabricated as a novel wound dressing. Scanning electron micrographs showed that gelatin/keratin nanofibers had a uniform morphology and bead-free structure with average fiber diameter of 160.4nm. 3-(4,5-Dimethylthiazolyl)-2,5-diphenyltetrazolium bromide assay using L929 fibroblast cells indicated that the residues released from the gelatin/keratin composite nanofibrous mat accelerated cell proliferation. Cell attachment experiments revealed that adhered cells spread better and migrated deeper into the gelatin/keratin nanofibrous mat than that into the gelatin nanofibrous mat. In animal studies, compared with the bilayer membrane without keratin, gauze and commercial wound dressing, Comfeel®, GKU membrane gave much more number of blood vessels and a greater reduction in wound area at 4days, and better wound repair at 14days with a thicker epidermis and larger number of newly formed hair follicles. GKU membrane, thus, could be a good candidate for wound dressing applications. Copyright © 2017 Elsevier B.V. All rights reserved.

21 CFR 878.4020 - Occlusive wound dressing.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Occlusive wound dressing. 878.4020 Section 878...) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4020 Occlusive wound dressing. (a) Identification. An occlusive wound dressing is a nonresorbable, sterile or non-sterile device...

21 CFR 878.4020 - Occlusive wound dressing.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Occlusive wound dressing. 878.4020 Section 878...) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4020 Occlusive wound dressing. (a) Identification. An occlusive wound dressing is a nonresorbable, sterile or non-sterile device...

21 CFR 878.4018 - Hydrophilic wound dressing.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Hydrophilic wound dressing. 878.4018 Section 878...) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4018 Hydrophilic wound dressing. (a) Identification. A hydrophilic wound dressing is a sterile or non-sterile device intended to cover...

21 CFR 878.4018 - Hydrophilic wound dressing.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hydrophilic wound dressing. 878.4018 Section 878...) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4018 Hydrophilic wound dressing. (a) Identification. A hydrophilic wound dressing is a sterile or non-sterile device intended to cover...

Preparation of SMART wound dressings based on colloidal microgels and textile fibres

NASA Astrophysics Data System (ADS)

Cornelius, Victoria J.; Majcen, Natasa; Snowden, Martin J.; Mitchell, John C.; Voncina, Bojana

2007-01-01

Wound dressings and other types of wound healing technologies are experiencing fast-paced development and rapid growth. As the population ages, demand will continue to rise for advanced dressings used to treat chronic wounds, such as pressure ulcers, venous stasis ulcers, and diabetic ulcers. Moist wound dressings, which facilitate natural wound healing in a cost-effective manner, will be increasingly important. In commercially available hydrogel / gauze wound dressings the gel swells to adsorb wound excreta and provide an efficient non adhesive particle barrier. An alternative to hydrogels are microgels. Essentially discrete colloidal gel particles, as a result of their very high surface area to volume ratio compared to bulk gels, they have a much faster response to external stimuli such as temperature or pH. In response to either an increase or decrease in solvent quality these porous networks shrink and swell reversibly. When swollen the interstitial regions within the polymer matrix are available for further chemistry; such as the incorporation of small molecules. The reversible shrinking and swelling as a function of external stimuli provides a novel drug release system. As the environmental conditions of a wound change over its lifetime, tending to increase in pH if there is an infection combining these discrete polymeric particles with a substrate such as cotton, results in a smart wound dressing.

The effect of negative pressure wound therapy with antibacterial dressings or antiseptics on an in vitro wound model.

PubMed

Matiasek, J; Domig, K J; Djedovic, G; Babeluk, R; Assadian, O

2017-05-02

The aim of this study was to investigate the bacterial bioburden in experimental in vitro wounds during the application of conventional negative pressure wound therapy (NPWT), with and without antimicrobial dressings (polyhexanide, silver), against NPWT instillation of octenidine. Experimental wounds produced in an in vitro porcine wound model were homogenously contaminated with bacterial suspension and treated with NPWT and different options. Group A: non-antimicrobial polyurethane foam dressing; group B: antimicrobial polyurethane foam dressing containing silver; group C: antimicrobial gauze dressing containing polyhexanide; group D: non-antimicrobial polyurethane foam dressing intermittently irrigated with octenidine; group E: negative control (non-antimicrobial polyurethane foam dressing without NPWT). Standard biopsies were harvested after 24 and 28 hours. This study demonstrated that the use of NPWT with intermitted instillation of octenidine (group D) or application of silver-based polyurethane foam dressings (group B) is significantly superior against Staphylococcus aureus colonisation in experimental wounds compared with non-antimicrobial polyurethane foam dressing (group A) after 48 hours. Surprisingly, the polyhexanide-based dressing (group C) used in this model showed no statistical significant effect compared with the control group (group E) after 24 or 48 hours of treatment. Both intermitted instillation of octenidine and silver-based dressings in standard NPWT were significantly superior compared with non-antimicrobial polyurethane foam dressings or PHMB coated gauze dressing after 48 hours.

Enhanced wound contraction in fresh wounds dressed with honey in Wistar rats (Rattus Novergicus).

PubMed

Osuagwu, F C; Oladejo, O W; Imosemi, I O; Aiku, A; Ekpos, O E; Salami, A A; Oyedele, O O; Akang, E U

2004-01-01

Due to reports that honey accelerates wound healing, an investigation on its role in wound contraction in fresh wounds inflicted on wistar rats was carried out. Twenty adult male wistar rats had 2cm by 2cm square wound inflicted on their right dorsolateral trunk. They were divided into two groups. The experimental group had their wounds dressed with honey while the control group had normal saline dressing. Wound dressing was done every five days and measurements taken at each dressing. Wound morphology was also assessed. Dressing with honey significantly enhanced percentage wound contraction on day 10 with value of 79.20+/-2.94 compared to control value of 53.50+/-4.32. p=0.0. The mean wound measurement on day 10 reduced significantly in honey group, 1.15+/-0.18 compared to control group 2.38+/-0.28. p=0.002. However, there was no significant difference in fibroblast count per high power field in honey group 68.0+/-2.59 compared to control 90.2+/-17.40, p=0.242. Honey dressing increased mean blood vessel count per high power field, 18.8+/-3.77 albeit non significantly when compared to control value of 13.4+/-2.44, p=0.264. Also honey dressing caused increased granulation tissue formation in wounds dressed with honey compared to control group. Our study suggests that honey dressing enhances wound contraction in fresh wounds which is one of the key features of wound healing.

Chitosan based metallic nanocomposite scaffolds as antimicrobial wound dressings.

PubMed

Mohandas, Annapoorna; Deepthi, S; Biswas, Raja; Jayakumar, R

2018-09-01

Chitosan based nanocomposite scaffolds have attracted wider applications in medicine, in the area of drug delivery, tissue engineering and wound healing. Chitosan matrix incorporated with nanometallic components has immense potential in the area of wound dressings due to its antimicrobial properties. This review focuses on the different combinations of Chitosan metal nanocomposites such as Chitosan/nAg, Chitosan/nAu, Chitosan/nCu, Chitosan/nZnO and Chitosan/nTiO 2 towards enhancement of healing or infection control with special reference to the antimicrobial mechanism of action and toxicity.

French national wound management survey: choice criteria of dressings.

PubMed

Meaume, Sylvie; Barrois, Brigitte; Faucher, Nathalie

Across Europe, wound care management is organized differently, and in some countries such as the UK or Denmark, wound healing centres have been implemented. In France, a large number of health professionals are not sufficiently educated in wound care management during their vocational training. The rapid evolution of dressings has changed wound management practices and has given rise to new professional recommendations. This national survey was carried out in France in 2009, including 465 health professionals, to determine the criteria they use to choose a dressing and their habits of care with acute or chronic wounds. Around 73% of respondents were nurses and, on average, participants took care of 43 wounds per month. It was also found that 89% of the health professionals who took part prefer the sequential treatment of the wound based on its appearance. Regardless of whether the wound is acute or chronic, the priorities for wound care and the choice of dressing are the management of the exudate and the prevention or treatment of infection. These results put into evidence the adequacy of the recommendations by these practitioners and the good correlation between the choice of dressing and the local therapeutic goal. To reach the same level of expertise, the professional training for health professionals who are less frequently involved in wound care is necessary.

Effects of wound dressings on cultured primary keratinocytes.

PubMed

Esteban-Vives, Roger; Young, Matthew T; Ziembicki, Jenny; Corcos, Alain; Gerlach, Jörg C

2016-02-01

Autologous cell-spray grafting of non-cultured epidermal cells is an innovative approach for the treatment of severe second-degree burns. After treatment, wounds are covered with dressings that are widely used in wound care management; however, little is known about the effects of wound dressings on individually isolated cells. The sprayed cells have to actively attach, spread, proliferate, and migrate in the wound for successful re-epithelialization, during the healing process. It is expected that exposure to wound dressing material might interfere with cell survival, attachment, and expansion. Two experiments were performed to determine whether some dressing materials have a negative impact during the early phases of wound healing. In one experiment, freshly isolated cells were seeded and cultured for one week in combination with eight different wound dressings used during burn care. Cells, which were seeded and cultured with samples of Adaptic(®), Xeroform(®), EZ Derm(®), and Mepilex(®) did not attach, nor did they survive during the first week. Mepitel(®), N-Terface(®), Polyskin(®), and Biobrane(®) dressing samples had no negative effect on cell attachment and cell growth when compared to the controls. In a second experiment, the same dressings were exposed to pre-cultured cells in order to exclude the effects of attachment and spreading. The results confirm the above findings. This study could be of interest for establishing skin cell grafting therapies in burn medicine and also for wound care in general. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Application of VitaVallis dressing for infected wounds

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kirilova, N. V., E-mail: n.kirilova@vitavallis.com; Fomenko, A. N., E-mail: alserova@ispms.tsc.ru; Korovin, M. S., E-mail: msk@ispms.tsc.ru

Today there is a growing demand for safe and efficient antimicrobial dressings for infected wound treatment. The antimicrobial sorption material for VitaVallis dressings was produced by one-stage oxidation of aluminum nanopowder in water in the presence of fibrous acetylcellulose matrix. Scanning electron microscopy revealed that the material is made up of fibers of diameter 1.5–3.0 µm with adhered agglomerated alumina nanosheets. An antimicrobial study revealed a high inhibitory effect of VitaVallis against the growth of gram-negative (E.coli, P. aeruginosa) and gram-positive (S. aureus) strains. The antimicrobial activity of the dressing against microbial pathogens on the wound surface was demonstrated in inmore » vivo experiments on male rats. The dressing was also tested on volunteer patients. The testing showed reduction of the wound healing period, accelerated cleaning of the infected wound and enhanced tissue regeneration in the wound. The results demonstrate that the VitaVallis dressing can be used for the treatment of deep infected wounds.« less

Real-time monitoring of moisture levels in wound dressings in vitro: an experimental study.

PubMed

McColl, David; Cartlidge, Brian; Connolly, Patricia

2007-10-01

Retaining an appropriate level of moisture at the interface between a healing wound and an applied dressing is considered to be critical for effective wound healing. Failure to control exudate at this interface can result in maceration or drying out of the wound surface. The ability to control moisture balance at the wound interface is therefore a key aspect of wound dressing performance. To date it has not been possible to monitor in any effective manner the distribution of moisture within dressings or how this varies with time. A new measurement system is presented based on sensors placed at the wound/dressing interface which are capable of monitoring moisture levels in real time. The system comprises a model wound bed and sensor array complete with fluid injection path to mimic exudate flow. Eight monitoring points, situated beneath the test dressing, allow the moisture profile across the complete dressing to be measured both during and after fluid injection. The system has been used to evaluate the performance of four foam dressings, a composite hydrofibre dressing and a film dressing. Stark contrasts in the performance of the wound contact layer were found between the different wound dressing types. The composite hydrofibre dressing retained moisture at the wound interface throughout the experiments while areas of the foam dressing quickly became dry, even during constant injection of fluid. The abundance of sensors allowed a moisture map of the surface of the wound dressing to be constructed, illustrating that the moisture profile was not uniform across several of the dressings tested during absorption and evaporation of liquid. These results raise questions as to how the dressings behave on a wound in vivo and indicate the need for a similar clinical monitoring system for tracking wound moisture levels.

Use of wound dressings with soft silicone adhesive technology.

PubMed

Morris, Clare; Emsley, Paulene; Marland, Elizabeth; Meuleneire, Frans; White, Richard

2009-04-01

To evaluate how pain, during and in-between dressing changes, is affected by the introduction of Mepilex Border Lite, a wound dressing manufactured by Mölnlycke Health Care using Safetac soft silicone adhesive technology, to the treatment of different types of paediatric wounds/skin injuries. Wounds/skin injuries that met the criteria for inclusion in the study were dressed with Mepilex Border Lite. Patients were followed for six weeks or until their wounds/skin injuries had healed, whichever occurred earlier. At each dressing change, pain severity before and during dressing removal was rated by the patient and the investigator on a scale from zero (no pain at all) to ten (worst pain ever). Other variables measured included: signs of trauma to wound/skin injury and surrounding skin, the proportion of viable/non-viable tissue, the quantity and appearance of exudate, odour, and clinical signs of infection. At the final dressing change, patients and investigators completed questionnaires to rate the dressing performance. Mean pain severity scores were significantly lower (p < or = 0.003) at the first dressing change than at baseline. Over 99.5 per cent of the Mepilex Border Lite dressing changes were reported to be atraumatic and more than half of the wounds healed within the study period. Conformability, ease of use, ease of removal, patient comfort, and overall experience with the dressing were rated as 'good' to 'very good' at the vast majority of final visit evaluations. This study provides further evidence of the ability of dressings with Safetac soft silicone adhesive technology to minimise trauma and pain and demonstrates the ability of Mepilex Border Lite to overcome the clinical challenges associated with the use of dressings on the wounds/skin injuries of paediatric patients.

Effects of honey and sugar dressings on wound healing.

PubMed

Mphande, A N G; Killowe, C; Phalira, S; Jones, H Wynn; Harrison, W J

2007-07-01

To investigate whether there is a difference between the efficacy of honey and sugar as wound dressings. Patients with open or infected wounds were randomised to receive either honey or sugar dressings. Bacterial colonisation, wound size, wound ASEPSIS score and pain were assessed at the start of treatment and at weekly intervals until full healing occurred. Forty patients were enrolled; 18 received sugar dressings and 22 honey dressings. In the honey group, 55% of patients had positive wound cultures at the start of treatment and 23% at one week, compared with 52% and 39% respectively in the sugar group.The median rate of healing in the first two weeks of treatment was 3.8cm2/week for the honey group and 2.2cm2/week for the sugar group. After three weeks of treatment 86% of patients treated with honey had no pain during dressing changes, compared with 72% treated with sugar. Honey appears to be more effective than sugar in reducing bacterial contamination and promoting wound healing, and slightly less painful than sugar during dressing changes and motion.

Assessment of Chicken-Egg Membrane as a Dressing for Wound Healing.

PubMed

Guarderas, Fernando; Leavell, Yaowaree; Sengupta, Trisha; Zhukova, Mariya; Megraw, Timothy L

2016-03-01

To examine the efficacy of the folk remedy of chicken-egg membrane dressing on wound healing. Full-thickness excisional wounds were created on 14 male Sprague-Dawley rats in 2 separate trials. Each animal received 2 wounds on the upper back. One wound was untreated, and the other was dressed with chicken-egg membrane to assess its impact on wound healing. Half of the rats received egg membrane treatment on the inferior wound, whereas the other half received egg membrane treatment on the superior wound. Membrane replacement, wound debridement, and imaging were done on days 5, 8, and 10 and then imaging continued on days 12, 14, 16, 18, and 20 of the experiment. Healing rate was measured based on the wound area over the 20 days of the experiment. The wounds dressed with chicken-egg membrane had a significantly (P < .01) faster rate of healing compared with the control at the early stages of healing between days 0 and 5. This group healed 21% faster during this early phase, compared with the control group. Overall, however, wound healing rates were indistinguishable from days 5 to 20. Chicken-egg membrane dressing significantly improves healing of cutaneous wounds in the early stages of wound healing.

Impact of an absorbent silver-eluting dressing system on lower extremity revascularization wound complications.

PubMed

Childress, Beverly B; Berceli, Scott A; Nelson, Peter R; Lee, W Anthony; Ozaki, C Keith

2007-09-01

Surgical wounds for lower extremity revascularization are prone to infection and dehiscence. Acticoat Absorbent, an antimicrobial dressing, offers sustained release of ionic silver. We hypothesized that immediate application of Acticoat as a postoperative dressing would reduce wound complications in patients undergoing leg revascularization. All infrainguinal revascularization cases involving leg incisions at a single Veterans Administration Medical Center were identified from July 1, 2002, to September 30, 2005. The control group received conventional dressings, while the treatment group received an Acticoat dressing. Wound complication rates were captured via National Surgical Quality Improvement Program data. Patient characteristics and procedure distributions were similar between groups. The wound complication rate fell 64% with utilization of the Acticoat-based dressing (control 14% [17/118], treatment 5% [7/130]; P = 0.016). An Acticoat-based dressing system offers a potentially useful, cost-effective adjunct to reduce open surgical leg revascularization wound complications.

21 CFR 878.4018 - Hydrophilic wound dressing.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Hydrophilic wound dressing. 878.4018 Section 878.4018 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4018 Hydrophilic wound dressing...

21 CFR 878.4018 - Hydrophilic wound dressing.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Hydrophilic wound dressing. 878.4018 Section 878.4018 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4018 Hydrophilic wound dressing...

21 CFR 878.4020 - Occlusive wound dressing.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Occlusive wound dressing. 878.4020 Section 878.4020 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4020 Occlusive wound dressing...

21 CFR 878.4020 - Occlusive wound dressing.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Occlusive wound dressing. 878.4020 Section 878.4020 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4020 Occlusive wound dressing...

21 CFR 878.4018 - Hydrophilic wound dressing.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Hydrophilic wound dressing. 878.4018 Section 878.4018 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4018 Hydrophilic wound dressing...

21 CFR 878.4020 - Occlusive wound dressing.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Occlusive wound dressing. 878.4020 Section 878.4020 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4020 Occlusive wound dressing...

A wearable wound moisture sensor as an indicator for wound dressing change: an observational study of wound moisture and status.

PubMed

Milne, Stephen D; Seoudi, Ihab; Al Hamad, Hanadi; Talal, Talal K; Anoop, Anzila A; Allahverdi, Niloofar; Zakaria, Zain; Menzies, Robert; Connolly, Patricia

2016-12-01

Wound moisture is known to be a key parameter to ensure optimum healing conditions in wound care. This study tests the moisture content of wounds in normal practice in order to observe the moisture condition of the wound at the point of dressing change. This study is also the first large-scale observational study that investigates wound moisture status at dressing change. The WoundSense sensor is a commercially available moisture sensor which sits directly on the wound in order to find the moisture status of the wound without disturbing or removing the dressing. The results show that of the 588 dressing changes recorded, 44·9% were made when the moisture reading was in the optimum moisture zone. Of the 30 patients recruited for this study, 11 patients had an optimum moisture reading for at least 50% of the measurements before dressing change. These results suggest that a large number of unnecessary dressing changes are being made. This is a significant finding of the study as it suggests that the protocols currently followed can be modified to allow fewer dressing changes and less disturbance of the healing wound bed. © 2015 The Authors. International Wound Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Human neutrophil elastase and collagenase sequestration with phosphorylated cotton wound dressings.

PubMed

Edwards, J Vincent; Howley, Phyllis S

2007-11-01

The design and preparation of wound dressings that redress the protease imbalance in chronic wounds is an important goal of wound healing and medical materials science. Chronic wounds contain high levels of tissue and cytokine-destroying proteases including matrix metalloprotease and neutrophil elastase. Thus, the lowering of excessive protease levels in the wound environment by wound dressing sequestration prevents the breakdown of extracellular matrix proteins and growth factors necessary for wound healing. Phosphorylated cotton wound dressings were prepared to target sequestration of proteases from chronic wound exudate through a cationic uptake binding mechanism involving salt bridge formation of the positively charged amino acid side chains of proteases with the phosphate counterions of the wound dressing fiber. Dressings were prepared by applying sodium hexametaphosphate and diammonium phosphate in separate formulations to cotton gauze by pad/dry/cure methods. Phosphorylated cotton dressings were assessed for their ability to lower elastase and collagenase activity. The phosphorylated cotton dressings lowered elastase and collagenase activity 40-80% more effectively than the untreated cotton wound dressings under conditions that mimic chronic wound exudate. Efficacy of the phosphorylated cotton was found to be related to the level of phosphorylation and a lower pH due to protonated phosphate at the surface of the dressing. The capacity of the modified gauze to sequester continued elastase secretions similar to that found in a chronic wound over a 24-h period was retained within a 80% retention of elastase sequestration and was dose-dependent. Copyright (c) 2007 Wiley Periodicals, Inc.

Modified wound dressing with phyto-nanostructured coating to prevent staphylococcal and pseudomonal biofilm development

NASA Astrophysics Data System (ADS)

Anghel, Ion; Holban, Alina Maria; Grumezescu, Alexandru Mihai; Andronescu, Ecaterina; Ficai, Anton; Anghel, Alina Georgiana; Maganu, Maria; Lazǎr, Veronica; Chifiriuc, Mariana Carmen

2012-12-01

This paper reports a newly fabricated nanophyto-modified wound dressing with microbicidal and anti-adherence properties. Nanofluid-based magnetite doped with eugenol or limonene was used to fabricate modified wound dressings. Nanostructure coated materials were characterized by TEM, XRD, and FT-IR. For the quantitative measurement of biofilm-embedded microbial cells, a culture-based method for viable cell count was used. The optimized textile dressing samples proved to be more resistant to staphylococcal and pseudomonal colonization and biofilm formation compared to the uncoated controls. The functionalized surfaces for wound dressing seems to be a very useful tool for the prevention of wound microbial contamination on viable tissues.

Modified wound dressing with phyto-nanostructured coating to prevent staphylococcal and pseudomonal biofilm development

PubMed Central

2012-01-01

This paper reports a newly fabricated nanophyto-modified wound dressing with microbicidal and anti-adherence properties. Nanofluid-based magnetite doped with eugenol or limonene was used to fabricate modified wound dressings. Nanostructure coated materials were characterized by TEM, XRD, and FT-IR. For the quantitative measurement of biofilm-embedded microbial cells, a culture-based method for viable cell count was used. The optimized textile dressing samples proved to be more resistant to staphylococcal and pseudomonal colonization and biofilm formation compared to the uncoated controls. The functionalized surfaces for wound dressing seems to be a very useful tool for the prevention of wound microbial contamination on viable tissues. PMID:23272823

Modified wound dressing with phyto-nanostructured coating to prevent staphylococcal and pseudomonal biofilm development.

PubMed

Anghel, Ion; Holban, Alina Maria; Grumezescu, Alexandru Mihai; Andronescu, Ecaterina; Ficai, Anton; Anghel, Alina Georgiana; Maganu, Maria; Laz R, Veronica; Chifiriuc, Mariana Carmen

2012-12-31

This paper reports a newly fabricated nanophyto-modified wound dressing with microbicidal and anti-adherence properties. Nanofluid-based magnetite doped with eugenol or limonene was used to fabricate modified wound dressings. Nanostructure coated materials were characterized by TEM, XRD, and FT-IR. For the quantitative measurement of biofilm-embedded microbial cells, a culture-based method for viable cell count was used. The optimized textile dressing samples proved to be more resistant to staphylococcal and pseudomonal colonization and biofilm formation compared to the uncoated controls. The functionalized surfaces for wound dressing seems to be a very useful tool for the prevention of wound microbial contamination on viable tissues.

Rapid hemostatic and mild polyurethane-urea foam wound dressing for promoting wound healing.

PubMed

Liu, Xiangyu; Niu, Yuqing; Chen, Kevin C; Chen, Shiguo

2017-02-01

A novel rapid hemostatic and mild polyurethane-urea foam (PUUF) wound dressing was prepared by the particle leaching method and vacuum freeze-drying method using 4, 4-Methylenebis(cyclohexyl isocyanate), 4,4-diaminodicyclohexylmethane and poly (ethylene glycol) as raw materials. And X-ray diffraction (XRD), tensile test, differential scanning calorimetry (DSC) and thermogravimetry (TG) were used to its crystallinity, stress and strain behavior, and thermal properties, respectively. Platelet adhesion, fibrinogen adhesion and blood clotting were performed to evaluate its hemostatic effect. And H&E staining and Masson Trichrome staining were used to its wound healing efficacy. The results revealed the pore size of PUUF is 50-130μm, and its porosity is 71.01%. Porous PUUF exhibited good water uptake that was benefit to adsorb abundant wound exudates to build a regional moist environment beneficial for wound healing. The PUUF wound dressing exhibit better blood coagulation effect than commercial polyurethane dressing (CaduMedi). Though both PUUF and CaduMedi facilitated wound healing generating full re-epithelialization within 13days, PUUF was milder and lead to more slight inflammatory response than CaduMedi. In addition, PUUF wound dressing exhibited lower cytotoxicity than CaduMedi against NIH3T3 cells. Overall, porous PUUF represents a novel mild wound dressing with excellent water uptake, hemostatic effect and low toxicity, and it can promote wound healing and enhance re-epithelialization. Copyright © 2016 Elsevier B.V. All rights reserved.

Evaluation of a foam dressing for acute and chronic wound exudate management.

PubMed

Bullough, Lindsay; Johnson, Sue; Forder, Rebecca

2015-09-01

This article discusses the use of a foam dressing for exudate management in both chronic and acute wounds, such as surgical wounds, pressure ulcers, diabetic ulcers, trauma wounds, and leg ulcers. The primary objective of the study was to observe patients' wound progression in terms of wound size and the condition of the wound bed, when using this foam dressing as either a primary or secondary dressing. The outcome of the evaluation demonstrated that ActivHeal Foam Contact dressing effectively managed exudate. It was also observed that the dressing can assist in autolysis and support improvements in peri-wound status. Choosing an appropriate dressing to manage a wound is essential. Clinicians working in the NHS are under pressure to deliver good-quality clinical outcomes, and the ActivHeal Foam Contact dressing supports this outcome.

Investigation on Curcumin nanocomposite for wound dressing.

PubMed

Venkatasubbu, G Devanand; Anusuya, T

2017-05-01

Curcuma longa (turmeric) has a long history of use in medicine as a treatment for inflammatory conditions. The primary active constituent of turmeric and the one responsible for its vibrant yellow color is curcumin. Curcumin is used for treatment of wound and inflammation. It had antimicrobial and antioxidant property. It has low intrinsic toxicity and magnificent properties like with comparatively lesser side-effects. Cotton cloth is one of the most successful wound dressings which utilize the intrinsic properties of cotton fibers. Modern wound dressings, however, require other properties such as antibacterial and moisture maintaining capabilities. In this study, conventional cotton cloth was coated with Curcumin composite for achieving modern wound dressing properties. Curcumin nanocomposite is characterized. The results show that coated cotton cloth with Curcumin nanocomposite has increased drying time (74%) and water absorbency (50%). Furthermore, they show antibacterial efficiency against bacterial species present in wounds. Copyright © 2017 Elsevier B.V. All rights reserved.

Formulation of Novel Layered Sodium Carboxymethylcellulose Film Wound Dressings with Ibuprofen for Alleviating Wound Pain

PubMed Central

Vinklárková, Lenka; Vetchý, David; Bernatonienė, Jurga

2015-01-01

Effective assessment and management of wound pain can facilitate both improvements in healing rates and overall quality of life. From a pharmacological perspective, topical application of nonsteroidal anti-inflammatory drugs in the form of film wound dressings may be a good choice. Thus, the aim of this work was to develop novel layered film wound dressings containing ibuprofen based on partially substituted fibrous sodium carboxymethylcellulose (nonwoven textile Hcel NaT). To this end, an innovative solvent casting method using a sequential coating technique has been applied. The concentration of ibuprofen which was incorporated as an acetone solution or as a suspension in a sodium carboxymethylcellulose dispersion was 0.5 mg/cm2 and 1.0 mg/cm2 of film. Results showed that developed films had adequate mechanical and swelling properties and an advantageous acidic surface pH for wound application. An in vitro drug release study implied that layered films retained the drug for a longer period of time and thus could minimize the frequency of changing the dressing. Films with suspended ibuprofen demonstrated higher drug content uniformity and superior in vitro drug release characteristics in comparison with ibuprofen incorporation as an acetone solution. Prepared films could be potential wound dressings for the effective treatment of wound pain in low exuding wounds. PMID:26090454

Effect of different wound dressings on cell viability and proliferation.

PubMed

Paddle-Ledinek, Joanne E; Nasa, Zeyad; Cleland, Heather J

2006-06-01

Many new dressings have been developed since the early 1980s. Wound healing comprises cleansing, granulation/vascularization, and epithelialization phases. An optimum microenvironment and the absence of cytotoxic factors are essential for epithelialization. This study examines the effect of extracts of different wound dressings on keratinocyte survival and proliferation. Keratinocyte cultures were exposed for 40 hours to at least three extracts of each of the following wound dressings, which were tested in octuplicate: Acticoat, Aquacel-Ag, Aquacel, Algisite M, Avance, Comfeel Plus transparent, Contreet-H, Hydrasorb, and SeaSorb. Silicone extract provided the reference material. Controls were included of cells cultured in medium that had been incubated under conditions identical to those used with the extracts. Cell survival (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide reduction) and proliferation (5-bromo-2':-deoxyuridine incorporation) were measured. Extracts of silver-containing dressings (Acticoat, Aquacel-Ag, Contreet-H, and Avance) were most cytotoxic. Extracts of Hydrasorb were less cytotoxic but markedly affected keratinocyte proliferation and morphology. Extracts of alginate-containing dressings (Algisite M, SeaSorb, and Contreet-H) demonstrated high calcium concentrations, markedly reduced keratinocyte proliferation, and affected keratinocyte morphology. Extracts of Aquacel and Comfeel Plus transparent induced small but significant inhibition of keratinocyte proliferation. The principle of minimizing harm should be applied to the choice of wound dressing. Silver-based dressings are cytotoxic and should not be used in the absence of infection. Alginate dressings with high calcium content affect keratinocyte proliferation probably by triggering terminal differentiation of keratinocytes. Such dressings should be used with caution in cases in which keratinocyte proliferation is essential. All dressings should be tested in vitro before

The wound-healing effects of a next-generation anti-biofilm silver Hydrofiber wound dressing on deep partial-thickness wounds using a porcine model.

PubMed

Davis, Stephen C; Li, Jie; Gil, Joel; Valdes, Jose; Solis, Michael; Higa, Alex; Bowler, Philip

2018-06-11

Topical antimicrobials are widely used to control wound bioburden and facilitate wound healing; however, the fine balance between antimicrobial efficacy and non-toxicity must be achieved. This study evaluated whether an anti-biofilm silver-containing wound dressing interfered with the normal healing process in non-contaminated deep partial thickness wounds. In an in-vivo porcine wound model using 2 pigs, 96 wounds were randomly assigned to 1 of 3 dressing groups: anti-biofilm silver Hydrofiber dressing (test), silver Hydrofiber dressing (control), or polyurethane film dressing (control). Wounds were investigated for 8 days, and wound biopsies (n = 4) were taken from each dressing group, per animal, on days 2, 4, 6, and 8 after wounding and evaluated using light microscopy. No statistically significant differences were observed in the rate of reepithelialisation, white blood cell infiltration, angiogenesis, or granulation tissue formation following application of the anti-biofilm silver Hydrofiber dressing versus the 2 control dressings. Overall, epithelial thickness was similar between groups. Some differences in infiltration of specific cell types were observed between groups. There were no signs of tissue necrosis, fibrosis, or fatty infiltration in any group. An anti-biofilm silver Hydrofiber wound dressing did not cause any notable interference with normal healing processes. © 2018 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Autoclavable physically-crosslinked chitosan cryogel as a wound dressing.

PubMed

Takei, Takayuki; Danjo, So; Sakoguchi, Shogo; Tanaka, Sadao; Yoshinaga, Takuma; Nishimata, Hiroto; Yoshida, Masahiro

2018-04-01

Moist wounds were known to heal more rapidly than dry wounds. Hydrogel wound dressings were suitable for the moist wound healing because of their hyperhydrous structure. Chitosan was a strong candidate as a base material for hydrogel wound dressings because the polymer had excellent biological properties that promoted wound healing. We previously developed physically-crosslinked chitosan cryogels, which were prepared solely by freeze-thawing of a chitosan-gluconic acid conjugate (CG) aqueous solution, for wound treatment. The CG cryogels were disinfected by immersing in 70% ethanol before applying to wounds in our previous study. In the present study, we examined the influence of autoclave sterilization (121°C, 20 min) on the characteristics of CG cryogel because complete sterilization was one of the fundamental requirements for medical devices. We found that optimum value of gluconic acid content of CG, defined as the number of the incorporated gluconic acid units per 100 glucosamine units of chitosan, was 11 for autoclaving. An increased crosslinking level of CG cryogel on autoclaving enhanced resistance of the gels to enzymatic degradation. Furthermore, the autoclaved CG cryogels retained favorable biological properties of the pre-autoclaved CG cryogels in that they showed the same hemostatic activity and efficacy in repairing full-thickness skin wounds as the pre-autoclaved CG cryogels. These results showed the great potential of autoclavable CG cryogels as a practical wound dressing. Copyright © 2017 The Society for Biotechnology, Japan. Published by Elsevier B.V. All rights reserved.

21 CFR 878.4022 - Hydrogel wound dressing and burn dressing.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Hydrogel wound dressing and burn dressing. 878.4022 Section 878.4022 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4022...

21 CFR 878.4022 - Hydrogel wound dressing and burn dressing.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Hydrogel wound dressing and burn dressing. 878.4022 Section 878.4022 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4022...

21 CFR 878.4022 - Hydrogel wound dressing and burn dressing.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Hydrogel wound dressing and burn dressing. 878.4022 Section 878.4022 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4022...

Highly Absorbent Antibacterial Hemostatic Dressing for Healing Severe Hemorrhagic Wounds

PubMed Central

Li, Ting-Ting; Lou, Ching-Wen; Chen, An-Pang; Lee, Mong-Chuan; Ho, Tsing-Fen; Chen, Yueh-Sheng; Lin, Jia-Horng

2016-01-01

To accelerate healing of severe hemorrhagic wounds, a novel highly absorbent hemostatic dressing composed of a Tencel®/absorbent-cotton/polylactic acid nonwoven base and chitosan/nanosilver antibacterial agent was fabricated by using a nonwoven processing technique and a freeze-drying technique. This study is the first to investigate the wicking and water-absorbing properties of a nonwoven base by measuring the vertical wicking height and water absorption ratio. Moreover, blood agglutination and hemostatic second tests were conducted to evaluate the hemostatic performance of the resultant wound dressing. The blending ratio of fibers, areal weight, punching density, and fiber orientation, all significantly influenced the vertical moisture wicking property. However, only the first two parameters markedly affected the water absorption ratio. After the nonwoven base absorbed blood, scanning electron microscope (SEM) observation showed that erythrocytes were trapped between the fibrin/clot network and nonwoven fibers when coagulation pathways were activated. Prothrombin time (PT) and activated partial thromboplastin time (APTT) blood agglutination of the resultant dressing decreased to 14.34 and 50.94 s, respectively. In the femoral artery of the rate bleeding model, hemostatic time was saved by 87.2% compared with that of cotton cloth. Therefore, the resultant antibacterial wound dressing demonstrated greater water and blood absorption, as well as hemostatic performance, than the commercially available cotton cloth, especially for healing severe hemorrhagic wounds. PMID:28773912

Functional poly(ε-caprolactone)/chitosan dressings with nitric oxide-releasing property improve wound healing.

PubMed

Zhou, Xin; Wang, He; Zhang, Jimin; Li, Xuemei; Wu, Yifan; Wei, Yongzhen; Ji, Shenglu; Kong, Deling; Zhao, Qiang

2017-05-01

Wound healing dressings are increasingly needed clinically due to the large number of skin damage annually. Nitric oxide (NO) plays a key role in promoting wound healing, thus biomaterials with NO-releasing property receive increasing attention as ideal wound dressing. In present study, we prepared a novel functional wound dressing by combining electrospun poly(ε-caprolactone) (PCL) nonwoven mat with chitosan-based NO-releasing biomaterials (CS-NO). As-prepared PCL/CS-NO dressing released NO sustainably under the physiological conditions, which was controlled by the catalysis of β-galactosidase. In vivo wound healing characteristics were further evaluated on full-thickness cutaneous wounds in mice. Results showed that PCL/CS-NO wound dressings remarkably accelerated wound healing process through enhancing re-epithelialization and granulation formation and effectively improved the organization of regenerated tissues including epidermal-dermal junction, which could be ascribed to the pro-angiogenesis, immunomodulation, and enhanced collagen synthesis provided by the sustained release of NO. Therefore, PCL/CS-NO may be a promising candidate for wound dressings, especially for the chronic wound caused by the ischemia. Serious skin damage caused by trauma, surgery, burn or chronic disease has become one of the most serious clinical problems. Therefore, there is an increasing demand for ideal wound dressing that can improve wound healing. Due to the vital role of nitric oxide (NO), we developed a novel functional wound dressing by combining electrospun polycaprolactone (PCL) mat with NO-releasing biomaterial (CS-NO). The sustained release of NO from PCL/CS-NO demonstrated positive effects on wound healing, including pro-angiogenesis, immunomodulation, and enhanced collagen synthesis. Hence, wound healing process was remarkably accelerated and the organization of regenerated tissues was effectively improved as well. Taken together, PCL/CS-NO dressing may be a promising

Plasma treatments of dressings for wound healing: a review.

PubMed

Eswaramoorthy, Nithya; McKenzie, David R

2017-12-01

This review covers the use of plasma technology relevant to the preparation of dressings for wound healing. The current state of knowledge of plasma treatments that have potential to provide enhanced functional surfaces for rapid and effective healing is summarized. Dressings that are specialized to the needs of individual cases of chronic wounds such as diabetic ulcers are a special focus. A summary of the biology of wound healing and a discussion of the various types of plasmas that are suitable for the customizing of wound dressings are given. Plasma treatment allows the surface energy and air permeability of the dressing to be controlled, to ensure optimum interaction with the wound. Plasmas also provide control over the surface chemistry and in cases where the plasma creates energetic ion bombardment, activation with long-lived radicals that can bind therapeutic molecules covalently to the surface of the dressing. Therapeutic innovations enabled by plasma treatment include the attachment of microRNA or antimicrobial peptides. Bioactive molecules that promote subsequent cell adhesion and proliferation can also be bound, leading to the recruitment of cells to the dressing that may be stem cells or patient-derived cells. The presence of a communicating cell population expressing factors promotes healing.

Efficacy and cost-effectiveness of octenidine wound gel in the treatment of chronic venous leg ulcers in comparison to modern wound dressings.

PubMed

Hämmerle, Gilbert; Strohal, Robert

2016-04-01

The aim of this study was to determine the efficacy, safety and cost-effectiveness of an octenidine-based wound gel in the treatment of chronic venous leg ulcers. For this purpose, 49 wounds were treated with either modern wound-phase-adapted dressings alone (treatment arm 1; n = 17), octenidine wound gel plus modern wound-phase-adapted dressings (treatment arm 2; n = 17) or octenidine wound gel alone (treatment arm 3; n = 15). During the study period of 42 days with dressing changes every 3-5 days, wound healing characteristics and treatment costs of different dressings were analysed. Wound size reduction was significantly better (P = 0·028) in both octenidine wound gel treatment arms compared to modern dressings alone with total reductions of 14·6%, 64·1% and 96·2% in treatment arms 1-3. Early wound healing was merely observed under octenidine wound gel treatment (n = 9), whereby lowest treatment costs were generated by octenidine wound gel alone (€20·34/dressing change). As a result, the octenidine wound gel is cost-effective and well suitable for the treatment of chronic venous leg ulcers, considering both safety and promotion of wound healing. © 2014 The Authors. International Wound Journal © 2014 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Painful dressing changes for chronic wounds: assessment and management.

PubMed

Solowiej, Kazia; Upton, Dominic

Wound pain can arise from the wound itself, continuing wound treatment and anticipatory pain, which occurs in some patients as a consequence of negative experiences of care. Specifically, pain caused by the removal and application of dressings has been identified as a major contributor to wound pain, from both patient and health professional perspectives. This article reviews literature on the impact of pain at dressing change, and provides practical suggestions for assessment and management of pain during wound care.

Recent advances on antimicrobial wound dressing: A review.

PubMed

Simões, Déborah; Miguel, Sónia P; Ribeiro, Maximiano P; Coutinho, Paula; Mendonça, António G; Correia, Ilídio J

2018-06-01

Skin and soft tissue infections (SSTIs) have high rates of morbidity and mortality associated. Despite the successful treatment of some SSTIs, those affecting the subcutaneous tissue, fascia, or muscle delay the healing process and can lead to life-threatening conditions. Therefore, more effective treatments are required to deal with such pathological situations. Recently, wound dressings loaded with antimicrobial agents emerged as viable options to reduce wound bacterial colonization and infection, in order to improve the healing process. In this review, an overview of the most prominent antibacterial agents incorporated in wound dressings along with their mode of action is provided. Furthermore, the recent advances in the therapeutic approaches used in the clinic and some future perspectives regarding antibacterial wound dressings are also discussed. Copyright © 2018 Elsevier B.V. All rights reserved.

Polysaccharide Fabrication Platforms and Biocompatibility Assessment as Candidate Wound Dressing Materials

PubMed Central

Aduba, Donald C.; Yang, Hu

2017-01-01

Wound dressings are critical for wound care because they provide a physical barrier between the injury site and outside environment, preventing further damage or infection. Wound dressings also manage and even encourage the wound healing process for proper recovery. Polysaccharide biopolymers are slowly becoming popular as modern wound dressings materials because they are naturally derived, highly abundant, inexpensive, absorbent, non-toxic and non-immunogenic. Polysaccharide biopolymers have also been processed into biomimetic platforms that offer a bioactive component in wound dressings that aid the healing process. This review primarily focuses on the fabrication and biocompatibility assessment of polysaccharide materials. Specifically, fabrication platforms such as electrospun fibers and hydrogels, their fabrication considerations and popular polysaccharides such as chitosan, alginate, and hyaluronic acid among emerging options such as arabinoxylan are discussed. A survey of biocompatibility and bioactive molecule release studies, leveraging polysaccharide’s naturally derived properties, is highlighted in the text, while challenges and future directions for wound dressing development using emerging fabrication techniques such as 3D bioprinting are outlined in the conclusion. This paper aims to encourage further investigation and open up new, disruptive avenues for polysaccharides in wound dressing material development. PMID:28952482

Chitosan-based dressings loaded with neurotensin--an efficient strategy to improve early diabetic wound healing.

PubMed

Moura, Liane I F; Dias, Ana M A; Leal, Ermelindo C; Carvalho, Lina; de Sousa, Hermínio C; Carvalho, Eugénia

2014-02-01

One important complication of diabetes mellitus is chronic, non-healing diabetic foot ulcers (DFUs). This study aims to develop and use dressings based on chitosan derivatives for the sustained delivery of neurotensin (NT), a neuropeptide that acts as an inflammatory modulator in wound healing. Three different derivatives, namely N-carboxymethyl chitosan, 5-methyl pyrrolidinone chitosan (MPC) and N-succinyl chitosan, are presented as potential biomaterials for wound healing applications. Our results show that MPC has the best fluid handling capacity and delivery profile, also being non-toxic to Raw 264.7 and HaCaT cells. NT-loaded and non-loaded MPC dressings were applied to control/diabetic wounds to evaluate their in vitro/in vivo performance. The results show that the former induced more rapid healing (50% wound area reduction) in the early phases of wound healing in diabetic mice. A NT-loaded MPC foam also reduced expression of the inflammatory cytokine TNF-α (P<0.001) and decreased the amount of inflammatory infiltrate on day 3. On day 10 MMP-9 was reduced in diabetic skin (P<0.001), significantly increasing fibroblast migration and collagen (COL1A1, COL1A2 and COL3A1) expression and deposition. These results suggest that MPC-based dressings may work as an effective support for sustained NT release to reduce DFUs. Copyright © 2013 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Honey: A Biologic Wound Dressing.

PubMed

Molan, Peter; Rhodes, Tanya

2015-06-01

Honey has been used as a wound dressing for thousands of years, but only in more recent times has a scientific explanation become available for its effectiveness. It is now realized that honey is a biologic wound dressing with multiple bioactivities that work in concert to expedite the healing process. The physical properties of honey also expedite the healing process: its acidity increases the release of oxygen from hemoglobin thereby making the wound environment less favorable for the activity of destructive proteases, and the high osmolarity of honey draws fluid out of the wound bed to create an outflow of lymph as occurs with negative pressure wound therapy. Honey has a broad-spectrum antibacterial activity, but there is much variation in potency between different honeys. There are 2 types of antibacterial activity. In most honeys the activity is due to hydrogen peroxide, but much of this is inactivated by the enzyme catalase that is present in blood, serum, and wound tissues. In manuka honey, the activity is due to methylglyoxal which is not inactivated. The manuka honey used in wound-care products can withstand dilution with substantial amounts of wound exudate and still maintain enough activity to inhibit the growth of bacteria. There is good evidence for honey also having bioactivities that stimulate the immune response (thus promoting the growth of tissues for wound repair), suppress inflammation, and bring about rapid autolytic debridement. There is clinical evidence for these actions, and research is providing scientific explanations for them.

Evaluation of dressings to aid healing of mulesing wounds on sheep.

PubMed

Levot, G W; Hughes, P B; Kaldor, C J

1989-11-01

Five proprietary and one experimental dressing were compared with no treatment in their ability to aid healing of mulesing wounds in over 1900 young lambs. Healing was judged as the completeness of shrinkage of the mulesing cuts and the condition of scabs on the new skin surface. When assessed at 21 d it was found that treatment with Heriots Crown Wound Powder or Coopers Mulesing Powder offered a significant advantage over leaving the wounds untreated. Neither aqueous organophosphate washes, Defiance nor Defiance containing 0.08% chlorfenvinphos offered any healing advantage over controls. However, washing the wounds with an aqueous organophosphate solution aided healing more than the Defiance-based dressings. It was considered that the powders or the washes encouraged quick scab formation either by creating a dry covering (powders) or by washing away blood and allowing fast drying of the wound. The Defiance-type dressings slowed healing by keeping the wound moist for up to 10 d, but healing was not significantly different to the untreated group by 21 d.

The Efficacy of Gelam Honey Dressing towards Excisional Wound Healing

PubMed Central

Tan, Mui Koon; Hasan Adli, Durriyyah Sharifah; Tumiran, Mohd Amzari; Abdulla, Mahmood Ameen; Yusoff, Kamaruddin Mohd

2012-01-01

Honey is one of the oldest substances used in wound management. Efficacy of Gelam honey in wound healing was evaluated in this paper. Sprague-Dawley rats were randomly divided into four groups of 24 rats each (untreated group, saline group, Intrasite Gel group, and Gelam honey group) with 2 cm by 2 cm full thickness, excisional wound created on neck area. Wounds were dressed topically according to groups. Rats were sacrificed on days 1, 5, 10, and 15 of treatments. Wounds were then processed for macroscopic and histological observations. Gelam-honey-dressed wounds healed earlier (day 13) than untreated and saline treated groups, as did wounds treated with Intrasite Gel. Honey-treated wounds exhibited less scab and only thin scar formations. Histological features demonstrated positive effects of Gelam honey on the wounds. This paper showed that Gelam honey dressing on excisional wound accelerated the process of wound healing. PMID:22536292

Evaluation of three-layered doxycycline-collagen loaded nanofiber wound dressing.

PubMed

Tort, Serdar; Acartürk, Füsun; Beşikci, Arzu

2017-08-30

Nanofiber wound dressings have great potential for both acute and chronic wound healing. The aim of this study is to develop a wound dressing by the electrospinning method and to determine its in vitro characteristics. The viscosity and the surface tension values of the polymer solutions used in the electrospinning were measured and their suitability for electrospinning was evaluated. Nanofiber wound dressing consists of three layers. The first and the second layers are sodium alginate and chitosan nanofibers, respectively. The core of the coaxial nanofibers that comprises the third layer of the wound dressing contains 1% polycaprolactone and 4.5% collagen, the shell comprises 2.5% doxycycline and 2.5% polyethylene oxide. The developed wound dressing comprises aligned nanofibers, with a contact angle of 38°, a work of bioadhesion value of 0.485mJ/cm 2 on rat skin, a tensile strength of 2.76MPa, an elongation at break value of 7.65%, a specific surface area of 9.65m 2 /g and a porosity of 52.3%. The amount of doxycycline content was found to be 260μg/cm 2 and the complete drug release was achieved in 15min. No cytotoxic effect was shown in cell culture studies with keratinocyte cell lines. As a result of the stability studies, it was found that the morphological, mechanical, bioadhesion and wettability properties and the amount of doxycycline remained stable for a period of 12 months at 4°C/ambient humidity condition. The developed three-layered wound dressing could be an alternative for wound healing applications. Copyright © 2017 Elsevier B.V. All rights reserved.

Antibacterial anti-oxidant electroactive injectable hydrogel as self-healing wound dressing with hemostasis and adhesiveness for cutaneous wound healing.

PubMed

Zhao, Xin; Wu, Hao; Guo, Baolin; Dong, Ruonan; Qiu, Yusheng; Ma, Peter X

2017-04-01

Injectable self-healing hydrogel dressing with multifunctional properties including anti-infection, anti-oxidative and conductivity promoting wound healing process will be highly desired in wound healing application and its design is still a challenge. We developed a series of injectable conductive self-healed hydrogels based on quaternized chitosan-g-polyaniline (QCSP) and benzaldehyde group functionalized poly(ethylene glycol)-co-poly(glycerol sebacate) (PEGS-FA) as antibacterial, anti-oxidant and electroactive dressing for cutaneous wound healing. These hydrogels presented good self-healing, electroactivity, free radical scavenging capacity, antibacterial activity, adhesiveness, conductivity, swelling ratio, and biocompatibility. Interestingly, the hydrogel with an optimal crosslinker concentration of 1.5 wt% PEGS-FA showed excellent in vivo blood clotting capacity, and it significantly enhanced in vivo wound healing process in a full-thickness skin defect model than quaternized chitosan/PEGS-FA hydrogel and commercial dressing (Tegaderm™ film) by upregulating the gene expression of growth factors including VEGF, EGF and TGF-β and then promoting granulation tissue thickness and collagen deposition. Taken together, the antibacterial electroactive injectable hydrogel dressing prolonged the lifespan of dressing relying on self-healing ability and significantly promoted the in vivo wound healing process attributed to its multifunctional properties, meaning that they are excellent candidates for full-thickness skin wound healing. Copyright © 2017 Elsevier Ltd. All rights reserved.

A model for quantitative evaluation of skin damage at adhesive wound dressing removal.

PubMed

Matsumura, Hajime; Ahmatjan, Niyaz; Ida, Yukiko; Imai, Ryutaro; Wanatabe, Katsueki

2013-06-01

The removal of adhesive wound dressings from the wound surface involves a risk of damaging the intact stratum corneum and regenerating epithelium. Pain associated with the removal of wound dressings is a major issue for patients and medical personnel. Recently, wound dressings coated with a silicone adhesive have been developed to reduce such skin damage and pain on removal and they have received good evaluation in various clinical settings. However, there is neither a standard method to quantify whether or not the integrity of the stratum corneum and regenerating epithelium is retained or if both structures are damaged by the removal of wound dressings, nor are there standardised values with which to assess skin damage. We applied six different types of adhesive wound dressing on plain copy paper printed with black ink by a laser printer, removed the dressings, examined the adhesive-coated surface of the wound dressings using a high-power videoscope, and examined the stripped areas. Wound dressings coated with a silicone adhesive showed significantly less detachment of the stratum corneum and regenerating epithelium, followed by those coated with polyurethane, hydrocolloid, and acrylic adhesives. The assessment method utilised in this study revealed distinct differences between wound dressing types, but less variation in the evaluation outcome of each type. This assessment method may be useful for the evaluation of adhesive wound dressings, particularly during product development. However, further studies will be needed to examine the effectiveness of this assessment method in the clinical setting because the adherent properties of polyurethane and hydrocolloid adhesives may be altered by the absorption of water from the skin. © 2012 The Authors. International Wound Journal © 2012 John Wiley & Sons Ltd and Medicalhelplines.com Inc.

Does the Use of Clean or Sterile Dressing Technique Affect the Incidence of Wound Infection?

PubMed

Kent, Dea J; Scardillo, Jody N; Dale, Barbara; Pike, Caitlin

The purpose of this article is to examine the evidence and provide recommendations for the use of clean or sterile dressing technique with dressing application to prevent wound infection. In all persons with acute or chronic wounds, does the use of clean or sterile dressing technique affect incidence of wound infection? A search of the literature was performed by a trained university librarian, which resulted in 473 articles that examined any age group that dealt with application of a wound dressing using either sterile or nonsterile technique. A systematic approach was used to review titles, abstracts, and text, yielding 4 studies that met inclusion criteria. Strength of the evidence was rated using rating methodology from Essential Evidence Plus: Levels of Evidence and Oxford Center for Evidence-Based Medicine, adapted by Gray and colleagues. Johns Hopkins Nursing Evidence-Based Practice Nursing Research Appraisal Tool was used to rate the quality of the evidence. All 4 studies reported no significant difference in the rate of wound infection when using either clean or sterile technique with dressing application. The strength of the evidence for the identified studies was identified as level 2 (1 level A, 3 level B). The study sizes were variable, and the wounds included do not represent the continuum of wounds clinically encountered across the board. Evidence indicates that the use of clean technique for acute wound care is a clinically effective intervention that does not affect the incidence of infection. There is no recommendation that can be made regarding type of dressing technique for a chronic wound due to the lack of evidence in the literature.

The role of allogenic keratin-derived dressing in wound healing in a mouse model.

PubMed

Konop, Marek; Sulejczak, Dorota; Czuwara, Joanna; Kosson, Piotr; Misicka, Aleksandra; Lipkowski, Andrzej W; Rudnicka, Lidia

2017-01-01

Keratin is an interesting protein needed for wound healing and tissue recovery. We have recently proposed a new, simple and inexpensive method to obtain fur and hair keratin-derived biomaterials suitable for medical application. The aim of the study was to evaluate the role of the fur keratin-derived protein (FKDP) dressing in the allogenic full-thickness surgical skin wound model. The data obtained using scanning electron microscopy showed that employed processed biomaterial had higher surface porosity compared with control raw material. From the MTS test, it was found keratin biomaterial is not only toxic to the NIH/3T3 cell line (p < 0.05), but also enhances cell proliferation compared with the control. In vivo studies have shown keratin dressings are tissue biocompatible, accelerate wound closure and epithelialization to the statistically significant differences on day 5 (p < 0.05) in comparison to control wounds. Histological examination revealed, that in FKDP-treated wounds the inflammatory response contained predominantly macrophages whilst their morphological untreated variants showed mixed cell infiltrates rich in neutrophils. Predominant macrophages based response creates more favorable environment for healing. In FKDP-dressed wounds the number of microhemorrhages was also significantly decreased (p < 0.05) as compared with undressed wounds. Applied keratin dressing favors reconstruction of a more regular skin structure and assures better cosmetic effect in terms of scar formation and appearance. In conclusion, fur keratin-derived protein dressings significantly accelerated wound healing in the mouse model. Further studies are needed to determine the molecular mechanisms involved in the multilayer wound healing process and to assess the possible use of these dressings for medical purposes. © 2016 by the Wound Healing Society.

A Wireless Electroceutical Dressing Lowers Cost of Negative Pressure Wound Therapy

PubMed Central

Ghatak, Piya Das; Schlanger, Richard; Ganesh, Kasturi; Lambert, Lynn; Gordillo, Gayle M.; Martinsek, Patsy; Roy, Sashwati

2015-01-01

Objective: To test whether the use of a wireless electroceutical dressing (WED) (Procellera®) in conjunction with a 5-day negative pressure wound therapy (NPWT) may reduce the number of dressing changes required per week with this therapy. Approach: At the Ohio State University Comprehensive Wound Center, chronic wound patients (n=30) undergoing NPWT were randomized into two arms following consent as approved by the institutional review board. The control arm received standard of care NPWT, where the dressing change was performed thrice a week. The test arm received the same care except that the WED was added as an interface layer and dressing change was limited to twice a week. Results: A reduced cost of care was achieved using the WED in conjunction with NPWT. Despite fewer dressing changes in wounds dressed with the WED, closure outcomes were comparable with no overt signs of any wound complication, including infection. The cost of NPWT care during the week was significantly lower (from $2918 to $2346) in the WED-treated group compared with patients in the control arm. Innovation: This work introduces a novel technology platform involving a WED, which may be used in conjunction with NPWT. If used as such, NPWT is effective in decreasing the frequency of dressing change and lowering the cost of care. Conclusion: This work points toward the benefit of using the WED combined with NPWT. A larger clinical trial investigating the cost-effectiveness of WED in wound care is warranted. PMID:26005596

N-Halamine Biocidal Materials with Superior Antimicrobial Efficacies for Wound Dressings.

PubMed

Demir, Buket; Broughton, Roy M; Qiao, Mingyu; Huang, Tung-Shi; Worley, S D

2017-09-21

This work demonstrated the successful application of N-halamine technology for wound dressings rendered antimicrobial by facile and inexpensive processes. Four N-halamine compounds, which possess different functional groups and chemistry, were synthesized. The N-halamine compounds, which contained oxidative chlorine, the source of antimicrobial activity, were impregnated into or coated onto standard non-antimicrobial wound dressings. N-halamine-employed wound dressings inactivated about 6 to 7 logs of Staphylococcus aureus and Pseudomonas aeruginosa bacteria in brief periods of contact time. Moreover, the N-halamine-modified wound dressings showed superior antimicrobial efficacies when compared to commercially available silver wound dressings. Zone of inhibition tests revealed that there was no significant leaching of the oxidative chlorine from the materials, and inactivation of bacteria occurred by direct contact. Shelf life stability tests showed that the dressings were stable to loss of oxidative chlorine when they were stored for 6 months in dark environmental conditions. They also remained stable under florescent lighting for up to 2 months of storage. They could be stored in opaque packaging to improve their shelf life stabilities. In vitro skin irritation testing was performed using a three-dimensional human reconstructed tissue model (EpiDerm™). No potential skin irritation was observed. In vitro cytocompatibility was also evaluated. These results indicate that N-halamine wound dressings potentially can be employed to prevent infections, while at the same time improving the healing process by eliminating undesired bacterial growth.

Electrospun Fibers as a Dressing Material for Drug and Biological Agent Delivery in Wound Healing Applications

PubMed Central

Gizaw, Mulugeta; Thompson, Jeffrey; Faglie, Addison; Lee, Shih-Yu; Neuenschwander, Pierre; Chou, Shih-Feng

2018-01-01

Wound healing is a complex tissue regeneration process that promotes the growth of new tissue to provide the body with the necessary barrier from the outside environment. In the class of non-healing wounds, diabetic wounds, and ulcers, dressing materials that are available clinically (e.g., gels and creams) have demonstrated only a slow improvement with current available technologies. Among all available current technologies, electrospun fibers exhibit several characteristics that may provide novel replacement dressing materials for the above-mentioned wounds. Therefore, in this review, we focus on recent achievements in electrospun drug-eluting fibers for wound healing applications. In particular, we review drug release, including small molecule drugs, proteins and peptides, and gene vectors from electrospun fibers with respect to wound healing. Furthermore, we provide an overview on multifunctional dressing materials based on electrospun fibers, including those that are capable of achieving wound debridement and wound healing simultaneously as well as multi-drugs loading/types suitable for various stages of the healing process. Our review provides important and sufficient information to inform the field in development of fiber-based dressing materials for clinical treatment of non-healing wounds. PMID:29382065

Designing cellulosic and nanocellulosic sensors for interface with a protease sequestrant wound-dressing prototype: Implications of material selection for dressing and protease sensor design.

PubMed

Fontenot, Krystal R; Edwards, J Vincent; Haldane, David; Pircher, Nicole; Liebner, Falk; Condon, Brian D; Qureshi, Huzaifah; Yager, Dorne

2017-11-01

Interfacing nanocellulosic-based biosensors with chronic wound dressings for protease point of care diagnostics combines functional material properties of high specific surface area, appropriate surface charge, and hydrophilicity with biocompatibility to the wound environment. Combining a protease sensor with a dressing is consistent with the concept of an intelligent dressing, which has been a goal of wound-dressing design for more than a quarter century. We present here biosensors with a nanocellulosic transducer surface (nanocrystals, nanocellulose composites, and nanocellulosic aerogels) immobilized with a fluorescent elastase tripeptide or tetrapeptide biomolecule, which has selectivity and affinity for human neutrophil elastase present in chronic wound fluid. The specific surface area of the materials correlates with a greater loading of the elastase peptide substrate. Nitrogen adsorption and mercury intrusion studies revealed gas permeable systems with different porosities (28-98%) and pore sizes (2-50 nm, 210 µm) respectively, which influence water vapor transmission rates. A correlation between zeta potential values and the degree of protease sequestration imply that the greater the negative surface charge of the nanomaterials, the greater the sequestration of positively charged neutrophil proteases. The biosensors gave detection sensitivities of 0.015-0.13 units/ml, which are at detectable human neutrophil elastase levels present in chronic wound fluid. Thus, the physical and interactive biochemical properties of the nano-based biosensors are suitable for interfacing with protease sequestrant prototype wound dressings. A discussion of the relevance of protease sensors and cellulose nanomaterials to current chronic wound dressing design and technology is included.

Neurotensin-loaded collagen dressings reduce inflammation and improve wound healing in diabetic mice.

PubMed

Moura, Liane I F; Dias, Ana M A; Suesca, Edward; Casadiegos, Sergio; Leal, Ermelindo C; Fontanilla, Marta R; Carvalho, Lina; de Sousa, Hermínio C; Carvalho, Eugénia

2014-01-01

Impaired wound healing is an important clinical problem in diabetes mellitus and results in failure to completely heal diabetic foot ulcers (DFUs), which may lead to lower extremity amputations. In the present study, collagen based dressings were prepared to be applied as support for the delivery of neurotensin (NT), a neuropeptide that acts as an inflammatory modulator in wound healing. The performance of NT alone and NT-loaded collagen matrices to treat wounds in streptozotocin (STZ) diabetic induced mice was evaluated. Results showed that the prepared dressings were not-cytotoxic up to 72h after contact with macrophages (Raw 264.7) and human keratinocyte (HaCaT) cell lines. Moreover, those cells were shown to adhere to the collagen matrices without noticeable change in their morphology. NT-loaded collagen dressings induced faster healing (17% wound area reduction) in the early phases of wound healing in diabetic wounded mice. In addition, they also significantly reduced inflammatory cytokine expression namely, TNF-α (p<0.01) and IL-1β (p<0.01) and decreased the inflammatory infiltrate at day 3 post-wounding (inflammatory phase). After complete healing, metalloproteinase 9 (MMP-9) is reduced in diabetic skin (p<0.05) which significantly increased fibroblast migration and collagen (collagen type I, alpha 2 (COL1A2) and collagen type III, alpha 1 (COL3A1)) expression and deposition. These results suggest that collagen-based dressings can be an effective support for NT release into diabetic wound enhancing the healing process. Nevertheless, a more prominent scar is observed in diabetic wounds treated with collagen when compared to the treatment with NT alone. © 2013.

Novel neomycin sulfate-loaded hydrogel dressing with enhanced physical dressing properties and wound-curing effect.

PubMed

Choi, Jong Seo; Kim, Dong Wuk; Kim, Dong Shik; Kim, Jong Oh; Yong, Chul Soon; Cho, Kwan Hyung; Youn, Yu Seok; Jin, Sung Giu; Choi, Han-Gon

2016-10-01

To develop a novel neomycin sulfate-loaded hydrogel dressing (HD), numerous neomycin sulfate-loaded HDs were prepared with various amounts of polyvinyl alcohol (PVA), polyvinyl pyrrolidone (PVP) and sodium alginate (SA) using freeze-thawing technique, and their physical dressing properties, drug release, in vivo wound curing and histopathology in diabetic-induced rats were assessed. SA had a positive effect on a swelling capacity, but a negative effect on the physical dressing properties and drug release of HD. However, PVP did the opposite. In particular, the neomycin sulfate-loaded HD composed of drug, PVA, PVP and SA at the weight ratio of 1/10/0.8/0.8 had excellent swelling and bioadhesive capacity, good elasticity and fast drug release. Moreover, this HD gave more improved wound curing effect compared to the commercial product, ensured the disappearance of granulation tissue and recovered the wound tissue to normal. Therefore, this novel neomycin sulfate-loaded HD could be an effective pharmaceutical product for the treatment of wounds.

Apitherapeutics and phage-loaded nanofibers as wound dressings with enhanced wound healing and antibacterial activity.

PubMed

Sarhan, Wessam A; Azzazy, Hassan Me

2017-09-01

Develop green wound dressings which exhibit enhanced wound-healing ability and potent antibacterial effects. Honey, polyvinyl alcohol, chitosan nanofibers were electrospun and loaded with bee venom, propolis and/or bacteriophage against the multidrug-resistant Pseudomonas aeruginosa and examined for their antibacterial, wound-healing ability and cytotoxicity. Among different formulations of nanofibers, honey, polyvinyl alcohol, chitosan-bee venom/bacteriophage exhibited the most potent antibacterial activity against all tested bacterial strains (Gram-positive and -negative strains) and achieved nearly complete killing of multidrug-resistant P. aeruginosa. In vivo testing revealed enhanced wound-healing results and cytotoxicity testing proved improved biocompatibility. The developed biocompatible nanofibers represent competitive wound-healing dressings with potent antibacterial and wound-healing activity.

Enhancing pressure ulcer prevention using wound dressings: what are the modes of action?

PubMed

Call, Evan; Pedersen, Justin; Bill, Brian; Black, Joyce; Alves, Paulo; Brindle, C Tod; Dealey, Carol; Santamaria, Nick; Clark, Michael

2015-08-01

Recent clinical research has generated interest in the use of sacral wound dressings as preventive devices for patients at risk of ulceration. This study was conducted to identify the modes of action through which dressings can add to pressure ulcer prevention, for example, shear and friction force redistribution and pressure distribution. Bench testing was performed using nine commercially available dressings. The use of dressings can reduce the amplitude of shear stress and friction reaching the skin of patients at risk. They can also effectively redirect these forces to wider areas which minimises the mechanical loads upon skeletal prominences. Dressings can redistribute pressure based upon their effective Poisson ratio and larger deflection areas, providing greater load redistribution. © 2013 The Authors. International Wound Journal © 2013 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

An mHealth App for Decision-Making Support in Wound Dressing Selection (WounDS): Protocol for a User-Centered Feasibility Study.

PubMed

Jordan, Scott; McSwiggan, Jane; Parker, Joanne; Halas, Gayle A; Friesen, Marcia

2018-04-24

Primary care health professionals, especially family physicians, see a variety of wounds, and yet-despite the frequency of providing wound care-many family physicians do not feel confident in wound care management. This is partly due to a lack of formal wound education in Family Medicine programs. While there are numerous electronic wound care resources available in the UK and North America, none were identified that address the specific need in supporting clinical decision-making in wound dressing selection. At the same time, healthcare providers are increasingly using technology in personal and professional contexts, and a logical extension is to use technology for knowledge translation strategies. This work developed a prototype mobile health software application named WounDS, designed to support clinical decision-making in selecting wound dressings. This article presents the development and evaluation plan for the WounDS app. WounDS has been developed on the iOS platform. The primary specification included ease of use, in that one of the primary influences in user adoption would be the ability to receive a wound dressing recommendation in under 30 seconds and under 5 taps on the screen. The WounDS app guides users through a series of binary decisions for assessing the wound and provides a wound dressing recommendation. The selection algorithm is based in best practices using the Wound Bed Preparation Paradigm. Current work is underway to examine the implementation needs for WounDS to be most effectively utilized and to pilot test its feasibility and use in clinical care. Data will be collected through user trials, focus groups, and user metadata will be collected within the app. Optimizing these preconditions will enable a subsequent phase of study to determine effects on clinical decision-making and clinical outcomes. WounDS is designed for knowledge translation, use of technology in clinical decision-making, and continuity of care. The benefits of WounDS

A preliminary study of silver sodium zirconium phosphate polyurethane foam wound dressing on wounds of the distal aspect of the forelimb in horses.

PubMed

Kelleher, Maureen E; Kilcoyne, Isabelle; Dechant, Julie E; Hummer, Emma; Kass, Philip H; Snyder, Jack R

2015-04-01

To determine if application of silver sodium zirconium phosphate polyurethane semi-occlusive foam (SPF) dressing would improve measures of wound healing and decrease bacterial contamination compared with a non-adherent, absorbent dressing applied to wounds created on the distal aspect of the equine limb. Controlled randomized experimental study. Adult Quarter Horse and Thoroughbred horses (n = 5). One 6.25 cm(2) wound was created on the dorsomedial aspect of the proximal metacarpus on each forelimb. A SPF dressing was applied to 1 randomly assigned limb as a treatment and a non-adherent, absorbent dressing was applied to the opposite limb as control. Bandages were changed every 3 days for 60 days. Granulation tissue was scored every 3 days, wound area measured every 6 days, and wound bed was cultured every 12 days. SPF-treatment wounds had significantly decreased wound area and decreased granulation tissue scores when evaluated <30 days and over the 60 day study, although complete wound healing times were not significantly different. Bacteria were cultured from all wounds at varying times throughout the study. The SPF wound dressing improved some measures of wound healing compared with the control dressing, most significantly during the first 30 days. This suggests that the SPF wound dressing may be useful in the early management of wounds on the equine lower limb. Further studies using the SPF dressing are needed to characterize the temporal and cellular effects on wound healing and evaluate this dressing in a clinical environment. © Copyright 2014 by The American College of Veterinary Surgeons.

Bi-Layer Wound Dressing System for Combat Casualty Care

DTIC Science & Technology

2004-08-01

25] P.G. Bowler. 2003. The 105 bacterial growth guideline: reassessing its clinical relevance to wound healing. Ostomy /Wound Management 49: 44-53...33] M. Briggs, I. Torra, and J.E. Bou. 2003. Understanding the origin of wound pain during dressing change. Ostomy /Wound Management 49: 10-11

Nanomaterials from bacterial cellulose for antimicrobial wound dressing

NASA Astrophysics Data System (ADS)

Liyaskina, E.; Revin, V.; Paramonova, E.; Nazarkina, M.; Pestov, N.; Revina, N.; Kolesnikova, S.

2017-01-01

Bacterial nanocellulose (BNC) is widely used in biomedical applications. BNC has attracted increasing attention as a novel wound dressing material, but it has no antimicrobial activity. To get over this problem in the present study the BNC was saturated with antibiotic fusidic acid (FA). The subject of the experiment was BNC, produced by bacteria Gluconacetobacter sucrofermentans B-11267. The resulting biocomposites have high antibiotic activity against Staphylococcus aureus and can be used in medicine as a wound dressing. The structure of BNC was analyzed by atomic force microscopy (AFM) and Fourier transform infrared spectroscopy (FTIR).

Development and formulation of Moringa oleifera standardised leaf extract film dressing for wound healing application.

PubMed

Chin, Chai-Yee; Jalil, Juriyati; Ng, Pei Yuen; Ng, Shiow-Fern

2018-02-15

M.oleifera is a medicinal plant traditionally used for skin sores, sore throat and eye infections. Recently, the wound healing property of the leaves of M. oleifera was has been well demonstrated experimentally in both in vivo and in vitro models. However, there is a lack of research which focuses on formulating M.oleifera into a functional wound dressing. In this study, the M.oleifera leaf standardized aqueous extract with highest potency in vitro migration was formulated into a film for wound healing application. Firstly, M. oleifera leaf were extracted in various solvents (aqueous, 50%, 70% and 100% ethanolic extracts) and standardized by reference standards using UHPLC technique. The extracts were then tested for cell migration and proliferation using HDF and HEK cell lines. M. oleifera leaf aqueous extract was then incorporated into alginate-pectin (SA-PC) based film dressing. The film dressings were characterized for the physicochemical properties and the bioactives release from the M. oleifera leaf extract loaded film dressing was also investigated using Franz diffusion cells. All extracts were found to contain vicenin-2, chlorogenic acid, gallic acid, quercetin, kaempferol, rosmarinic acid and rutin. Among all M. oleifera extracts, aqueous standardized leaf extracts showed the highest human dermal fibroblast and human keratinocytes cells proliferation and migration properties. Among the film formulations, SA-PC (3% w/v) composite film dressing containing M. oleifera aqueous leaf extract was found to possess optimal physicochemical properties as wound dressing. A potentially applicable wound dressing formulated as an alginate-pectin film containing aqueous extracts of M. oleifera has been developed. The dressing would be suitable for wounds with moderate exudates. Copyright © 2017 Elsevier B.V. All rights reserved.

Early versus delayed dressing removal after primary closure of clean and clean-contaminated surgical wounds.

PubMed

Toon, Clare D; Lusuku, Charnelle; Ramamoorthy, Rajarajan; Davidson, Brian R; Gurusamy, Kurinchi Selvan

2015-09-03

outcomes. However, it should be noted that the point estimate supporting this statement is based on very low quality evidence from three small randomised controlled trials, and the confidence intervals around this estimate were wide. Early dressing removal may result in a significantly shorter hospital stay, and significantly reduced costs, than covering the surgical wound with wound dressings beyond the first 48 hours after surgery, according to very low quality evidence from one small randomised controlled trial. Further randomised controlled trials of low risk of bias are necessary to investigate whether dressings are necessary after 48 hours in different types of surgery and levels of contamination and investigate whether antibiotic therapy influences the outcome.

Early versus delayed dressing removal after primary closure of clean and clean-contaminated surgical wounds.

PubMed

Toon, Clare D; Ramamoorthy, Rajarajan; Davidson, Brian R; Gurusamy, Kurinchi Selvan

2013-09-05

outcomes. However, it should be noted that the point estimate supporting this statement is based on very low quality evidence from three small randomised controlled trials, and the confidence intervals around this estimate were wide. Early dressing removal may result in a significantly shorter hospital stay, and significantly reduced costs, than covering the surgical wound with wound dressings beyond the first 48 hours after surgery, according to very low quality evidence from one small randomised controlled trial. Further randomised controlled trials of low risk of bias are necessary to investigate whether dressings are necessary after 48 hours in different types of surgery and levels of contamination and investigate whether antibiotic therapy influences the outcome.

Active wound dressings based on bacterial nanocellulose as drug delivery system for octenidine.

PubMed

Moritz, Sebastian; Wiegand, Cornelia; Wesarg, Falko; Hessler, Nadine; Müller, Frank A; Kralisch, Dana; Hipler, Uta-Christina; Fischer, Dagmar

2014-08-25

Although bacterial nanocellulose (BNC) may serve as an ideal wound dressing, it exhibits no antibacterial properties by itself. Therefore, in the present study BNC was functionalized with the antiseptic drug octenidine. Drug loading and release, mechanical characteristics, biocompatibility, and antimicrobial efficacy were investigated. Octenidine release was based on diffusion and swelling according to the Ritger-Peppas equation and characterized by a time dependent biphasic release profile, with a rapid release in the first 8h, followed by a slower release rate up to 96 h. The comparison between lab-scale and up-scale BNC identified thickness, water content, and the surface area to volume ratio as parameters which have an impact on the control of the release characteristics. Compression and tensile strength remained unchanged upon incorporation of octenidine in BNC. In biological assays, drug-loaded BNC demonstrated high biocompatibility in human keratinocytes and antimicrobial activity against Staphylococcus aureus. In a long-term storage test, the octenidine loaded in BNC was found to be stable, releasable, and biologically active over a period of 6 months without changes. In conclusion, octenidine loaded BNC presents a ready-to-use wound dressing for the treatment of infected wounds that can be stored over 6 months without losing its antibacterial activity. Copyright © 2014 Elsevier B.V. All rights reserved.

Association of Alpha Tocopherol and Ag Sulfadiazine Chitosan Oleate Nanocarriers in Bioactive Dressings Supporting Platelet Lysate Application to Skin Wounds.

PubMed

Bonferoni, Maria Cristina; Sandri, Giuseppina; Rossi, Silvia; Dellera, Eleonora; Invernizzi, Alessandro; Boselli, Cinzia; Cornaglia, Antonia Icaro; Del Fante, Claudia; Perotti, Cesare; Vigani, Barbara; Riva, Federica; Caramella, Carla; Ferrari, Franca

2018-02-09

Chitosan oleate was previously proposed to encapsulate in nanocarriers some poorly soluble molecules aimed to wound therapy, such as the anti-infective silver sulfadiazine, and the antioxidant α tocopherol. Because nanocarriers need a suitable formulation to be administered to wounds, in the present paper, these previously developed nanocarriers were loaded into freeze dried dressings based on chitosan glutamate. These were proposed as bioactive dressings aimed to support the application to wounds of platelet lysate, a hemoderivative rich in growth factors. The dressings were characterized for hydration capacity, morphological aspect, and rheological and mechanical behavior. Although chitosan oleate nanocarriers clearly decreased the mechanical properties of dressings, these remained compatible with handling and application to wounds. Preliminary studies in vitro on fibroblast cell cultures demonstrated good compatibility of platelet lysate with nanocarriers and bioactive dressings. An in vivo study on a murine wound model showed an accelerating wound healing effect for the bioactive dressing and its suitability as support of the platelet lysate application to wounds.

Association of Alpha Tocopherol and Ag Sulfadiazine Chitosan Oleate Nanocarriers in Bioactive Dressings Supporting Platelet Lysate Application to Skin Wounds

PubMed Central

Bonferoni, Maria Cristina; Dellera, Eleonora; Invernizzi, Alessandro; Cornaglia, Antonia Icaro; Perotti, Cesare; Vigani, Barbara; Caramella, Carla; Ferrari, Franca

2018-01-01

Chitosan oleate was previously proposed to encapsulate in nanocarriers some poorly soluble molecules aimed to wound therapy, such as the anti-infective silver sulfadiazine, and the antioxidant α tocopherol. Because nanocarriers need a suitable formulation to be administered to wounds, in the present paper, these previously developed nanocarriers were loaded into freeze dried dressings based on chitosan glutamate. These were proposed as bioactive dressings aimed to support the application to wounds of platelet lysate, a hemoderivative rich in growth factors. The dressings were characterized for hydration capacity, morphological aspect, and rheological and mechanical behavior. Although chitosan oleate nanocarriers clearly decreased the mechanical properties of dressings, these remained compatible with handling and application to wounds. Preliminary studies in vitro on fibroblast cell cultures demonstrated good compatibility of platelet lysate with nanocarriers and bioactive dressings. An in vivo study on a murine wound model showed an accelerating wound healing effect for the bioactive dressing and its suitability as support of the platelet lysate application to wounds. PMID:29425164

Ward nurses' use of wound dressings before and after a bespoke education programme.

PubMed

Smith, G; Greenwood, M; Searle, R

2010-09-01

A survey of ward nurses in medical, surgical, orthopaedic and rehabilitation specialties in relation to their care of wounds and their choice and use of wound dressings was carried out in May and August 2009 at St Mary's Hospital. Isle of Wight, UK. The objectives were to find out the distribution of wound types, and their characteristics, that were treated by ward nurses in the hospital, and to assess clinical practice in the use of wound dressings, before and after a bespoke programme of education and training. A visual framework to aid the ward nurses in the choice of dressings and frequency of change was introduced after the May 2009 survey. Following the nurses' education and training programme a repeat survey, using the same methodology, was conducted in August 2009. In the initial survey, 172 wounds were included (mean number of wounds per patient 1.64) and in the repeat one, 159 (mean number of wounds per patient 1.54). In both phases of the survey, the most common wound type was pressure ulcers, followed by surgical wounds; over 60% of the wounds were pressure ulcers, of which around half were category 1, and one-third were category 2. No category 4 ulcers were recorded. About one-third of the wounds had a duration of more than 21 days. On average, wound dressings were left in place for between two and three days, with 35% of dressings being changed on a daily basis. The mean cost of dressings per wound per week was observed to be lower in the repeat survey than in the initial one (£9.02 and £11.23 respectively). The number of undesirable reasons for changing the dressing was lower in the second phase than the first. The methodology of the surveys provided meaningful and valuable results over a short timescale, and increased understanding of wound types, their characteristics, and clinical practice. The surveys showed that data that can be collected in a short period using a simple tool can yield complex and revealing data trends. They also showed that

Hypericum perforatum incorporated chitosan films as potential bioactive wound dressing material.

PubMed

Güneş, Seda; Tıhmınlıoğlu, Funda

2017-09-01

Recent studies in wound dressing applications offer new therapies and promote wound healing process. The aim of this study was to develop Hypericum perforatum (St John's Wort) oil incorporated chitosan films for wound dressing applications. H. perforatum oil as a potential therapeutic agent was encapsulated in chitosan film to achieve a better wound dressing material. Oil incorporated chitosan films were successfully prepared by solvent casting method in different oil concentrations (0.25-1.5%v/v). Water vapor permeability (WVP), mechanical test, swelling behavior and surface hydrophobicity were performed in order to characterize the prepared films. Antimicrobial test was performed by disc diffusion method and the growth inhibition effects of the films including different amount of H. perforatum oil were investigated on Escherichia coli and Staphylococcus aureus. WVP increased with oil incorporation and the highest value was obtained for 0.25% oil concentration.The highest strain value was obtained in 0.25% oil content films although tensile stress decreased with increasing oil content. H. perforatum oil incorporated films had antimicrobial effect on both microorganisms. Chitosan based films had no cytotoxic effects on NIH3T3fibroblast cells and provided a good surface for cell attachment and proliferation. The results showed that the H. perforatum incorporated chitosan films seems to be a potential and novel biomaterial for wound healing applications. Copyright © 2017 Elsevier B.V. All rights reserved.

Controlled Release of Chitosan and Sericin from the Microspheres-Embedded Wound Dressing for the Prolonged Anti-microbial and Wound Healing Efficacy.

PubMed

Aramwit, Pornanong; Yamdech, Rungnapha; Ampawong, Sumate

2016-05-01

One approach in wound dressing development is to incorporate active molecules or drugs in the dressing. In order to reduce the frequency of dressing changes as well as to prolong wound healing efficacy, wound dressings that can sustain the release of the active molecules should be developed. In our previous work, we developed chitosan/sericin (CH/SS) microspheres that released sericin in a controlled rate. However, the difficulty of applying the microspheres that easily diffuse and quickly degrade onto the wound was its limitations. In this study, we aimed to develop wound dressing materials which are easier to apply and to provide extended release of sericin. Different amounts of CH/SS microspheres were embedded into various compositions of polyvinyl alcohol/gelatin (PVA/G) scaffolds and fabricated using freeze-drying and glutaraldehyde crosslinking techniques. The obtained CH/SS microspheres-embedded scaffolds with appropriate design and formulation were introduced as a wound dressing material. Sericin was released from the microspheres and the scaffolds in a sustained manner. Furthermore, an optimized formation of the microspheres-embedded scaffolds (2PVA2G+2CHSS) was shown to possess an effective antimicrobial activity against both gram-positive and gram-negative bacteria. These microspheres-embedded scaffolds were not toxic to L929 mouse fibroblast cells, and they did not irritate the tissue when applied to the wound. Finally, probably by the sustained release of sericin, these microspheres-embedded scaffolds could promote wound healing as well as or slightly better than a clinically used wound dressing (Allevyn®) in a mouse model. The antimicrobial CH/SS microspheres-embedded PVA/G scaffolds with sustained release of sericin would appear to be a promising candidate for wound dressing application.

Unravelling nocebo effect: the mediating effect of anxiety between anticipation and pain at wound dressing change.

PubMed

Woo, Kevin Y

2015-07-01

The purpose of this study was to examine the mediating effect of anxiety in the relationship between anticipation and pain in people with chronic wounds. Pain is common in people with chronic wounds. Anticipation or negative expectation of discomfort has been shown to have an augmenting effect on pain; also known as nocebo hyperalgesia. This was a cross-sectional study with repeated measures. Prior to dressing change, anticipatory pain level was evaluated by a 11-point numerical rating scale and anxiety by the Six-items State-Trait Anxiety Inventory (STAI-6). During wound dressing changes, pain was measured before dressing removal, at dressing removal, at cleansing and dressing application using the numerical scale. Analysis was completed based on the data from a convenience sample of 96 patients. Participants reported more pain at cleansing and dressing removal than baseline. High levels of anticipation, anxiety and pain at dressing change for wounds were related to heavy exudate and wound that were covered with necrotic tissue. Finally, the relationship between anticipation and pain perception was mediated by anxiety. Anticipation of pain triggers anxiety that can lead to increased pain. There is a need to incorporate evaluation of anxiety and personal expectations as part of comprehensive pain assessment. Clinicians should be aware of the impact of emotions and anticipation on overall pain experience. © 2015 John Wiley & Sons Ltd.

Electrospun polymeric dressings functionalized with antimicrobial peptides and collagen type I for enhanced wound healing

NASA Astrophysics Data System (ADS)

Felgueiras, H. P.; Amorim, M. T. P.

2017-10-01

Modern wound dressings combine medical textiles with active compounds that stimulate wound healing while protecting against infection. Electrospun wound dressings have been extensively studied and the electrospinning technique recognized as an efficient approach for the production of nanoscale fibrous mats. The unique diverse function and architecture of antimicrobial peptides (AMPs) has attracted considerable attention as a tool for the design of new anti-infective drugs. Functionalizing electrospun wound dressings with these AMPs is nowadays being researched. In the present work, we explore these new systems by highlighting the most important characteristics of electropsun wound dressings, revealing the importance of AMPs to wound healing, and the methods available to functionalize the electrospun mats with these molecules. The combined therapeutic potential of collagen type I and these AMP functionalized dressings will be highlighted as well; the significance of these new strategies for the future of wound healing will be clarified.

Comparison of two silver dressings for wound management in pediatric burns.

PubMed

Jester, Ingo; Bohn, Ingo; Hannmann, Thorsten; Waag, Karl-Ludwig; Loff, Steffan

2008-11-01

Purpose. Silver wound dressings are widely used in the treatment of burns. Dressings differ in material characteristics, various antimicrobial activities, and ease of use. The purpose of this study was to evaluate both dressing performance and amount of pain during the dressing changes of 2 silver dressings Urgotul SSD® (Laboratoires Urgo, Chenove, France), and Contreet Ag® (Coloplast, Minneapolis, MN) in children. A retrospective cohort study was performed with 2 groups of 20 burns treated with Urgotul SSD and Contreet Ag until the wounds were healed or grafted. Seventy dressing changes in the Contreet Ag group and 67 dressing changes in the Urgotul group were evaluated. Every dressing change was assessed regarding the dressing performance (exudate, adherence, bleeding, and dressing application/removal), and pain. Pain was "absent or slight" in 61 (92%) dressing changes with Urgotul SSD, and in 60 (85%) of the dressing changes with Contreet Ag. Dressing application in the Urgotul group was more often "very easy" (n = 33; 49%) or "easy" (n = 32; 48%) than in the Contreet Ag group, "very easy" (n = 25; 35%), and "easy" (n = 42; 60%). Contreet Ag had a greater ability to absorb exudate ("very good" n = 60; 85%, and "good" n = 11; 15%) than Urgotul SSD ("very good" n = 34; 51%, and "good" n = 13; 19%). Urgotul SSD and Contreet Ag are comparable regarding pain during dressing change. The dressings differ in their ability to absorb exudate and ease of application. Both dressings provided nearly painless wound management, and therefore were highly accepted by the nurses and especially the children being treated.

Superabsorbent polymer-containing wound dressings have a beneficial effect on wound healing by reducing PMN elastase concentration and inhibiting microbial growth.

PubMed

Wiegand, C; Abel, M; Ruth, P; Hipler, U C

2011-11-01

A comprehensive in vitro approach was used to assess the effects of superabsorbent polymer (SAP) containing wound dressings in treatment of non-healing wounds. A slight negative effect on HaCaT cells was noted in vitro which is most likely due to the Ca(2+) deprivation of the medium by binding to the SAP. It could be shown that SAP wound dressings are able to bind considerable amounts of elastase reducing enzyme activity significantly. Furthermore, SAP's inhibit the formation of free radicals. The SAP-containing wound dressings tested also exhibited a significant to strong antimicrobial activity effectively impeding the growth of gram-negative and gram-positive bacteria as well as yeasts. In conclusion, in vitro data confirm the positive effect of SAP wound dressings observed in vivo and suggest that they should be specifically useful for wound cleansing.

Dressing for alveolopalatal wounds after alveolar bone grafting.

PubMed

Kondoh, Shoji; Matsuo, Kiyoshi; Yuzuriha, Shunsuke; Kikuchi, Nirou; Ban, Ryokuya

2003-09-01

Cotton gauze with alpha cyanoacrylate was used for alveolopalatal wound dressing after alveolar bone grafting to treat 93 alveolar clefts in 74 cleft patients to reduce mechanical injuries, tension for wound dehiscence, and adhesion of food remnants. T-shaped cotton gauze was put on the gingivoperiosteal flaps and was impregnated with cyanoacrylate. The procedure required no preoperative preparation and its intraoperative execution took less than 5 minutes. The gauze with cyanoacrylate was removed approximately 1 week after surgery. No infection was observed at any of the operational sites, but tiny fistulas developed at four of them. The mean bone graft score was 1.4 point. No complications such as thermal injury resulted from the use of cyanoacrylate. Gauze impregnated with cyanoacrylate proved to be a convenient and dependable dressing for alveolopalatal wounds resulting from gingivoperiosteoplasty for alveolar bone grafting.

Preparation and evaluation of biocomposites as wound dressing material.

PubMed

Ramnath, V; Sekar, S; Sankar, S; Sankaranarayanan, C; Sastry, T P

2012-12-01

Collagen was isolated from the chrome containing leather waste (CCLW) which is a major solid waste in leather industry. Composite films were made using sago starch (SG), soya protein (SY), and collagen (C) and were cross linked with glutaraldehyde (G).The films prepared were characterized for their physico chemical properties like tensile strength, infrared spectra, thermogravimetric analysis, surface morphology, and water absorption studies. Better mechanical properties and surface morphology were observed for SG-SY-G-C films compared to other films prepared using collagen. The composite films prepared were used as wound dressing material on the experimental wounds of rats and healing pattern was evaluated using planimetric, biochemical, and histopathological studies. These studies have revealed better wound healing capacity of SG-SY-G-C film and utilization of CCLW in the preparation of value added product like wound dressing material.

Disconnection: the user voice within the wound dressing supply chain.

PubMed

Campling, Natasha; Grocott, Patricia; Cowley, Sarah

2008-03-01

This study examined the user voice in England's National Health Service (NHS) wound dressing supply chain. The impetus for this work came from involvement in a collaboration between industry and clinicians, entitled Woundcare Research for Appropriate Products. Experiences from that study highlighted the notable absence of research about the impact of the supply chain on the users of dressings. Interview data are presented following an outline of the grounded theory method used. These data were obtained from key stakeholders (n = 41) within the wound dressing supply chain such as nurses, manufacturers, distributors, professional organizations, government organizations and user groups. The consequences of supply disconnection revealed haphazard supply, unmet user needs and lack of information transfer between player groups. These consequences explain the lack of user voice in the supply chain and have far-reaching implications for nursing management, through purchasing decisions and nurses' management of wound care.

Prospective randomised controlled trial of nanocrystalline silver dressing versus plain gauze as the initial post-debridement management of military wounds on wound microbiology and healing.

PubMed

Fries, C A; Ayalew, Y; Penn-Barwell, J G; Porter, K; Jeffery, S L A; Midwinter, M J

2014-07-01

Recent conflicts have been characterised by the use of improvised explosive devices causing devastating injuries, including heavily contaminated wounds requiring meticulous surgical debridement. After being rendered surgical clean, these wounds are dressed and the patient transferred back to the UK for on-going treatment. A dressing that would prevent wounds from becoming colonised during transit would be desirable. The aim of this study was to establish whether using nanocrystalline silver dressings, as an adjunct to the initial debridement, would positively affect wound microbiology and wound healing compared to standard plain gauze dressings. Patients were prospectively randomised to receive either silver dressings, in a nanocrystalline preparation (Acticoat™), or standard of care dressings (plain gauze) following their initial debridement in the field hospital. On repatriation to the UK microbiological swabs were taken from the dressing and the wound, and an odour score recorded. Wounds were followed prospectively and time to wound healing was recorded. Additionally, patient demographic data were recorded, as well as the mechanism of injury and Injury Severity Score. 76 patients were recruited to the trial between February 2010 and February 2012. 39 received current dressings and 37 received the trial dressings. Eleven patients were not swabbed. There was no difference (p=0.1384, Fishers) in the primary outcome measure of wound colonisation between the treatment arm (14/33) and the control arm (20/32). Similarly time to wound healing was not statistically different (p=0.5009, Mann-Whitney). Wounds in the control group were scored as being significantly more malodorous (p=0.002, Mann-Whitney) than those in the treatment arm. This is the first randomised controlled trial to report results from an active theatre of war. Performing research under these conditions poses additional challenges to military clinicians. Meticulous debridement of wounds remains the

Cell recruiting chemokine-loaded sprayable gelatin hydrogel dressings for diabetic wound healing.

PubMed

Yoon, Dong Suk; Lee, Yunki; Ryu, Hyun Aae; Jang, Yeonsue; Lee, Kyoung-Mi; Choi, Yoorim; Choi, Woo Jin; Lee, Moses; Park, Kyung Min; Park, Ki Dong; Lee, Jin Woo

2016-07-01

In this study, we developed horseradish peroxidase (HRP)-catalyzed sprayable gelatin hydrogels (GH) as a bioactive wound dressing that can deliver cell-attracting chemotactic cytokines to the injured tissues for diabetic wound healing. We hypothesized that topical administration of chemokines using GH hydrogels might improve wound healing by inducing recruitment of the endogenous cells. Two types of chemokines (interleukin-8; IL-8, macrophage inflammatory protein-3α; MIP-3α) were simply loaded into GH hydrogels during in situ cross-linking, and then their wound-healing effects were evaluated in streptozotocin-induced diabetic mice. The incorporation of chemokines did not affect hydrogels properties including swelling ratio and mechanical stiffness, and the bioactivities of IL-8 and MIP-3α released from hydrogel matrices were stably maintained. In vivo transplantation of chemokine-loaded GH hydrogels facilitated cell infiltration into the wound area, and promoted wound healing with enhanced re-epithelialization/neovascularization and increased collagen deposition, compared with no treatment or the GH hydrogel alone. Based on our results, we suggest that cell-recruiting chemokine-loaded GH hydrogel dressing can serve as a delivery platform of various therapeutic proteins for wound healing applications. Despite development of materials combined with therapeutic agents for diabetic wound treatment, impaired wound healing by insufficient chemotactic responses still remain as a significant problem. In this study, we have developed enzyme-catalyzed gelatin (GH) hydrogels as a sprayable dressing material that can deliver cell-attracting chemokines for diabetic wound healing. The chemotactic cytokines (IL-8 and MIP-3α) were simply loaded within hydrogel during in situ gelling, and wound healing efficacy of chemokine-loaded GH hydrogels was investigated in STZ-induced diabetic mouse model. These hydrogels significantly promoted wound-healing efficacy with faster wound

Effects of a just-in-time educational intervention placed on wound dressing packages: a multicenter randomized controlled trial.

PubMed

Kent, Dea J

2010-01-01

I compared the effects of a just-in-time educational intervention (educational materials for dressing application attached to the manufacturer's dressing package) to traditional wound care education on reported confidence and dressing application in a simulated model. Nurses from a variety of backgrounds were recruited for this study. The nurses possessed all levels of education ranging from licensed practical nurse to master of science in nursing. Both novice and seasoned nurses were included, with no stipulations regarding years of nursing experience. Exclusion criteria included nurses who spent less than 50% of their time in direct patient care and nurses with advanced wound care training and/or certification (CWOCN, CWON). Study settings included community-based acute care facilities, critical access hospitals, long-term care facilities, long-term acute care facilities, and home care agencies. No level 1 trauma centers were included in the study for geographical reasons. Participants were randomly allocated to control or intervention groups. Each participant completed the Kent Dressing Confidence Assessment tool. Subjects were then asked to apply the dressing to a wound model under the observation of either the principal investigator or a trained observer, who scored the accuracy of dressing application according to established criteria. None of the 139 nurses who received traditional dressing packaging were able to apply the dressing to a wound model correctly. In contrast, 88% of the nurses who received the package with the educational guide attached to it were able to apply the dressing to a wound model correctly (χ2 = 107.22, df = 1, P = .0001). Nurses who received the dressing package with the attached educational guide agreed that this feature gave them confidence to correctly apply the dressing (88%), while no nurse agreed that the traditional package gave him or her the confidence to apply the dressing correctly (χ2 = 147.47, df = 4, P < .0001). A

Randomized clinical trial to compare negative-pressure wound therapy approaches with low and high pressure, silicone-coated dressing, and polyurethane foam dressing.

PubMed

Lavery, Lawrence A; La Fontaine, Javier; Thakral, Gaurav; Kim, Paul J; Bhavan, Kavita; Davis, Kathryn E

2014-03-01

This study was designed to compare two approaches to negative-pressure wound therapy: 125-mmHg pressure with a polyurethane foam dressing and 75-mmHg pressure with a silicone-coated dressing. Forty patients with diabetic foot wounds, after incision and drainage or amputation for infection, were assigned randomly to negative-pressure wound therapy with 75-mmHg continuous pressure with a silicone-covered dressing (75-mmHg group) or 125-mmHg with a polyurethane foam dressing (125-mmHg group) for up to 4 weeks or until surgical closure. There was no difference in the proportion of wounds that were closed surgically (75-mmHg group, 50 percent; 125-mmHg group, 60 percent), wounds that demonstrated 50 percent wound area reduction (75-mmHg group, 65 percent; 125-mmHg group, 80 percent), or wounds that demonstrated 50 percent wound volume reduction after 4 weeks of therapy (75-mmHg group, 95 percent; 125-mmHg group, 90 percent). The authors' results suggest that there was no difference in outcomes in wounds treated with low pressure (75 mmHg) with a silicone-coated interface and high pressure (125 mmHg) with a polyurethane foam interface. Therapeutic, II.

A study of long-term stability and antimicrobial activity of chlorhexidine, polyhexamethylene biguanide, and silver nanoparticle incorporated in sericin-based wound dressing.

PubMed

Ampawong, Sumate; Aramwit, Pornanong

2017-09-01

In this study, three kinds of antiseptics which were 0.05% chlorhexidine, 0.2% polyhexamethylene biguanide (PHMB), or 200 ppm silver nanoparticle was introduced to incorporate in the sericin-based scaffold to produce the antimicrobial dressing for the treatment of infected chronic wound. The effects of antiseptic incorporation on the stability, release of sericin, and short-term and long-term (6 months) antimicrobial activity of the sericin dressing against gram-negative and gram-positive bacteria were investigated. We showed that the incorporation of each antiseptic did not have significant effect on the internal morphology (pore size ~ 73-105 μm), elasticity (Young's modulus ~ 200-500 kPa), and the sericin release behavior of the sericin-based dressing. The release of sericin from the dressing was prolonged over 120 h and thereafter. Comparing among three antiseptics, 0.05% chlorhexidine incorporated in the sericin dressing showed the highest immediate and long-term (6 months) antimicrobial effect (largest inhibition zone) against most bacteria either gram-positive or gram-negative bacteria. The in vivo safety test following ISO10993 standard (Biological evaluation of medical devices - Part 6: Tests for local effects after implantation) confirmed that the sericin dressing incorporating 0.05% chlorhexidine did not irritate to tissue, comparing with the commercial material used generally in clinic (Allevyn®, Smith & Nephew). We suggested the sericin dressing incorporating 0.05% chlorhexidine for the treatment of infected chronic wound. Chlorhexidine would reduce the risk of infection while the sericin may promote wound healing.

Novel biodegradable composite wound dressings with controlled release of antibiotics: results in a guinea pig burn model.

PubMed

Elsner, Jonathan J; Egozi, Dana; Ullmann, Yehuda; Berdicevsky, Israela; Shefy-Peleg, Adaya; Zilberman, Meital

2011-08-01

Approximately 70% of all people with severe burns die from related infections despite advances in treatment regimens and the best efforts of nurses and doctors. Silver ion-eluting wound dressings are available for overcoming this problem. However, there are reports of deleterious effects of such dressings due to cellular toxicity that delays the healing process, and the dressing changes needed 1-2 times a day are uncomfortable for the patient and time consuming for the stuff. An alternative concept in wound dressing design that combines the advantages of occlusive dressings with biodegradability and intrinsic topical antibiotic treatment is described herewith. The new composite structure presented in this article is based on a polyglyconate mesh and a porous poly-(dl-lactic-co-glycolic acid) matrix loaded with gentamicin developed to provide controlled release of antibiotics for three weeks. In vivo evaluation of the dressing material in contaminated deep second degree burn wounds in guinea pigs (n=20) demonstrated its ability to accelerate epithelialization by 40% compared to an unloaded format of the material and a conventional dressing material. Wound contraction was reduced significantly, and a better quality scar tissue was formed. The current dressing material exhibits promising results, does not require frequent bandage changes, and offers a potentially valuable and economic approach to treating the life-threatening complication of burn-related infections. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

Comparison of DNA Damage and Apoptosis Induced By Silver Nanoparticle-containing Dressing Materials During Wound Healing.

PubMed

Choi, Young Suk; Gwak, Heui-Chul; Park, Jae Keun; Lim, Ji Yun; Yeo, Eui Dong; Park, Eunseok; Kim, Junyong; Lee, Young Koo

2018-04-13

Silver nanoparticle (AgNP)-containing dressings are used worldwide for the treatment of wounds; however, many studies have indicated that AgNPs are toxic to humans and cause cell death, primarily via apoptosis. In this study, the investigators compare the apoptotic effects of various AgNP dressing materials, with the hypothesis that nanosilver would be less toxic than ionic silver. For the in vivo experiments, Sprague-Dawley (SD) and streptozotocin (STZ)-induced diabetic rats were treated with 5 dressing materials: Aquacel Ag (product A, silver ion; ConvaTec, Berkshire, UK), Acticoat (product B, AgNP; Smith & Nephew, Fort Worth, TX), Medifoam Silver (product C, silver ion; Genewel Science Co Ltd, Seongnam, South Korea), PolyMem Silver (product D, AgNP; Ferris Mfg Corp, Fort Worth, TX), and Vaseline-impregnated dressing gauze (control; Unilever, London, UK). All treatments were applied 3 times per week. After 14 days of treatment, the SD and STZ rats were euthanized, and wound samples were examined for apoptosis. The analysis included immunohistochemistry, terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining, Western blotting, and reverse transcription polymerase chain reaction for a semiquantitative evaluation of apoptosis. The AgNP-containing dressing materials were more cytotoxic than the silver dressings. Compared with the AgNP dressing materials, no significant levels of apoptotic factors were observed in the silver dressing-treated wounds. The TUNEL staining showed that product C-dressed wounds contained the most apoptotic cells, while some apoptotic cells were observed in product B-dressed wounds. Moreover, apoptotic gene expression was altered, including a decline in B-cell lymphoma-2 and activation of caspase-3. This was most evident in wounds treated with product C. Interestingly, apoptotic gene expression was not induced in product A-treated wounds. Finally, product D had a relatively lower silver concentration and was less toxic

Superficial Burn Wound Healing with Intermittent Negative Pressure Wound Therapy Under Limited Access and Conventional Dressings

PubMed Central

Honnegowda, Thittamaranahalli Muguregowda; Padmanabha Udupa, Echalasara Govindarama; Rao, Pragna; Kumar, Pramod; Singh, Rekha

2016-01-01

BACKGROUND Thermal injury is associated with several biochemical and histopathological alteration in tissue. Analysis of these objective parameters in research and clinical field are common to determine healing rate of burn wound. Negative pressure wound therapy has been achieved wide success in treating chronic wounds. This study determines superficial burn wound healing with intermittent negative pressure wound therapy under limited access and conventional dressings METHODS A total 50 patients were randomised into two equal groups: limited access and conventional dressing groups. Selective biochemical parameters such as hydroxyproline, hexosamine, total protein, and antioxidants, malondialdhyde (MDA), wound surface pH, matrix metalloproteinase-2 (MMP-2), and nitric oxide (NO) were measured in the granulation tissue. Histopathologically, necrotic tissue, amount of inflammatory infiltrate, angiogenesis and extracellular matrix deposition (ECM) were studied to determine wound healing under intermittent negative pressure. RESULTS Patients treated with limited access have shown significant increase in the mean hydroxyproline, hexosamine, total protein, reduced glutathione (GSH), glutathione peroxidase (GPx), and decrease in MDA, MMP-2, wound surface pH, and NO. Histopathologic study showed that there was a significant difference after 10 days of treatment between limited access vs conventional dressing group, Median (Q1, Q3)=3 (2, 4.25) vs 2 (1.75, 4). CONCLUSION Limited access was shown to exert its beneficial effects on wound healing by increasing ground substance, antioxidants and reducing MMP-2 activity, MDA, NO and providing optimal pH, decreasing necrotic tissue, amount of inflammatory infiltrate, increasing ECM deposition and angiogenesis. PMID:27853690

Protease Inhibition by Oleic Acid Transfer From Chronic Wound Dressings to Albumin

DOE Office of Scientific and Technical Information (OSTI.GOV)

Edwards, J. V.; Howley, Phyllis; Davis, Rachel M.

High elastase and cathepsin G activities have been observed in chronic wounds. These levels can inhibit healing through degradation of growth factors, cytokines, and extracellular matrix proteins. Oleic acid (18:1) is a non-toxic elastase inhibitor with some potential for redressing the imbalance of elastase activity found in chronic wounds. Cotton wound dressing material was characterized as a transfer carrier for affinity uptake of 18:1 by albumin under conditions mimicking chronic wounds. 18:1-treated cotton was examined for its ability to bind and release the fatty acid in the presence of albumin. The mechanism of 18:1 uptake from cotton and binding bymore » albumin was examined with both intact dressings and cotton fiber-designed chromatography. Raman spectra of the albumin-18:1 complexes under liquid-liquid equilibrium conditions revealed fully saturated albumin-18:1 complexes with a 1:1 weight ratio of albumin:18:1. Cotton chromatography under liquid-solid equilibrium conditions revealed oleic acid transfer from cotton to albumin at 27 mole equivalents of 18:1 per mole albumin. Cotton was contrasted with hydrogel, and hydrocolloid wound dressing for its comparative ability to lower elastase activity. Each dressing material evaluated was found to release 18:1 in the presence of albumin with significant inhibition of elastase activity. The 18:1-formulated wound dressings lowered elastase activity in a dose dependent manner in the order cotton gauze > hydrogel > hydrocolloid. In contrast the cationic serine protease Cathepsin G was inihibited by 18:1 within a narrow range of 18:1-cotton formulations. Four per cent Albumin solutions were most effective in binding cotton bound-18:1. However, 2% albumin was sufficient to transfer quantities of 18:1 necessary to achieve a significant elastase-lowering effect. Formulations with 128 mg 18:1/g cotton gauze had equivalent elastase lowering with 1 - 4% albumin. 18:1 bound to cotton wound dressings may have promise in

Guanidine hydrochloride embedded polyurethanes as antimicrobial and absorptive wound dressing membranes with promising cytocompatibility.

PubMed

Sahraro, Maryam; Yeganeh, Hamid; Sorayya, Marziyeh

2016-02-01

Preparation and assessments of novel absorptive wound dressing materials with efficient antimicrobial activity as well as very good cytocompatibility were described in this work. An amine terminated poly(hexamethylene guanidine hydrochloride) was prepared and used as curing agent of different epoxy-terminated polyurethane prepolymers. The structures of prepared materials were elucidated by evaluation of their (1)H NMR and FTIR spectra. The recorded tensile strength of membranes confirmed the excellent dimensional stability of the film type dressings even at fully hydrated conditions. Therefore, these dressings could protect the wound bed from external forces during the healing period. The structurally optimized dressing membranes could preserve the desired moist environment over the wounded area, as a result of their balanced equilibrium, water absorption and water vapor transmission rate. Therefore, a very good condition for stimulation of self-healing of wound bed was attained. Also, owing to the presence of guanidine hydrochloride moieties embedded into the structure of dressings, efficient antimicrobial activity against Staphylococcus aureus, Pseudomonas aeruginosa and Candida albicans were detected. In vitro cytotoxicity assay of the prepared dressings revealed cytocompatibility of these materials against fibroblast cells. Therefore, they could support cell growth and proliferation at the wounded area. Copyright © 2015 Elsevier B.V. All rights reserved.

Open burn wound dressing: a practical option in resource constrained settings

PubMed Central

Olawoye, O.A.; Osinupebi, O.O.; Ayoade, B.A.

2013-01-01

Summary Various types of wound care products abound for the treatment of burn injuries. Most of these products are rather expensive and beyond the means of many patients in poorer countries. This poses a challenge to burn care workers in these environments and calls for the adoption of practical solutions with the use of less expensive and readily available alternatives. The aim of this study is to review the outcome of our burn patients managed with topical silver sulphadiazine dressing in terms of time to wound healing and length of hospital stay. Consecutive burn patients admitted over a four year period were included in the study. The patients were resuscitated along standard protocols and their wounds were dressed daily with dermazin. The demographic and clinical characteristics of the patients were retrieved and analyzed using the SPSS version 16. The primary outcome measure for the study was the time to complete re-epithelialization of the wounds and discharge of the patients. 144 patients with a M: F ratio of 2.3: 1 were managed during the period. The age range was 4 months to 81.9 years with a median age of 26 years. The TBSA range was 1 to 99% with a median of 28.5%. The mean duration from time of injury to wound healing was 21.5 days with a median of 17 days. Open burn wound dressing with silver sulphadiazine offers a satisfactory outcome and should be considered for burn dressing in low resource settings. PMID:24563642

A systematic review of silver-releasing dressings in the management of infected chronic wounds.

PubMed

Lo, Shu-Fen; Hayter, Mark; Chang, Chee-Jen; Hu, Wen-Yu; Lee, Ling-Ling

2008-08-01

This paper is a systematic review with the objective of determining the effectiveness of silver-releasing dressing in the management of infected chronic wounds. Chronic wounds exhibit increased bacterial burdens which not only result in a negative physical impact on patients, impairing their quality of life, but also increase treatment costs. Silver dressings are wound products designed to control and inhibit infection and provide a wound environment conducive to healing. However, there is limited evidence on their effectiveness in doing so. A systematic review of literature from 1950-May 2007 was conducted using the PubMed, CINAHL, Cochrane, MEDLINE, British Nursing Index, EBSCO Host, OCLC, Proquest and PsychInfo databases. The review included randomised or non-randomised control trials, published in English or non-English, of silver-releasing dressings in infected chronic wounds. Of the over 1957 potentially releasing studies examined, 14 pertinent articles involving 1285 participants were identified. Almost all the participants reported one or more statistically significant outcomes. The main points to emerge from this review of studies are that silver-releasing dressings show positive effects on infected chronic wounds. The quality of the trials was limited by the potential for bias associated with inadequate concealment, no detailed description of the outcome measurement and no reported intention-to-treat analysis. Moreover, problems existed in some studies with confounding factors. The review clearly highlights the need for well-designed, methodologically standardised outcome measurement research into the effectiveness of silver-releasing dressings. It also points to the need for a comprehensive assessment of wound bed status in further studies. This review strengthens the case for the use of silver dressings when managing infected chronic wounds. They appear more effective and are tolerated well by patients. However, their use should be accompanied by a

Role of honey in wound dressing in diabetic foot ulcer.

PubMed

Surahio, Abdul Rashid; Khan, Ashar Ahmad; Farooq, MainUsman; Fatima, Iffat

2014-01-01

Honey has antibacterial and antimicrobial properties. This study was conducted to evaluate the efficacy and role of honey as local wound dressing agent in the management of diabetic foot and its effect on rate of amputation. This prospective observational study was done in the general surgery department, Al- Noor Specialist hospital, Holly Makkah, KSA from 1st March, 2007 to 31st May, 2008 (15 months). This study includes 172 patients of either gender, above 18 years of age, belonging to different nationalities admitted to A1- Noor specialist hospital, Holly Makkah, KSA. A total of 172 patients with male to female ratio 1.54:1 were admitted from 1st March, 2007 to 31st May, 2008 with complicated and non-healing diabetic foot ulcers. Out of these 172 patients, 135 (78.48%) were Saudi and 37 (21.52%) were non Saudi residents with ratio of 3.6:1. After admission and resuscitation, all the patients under went early surgical debridement and dressing with the thick layer of honey locally available. Wounds became healthy within 7-35 days. Three patients (1.75%) underwent big toe amputation and 2 (1.16%) patients under.went below knee amputations. Twenty (11.6%) patients under went split skin grafting to cover the wound while in other patients wound healed by secondary intention. Use of honey significantly reduced rate of amputation and improve wound healing when used for wound dressing in chronic diabetic foot ulcers.

12. Influence of Wound Dressing on the Fracture Healing Effect of Low-Intensity Pulsed Ultrasound (LIPUS).

PubMed

Naruse, Koji; Uchino, Masataka; Hirakawa, Noriko; Toyama, Masahiro; Miyajima, Genyo; Mukai, Manabu; Urabe, Ken; Uchida, Kentaro; Itoman, Moritoshi

2016-08-01

We have conducted a basic study on the influences on ultrasonic properties when LIPUS is applied through wound dressing. According to the results of ex vivo experiments conducted to date, LIPUS showed ultrasonic properties such as transmittance, coefficient of transmission, and a non-uniformity ratio through film wound dressing better than other wound dressing, and it was considered that LIPUS's effect for fracture healing was not influenced by film wound dressing. Then, we discussed the influence on the effect of LIPUS through film wound dressing. Thirty male 8-week-old Sprague-Dawley rats were used for the trial. After creating close transverse femoral fractures on the right legs of these 30 rats, they were divided into 3 groups of 10; LIPUS through wound dressing (Group A), LIPUS without wound dressing (Group B), and No LIPUS treatment (Group C). OPSITE Wound, which was thought to have the least influence on ultrasound properties, was used for this trial. Group A and B received LIPUS for 20 minutes a day from the first day after the fractures. LIPUS was generated from Teijin Pharma's device for a basic experiment. When treating Group A, the wound dressing was pasted on the ultrasound terminal in order to apply LIPUS through the dressing. We assessed the time-oriented morphological change of each group in anesthetized condition using simple radiographs on the 8th, 16th, and 24th day after the fractures. Six rats in Group A, 2 in Group B, and 1 in Group C died in anesthesia, and we discussed the remaining 4 rats in Group A, 8 in Group B, and 9 in Group C. We defined more than one teleost callus bridging as bone-union. We also counted a bone remodeling when we recognized the absorption of existing cortical bone and the transformation of new bone to cortical bone in simple radiographs. As a result, compared with Group C, we recognized that both bone union and remodeling accelerated remarkably in Group B, but not in Group A. It suggested that LIPUS through wound

An in vitro test of the efficacy of an anti-biofilm wound dressing.

PubMed

Said, Jawal; Walker, Michael; Parsons, David; Stapleton, Paul; Beezer, Anthony E; Gaisford, Simon

2014-10-20

Broad-spectrum antimicrobial agents, such as silver, are increasingly being formulated into medicated wound dressings in order to control colonization of wounds by opportunistic pathogens. Medicated wound dressings have been shown in-vitro to be effective against planktonic cultures, but in-vivo bacteria are likely to be present in biofilms, which makes their control and eradication more challenging. Recently, a functional wound dressing (AQUACEL(®) Ag+ Extra™ (AAg + E)) has been developed that in addition to silver contains two agents (ethylenediaminetetraacetic acid (EDTA) and benzethonium chloride (BC)) designed to disrupt biofilms. Here, the efficacy of AAg + E is demonstrated using a biofilm model developed in an isothermal microcalorimeter. The biofilm was seen to remain viable in the presence of unmedicated dressing, silver-containing dressing or silver nitrate solution. In the presence of AAg + E, however, the biofilm was eradicated. Control experiments showed that neither EDTA nor BC alone had a bactericidal effect, which means it is the synergistic action of EDTA and BC disrupting the biofilm with silver being bactericidal that leads to the product's efficacy. Copyright © 2014 Elsevier B.V. All rights reserved.

Antimicrobial cerium ion-chitosan crosslinked alginate biopolymer films: A novel and potential wound dressing.

PubMed

Kaygusuz, Hakan; Torlak, Emrah; Akın-Evingür, Gülşen; Özen, İlhan; von Klitzing, Regine; Erim, F Bedia

2017-12-01

Wound dressings require good antiseptic properties, mechanical strength and, more trustably, natural material ingredients. Antimicrobial properties of cerium ions and chitosan are known and alginate based wound dressings are commercially available. In this study, the advantages of these materials were combined and alginate films were crosslinked with cerium(III) solution and chitosan added cerium(III) solution. Films were characterized by Fourier transform infrared spectroscopy (FTIR), light transmittance, scanning electron microscopy (SEM), swelling experiments, water vapor transmittance tests, and mechanical stretching tests. The antibacterial and physical properties of the films were compared with those of conventional calcium alginate films. Both cerium ion crosslinked and cerium ion-chitosan crosslinked alginate films gained antibacterial activity against Gram-negative (Escherichia coli) and Gram-positive (Staphylococcus aureus) bacteria. Cerium alginate-chitosan films showed high resistance to being deformed elastically. Results show that cerium alginate-chitosan films can be flexible, ultraviolet-protecting, and antibacterial wound dressings. Copyright © 2017 Elsevier B.V. All rights reserved.

Polymer-xerogel composites for controlled release wound dressings.

PubMed

Costache, Marius C; Qu, Haibo; Ducheyne, Paul; Devore, David I

2010-08-01

Many polymers and composites have been used to prepare active wound dressings. These materials have typically exhibited potentially toxic burst release of the drugs within the first few hours followed by a much slower, potentially ineffective drug release rate thereafter. Many of these materials also degraded to produce inflammatory and cytotoxic products. To overcome these limitations, composite active wound dressings were prepared here from two fully biodegradable and tissue compatible components, silicon oxide sol-gel (xerogel) microparticles that were embedded in tyrosine-poly(ethylene glycol)-derived poly(ether carbonate) copolymer matrices. Sustained, controlled release of drugs from these composites was demonstrated in vitro using bupivacaine and mepivacaine, two water-soluble local anesthetics commonly used in clinical applications. By systematically varying independent compositional parameters of the composites, including the hydrophilic:hydrophobic balance of the tyrosine-derived monomers and poly(ethylene glycol) in the copolymers and the porosity, weight ratio and drug content of the xerogels, drug release kinetics approaching zero-order were obtained. Composites with xerogel mass fractions up to 75% and drug payloads as high as 13% by weight in the final material were fabricated without compromising the physical integrity or the controlled release kinetics. The copolymer-xerogel composites thus provided a unique solution for the sustained delivery of therapeutic agents from tissue compatible wound dressings. 2010 Elsevier Ltd. All rights reserved.

Honey/Chitosan Nanofiber Wound Dressing Enriched with Allium sativum and Cleome droserifolia: Enhanced Antimicrobial and Wound Healing Activity.

PubMed

Sarhan, Wessam A; Azzazy, Hassan M E; El-Sherbiny, Ibrahim M

2016-03-01

Two natural extracts were loaded within fabricated honey, poly(vinyl alcohol), chitosan nanofibers (HPCS) to develop biocompatible antimicrobial nanofibrous wound dressing. The dried aqueous extract of Cleome droserifolia (CE) and Allium sativum aqueous extract (AE) and their combination were loaded within the HPCS nanofibers in the HPCS-CE, HPCS-AE, and HPCS-AE/CE nanofiber mats, respectively. It was observed that the addition of AE resulted in the least fiber diameter (145 nm), whereas the addition of the AE and CE combination resulted in the least swelling ability and the highest weight loss. In vitro antibacterial testing against Staphylococcus aureus, Escherichia coli, Methicillin-resistant S. aureus (MRSA), and multidrug-resistant Pseudomonas aeruginosa was performed in comparison with the commercial dressing AquacelAg and revealed that the HPCS-AE and HPCS-AE/CE nanofiber mats allowed complete inhibition of S. aureus and the HPCS-AE/CE exhibited mild antibacterial activity against MRSA. A preliminary in vivo study revealed that the developed nanofiber mats enhanced the wound healing process as compared to the untreated control as proved by the enhanced wound closure rates in mice and by the histological examination of the wounds. Moreover, comparison with the commercial dressing Aquacel Ag, the HPCS, and HPCS-AE/CE demonstrated similar effects on the wound healing process, whereas the HPCS/AE allowed an enhanced wound closure rate. Cell culture studies proved the biocompatibility of the developed nanofiber mats in comparison with the commercial Aquacel Ag, which exhibited noticeable cytotoxicity. The developed natural nanofiber mats hold potential as promising biocompatible antibacterial wound dressing.

Exploratory Development of an Ultrafast-Curing Wound Dressing

DTIC Science & Technology

1988-11-30

removed at will. 0 Control water vapor and oxygen exchange, thus maintaining a moist environment for rapid healing. * Gradually deliver broad-spectrum...removal without precipitating another bjeeding episode, (c) promotion of normal wound healing under moist , aseptic environment, and (d) prevention of...conditions, the field dressing is capable of maintaining the wound moist , but aseptic. And, as explained in the following paragraphs, it is ncm

Beta-glucan-loaded nanofiber dressing improves wound healing in diabetic mice.

PubMed

Grip, Jostein; Engstad, Rolf Einar; Skjæveland, Ingrid; Škalko-Basnet, Nataša; Isaksson, Johan; Basnet, Purusotam; Holsæter, Ann Mari

2018-06-01

The increased prevalence of chronic wounds requires novel treatment options. The aim of this study was to develop a beta-glucan (βG)-loaded nanofiber wound dressing. Nanofibers were prepared using the needle-free Nanospider™ technology, an electrospinning method which enables the production of nanofibers at an industrial scale. The βG was selected as active ingredient based on its confirmed wound healing potential in both animals and humans. Hydroxypropyl methylcellulose (HPMC) and polyethylene oxide (PEO) were included as copolymers. Rheological profiles of spinning solutions containing HPMC, PEO, βG, ethanol and water, were optimized. The nanofiber formation was confirmed by Field Emission Scanning Electron Microscopy (FE-SEM), and both nanofibers with (βG-nanofibers) or without βG (NoβG-nanofibers) were evaluated by their swelling index and FT-IR spectroscopy. The formulations, active ingredient and excipients were tested for their possible in vitro toxicity in keratinocytes. Finally, the wound healing potential of the nanofibers was tested in externally induced excisional wounds in male diabetic db/db mice. Three different doses of βG-nanofibers and the βG-free, NoβG-nanofibers, were evaluated for their in vivo wound healing efficacy. All nanofiber-treatments provided improved wound healing as compared to the negative control (water). All βG-nanofiber treated groups exhibited significantly improved wound healing as compared to the NoβG-nanofiber treated group, indicating the potential of βG-nanofibers as wound dressing. Copyright © 2018 Elsevier B.V. All rights reserved.

Stimulation of Wound Healing by Electroactive, Antibacterial, and Antioxidant Polyurethane/Siloxane Dressing Membranes: In Vitro and in Vivo Evaluations.

PubMed

Gharibi, Reza; Yeganeh, Hamid; Rezapour-Lactoee, Alireza; Hassan, Zuhair M

2015-11-04

A series of novel polyurethane/siloxane-based wound dressing membranes was prepared through sol-gel reaction of methoxysilane end-functionalized urethane prepolymers composed of castor oil and ricinoleic methyl ester as well as methoxysilane functional aniline tetramer (AT) moieties. The samples were fully characterized and their physicochemical, mechanical, electrical, and biological properties were assayed. The biological activity of these dressings against fibroblast cells and couple of microbes was also studied. It was revealed that samples that displayed electroactivity by introduction of AT moieties showed a broad range of antimicrobial activity toward different microorganisms, promising antioxidant (radical scavenging) efficiency and significant activity for stimulation of fibroblast cell growth and proliferation. Meanwhile, these samples showed appropriate tensile strength and ability for maintaining a moist environment over a wound by controlled equilibrium water absorption and water vapor transmission rate. The selected electroactive dressing was subjected to an in vivo assay using a rat animal model and the wound healing process was monitored and compared with analogous dressing without AT moieties. The recorded results showed that the electroactive dressings induced an increase in the rate of wound contraction, promoted collagen deposition, and encouraged vascularization in the wounded area. On the basis of the results of in vitro and in vivo assays, the positive influence of designed dressings for accelerated healing of a wound model was confirmed.

Synthesis and characterization of tragacanth gum based hydrogels by radiation method for use in wound dressing application

NASA Astrophysics Data System (ADS)

Singh, Baljit; Varshney, Lalit; Francis, Sanju; Rajneesh

2017-06-01

Keeping in view the inherent wound healing ability of tragacanth gum (TG), mucoadhesive and gel forming nature of polyvinyl alcohol (PVA) and polyvinyl pyrrolidone (PVP), in the present work, an attempt has been made to prepare the antibiotic drug 'gentamicin' and analgesic drug 'lidocaine' loaded sterile TG-PVA-PVP hydrogel dressings for care of wound infection and wound pain together. These polymers were characterized by cryo-SEM, AFM, FTIR, XRD, 13C NMR, TGA, DSC and swelling studies. Drug release mechanism and kinetic models, network parameters and other properties like haemolysis, mucoadhesion, water vapor permeability, microbial penetration, antioxidant activities and oxygen permeability were also determined. The results showed wound fluid absorption and slow drug release ability of hydrogel films. These polymer films were found to be blood compatible, permeable to water vapor and O2, and impermeable to microorganism. Further, the synergic effects of mucoadhesive, antimicrobial and antioxidant nature of hydrogel dressings will make them suitable candidate for wound management.

Chitosan-aluminum monostearate composite sponge dressing containing asiaticoside for wound healing and angiogenesis promotion in chronic wound.

PubMed

Phaechamud, Thawatchai; Yodkhum, Kotchamon; Charoenteeraboon, Juree; Tabata, Yasuhiko

2015-05-01

There are many factors that delay healing in chronic wounds including lowering level of growth factors and increasing exudate level comprising high amount of tissue destructive enzymes. Asiaticoside possesses interesting wound healing and angiogenic activities that are employed to stimulate tissue regeneration in wound healing application. This study attempted to develop chitosan-aluminum monostearate (Alst) composite sponge containing asiaticoside for use as an absorbent medical dressing in chronic wound. N-methyl-2-pyrrolidone (NMP) was used to enhance homogeneity of asiaticoside in the polymer composite matrix. The sponge dressings were prepared by lyophilization and dehydrothermal treatment (DHT). Functional group interaction, crystallinity, and morphology of the prepared sponges were investigated using FT-IR, PXRD, and SEM, respectively. Physicochemical properties, porosity, hydrophilic/hydrophobic properties and mechanical property, were evaluated. Wound dressing properties, water vapor transmission rate (WVTR), fluid absorbency, oxygen permeation (OP), and bio-adhesive property, were investigated. In vitro asiaticoside release study was conducted using immersion method. Cytotoxicity was studied in normal human dermal fibroblast (NHDF) and normal human epidermal keratinocyte (NHEK). Angiogenic activity of asiaticoside was evaluated using chick-chorioallantoic membrane (CAM) assay. FT-IR and PXRD results revealed the amidation after DHT to enhance the crystallinity of the prepared sponges. The prepared sponges had high porosity comprising high Alst-loaded amount that exhibited more compact structure. Alst enhanced hydrophobicity therefore it reduced the fluid absorption and WVTR together with bio-adhesion of the prepared sponge dressings. Porosity of all sponges was more than 85% therefore resulting in their high OP. Enhancing hydrophobicity of the material by Alst and more homogeneity caused by NMP eventually retarded the asiaticoside release for 7 days. The

Measuring the microbiome of chronic wounds with use of a topical antimicrobial dressing – A feasibility study

PubMed Central

Labbie, Michele; Willing, Benjamin

2017-01-01

Background Polymicrobial communities colonize all wounds, and biofilms are hypothesized to be a key link to the chronic state and stalled healing. Molecular methods offer greater insight when studying microbial ecology in chronic wounds, as only a small fraction of wound bacteria are cultured by currently available methods and studies have shown little agreement between culture and molecular based approaches. Some interventions, like dressings with oxidized silver, are reported to help the stalled wounds move to a normal healing trajectory but the underlying mechanisms are difficult to measure. One hypothesis is that the use of topical antimicrobial dressings targets the wound microbiome and reduces bioburden. Objectives Our objective was to determine if culture-independent molecular methods could be used to identify the microbial composition in chronic wounds, and measure the microbiome over time when a topical antimicrobial dressing is used to reduce bioburden. Methods Patients with chronic wounds defined as >6 weeks in duration and not taking systemic antibiotics were recruited to participate. A wound contact layer containing silver oxynitrate was applied immediately after routine sharp debridement material was collected and swabs of the wound bed taken. Next-generation sequencing of the bacterial 16S rRNA gene in each specimen was used to measure the microbiome. Results Distinct bacterial communities were observed between swab and debridement samples, highlighting spatial differences and the importance of sampling consistency. The microbial communities appeared to be similar between different diabetes statuses, but different among the three wound categories included. Conclusions Culture-independent methods can be applied to measure the microbiome of chronic wounds even when a topical antimicrobial dressing is applied to the wound. PMID:29155834

Situating wound management: technoscience, dressings and 'other' skins.

PubMed

Rudge, T

1999-09-01

This paper addresses the notion of wound care as a technology of skin and other skins imbued with the combined power of technology and science. It presents the discourses of wound care evident in the accounts of patients and nurses concerning this care, and discussions about wounds in wound care interest groups, journals, and advertising material about wound care products. The discussion focuses on wounds and wound dressings as effects immanent in the power relations of discourses of wound care. These effects colour and influence nurses' responses to wounds and wound care products. Moreover, the discourses that portray these practices are evidence of the complex articulation between technoscience and gender. Nurses and patients are fascinated by wound technoscience and lured towards it by its potential for mastery and control over wounds. Such seductions are evident in the texts of nurses, patients, and pharmaceutical advertisements for wound care products. Finally, the ways that these representations are used to talk about and market wound care products are shown as exemplifying the finer points of wound management as a nursing technoscience.

Role of natural polysaccharides in radiation formation of PVA hydrogel wound dressing

NASA Astrophysics Data System (ADS)

Varshney, Lalit

2007-02-01

Radiation processed PVA-polysaccharides hydrogels have been observed to be suitable for producing transparent, flexible, mechanically strong, biocompatible, effective and economical hydrogel dressings. The dressings were formed in single stage irradiation process achieving gel formation and sterilization at 25-30 kGy gamma radiation dose. No synthetic plasticizers and additives were used. Different formulations containing poly-vinylalcohol (PVA) and polysaccharides selected from combinations of agar and carrageenan were used to make the dressings. The selected polysaccharides themselves form thermo-reversible gels and degrade on irradiation. Using concentration of polysaccharides as low as 0.5-2% resulted in increase of tensile strength from 45 g/cm 2 to 411 g/cm 2, elongation from 30% to 410% and water uptake from 25% to 157% with respect to PVA gel without polysaccharides. Besides improving mechanical strength, agar contributes more to elongation and carrageenan to mechanical strength of the gel dressing. PVA formulations containing the polysaccharides show significantly different pre-gel viscosities behaviour. Increasing the concentration of agar in the formulation to about 2% converts the sheet gel to paste gel useful for filling wound cavities. The results indicate that pre irradiation network structure of the formulation plays an important role in determining mechanical properties of the irradiated gel dressing. Formulations containing 7-9% PVA, 0.5-1.5% carrageenan and 0.5-1% agar gave highly effective usable hydrogel dressings. Scanning electron micrographs show highly porous structure of the gel. Clinical trials of wound dressing on human patients established safety and efficacy of the dressing. The dressing has been observed to be useful in treating burns, non-healing ulcers of diabetes, leprosy and other external wounds. The dressings are now being marketed in India under different brand names.

OUTCOME OF FOAM VERSUS GAUZE DRESSINGS IN NEGATIVE PRESSURE WOUND THERAPY FOR THE MANAGEMENT OF ACUTE TRAUMATIC WOUNDS WITH SOFT TISSUE LOSS AT KENYATTA NATIONAL HOSPITAL.

PubMed

Ondieki, J G; Khainga, S O; Owilla, F; Nangole, F W

2012-07-01

Wounds have provided a challenge to the clinicians for centuries and this scenario persists to the 21st century. Negative pressure wound therapy (NPWT) is one of the latest additions in wound management. It has been widely adopted in developed countries with foam as the default wound dressing although it has some limitations. To determine the difference in outcomes between the use of gauze versus foam as wound dressing in NPWT for the management of acute traumatic wounds with soft tissue loss. Prospective randomised comparative interventional study. Kenyatta National Hospital Orthopaedic and Surgical wards. All patients aged above 12 years with Class III and Class IV acute traumatic wounds. The main outcome measure is the time taken to achieve 100% wound granulation. Comparisons were also made on the mean pain scores during dressing change and the percentage change in wound surface area. Wounds took an average of 8.4 days in the gauze group and 8.1 days in the foam group (p = 0.698) to achieve full granulation. The percentage change in wound surface area was 5.3 versus 5.5 (P = 0.769) in the gauze and foam groups respectively. The infection rates were comparable between the two groups (28% for gauze and 23.1% for foam, p = 0.697) and there was no significant difference in the median pain scores (gauze = 4.5, foam = 4.8 with p = 0.174). However, outcomes with gauze dressing were influenced significantly by the time to application of NPWT, initial wound surface area and wound infection while with foam dressing outcomes tended to be affected less so by the above factors. In the use of NPWT for the management of acute traumatic wounds, there is no difference in terms of time to full wound granulation, change in wound surface area, wound infection and pain during dressing change whether gauze or foam is used as the wound dressing material.

The effectiveness of silver-releasing dressings in the management of non-healing chronic wounds: a meta-analysis.

PubMed

Lo, Shu-Fen; Chang, Chee-Jen; Hu, Wen-Yu; Hayter, Mark; Chang, Yu-Ting

2009-03-01

The purpose of this study was to examine the efficacy of silver-releasing dressings in the management of non-healing chronic wounds. Non-healing chronic wounds often have a negative physical impact on patients and place a financial burden on healthcare systems. Silver dressings are wound products designed to control infection and provide a wound environment conducive to healing. However, validation of the clinical efficacy of these dressings is lacking. Systematic review and meta-analysis. A systematic search of the major electronic databases PubMed, CINAHL, Cochrane, MEDLINE, British Nursing Index, EBSCO, OCLC and Proquest between 1950-June 2007 was conducted. Hand searches of selected periodicals, textbooks and checking reference lists and contacting experts was also performed. Eight studies were selected from a potentially relevant 1957 references screened. Analysis incorporated data from 1399 participants in the eight randomised control trials. We found that silver dressings significantly improved wound healing (CI(95): 0.16-0.39, p < 0.001), reduced odour (CI(95): 0.24-0.52, p < 0.001) and pain-related symptoms (CI(95): 0.18-0.47, p < 0.001), decreased wound exudates (CI(95): 0.17-0.44, p < 0.001) and had a prolonged dressing wear time (CI(95): 0.19-0.48, p = 0.028) when compared with alternative wound management approaches. An analysis of sensitivity in these studies by subgroup analysis generally supported these associations. Furthermore, studies indicated an improvement in quality of life (CI(95): 0.04-0.33, p = 0.013) using silver dressings in wound management with no associated severe adverse events. This meta-analysis confirms the effectiveness of silver dressings in wound healing and improving patients' quality of life. However, it also highlights the need for additional well-designed randomised controlled trials to evaluate the effectiveness of silver-related dressings further. The results of this study provide objective data on the effectiveness of

Clinical potential of a silk sericin-releasing bioactive wound dressing for the treatment of split-thickness skin graft donor sites.

PubMed

Siritientong, Tippawan; Angspatt, Apichai; Ratanavaraporn, Juthamas; Aramwit, Pornanong

2014-01-01

An ethyl alcohol-precipitated silk sericin/PVA scaffold that controlled the release of silk sericin was previously developed and applied for the treatment of full-thickness wounds in rats and demonstrated efficient healing. In this study, we aimed to further evaluate the clinical potential of this scaffold, hereafter called "silk sericin-releasing wound dressing", for the treatment of split-thickness skin graft donor sites by comparison with the clinically available wound dressing known as "Bactigras®". In vitro characterization and in vivo evaluation for safety of the wound dressings were performed. A clinical trial of the wound dressings was conducted according to standard protocols. The sericin released from the wound dressing was not toxic to HaCat human keratinocytes. A peel test indicated that the silk sericin-releasing wound dressing was less adhesive than Bactigras®, potentially reducing trauma and the risk of repeated injury upon removal. There was no evidence of skin irritation upon treatment with either wound dressing. When tested in patients with split-thickness skin graft donor sites, the wounds treated with the silk sericin-releasing wound dressing exhibited complete healing at 12 ± 5.0 days, whereas those treated with Bactigras® were completely healed at 14 ± 5.2 days (p = 1.99 × 10(-4)). In addition, treatment with the silk sericin-releasing wound dressing significantly reduced pain compared with Bactigras® particularly during the first 4 postoperative days (p = 2.70 × 10(-5) on day 1). We introduce this novel silk sericin-releasing wound dressing as an alternative treatment for split-thickness skin graft donor sites.

Comprehensive In Situ Killing of Six Common Wound Pathogens With Manuka Honey Dressings Using a Modified AATCC-TM100.

PubMed

Watson, Denis; Bergquist, Stephen; Nicholson, Julie; Norrie, David H

2017-06-28

While Manuka honey in vitro is strongly antimicrobial, there have been, to the best of the authors' knowledge, no studies showing that dressings impregnated with Manuka honey can kill organisms in the dressing itself. The investigators used the American Association of Textile Chemists and Colorists' 100 test methodology to compare honey-impregnated dressings with control dressings (without honey) on the ability to kill common wound pathogens. Organisms were chosen after a review of the causal organisms found in actual wound infections over a 12-month period in a busy outpatient wound clinic. Even when the dressings were challenged daily with further inoculated organisms, > 5-log reductions were routinely noted across a range of pathogens, including multiple drug-resistant species using dressings containing Manuka honey relative to the control. The results presented herein show that when well-characterized medical-grade Manuka honey is used in dressings (ie, a minimum of 400 mg methylglyoxal/kg) these dressings can comprehensively kill common wound pathogens associated with infected wounds.

Chitosan-containing hydrogel wound dressings prepared by radiation technique

NASA Astrophysics Data System (ADS)

Mozalewska, Wiktoria; Czechowska-Biskup, Renata; Olejnik, Alicja K.; Wach, Radoslaw A.; Ulański, Piotr; Rosiak, Janusz M.

2017-05-01

The aim of the study was to develop an antimicrobial hydrogel wound dressing by means of radiation-initiated crosslinking of hydrophilic polymers, i.e. by well-established technology comprising gel manufacturing and its sterilization in one process. The approach included admixture of chitosan of relatively low molecular weight dissolved in lactic acid (LA) into the initial regular components of the conventional hydrogel dressing based on poly(N-vinyl pyrrolidone) (PVP) and agar. Molecular weight of chitosan was regulated by radiation-initiated degradation in the range of 39-132 kg mol-1. Optimum total concentration of LA in the resultant hydrogel dressing was evaluated as 0.05 mol dm-3, that is ca. 0.5%. Presence of LA in the system influenced essential radiation and technological parameters of hydrogel manufacturing. The setting temperature of the pre-hydrogel mixture, resulting from agar ability to congeal, was reduced with LA concentration, yet remained significantly above the room temperature. 0.5% of chitosan was effectively dissolved in aqueous solution of lactic acid due to its pH (lower than 5.5). Radiation parameters of PVP crosslinking in the presence of LA, as determined with generalized Charlesby-Pinner equation, were reflected in slight reduction of the maximum gel fraction and increase in gelation dose and in the factor comparing yields of scission to crosslinking. Nevertheless, essentially physical characteristics of the hydrogel was not affected, except for somewhat increased water uptake capacity, what in turn improves functionality of the dressing as extensive exudate for the wound can be efficiently absorbed. Preliminary microbiological studies showed antimicrobial character of the chitosan-containing hydrogel towards Gram-positive bacterial strain.

Hydroxyethyl cellulose hydrogel for wound dressing: Fabrication, characterization and in vitro evaluation.

PubMed

El Fawal, Gomaa F; Abu-Serie, Marwa M; Hassan, Mohamed A; Elnouby, Mohamed S

2018-05-01

In this study, new hydrogel membranes were developed based on hydroxyethyl cellulose (HEC) supplemented with tungsten oxide for further implementing in wound treatment. HEC hydrogel membranes were fabricated and crosslinked using citric acid (CA). Various tests were carried out including FTIR, XRD, porosity measurements, swelling, mechanical properties, gel fraction, and thermal gravimetric analysis to evaluate the efficiency of the prepared membranes as wound dressing material. In addition, wound healing activity of the examined membranes for human dermal fibroblast cell line was investigated employing in vitro scratching model. Furthermore, the potency of the prepared membranes to suppress wound complications was studied via determination of their anti-inflammatory and antibacterial activities exploiting MTT, ELISA, and disk agar diffusion methods. The results demonstrated that the HEC hydrogel membranes revealed an anti-inflammatory and antibacterial efficacy. Moreover, HEC improved the safety of tungsten oxide toward normal human cells (white blood cells and dermal fibroblast). Furthermore, HEC membranes loaded with WO 3 revealed the highest activities against Salmonella sp. pursued by P. aeruginosa in compared with the negative HEC hydrogel membrane. The current approach corroborated that HEC amended by tungsten oxide could be applied as a promising safe candidate for wound dressing material. Copyright © 2018 Elsevier B.V. All rights reserved.

Polymeric Multilayers that Localize the Release of Chlorhexidine from Biologic Wound Dressings

PubMed Central

Agarwal, Ankit; Nelson, Tyler B.; Kierski, Patricia R.; Schurr, Michael J.; Murphy, Christopher J.; Czuprynski, Charles J.; McAnulty, Jonathan F.; Abbott, Nicholas L.

2012-01-01

Biologic wound dressings contain animal-derived components and are susceptible to high infection rates. To address this issue, we report an approach that permits incorporation of non-toxic levels of the small-molecule antiseptic ‘chlorhexidine’ into biologic dressings. The approach relies on the fabrication of polyelectrolyte multilayer (PEMs) films containing poly(allylaminehydrochloride) (PAH), poly(acrylicacid) (PAA), and chlorhexidine acetate (CX) on elastomeric poly(dimethylsiloxane) (PDMS) sheets. The PEMs (20-100 nm thick) are subsequently stamped onto the wound-contact surface of a synthetic biologic dressing, Biobrane, which contains collagen peptides. Chlorhexidine loading in the PEMs was tailored by tuning the number of (CX/PAA) bilayers deposited, providing burst release of up to 0.98±0.06 μg/cm2 of CX over 24 h, followed by zero order release of 0.35±0.04 μg/cm2/day for another week. Although the CX concentrations released were below the reported in vitro cytotoxicity limit (5 μg/mL over 24 h) for human dermal fibroblasts, they killed 4 log10 counts of pathogenic bacteria Staphylococcus aureus in solution. The CX/PEMs could be stamped onto Biobrane with high efficiency to provide CX release kinetics and in-vitro antibacterial activity similar to that on PDMS stamps. In a full-thickness ‘splinted’ dermal wound-model in normal wild-type mice, the CX-functionalized Biobrane showed no decrease in either its adherence to the wound-bed or wound-closure rate over 14 days. The murine wounds topically inoculated with ~105 CFU/cm2 of S. aureus and treated with CX-functionalized Biobrane demonstrated a 3 log10 decrease in the wound's bacterial burden within 3 days, compared to persistent bacterial colonization found in wounds treated with unmodified Biobrane (n=10 mice, p<0.005). Overall, this study presents a promising approach to prevent bacterial colonization in wounds under biologic dressings. PMID:22784602

Terbinafine-loaded wound dressing for chronic superficial fungal infections.

PubMed

Paskiabi, Farnoush Asghari; Bonakdar, Shahin; Shokrgozar, Mohammad Ali; Imani, Mohammad; Jahanshiri, Zahra; Shams-Ghahfarokhi, Masoomeh; Razzaghi-Abyaneh, Mehdi

2017-04-01

In spite of developing new drugs and modern formulations, the treatments of chronic fungal infections are still challenging. Fibrous wound dressings are new suggestions for the treatment of chronic superficial infections. In the present study, we formulated an antifungal agent, terbinafine hydrochloride (TFH), which is a hydrophobic drug, in wound dressings prepared by electrospun polycaprolactone, polycaprolactone/gelatin (50:50 w/w) and gelatin. To obtain more water-stable meshes, the preparations were treated by glutaraldehyde and their properties were determined before and after treatment. The morphology of fibrous meshes was observed by scanning electron microscopy. Drug loading efficiency and release rate were measured by high performance liquid chromatography (HPLC) and the release rate was monitored for 144h. Antifungal tests were performed on Trichophyton mentagrophytes, Aspergillus fumigatus and Candida albicans cultured on Muller-Hinton agar. The toxicity of the meshes was measured after 24h and 14days by MTT assay. Terbinafine loading of polycaprolactone/gelatin (50:50) was 100% and it released the highest amount of TFH too. In antifungal tests, all samples were able to hinderT. mentagrophytes and A. fumigatus but not C. albicans growth among them, polycaprolactone fibers made the largest inhibition zone. In MTT assay, none of prepared samples showed toxicity against L929 cells. Teken together, the prepared TFH-loaded PCL/gelatin electrospun meshes were able to release TFH slowly and in a steady state in time. With respect to no obvious cytotoxicity in MTT assay and stong antifungal activity toward T. mentagrophytesin vitro, these TFH-based meshes could be considered as potential candidates in clinical application as wound dressing for treatment of chronic dermatophytosis. Copyright © 2016 Elsevier B.V. All rights reserved.

Clinical safety and effectiveness evaluation of a new antimicrobial wound dressing designed to manage exudate, infection and biofilm.

PubMed

Metcalf, Daniel G; Parsons, David; Bowler, Philip G

2017-02-01

The objective of this work was to evaluate the safety and effectiveness of a next-generation antimicrobial wound dressing (NGAD; AQUACEL ® Ag+ Extra™ dressing) designed to manage exudate, infection and biofilm. Clinicians were requested to evaluate the NGAD within their standard protocol of care for up to 4 weeks, or as long as deemed clinically appropriate, in challenging wounds that were considered to be impeded by suspected biofilm or infection. Baseline information and post-evaluation dressing safety and effectiveness data were recorded using standardised evaluation forms. This data included wound exudate levels, wound bed appearance including suspected biofilm, wound progression, skin health and dressing usage. A total of 112 wounds from 111 patients were included in the evaluations, with a median duration of 12 months, and biofilm was suspected in over half of all wounds (54%). After the introduction of the NGAD, exudate levels had shifted from predominantly high or moderate to low or moderate levels, while biofilm suspicion fell from 54% to 27% of wounds. Wound bed coverage by tissue type was generally shifted from sloughy or suspected biofilm towards predominantly granulation tissue after the inclusion of the NGAD. Stagnant (65%) and deteriorating wounds (27%) were shifted to improved (65%) or healed wounds (13%), while skin health was also reported to have improved in 63% of wounds. High levels of clinician satisfaction with the dressing effectiveness and change frequency were accompanied by a low number of dressing-related adverse events (n = 3; 2·7%) and other negative observations or comments. This clinical user evaluation supports the growing body of evidence that the anti-biofilm technology in the NGAD results in a safe and effective dressing for the management of a variety of challenging wound types. © 2016 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Composite wound dressings of pectin and gelatin with aloe vera and curcumin as bioactive agents.

PubMed

Tummalapalli, Mythili; Berthet, Morgane; Verrier, Bernard; Deopura, B L; Alam, M S; Gupta, Bhuvanesh

2016-01-01

Aloe vera and curcumin loaded oxidized pectin-gelatin (OP-Gel) matrices were used as antimicrobial finishes on nonwoven cotton fabrics to produce composite wound care devices. The drug release characteristics of the biocomposite dressings indicated that curcumin is released through a biphasic mechanism - erosion of the polymeric matrix, followed by diffusion, while aloe vera is released upon leaching of the polymeric matrix. A 50/50 composition of aloe vera/curcumin was used to fabricate OP-Gel-Aloe Curcumin dressings. However, contrary to our expectations, OP-Gel-Aloe Curcumin dressings exhibited lesser antimicrobial activity compared to OP-Gel-Aloe and OP-Gel-Curcumin dressings. The cytocompatibility of the fabricated dressings was evaluated using NIH3T3 mouse fibroblast cells. OP-Gel-Aloe treated fibroblasts had the highest viability, with the matrices providing a substrate for good cell attachment and proliferation. On the other hand, OP-Gel-Curcumin and OP-Gel-Aloe Curcumin seemed to have induced apoptosis in NIH3T3 cells. In vivo wound healing analysis was carried out using an excisional splint wound model on C57BL/6J mice. OP-Gel-Aloe treated wounds exhibited very rapid healing with 80% of the wound healing in just 8 days. Furthermore, aloe vera exerted a strong anti-inflammatory effect and prominent scar prevention. Histological examination revealed that an ordered collagen formation and neovascularization could be observed along with migration of nuclei. Therefore, OP-Gel-Aloe biocomposite dressings are proposed as viable materials for effective wound management. Copyright © 2015 Elsevier B.V. All rights reserved.

In vitro microbial inhibition and cellular response to novel biodegradable composite wound dressings with controlled release of antibiotics.

PubMed

Elsner, J J; Berdicevsky, I; Zilberman, M

2011-01-01

About 70% of all people with severe burns die from related infections, despite advances in treatment regimens and the best efforts of nurses and doctors. Although silver-eluting wound dressings are available for addressing this problem, there is growing evidence of the deleterious effects of such dressings in delaying the healing process owing to cellular toxicity. A new concept of antibiotic-eluting composite wound dressings is described here. These dressings are based on a polyglyconate mesh coated with a porous poly-(dl-lactic-co-glycolic acid) matrix loaded with antibiotic drugs. The effect of antibiotic release on bacterial inhibition was studied, and cell cytotoxicity was examined. The dressings resulted in a 99.99% decrease in the viable counts of Pseudomonas aeruginosa and Staphylococcus albus at very high initial inoculations of 10⁷-10⁸ CFU ml⁻¹ after only 1 day, while such a decrease in Staphylococcus aureus was obtained within 3 days. Bacterial inhibition zones around the dressing material were found to persist for 2 weeks, indicating a long-lasting antimicrobial effect. Despite severe toxicity to bacteria, the dressing material was found to have no toxic effect on cultured fibroblasts, indicating that the new antibiotic-eluting wound dressings represent an effective option for selective treatment of bacterial infections. Copyright © 2010 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

[Healing of a deep skin wound using a collagen sponge as dressing in the animal experiment].

PubMed

Sedlarik, K M; Schoots, C; Oosterbaan, J A; Klopper, J P

1992-10-01

The high number of available wound dressing materials as well as the scientific reports about the topic indicates that the problem of an ideal wound dressing is not jet solved. In the last thirty years lot of scientific reports about collagen as wound covering has been published. The positive effect of collagen by his application on a wound ist well known. We investigated the effect of a collagen sponge on healing of full thickness skin wound in guinea pig. The animals were divided in two control groups and two experimental groups. In the control group there were air exposed wounds and another wounds covered with paraffin gauze. In the experimental groups were such wounds covered with natural reconstituted collagen sponge as well as wounds covered with chemically prepared collagen sponge with hexamethyldiisocyanat. The results were compared. The air exposed wounds healed in 50 days, the wounds covered with paraffin gauze healed in 48 days. By covering the wounds with collagen sponge the healing was shortened in 24 or 27 days respectively. Not only the healing time was shortened but also the quality of the wound repair by dressing the wounds with collagen sponge was enhanced.

Comparison of Negative Pressure Wound Therapy and Silver-Coated Foam Dressings in Open Wound Treatment in Dogs: A Prospective Controlled Clinical Trial.

PubMed

Nolff, Mirja C; Albert, Rebecca; Reese, Sven; Meyer-Lindenberg, Andrea

2018-06-11

 To evaluate negative pressure wound therapy (NPWT) for treatment of complicated wounds in dogs.  Prospective randomized clinical study MATERIALS AND METHODS:  Dogs ( n  = 26) undergoing open-wound treatment were randomly assigned to one of two groups: Group A ( n  = 13) NPWT; Group B ( n  = 13) silver-coated foam dressing. Pairs of patients were matched based on wound conformation, localization, and underlying cause and compared in terms of duration of previous treatment, development of wound size (wound planimetry), time to closure, bacterial bio-burden and complications. Wound dressing changes were performed every 3 days during the first 9 days of therapy for both groups. Statistical analysis was performed.  Pre-treatment signalment and bacterial status were comparable between groups. Total time to closure was significantly ( p  = 0.018) shorter in Group A (14.2 days) compared with Group B (28.6 days), and wound planimetry on days 3, 6 and 9 showed significant greater reduction in total wound area for Group A at all-time points ( p  < 0.05). Furthermore, wounds in Group A showed less progression of local infection than did wounds in Group B ( p  = 0.01).  NPWT-treated wounds showed faster closure, improved macro-deformation and less local signs of infection. Schattauer GmbH Stuttgart.

Randomized Clinical Trial of the Innovative Bilayered Wound Dressing Made of Silk and Gelatin: Safety and Efficacy Tests Using a Split-Thickness Skin Graft Model

PubMed Central

Hasatsri, Sukhontha; Angspatt, Apichai

2015-01-01

We developed the novel silk fibroin-based bilayered wound dressing for the treatment of partial thickness wounds. And it showed relevant characteristics and accelerated the healing of full-thickness wounds in a rat model. This study is the clinical evaluation of the bilayered wound dressing to confirm its safety and efficacy for the treatment of split-thickness skin donor sites. The safety test was performed using a patch model and no evidence of marked and severe cutaneous reactions was found. The efficacy test of the bilayered wound dressing was conducted on 23 patients with 30 split-thickness skin graft donor sites to evaluate healing time, pain score, skin barrier function, and systemic reaction in comparison to Bactigras. We found that the healing time of donor site wounds treated with the bilayered wound dressing (11 ± 6 days) was significantly faster than those treated with Bactigras (14 ± 6 days) (p = 10−6). The wound sites treated with the bilayered wound dressing showed significantly less pain and more rapid skin functional barrier recovery than those treated with Bactigras (p = 10−5). Therefore, these results confirmed the clinical safety and efficacy of the bilayered wound dressing for the treatment of split-thickness skin graft donor sites. PMID:26221170

The safety and efficacy of bacterial nanocellulose wound dressing incorporating sericin and polyhexamethylene biguanide: in vitro, in vivo and clinical studies.

PubMed

Napavichayanun, Supamas; Yamdech, Rungnapha; Aramwit, Pornanong

2016-03-01

In our previous work, we have attempted to develop a novel bacterial nanocellulose wound dressing which composed of both polyhexamethylene biguanide (PHMB) as an antimicrobial agent and sericin as an accelerative wound healing component. The loading sequence and concentration of PHMB and sericin were optimized to provide the wound dressing with the most effective antimicrobial activity and enhanced collagen production. In this study, further in vitro, in vivo, and clinical studies of this novel wound dressing were performed to evaluate its safety, efficacy, and applicability. For the in vitro cytotoxic test with L929 mouse fibroblast cells, our novel dressing was not toxic to the cells and also promoted cell migration as good as the commercially available dressing, possibly due to the component of sericin released. When implanted subcutaneously in rats, the lower inflammation response was observed for the novel dressing implanted, comparing to the commercially available dressing. This might be that the antimicrobial PHMB component of the novel dressing played a role to reduce infection and inflammation reaction. The clinical trial patch test was performed on the normal skin of healthy volunteers to evaluate the irritation effect of the dressing. Our novel dressing did not irritate the skin of any volunteers, as characterized by the normal levels of erythema and melanin and the absence of edema, papule, vesicle, and bullae. Then, the novel dressing was applied for the treatment of full-thickness wounds in rats. The wounds treated with our novel dressing showed significantly lower percentage of wound size and higher extent of collagen formation mainly due to the activity of sericin. We concluded that our novel bacterial nanocellulose incorporating PHMB and sericin was a safe and efficient wound dressing material for further investigation in the wound healing efficacy in clinic.

Enhancing in situ hydrogen peroxide generation of greige cotton nonwoven wound dressings via ascorbate stabilized copper micro- and nano-particles

USDA-ARS?s Scientific Manuscript database

Understanding how wound dressings may be designed to address critical unsolved issues in wound repair and treatment influences the development of dressings and new concepts of promoting healing. The vast majority of commercial dressing materials focus on the physical aspects of wounds, e.g., acting ...

The accelerating effect of chitosan-silica hybrid dressing materials on the early phase of wound healing.

PubMed

Park, Ji-Ung; Jung, Hyun-Do; Song, Eun-Ho; Choi, Tae-Hyun; Kim, Hyoun-Ee; Song, Juha; Kim, Sukwha

2017-10-01

Commercialized dressing materials with or without silver have played a passive role in early-phase wound healing, protecting the skin defects from infections, absorbing exudate, and preventing dehydration. Chitosan (CTS)-based sponges have been developed in pure or hybrid forms for accelerating wound healing, but their wound-healing capabilities have not been extensively compared with widely used commercial dressing materials, providing limited information in a practical aspect. In this study, we have developed CTS-silica (CTS-Si) hybrid sponges with water absorption, flexibility, and mechanical behavior similar to those of CTS sponges. In vitro and in vivo tests were performed to compare the CTS-Si sponges with three commercial dressing materials [gauze, polyurethane (PU), and silver-containing hydrofiber (HF-Ag)] in addition to CTS sponges. Both in vitro and in vivo tests showed that CTS-Si sponges promoted fibroblast proliferation, leading to accelerated collagen synthesis, whereas the CTS sponges did not exhibit significant differences in fibroblast proliferation and collagen synthesis from gauze, PU, and HF-Ag sponges. In case of CTS-Si, the inflammatory cells were actively recruited to the wound by the influence of the released silicon ions from CTS-Si sponges, which, in return, led to an enhanced secretion of growth factors, particularly TGF-β during the early stage. The higher level of TGF-β likely improved the proliferation of fibroblasts, and as a result, collagen synthesis by fibroblasts became remarkably productive, thereby increasing collagen density at the wound site. Therefore, the CTS-Si hybrid sponges have considerable potential as a wound-dressing material for accelerating wound healing. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 1828-1839, 2017. © 2016 Wiley Periodicals, Inc.

A Post-marketing Surveillance Study of Chronic Wounds Treated With a Native Collagen Calcium Alginate Dressing.

PubMed

Sabo, Matthew; Le, Lam; Yaakov, Raphael A; Carter, Marissa; Serena, Thomas E

2018-04-01

Chronic wounds (ie, wounds that fail to progress through a normal, orderly, timely sequence of repair) continue to pose significant clinical and economic burdens. A prospective, descriptive, 3-week post-marketing surveillance study was conducted across 3 wound care centers in the United States to evaluate the effectiveness of a collagen calcium alginate dressing on chronic wounds in conjunction with standard care (SC) practices (eg, offloading, debridement, compression) to support healing. Eligible participants had to be >18 years of age, have at least 1 chronic wound, and no known sensitivity to collagen. Demographic characteristics were recorded at the screening visit on case report forms. At each visit, wound-related pain was assessed using the Visual Analog Scale along with wound characteristics including size (using digital planimetry), wound exudate (minimal, moderate, heavy), and odor (none, mild). Participants were monitored for adverse events as well as infection based on signs and symptoms in and around the local wound bed, the deeper structures, and the surrounding skin. An intention-to-treat approach was used for all analyses. If an observation was missing, the last observation carried forward principle was used. For wounds that healed, pain and exudate were set to 0 (no pain/exudate) at visit 4. Descriptive, paired t tests and the Wilcoxon signed rank test were used to analyze the data. Of the 31 participants (15 men, 16 women, mean age 66.6 years), most (13, 42%) had a diabetic foot ulcer or venous leg ulcer (10, 32%); median duration of all wounds was 148 days. Thirty (30) patients completed the study. The mean number of comorbidities was 10.6 ± 6.3, and patients used a mean of 9.3 ± 5.64 prescription or over-the-counter medications. For all wounds combined, mean wound area was 4.8 ± 8.38 cm2 at baseline. At week 3, a decrease in wound area of 38.1% was noted (median: 45% ± 42.54; P = .006); 3 wounds healed completely. The change in wound exudate

Hybrid Nanoscale Architecture of Wound Dressing with Super Hydrophilic, Antimicrobial, and Ultralow Fouling Attributes.

PubMed

Depan, D; Misra, R D K

2015-02-01

Currently available wound dressings to heal thermal and chronic wounds are unable to respond to the challenges of resistance to bacterial infection, protein adsorption, and increased levels of wound exudates. To this end, we have conceived the fabrication of a new and ideal wound dressing with a number of key attributes. They include effective antimicrobial activity in a controlled manner, ultralow fouling property that provides resistance to protein adsorption and bacterial adhesion, maintain a moist but not saturated environment to promote healing, and is non-adherent and effective in the presence of heavy wound exudate. The novel approach to reduce infection and bacterial colonization involves incorporation of a unique silver-clay nanohybrid architecture in zwitterionic polymer, poly(sulfobetaine). The innovative concept of silver-clay hybrid structure enables us to obtain high, sustained, and diffusion-controlled antimicrobial activity of silver eluting polymer. The sustained and diffusion-controlled high antimicrobial efficiency is obtained through a process involving in situ precipitation of silver nanoparticles with large surface area on the surface of clay platelets. Furthermore, the use of recently developed zwitterionic polymer, poly(sulfobetaine) [poly(SB)] for wound dressing, provides antifouling property, which resists protein adsorption.

The multifunctional wound dressing with core-shell structured fibers prepared by coaxial electrospinning

NASA Astrophysics Data System (ADS)

Wei, Qilin; Xu, Feiyang; Xu, Xingjian; Geng, Xue; Ye, Lin; Zhang, Aiying; Feng, Zengguo

2016-06-01

The non-woven wound dressing with core-shell structured fibers was prepared by coaxial electrospinning. The polycaprolactone (PCL) was electrospun as the fiber's core to provide mechanical strength whereas collagen was fabricated into the shell in order to utilize its good biocompatibility. Simultaneously, the silver nanoparticles (Ag-NPs) as anti-bacterial agent were loaded in the shell whereas the vitamin A palmitate (VA) as healing-promoting drug was encapsulated in the core. Resulting from the fiber's core-shell structure, the VA released from the core and Ag-NPs present in the shell can endow the dressing both heal-promoting and anti-bacteria ability simultaneously, which can greatly enhance the dressing's clinical therapeutic effect. The dressing can maintain high swelling ratio of 190% for 3 d indicating its potential application as wet dressing. Furthermore, the dressing's anti-bacteria ability against Staphylococcus aureus was proved by in vitro anti-bacteria test. The in vitro drug release test showed the sustainable release of VA within 72 h, while the cell attachment showed L929 cells can well attach on the dressing indicating its good biocompatibility. In conclusion, the fabricated nanofibrous dressing possesses multiple functions to benefit wound healing and shows promising potential for clinical application.

Evaluating a native collagen matrix dressing in the treatment of chronic wounds of different aetiologies: a case series.

PubMed

Ricci, E; Cutting, K F

2016-11-02

To collate clinical evidence on the use of a native collagen matrix dressing, consisting of a fibrillary collagen network, in patients with a variety of chronic wounds. Patients whose wounds had not improved in the eight weeks before the beginning of the evalutaion were recruited. All participants had their dressings changed twice weekly and received standard adjunctive wound care as part of their treatment. Data, collected over a 4-week period, included: patient demographics, wound surface area measurements, Bates-Jensen score, level of wound pain, wound infection status, wound bed preparation staging score, depth of wound according to tissue type, and photographic imaging of patients' wounds. We recruited 19 patients with 20 wounds and a mean wound duration of 66.6 months (range: 4-480 months). There was a mean decrease in wound surface area of 29% (median reduction: 47%). A reduction in the Bates-Jensen score was demonstrated in 85% of cases. Wound pain reduced by 66.66% and the wound bed preparation score reduced in 16 wounds with four remaining static. No adverse events arose. This case series provides clinical evidence on the use of a native collagen matrix dressing in the management of hard-to-heal wounds that have previously received local standard therapy. The decrease in wound surface area together with other data indicating improved wound status suggests that a native collagen matrix dressing supports healing and improves quality of life through reduction in wound pain.

Physico-chemical properties and efficacy of silk fibroin fabric coated with different waxes as wound dressing.

PubMed

Kanokpanont, Sorada; Damrongsakkul, Siriporn; Ratanavaraporn, Juthamas; Aramwit, Pornanong

2013-04-01

Silk fibroin (SF) has been widely used as a wound dressing material due to its suitable physical and biological characteristics. In this study, a non-adhesive wound dressing which applies to cover the wound surface as an absorbent pad that would absorb wound fluid while accelerate wound healing was developed. The modification of SF fabrics by wax coating was purposed to prepare the non-adhesive wound dressing that is required in order to minimize pain and risk of repeated injury. SF woven fabrics were coated with different types of waxes including shellac wax, beeswax, or carnauba wax. Physical and mechanical properties of the wax-coated SF fabrics were characterized. It was clearly observed that all waxes could be successfully coated on the SF fabrics, possibly due to the hydrophobic interactions between hydrophobic domains of SF and waxes. The wax coating improved tensile modulus and percentage of elongation of the SF fabrics due to the denser structure and the thicker fibers coated. The in vitro degradation study demonstrated that all wax-coated SF fabrics remained up to 90% of their original weights after 7 weeks of incubation in lysozyme solution under physiological conditions. The wax coating did not affect the degradation behavior of the SF fabrics. A peel test of the wax-coated SF fabrics was carried out in the partial- and full-thickness wounds of porcine skin in comparison to that of the commercial wound dressing. Any wax-coated SF fabrics were less adhesive than the control, as confirmed by less number of cells attached and less adhesive force. This might be that the wax-coated SF fabrics showed the hydrophobic property, allowing the loosely adherence to the hydrophilic wound surface. In addition, the in vivo biocompatibility test of the wax-coated SF fabrics was performed in Sprague-Dawley rats with subcutaneous model. The irritation scores indicated that the carnauba wax-coated SF fabric was not irritant while the shellac wax or beeswax-coated SF

Use of Ovine-based Collagen Extracellular Matrix and Gentian Violet/Methylene Blue Antibacterial Foam Dressings to Help Improve Clinical Outcomes in Lower Extremity Wounds: A Retrospective Cohort Study.

PubMed

Lullove, Eric J

2017-04-01

Dressings that provide broad spectrum metalloprotease reduction along with inherent aspects of an extracellular matrix may contribute to improved wound healing outcomes and shorter treatment times. The author performed a retrospective case series analysis to determine the clinical outcomes of regular debridement with the use of ovine-based collagen extracellular matrix dressings and gentian violet/methylene blue polyurethane antibacterial foam dressings in treating 53 patients with 53 chronic lower extremity wounds (diabetic foot ulcers [DFUs], venous leg ulcers, and heel pressure ulcers). Patients were treated twice weekly in an outpatient clinic for the first 4 weeks and weekly thereafter until closure. Average body mass index (BMI) for the study population was 28.3, and the average patient age was 75.9 years. Mean percent wound surface area reduction at 4, 8, and 12 weeks was 38.5%, 73.3%, and 91.3%, respectively. Average time to closure for all wounds was 10.6 weeks (range, 5-24 weeks). All wounds were 100% reepithelialized by week 20 except 1 DFU that reepithelialized at week 24. The average cost of care for a single wound episode (from presentation to closure) was $2749.49. Results of this analysis showed that the healing of chronic wounds in this series could be achieved at a reasonable cost with regular debridement and a collagen matrix dressing regimen, even in patients of advanced age and above average BMI as well as in wounds that did not achieve > 40% wound surface area reduction at 4 weeks.

Antibacterial Properties of Nonwoven Wound Dressings Coated with Manuka Honey or Methylglyoxal

PubMed Central

Bulman, Sophie E. L.; Carr, Chris; Russell, Stephen J.

2017-01-01

Manuka honey (MH) is used as an antibacterial agent in bioactive wound dressings via direct impregnation onto a suitable substrate. MH provides unique antibacterial activity when compared with conventional honeys, owing partly to one of its constituents, methylglyoxal (MGO). Aiming to investigate an antibiotic-free antimicrobial strategy, we studied the antibacterial activity of both MH and MGO (at equivalent MGO concentrations) when applied as a physical coating to a nonwoven fabric wound dressing. When physically coated on to a cellulosic hydroentangled nonwoven fabric, it was found that concentrations of 0.0054 mg cm−2 of MGO in the form of MH and MGO were sufficient to achieve a 100 colony forming unit % bacteria reduction against gram-positive Staphylococcus aureus and gram-negative Klebsiella pneumoniae, based on BS EN ISO 20743:2007. A 3- to 20-fold increase in MGO concentration (0.0170–0.1 mg cm−2) was required to facilitate a good antibacterial effect (based on BS EN ISO 20645:2004) in terms of zone of inhibition and lack of growth under the sample. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) was also assessed for MGO in liquid form against three prevalent wound and healthcare-associated pathogens, i.e., Staphylococcus aureus, gram-negative Pseudomonas aeruginosa and gram-positive Enterococcus faecalis. Other than the case of MGO-containing fabrics, solutions with much higher MGO concentrations (128 mg L−1–1024 mg L−1) were required to provide either a bacteriostatic or bactericidal effect. The results presented in this study therefore demonstrate the relevance of an MGO-based coating as an environmentally friendly strategy for the design of functional dressings with antibiotic-free antimicrobial chemistries. PMID:28813014

Results of a retrospective comparative study: material cost for managing a series of large wounds in subjects with serious morbidity with a hydrokinetic fiber dressing or negative pressure wound therapy.

PubMed

Hermans, Michel H E; Kwon Lee, S; Ragan, Mitzie R; Laudi, Pam

2015-03-01

This retrospective observational study analyzed lesions with regard to healing trends and cost of materials. The observed lesions were mostly postsurgical or stage IV pressure ulcers in patients with serious morbidity. The wounds were treated with a hydrokinetic fiber dressing (sorbion Sachet S, sorbion Gmbh & Co, a BSN medical company, Senden, Germany) (n = 26) or negative pressure wound therapy (NPWT) (n = 16). Primary healing trends (ie, reduction of wound size, change from necrosis to granulation tissue, and change from granulation tissue to epithelium) and secondary healing trends (ie, periwound conditions) were similar for wounds treated with the hydrokinetic dressing when compared to wounds treated with NPWT. Cost of materials was substantially lower for wounds treated with the hydrokinetic fiber dressing compared to the NPWT, with cost reductions of $1,640 (348%) to $2,242 (1794%) per wound, depending on the criteria used for the analysis. In this set of wounds, the hydrokinetic fiber dressing was shown to lead to similar healing results while providing substantial reductions of the cost of materials. For the types of wounds presented in this observational study, the hydrokinetic fiber dressing seems to be an effective substitution for negative pressure wound therapy.

Extra-large negative pressure wound therapy dressings for burns - Initial experience with technique, fluid management, and outcomes.

PubMed

Fischer, Sebastian; Wall, Jennifer; Pomahac, Bohdan; Riviello, Robert; Halvorson, Eric G

2016-03-01

The use of negative-pressure-wound-therapy (NPWT) is associated with improved outcomes in smaller burns. We report our experience using extra-large (XL) NPWT dressings to treat ≥15% total body surface area (TBSA) burned and describe our technique and early outcomes. We also provide NPWT exudate volume for predictive fluid resuscitation in these critically ill patients. We retrospectively reviewed patients treated with XL-NPWT from 2012 to 2014. Following excision/grafting, graft and donor sites were sealed with a layered NPWT dressing. We documented wound size, dressing size, NPWT outputs, graft take, wound infections, and length of stay (LOS). Mean NPWT exudate volume per %TBSA per day was calculated. Twelve burn patients (mean TBSA burned 30%, range 15-60%) were treated with XL-NPWT (dressing TBSA burned and skin graft donor sites range 17-44%). Average graft take was 97%. No wound infections occurred. Two patients had burns ≥50% TBSA and their LOS was reduced compared to ABA averages. XL-NPWT outputs peaked at day 1 after grafting followed by a steady decline until dressings were removed. Average XL-NPWT dressing output during the first 5 days was 101±66mL/%BSA covered per day. 2 patients developed acute kidney injury. The use of XL-NPWT to treat extensive burns is feasible with attention to application technique. NPWT dressings appear to improve graft take, and to decrease risk of infection, LOS, and pain and anxiety associated with wound care. Measured fluid losses can improve patient care in future applications of NPWT to large burn wounds. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Papain incorporated chitin dressings for wound debridement sterilized by gamma radiation

NASA Astrophysics Data System (ADS)

Singh, Durgeshwer; Singh, Rita

2012-11-01

Wound debridement is essential for the removal of necrotic or nonviable tissue from the wound surface to create an environment conducive to healing. Nonsurgical enzymatic debridement is an attractive method due to its effectiveness and ease of use. Papain is a proteolytic enzyme derived from the fruit of Carica papaya and is capable of breaking down a variety of necrotic tissue substrates. The present study was focused on the use of gamma radiation for sterilization of papain dressing with wound debriding activity. Membranes with papain were prepared using 0.5% chitin in lithium chloride/dimethylacetamide solvent and sterilized by gamma radiation. Fluid absorption capacity of chitin-papain membranes without glycerol was 14.30±6.57% in 6 h. Incorporation of glycerol resulted in significant (p<0.001) increase in the absorption capacity. Moisture vapour transmission rate of the membranes was 4285.77±455.61 g/m2/24 h at 24 h. Gamma irradiation at 25 kGy was found suitable for sterilization of the dressings. Infrared (IR) spectral scanning has shown that papain was stable on gamma irradiation at 25-35 kGy. The irradiated chitin-papain membranes were impermeable to different bacterial strains and also exhibited strong bactericidal action against both Gram-positive and Gram-negative bacteria. The fluid handling characteristics and the antimicrobial properties of chitin-papain membranes sterilized by gamma radiation were found suitable for use as wound dressing with debriding activity.

A bioactive film based on cashew gum polysaccharide for wound dressing applications.

PubMed

Moreira, Bruna R; Batista, Karla A; Castro, Elisandra G; Lima, Eliana M; Fernandes, Kátia F

2015-05-20

This work presents the development of a new bioactive material for wound therapeutics which may play a dual role of modulate metallo proteinases activity while prevents infection blocking out pathogenic microorganisms and foreign materials. A CGP/PVA film was activated by covalent immobilization of trypsin. Results from biocompatibility test revealed that PDL fibroblasts grown on the surface of CGP/PVA and the high amount of viable cells proved absence of cytotoxicity. Trypsin immobilized onto CGP/PVA film remained 100% active after 28 days stored dried at room temperature. In addition, CGP/PVA-trypsin film could be used for 9 cycles of storage/use without loss of activity. After immobilization, trypsin retained its collagenolytic activity, indicating this material as a promising material for wound dressing applications. Copyright © 2015 Elsevier Ltd. All rights reserved.

A multicentre, clinical evaluation of a hydro-responsive wound dressing: the Glasgow experience.

PubMed

Hodgson, H; Davidson, D; Duncan, A; Guthrie, J; Henderson, E; MacDiarmid, M; McGown, K; Pollard, V; Potter, R; Rodgers, A; Wilson, A; Horner, J; Doran, M; Simm, S; Taylor, R; Rogers, A; Rippon, M G; Colgrave, M

2017-11-02

Our aim was to assess the effectiveness of hydro-responsive wound dressing (HRWD) in debridement and wound bed preparation of a variety of acute and chronic wounds that presented with devitalised tissue needing removal so that healing may proceed. This was a non-comparative evaluation of acute and chronic wounds that required debridement as part of their normal treatment regimen. Clinicians recorded wound changes including a subjective assessment level of devitalised tissue and wound bed preparation, presence of pain, wound status (e.g., wound size) and periwound skin condition. Data was also collected from clinicians and patients to provide information on clinical performance of the dressing. We recruited 100 patients with a variety of wound types into the study. Over 90% of the clinicians reported removal of devitalised tissue to enable a healing response in both chronic and acute wounds. Specifically, over the course of the evaluation period, levels of devitalised tissue (necrosis and slough) reduced from 85.5% to 26.3%, and this was accompanied by an increase in wound bed granulation from 12.0% to 33.7%. Correspondingly, there was a 40% reduction in wound area, hence a clinically relevant healing response was seen upon treatment with HRWD. It is also noteworthy that this patient population included a significant proportion of chronic wounds (51.4%) that showed no signs of wound progression within <4 weeks before study inclusion. Of these chronic wounds, 93% demonstrated wound progression upon treatment with HRWD. Despite reported pain levels being low pre- and post-dressing change, overall wound pain improved (reduced) in 48% of patients. Periwound skin condition showed a tendency towards improvement, and the fluid management capabilities of the HRWD was reported as good to excellent in the majority of cases. Wound infections were reduced by at least 60% over the evaluation period. A simple cost-effective analysis demonstrated significant savings using HRWD (�

Polyurethane Foam Wound Dressing Technique for Areola Skin Graft Stabilization and Nipple Protection After Nipple-Areola Reconstruction.

PubMed

Satake, Toshihiko; Muto, Mayu; Nagashima, Yu; Haga, Shoko; Homma, Yuki; Nakasone, Reiko; Kadokura, Marina; Kou, Seiko; Fujimoto, Hiroshi; Maegawa, Jiro

2018-04-01

We describe a new wound management technique using a soft dressing material to stabilize the areola skin graft and protect the nipple after nipple-areola reconstruction at the final stage of breast reconstruction. We introduced a center-fenestrated multilayered hydrocellular polyurethane foam dressing material that provides adequate pressure and retains a moist environment for a smooth skin graft "take." Moreover, the reconstructed nipple can be monitored at any time through the fenestrated window for adequate blood circulation. Altogether, this simple and inexpensive wound dressing technique improves the clinical outcome. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266 .

A comparison of an antibacterial sandwich dressing vs dressing containing silver.

PubMed

Krasowski, Grzegorz; Jawień, Arkadiusz; Tukiendorf, Andrzej; Rybak, Zbigniew; Junka, Adam; Olejniczak-Nowakowska, Małgorzata; Bartoszewicz, Marzenna; Smutnicka, Danuta

2015-01-01

The purpose of this study was to compare the efficacy of dressings containing octenidine vs. dressings containing silver in the wound healing in the course of a chronic venous disease. There were two groups of 40 patients who met the inclusion criteria and who did not meet the exclusion criteria. The patients were randomly assigned into the groups (envelope method). The first, "O group" was treated with octenidine-based dressings. The second, "S group" was treated with silver dressings. The study lasted for 56 days. All patients in the research were treated with medical compression stockings with cotton understockings. Microbiological eradication was observed on the 28th day of the study among 33% of patients in the treatment group vs. 6% in control group. On the 56th day of the treatment, these percentages equalled 72% and 35%. The rate of healing was faster in the 0 group than in the S group. In the wounds <10 cm(2) it was faster by 1.35 cm(2)/week and in wounds >10 cm(2) it equalled 3.44 cm(2). The reduction of pain level was 37.5% higher in the O group, in contrast with the S group. One change of a dressing in the O group led to a 0.06 cm(2) greater wound size reduction and in the case of wounds >10 cm(2) to 0.29 cm(2) reduction compared with the S group. The presented results indicate that the efficacy of dressings containing octenidine is higher compared to silver dressings. © 2015 by the Wound Healing Society.

Acemannan-containing wound dressing gel reduces radiation-induced skin reactions in C3H mice

DOE Office of Scientific and Technical Information (OSTI.GOV)

Roberts, D.B.; Travis, E.L.

To determine (a) whether a wound dressing gel that contains acemannan extracted from aloe leaves affects the severity of radiation-induced acute skin reactions in C3H mice; (b) if so, whether other commercially available gels such as a personal lubricating jelly and a healing ointment have similar effects; and (c) when the wound dressing gel should be applied for maximum effect. Male C3H mice received graded single doses of gamma radiation ranging from 30 to 47.5 Gy to the right leg. In most experiments, the gel was applied daily beginning immediately after irradiation. Dose-response curves were obtained by plotting the percentagemore » of mice that reached or exceeded a given peak skin reaction as a function of dose. Curves were fitted by logit analysis and ED{sub 50} values, and 95% confidence limits were obtained. The average peak skin reactions of the wound dressing gel-treated mice were lower than those of the untreated mice at all radiation doses tested. The ED{sub 50} values for skin reactions of 2.0-2.75 were approximately 7 Gy higher in the wound dressing gel-treated mice. The average peak skin reactions and the ED{sub 50} values for mice treated with personal lubricating jelly or healing ointment were similar to irradiated control values. Reduction in the percentage of mice with skin reactions of 2.5 or more was greatest in the groups that received wound dressing gel for at least 2 weeks beginning immediately after irradiation. There was no effect if gel was applied only before irradiation or beginning 1 week after irradiation. Wound dressing gel, but not personal lubricating jelly or healing ointment, reduces acute radiation-induced skin reactions in C3H mice if applied daily for at least 2 weeks beginning immediately after irradiation. 31 refs., 4 figs., 1 tab.« less

Control of traumatic wound bleeding by compression with a compact elastic adhesive dressing.

PubMed

Naimer, Sody Abby; Tanami, Menachem; Malichi, Avishai; Moryosef, David

2006-07-01

Compression dressing has been assumed effective, but never formally examined in the field. A prospective interventional trial examined efficacy and feasibility of an elastic adhesive dressing compression device in the arena of the traumatic incident. The primary variable examined was the bleeding rate from wounds compared before and after dressing. Sixty-two consecutive bleeding wounds resulting from penetrating trauma were treated. Bleeding intensity was profuse in 58%, moderate 23%, and mild in 19%. Full control of bleeding was achieved in 87%, a significantly diminished rate in 11%, and, in 1 case, the technique had no influence on the bleeding rate. The Wilcoxon test for variables comparing bleeding rates before and after the procedure obtained significant difference (Z = -6.9, p < 0.01). No significant complications were observed. Caregivers were highly satisfied in 90% of cases. Elastic adhesive dressing was observed as an effective and reliable technique, demonstrating a high rate of success without complications.

The Effect of Virtual Reality Distraction on Pain Relief During Dressing Changes in Children with Chronic Wounds on Lower Limbs.

PubMed

Hua, Yun; Qiu, Rong; Yao, Wen-Yan; Zhang, Qin; Chen, Xiao-Li

2015-10-01

It has been demonstrated that patients with chronic wounds experience the most pain during dressing changes. Currently, researchers focus mostly on analgesics and appropriate dressing materials to relieve pain during dressing changes of chronic wounds. However, the effect of nonpharmacologic interventions, such as virtual reality distraction, on pain management during dressing changes of pediatric chronic wounds remains poorly understood. To investigate the effect of virtual reality distraction on alleviating pain during dressing changes in children with chronic wounds on their lower limbs. A prospective randomized study. A pediatric center in a tertiary hospital. Sixty-five children, aged from 4 to 16 years, with chronic wounds on their lower limbs. Pain and anxiety scores during dressing changes were recorded by using the Wong-Baker Faces picture scale, visual analogue scale, and pain behavior scale, as well as physiological measurements including pulse rate and oxygen saturation. Time length of dressing change was recorded. Virtual reality distraction significantly relieved pain and anxiety scores during dressing changes and reduced the time length for dressing changes as compared to standard distraction methods. The use of virtual reality as a distraction tool in a pediatric ward offered superior pain reduction to children as compared to standard distractions. This device can potentially improve clinical efficiency by reducing length time for dressing changes. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Efficacy of a collagen-based dressing in an animal model of delayed wound healing.

PubMed

Guillemin, Y; Le Broc, D; Ségalen, C; Kurkdjian, E; Gouze, J N

2016-07-02

The aim of this study was to evaluate in vitro and in vivo the efficacy of GBT013, a collagen-based dressing, for the treatment of chronic wounds, in a db/db mouse model of diabetes. Macroscopic and histologic analyses of db/db mice wound healing with GBT013 or saline gauze were assessed. The mRNA expression and the proliferation of dermal fibroblast were investigated. Matrix metalloproteinases (MMP)-2 and MMP-9 activities were quantified. In db/db mice, GBT013 improves wound epithelialisation when compared with saline gauze. Histological analysis of scar tissue also shows an enhancement of remodelling associated with no sign of acute inflammation. In addition, GBT013 significantly decreases interleukin (IL)-6 and IL-8, significantly increases tissue inhibitors of metalloproteinases (TIMP)-1 and TIMP-2 fibroblast mRNA expression and significantly reduces in vitro MMP-2 and MMP-9 enzymatic activities. Moreover, GBT013 allows cell growth inside the matrix and stimulates proliferation of human dermal fibroblast. By contributing to restore MMPs/TIMPs balance, GBT013 may function in all key stages of wound healing, such as inflammation, proliferation and tissue remodelling, and ultimately may provide a favourable environment for skin repair. This work was supported by Genbiotech, the R&D subsidiary of Laboratoires Genévrier, a pharmaceutical company.

Growth factors, silver dressings and negative pressure wound therapy in the management of hard-to-heal postoperative wounds in obstetrics and gynecology: a review.

PubMed

Stanirowski, Paweł Jan; Wnuk, Anna; Cendrowski, Krzysztof; Sawicki, Włodzimierz

2015-10-01

The last two decades witnessed the development of numerous innovative regimens for the management of patients with abnormally healing and infected wounds. Growth factors, negative pressure wound therapy (NPWT) and antiseptic dressings containing silver are examples of methods with best documented efficacy, being widely used in the treatment of acute and chronic post-traumatic wounds, burns and ulcers of various etiology. As far as obstetrics and gynecology are concerned, prevention and treatment of infected, hard-to-heal postoperative wounds is of crucial importance. This article reviews the available literature to discuss the possibilities for use, efficacy and cost-effectiveness of growth factors, NPWT and silver dressings in the treatment of difficult-to-heal postsurgical wounds in obstetrics and gynecology. An extensive search of the English and Polish literature via PubMed and EMBASE databases was undertaken for articles published between January 1960 and April 30, 2014 to identify articles that described and assessed use, efficacy and cost-effectiveness of growth factors, silver dressings and NPWT in patients with hard-to-heal postoperative wounds following obstetric or gynecological surgery. Literature review regarding the use of growth factors, NPWT and silver dressings suggests that these methods may play an important role in the management of wounds after invasive obstetric and gynecological procedures. Obese patients, patients after vulvectomy or prior radiation therapy may benefit most, however, due to non-numerous randomized reports, prospective studies on the use of above-mentioned methods in the treatment of postsurgical wounds following obstetric and gynecological interventions are required.

Evaluation of a non-adherent, povidone-iodine dressing in a case series of chronic wounds.

PubMed

Campbell, N; Campbell, D

2013-08-01

Here we report a product evaluation for a non-adherent, povidone-iodine (PVP-I) dressing, determining the clinical need for the product, performing a literature review, clinical evaluation and cost-analysis, and developing a recommendation. This evaluation included 20 patients who experienced dressing pain with the previous antimicrobial dressing. Two patients discontinued the evaluation and four ulcers were non-healing; the remaining wounds closed with the PVP-I dressing. Patients indicated a preference for the PVP-I dressing, primarily due to lack of dressing pain. The PVP-I dressing was also the most cost-efficient.

Biomechanical Skin Property Evaluation for Wounds Treated With Synthetic and Biosynthetic Wound Dressings and a Newly Developed Collagen Matrix During Healing of Superficial Skin Defects in a Rat Models.

PubMed

Held, Manuel; Engelke, Anne-Sophie; Tolzmann, Dascha Sophie; Rahmanian-Schwarz, Afshin; Schaller, Hans-Eberhard; Rothenberger, Jens

2016-09-01

There is a high prevalence of superficial wounds such as partial-thickness burns. Treatment of these wounds frequently includes temporary application of wound dressings. The aim of this study was to compare a newly developed collagen matrix with commonly used temporary skin dressings for treatment of partial-thickness skin defects. Through a skin dermatome, 42 standardized superficial skin defects were generated on the back of 28 adult male Lewis rats. The wounds were treated with a synthetic wound dressing (Suprathel, Polymedics Innovations Inc, Woodstock, GA) (n = 14), a biosynthetic skin dressing (Biobrane, Smith & Nephew, Hull, UK) (n = 14), or a newly developed bovine collagen matrix, Collagen Cell Carrier (Viscofan BioEngineering, Weinheim, Germany) (n = 14). Biomechanical properties of the skin were determined and compared every 10 days over a 3-month period of using the Cutometer MPA 580 (Courage + Khazaka Electronic GmbH, Cologne, Germany). As opposed to healthy skin, statistically significant differences were detected between days 10 and 30, and between days 60 and 80, for calculated elasticity (Ue), firmness of skin (R0), and overall elasticity (R8). After 3 months, no statistically significant differences in skin elasticity were detected between the different wound dressings. The presented results give an opportunity to compare the wound dressings used for treatment with respect to skin elasticity and reveal the potential of the bovine collagen matrix in the treatment of superficial skin defects; therefore the results facilitate further evaluation of collagen matrix in surgical applications and regenerative medicine.

Hemostatic kaolin-polyurethane foam composites for multifunctional wound dressing applications.

PubMed

Lundin, Jeffrey G; McGann, Christopher L; Daniels, Grant C; Streifel, Benjamin C; Wynne, James H

2017-10-01

There are numerous challenges associated with the acute care of traumatic limb injuries in forward military settings. A lack of immediate medical facilities necessitates that the wound dressing perform multiple tasks including exudate control, infection prevention, and physical protection of the wound for extended periods of time. Here, kaolin was incorporated into recently developed robust polyurethane (PU) hydrogel foams at 1-10wt% in an effort to impart hemostatic character. ATR-IR and gel fraction analysis demonstrated that the facile, one-pot synthesis of the PU hydrogel was unaffected by kaolin loading, as well as the use of a non-toxic catalyst, which significantly improved cytocompatibility of the materials. Kaolin was generally well dispersed throughout the PU matrix, though higher loadings exhibited minor evidence of aggregation. Kaolin-PU composites exhibited burst release of ciprofloxacin over 2h, the initial release rates of which increased with kaolin loading. Kaolin loading imparted excellent hemostatic character to the PU foams at relatively low loading levels (5wt%). This work demonstrates the simple and inexpensive synthesis of robust, hemostatic, and absorptive kaolin-PU foams that have promising potential as multifunctional wound dressing materials. Published by Elsevier B.V.

[Radiation load on the skin using a silicone-coated polyamide wound dressing during photon and electron radiotherapy].

PubMed

Thilmann, C; Adamietz, I A; Ramm, U; Mose, S; Saran, F; Böttcher, H D

1996-05-01

Silicone-coated polyamide wound dressing is frequently used for the supportive treatment in patients with radiation induced skin lesions. The use of this kind of dressing during radiotherapy with high energy beams shifts the dose built-up effect towards the skin surface. Thus the dose delivered to the skin increases. The present work quantifies changes of the skin dose by a commercial silicon-coated polyamide wound dressing. The dependence on the beam quality and on different treatment techniques is investigated. Measurements were performed with photon (60Co, 6 MV, 42 MV) and electron (7 MeV, 20 MeV, 40 MeV) beams using thin LiF thermoluminescence dosimeters (TLD) in a perspex phantom. The beams were directed perpendicularly to the phantom surface. For 60Co and 6 MV photon beams the skin dose was evaluated in vivo at different beam arrangements and at a given reference dose. For 60Co, 6 MV and 42 MV photon beams wound dressing caused a dose increase on the surface of the perspex phantom by a factor of 1.65, 1.39 and 1.33 respectively. Using oblique or rotational techniques for 60Co and 6 MV photon irradiation the wound dressing increased the skin dose but less compared to perpendicular beam direction. For electron beams the skin dose is relatively high (from 84% to 92%) and an increase by a dressing has no clinical relevance (factor 1.03 to 1.05). The silicone-coated polyamide wound dressing causes no relevant skin dose increase during radiation treatment with electron beams and can be left on the skin during irradiation. During radiation treatment with photon beams like 60Co and 6 MV the protective procedure should be adapted to skin changes, in case of strong skin reactions a removal during the time of irradiation should be considered.

Bio-inspired crosslinking and matrix-drug interactions for advanced wound dressings with long-term antimicrobial activity.

PubMed

Dhand, Chetna; Venkatesh, Mayandi; Barathi, Veluchami Amutha; Harini, Sriram; Bairagi, Samiran; Goh Tze Leng, Eunice; Muruganandham, Nandhakumar; Low, Kenny Zhi Wei; Fazil, Mobashar Hussain Urf Turabe; Loh, Xian Jun; Srinivasan, Dinesh Kumar; Liu, Shou Ping; Beuerman, Roger W; Verma, Navin Kumar; Ramakrishna, Seeram; Lakshminarayanan, Rajamani

2017-09-01

There is a growing demand for durable advanced wound dressings for the management of persistent infections after deep burn injuries. Herein, we demonstrated the preparation of durable antimicrobial nanofiber mats, by taking advantage of strong interfacial interactions between polyhydroxy antibiotics (with varying number of OH groups) and gelatin and their in-situ crosslinking with polydopamine (pDA) using ammonium carbonate diffusion method. Polydopamine crosslinking did not interfere with the antimicrobial efficacy of the loaded antibiotics. Interestingly, incorporation of antibiotics containing more number of alcoholic OH groups (N OH  ≥ 5) delayed the release kinetics with complete retention of antimicrobial activity for an extended period of time (20 days). The antimicrobials-loaded mats displayed superior mechanical and thermal properties than gelatin or pDA-crosslinked gelatin mats. Mats containing polyhydroxy antifungals showed enhanced aqueous stability and retained nanofibrous morphology under aqueous environment for more than 4 weeks. This approach can be expanded to produce mats with broad spectrum antimicrobial properties by incorporating the combination of antibacterial and antifungal drugs. Direct electrospinning of vancomycin-loaded electrospun nanofibers onto a bandage gauze and subsequent crosslinking produced non-adherent durable advanced wound dressings that could be easily applied to the injured sites and readily detached after treatment. In a partial thickness burn injury model in piglets, the drug-loaded mats displayed comparable wound closure to commercially available silver-based dressings. This prototype wound dressing designed for easy handling and with long-lasting antimicrobial properties represents an effective option for treating life-threatening microbial infections due to thermal injuries. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

A study on the ability of quaternary ammonium groups attached to a polyurethane foam wound dressing to inhibit bacterial attachment and biofilm formation.

PubMed

Tran, Phat L; Hamood, Abdul N; de Souza, Anselm; Schultz, Gregory; Liesenfeld, Bernd; Mehta, Dilip; Reid, Ted W

2015-01-01

Bacterial infection of acute and chronic wounds impedes wound healing significantly. Part of this impediment is the ability of bacterial pathogens to grow in wound dressings. In this study, we examined the effectiveness of a polyurethane (PU) foam wound dressings coated with poly diallyl-dimethylammonium chloride (pDADMAC-PU) to inhibit the growth and biofilm development by three main wound pathogens, Staphylococcus aureus, Pseudomonas aeruginosa, and Acinetobacter baumannii, within the wound dressing. pDADMAC-PU inhibited the growth of all three pathogens. Time-kill curves were conducted both with and without serum to determine the killing kinetic of pDADMAC-PU. pDADMAC-PU killed S. aureus, A. baumannii, and P. aeruginosa. The effect of pDADMAC-PU on biofilm development was analyzed quantitatively and qualitatively. Quantitative analysis, colony-forming unit assay, revealed that pDADMAC-PU dressing produced more than eight log reduction in biofilm formation by each pathogen. Visualization of the biofilms by either confocal laser scanning microscopy or scanning electron microscopy confirmed these findings. In addition, it was found that the pDADMAC-PU-treated foam totally inhibited migration of bacteria through the foam for all three bacterial strains. These results suggest that pDADMAC-PU is an effective wound dressing that inhibits the growth of wound pathogens both within the wound and in the wound dressing. © 2014 by the Wound Healing Society.

A potential bioactive wound dressing based on carboxymethyl cellulose/ZnO impregnated MCM-41 nanocomposite hydrogel.

PubMed

Rakhshaei, Rasul; Namazi, Hassan

2017-04-01

Lack of antibacterial activity, deficient water vapor and oxygen permeability, and insufficient mechanical properties are disadvantages of existing wound dressings. Hydrogels could absorb wound exudates due to their strong swelling ratio and give a cooling sensation and a wet environment. To overcome these shortcomings, flexible nanocomposite hydrogel films was prepared through combination of zinc oxide impregnated mesoporous silica (ZnO-MCM-41) as a nano drug carrier with carboxymethyl cellulose (CMC) hydrogel. Citric acid was used as cross linker to avoid the cytotoxicity of conventional cross linkers. The prepared nanocomposite hydrogel was characterized using X-ray diffractometry (XRD), scanning electron microscopy (SEM), transmission electron microscopy (TEM), Zeta potential and UV-vis spectroscopy. Results of swelling and erosion tests showed CMC/ZnO nanocomposite hydrogel disintegrated during the first hours of the test. Using MCM-41 as a substrate for ZnO nanoparticles solved this problem and the CMC/ZnO-MCM-41 showed a great improvement in tensile strength (12%), swelling (100%), erosion (53%) and gas permeability (500%) properties. Drug delivery and antibacterial properties of the nanocomposite hydrogel films studied using tetracycline (TC) as a broad spectrum antibiotic and showed a sustained TC release. This could efficiently decrease bandage exchange. Cytocompatibility of the nanocomposite hydrogel films has been analyzed in adipose tissue-derived stem cells (ADSCs) and results showed cytocompatibility of CMC/ZnO-MCM-41. Based on these results the prepared CMC nanocomposite hydrogel containing ZnO impregnated MCM-41, could serve as a kind of promising wound dressing with sustained drug delivery properties. Copyright © 2016 Elsevier B.V. All rights reserved.

Evaluation of a non-woven fabric coated with a chitosan bi-layer composite for wound dressing.

PubMed

Liu, Bai-Shuan; Yao, Chun-Hsu; Fang, Shr-Shin

2008-05-13

This study presents a novel design of an easily stripped bi-layer composite that consists of an upper layer of a soybean protein non-woven fabric coated with a lower layer, a genipin-crosslinked chitosan film, as a wound dressing material. This study examines the in vitro properties of the genipin-crosslinked chitosan film and the bi-layer composite. Furthermore, in vivo experiments are conducted to study wounds treated with the composite in a rat model. Experimental results show that the degree of crosslinking and the in vitro degradation rate of the genipin-crosslinked chitosan films can be controlled by varying the genipin contents. In addition, the genipin contents should exceed 0.025 wt.-% of the chitosan-based material if complete crosslinking reactions between genipin and chitosan molecules are required. Water contact angle analysis shows that the genipin-crosslinked chitosan film is not highly hydrophilic; therefore, the genipin-crosslinked chitosan layer is not entangled with the soybean protein non-woven fabric, which forms an easily stripped interface layer between them. Furthermore, this new wound dressing material provides adequate moisture, thereby minimizing the risk of wound dehydration, and exhibits good mechanical properties. The in vivo histological assessment results reveal that epithelialization and reconstruction of the wound are achieved by covering the wound with the composite, and the composite is easily stripped from the wound surface without damaging newly regenerated tissue.

Children's experiences of procedural pain management in conjunction with trauma wound dressings.

PubMed

Nilsson, Stefan; Hallqvist, Carina; Sidenvall, Birgitta; Enskär, Karin

2011-07-01

This paper is a report of the experiences of children (5-10 years) of procedural pain when they underwent a trauma wound care session. Procedural pain in conjunction with trauma wound care often induces anxiety and distress in children. Children need to alleviate pain and avoid the development of fear in conjunction with examinations and treatments. The nurse could help children to reach this goal by using the comfort theory, which describes holistic nursing in four contexts: physical, psychospiritual, environmental and sociocultural. Few studies have focused on children's experiences of comforting activities in conjunction with trauma wound dressings. This study was conducted between May 2008 and January 2010. Thirty-nine participants aged 5-10 were consecutively included in this study. The wound care session was standardized for all the participants, and semi-structured qualitative interviews with open-ended questions were conducted with all the children in conjunction with the procedure. All the interviews were transcribed verbatim and analysed with qualitative content analysis. Four themes were identified: clinical competence, distraction, participation and security. The children were helped to reach comforting activities to enhance pain management. Children require more than just analgesics in wound care. They also need to experience security and participation in this context. When children feel clinical competence in wound care, they trust the nurse to carry out the wound dressing and instead can focus on the distraction that increases their positive outcomes. © 2011 Blackwell Publishing Ltd.

pH and Glucose Dual-Responsive Injectable Hydrogels with Insulin and Fibroblasts as Bioactive Dressings for Diabetic Wound Healing.

PubMed

Zhao, Lingling; Niu, Lijing; Liang, Hongze; Tan, Hui; Liu, Chaozong; Zhu, Feiyan

2017-11-01

pH and glucose dual-responsive injectable hydrogels were prepared through the cross-linking of Schiff's base and phenylboronate ester using phenylboronic-modified chitosan, poly(vinyl alcohol) and benzaldehyde-capped poly(ethylene glycol). Protein drugs and live cells could be incorporated into the hydrogels during the in situ cross-linking, displaying sustained and pH/glucose-triggered drug release from the hydrogels and cell viability and proliferation in the three-dimensional hydrogel matrix as well. Hence, the hydrogels with insulin and fibroblasts were considered as bioactive dressings for diabetic wound healing. A streptozotocin-induced diabetic rat model was used to evaluate the efficacy of hydrogel dressings in wound repair. The results revealed that the incorporation of insulin and L929 in the hydrogels could promote neovascularization and collagen deposition and enhance the wound-healing process of diabetic wounds. Thus, the drug- and cell-loaded hydrogels have promising potential in wound healing as a medicated system for various therapeutic proteins and live cells.

Clinical approach to wounds: débridement and wound bed preparation including the use of dressings and wound-healing adjuvants.

PubMed

Attinger, Christopher E; Janis, Jeffrey E; Steinberg, John; Schwartz, Jaime; Al-Attar, Ali; Couch, Kara

2006-06-01

This is a clinical review of current techniques in wound bed preparation found to be effective in assisting the wound-healing process. The process begins with the identification of a correct diagnosis of the wound's etiology and continues with optimizing the patient's medical condition, including blood flow to the wound site. Débridement as the basis of most wound-healing strategies is then emphasized. Various débridement techniques, including surgery, topical agents, and biosurgery, are thoroughly discussed and illustrated. Wound dressings, including the use of negative pressure wound therapy, are then reviewed. To properly determine the timing of advance therapeutic intervention, the wound-healing progress needs to be monitored carefully with weekly measurements. A reduction in wound area of 10 to 15 percent per week represents normal healing and does not mandate a change in the current wound-healing strategy. However, if this level of wound area reduction is not met consistently on a weekly basis, then alternative healing interventions should be considered. There is a growing body of evidence that can provide guidance on the appropriate use of such adjuvants in the problem wound. Several adjuvants are discussed, including growth factor, bioengineered tissues, and hyperbaric medicine.

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

PubMed

Hickerson, W L; Kealey, G P; Smith, D J; Thomson, P D

1994-01-01

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.

[ALEA study. Treatment of chronic wounds infected by the application of silver dressings nanocrystalline combined with dressings hydrocellular].

PubMed

Verdú Soriano, José; Nolasco Bonmati, Andreu

2010-10-01

This study was conducted with the objective to assess, in real clinical conditions in primary care and geriatric centers, application and utility of nanocrystalline silver dressings dressings combined with hydrocellular in relation to the development during 20 shifts dressing or complete healing of the characteristics of the lesions included in the study Prospective observational multicenter open, repeated measures. It could include injuries of different etiologies (pressure ulcers stage 11-111, lower limb and traumatic wounds or surgical origin), with clinical signs of local infection (at least three of the following: redness, purulent discharge, heat, edema and pain). Only one wound was included per patient. An analysis of effectiveness by intention to treat all lesions included. We recruited 103 patients who met the inclusion criteria but were collected in which 77 patients were used for nanocrystalline silver dressings in some phase of the study, They had a median of 80 years of age and 58.4% were women. By type of injury: 53.2% pressure ulcers, 31.2% lower extremity ulcers and 14.3% traumatic or surgical wounds. Over 50% of the lesions was older than eight months and a larger area of 22.75 cm2. At first, 70.1% had redness, purulent discharge 64.9%, 37.7% heat edema 42.9% and 65.8% pain. Remained in the study a median of 42.5 days at a rate of change of dressing every 2.5. During this time in 96.1% of the lesions were removed for clinical signs of local infection in a statistically significant (p < or = 0.001). 27.3% healed from injuries and those not healed, 92.9% experienced improvement, and its healing curves were statistically significant (p < 0.05). 92.2% of clinicians assessed treatment with these products as good or excellent. The use of the products used in this study consistent with the concept and PLH TIME, has proved useful in this type of injury reducing the clinical signs of infection, promoting granulation tissue and necrotic removing the burden

Polyox and carrageenan based composite film dressing containing anti-microbial and anti-inflammatory drugs for effective wound healing.

PubMed

Boateng, Joshua S; Pawar, Harshavardhan V; Tetteh, John

2013-01-30

Polyethylene oxide (Polyox) and carrageenan based solvent cast films have been formulated as dressings for drug delivery to wounds. Films plasticised with glycerol were loaded with streptomycin (30%, w/w) and diclofenac (10%, w/w) for enhanced healing effects in chronic wounds. Blank and drug loaded films were characterised by texture analysis (for mechanical and mucoadhesive properties), scanning electron microscopy, differential scanning calorimetry, X-ray diffraction and Fourier transform infrared spectroscopy. In addition, swelling, in vitro drug release and antibacterial studies were conducted to further characterise the films. Both blank and drug loaded films showed a smooth, homogeneous surface morphology, excellent transparency, high elasticity and acceptable tensile (mechanical) properties. The drug loaded films showed a high capacity to absorb simulated wound fluid and significant mucoadhesion force which is expected to allow effective adherence to and protection of the wound. The films showed controlled release of both streptomycin and diclofenac for 72 h. These drug loaded films produced higher zones of inhibition against Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli compared to the individual drugs zones of inhibition. Incorporation of streptomycin can prevent and treat chronic wound infections whereas diclofenac can target the inflammatory phase of wound healing to relieve pain and swelling. Copyright © 2012 Elsevier B.V. All rights reserved.

Synthesis and characterization of biosheet impregnated with Macrotyloma uniflorum extract for burn/wound dressings.

PubMed

Muthukumar, Thangavelu; Senthil, Rethinam; Sastry, Thotapalli Parvathaleswara

2013-02-01

Developing biomaterials having wound healing properties within the search of a common man is the need of hour, particularly in developing and third world countries. Keeping this objective in view we have developed a wound dressing material, in sheet form, containing fish scale collagen (FSC) and physiologically clotted fibrin (PCF), both are by products of aqua food and meat industries respectively. To impart antimicrobial properties to the composite sheet, it was incorporated with Macrotyloma uniflorum plant extract (MPE). SEM pictures have shown that FSC:PCF:MPE composite has fibrous and porous surface which helps in transportation of oxygen as well as absorbing wound fluids and their evaporation. The biomaterials have shown 100% biocompatibility and the percentage cell viability was found to be above 89%. The FSC:PCF:MPE biocomposite film with required mechanical strength, biocompatibility and antimicrobial properties can be tried as a burn/wound dressing material. Copyright © 2012 Elsevier B.V. All rights reserved.

Synthesis and characterization of arginine-NIPAAm hybrid hydrogel as wound dressing: In vitro and in vivo study.

PubMed

Wu, De-Qun; Zhu, Jie; Han, Hua; Zhang, Jun-Zhi; Wu, Fei-Fei; Qin, Xiao-Hong; Yu, Jian-Yong

2018-01-01

A multi-functional hybrid hydrogel P(M-Arg/NIPAAm) with temperature response, anti-protein adsorption and antibacterial properties was prepared and applied as wound dressing. The hydrogel was carried out by free radical copolymerization of methacrylate arginine (M-Arg) and N-isopropyl acrylamide (NIPAAm) monomers using N,N'-methylene bisacrylamide as a crosslinker, and ammonium persulfate/N,N,N', N'-tetramethylethylenediamine as the redox initiator. To endow the antimicrobial property, chlorhexidine diacetate (CHX) was preloaded into the hydrogel and polyhexamethylene guanidine phosphate (PHMG) was grafted on the hydrogel surface, respectively. The antimicrobial property of two series of hydrogels was evaluated and compared. The successful synthesis of M-Arg, PHMG and hydrogels was proved by 13 C NMR, 1 H NMR and FTIR spectroscopy. The hydrogel morphology characterized by scanning electron microscopy confirmed that the homogeneous porous and interconnected structures of the hydrogels. The swelling, protein adsorption property, in vitro release of CHX, antimicrobial assessment, cell viability as well as in vivo wound healing in a mouse model were studied. The results showed the nontoxicity and antimicrobial P(M-Arg/NIPAAm) hydrogel accelerated the full-thickness wound healing process and had the potential application in wound dressing. Despite the zwitterionic characteristic and biocompatible property of arginine based hydrogels, the brittle behavior and non-transparency still remain as a significant problem for wound dressing. Furthermore promoting the antibacterial property of the zwitterionic hydrogel is also necessary to prevent the bacterial colonization and subsequent wound infection. Therefore, we created a hybrid hydrogel combined methacrylate arginine (M-Arg) and N-isopropyl acrylamide (NIPAAm). NIPAAm improves transparency and mechanical property as well as acts as a temperature-response drug release system. Additionally, chlorhexidine (CHX) was preloaded

Combination Growth Factor Therapy via Electrostatically Assembled Wound Dressings Improves Diabetic Ulcer Healing In Vivo.

PubMed

Almquist, Benjamin D; Castleberry, Steven A; Sun, Julia B; Lu, Alice Y; Hammond, Paula T

2015-10-01

Chronic skin ulcerations are a common complication of diabetes mellitus, affecting up to one in four diabetic individuals. Despite the prevalence of these wounds, current pharmacologic options for treating them remain limited. Growth factor-based therapies have displayed a mixed ability to drive successful healing, which may be due to nonoptimal delivery strategies. Here, a method for coating commercially available nylon dressings using the layer-by-layer process is described to enable both sustained release and independent control over the release kinetics of vascular endothelial growth factor 165 and platelet-derived growth factor BB. It is shown that the use of strategically spaced diffusion barriers formed spontaneously by disulfide bonds enables independent control over the release rates of incorporated growth factors, and that in vivo these dressings improve several aspects of wound healing in db/db mice. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Evaluation of sericin/collagen membranes as prospective wound dressing biomaterial.

PubMed

Akturk, Omer; Tezcaner, Aysen; Bilgili, Hasan; Deveci, M Salih; Gecit, M Rusen; Keskin, Dilek

2011-09-01

Sericin, a silk protein, has high potential for use in biomedical applications. In this study, wound dressing membranes of Sericin (S) and Collagen (C) were prepared by glutaraldehyde cross-linking at S/C; 2:1, 1:1, 1:2, and 0:1 weight ratios. They were stable in water for 4 weeks. However, increasing the proportion of sericin had decreasing effect on the membrane stability. Water swelling property of membranes was enhanced with sericin. The highest water swelling was obtained in 1:1 group (9.06 g/g), but increasing collagen or sericin content in the membranes had a diminishing effect. Highest water vapor transmission rate was obtained with 1:2 group (1013.80 g/m(2)/day). Oxygen permeability results showed that 1:2 (7.67 mg/L) and 2:1 (7.85 mg/L) S/C groups were better than the other groups. While sericin decreased the tensile strength and elongation of membranes, it increased modulus. Sericin also increased brittleness of membranes, but their UTS range (24.93-44.92 MPa) was still suitable for a wound dressing. Membranes were not penetrable to microorganisms. Cytotoxicity studies showed that fibroblasts and keratinocytes attached and gained their characteristic morphologies. They also proliferated on membranes significantly. After 1 week of subcutaneous implantation, a fibrous capsule formed around all membranes with an acute inflammation. Sericin containing membranes showed signs of degradation (at 2nd week), while collagen only membranes remained largely intact. Eventually, sericin containing membranes degraded in 3 weeks with moderate inflammatory response. Overall results suggest that sericin/collagen membranes would be favorable as wound dressing material when sericin ratio is less than or equal to the collagen component. Copyright © 2011 The Society for Biotechnology, Japan. Published by Elsevier B.V. All rights reserved.

Biological wound dressings sterilized with gamma radiation: Mexican clinical experience

NASA Astrophysics Data System (ADS)

Martínez-Pardo, M. E.; Ley-Chávez, E.; Reyes-Frías, M. L.; Rodríguez-Ferreyra, P.; Vázquez-Maya, L.; Salazar, M. A.

2007-11-01

Biological wound dressings sterilized with gamma radiation, such as amnion and pig skin, are a reality in Mexico. These tissues are currently processed in the tissue bank and sterilized in the Gamma Industrial Irradiation Plant; both facilities belong to the Instituto Nacional de Investigaciones Nucleares (ININ) (National Institute of Nuclear Research). With the strong support of the International Atomic Energy Agency, the bank was established at the ININ and the Mexican Ministry of Health issued its sanitary license on July 7, 1999. The Quality Management System of the bank was certified by ISO 9001:2000 on August 1, 2003; the scope of the system is "Research, Development and Processing of Biological Tissues Sterilized with Gamma Radiation". At present, more than 150 patients from 16 hospitals have been successfully treated with these tissues. This paper presents a brief description of the tissue processing, as well as the present Mexican clinical experience with children and adult patients who underwent medical treatment with radiosterilized amnion and pig skin, used as biological wound dressings on burns and ocular surface disorders.

Silver-Zinc Redox-Coupled Electroceutical Wound Dressing Disrupts Bacterial Biofilm

PubMed Central

Roy, Sashwati; Khanna, Savita; Hemann, Craig; Deng, Binbin; Das, Amitava; Zweier, Jay L.; Wozniak, Daniel; Sen, Chandan K.

2015-01-01

Pseudomonas aeruginosa biofilm is commonly associated with chronic wound infection. A FDA approved wireless electroceutical dressing (WED), which in the presence of conductive wound exudate gets activated to generate electric field (0.3–0.9V), was investigated for its anti-biofilm properties. Growth of pathogenic P. aeruginosa strain PAO1 in LB media was markedly arrested in the presence of the WED. Scanning electron microscopy demonstrated that WED markedly disrupted biofilm integrity in a setting where silver dressing was ineffective. Biofilm thickness and number of live bacterial cells were decreased in the presence of WED. Quorum sensing genes lasR and rhlR and activity of electric field sensitive enzyme, glycerol-3-phosphate dehydrogenase was also repressed by WED. This work provides first electron paramagnetic resonance spectroscopy evidence demonstrating that WED serves as a spontaneous source of reactive oxygen species. Redox-sensitive multidrug efflux systems mexAB and mexEF were repressed by WED. Taken together, these observations provide first evidence supporting the anti-biofilm properties of WED. PMID:25803639

The effect and safety of dressing composed by nylon threads covered with metallic silver in wound treatment.

PubMed

Brogliato, Ariane R; Borges, Paula A; Barros, Janaina F; Lanzetti, Manuela; Valença, Samuel; Oliveira, Nesser C; Izário-Filho, Hélcio J; Benjamim, Claudia F

2014-04-01

Silver is used worldwide in dressings for wound management. Silver has demonstrated great efficacy against a broad range of microorganisms, but there is very little data about the systemic absorption and toxicity of silver in vivo. In this study, the antimicrobial effect of the silver-coated dressing (SilverCoat(®)) was evaluated in vitro against the most common microorganisms found in wounds, including Pseudomonas aeruginosa, Candida albicans, Staphylococcus aureus, Methicillin-resistant Staphylococcus aureus and Klebsiella pneumoniae. We also performed an excisional skin lesion assay in mice to evaluate wound healing after 14 days of treatment with a silver-coated dressing, and we measured the amount of silver in the blood, the kidneys and the liver after treatment. Our data demonstrated that the nylon threads coated with metallic silver have a satisfactory antimicrobial effect in vitro, and the prolonged use of these threads did not lead to systemic silver absorption, did not induce toxicity in the kidneys and the liver and were not detrimental to the normal wound-healing process. © 2012 The Authors. International Wound Journal © 2012 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

21 CFR 878.4015 - Wound dressing with poly (diallyl dimethyl ammonium chloride) (pDADMAC) additive.

Code of Federal Regulations, 2010 CFR

2010-04-01

... ammonium chloride) (pDADMAC) additive. 878.4015 Section 878.4015 Food and Drugs FOOD AND DRUG...) additive. (a) Identification. A wound dressing with pDADMAC additive is intended for use as a primary... Dressing With Poly (Diallyl Dimethyl Ammonium Chloride) (pDADMAC) Additive.” See § 878.1(e) for...

21 CFR 878.4015 - Wound dressing with poly (diallyl dimethyl ammonium chloride) (pDADMAC) additive.

Code of Federal Regulations, 2014 CFR

2014-04-01

... ammonium chloride) (pDADMAC) additive. 878.4015 Section 878.4015 Food and Drugs FOOD AND DRUG...) additive. (a) Identification. A wound dressing with pDADMAC additive is intended for use as a primary... Dressing With Poly (Diallyl Dimethyl Ammonium Chloride) (pDADMAC) Additive.” See § 878.1(e) for...

21 CFR 878.4015 - Wound dressing with poly (diallyl dimethyl ammonium chloride) (pDADMAC) additive.

Code of Federal Regulations, 2012 CFR

2012-04-01

... ammonium chloride) (pDADMAC) additive. 878.4015 Section 878.4015 Food and Drugs FOOD AND DRUG...) additive. (a) Identification. A wound dressing with pDADMAC additive is intended for use as a primary... Dressing With Poly (Diallyl Dimethyl Ammonium Chloride) (pDADMAC) Additive.” See § 878.1(e) for...

21 CFR 878.4015 - Wound dressing with poly (diallyl dimethyl ammonium chloride) (pDADMAC) additive.

Code of Federal Regulations, 2011 CFR

2011-04-01

... ammonium chloride) (pDADMAC) additive. 878.4015 Section 878.4015 Food and Drugs FOOD AND DRUG...) additive. (a) Identification. A wound dressing with pDADMAC additive is intended for use as a primary... Dressing With Poly (Diallyl Dimethyl Ammonium Chloride) (pDADMAC) Additive.” See § 878.1(e) for...

21 CFR 878.4015 - Wound dressing with poly (diallyl dimethyl ammonium chloride) (pDADMAC) additive.

Code of Federal Regulations, 2013 CFR

2013-04-01

... ammonium chloride) (pDADMAC) additive. 878.4015 Section 878.4015 Food and Drugs FOOD AND DRUG...) additive. (a) Identification. A wound dressing with pDADMAC additive is intended for use as a primary... Dressing With Poly (Diallyl Dimethyl Ammonium Chloride) (pDADMAC) Additive.” See § 878.1(e) for...

Closed Incision Negative Pressure Wound Therapy vs Conventional Dry Dressings After Primary Knee Arthroplasty: A Randomized Controlled Study.

PubMed

Manoharan, Varaguna; Grant, Andrea L; Harris, Alicia C; Hazratwala, Kaushik; Wilkinson, Matthew P R; McEwen, Peter J C

2016-11-01

The purpose of this study was to assess the effect of negative pressure wound therapy (NPWT) on quality of life (QoL), wound complications, and cost after primary knee arthroplasty. A prospective analysis of 33 patients undergoing primary knee arthroplasty performed by 3 surgeons in one institution. The first 12 patients (3 bilateral and 9 unilateral) had conventional dry dressings (CDD) applied and cost of dressings was assessed. The other 21 patients all underwent bilateral knee arthroplasty and had either side randomized to receiving NPWT or CDD. Cost of dressings, wound complications, and QoL were compared. One patient had a reaction to the NPWT requiring readmission. Another had persistent wound drainage that required NPWT application. There were no wound issues in the remaining 31 patients. The average cost in the first 12 patients was Australian dollar $48.70 with an average of 1.5 changes on ward. In the 21 patients receiving both dressings, the average cost for CDD was less (Australian dollar $43.51 vs $396.02, P ≤ .011, effect size [ES] = 1.06). When comparing QoL factors, wound leakage (0.14 vs 0.39 P = .019, ES = 1.02), and wound protection (0.16 vs 0.33, P = .001, ES = 0.021) were better in the NPWT group. There was no other significant difference in QoL factors. The average number of changes on the ward was less for the NPWT group (1.19 vs 1.38, P = .317, ES = 1.02). We found no benefit in wound healing or cost with NPWT post knee arthroplasty. There was some benefit in NPWT QoL factors less wound leakage and better protection. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

[The therapeutic effect of nanometer silver impregnated dressing on gunshot wounds after being immersed in brine and tapwater in rabbits].

PubMed

Chen, Bi; Ding, Guo-bin; Tang, Chao-wu

2004-03-22

To investigate the therapeutic effect of nanometer silver impregnated dressing on gunshot wounds after being immersed in brine and tapwater in rabbits. Rabbits were randomly divided into two groups after receiving gunshot wounds in both lower limbs. In group 1, the wounded limbs on the experimental side were immersed in brine for 5 h; in group 2, the wounded limbs on experimental side were immersed in tapwater for 5 h. All the wounds were treated with nanometer silver impregnated dressing on the experimental sides, while those of the control sides were treated with vaseline dressing. Biopsy was done after 30 min and 1, 2, 3, 4, 5 h, respectively. In group 1, the onset of inflammation around the wounds of the experimental sides was delayed, the inflammatory response was less serious, and the wounds were dry with less exudation compared to the controls. The mean healing time of the entry wounds on experimental and control sides was (29.4 +/- 6.6) d and (36.3 +/- 6.0) d (P < 0.01), respectively, and that of the exit wounds on experimental and control sides was (20.1 +/- 6.0) d and (27.3 +/- 5.7) d (P < 0.01), respectively. In group 2, only one of the experimental wounds showed mild inflammation, while all of the control wounds showed serious inflammation with much exudation. The mean healing time of the entry wounds on experimentsides was (13.0 +/- 1.52) d, while that on control sides was (16.0 +/- 3.10) d (P < 0.01). The mean healing time of exit wounds on experimental sides was (11.0 +/- 2.75) d, and those of the control sides was (15.6 +/- 2.85) d (P < 0.01). The nanometer silver impregnated dressing can control infection and accelerate healing in gunshot wounds in rabbits.

Antimicrobial-impregnated dressing combined with negative-pressure wound therapy increases split-thickness skin graft engraftment: a simple effective technique.

PubMed

Wu, Cheng-Chun; Chew, Khong-Yik; Chen, Chien-Chang; Kuo, Yur-Ren

2015-01-01

Immobilization and adequate surface contact to wounds are critical for skin graft take. Techniques such as the tie-over dressing, cotton bolster, and vacuum-assisted closure are used to address this, but each has its limitations. This study is designed to assess the effect of antimicrobial-impregnated dressing (AMD) combined with negative-pressure wound therapy (NPWT) on skin graft survival. Retrospective case-control study : Patients with chronic or contaminated wounds treated with split-thickness skin graft. A broad spectrum of wounds was included, from causes such as trauma, burns, chronic diabetic ulcers, and infection. Antimicrobial-impregnated dressing, which contains 0.2% polyhexamethylene biguanide, with NPWT MAIN OUTCOME MEASURE:: Success of skin graft : In the AMD group, all skin grafts achieved 100% take without secondary intervention. No infection or graft failure was observed in any patients, and no complications, such as hematoma or seroma formation, were noted, although in the control group partial loss of skin grafts was noted in 3 patients. Infection and inadequate immobilization were thought to be the main reasons. There were no hematoma or seroma formations in the control group. Use of an AMD dressing with NPWT after split-thickness skin grafting can be an effective method to ensure good graft to wound contact and enhances skin graft take in chronic and contaminated wounds.

Designing cellulosic and nanocellulosic sensors for interface with a protease sequestrant wound-dressing prototype: implications of material selection for dressing and protease sensor design

USDA-ARS?s Scientific Manuscript database

An intelligent dressing is a self-adjusting material with multifunctional properties and/or a biosensor-interface designed to treat specific pathological issues of wounds at a molecular or cellular level. The ability to detect and treat excessive protease levels in wounds, one indicator of chronic w...

Biodegradable soy wound dressings with controlled release of antibiotics: Results from a guinea pig burn model.

PubMed

Egozi, Dana; Baranes-Zeevi, Maya; Ullmann, Yehuda; Gilhar, Amos; Keren, Aviad; Matanes, Elias; Berdicevsky, Israela; Krivoy, Norberto; Zilberman, Meital

2015-11-01

There is growing interest in the development of biodegradable materials from renewable biopolymers, such as soy protein, for biomedical applications. Soy protein is a major fraction of natural soybean and has the advantages of being economically competitive, biodegradable and biocompatible. It presents good water resistance as well as storage stability. In the current study, homogenous antibiotic-loaded soy protein films were cast from aqueous solutions. The antibiotic drug gentamicin was incorporated into the films in order to inhibit bacterial growth, and thus prevent or combat infection, upon its controlled release to the surrounding tissue. The current in vivo study of the dressing material in contaminated deep second-degree burn wounds in guinea pigs (n=20) demonstrated its ability to accelerate epithelialization with 71% epithelial coverage compared to an unloaded format of the soy material (62%) and a significant improved epithelial coverage as compared to the conventional dressing material (55%). Our new platform of antibiotic-eluting wound dressings is advantageous over currently used popular dressing materials that provide controlled release of silver ions, due to its gentamicin release profile, which is safer. Another advantage of our novel concept is that it is based on a biodegradable natural polymer and therefore does not require bandage changes and offers a potentially valuable and economic approach for treating burn-related infections. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Novel soy protein wound dressings with controlled antibiotic release: mechanical and physical properties.

PubMed

Peles, Zachi; Zilberman, Meital

2012-01-01

Naturally derived materials are becoming widely used in the biomedical field. Soy protein has advantages over various types of natural proteins employed for biomedical applications due to its low price, non-animal origin and relatively long storage time and stability. In the current study soy protein isolate (SPI) was investigated as a matrix for wound dressing applications. The antibiotic drug gentamicin was incorporated into the matrix for local controlled release and, thus, protection against bacterial infection. Homogeneous yellowish films were cast from aqueous solutions. After cross-linking they combined high tensile strength and Young's modulus with the desired ductility. The plasticizer type, cross-linking agent and method of cross-linking were found to strongly affect the tensile properties of the SPI films. Selected SPI films were tested for relevant physical properties and the gentamicin release profile. The cross-linking method affected the degree of water uptake and the weight loss profile. The water vapor transmission rate of the films was in the desired range for wound dressings (∼2300 g m(-2) day(-1)) and was not affected by the cross-linking method. The gentamicin release profile exhibited a moderate burst effect followed by a decreasing release rate which was maintained for at least 4 weeks. Diffusion was the dominant release mechanism of gentamicin from cross-linked SPI films. Appropriate selection of the process parameters yielded SPI wound dressings with the desired mechanical and physical properties and drug release behavior to protect against bacterial infection. These unique structures are thus potentially useful as burn and ulcer dressings. Copyright © 2011 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

A Randomized Controlled Trial on the Outcome in Comparing an Alginate Silver Dressing With a Conventional Treatment of a Necrotizing Fasciitis Wound.

PubMed

Meekul, Jarernchon; Chotirosniramit, Arnon; Himakalasa, Woraluck; Orrapin, Saritphat; Wongthanee, Antika; Pongtam, Orapin; Kulprachakarn, Kanokwan; Rerkasem, Kittipan

2017-06-01

Necrotizing fasciitis (NF) is a high morbidity and mortality disease and also demands high economic resources. The standard treatment of NF is surgical debridement and proper dressing for wound bed preparation. The efficacy of silver alginate dressing can inhibit the growth of microorganisms and keep the environment clean for wound bed preparation. However an optimal dressing to manage such wounds has yet to emerge. NF patients who were admitted between April 2013 and May 2016 were randomized to have wound dressing using either silver dressing (Ag group) or normal saline solution gauze (NSS group). The 4 main outcomes for comparison between the 2 groups were the duration of wound bed preparation, total cost during hospital stay, the duration of hospital stay, and the pain score. Thirty-nine patients were included in the study: 19 patients in the NSS group and 20 patients in the Ag group. The mean duration of wound bed preparation in the NSS group was 31.87 days, and in Ag group it was 21.39 days, but this trend was not statistically significant ( P = .057). The mean cost of treatment in the NSS and Ag groups was not significantly different ( P = .434; US$3308.83 and US$2647.82, respectively). The duration of hospital days in the 2 groups was not significantly different either (29.19 days [NSS group] and 20.99 days [Ag group]; P = .222). The pain score was significantly lower in the Ag group than those in the NSS group. Although silver dressing seems to be expensive, the cost of total treatment during hospital stay and the duration of hospital stay were not significantly different between groups. However, the mean duration of wound bed preparation seems to trend favoring toward the silver dressing group.

Enhanced healing of mitomycin C-treated healing-impaired wounds in rats with hydrosheets composed of chitin/chitosan, fucoidan, and alginate as wound dressings.

PubMed

Murakami, Kaoru; Ishihara, Masayuki; Aoki, Hiroshi; Nakamura, Shingo; Nakamura, Shin-Ichiro; Yanagibayashi, Satoshi; Takikawa, Megumi; Kishimoto, Satoko; Yokoe, Hidetaka; Kiyosawa, Tomoharu; Sato, Yasunori

2010-01-01

To create a moist environment for rapid wound healing, a hydrosheet composed of alginate, chitin/chitosan, and fucoidan (ACF-HS) has been developed as a functional wound dressing. The aim of this study was to evaluate the accelerating effect of ACF-HS on wound healing for rat mitomycin C-treated healing-impaired wounds. Full-thickness skin defects were made on the back of rats and mitomycin C was applied onto the wound for 10 minutes to prepare a healing-impaired wound. After thoroughly washing out the mitomycin C, ACF-HS was applied to the healing-impaired wounds. The rats were later euthanized and histological sections of the wounds were prepared. The histological examinations showed significantly advanced granulation tissue and capillary formations in the healing-impaired wounds treated with ACF-HS on days 7 and 14, in comparison with that in alginate fiber (Kaltostat), hydrogel wound dressing (DuoACTIVE), and nontreatment (negative control). Furthermore, in cell culture studies, ACF-HS-absorbed serum and fibroblast growth factor-2 was found to be proliferative for fibroblasts and endothelial cells, respectively, and ACF-HS-absorbed serum was found to be chemoattractive for fibroblasts. However, our results may not be strictly comparable with general healing-impaired wound models in humans because of the cell damage by mitomycin C. In addition, more biocompatibility studies of fucoidan are essential due to the possibility of renal toxicity. © 2010 by the Wound Healing Society.

A cost and clinical effectiveness analysis among moist wound healing dressings versus traditional methods in home care patients with pressure ulcers.

PubMed

Souliotis, Kyriakos; Kalemikerakis, Ioannis; Saridi, Maria; Papageorgiou, Manto; Kalokerinou, Athena

2016-05-01

The aim of the study was a cost and clinical effectiveness analysis between moist wound healing dressings and gauze in a homecare set up for the treatment of stage III and IV pressure ulcers up to complete healing. In addition, we assessed the overall economic burden on the Healthcare System. Treatment method for each patient was chosen randomly by using sealed opaque envelopes. The authors monitored the healing progress and recorded treatment costs without interfering with the treatment process. The healing progress was estimated by using surface measurement transparent films. To estimate treatment costs, the authors took into account labor costs, cost of dressings, as well the cost of other materials such as cleansing gauzes, normal saline, syringes, examination gloves, antiseptics and adhesive tape. The patient group under treatment with moist wound healing dressings consisted of 27 men and 20 women aged 75.1 ± 8,6 and had an average ulcer surface of 43.5 ± 30.70 cm(2) ; the patient group under treatment with gauze comprised 25 men and 23 women aged 77.02 ± 8.02 and had an average ulcer surface 41.52 ± 29.41 cm(2) (p = 0.25, 95% CI, Student's t test). The average healing time for the moist wound healing dressings group' was 85.56 ± 52.09 days, while 121.4 ± 52.21 days for the "gauze group" (p = 0.0001, 95% CI, Student's t test). The dressing change frequency per patient was reduced in the "moist wound healing dressings group," 49.5 ± 29.61, compared with a dressing change frequency per patient of 222.6 ± 101.86 for the "gauze group" (p = 0.0001, 95% CI, Student's t test). The use of moist wound healing dressings had a lower total treatment cost of 1,351 € per patient compared with, the use of gauzes (3,888 €). © 2016 by the Wound Healing Society.

A.D.A.M. test (Antibiofilm Dressing's Activity Measurement) - Simple method for evaluating anti-biofilm activity of drug-saturated dressings against wound pathogens.

PubMed

Junka, Adam F; Żywicka, Anna; Szymczyk, Patrycja; Dziadas, Mariusz; Bartoszewicz, Marzena; Fijałkowski, Karol

2017-12-01

In the present article, we propose a simple Antibiofilm Dressing's Activity Measurement (A.D.A.M.) test that allows to check in vitro a dressing's suitability against biofilm-related wound infections. To perform the test, three agar discs are covered with biofilm formed by the tested pathogen after which they are assembled one over another in the form of an agar plug and placed in the well of a 24-well plate. The top disc is covered with the analyzed dressing and the entire set is incubated for 24h. During this time, the investigated antimicrobial substance is released from the dressing and penetrates to subsequent biofilm-covered agar discs. Biofilm reduction is measured using 2,3,5-triphenyl-2H-tetrazolium chloride (TTC) spectrometric assay and the results are compared to untreated control samples (agar plug covered with biofilm and without the dressing/or with a passive dressing placed on the top disc). Furthermore, in order to standardize the differences in penetrability of the drugs released from active dressings the results can be expressed as a dimensionless value referred to as the Penetrability Index. In summary, A.D.A.M. test is simple, cheap, can be performed practically in every clinical laboratory and takes no more time than routine microbiological diagnostics. Apart from measuring the released drug's activity, the A.D.A.M. test allows to assess drug penetrability (across three agar discs), reflecting real wound conditions, where microbes are frequently hidden under the necrotic tissue or cloth. In conclusion, the A.D.A.M. test produces a high volume of data that, when analyzed, can provide a researcher with a valuable hint concerning the applicability of active dressings against specific biofilm pathogens in a particular setting. Copyright © 2017 Elsevier B.V. All rights reserved.

In vitro investigations of a novel wound dressing concept based on biodegradable polyurethane

NASA Astrophysics Data System (ADS)

Rottmar, Markus; Richter, Michael; Mäder, Xenia; Grieder, Kathrin; Nuss, Katja; Karol, Agnieszka; von Rechenberg, Brigitte; Zimmermann, Erika; Buser, Stephan; Dobmann, Andreas; Blume, Jessica; Bruinink, Arie

2015-06-01

Non-healing and partially healing wounds are an important problem not only for the patient but also for the public health care system. Current treatment solutions are far from optimal regarding the chosen material properties as well as price and source. Biodegradable polyurethane (PUR) scaffolds have shown great promise for in vivo tissue engineering approaches, but accomplishment of the goal of scaffold degradation and new tissue formation developing in parallel has not been observed so far in skin wound repair. In this study, the mechanical properties and degradation behavior as well as the biocompatibility of a low-cost synthetic, pathogen-free, biocompatible and biodegradable extracellular matrix mimicking a PUR scaffold was evaluated in vitro. The novel PUR scaffolds were found to meet all the requirements for optimal scaffolds and wound dressings. These three-dimensional scaffolds are soft, highly porous, and form-stable and can be easily cut into any shape desired. All the material formulations investigated were found to be nontoxic. One formulation was able to be defined that supported both good fibroblast cell attachment and cell proliferation to colonize the scaffold. Tunable biodegradation velocity of the materials could be observed, and the results additionally indicated that calcium plays a crucial role in PUR degradation. Our results suggest that the PUR materials evaluated in this study are promising candidates for next-generation wound treatment systems and support the concept of using foam scaffolds for improved in vivo tissue engineering and regeneration.

In situ deposition of a personalized nanofibrous dressing via a handy electrospinning device for skin wound care

NASA Astrophysics Data System (ADS)

Dong, Rui-Hua; Jia, Yue-Xiao; Qin, Chong-Chong; Zhan, Lu; Yan, Xu; Cui, Lin; Zhou, Yu; Jiang, Xingyu; Long, Yun-Ze

2016-02-01

Current strategies for wound care provide limited relief to millions of patients who suffer from burns, chronic skin ulcers or surgical-related wounds. The goal of this work is to develop an in situ deposition of a personalized nanofibrous dressing via a handy electrospinning (e-spinning) device and evaluate its properties related to skin wound care. MCM-41 type mesoporous silica nanoparticles decorated with silver nanoparticles (Ag-MSNs) were prepared by a facile and environmentally friendly approach, which possessed long-term antibacterial activity and low cytotoxicity. Poly-ε-caprolactone (PCL) incorporated with Ag-MSNs was successfully electrospun (e-spun) into nanofibrous membranes. These in situ e-spun nanofibrous membranes allowed the continuous release of Ag ions and showed broad-spectrum antimicrobial activity against two common types of pathogens, Staphylococcus aureus and Escherichia coli. In addition, the in vivo studies revealed that these antibacterial nanofibrous membranes could reduce the inflammatory response and accelerate wound healing in Wistar rats. The above results strongly demonstrate that such patient-specific dressings could be broadly applied in emergency medical transport, hospitals, clinics and at the patients' home in the near future.Current strategies for wound care provide limited relief to millions of patients who suffer from burns, chronic skin ulcers or surgical-related wounds. The goal of this work is to develop an in situ deposition of a personalized nanofibrous dressing via a handy electrospinning (e-spinning) device and evaluate its properties related to skin wound care. MCM-41 type mesoporous silica nanoparticles decorated with silver nanoparticles (Ag-MSNs) were prepared by a facile and environmentally friendly approach, which possessed long-term antibacterial activity and low cytotoxicity. Poly-ε-caprolactone (PCL) incorporated with Ag-MSNs was successfully electrospun (e-spun) into nanofibrous membranes. These in situ e

Single-Dose Electrospun Nanoparticles-in-Nanofibers Wound Dressings with Enhanced Epithelialization, Collagen Deposition, and Granulation Properties.

PubMed

Ali, Isra H; Khalil, Islam A; El-Sherbiny, Ibrahim M

2016-06-15

Phenytoin (Ph), an antiepileptic drug, was reported to exhibit high wound healing activity. However, its limited solubility, bioavailability, and inefficient distribution during topical administration limit its use. Therefore, this study aims to develop new single-dose electrospun nanoparticles-in-nanofibers (NPs-in-NFs) wound dressings that allow a well-controlled release of Ph. These NPs-in-NFs systems are based on enhanced chitosan (CS)/poly(ethylene oxide) (PEO) electrospun nanofibers (NFs) incorporating optimized Ph-loaded nanocarriers. First, a study was conducted to investigate Ph loading efficiency into polymeric nanocarriers of different types; pluronic nanomicelles and poly(lactic-co-glycolic) acids nanoparticles (PLGA NPs). The drug release profile from the nanocarriers was further optimized via lecithin coating. Second, different electrospinning parameters were manipulated to fabricate beads-free homogeneous NFs with optimized polymer ratios. Plain and Ph-loaded nanocarriers were characterized using Fourier transform infrared (FTIR), differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), dynamic light scattering (DLS), and scanning electron microscopy (SEM). Both entrapment efficiency of Ph (EE%) and its release profile in phosphate buffer saline (PBS; pH 5.5), simulating the wound environment, were studied. Biodegradability, swelling, vapor permeability, and porosity of the developed Ph-loaded NPs-in-NFs wound dressings were investigated. Morphology of the NPs-in-NFs was also studied using SEM and confocal laser microscopy (CLSM). Besides, the release profiles of Ph from the optimized NPs-in-NFs were assessed. The newly developed wound dressings were evaluated in vitro for their cytotoxicity using human fibroblasts and in vivo using a wound healing mice model. Nanocarriers with particle size ranging from 100 to 180 nm were successfully prepared. All nanocarriers attained a high drug entrapment efficiency exceeding 94% and showed

Physical properties and biocompatibility of oligochitosan membrane film as wound dressing.

PubMed

Ujang, Zanariah; Abdul Rashid, Ahmad Hazri; Suboh, Siti Kasmarizawaty; Halim, Ahmad Sukari; Lim, Chin Keong

2014-12-30

The physical and biological characteristics of oligochitosan (O-C) film, including its barrier and mechanical properties, in vitro cytotoxicity and in vivo biocompatibility, were studied to assess its potential use as a wound dressing. Membrane films were prepared from water-soluble O-C solution blended with various concentrations of glycerol to modify the physical properties of the films. In vitro and in vivo biocompatibility evaluations were performed using primary human skin fibroblast cultures and subcutaneous implantation in a rat model, respectively. Addition of glycerol significantly influenced the barrier and mechanical properties of the films. Water absorption capacity was in the range of 80%-160%, whereas water vapor transmission rate varied from 1,180 to 1,618 g/m2 per day. Both properties increased with increasing glycerol concentration. Tensile strength decreased while elongation at break increased with the addition of glycerol. O-C films were found to be noncytotoxic to human fibroblast cultures and histological examination proved that films are biocompatible. These results indicate that the membrane film from O-C has potential application as a wound-dressing material.

Silver deposition and tissue staining associated with wound dressings containing silver.

PubMed

Walker, Michael; Cochrane, Christine A; Bowler, Philip G; Parsons, David; Bradshaw, Peter

2006-01-01

Argyria is the general term used to denote a clinical condition in which excessive administration and deposition of silver causes a permanent irreversible gray-blue discoloration of the skin or mucous membranes. The amount of discoloration usually depends on the route of silver delivery (ie, oral or topical administration) along with the body's ability to absorb and excrete the administered silver compound. Argyria is accepted as a rare dermatosis but once silver particles are deposited, they remain immobile and may accumulate during the aging process. Topical application of silver salts (eg, silver nitrate solution) may lead to transient skin staining. To investigate their potential to cause skin staining, two silver-containing dressings (Hydrofiber and nanocrystalline) were applied to human skin samples taken from electively amputated lower limbs. The potential for skin discoloration was assayed using atomic absorption spectroscopy. When the dressings were hydrated with water, a significantly higher amount of silver was released from the nanocrystalline dressing compared to the Hydrofiber dressing (P <0.005), which resulted in approximately 30 times more silver deposition. In contrast, when saline was used as the hydration medium, the release rates were low for both dressings and not significantly different (silver deposition was minimal). Controlling the amount of silver released from silver-containing dressings should help reduce excessive deposition of silver into wound tissue and minimize skin staining.

Establishment of a cell-based wound healing assay for bio-relevant testing of wound therapeutics.

PubMed

Planz, Viktoria; Wang, Jing; Windbergs, Maike

Predictive in vitro testing of novel wound therapeutics requires adequate cell-based bio-assays. Such assays represent an integral part during preclinical development as pre-step before entering in vivo studies. Simple "scratch tests" based on defected skin cell monolayers exist, however these can solely be used for testing liquids, as cell monolayer destruction and excessive hydration limit their applicability for (semi-)solid systems like wound dressings. In this context, a cell-based wound healing assay is introduced for rapid and predictive testing of wound therapeutics independent of their physical state in a bio-relevant environment. A novel wound healing assay was established for bio-relevant and predictive testing of (semi-) solid wound therapeutics. The assay allows for physiologically relevant hydration of the tested wound therapeutics at the air-liquid interface and their removal without cell monolayer disruption. In a proof-of-concept study, the applicability and discriminative power could be demonstrated by examining unloaded and drug-loaded wound dressings with two different established wound healing actives (dexpanthenol and metyrapone) and their effect on skin cell behavior. The influence of the released drug on the cells´ healing behavior could successfully be monitored over time. Wound size assessment after 96h resulted in an eight fold smaller wound area for drug treated models compared to the ones treated with unloaded fibers and non-treated wounds. This assay provides valuable first insights towards the establishment of a valid screening and evaluation tool for preclinical wound therapeutic development from liquid to (semi-)solid systems to improve predictability in a simple, yet standardized way. Copyright © 2017 Elsevier Inc. All rights reserved.

Antibacterial chitosan/silk sericin 3D porous scaffolds as a wound dressing material.

PubMed

Karahaliloglu, Zeynep; Kilicay, Ebru; Denkbas, Emir Baki

2017-09-01

Antimicrobial mixed dressings have traditionally been used to minimize bacterial infection of burns and other wounds. This study presents the advancement of biocompatible chitosan/silk sericin (CHT/SS) scaffolds combined with lauric acid (LA) and zinc oxide nanoparticles (nZnO) for the successful wound dressing applications. Antibacterial assay results showed that the diameters of the inhibition zone increased from 2 ± 0.4 to 7 ± 0.1 mm for Escherichia coli, as well as from 2.5 ± 0.2 to 6 ± 0.4 mm for Staphylococcus aureus while CHTS/SS/100nZnO compared to CHT/SS/0.01LA. The results not only showed excellent inhibition against Gram-positive and Gram-negative bacterial growth but also revealed improved proliferation and extended viability for HaCaT cells.

Experimental study of reparative regeneration processes in the wound treated with bioactive dressings.

PubMed

Chekmareva, I A

2002-02-01

Quantitative and structural functional analysis of granulation tissue cells during treatment with protein-polysaccharide dressing Collahit F was carried out. The preparation effectively cleansed the wound from detritus, prevented secondary infection due to stimulation of the functional activity of macrophages and due to the effect of its antiseptic component (furagin), and stimulated proliferative activity of fibroblasts and granulation tissue microvessels on day 5 of treatment, thus promoting repair processes in the wound.

Nanoclay cross-linked semi-IPN silk sericin/poly(NIPAm/LMSH) nanocomposite hydrogel: An outstanding antibacterial wound dressing.

PubMed

Yang, Chaochao; Xue, Rui; Zhang, Qingsong; Yang, Shulin; Liu, Pengfei; Chen, Li; Wang, Ke; Zhang, Xiaoyong; Wei, Yen

2017-12-01

High antibacterial and skin-like hydrogels have always been the perfect wound dressing for human to protect wound from infection. Here, based on silk sericin, we design a series of nanoclay lithium magnesium silicate hydrate (LMSH) cross-linked semi-IPN sericin/poly(NIPAm/LMSH) (HSP) nanocomposite hydrogels and demonstrate advantages in serving as antibacterial wound dressing in comparison with gauze. Firstly, the effect of mass ratios of sericin/(sericin+NIPAm) upon pore structure, feasibility of mechanics and gas permeability of HSP nanocomposite hydrogels were evaluated. Then, the relationship between nanocomposite hydrogel and histological/antimicrobial properties was systematically analyzed. It was found that, the introduction of sericin increased internal pore size, leading to obvious transition from honeycomb to layered structure. Furthermore, as mass ratio of sericin/(sericin+NIPAm) is 20%, the wound healing area treated with nanocomposite hydrogels at 6th day reached up to 83%, 3 times of gauze, and almost recovered at 13th day. Especially, antibacterial mechanism can be thought to be the results that the macromolecular sericin embedded in the nanocomposite hydrogel adsorbed bacteria by charge interaction and micromolecular sericin dissociating out from nanocomposite hydrogels can be adsorbed onto bacteria. Copyright © 2017 Elsevier B.V. All rights reserved.

[Influence of different inner dressings in negative-pressure wound therapy on escharectomy wound of full-thickness burn rabbits].

PubMed

Lin, J H; Chen, J; Xue, D J; Huang, W X; Su, G L

2017-07-20

Objective: To explore the influence of different inner dressings in negative-pressure wound therapy (NPWT) on escharectomy wound of full-thickness burn rabbits. Methods: Eighteen Japanese white rabbits were inflicted with full-thickness burn on unilateral back. They were divided into polymer dressing group (PD), biological dressing group (BD), and silver biological dressing group (SBD), according to the random number table, with 6 rabbits in each group. On 3 days post burn, the wounds were performed with escharectomy, and then wounds of rabbits in group PD were covered with polyurethane foam. Wounds of rabbits in group BD were covered with porcine acellular dermal matrix (ADM) and wounds of rabbits in group SBD were covered with silver porcine ADM. Then continuous NPWT was performed on rabbits of the three groups for 7 days. Immediately after surgery and on post surgery day (PSD) 7, general observation of wound was conducted and tissue around the wound was harvested for determination of dry to wet weight ratio. The content of bacteria was counted and the content of tumor necrosis factor α (TNF-α), interleukin-1β (IL-1β), and IL-6 in wound was determined by enzyme-linked immunosorbent assay. Fibroblasts in wound were counted after Masson staining and number of microvessels was counted after CD31 antibody immunohistochemical staining. Data were processed with analysis of variance for repeated measurement, LSD- t test, paired samples t test, and Bonferroni correction. Results: (1) Immediately after surgery, there was no granulation tissue in basal wound of rabbits in the three groups, with rich blood supply and obvious edema. On PSD 7, much granulation tissue was found in basal wound of rabbits in the three groups, with no or mild edema and no obvious redness and swelling in wound edge. (2) There were no significant differences in dry to wet weight ratios of tissue around the wound among and within the three groups immediately after surgery and on PSD 7 (with F

Effectiveness of Aloe Vera gel compared with 1% silver sulphadiazine cream as burn wound dressing in second degree burns.

PubMed

Shahzad, Muhammad Naveed; Ahmed, Naheed

2013-02-01

To assess the efficacy of Aloe Vera gel compared with 1% silver sulfadiazine cream as a burn dressing for the treatment of superficial and partial thickness burns. This Interventional Comparative study was carried out at the Burn unit and Plastic surgery department, Nishtar Hospital Multan, Pakistan from July 2008 to December 2010. A total of 50 patients with superficial and partial thickness burns were divided into two equal groups randomly by consecutive sampling method, one group was dressed with Aloe Vera gel while the other was treated with 1% silversulphadiazine cream, and the results regarding duration of wound epithelialization, pain relief and cost of treatment were compared. In patients treated with Aloe Vera gel, healing of burn wounds were remarkably early than those patients treated with 1% silver sulfadiazine. All the patients of Aloe Vera group were relieved of pain earlier than those patients who were treated with SSD. Thermal burns patients dressed with Aloe Vera gel showed advantage compared to those dressed with SSD regarding early wound epithelialization, earlier pain relief and cost-effectiveness.

A retrospective review of burn dressings on a porcine burn model.

PubMed

Wang, Xue-Qing; Kravchuk, Olena; Kimble, Roy M

2010-08-01

This is a study to compare wound healing among three types of dressings on a porcine model with deep-dermal-partial-thickness burns. The burns in this study were from eight animal trials conducted in the past for other purposes and only burns with a uniform pale appearance that had served as controls in original experiments were selected. In total, there were 57 burns in 33 pigs, using one of following three dressings: Acticoat (Silver) (3 trials), Jelonet (Gauze) (3 trials), and Solosite Gel/Jelonet (Gel/Gauze) (2 trials). The wound healing assessments included wound re-epithelialisation during a 6-week period, clinical and histological scar assessments at week 6 after burn. Of all wound healing/scar assessments, only re-epithelialisation showed statistical difference between dressings. Earlier re-epithelialisation was observed in Gel/Gauze dressings compared to Silver and/or Gauze dressings. However, this study revealed huge variation in wound healing outcome between 3 trials within both Silver and/or Gauze dressings, supported by significant differences on re-epithelialisation, clinical and histological scar measurements. In addition, it was found that larger animals healed better than smaller ones, based on weights from 21 pigs. Of all dressings, Silver delivers the best protection for wound colonization/infection. Wound colonization/infection was found to confine wound healing and lead to thinner RND in scars. From this study, we cannot find enough evidence to suggest the beneficial effect of one dressing(s) over others on burn wound healing outcome on a porcine model with small deep-dermal-partial-thickness burns with a relative small sample size.

The use of honey as a topical dressing to treat a large, devitalized wound in a stumptail macaque (Macaca arctoides).

PubMed

Staunton, Christine J; Halliday, Lisa C; Garcia, Kelly D

2005-07-01

There are many reasons wounds are managed as open wounds rather than by primary closure. Indications include gross contamination, infection, and skin loss leading to insufficient adjacent tissue for wound closure. The most common method of managing an open wound is with wet-to-dry dressings. Wet-to-dry dressings provide mechanical debridement and promote the movement of viscous exudates away from the wound. Wet-to-dry bandages ideally are changed every 12 to 24 h. For nonhuman primates, it is desirable to develop wound management techniques that limit animal handling for bandage changes and thus the frequency of sedation. Anecdotal reports on the use of honey to treat wounds date back to 2000 B.C. Recently, scientific inquiries have found merit to these reports. Honey accelerates healing because of its direct effects on tissue and antibacterial properties. In addition, dressings with honey can be changed relatively infrequently. Honey decreases inflammatory edema, hastens sloughing of devitalized tissue, attracts macrophages which cleanse the wound, provides a local cellular energy source, and protectively covers the wound. A high osmolarity, acidity, and hydrogen peroxide content confer honey with antibacterial properties. Here we describe the use of honey to manage a bite wound in a stumptail macaque (Macaca arctoides). The wound healed rapidly: after 2 weeks of treatment, there was markedly less exudate and no necrotic tissue. This report describes how honey may be helpful in the management of open wounds in nonhuman primates by minimizing the need for sedation for bandage changes.

Development of novel wound care systems based on nanosilver nanohydrogels of polymethacrylic acid with Aloe vera and curcumin.

PubMed

Anjum, Sadiya; Gupta, Amlan; Sharma, Deepika; Gautam, Deepti; Bhan, Surya; Sharma, Anupama; Kapil, Arti; Gupta, Bhuvanesh

2016-07-01

This study is aimed at the development of a composite material for wound dressing containing nanosilver nanohydrogels (nSnH) along with Aloe vera and curcumin that promote antimicrobial nature, wound healing and infection control. Nanosliver nanohydrogels were synthesized by nanoemulsion polymerization of methacrylic acid (MAA) followed by subsequent crosslinking and silver reduction under irradiation. Both the polymerization and irradiation time had significant influence on the nanoparticle shape, size and its formation. Polyvinyl alcohol/polyethylene oxide/carboxymethyl cellulose matrix was used as gel system to blend with nSnH, A. vera, curcumin and coat it on the hydrolysed PET fabric to develop antimicrobial dressings. The cumulative release of silver from the dressing was found to be ~42% of the total loading after 48h. The antimicrobial activity of the dressings was studied against both Staphylococcus aureus and Escherichia coli. In vivo wound healing studies were carried out over a period of 16d on full-thickness skin wounds created on Swiss albino mice. Fast healing was observed in Gel/nSnH/Aloe treated wounds with minimum scarring, as compared to other groups. The histological studies showed A. vera based dressings to be the most optimum one. These results suggest that nSnH along with A. vera based dressing material could be promising candidates for wound dressings. Copyright © 2016 Elsevier B.V. All rights reserved.

A modified collagen gel dressing promotes angiogenesis in a preclinical swine model of chronic ischemic wounds.

PubMed

Elgharably, Haytham; Ganesh, Kasturi; Dickerson, Jennifer; Khanna, Savita; Abas, Motaz; Ghatak, Piya Das; Dixit, Sriteja; Bergdall, Valerie; Roy, Sashwati; Sen, Chandan K

2014-01-01

We recently performed proteomic characterization of a modified collagen gel (MCG) dressing and reported promising effects of the gel in healing full-thickness excisional wounds. In this work, we test the translational relevance of our aforesaid findings by testing the dressing in a swine model of chronic ischemic wounds recently reported by our laboratory. Full-thickness excisional wounds were established in the center of bipedicle ischemic skin flaps on the backs of animals. Ischemia was verified by laser Doppler imaging, and MCG was applied to the test group of wounds. Seven days post wounding, macrophage recruitment to the wound was significantly higher in MCG-treated ischemic wounds. In vitro, MCG up-regulated expression of Mrc-1 (a reparative M2 macrophage marker) and induced the expression of anti-inflammatory cytokine interleukin (IL)-10 and of fibroblast growth factor-basic (β-FGF). An increased expression of CCR2, an M2 macrophage marker, was noted in the macrophages from MCG treated wounds. Furthermore, analyses of wound tissues 7 days post wounding showed up-regulation of transforming growth factor-β, vascular endothelial growth factor, von Willebrand's factor, and collagen type I expression in MCG-treated ischemic wounds. At 21 days post wounding, MCG-treated ischemic wounds displayed higher abundance of proliferating endothelial cells that formed mature vascular structures and increased blood flow to the wound. Fibroblast count was markedly higher in MCG-treated ischemic wound-edge tissue. In addition, MCG-treated wound-edge tissues displayed higher abundance of mature collagen with increased collagen type I : III deposition. Taken together, MCG helped mount a more robust inflammatory response that resolved in a timely manner, followed by an enhanced proliferative phase, angiogenic outcome, and postwound tissue remodeling. Findings of the current study warrant clinical testing of MCG in a setting of ischemic chronic wounds. © 2014 by the Wound

Comparative effectiveness of different wound dressings for patients with partial-thickness burns: study protocol of a systematic review and a Bayesian framework network meta-analysis

PubMed Central

Jiang, Qiong; Chen, Zhao-Hong; Wang, Shun-Bin; Chen, Xiao-Dong

2017-01-01

Introduction Selecting a suitable wound dressing for patients with partial-thickness burns (PTBs) is important in wound care. However, the comparative effectiveness of different dressings has not been studied. We report the protocol of a network meta-analysis designed to combine direct and indirect evidence of wound dressings in the management of PTB. Methods and analysis We will search for randomised controlled trials (RCTs) evaluating the wound-healing effect of a wound dressing in the management of PTB. Searches will be conducted in MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, the Cochrane Wounds Group Specialised Register and CINAHL. A comprehensive search strategy is developed to retrieve articles reporting potentially eligible RCTs. Besides, we will contact the experts in the field and review the conference proceedings to locate non-published studies. The reference lists of articles will be reviewed for any candidate studies. Two independent reviewers will screen titles and abstracts of the candidate articles. All eligible RCTs will be obtained in full text to perform a review. Disagreement on eligibility of an RCT will be solved by group discussion. The information of participants, interventions, comparisons and outcomes from included RCTs will be recorded and summarised. The primary outcome is time to complete wound healing. Secondary outcomes include the proportion of burns completely healed at the end of treatment, change in wound surface area at the end of treatment, incidence of adverse events, etc. Ethics and dissemination The result of this review will provide evidence for the comparative effectiveness of different wound dressings in the management of PTB. It will also facilitate decision-making in choosing a suitable wound dressing. We will disseminate the review through a peer-review journal and conference abstracts or posters. Trial registration number PROSPERO CRD42016041574; Pre-results. PMID:28336737

Clinical evaluation of a dressing with poly absorbent fibres and a silver matrix for managing chronic wounds at risk of infection: a non comparative trial.

PubMed

Dalac, S; Sigal, L; Addala, A; Chahim, M; Faivre-Carrere, C; Lemdjadi, Z; Bohbot, S

2016-09-01

To assess the efficacy, safety and acceptability of a new silver poly absorbent dressing (UrgoCleanAg) in the local management of exudative chronic wounds at risk of infection, with inflammatory signs suggesting heavy bacterial load. This prospective, multicentre, non-comparative clinical trial was conducted in French hospital wards (dermatology and vascular medicine) or specialised private-practice physicians. Patients were considered at high-risk of infection when presenting with at least three of five selected inflammatory clinical signs, suggesting a heavy bacterial load (pain between two dressing changes, erythema, oedema, malodorous wound and presence of a heavy exudate). They were treated for a maximum period of four weeks, and followed by the physician on a weekly basis, including a clinical examination, area tracings and photographs. The primary efficacy criterion of the trial was the relative wound surface area reduction at the end of the four weeks of treatment. Acceptability was documented by the nursing staff at each dressing change between the weekly evaluations. We recruited 37 patients with chronic wounds. Wound surface area, mostly covered by sloughy tissue, was reduced by 32.5% at the end of the treatment (median value), while the clinical score (maximum value of 5, based on inflammatory clinical signs) decreased from 4.0 to 2.0. Effective debridement properties were documented (62.5% relative reduction of sloughy tissue at week 4; 58.8% of debrided wounds at week 4) and improvement of the periwound skin status was noted (healthy for 28.6% of the patients at week 4 versus 2.7% at baseline). In addition, the tested wound dressing presented a good safety profile associated to a high level of acceptability, noted by both patients and nursing staff. These clinical data support that the tested dressing is a credible therapeutic alternative for the management of chronic wounds at risk of infection with inflammatory signs suggesting heavy bacterial load.

Evaluation of an Oxygen-Diffusion Dressing for Accelerated Healing of Donor-Site Wounds

DTIC Science & Technology

2014-06-01

such as fine- mesh gauze, scarlet-red gauze, Xeroform gauze, and other dressings. Slow healing times, cellulitis , and pain are perennial problems in...burn wound cellulitis preoperatively, and critically ill patients on mechanical ventilation who would be unable to provide consent for the study or

Development and Characterization of Novel Films Based on Sulfonamide-Chitosan Derivatives for Potential Wound Dressing

PubMed Central

Dragostin, Oana Maria; Samal, Sangram Keshari; Lupascu, Florentina; Pânzariu, Andreea; Dubruel, Peter; Lupascu, Dan; Tuchilus, Cristina; Vasile, Cornelia; Profire, Lenuta

2015-01-01

The objective of this study was to develop new films based on chitosan functionalized with sulfonamide drugs (sulfametoxydiazine, sulfadiazine, sulfadimetho-xine, sulfamethoxazol, sulfamerazine, sulfizoxazol) in order to enhance the biological effects of chitosan. The morphology and physical properties of functionalized chitosan films as well the antioxidant effects of sulfonamide-chitosan derivatives were investigated. The chitosan-derivative films showed a rough surface and hydrophilic properties, which are very important features for their use as a wound dressing. The film based on chitosan-sulfisoxazol (CS-S6) showed the highest swelling ratio (197%) and the highest biodegradation rate (63.04%) in comparison to chitosan film for which the swelling ratio was 190% and biodegradation rate was only 10%. Referring to the antioxidant effects the most active was chitosan-sulfamerazine (CS-S5) which was 8.3 times more active than chitosan related to DPPH (1,1-diphenyl-2-picrylhydrazyl) radical scavenging ability. This compound showed also a good ferric reducing power and improved total antioxidant capacity. PMID:26694354

Routine use of PICO dressings may reduce overall groin wound complication rates following peripheral vascular surgery.

PubMed

Fleming, C A; Kuteva, M; O'Hanlon, K; O'Brien, G; McGreal, G

2018-05-01

Approximately 19% of morbidity in peripheral vascular surgery is attributable to wound complications, which can result in delayed healing, and also arterial or graft infection leading to limb loss and even mortality in extreme cases. To determine whether groin wound complications were reduced following the routine introduction of PICO negative pressure wound therapy dressings in patients who underwent peripheral vascular surgery. Patients who underwent peripheral vascular surgery from 2011 to 2016 were identified and divided into PICO and non-PICO groups. Patient, procedure and wound characteristics were tabulated and analysed. Patients were followed-up for at least six weeks postoperatively. Wound complication rates, infection confirmed by microbiology, and requirement for re-admission due to wound complications were noted. Basic cost analysis was performed. In total, 151 patients were analysed (N = 73 PICO, N = 78 non-PICO). No difference in age (P = 0.862), body mass index (P = 0.673), diabetes (P = 0.339), pre-operative albumin (P = 0.196), use of drain (P = 0.343) and history of meticillin-resistant Staphylococcus aureus (P = 0.281) was observed between groups. The PICO group contained more smokers than the non-PICO group (45% vs 29%, P = 0.034). Wound complications were seen in 8% (N = 6) of the PICO group and 19% (N = 15) of the non-PICO group (P = 0.042). No significant difference in infection was found between the two groups (3% vs 6%, P = 0.249), but fewer seromas were observed when PICO dressings were used (1.4% vs 7.7%, P = 0.069). Haematoma (2.7% vs 3.8%, P = 0.531) and dehiscence rates (1.4% vs 1.3%, P = 0.735) were similar between the two groups. Routine use of PICO dressings is associated with a reduction in wound complication rates following peripheral vascular surgery, and is cost-effective. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Silver-pig skin nanocomposites and mesenchymal stem cells: suitable antibiofilm cellular dressings for wound healing.

PubMed

Pérez-Díaz, Mario Alberto; Silva-Bermudez, Phaedra; Jiménez-López, Binisa; Martínez-López, Valentín; Melgarejo-Ramírez, Yaaziel; Brena-Molina, Ana; Ibarra, Clemente; Baeza, Isabel; Martínez-Pardo, M Esther; Reyes-Frías, M Lourdes; Márquez-Gutiérrez, Erik; Velasquillo, Cristina; Martínez-Castañon, Gabriel; Martinez-Gutierrez, Fidel; Sánchez-Sánchez, Roberto

2018-01-10

Treatment of severe or chronic skin wounds is an important challenge facing medicine and a significant health care burden. Proper wound healing is often affected by bacterial infection; where biofilm formation is one of the main risks and particularly problematic because it confers protection to microorganisms against antibiotics. One avenue to prevent bacterial colonization of wounds is the use of silver nanoparticles (AgNPs); which have proved to be effective against non-multidrug-resistant and multidrug-resistant bacteria. In addition, the use of mesenchymal stem cells (MSC) is an excellent option to improve wound healing due to their capability for differentiation and release of relevant growth factors. Finally, radiosterilized pig skin (RPS) is a biomatrix successfully used as wound dressing to avoid massive water loss, which represents an excellent carrier to deliver MSC into wound beds. Together, AgNPs, RPS and MSC represent a potential dressing to control massive water loss, prevent bacterial infection and enhance skin regeneration; three essential processes for appropriate wound healing with minimum scaring. We synthesized stable 10 nm-diameter spherical AgNPs that showed 21- and 16-fold increase in bacteria growth inhibition (in comparison to antibiotics) against clinical strains Staphylococcus aureus and Stenotrophomonas maltophilia, respectively. RPS samples were impregnated with different AgNPs suspensions to develop RPS-AgNPs nanocomposites with different AgNPs concentrations. Nanocomposites showed inhibition zones, in Kirby-Bauer assay, against both clinical bacteria tested. Nanocomposites also displayed antibiofilm properties against S. aureus and S. maltophilia from RPS samples impregnated with 250 and 1000 ppm AgNPs suspensions, respectively. MSC were isolated from adipose tissue and seeded on nanocomposites; cells survived on nanocomposites impregnated with up to 250 ppm AgNPs suspensions, showing 35% reduction in cell viability, in comparison

Antiseptic with modern wound dressings in the treatment of venous leg ulcers: clinical and microbiological aspects.

PubMed

Sopata, M; Kucharzewski, M; Tomaszewska, E

2016-08-01

To assess the impact of a two-period treatment on the clinical condition, bacteriological changes and results of treatment of venous leg ulcers (VLU) using octenidine dihydrochloride. Patients with a VLU were recruited and treated with octenidine dihydrochloride for one month, after which they were randomised and treated with hydrocolloids or foam dressings. The wounds were clinically assessed for the amount of necrotic tissue, granulation tissue, epithelialisation, amount of exudate and pain level. During the first period, bacterial colonisation and antimicrobial efficacy of octenidine dihydrochloride were also evaluated. In the second period the efficacy of treatment, time of treatment and healing rate were investigated. In the group of 50 VLU patients, all wounds (100%) improved after the first treatment period. No clinical signs of infection were observed. Statistically significant changes were observed in all the clinical parameters studied in the treated groups of VLU patients, including reduction of necrotic tissue, the amount of exudate and of pain, as well as increased granulation and epithelialisation. In the second period including treatment with the two dressings, no differences were observed in treatment efficacy, time of treatment or healing rate. As used in this study, octenidine dihydrochloride proved to be effective and useful, changing the clinical condition of VLU, preparing the wound for future treatment with modern dressings. High microbicidal activity of octenidine was observed, both against Gram-negative and Gram-positive bacteria isolated from the ulcers. Octenidine dihydrochloride caused an eradication of multiresistant strains (88%) as well as of bacteria qualified as alert-pathogens (100%) in the treated wounds after four weeks. However, no differences in the effects, time or rate of healing of VLU with two dressings were found in the second period. No side effects or significant local intolerance reactions used for treatment were

Comparison of antimicrobial activity of selected, commercially available wound dressing materials.

PubMed

Szweda, Piotr; Gorczyca, Grzegorz; Tylingo, Robert

2018-05-02

The aim of our study was to examine the antimicrobial potential of eight selected, commercially available wound dressings containing different antimicrobial agents: silver, chlorhexidine acetate, povidone-iodine, and manuka honey. The materials were tested against four reference strains of bacteria: Staphylococcus aureus (PCM 2051), Staphylococcus epidermidis (PCM 2118), Pseudomonas aeruginosa (ATCC 27853), and Escherichia coli (K12), using the disc diffusion-like method and a time-killing assay. For both experiments, the highest activity against all four tested strains of bacteria was observed in the case of Mepilex Ag, which contains silver as an antibacterial agent. Incubation for four hours of a 10x10mm 2 piece of this material in 10ml cells suspension (concentration: 10 9 -10 10 CFU/ml) resulted in complete elimination of bacteria of all four strains tested. The same results were obtained for a povidone-iodine containing dressing, Inadine, though its activity was lower in the disc diffusion assay. Silvercel, Aquacel Ag and Melgisorb Ag, which also contain silver, also exhibited a satisfactory level of activity. In the case of Aquacel Ag, 24 hours' incubation resulted in complete elimination of the cells of both Gram-negative bacteria, Escherichia coli and Pseudomonas aeruginosa.The Escherichia coli cells were killed after only four hours' treatment. High effectiveness against Escherichia coli was also demonstrated for Silvercel. However, 24 hours' includation was required for complete elimination of the cells of this bacteria strain. High activity against all tested bacteria, but only in the disc diffusion assay, was observed for Algivon, which contains manuka honey. The Medisorb Silver Pad, containing silver, and Bactigras, which contains chlorhexidine acetate, revealed much lower antimicrobial activity, particularly noticeable in the time-killing assay. In addition, we also tested the anti-staphylococcal activity of a biopolymer material impregnated with

Transparent crosslinked ultrashort peptide hydrogel dressing with high shape-fidelity accelerates healing of full-thickness excision wounds

NASA Astrophysics Data System (ADS)

Seow, Wei Yang; Salgado, Giorgiana; Lane, E. Birgitte; Hauser, Charlotte A. E.

2016-09-01

Wound healing is a major burden of healthcare systems worldwide and hydrogel dressings offer a moist environment conducive to healing. We describe cysteine-containing ultrashort peptides that self-assemble spontaneously into hydrogels. After disulfide crosslinking, the optically-transparent hydrogels became significantly stiffer and exhibited high shape fidelity. The peptide sequence (LIVAGKC or LK6C) was then chosen for evaluation on mice with full-thickness excision wounds. Crosslinked LK6C hydrogels are handled easily with forceps during surgical procedures and offer an improvement over our earlier study of a non-crosslinked peptide hydrogel for burn wounds. LK6C showed low allergenic potential and failed to provoke any sensitivity when administered to guinea pigs in the Magnusson-Kligman maximization test. When applied topically as a dressing, the medium-infused LK6C hydrogel accelerated re-epithelialization compared to controls. The peptide hydrogel is thus safe for topical application and promotes a superior rate and quality of wound healing.

A pre-clinical evaluation of silver, iodine and Manuka honey based dressings in a model of traumatic extremity wounds contaminated with Staphylococcus aureus.

PubMed

Guthrie, Hugo C; Martin, Kevin R; Taylor, Christopher; Spear, Abigail M; Whiting, Rachel; Macildowie, Sara; Clasper, Jonathan C; Watts, Sarah A

2014-08-01

Prevention of extremity war wound infection remains a clinical challenge. Staphylococcus aureus is the most common pathogen in delayed infection. We hypothesised that choice of wound dressings may affect bacterial burden over 7 days reflecting the current practice of delayed primary closure of wounds within this timeframe. A randomised controlled trial of 3 commercially available dressings (Inadine(®) (Johnson & Johnson, NJ, USA), Acticoat(®) (Smith & Nephew, Hull, UK), Activon Tulle (Advancis Medical, Nottingham, UK)) was conducted in a rabbit model of contaminated forelimb muscle injury. A positive control group treated with antibiotics was included. Groups were compared to a saline soaked gauze control. The primary outcome was a statistically significant reduction (p < 0.05) in tissue S. aureus at 7 days post-injury. Secondary outcome measurements included bacteraemias, observational data, whole blood determination, ELISA for plasma biomarkers, PCR array analysis of wound healing gene expression and muscle/lymph node histopathology. Antibiotic, Inadine and Acticoat groups had statistically significant lower bacterial counts (mean 7.13 [95% CI 0.00-96.31]×10(2); 1.66 [0.94-2.58]×10(5); 8.86 [0.00-53.35]×10(4)cfu/g, respectively) and Activon Tulle group had significantly higher counts (2.82 [0.98-5.61]×10(6)cfu/g) than saline soaked gauze control (7.58 [1.65-17.83]×10(5)cfu/g). There were no bacteraemias or significant differences in observational data or whole blood determination. There were no significant differences in muscle/loss or pathology and lymph node cross-sectional area or morphology. There were some significant differences between treatment groups in the plasma cytokines IL-4, TNFα and MCP-1 in comparison to the control. PCR array data demonstrated more general changes in gene expression in the muscle tissue from the Activon Tulle group than the Inadine or Acticoat dressings with a limited number of genes showing significantly altered

Oxidized Regenerated Cellulose/Collagen Dressings: Review of Evidence and Recommendations.

PubMed

Wu, Stephanie; Applewhite, Andrew J; Niezgoda, Jeffrey; Snyder, Robert; Shah, Jayesh; Cullen, Breda; Schultz, Gregory; Harrison, Janis; Hill, Rosemary; Howell, Melania; Speyrer, Marcus; Utra, Howard; de Leon, Jean; Lee, Wayne; Treadwell, Terry

2017-11-01

Healthcare systems are being challenged to manage increasing numbers of nonhealing wounds. Wound dressings are one of the first lines of defense in wound management, and numerous options exist. The oxidized regenerated cellulose (ORC)/collagen dressing may offer healthcare providers a robust and cost-effective tool for use in a variety of wounds. A multidisciplinary panel meeting was convened to discuss the use of ORC/collagen dressings in wound care and provide practice recommendations. A literature search was conducted to provide a brief review of the peer-reviewed studies published between January 2000 and March 2016 to inform the meeting. A 2-day panel meeting convened in February 2017. Healthcare providers with experience using ORC/collagen dressings. This multidisciplinary panel of 15 experts in wound healing included podiatrists, wound care specialists (doctors, certified wound care nurses, and research scientists), and an orthopedist. The literature search identified 58 articles, a majority of which were low levels of evidence (69.3% were level 3 or lower). Panel members identified wound types, such as abrasions, burns, stalled wounds, diabetic foot ulcers, and pressure injuries, where ORC/collagen dressing use could be beneficial. Panel members then provided recommendations and technical pearls for the use of ORC/collagen dressings in practice. Barriers to ORC/collagen dressing use were discussed, and potential resolutions were offered. An ORC/collagen dressing can be a critical tool for clinicians to help manage a variety of wounds. Clinical and economic studies comparing standard-of-care dressings and plain collagen dressings to ORC/collagen dressings are needed.

Comparative effectiveness of different wound dressings for patients with partial-thickness burns: study protocol of a systematic review and a Bayesian framework network meta-analysis.

PubMed

Jiang, Qiong; Chen, Zhao-Hong; Wang, Shun-Bin; Chen, Xiao-Dong

2017-03-22

Selecting a suitable wound dressing for patients with partial-thickness burns (PTBs) is important in wound care. However, the comparative effectiveness of different dressings has not been studied. We report the protocol of a network meta-analysis designed to combine direct and indirect evidence of wound dressings in the management of PTB. We will search for randomised controlled trials (RCTs) evaluating the wound-healing effect of a wound dressing in the management of PTB. Searches will be conducted in MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, the Cochrane Wounds Group Specialised Register and CINAHL. A comprehensive search strategy is developed to retrieve articles reporting potentially eligible RCTs. Besides, we will contact the experts in the field and review the conference proceedings to locate non-published studies. The reference lists of articles will be reviewed for any candidate studies. Two independent reviewers will screen titles and abstracts of the candidate articles. All eligible RCTs will be obtained in full text to perform a review. Disagreement on eligibility of an RCT will be solved by group discussion. The information of participants, interventions, comparisons and outcomes from included RCTs will be recorded and summarised. The primary outcome is time to complete wound healing. Secondary outcomes include the proportion of burns completely healed at the end of treatment, change in wound surface area at the end of treatment, incidence of adverse events, etc. The result of this review will provide evidence for the comparative effectiveness of different wound dressings in the management of PTB. It will also facilitate decision-making in choosing a suitable wound dressing. We will disseminate the review through a peer-review journal and conference abstracts or posters. PROSPERO CRD42016041574; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please

A Modified Collagen Gel Dressing Promotes Angiogenesis in a Pre-Clinical Swine Model of Chronic Ischemic Wounds

PubMed Central

Elgharably, Haytham; Ganesh, Kasturi; Dickerson, Jennifer; Khanna, Savita; Abas, Motaz; Ghatak, Piya Das; Dixit, Sriteja; Bergdall, Valerie; Roy, Sashwati; Sen, Chandan K.

2015-01-01

We recently performed proteomic characterization of a modified collagen gel (MCG) dressing and reported promising effects of the gel in healing full-thickness excisional wounds. In this work, we test the translational relevance of our aforesaid findings by testing the dressing in a swine model of chronic ischemic wounds recently reported by our laboratory. Full thickness excisional wounds were established in the center of bi- pedicle ischemic skin flaps on the backs of animals. Ischemia was verified by Laser Doppler imaging and MCG was applied to the test group of wounds. Seven days post- wounding, macrophage recruitment to the wound was significantly higher in MCG- treated ischemic wounds. In vitro, MCG up-regulated expression of Mrc-1 (a reparative M2 macrophage marker) and induced the expression of anti-inflammatory cytokine IL-10 and of β-FGF. An increased expression of CCR2, a M2 macrophage marker, was noted in the macrophages from MCG treated wounds. Furthermore, analyses of wound tissues 7 days post wounding showed up-regulation of TGF-β, VEGF, vWF, and collagen type I expression in MCG-treated ischemic wounds. At 21 days post-wounding, MCG-treated ischemic wounds displayed higher abundance of proliferating endothelial cells that formed mature vascular structures and increased blood flow to the wound. Fibroblast count was markedly higher in MCG-treated ischemic wound-edge tissue. In addition, MCG-treated wound-edge tissues displayed higher abundance of mature collagen with increased collagen type I:III deposition. Taken together, MCG helped mount a more robust inflammatory response which resolved in a timely manner, followed by an enhanced proliferative phase, angiogenic outcome and post-wound tissue remodeling. Findings of the current study warrant clinical testing of MCG in a setting of ischemic chronic wounds. PMID:25224310

L. inermis-loaded nanofibrous scaffolds for wound dressing applications.

PubMed

Vakilian, Saeid; Norouzi, Mohammad; Soufi-Zomorrod, Mahsa; Shabani, Iman; Hosseinzadeh, Simzar; Soleimani, Masoud

2018-04-01

Since ancient times, some herbal medicines have been extensively used for burn and wound treatments, showing preference to the common synthetic medications by virtue of having less side effects and faster healing rate. In this study, hybrid nanofibrous scaffolds of poly-l-lactic-acid (PLLA) and gelatin incorporated L. inermis were fabricated via electrospinning technique. Morphology and characteristics of the scaffolds were studied by scanning electron microscopy (SEM) and Fourier transform infrared (FTIR), respectively. The release profile of the L. inermis from the nanofibers was also assessed in vitro. Moreover, the structural stability of the released L. inermis from the nanofibers was evaluated using high-performance liquid chromatography (HPLC). The nanofibers showed a gradual release of L. inermis up to two days while the intact structure was preserved. Furthermore, antibacterial assay demonstrated that L. inermis-loaded nanofibrous scaffolds could effectively kill E. coli and S. aureus within 2 h. Finally, biocompatibility of the nanofibers was proven on 3T3 fibroblasts. Therefore, the L. inermis loaded PLLA-Gelatin nanofibers showed a potential application as a wound dressing in order to control wound infections. Copyright © 2018. Published by Elsevier Ltd.

Modelling the cost implications of using carboxymethylcellulose dressing compared with gauze in the management of surgical wounds healing by secondary intention in the US and UK.

PubMed

Guest, Julian F; Ruiz, Francis J

2005-02-01

To estimate the costs of using carboxymethyl cellulose dressing (CMCD; Aquacel* Hydrofiber) compared to gauze in managing surgical wounds healing by secondary intention in the US and UK. This was a modelling study performed from the perspective of payers (i.e. the hospital and community sector in the US and the National Health Service (NHS) in the UK). Clinical outcomes attributable to managing surgical wounds healing by secondary intention with gauze were obtained from the published literature in the English language. There were no published studies on wounds healing by secondary intention with CMCD. Hence, the analysis conservatively assumed that wound healing rates associated with gauze would be the same for CMCD. These data were combined with resource utilisation estimates derived from a panel of clinicians enabling us to perform decision modelling. The models were used to determine the expected direct healthcare costs eight weeks after the surgical wounds were dressed by CMCD or gauze and left to heal by secondary intention in the US and UK. All wounds are expected to heal within eight weeks, irrespective of dressing. Managing abscesses and other surgical wounds with CMCD instead of gauze in the US is expected to reduce costs by 4% in both wound types (i.e. $247 and $507 respectively) per patient over eight weeks. In the UK, managing abscesses and other surgical wounds with CMCD instead of gauze is expected to reduce costs by 30% (574 pounds) and 12% (581 pounds) respectively per patient over eight weeks. The lower cost of managing CMCD-treated patients is due to decreased nursing costs associated with a lower frequency of CMCD changes compared to gauze dressing changes. Dressing surgical wounds healing by secondary intention with CMCD instead of gauze is expected to lead to a reduction in healthcare costs in both the US and UK. Hence, the purchase price of a dressing is not indicative of the cost effectiveness of a given method of surgical wound care.

Oxidized Regenerated Cellulose/Collagen Dressings: Review of Evidence and Recommendations

PubMed Central

Wu, Stephanie; Applewhite, Andrew J.; Niezgoda, Jeffrey; Snyder, Robert; Shah, Jayesh; Cullen, Breda; Schultz, Gregory; Harrison, Janis; Hill, Rosemary; Howell, Melania; Speyrer, Marcus; Utra, Howard; de Leon, Jean; Lee, Wayne; Treadwell, Terry

2017-01-01

ABSTRACT OBJECTIVE: Healthcare systems are being challenged to manage increasing numbers of nonhealing wounds. Wound dressings are one of the first lines of defense in wound management, and numerous options exist. The oxidized regenerated cellulose (ORC)/collagen dressing may offer healthcare providers a robust and cost-effective tool for use in a variety of wounds. DESIGN: A multidisciplinary panel meeting was convened to discuss the use of ORC/collagen dressings in wound care and provide practice recommendations. A literature search was conducted to provide a brief review of the peer-reviewed studies published between January 2000 and March 2016 to inform the meeting. SETTING: A 2-day panel meeting convened in February 2017. PARTICIPANTS: Healthcare providers with experience using ORC/collagen dressings. This multidisciplinary panel of 15 experts in wound healing included podiatrists, wound care specialists (doctors, certified wound care nurses, and research scientists), and an orthopedist. RESULTS: The literature search identified 58 articles, a majority of which were low levels of evidence (69.3% were level 3 or lower). Panel members identified wound types, such as abrasions, burns, stalled wounds, diabetic foot ulcers, and pressure injuries, where ORC/collagen dressing use could be beneficial. Panel members then provided recommendations and technical pearls for the use of ORC/collagen dressings in practice. Barriers to ORC/collagen dressing use were discussed, and potential resolutions were offered. CONCLUSIONS: An ORC/collagen dressing can be a critical tool for clinicians to help manage a variety of wounds. Clinical and economic studies comparing standard-of-care dressings and plain collagen dressings to ORC/collagen dressings are needed. PMID:29049055

Release of antibiotics from collagen dressing.

PubMed

Grzybowski, J; Antos-Bielska, M; Ołdak, E; Trafny, E A

1997-01-01

Our new collagen dressing has been developed recently. Three types (A, B, and C) of the dressing were prepared in this study. Each type contained bacitracin, neomycin or colistin. The antibiotic was input into: i. collagen sponge (CS)--type A, ii. layer of limited hydrophobicity (LLH)--type B, and iii. into both CS and LLH layers--type C. The final concentration of the antibiotic that resulted from the loading level was 2 mg/cm2 for the dressings of type A and B and 4 mg/cm2 for the dressing of type C. The antibiotics were then extracted from the pieces of dressings for two days through dialysis membrane. Susceptibility of 54 bacterial strains (S. aureus, P. aeruginosa, and Acinetobacter) isolated from burn wounds were tested to the three antibiotics used for preparation of the dressings. The results of the study evidenced that efficiency of released of antibiotics into the extracts depended on the kind of antibiotic and on the type of dressing. The concentration of the antibiotics proved to be much higher than MIC90 values of the bacterial isolates tested in respect to their susceptibility. The dressing containing mixture of the three antibiotics in two layers--CS and LLH is now considered as potentially effective for care of infected wounds. It may be useful for the treatment of infected wounds or for profilaxis of contaminated wounds, ensuring: i. sufficient antimicrobial activity in wound, and ii. optimal wound environment for the presence of collagenic biomaterial on the damaged tissue.

A prospective randomized trial comparing subatmospheric wound therapy with a sealed gauze dressing and the standard vacuum-assisted closure device.

PubMed

Dorafshar, Amir H; Franczyk, Mieczyslawa; Gottlieb, Lawrence J; Wroblewski, Kristen E; Lohman, Robert F

2012-07-01

Two methods of subatmospheric pressure wound therapy--wall suction applied to a sealed gauze dressing (GSUC) and the vacuum-assisted closure device (VAC)--were compared in hospitalized patients at University of Chicago Medical Center. VAC therapy is widely used, but can be expensive and difficult to apply; it also fails in some patients. A randomized prospective study of 87 patients (N = 45 in the GSUC arm and N = 42 in the VAC arm) was undertaken between October 2006 and May 2008. The study comprised patients with acute wounds resulting from trauma, dehiscence, or surgery. Demographics and wound characteristics were similar in both groups. There were significant reductions in wound surface area and volume in each group. In the GSUC group, the reductions in wound surface area and volume were 4.5%/day and 8.4%/day, respectively (P < 0.001 for both), and in the VAC group, this was 4.9%/day and 9.8%/day, respectively (P < 0.001 for both). The reductions in wound surface area and volume were similar in both groups (P = 0.60 and 0.19, respectively, for the group-by-time interaction). The estimated difference (VAC - GSUC) was 0.4% (95% confidence interval: -1.0, 1.7) for wound surface area and 1.4% (95% confidence interval: -0.7, 3.5) for volume. The mean cost per day for GSUC therapy was $4.22 versus $96.51 for VAC therapy (P < 0.01) and the average time required for a GSUC dressing change was 19 minutes versus 31 minutes for a VAC dressing change (P < 0.01). The sum of pain intensity differences was 0.50 in the GSUC group compared with 1.73 for the VAC group (P = 0.02). GSUC is noninferior to VAC with respect to changes in wound volume and surface area in an acute care setting. In addition, GSUC dressings were easier to apply, less expensive, and less painful.

Aquacel(®) Ag dressing versus Acticoat™ dressing in partial thickness burns: a prospective, randomized, controlled study in 100 patients. Part 1: burn wound healing.

PubMed

Verbelen, Jozef; Hoeksema, Henk; Heyneman, Alexander; Pirayesh, Ali; Monstrey, Stan

2014-05-01

Studies comparing contemporary silver dressings in burns are scarce. In a prospective, randomized, controlled study, counting 50 patients/research group, we compared two frequently used silver dressings, Acticoat™ and Aquacel(®) Ag, in the management of partial thickness burns with a predicted healing time between 7 and 21 days as assessed by laser Doppler imaging between 48 and 72h after burn. Variables investigated were related to baseline research group characteristics, wound healing, bacteriology, economics, nurse, and patient experience. Both research groups were comparably composed taking into account gender, age and burn characteristics. Similar results were obtained as to healing time and bacterial control with both silver dressings. A statistically significant difference in favor of the Aquacel(®) Ag dressing was found for average ease of use (p<0.001), average ease of application (p=0.001), patient pain (p<0.001), patient comfort with the dressing (p=0.017), silver staining (p<0.001), and cost effectiveness (p<0.001). Both silver dressings resulted in comparable healing times and bacterial control but the Aquacel(®) Ag dressing significantly increased comfort for patients as well as nurses and was significantly more cost-effective than the Acticoat™ dressing for the given indication. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

Loofah sponge as an interface dressing material in negative pressure wound therapy: results of an in vivo study.

PubMed

Tuncel, Umut; Turan, Aydin; Markoc, Fatma; Erkorkmaz, Unal; Elmas, Cigdem; Kostakoglu, Naci

2014-03-01

Since the introduction of negative pressure wound therapy (NPWT), the physiological effects of various interface dressing materials have been studied. The purpose of this experimental study was to compare the use of loofah sponge to standard polyurethane foam or a cotton gauze sponge. Three wounds, each measuring 3 cm x 3 cm, were created by full-thickness skin excision on the dorsal sides of 24 New Zealand adult white rabbits. The rabbits were randomly divided into four groups of six rabbits each. In group 1 (control), conventional saline-moistened gauze dressing was provided and changed at daily intervals. The remaining groups were provided NPWT dressings at -125 mm Hg continuous pressure. This dressing was changed every 3 days for 9 days; group 2 was provided polyurethane foam, group 3 had conventional saline-soaked antimicrobial gauze, and group 4 had loofah sponge. Wound area measurements and histological findings (inflammation, granulation tissue, neovascularization, and reepithelialization) were analyzed on days 3, 6, and 9. Wound area measurements at these intervals were significantly different between the control group and study groups (P<0.05). Granulation and neovascularization scores were also significantly different between the control and treatment groups at day 3 (P=0.002). No differences in any of the healing variables studied were observed between the other three dressing materials. According to scanning electron microscopy analysis of the three interface materials, the mean pore size diameter of foam and gauze interface materials was 415.80±217.58 μm and 912.33±116.88 μm, respectively. The pore architecture of foam was much more regular than that of gauze. The average pore size diameter of loofah sponge was 736.83±23.01 μm; pores were hierarchically located--ie, the smaller ones were usually peripheral and larger ones werecentral. For this study, the central part of loofah sponge was discarded to achieve a more homogenous structure of

Nanosilver–Silica Composite: Prolonged Antibacterial Effects and Bacterial Interaction Mechanisms for Wound Dressings

PubMed Central

Ge, Yanling; Palva, Airi; Nordström, Katrina

2017-01-01

Infected superficial wounds were traditionally controlled by topical antibiotics until the emergence of antibiotic-resistant bacteria. Silver (Ag) is a kernel for alternative antibacterial agents to fight this resistance quandary. The present study demonstrates a method for immobilizing small-sized (~5 nm) silver nanoparticles on silica matrix to form a nanosilver–silica (Ag–SiO2) composite and shows the prolonged antibacterial effects of the composite in vitro. The composite exhibited a rapid initial Ag release after 24 h and a slower leaching after 48 and 72 h and was effective against both methicillin-resistant Staphylococcus aureus (MRSA) and Escherichia coli (E. coli). Ultraviolet (UV)-irradiation was superior to filter-sterilization in retaining the antibacterial effects of the composite, through the higher remaining Ag concentration. A gauze, impregnated with the Ag–SiO2 composite, showed higher antibacterial effects against MRSA and E. coli than a commercial Ag-containing dressing, indicating a potential for the management and infection control of superficial wounds. Transmission and scanning transmission electron microscope analyses of the composite-treated MRSA revealed an interaction of the released silver ions with the bacterial cytoplasmic constituents, causing ultimately the loss of bacterial membranes. The present results indicate that the Ag–SiO2 composite, with prolonged antibacterial effects, is a promising candidate for wound dressing applications. PMID:28878170

Synthesis, characterization, and evaluation of poly(aminoethyl) modified chitosan and its hydrogel used as antibacterial wound dressing.

PubMed

Zhang, Yubei; Dang, Qifeng; Liu, Chengsheng; Yan, Jingquan; Cha, Dongsu; Liang, Shengnan; Li, Xiaoli; Fan, Bing

2017-09-01

This study aims to develop new antibacterial hydrogel wound dressings composed of poly(aminoethyl) modified chitosan (PAEMCS). FTIR, 1 H NMR, and elemental analysis demonstrated that PAEMCS was successfully synthesized via grafting poly(aminoethyl) groups onto hydroxyl groups on chitin first, and removing acetyl groups from the grafted polymer afterward. XRD and TGA implied its well-defined crystallinity and thermostability. Furthermore, a series of hydrogels were fabricated under the participation of dipotassium hydrogen phosphate (DHP). The gelation tests suggested that the higher concentration of PAEMCS or DHP was beneficial to the formation of hydrogels. The pH values of hydrogels at 37°C were all in the range of 7.12-7.50. The rheological tests indicated that PAEMCS-based hydrogels were of lower DHP addition and higher elasticity than CS-based hydrogels to achieve the same gelation temperature under the same polymer's concentration. Additionally, the swelling, anti-bacteria, and cytotoxicity experiments showed that PAEMCS-based hydrogels possessed excellent hygroscopicity, high antibacterial activity against E. coli, S. aureus, or S. epidermidis, and good cytocompatibility toward L929 cells or HUVECs, respectively. All the results implied that PAEMCS-based hydrogels not only maintained inherent multiple properties of chitosan but also possessed excellent antibacterial activity, and might be promising antibacterial hydrogel dressings used in wound therapy. Copyright © 2017 Elsevier B.V. All rights reserved.

Molecular Wiring in Smart Dressings: Opening a New Route to Monitoring Wound pH

PubMed Central

McLister, Anna; Davis, James

2015-01-01

It has been proposed that fluctuations in wound pH can give valuable insights into the healing processes in chronic wounds, but acquiring such data can be a technological challenge especially where there is little sample available. Developments in voltammetric pH sensing have opened up new avenues for the design of probes that can function in ultra-small volumes and can be inherently disposable but, as yet few can meet the demands of wound monitoring. A preliminary investigation of the pH response of a new redox wire prepared from a peptide homopolymer of tryptophan is presented and its potential applicability as a sensing material for use in smart dressings is critically discussed. PMID:27417774

[Evaluation of the influence of sterilization method on the stability of carboxymethyl cellulose wound dressing].

PubMed

Muselík, Jan; Wojnarová, Lenka; Masteiková, Ruta; Sopuch, Tomáš

2013-04-01

Carboxymethyl cellulose, especially its sodium salt, is a versatile pharmaceutical excipient. From a therapeutic point of view, sodium salt of carboxymethyl cellulose is used in the production of modern wound dressings to allow moist wound healing. Wound dressings must be sterile and stable throughout their shelf life and have to be able to withstand different temperature conditions. At the present time, a number of sterilization methods are available. In the case of polymeric materials, the selected sterilization process must not induce any changes in the polymer structure, such as polymer chains cleavage, changes in cross-linking, etc. This paper evaluates the influence of different sterilization methods (γ-radiation, β-radiation, ethylene oxide) on the stability of carboxymethyl cellulose and the results of long-term and accelerated stability testing. Evaluation of samples was performed using size-exclusion chromatography. The obtained results showed that ethylene oxide sterilization was the least aggressive variant of the sterilization methods tested. When the γ-radiation sterilization was used, the changes in the size of the carboxymethyl cellulose molecule occurred. In the course of accelerated and long term stability studies, no further degradation changes were observed, and thus sterilized samples are suitable for long term storage.

Wide topical negative pressure wound dressing treatment for patients undergoing abdominal dermolipectomy following massive weight loss.

PubMed

Dragu, Adrian; Schnürer, Stefan; Unglaub, Frank; Wolf, Maya B; Beier, Justus P; Kneser, Ulrich; Horch, Raymund E

2011-11-01

Postbariatric plastic surgery is considered to be a high-risk procedure, which entails such frequent minor complications as postoperative seroma, bleeding and wound dehiscence. These occur with a high incidence, especially, following postbariatric abdominal dermolipectomy. In order to reduce these complication rates, a new type of dressing with wide abdominal topical negative pressure (TNP) application was applied. We performed abdominal dermolipectomy in 23 obese patients. The average body mass index was 32.8 kg/m(2), and the median age of the patients was 42.9 years. Ten patients received conventional standard dressings (control group I), whereas the other 13 patients received a wide TNP dressing including the ventral and lateral trunk (negative pressure group II). Postoperative exudate volumes were collected, tallied and documented for each group separately until all drains could be removed. The conventionally treated control group (I) showed a significantly higher postoperative secretion volume compared with the negative pressure group (II). In addition, the average time to postoperative final drain removal was significantly lower in the negative pressure group (II) compared with the control group (I). The results indicate that widely applied external TNP wound dressing on the ventral and lateral trunk following postbariatric abdominal dermolipectomy leads to a significant reduction in exudate formation, enables early drain removal and thus, decreases length of hospitalization.

Preliminary Characterization of Genipin-Cross-Linked Silk Sericin/Poly(vinyl alcohol) Films as Two-Dimensional Wound Dressings for the Healing of Superficial Wounds

PubMed Central

Siritientong, Tippawan; Ratanavaraporn, Juthamas; Srichana, Teerapol; Aramwit, Pornanong

2013-01-01

The genipin-cross-linked silk sericin/poly(vinyl alcohol) (PVA) films were developed aiming to be applied as two-dimensional wound dressings for the treatment of superficial wounds. The effects of genipin cross-linking concentration on the physical and biological properties of the films were investigated. The genipin-cross-linked silk sericin/PVA films showed the increased surface density, tensile strength, and percentage of elongation, but decreased percentage of light transmission, water vapor transmission rate, and water swelling, compared to the non-cross-linked films. This explained that the cross-linking bonds between genipin and silk sericin would reduce the mobility of molecular chains within the films, resulting in the more rigid molecular structure. Silk sericin was released from the genipin-cross-linked films in a sustained manner. In addition, either L929 mouse fibroblast or HaCat keratinocyte cells showed high percentage of viability when cultured on the silk sericin/PVA films cross-linked with 0.075 and 0.1% w/v genipin. The in vivo safety test performed according to ISO 10993-6 confirmed that the genipin-cross-linked silk sericin/PVA films were safe for the medical usages. The efficacy of the films for the treatment of superficial skin wounds will be further investigated in vivo and clinically. The genipin-cross-linked silk sericin/PVA films would be promising choices of two-dimensional wound dressings for the treatment of superficial wounds. PMID:24106722

Preliminary characterization of genipin-cross-linked silk sericin/poly(vinyl alcohol) films as two-dimensional wound dressings for the healing of superficial wounds.

PubMed

Siritientong, Tippawan; Ratanavaraporn, Juthamas; Srichana, Teerapol; Aramwit, Pornanong

2013-01-01

The genipin-cross-linked silk sericin/poly(vinyl alcohol) (PVA) films were developed aiming to be applied as two-dimensional wound dressings for the treatment of superficial wounds. The effects of genipin cross-linking concentration on the physical and biological properties of the films were investigated. The genipin-cross-linked silk sericin/PVA films showed the increased surface density, tensile strength, and percentage of elongation, but decreased percentage of light transmission, water vapor transmission rate, and water swelling, compared to the non-cross-linked films. This explained that the cross-linking bonds between genipin and silk sericin would reduce the mobility of molecular chains within the films, resulting in the more rigid molecular structure. Silk sericin was released from the genipin-cross-linked films in a sustained manner. In addition, either L929 mouse fibroblast or HaCat keratinocyte cells showed high percentage of viability when cultured on the silk sericin/PVA films cross-linked with 0.075 and 0.1% w/v genipin. The in vivo safety test performed according to ISO 10993-6 confirmed that the genipin-cross-linked silk sericin/PVA films were safe for the medical usages. The efficacy of the films for the treatment of superficial skin wounds will be further investigated in vivo and clinically. The genipin-cross-linked silk sericin/PVA films would be promising choices of two-dimensional wound dressings for the treatment of superficial wounds.

Papain wound dressings obtained from poly(vinyl alcohol)/calcium alginate blends as new pharmaceutical dosage form: Preparation and preliminary evaluation.

PubMed

Dutra, J A P; Carvalho, S G; Zampirolli, A C D; Daltoé, R D; Teixeira, R M; Careta, F P; Cotrim, M A P; Oréfice, R L; Villanova, J C O

2017-04-01

Transparent, soft, flexible, mechanically resistant films, which are ideal for use as wound dressings were prepared in the presence of 2% papain, a proteolytic enzyme that can play a role in the chemical debridement of the skin and can accelerate the healing process. The films, based on poly(vinyl alcohol):calcium alginate blends with increasing concentrations of polysaccharide (10, 20, and 30% v/v), were obtained by casting method. FTIR and DSC analyses were performed to assess the composition and miscibility of blends. Mechanical properties such as tensile strength, elasticity modulus, and elongation at breakpoint were evaluated. The influence of different concentrations of calcium alginate on physical attributes of films like wettability, swelling capacity and mechanical properties was determined. The stability of papain in the films was assessed indirectly by hemolytic activity assay employing direct contact method and confirmed by technique based on blood agar diffusion. Preliminary cytotoxicity was evaluated with the XTT method. The results showed that at the polymer concentrations tested, the blends were miscible. The increase in the content of the calcium alginate increased the wettability and swelling capacity of the films, which is desirable in wound dressings. On the other hand, mechanical resistance decreased without causing breakage of the films during the swelling tests. The hemolytic activity of the films was maintained during the studied period, suggesting the stability of papain in the proposed formulations. Cellular viability indicated that the films were non-toxic. The analysis of the results showed that it is possible to prepare interactive and bioactive wound dressing containing papain from blends of PVA and calcium alginate polymers. Copyright © 2016 Elsevier B.V. All rights reserved.

Preparation of carboxymethyl cellulose sulfates and its application as anticoagulant and wound dressing.

PubMed

Fan, Lihong; Zhou, Xiaoyu; Wu, Penghui; Xie, Weiguo; Zheng, Hua; Tan, Wang; Liu, Shuhua; Li, Qingyuan

2014-05-01

Tissue engineering is aiming to build an artificial environment or biological scaffold material that imitates the living environment of cells in the body. In this work, carboxymethyl cellulose sulfates were prepared by reacting carboxymethyl cellulose with N(SO3Na)3 which was synthesized by sodium bisulfite and sodium nitrite in aqueous solution. The reaction conditions affected the degree of substitution (DS) were measured by the barium sulfate nephelometry method. And the anticoagulant activity of carboxymethyl cellulose sulfates with different DS, concentration and molecular weights were investigated by the activated partial thromboplastin time (APTT), thrombin time (TT) and prothrombin time (PT). In addition, the effect of carboxymethyl cellulose sulfates on wound healing had been evaluated by the rate of wound healing and the histological examinations. The results indicated that the introduction of sulfate groups into the carboxymethyl cellulose sulfates improved its anticoagulant activity, and the wound dressings treated with carboxymethyl cellulose sulfates obviously promoted wound healing. Copyright © 2014 Elsevier B.V. All rights reserved.

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

PubMed

Hormbrey, E; Pandya, A; Giele, H

2003-07-01

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.

Elastic adhesive dressing treatment of bleeding wounds in trauma victims.

PubMed

Naimer, S A; Chemla, F

2000-11-01

Conventional methods for hemorrhage control in the trauma patient fall short of providing a full solution for the life-threatening bleeding injury. The tourniquet is limited specifically to injuries of the distal limbs. Local pressure or tight bandaging with military bandages is cumbersome and often insufficient. Therefore, we sought a superior method to stop bleeding in emergency situations. Our objective is report and description of our experience with this method. Since 1992 our trauma team repeatedly encountered multiple trauma victims presenting with bleeding wounds. We achieved hemorrhage control by means of an adhesive elastic bandage applied directly over a collection of 4 x 4 gauze pads placed on the wound surface. The roll is then wrapped around the body surface, over the bleeding site, until sufficient pressure is reached to terminate ongoing hemorrhage. Three typical cases are described in detail. Adhesive elastic dressing compression was successful in fully controlling bleeding without compromise of distal blood flow. Our method corresponded to the demand for an immediate, effective and lasting form of hemorrhage control without complications. Furthermore, this technique proved successful even over body surfaces normally recognized as difficult to compress. We experienced equal favorable success while working during transit by either ambulance or helicopter transportation. We find our preliminary experience using elastic adhesive dressing for bleeding control encouraging and suggest that this may substitute existing practices as the selected treatment when indicated. This method is presently underrecognized for this purpose. Development of a single unit bandage may further enhance success in the future.

The clinical and cost effectiveness of bee honey dressing in the treatment of diabetic foot ulcers.

PubMed

Moghazy, A M; Shams, M E; Adly, O A; Abbas, A H; El-Badawy, M A; Elsakka, D M; Hassan, S A; Abdelmohsen, W S; Ali, O S; Mohamed, B A

2010-09-01

Honey is known, since antiquity, as an effective wound dressing. Emergence of resistant strains and the financial burden of modern dressings, have revived honey as cost-effective dressing particularly in developing countries. Its suitability for all stages of wound healing suggests its clinical effectiveness in diabetic foot wound infections. Thirty infected diabetic foot wounds were randomly selected from patients presenting to Surgery Department, Suez Canal University Hospital, Ismailia, Egypt. Honey dressing was applied to wounds for 3 months till healing, grafting or failure of treatment. Changes in grade and stage of wounds, using University of Texas Diabetic Wound Classification, as well as surface area were recorded weekly. Bacterial load was determined before and after honey dressing. Complete healing was significantly achieved in 43.3% of ulcers. Decrease in size and healthy granulation was significantly observed in another 43.3% of patients. Bacterial load of all ulcers was significantly reduced after the first week of honey dressing. Failure of treatment was observed in 6.7% of ulcers. This study proves that commercial clover honey is a clinical and cost-effective dressing for diabetic wound in developing countries. It is omnipresence and concordance with cultural beliefs makes it a typical environmentally based method for treating these conditions. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

Improvement of Physical and Wound Adhesion Properties of Silk Sericin and Polyvinyl Alcohol Dressing Using Glycerin.

PubMed

Aramwit, Pornanong; Ratanavaraporn, Juthamas; Siritientong, Tippawan

2015-08-01

This study aimed to use glycerin to improve physical and wound adhesion properties of a wound dressing made of silk sericin and polyvinyl alcohol (PVA). Glycerin of a natural-derived plasticizer was used to modify the properties of silk sericin/PVA scaffolds. Various concentrations of glycerin were mixed with silk sericin and PVA and then fabricated into the scaffolds by a freeze-drying technique. The control study was performed to examine the properties of the silk sericin/PVA scaffolds with and without glycerin. Physical, mechanical, wound adhesion properties, the release profile of silk sericin, and in vivo safety of the silk sericin/PVA scaffolds with and without glycerin were investigated. The silk sericin/PVA scaffolds with glycerin exhibited more homogenous structure, less compressive modulus, higher Young modulus and elongation percentage, and a higher degree of crosslinking compared with the scaffold without glycerin. The silk sericin/PVA scaffold with 2% wt/vol glycerin showed more controlled release of silk sericin than the other scaffolds. The sustained release of silk sericin from the scaffold with glycerin would be advantageous for long-term healing of wounds. The silk sericin/PVA scaffold with 2% (wt/vol) glycerin was less adhesive to the wound compared with the scaffold without glycerin. Furthermore, the implantation of silk sericin/PVA scaffolds with 2% (wt/vol) glycerin did not cause any irritation to the tissue. The silk sericin/PVA scaffolds with glycerin were introduced as a biocompatible, more flexible, and less adhesive wound dressing than the scaffold without glycerin.

Feasibility study of the sterilization of pigskin used as wound dressings by neutral electrolyzed water.

PubMed

Ge, Liangpeng; Zhang, Xiaochun; Cao, Chuan; Gu, Zhaobin; Liu, Zuohua; Liu, Lubin; Lin, Baozhong

2012-06-01

Neutral electrolyzed water (NEW) is considered to be a high-level biodegradable disinfectant with sporicidal, bactericidal, and virucidal activity. It has also been reported to accelerate wound healing; thus, it is particularly attractive for the elimination or minimization of the microbial population of skin grafts to be used as wound dressings. Pigskins were sterilized with different concentrations of NEW and with different methods. The feasibility of pigskin sterilization by NEW was evaluated through microbiological analyses, viability assays, histologic assessments, contact cytotoxicity assays, and extract cytotoxicity assays. NEW has strong bactericidal effects on pigskin microorganisms, does not change skin graft histologic properties, and has no cytotoxicity; however, skin viability was significantly reduced after NEW treatment. Although NEW treatment is a very safe and effective method for nonviable pigskin dressing sterilization, to obtain a complete sterilization of pigskin grafts, available chlorine concentration of NEW as well as sterilization time and methods should be optimized. Copyright © 2012 by Lippincott Williams & Wilkins.

Scar quality and physiologic barrier function restoration after moist and moist-exposed dressings of partial-thickness wounds.

PubMed

Atiyeh, Bishara S; El-Musa, Kusai A; Dham, Ruwayda

2003-01-01

There is growing evidence of improved healing of full- and partial-thickness cutaneous wounds in wet and moist environments. Retention of biologic fluids over the wound prevents desiccation of denuded dermis or deeper tissues and allows faster and unimpeded migration of keratinocytes over the wound surface. It allows also the naturally occurring cytokines and growth factors to exert their beneficial effect on wound contracture and re-epithelialization. Despite all of these documented benefits, applying the moist healing principles to large surface areas, in particular to large burns, is hindered by the major technical handicap of creating and maintaining a sealed moist environment over these areas. From January to September 2001, healing of partial-thickness skin graft donor sites was studied in a prospective comparative study of two types of moist dressings, Tegaderm (3M Health Care, St. Paul, MN), a semipermeable membrane occlusive dressing, and moist exposed burn ointment (MEBO) (Julphar; Gulf Pharmaceutical Industries, United Arab of Emirates), an ointment that can provide a moist environment without the need of an overlying occlusive dressing. Healing was assessed both clinically and with serial measurements of transepidermal water loss (TEWL) and moisture. Following healing, scar quality was evaluated by two members of the team separately using a visual analog scale. Results were statistically analyzed. Faster healing was observed clinically with MEBO application. Physiologic healing as determined by TEWL measurements occurred at an extremely significant earlier stage for MEBO, and this was associated with better scar quality, demonstrating a positive relationship between function and cosmetic appearance. Moreover, the ointment is definitely easier to apply than the occlusive self-adhesive membrane, which requires some degree of dexterity and expertise. MEBO application is an effective and valid alternative to conventional occlusive dressings. Moreover, the

Poly(n-vinylpyrrolidone) hydrogels: 2.Hydrogel composites as wound dressing for tropical environment

NASA Astrophysics Data System (ADS)

Himly, N.; Darwis, D.; Hardiningsih, L.

1993-10-01

POLY(N-VINYLPYRROLIDONE) HYDROGELS: 2. HYDROGEL COMPOSITES AS WOUND DRESSING FOR TROPICAL ENVIRONMENT. The effects of irradiation on hydration and other properties of poly(vinylpyrrolidone) (PVP) hydrogel composites have been investigated. The aqueous solution of vinylpyrrolidone (VP) 10 wt % was mixed with several additives such as agar and polyethylen glycol (PEG). The solution was then irradiated with gamma rays from Cobalt-60 source at room temperature. Several parameters such as elongation at break (EB), tensile strength (TS), degree of swelling (DS), water vapor transmission rate (WVTR), equilibrium water content (EWC), microbial growth and penetration test, and water activity (Aw) were analysed at room temperature of 29 ±2°C humidity of 80 ± 10%. Results show that elongation at break of hydrogel membranes with initial composition of VP with agar, VP with agar and PEG were 240 % and 250 % kGy, the equilibrium water content of membranes were 96 to 90%, whereas degree of swelling were 55 to 10. The WVTR of hydrogel membranes with initial composition of VP with agar and PEG was 70 g m -2h -1, while the water activity was 0.9. Such hydrogel membranes exhibits the following properties: They are elastic, transparent, flexible, impermeable for bacteria. They absopt a high capacity of water, attached to healthy skin but not to the wound and they are easy to remove. These properties of the hydrogel membranes allow for applying as a wound dressings in tropical environment.

Investigation of Electrospun Poly Vinyl Alcohol Fibers Towards the Development of Manufacturable Wound Dressings

NASA Astrophysics Data System (ADS)

Vora, Asad

Polymers such as polyvinyl alcohol, chitosan, and starch have excellent bio-compatible and bio-degradable properties. Their applications in drug delivery, wound dressings, artificial cartilage materials have increased dramatically due to their much sought-after renewable and biological properties. Hence, polyvinyl alcohol has been chosen for this study to test the feasibility of polyvinyl alcohol nanofibers towards the manufacturable wound dressings. Polyvinyl alcohol nanofibers are prepared via electrospinning technique, where different wt% polyvinyl alcohol solutions are prepared. The fibers were optimized by varying important electrospninning parameters which include voltage applied, the collector-needle distance and flow rate. Morphology and structure of the electrospun fibers are analysed using scanning electron microscopy and fourier transform infrared respectively. The diameter of fibers obtained was found to be in the range of 100 nm-160 nm. Thermal stability was examined using DSC and TGA characterization technique and fibers are found to be stable up to 220oC. Finally, each weight sample of PVA fibers are analysed by goniometer for wettability and is found to be hydrophilic.

Wound Healing Potential of Intermittent Negative Pressure under Limited Access Dressing in Burn Patients: Biochemical and Histopathological Study

PubMed Central

Muguregowda, Honnegowda Thittamaranahalli; Kumar, Pramod; Govindarama, Padmanabha Udupa Echalasara

2018-01-01

BACKGROUND Malondialdehyde (MDA) is an oxidant that causes damage to membranes, DNA, proteins, and lipids at the cellular level. Antioxidants minimize the effects of oxidants and thus help in formation of healthy granulation tissues with higher level of hydroxyproline and total protein. This study compared the effect of limited access dressing (LAD) with conventional closed dressing biochemically and histopathologically. METHODS Seventy-two 12-65 years old burn patients with mean wound size of 14 cm2 were divided to two groups of LAD (n=37), and conventional dressing groups (n=35). Various biochemical parameters were measured in granulation tissue. Histopathological analysis of the granulation tissue was studied too. RESULTS LAD group showed significant increase in hydroxyproline, total protein, GSH, and GPx and decrease in MDA levels compared to conventional dressing group. A significant negative correlation between GSH and MDA was noted in LAD group, but in conventional dressing group there was no significant correlation. A significant negative correlation between GPx and MDA was noticed in LAD group, but in conventional dressing group was not significant. There was a histologically fewer inflammatory cells, increased and well organized extracellular matrix deposit, more angiogenesis in LAD group after 10 days while the difference was significant between the groups. CONCLUSION Our study showed a significant reduction in oxidative stress biomarker of MDA, increase in hydroxyproline, total protein, antioxidants and amount of ECM deposition, number of blood vessels and a decrease in the amount of inflammatory cells and necrotic tissues in LAD group indicating the better healing effect of burn wounds. PMID:29651393

An evaluation of the skin stripping of wound dressing adhesives.

PubMed

Waring, M; Bielfeldt, S; Mätzold, K; Wilhelm, K P; Butcher, M

2011-09-01

This study looks at six different modern wound dressings to investigate how likely they are to cause skin stripping and impairment of the skin's barrier function. Healthy volunteers had each dressing applied, removed and reapplied to the skin on their back over the study period of 15 days. Skin barrier function was investigated using the amount of transepidermal water loss (TEWL) and then related to the amount of skin stripping, investigated by measuring stained skin removal, the thickness of the stratum corneum after treatment, and the amount of skin attached to the removed dressings. General signs of trauma, such as skin dryness and erythema, were investigated by subjective and objective parameters. TEWL values measured on the untreated test area, as well as after application of Urgotul Trio, remained relatively unchanged and Mepilex Border decreased slightly (?1g/m2/h), while all other dressings displayed an increased in TEWL: Allevyn Adhesive (5g/m2/h), Versiva XC (14g/m2/h), Comfeel Plus (22g/m2/h) and Biatain (28g/m2/h). By the end of the study, only the untreated area (mean 43% dye remaining), Mepilex Border (76%) and Urgotul Trio (34%) areas had visible dye remaining. It is interesting to note that the untreated site had a colour change, suggesting loss of stratum corneum, due to the shedding of skin cells from the surface. The increase in total skin colour for Comfeel Plus and Biatain after day 8 might be assigned to an increased redness due to erythema. All the dressings showed evidence of stratum corneum attached to the adhesive, except Mepilex Border, which appeared to be free of any attached stratum corneum. Overall the best performance in terms of skin protection and failure to cause skin trauma was found to be for Mepilex Border. This project was funded by a grant from Mölnlycke Healthcare Ltd.

Smart Dressings Based on Nanostructured Fibers Containing Natural Origin Antimicrobial, Anti-Inflammatory, and Regenerative Compounds

PubMed Central

Andreu, Vanesa; Mendoza, Gracia; Arruebo, Manuel; Irusta, Silvia

2015-01-01

A fast and effective wound healing process would substantially decrease medical costs, wound care supplies, and hospitalization significantly improving the patients’ quality of life. The search for effective therapeutic approaches seems to be imperative in order to avoid the aggravation of chronic wounds. In spite of all the efforts that have been made during the recent years towards the development of artificial wound dressings, none of the currently available options combine all the requirements necessary for quick and optimal cutaneous regeneration. Therefore, technological advances in the area of temporary and permanent smart dressings for wound care are required. The development of nanoscience and nanotechnology can improve the materials and designs used in topical wound care in order to efficiently release antimicrobial, anti-inflammatory and regenerative compounds speeding up the endogenous healing process. Nanostructured dressings can overcome the limitations of the current coverings and, separately, natural origin components can also overcome the drawbacks of current antibiotics and antiseptics (mainly cytotoxicity, antibiotic resistance, and allergies). The combination of natural origin components with demonstrated antibiotic, regenerative, or anti-inflammatory properties together with nanostructured materials is a promising approach to fulfil all the requirements needed for the next generation of bioactive wound dressings. Microbially compromised wounds have been treated with different essential oils, honey, cationic peptides, aloe vera, plant extracts, and other natural origin occurring antimicrobial, anti-inflammatory, and regenerative components but the available evidence is limited and insufficient to be able to draw reliable conclusions and to extrapolate those findings to the clinical practice. The evidence and some promising preliminary results indicate that future comparative studies are justified but instead of talking about the beneficial or

Effects of adhesive dressings on stratum corneum conductance.

PubMed

Cavallini, Maurizio; Gazzola, Riccardo; Vaienti, Luca

2012-05-01

Stratum corneum is a fundamental layer of epidermis. It acts as a barrier, with antimicrobial features, regulating skin permeability and integrity as well. Adhesive dressings and their removal could alter this layer, affecting cutaneous water balance and lipid composition of stratum corneum. These changes could be monitored by measurement of cutaneous hydration. Ninety-two patients affected by wounds dressed with adhesive tapes or plasters have been studied. Measurement of skin conductance under tape/plaster and in the surrounding healthy skin, immediately after removal of dressing has been performed. Dressing age, wound localization, and characteristics were also considered. Adhesive dressings alter significantly stratum corneum conductance. Although healthy skin hydration has significant variations throughout the body, cutaneous conductance under adhesive dressing in different areas displays no significative changes. Moreover, the increase in hydration due to adhesive tapes/plasters showed no association with wound dehiscence. Adhesive dressings cause a significative increase in stratum corneum conductance, acting as a barrier to apocrine secretions. Although different hydration levels have been observed in healthy skin throughout the body, no difference exists under adhesive dressing among different regions, suggesting no contraindications in their employment throughout the body. Increase in cutaneous hydration showed no correlations with wound dehiscence, thus confirming safety and practicality of these dressings. © 2011 John Wiley & Sons A/S.

Negative pressure wound therapy combined with acoustic pressure wound therapy for infected post surgery wounds: a case series.

PubMed

Howell-Taylor, Melania; Hall, Macy G; Brownlee Iii, William J; Taylor, Mary

2008-09-01

Acute infection of surgical incision sites often requires specialized wound care in preparation for surgical closure. Optimal therapy for preparing such wounds for a secondary closure procedure remains uncertain. The authors report wound outcomes after administering acoustic pressure wound therapy in conjunction with negative pressure wound therapy with reticulated open-cell foam dressing changes to assist with bacteria removal from open, infected surgical-incision sites in preparation for secondary surgical closure in three patients. Before incorporating acoustic pressure wound therapy at the authors' facility, the average negative pressure wound therapy with reticulated open-cell foam dressing course prior to secondary surgical closure was 30 days; with its addition, two of three patients underwent successful surgical closure with no postoperative complications after 21 and 14 days, respectively; one patient succumbed to nonwound-related complications before wound closure. Larger, prospective studies are needed to evaluate combining negative pressure wound therapy with reticulated open-cell foam dressing and acoustic pressure wound therapy for infected, acute post surgery wounds.

Clinical experiences derived from implementation of an easy to use concept for treatment of wound healing by secondary intention and guidance in selection of appropriate dressings.

PubMed

Braumann, Chris; Guenther, Nina; Menenakos, Charalambos; Muenzberg, Helga; Pirlich, Matthias; Lochs, Herbert; Mueller, Joachim M

2011-06-01

The main objective of this case-cohort-type observational study conducted at different Surgical Departments of the Charité-Universitätsmedizin in Berlin was to evaluate the sequential use concept first described by Systagenix Wound Management in 2007. Fifty-two patients with different wound healing by secondary intention were treated for 7 weeks at the Charité-Universitätsmedizin in Berlin. A multidisciplinary team worked together to reach consensus in wound assessment; in classification of infection status according to the criteria described by European Wound Management Association (EWMA); in treatment protocol and on dressings to be used to 'cover' wounds. Before dressing application, all wounds were cleaned from debris. Following the sequential use concept, wounds classified as stages 2 and 3 were dressed with SILVERCEL(®) and TIELLE(®) or TIELLE PLUS(®) to 'clean' the wounds. After 2-3 weeks, treatment was changed to PROMOGRAN PRISMA(®) and TIELLE(®) to 'close and cover' wounds, thus providing optimal wound healing. Wounds classified as non infected were dressed with PROMOGRAN PRISMA(®) and TIELLE(®) during the complete treatment period. Patients were asked to evaluate the treatment using a simplified questionnaire developed at the Charité-Universitätsmedizin in Berlin. Wounds comprised 37 surgical procedures, 8 chronic mixed ulcer, 4 pressure sores, 1 diabetic foot ulcer, 1 venous leg ulcer, and 1 mixed arterial/venous ulcer. At baseline, 12 wounds were classified as stage 3, 38 wounds as stage 2 and 2 wounds as stage 1. After 7 weeks of treatment, all patients showed a positive clinical response to the sequential use treatment. Results of wound size showed a high significant progression of wound healing expressed with a profound reduction of wound area (P in all measurements <0·001, chi-square test) and improved granulation. This study summarises the clinical experiences derived from the evaluation of the sequential use concept in the daily

Protease biosensors based on peptide-nanocellulose conjugates: from molecular design to dressing interface

USDA-ARS?s Scientific Manuscript database

The development of point of care diagnostic protease sensors applied to wound healing has received increased interest for chronic wound treatment and as an interface with chronic wound dressings. Biosensor technology has grown exponentially in recent years. Here we focus on nanocelluosic biosensor t...

Evidence-based topical management of chronic wounds according to the T.I.M.E. principle.

PubMed

Klein, Silvan; Schreml, Stephan; Dolderer, Juergen; Gehmert, Sebastian; Niederbichler, Andreas; Landthaler, Michael; Prantl, Lukas

2013-09-01

The number of patients suffering from chronic wound healing disorders in Germany alone is estimated to be 2.5-4 million. Therapy related expenses reach 5-8 billion Euros annually. This number is partially caused by costly dressing changes due to non-standardized approaches and the application of non-evidence-based topical wound therapies. The purpose of this paper is to elucidate a straightforward principle for the management of chronic wounds, and to review the available evidence for the particular therapy options. The T.I.M.E.-principle (Tissue management, Inflammation and infection control, Moisture balance, Epithelial [edge] advancement) was chosen as a systematic strategy for wound bed preparation. Literature was retrieved from the PubMed and Cochrane Library databases and subjected to selective analysis. Topical wound management should be carried out according to a standardized principle and should further be synchronized to the phases of wound healing. Despite the broad implementation of these products in clinical practice, often no benefit exists in the rate of healing, when evaluated in meta-analyses or systematic reviews. This insufficient evidence is additionally limited by varying study designs. In case of non-superiority, the results suggest to prefer relatively inexpensive wound dressings over expensive alternatives. Arbitrary endpoints to prove the effectiveness of wound dressings, contribute to the random use of such therapies. Defining rational endpoints for future studies as well as the deployment of structured therapy strategies will be essential for the economical and evidence-based management of chronic wounds. © The Authors | Journal compilation © Blackwell Verlag GmbH, Berlin.

A simple route to develop transparent doxorubicin-loaded nanodiamonds/cellulose nanocomposite membranes as potential wound dressings.

PubMed

Luo, Xiaogang; Zhang, Hao; Cao, Zhenni; Cai, Ning; Xue, Yanan; Yu, Faquan

2016-06-05

The objective of this study is to develop transparent porous nanodiamonds/cellulose nanocomposite membranes with controlled release of doxorubicin for potential applications as wound dressings, which were fabricated by tape casting method from dispersing carboxylated nanodiamonds and dissolving cellulose homogeneously in 7 wt% NaOH/12 wt% urea aqueous solution. By adjusting the carboxylated nanodiamonds content, various nanocomposite membranes were obtained. The structure and properties of these membranes have been investigated by light transmittance measurements, scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), differential scanning calorimetry (DSC), tensile tests, water loss analyses, etc. The drug loading and release was investigated using doxorubicin hydrochloride as a model drug. In vitro cytotoxicity assay of the membranes was also studied. This work presented a proof-of-concept utility of these membranes for loading and release of bioactive compounds to be employed as a candidate for wound dressing. Copyright © 2016 Elsevier Ltd. All rights reserved.

Highly biocompatible collagen-Delonix regia seed polysaccharide hybrid scaffolds for antimicrobial wound dressing.

PubMed

Cheirmadurai, Kalirajan; Thanikaivelan, Palanisamy; Murali, Ragothaman

2016-02-10

Biomaterials based entirely on biological resources are ideal for tissue engineering applications. Here we report the preparation of hybrid collagen scaffolds comprising gulmohar seed polysaccharide (GSP) and cinnamon bark extract as cross-linking agent. (1)H NMR spectrum of GSP confirms the presence of galactose and mannose in the ratio of 1:1.54, which was further corroborated using FT-IR. The hybrid scaffolds show better enzyme and thermal stability in contrast to pure collagen scaffold probably due to weak interactions from GSP and covalent interaction through cinnamaldehyde. Gas permeability and scanning electron microscopic analysis show that the porosity of the hybrid scaffolds is slightly reduced with the increase in the concentration of GSP. The infrared and circular dichroic spectral studies show that the secondary structure of the collagen did not change after the interaction with GSP and cinnamaldehyde. The hybrid scaffolds stabilized with cinnamaldehyde show good antimicrobial activity against the common multi-drug resistant wound pathogens. These results suggest that the prepared hybrid scaffolds have great potential for antimicrobial wound dressing applications. Copyright © 2015 Elsevier Ltd. All rights reserved.

Current wound healing procedures and potential care.

PubMed

Dreifke, Michael B; Jayasuriya, Amil A; Jayasuriya, Ambalangodage C

2015-03-01

In this review, we describe current and future potential wound healing treatments for acute and chronic wounds. The current wound healing approaches are based on autografts, allografts, and cultured epithelial autografts, and wound dressings based on biocompatible and biodegradable polymers. The Food and Drug Administration approved wound healing dressings based on several polymers including collagen, silicon, chitosan, and hyaluronic acid. The new potential therapeutic intervention for wound healing includes sustained delivery of growth factors, and siRNA delivery, targeting microRNA, and stem cell therapy. In addition, environment sensors can also potentially utilize to monitor and manage microenvironment at wound site. Sensors use optical, odor, pH, and hydration sensors to detect such characteristics as uric acid level, pH, protease level, and infection - all in the hopes of early detection of complications. Copyright © 2014 Elsevier B.V. All rights reserved.

Current wound healing procedures and potential care

PubMed Central

Dreifke, Michael B.; Jayasuriya, Amil A.; Jayasuriya, Ambalangodage C.

2015-01-01

In this review, we describe current and future potential wound healing treatments for acute and chronic wounds. The current wound healing approaches are based on autografts, allografts, and cultured epithelial autografts, and wound dressings based on biocompatible and biodegradable polymers. The Food and Drug Administration approved wound healing dressings based on several polymers including collagen, silicon, chitosan, and hyaluronic acid. The new potential therapeutic intervention for wound healing includes sustained delivery of growth factors, and siRNA delivery, targeting micro RNA, and stem cell therapy. In addition, environment sensors can also potentially utilize to monitor and manage micro environment at wound site. Sensors use optical, odor, pH, and hydration sensors to detect such characteristics as uric acid level, pH, protease level, and infection – all in the hopes of early detection of complications. PMID:25579968

The Hanikoda Method: 3-layered Negative Pressure Wound Therapy in Wound Bed Preparation.

PubMed

Chik, Ian; Kelly, Enda G; Jarmin, Razman; Imran, Farrah-Hani

2016-10-01

Negative pressure wound therapy is a widely used method of wound dressing with various commercially available brands. The authors created the Hanikoda Method (HM) for effective wound bed preparation or definite wound closure. In this case series, the authors discuss 8 different wound cases that presented to their Plastics Unit from January 2014 to June 2015. Patients with traumatic or infected wounds were selected for treatment with the HM. Selected patients underwent multiple cycles of this method until their wounds were ready for definite wound closure or the wounds had closed by secondary closure. The purpose of any wound dressing is to encourage epithelization while ensuring no factors impede wound healing. An additional benefit is to reduce wound bed size so that it may close by secondary intention or require less skin graft coverage. Each layer of the dressing is described, along with its function in wound bed preparation or in closure. The HM facilitates reduction of wound size, wound bed preparation, and overall management.

Moist exposed therapy: an effective and valid alternative to occlusive dressings for postlaser resurfacing wound care.

PubMed

Atiyeh, Bishara S; Dham, Ruwayda; Costagliola, Michel; Al-Amm, Christian A; Belhaouari, Lakhdar

2004-01-01

Laser resurfacing has now become an accepted and important component of facial rejuvenation. With the introduction of computerized scanning systems, the actual laser resurfacing technique has been greatly simplified; however, the final outcome still depends to a large extent on the efficiency of the postlaser wound care in promoting wound healing and preventing early and late complications. It has been repeatedly confirmed that a moist environment is the single most important external factor affecting the rate of re-epithelialization. Occlusive moisture-retentive dressings, however, are difficult to apply and maintain in position and may as well be complicated by serious infections. Moist exposed burn ointment has been shown to maintain adequate moisture for optimal healing by frequent ointment application without the need for a secondary overlying dressing. It would be ideal for postoperative laser care. Twenty-eight consecutive patients treated with coherent ultrapulse CO2 laser in Toulouse, France, were included in the trial. Moisture-retentive ointment was applied over the treated areas every 4 to 6 hours. Healing was assessed clinically and with repeated transepidermal water loss measurements. Swab cultures were taken, and pain was evaluated with a visual analog scale. Colorimetric analysis of pictures taken was statistically compared with picture analysis of 20 patients treated earlier with an occlusive dressing. Uneventful timely healing occurred in all patients with minimal pain and discomfort. Healing with moist exposed therapy resulted in faster recovery of cutaneous erythema, as evidenced by colorometry. Moist exposed burn ointment application can be safely considered a good and valid alternative to occlusive dressings for postoperative laser care.

Polysaccharides and Cellulose in the Design of Wound Healing Materials

USDA-ARS?s Scientific Manuscript database

Chronic Wound Dressings that Sequester Harmful Proteases: Traditionally the use of carbohydrate-based wound dressings including cotton, xerogels, charcoal cloth, alginates, chitosan and hydrogels, have afforded properties such as absorbency, ease of application and removal, bacterial protection, flu...

Polysaccharides and cellulose in the design of wound healing materials

USDA-ARS?s Scientific Manuscript database

1. Chronic Wound Dressings that Sequester Harmful Proteases: Traditionally the use of carbohydrate-based wound dressings including cotton, xerogels, charcoal cloth, alginates, chitosan and hydrogels, have afforded properties such as absorbency, ease of application and removal, bacterial protection, ...

The Effect of a Bacteria- and Fungi- binding Mesh Dressing on the Bacterial Load of Pressure Ulcers Treated With Negative Pressure Wound Therapy: A Pilot Study.

PubMed

Ciliberti, Marino; De Lara, Francesco; Serra, Gianfranco; Tafuro, Felice; Iazzetta, Francesco Maria; Filosa, Alessia; Scognamiglio, Rosa; Ciliberti, Giorgia; Veneri, Maria Rosaria

2016-11-01

This study was designed to clinically evaluate the efficacy of a bacteria- and-fungi-binding mesh (BFBM) dressing to modify the bacterial load of pressure ulcers (PUs) of categories 3 and 4, when used as a wound contact layer (WCL) during negative pressure wound therapy (NPWT). This was an observational single-centre study in patients with PUs of categories 3 or 4, who were treated with NPWT. Patients were observed for 7 days and received NPWT at -80 mm Hg with the BFBM dressing as the WCL. Wound biopsies were performed at inclusion (B0), at 48 hours (B1), and at day 7 (B7). Bacteria- and fungi-binding mesh dressings were examined for bacterial load at 48 hours (D1) and at 7 days (D7). The primary endpoint was the changes in bacterial loads. Fifty patients were enrolled; 43 (86%) of their PUs were on the sacrum. At B0, 3 groups of wounds were identified by the bioburden level: group A had negative results (28%) to bacterial loads from 102 to 5 x 103 colony forming units (CFU) CFU/mL (18%); group B had 104 to 105 CFU/mL (18%); and group C with ≥ 106 CFU/mL (36%). The authors did not find any significant difference in bacterial loads in group A, but significant differences were found in group B at B1 and B7 (P = 0.04 and P = 0.0067) and in group C at B1 and B7 (P < 0.00001). There was no significant difference on the bacterial loads of the dressing at D1 and D7 (P = 0.823). No device-related adverse events were reported. The BFBM dressing seems to be at the origin of a statistically significant reduction of bacterial burden in wounds with moderate or high levels of colonization. The authors' findings suggest BFBM dressings may be a WCL of choice during the treatment of chronic wounds with NPWT.

Evaluation of human amniotic membrane as a wound dressing for split-thickness skin-graft donor sites.

PubMed

Loeffelbein, Denys J; Rohleder, Nils H; Eddicks, Matthias; Baumann, Claudia M; Stoeckelhuber, Mechthild; Wolff, Klaus-D; Drecoll, Enken; Steinstraesser, Lars; Hennerbichler, Simone; Kesting, Marco R

2014-01-01

Human amniotic membrane (HAM) has been used as a biomaterial in various surgical procedures and exceeds some qualities of common materials. We evaluated HAM as wound dressing for split-thickness skin-graft (STSG) donor sites in a swine model (Part A) and a clinical trial (Part B). Part A: STSG donor sites in 4 piglets were treated with HAM or a clinically used conventional polyurethane (PU) foil (n = 8 each). Biopsies were taken on days 5, 7, 10, 20, 40, and 60 and investigated immunohistochemically for alpha-smooth muscle actin (αSMA: wound contraction marker), von Willebrand factor (vWF: angiogenesis), Ki-67 (cell proliferation), and laminin (basement membrane integrity). Part B: STSG donor sites in 45 adult patients (16 female/29 male) were treated with HAM covered by PU foam, solely by PU foam, or PU foil/paraffin gauze (n = 15 each). Part A revealed no difference in the rate of wound closure between groups. HAM showed improved esthetic results and inhibitory effects on cicatrization. Angioneogenesis was reduced, and basement membrane formation was accelerated in HAM group. Part B: no difference in re-epithelialization/infection rate was found. HAM caused less ichor exudation and less pruritus. HAM has no relevant advantage over conventional dressings but might be a cost-effective alternative.

Novel nanofibrous dressings containing rhEGF and Aloe vera for wound healing applications.

PubMed

Garcia-Orue, Itxaso; Gainza, Garazi; Gutierrez, Franciso Borja; Aguirre, Jose Javier; Evora, Carmen; Pedraz, Jose Luis; Hernandez, Rosa Maria; Delgado, Araceli; Igartua, Manoli

2017-05-25

Nanofibrous membranes produced by electrospinning possess a large surface area-to-volume ratio, which mimics the three-dimensional structure of the extracellular matrix. Thus, nanofibrous dressings are a promising alternative for chronic wound healing, since they can replace the natural ECM until it is repaired. Therefore, in this study we have developed a PLGA nanofibrous membrane that contains recombinant human Epidermal Growth Factor (rhEGF) and Aloe vera (AV) extract. Both of them promote wound healing, as EGF is a wound healing mediator and AV stimulates the proliferation and activity of fibroblast. The obtained membranes were composed of uniform and randomly oriented fibers with an average diameter of 356.03±112.05nm, they presented a porosity of 87.92±11.96% and the amount of rhEGF was 9.76±1.75μg/mg. The in vitro viability assay demonstrated that the membranes containing rhEGF and AV improved fibroblast proliferation, revealing the beneficial effect of the combination. Furthermore, these membranes accelerated significantly wound closure and reepithelisation in an in vivo full thickness wound healing assay carried out in db/db mice. Overall, these findings demonstrated the potential of PLGA nanofibers containing rhEGF and AV for the treatment of chronic wounds. Copyright © 2016 Elsevier B.V. All rights reserved.

Antimicrobial activity of silver nanoparticles impregnated wound dressing

NASA Astrophysics Data System (ADS)

Shinde, V. V.; Jadhav, P. R.; Patil, P. S.

2013-06-01

In this work, silver nanoparticles were synthesized by simple wet chemical reduction method. The silver nitrate was reduced by Sodium borohydride used as reducing agent and Poly (vinyl pyrrolidone) (PVP) as stabilizing agent. The formation of silver nanoparticles was evaluated by UV-visible spectroscope and transmission electron microscope (TEM). Absorption spectrum consist two plasmon peaks at 410 and 668 nm revels the formation of anisotropic nanoparticles confirmed by TEM. The formation of silver nanoparticles was also evidenced by dynamic light scattering (DLS) study. DLS showed polydisperse silver nanoparticles with hydrodynamic size 32 nm. Protecting mechanism of PVP was manifested by FT-Raman study. Silver nanoparticles were impregnated into wound dressing by sonochemical method. The Kirby-Bauer disc diffusion methods were used for antimicrobial susceptibility testing. The antimicrobial activity of the samples has been tested against gram-negative bacterium Escherichia coli and gram-positive bacterium Staphylococcus aureus.

Multifunctional medicated lyophilised wafer dressing for effective chronic wound healing.

PubMed

Pawar, Harshavardhan V; Boateng, Joshua S; Ayensu, Isaac; Tetteh, John

2014-06-01

Wafers combining weight ratios of Polyox with carrageenan (75/25) or sodium alginate (50/50) containing streptomycin and diclofenac were prepared to improve chronic wound healing. Gels were freeze-dried using a lyophilisation cycle incorporating an annealing step. Wafers were characterised for morphology, mechanical and in vitro functional (swelling, adhesion, drug release in the presence of simulated wound fluid) characteristics. Both blank (BLK) and drug-loaded (DL) wafers were soft, flexible, elegant in appearance and non-brittle in nature. Annealing helped to improve porous nature of wafers but was affected by the addition of drugs. Mechanical characterisation demonstrated that the wafers were strong enough to withstand normal stresses but also flexible to prevent damage to newly formed skin tissue. Differences in swelling, adhesion and drug release characteristics could be attributed to differences in pore size and sodium sulphate formed because of the salt forms of the two drugs. BLK wafers showed relatively higher swelling and adhesion than DL wafers with the latter showing controlled release of streptomycin and diclofenac. The optimised dressing has the potential to reduce bacterial infection and can also help to reduce swelling and pain associated with injury due to the anti-inflammatory action of diclofenac and help to achieve more rapid wound healing. © 2014 Wiley Periodicals, Inc. and the American Pharmacists Association.

Positively and Negatively Charged Ionic Modifications to Cellulose Assessed as Cotton-Based Protease-Lowering and Haemostatic Wound Agents

USDA-ARS?s Scientific Manuscript database

Recent developments in cellulose wound dressings targeted to different stages of wound healing have been based on structural and charge modifications that function to modulate events in the complex inflammatory and hemostatic phases of wound healing. Hemostasis and inflammation comprise two overlapp...

Allergic contact dermatitis caused by acrylic-based medical dressings and adhesives.

PubMed

Mestach, Lien; Huygens, Sara; Goossens, An; Gilissen, Liesbeth

2018-06-11

Acrylates and methacrylates are acrylic resin monomers that are known to induce skin sensitization as a result of their presence in different materials, such as nail cosmetics, dental materials, printing inks, and adhesives. Allergic contact dermatitis resulting from the use of modern wound dressings containing them has only rarely been reported. To describe 2 patients who developed allergic contact dermatitis caused by acrylic-based modern medical dressings and/or adhesives. The medical charts of patients observed since 1990 were retrospectively reviewed for (meth)acrylate allergy resulting from contact with such materials, and their demographic characteristics and patch test results were analysed. Two patients were observed in 2014 and 2016 who had presented with positive patch test reactions to several acrylic-based dressings and/or adhesive materials, and to several (meth)acrylates, that is, hydroxyethyl acrylate, hydroxyethyl methacrylate, ethyleneglycol dimethacrylate, bisphenol A-glycidyl methacrylate/epoxy-acrylate, urethane diacrylate, and/or penta-erythritol acrylate. Allergic contact dermatitis needs to be considered in patients with eczematous reactions or delayed healing following the use of acrylic-based modern dressings or adhesives. However, identification of the culprit allergen is hampered by poor cooperation from the producers, so adequate labelling of medical devices is an urgent necessity. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Evaluation of a honey-impregnated tulle dressing in primary care.

PubMed

Stephen-Haynes, Jackie

2004-06-01

Honey has been used for its healing properties for centuries and has been used to dress wounds with favourable results. The emergence of antibiotic resistance and growing interest in "natural" or "complementary" therapies has led to an interest in honey dressings. Much of the research to date has been related to honey's antibacterial properties. However, the healing properties claimed for honey also include stimulating new tissue growth, moist wound healing, fluid handling and promoting epithelialization. Until recently, honey had not been developed as a wound management product and was not a certified pharmaceutical device. Activon Tulle is a sterile, non-adherent dressing impregnated with Leptospermum scoparium hone. The claimed properties of honey dressings would make this a valuable addition to the dressing currently available in the primary care setting. An evaluation was undertaken involving 20 patients with a variety of wounds. A conclusion is drawn that while further research is needed, medical grade honey does appear to be a valuable addition to the wound management formulary.

Arginine functionalized bacterial cellulose nanofibers containing gel as an effective wound dressing; in vitro and in vivo evaluation.

PubMed

Feizabadi, Farideh; Minaiyan, Mohsan; Taheri, Azade

2018-02-19

Nanofibers such as bacterial cellulose nanofibers (BC-NFs) have gained increasing attention for use in wound dressings. Topical application of arginine can stimulate wound healing significantly. In order to promote the wound healing process, arginine functionalized BC-NFs containing gel (Arg-BC-NFs gel) was prepared by the electrostatic attachment of arginine on the surface of BC-NFs. The effect of pH was evaluated on the amount of the attached arginine on the BC-NFs surface. The attachment of arginine on BC-NFs surface was investigated by FTIR spectroscopy. The morphology of Arg-BC-NFs was evaluated using FESEM. The viscosity and spreadability of Arg-BC-NFs and the release of arginine from Arg-BC-NFs were evaluated. The effectiveness of Arg-BC-NFs gel was assessed in a full thickness wound model in rats. Re-epithelization, collagen deposition and neovascularization were investigated in the wound tissues using histological and immunohistochemical analysis. FTIR spectra and the zeta potential of BC-NFs confirmed the surface modification of BC-NFs by arginine. FESEM images showed the nanofibrous structure of Arg-BC-NFs. The release of arginine from Arg-BC-NFs gel was in a sustained release manner for 24 h. The appropriate viscosity and spreadability of Arg-BC-NFs gel confirmed its easy topical application. In vivo studies revealed that Arg-BC-NFs gel promoted wound closure at a faster rate than BC-NFs gel and arginine solution. Moreover, faster and more organized re-epithelialization, angiogenesis and collagen deposition were achieved in Arg-BC-NFs gel treated group in comparison to other groups. Arg-BC-NFs gel can be introduced as an effective wound dressing for acute wounds. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

A multi-centre clinical evaluation of reactive oxygen topical wound gel in 114 wounds.

PubMed

Dryden, M; Dickinson, A; Brooks, J; Hudgell, L; Saeed, K; Cutting, K F

2016-03-01

This article reports the outcomes of the use of Surgihoney RO (SHRO), topical wound dressing in a multi-centre, international setting. The aims were to explore the clinical effects of SHRO, including a reduction in bacterial load and biofilm and improvement in healing in a variety of challenging non-healing and clinically infected wounds. This was a non-comparative evaluation, where both acute and chronic wounds with established delayed healing were treated with the dressing. Clinicians prospectively recorded wound improvement or deterioration, level of wound exudate, presence of pain, and presence of slough and necrosis. Analysis of this data provided information on clinical performance of the dressing. Semi-quantitative culture to assess bacterial bioburden was performed where possible. We recruited 104 patients, mean age 61 years old, with 114 wounds. The mean duration of wounds before treatment was 3.7 months and the mean duration of treatment was 25.7 days. During treatment 24 wounds (21%) healed and the remaining 90 (79%) wounds improved following application of the dressing. No deterioration in any wound was observed. A reduction in patient pain, level of wound exudate and in devitalised tissue were consistently reported. These positive improvements in wound progress were reflected in the wound cultures that showed a reduction in bacterial load in 39 out of the 40 swabs taken. There were two adverse events recorded: a stinging sensation following application of the dressing was experienced by 2 patients, and 2 elderly patients died of causes unrelated to the dressing or to the chronic wound. These patients' wounds and their response to SHRO have been included in the analysis. SHRO was well tolerated and shows great promise as an effective potent topical antimicrobial in the healing of challenging wounds. Matthew Dryden has become a shareholder in Matoke Holdings, the manufacturer of Surgihoney RO, since the completion of this study. Keith Cutting is a

Preparation of silver-chitosan nanocomposites and coating on bandage for antibacterial wound dressing application

DOE Office of Scientific and Technical Information (OSTI.GOV)

Susilowati, Endang, E-mail: endwati@yahoo.co.id; Ashadi; Maryani

Bandage is a medical device that is essential for wound dressing. To improve the performance of the bandage, it has been coated by silver-chitosan nanocomposites (Ag/Chit) with pad-dry-cure method. The nanocomposites were performed by chemical reduction method at room temperature using glucose as reducing agent, sodium hydroxide (NaOH) as accelerator reagent, silver nitrate (AgNO{sub 3}) as metal precursor and chitosan as stabilizing agent. Localized surface plasmon resonance (LSPR) absorption band of silver nanoparticles was investigated using UV-Vis spectrophotometer. The bandage coated Ag/Chit nanocomposites (B-Ag/Chit) were characterized by fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD) and scanning electron microscope (SEM).more » In addition, antibacterial activity of the bandage toward Gram positive (Staphylococcus aureus) and Gram negative (Escherichia coli) were also studied. The formation of silver nanoparticles was confirmed by the appearance of LSPR absorption peak at 412.2 – 423.2 nm. Coating of nanocomposite cause increasing rigidity of bandage and decreasing on crystallinity. The bandages of B-Ag/Chit demonstrated good activity against both Gram positive (S. aureus) and Gram negative (E.Coli). Thus the bandages have a potential to be used for antibacterial wound dressing application.« less

Polyurethane foam containing rhEGF as a dressing material for healing diabetic wounds: Synthesis, characterization, in vitro and in vivo studies.

PubMed

Pyun, Do Gi; Choi, Hyun Jun; Yoon, Hyoung Soon; Thambi, Thavasyappan; Lee, Doo Sung

2015-11-01

Diabetic wounds are a major health issue associated with diabetes mellitus. To surmount this issue, we developed polyurethane foams (PUFs) incorporating varying amounts of recombinant human epidermal growth factor (rhEGF) (rhEGF-PUFs) as a wound dressing for diabetic wounds. From electron microscopy images, it was found that the pore size of the rhEGF-PUFs surface (the wound contact layer) was less than 100μm, regardless of rhEGF content. The release of rhEGF from the PUFs was evaluated using an enzyme-linked immunosorbent assay. The result showed that the release of rhEGF was time and concentration dependent, i.e., the amount of released rhEGF significantly increased as the immersion time and the rhEGF content of the PUFs increased. In vitro cytotoxicity testing showed that rhEGF-PUFs increased the viability of HaCaT human keratinocytes and CCD986-sk human fibroblasts, which indicated that the incorporated rhEGF maintained its biological activity. In an in vitro scratch wound healing assay, the wound closure rate was faster in CCD986-sk human fibroblasts than in HaCaT human keratinocytes. Finally, the rhEGF-PUFs were evaluated as an in vivo treatment in a full-thickness wound model in diabetized Sprague-Dawley rats. The result indicated that compared with PUFs, rhEGF-PUFs accelerated wound healing by promoting wound contraction, re-epithelialization, collagen deposition and the formation of a skin appendage. These findings demonstrate that rhEGF-PUFs are a promising dressing for diabetic wounds. Copyright © 2015. Published by Elsevier B.V.

150 patient experiences with a soft silicone foam dressing.

PubMed

Bateman, Sharon Dawn

Pain, malodour and exudate from acute and chronic wounds can be catastrophic to the patient. Excessive exudate results in significant tissue damage to the wound bed and surrounding skin, reduces quality of life, and often requires costly specialist service input. Effective wound assessment and management including appropriate dressing choice is, therefore, paramount to ensure wound healing can take place in a timely manner. This observational evaluation explores 150 ward-based patients who presented with acute and chronic exuding wounds; it examines and evaluates the proposed benefits of the Cutimed(®) Siltec foam dressing range over a 4-month period in an acute hospital setting. The outcomes of the evaluation were exudate management, maceration reduction, atraumatic application and removal, non-adherence and patient experience. The evaluation highlights not only an overall positive improvement in exudate management and maceration reduction, non-adherence, atraumatic application and removal but also emphasises the importance of a positive patient experience in the wound-care journey.

Recent advances in topical wound care

PubMed Central

Sarabahi, Sujata

2012-01-01

There are a wide variety of dressing techniques and materials available for management of both acute wounds and chronic non-healing wounds. The primary objective in both the cases is to achieve a healed closed wound. However, in a chronic wound the dressing may be required for preparing the wound bed for further operative procedures such as skin grafting. An ideal dressing material should not only accelerate wound healing but also reduce loss of protein, electrolytes and fluid from the wound, and help to minimize pain and infection. The present dictum is to promote the concept of moist wound healing. This is in sharp contrast to the earlier practice of exposure method of wound management wherein the wound was allowed to dry. It can be quite a challenge for any physician to choose an appropriate dressing material when faced with a wound. Since wound care is undergoing a constant change and new products are being introduced into the market frequently, one needs to keep abreast of their effect on wound healing. This article emphasizes on the importance of assessment of the wound bed, the amount of drainage, depth of damage, presence of infection and location of wound. These characteristics will help any clinician decide on which product to use and where,in order to get optimal wound healing. However, there are no ‘magical dressings’. Dressings are one important aspect that promotes wound healing apart from treating the underlying cause and other supportive measures like nutrition and systemic antibiotics need to be given equal attention. PMID:23162238

Foam dressings for treating pressure ulcers.

PubMed

Walker, Rachel M; Gillespie, Brigid M; Thalib, Lukman; Higgins, Niall S; Whitty, Jennifer A

2017-10-12

Pressure ulcers, also known as pressure injuries and bed sores, are localised areas of injury to the skin or underlying tissues, or both. Dressings made from a variety of materials, including foam, are used to treat pressure ulcers. An evidence-based overview of dressings for pressure ulcers is needed to enable informed decision-making on dressing use. This review is part of a suite of Cochrane Reviews investigating the use of dressings in the treatment of pressure ulcers. Each review will focus on a particular dressing type. To assess the clinical and cost effectiveness of foam wound dressings for healing pressure ulcers in people with an existing pressure ulcer in any care setting. In February 2017 we searched: the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE (including In-Process & Other Non-Indexed Citations); Ovid Embase; EBSCO CINAHL Plus and the NHS Economic Evaluation Database (NHS EED). We also searched clinical trials registries for ongoing and unpublished studies, and scanned reference lists of relevant included studies as well as reviews, meta-analyses and health technology reports to identify additional studies. There were no restrictions with respect to language, date of publication or study setting. Published or unpublished randomised controlled trials (RCTs) and cluster-RCTs, that compared the clinical and cost effectiveness of foam wound dressings for healing pressure ulcers (Category/Stage II or above). Two review authors independently performed study selection, risk of bias and data extraction. A third reviewer resolved discrepancies between the review authors. We included nine trials with a total of 483 participants, all of whom were adults (59 years or older) with an existing pressure ulcer Category/Stage II or above. All trials had two arms, which compared foam dressings with other dressings for treating pressure ulcers.The certainty of evidence ranged from low to very low due

[Clinical study using activity-based costing to assess cost-effectiveness of a wound management system utilizing modern dressings in comparison with traditional wound care].

PubMed

Ohura, Takehiko; Sanada, Hiromi; Mino, Yoshio

2004-01-01

In recent years, the concept of cost-effectiveness, including medical delivery and health service fee systems, has become widespread in Japanese health care. In the field of pressure ulcer management, the recent introduction of penalty subtraction in the care fee system emphasizes the need for prevention and cost-effective care of pressure ulcer. Previous cost-effectiveness research on pressure ulcer management tended to focus only on "hardware" costs such as those for pharmaceuticals and medical supplies, while neglecting other cost aspects, particularly those involving the cost of labor. Thus, cost-effectiveness in pressure ulcer care has not yet been fully established. To provide true cost effectiveness data, a comparative prospective study was initiated in patients with stage II and III pressure ulcers. Considering the potential impact of the pressure reduction mattress on clinical outcome, in particular, the same type of pressure reduction mattresses are utilized in all the cases in the study. The cost analysis method used was Activity-Based Costing, which measures material and labor cost aspects on a daily basis. A reduction in the Pressure Sore Status Tool (PSST) score was used to measure clinical effectiveness. Patients were divided into three groups based on the treatment method and on the use of a consistent algorithm of wound care: 1. MC/A group, modern dressings with a treatment algorithm (control cohort). 2. TC/A group, traditional care (ointment and gauze) with a treatment algorithm. 3. TC/NA group, traditional care (ointment and gauze) without a treatment algorithm. The results revealed that MC/A is more cost-effective than both TC/A and TC/NA. This suggests that appropriate utilization of modern dressing materials and a pressure ulcer care algorithm would contribute to reducing health care costs, improved clinical results, and, ultimately, greater cost-effectiveness.

Application of the Single Use Negative Pressure Wound Therapy Device (PICO) on a Heterogeneous Group of Surgical and Traumatic Wounds

PubMed Central

Payne, Caroline; Edwards, Daren

2014-01-01

Objectives: Traumatic wounds and surgery inherently have their complications. Localized infections, wound dehiscence, and excessive wound leakage can be devastating to the patient with a prolonged recovery, but it is also costly to the hospital with an increased length of stay, extra workload, and dressing changes. The single use PICO (Smith and Nephew Healthcare, Hull, United Kingdom) negative pressure wound therapy (NPWT) dressing has revolutionized our management of various acute, chronic, and high output wounds. It requires fewer dressing changes than conventional practice, is used in the outpatient setting, and is a necessary adjuvant therapy to hasten wound healing. Aims: To observe the efficacy of the PICO vacuum-assisted healing within a cost improvement programme. Settings: Plastic surgery department, Royal London Hospital. Materials and Methods: Twenty-one patients with a diversity of postoperative or posttraumatic wounds were considered suitable for PICO application and treated totally on an outpatient basis once the PICO dressing was applied. All wounds were then subjected to continued PICO dressings until healed. Results: All patients tolerated the PICO well with no dressing failure or failure to comply. The number of dressings per patient ranged from 1 to 7. The cost per patient of treatment ranged from £120 to £1578. Estimated cost of all PICO dressing for 21 patients including plastic surgery dressing clinic appointments = £13,345. Median length of treatment to healing (days) = 16; standard deviation = 9.5. Eight patients would have had an inpatient bed stay with conventional therapy, total 24 bed days saved at Bartshealth @£325 per day. Conclusions: The outpatient application of a disposable NPWT can benefit a wide range of clinical wounds that optimizes patient care, promotes rapid wound healing, and importantly helps manage costs. PMID:24917894

Fluorinated methacrylamide chitosan hydrogels enhance collagen synthesis in wound healing through increased oxygen availability.

PubMed

Patil, Pritam S; Fountas-Davis, Natalie; Huang, He; Michelle Evancho-Chapman, M; Fulton, Judith A; Shriver, Leah P; Leipzig, Nic D

2016-05-01

In this study, methacrylamide chitosan modified with perfluorocarbon chains (MACF) is used as the base material to construct hydrogel dressings for treating dermal wounds. MACF hydrogels saturated with oxygen (+O2) are examined for their ability to deliver and sustain oxygen, degrade in a biological environment, and promote wound healing in an animal model. The emerging technique of metabolomics is used to understand how MACF+O2 hydrogel dressings improve wound healing. Results indicate that MACF treatment facilitates oxygen transport rate that is two orders of magnitude greater than base MAC hydrogels. MACF hydrogel dressings are next tested in an in vivo splinted rat excisional wound healing model. Histological analysis reveals that MACF+O2 dressings improve re-epithelialization (p<0.0001) and synthesis of collagen over controls (p<0.01). Analysis of endogenous metabolites in the wounds using global metabolomics demonstrates that MACF+O2 dressings promotes a regenerative metabolic process directed toward hydroxyproline and collagen synthesis, with confirmation of metabolite levels within this pathway. The results of this study confirm that increased oxygen delivery through the application of MACF+O2 hydrogels enhances wound healing and metabolomics analyses provides a powerful tool to assess wound healing physiology. This work presents the first application of a novel class of oxygen delivering biomaterials (methacrylamide chitosan modified with perfluorocarbon chains (MACF)) as a hydrogel wound dressing. This manuscript also contains strong focus on the biochemical benefits of MACF dressings on underlying mechanisms vital to successful wound healing. In this vein, this manuscript presents the application of applied metabolomics (tandem mass spectroscopy) to uncover biomaterial interactions with wound healing mechanisms. We believe the approaches described in this manuscript will be of great interest to biomedical scientists and particularly to researchers

Early use of negative pressure therapy in combination with silver dressings in a difficult breast abscess.

PubMed

Richards, Alastair J; Hagelstein, Sue M; Patel, Girish K; Ivins, Nicola M; Sweetland, Helen M; Harding, Keith G

2011-12-01

Combining silver-based dressings with negative pressure therapy after radical excision of chronically infected breast disease is a novel application of two technologies. One patient with complex, chronic, infected breast disease underwent radical excision of the affected area and was treated early with a combination of silver-based dressings and topical negative pressure therapy. The wound was then assessed sequentially using clinical measurements of wound area and depth, pain severity scores and level of exudation. It is possible to combine accepted techniques with modern dressing technologies that result in a positive outcome. In this case, the combination of a silver-based dressing with negative pressure therapy following radical excision proved safe and was well tolerated by the patient. Full epithelisation of the wound was achieved and there was no recurrence of the infection for the duration of the treatment. © 2011 The Authors. © 2011 Blackwell Publishing Ltd and Medicalhelplines.com Inc.

[THE ROLE OF PRESSURE ULCER SURROUNDING SKIN PREPARATION PRIOR TO THE APPLICATION OF WOUND DRESSING].

PubMed

Kulišić, S Marinović

2016-01-01

Pressure ulcer develops as a result of many factors, primarily pressure, tensile forces and ischemia with immobility and incontinence. Targeted and properly designed preventive measures reduce the incidence and complications of pressure ulcers, among which the most common are infections. An important preventive measure is protection of the surrounding skin before the application of wound dressings. Skin changes dictate the use of emollients and topical therapy according to dermatological status.

Non-healing foot ulcers in diabetic patients: general and local interfering conditions and management options with advanced wound dressings.

PubMed

Uccioli, Luigi; Izzo, Valentina; Meloni, Marco; Vainieri, Erika; Ruotolo, Valeria; Giurato, Laura

2015-04-01

Medical knowledge about wound management has improved as recent studies have investigated the healing process and its biochemical background. Despite this, foot ulcers remain an important clinical problem, often resulting in costly, prolonged treatment. A non-healing ulcer is also a strong risk factor for major amputation. Many factors can interfere with wound healing, including the patient's general health status (i.e., nutritional condition indicated by albumin levels) or drugs such as steroids that can interfere with normal healing. Diabetic complications (i.e., renal insufficiency) may delay healing and account for higher amputation rates observed in diabetic patients under dialysis treatment. Wound environment (e.g., presence of neuropathy, ischaemia, and infection) may significantly influence healing by interfering with the physiological healing cascade and adding local release of factors that may worsen the wound. The timely and well-orchestrated release of factors regulating the healing process, observed in acute wounds, is impaired in non-healing wounds that are blocked in a chronic inflammatory phase without progressing to healing. This chronic phase is characterised by elevated protease activity (EPA) of metalloproteinases (MMPs) and serine proteases (e.g., human neutrophil elastase) that interfere with collagen synthesis, as well as growth factor release and action. EPA (mainly MMP 9, MMP-8 and elastase) and inflammatory factors present in the wound bed (such as IL-1, IL-6, and TNFa) account for the catabolic state of non-healing ulcers. The availability of wound dressings that modulate EPA has added new therapeutic options for treating non-healing ulcers. The literature confirms advantages obtained by reducing protease activity in the wound bed, with better outcomes achieved by using these dressings compared with traditional ones. New technologies also allow a physician to know the status of the wound bed environment, particularly EPA, in a clinical

The Novelty in Fabrication of Poly Vinyl Alcohol/κ-Carrageenan Hydrogel with Lactobacillus bulgaricus Extract as Anti-inflammatory Wound Dressing Agent.

PubMed

El-Fawal, Gomaa F; Yassin, Abdelrahman M; El-Deeb, Nehal M

2017-07-01

Material barrier properties to microbes are an important issue in many pharmaceutical applications like wound dressings. A wide range of biomaterials has been used to manage the chronic inflamed wounds. Eight hydrogel membranes of poly vinyl alcohol (PVA) with κ-carrageenan (KC) and Lactobacillus bulgaricus extract (LAB) have been prepared by using freeze-thawing technique. To evaluate the membranes efficiency as wound dressing agents, various tests have been done like gel fraction, swelling behavior, mechanical properties, etc. The antibacterial activities of the prepared membranes were tested against the antibiotic-resistant bacterial isolates. In addition, the safety usage of the prepared hydrogel was checked on human dermal fibroblast cells. The anti-inflammatory properties of the prepared hydrogel on LPS-PBMC cell inflammatory model were quantified using enzyme-linked immunosorbent assay (ELISA) and real-time polymerase chain reaction (RT-qPCR). The analysis data of TGA, SEM, gel fraction, and swelling behavior showed changes in properties of prepared PVA\\KC\\LAB hydrogel membrane than pure PVA hydrogel membrane. The antibacterial activities of the prepared membranes augmented in LAB extract-prepared membranes. Out of the eight used hydrogel membranes, the PVAKC4 hydrogel membrane is the safest one on fibroblast cellular proliferation with a maximum proliferation percentage 97.3%. Also, all the used hydrogel membrane showed abilities to reduce the concentration of IL-2 and IL-8 compared with both negative and positive control. In addition, almost all the prepared hydrogel membrane showed variable abilities to downregulate the expression of TNF-α gene with superior effect of hydrogel membrane KC1. PVA/KC/LAB extract hydrogel membrane may be a promising material for wound dressing application and could accelerate the healing process of the chronic wound because of its antimicrobial and anti-inflammatory properties.

A silver coated dressing reduces the incidence of early burn wound cellulitis and associated costs of inpatient treatment: comparative patient care audits.

PubMed

Fong, J; Wood, F; Fowler, B

2005-08-01

In 2000 and 2002, the Royal Perth Hospital (RPH) Burn Unit, Western Australia, conducted two 'before and after' patient care audits comparing the effectiveness and cost of Silvazine (silver sulphadiazine and chlorhexidine digluconate cream) and Acticoat, a new dressing product for in-patient treatment of early burn wounds. The main outcome variables were: burn wound cellulitis, antibiotic use and cost of treatment. Two patient care audits and a comparative sample were used. The two regimes audited were, 'standard treatment' of twice daily showers or washes with 4% chlorhexidine soap and Silvazine cream as a topical dressing (2000, n=51), compared with the 'new treatment' of daily showers of the burn wound with 4% chlorhexidine soap and the application of an Acticoat dressing (2002, n=19). In 2002, costs were also examined using a sample of matched pairs (n=8) of current and previous patients. The main findings were: when using Acticoat the incidence of infection and antibiotic use fell from 55% (28/51) and 57% (29/51) in 2000 to 10.5% (2/19) and 5.2% (1/19) in 2002. The total costs (excluding antibiotics, staffing and surgery) for those treated with Silvazine were US$ 109,357 and those treated with Acticoat were US$ 78,907, demonstrating a saving of US$ 30,450 with the new treatment. The average length of stay (LOS) in hospital was 17.25 days for the Silvazine group and 12.5 days for the Acticoat group-a difference of 4.75 days. These audits demonstrate that Acticoat results in a reduced incidence of burn wound cellulitis, antibiotic use and overall cost compared to Silvazine in the treatment of early burn wounds.

An Inexpensive Bismuth-Petrolatum Dressing for Treatment of Burns

PubMed Central

Chattopadhyay, Arhana; Chang, Kathleen; Nguyen, Khoa; Galvez, Michael G.; Legrand, Anais; Davis, Christopher; McGoldrick, Rory; Long, Chao; Pham, Hung

2016-01-01

Background: Xeroform remains the current standard for treating superficial partial-thickness burns but can be prohibitively expensive in developing countries with prevalent burn injuries. This study (1) describes the production of an alternative low-cost dressing and (2) compares the alternative dressing and Xeroform using the metrics of cost-effectiveness, antimicrobial activity, and biocompatibility in vitro, and wound healing in vivo. Methods: To produce the alternative dressing, 3% bismuth tribromophenate powder was combined with petroleum jelly by hand and applied to Kerlix gauze. To assess cost-effectiveness, the unit costs of Xeroform and components of the alternative dressing were compared. To assess antimicrobial properties, the dressings were placed on agar plated with Escherichia coli and the Kirby-Bauer assay performed. To assess biocompatibility, the dressings were incubated with human dermal fibroblasts and cells stained with methylene blue. To assess in vivo wound healing, dressings were applied to excisional wounds on rats and the rate of re-epithelialization calculated. Results: The alternative dressing costs 34% of the least expensive brand of Xeroform. Antimicrobial assays showed that both dressings had similar bacteriostatic effects. Biocompatibility assays showed that there was no statistical difference (P < 0.05) in the cytotoxicity of Xeroform, alternative dressing, and Kerlix gauze. Finally, the in vivo healing model showed no statistical difference (P < 0.05) in mean re-epithelialization time between Xeroform (13.0 ± 1.6 days) and alternative dressing (13.5 ± 1.0 days). Conclusions: Xeroform is biocompatible, reduces infection, and enhances healing of burn wounds by preventing desiccation and mechanical trauma. Handmade petrolatum gauze may be a low-cost replacement for Xeroform. Future studies will focus on clinical trials in burn units. PMID:27482485

Cellular interactions with bacterial cellulose: Polycaprolactone nanofibrous scaffolds produced by a portable electrohydrodynamic gun for point-of-need wound dressing.

PubMed

Aydogdu, Mehmet Onur; Altun, Esra; Crabbe-Mann, Maryam; Brako, Francis; Koc, Fatma; Ozen, Gunes; Kuruca, Serap Erdem; Edirisinghe, Ursula; Luo, C J; Gunduz, Oguzhan; Edirisinghe, Mohan

2018-05-27

Electrospun nanofibrous scaffolds are promising regenerative wound dressing options but have yet to be widely used in practice. The challenge is that nanofibre productions rely on bench-top apparatuses, and the delicate product integrity is hard to preserve before reaching the point of need. Timing is critically important to wound healing. The purpose of this investigation is to produce novel nanofibrous scaffolds using a portable, hand-held "gun", which enables production at the wound site in a time-dependent fashion, thereby preserving product integrity. We select bacterial cellulose, a natural hydrophilic biopolymer, and polycaprolactone, a synthetic hydrophobic polymer, to generate composite nanofibres that can tune the scaffold hydrophilicity, which strongly affects cell proliferation. Composite scaffolds made of 8 different ratios of bacterial cellulose and polycaprolactone were successfully electrospun. The morphological features and cell-scaffold interactions were analysed using scanning electron microscopy. The biocompatibility was studied using Saos-2 cell viability test. The scaffolds were found to show good biocompatibility and allow different proliferation rates that varied with the composition of the scaffolds. A nanofibrous dressing that can be accurately moulded and standardised via the portable technique is advantageous for wound healing in practicality and in its consistency through mass production. © 2018 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Decellularized amnion scaffold with activated PRP: a new paradigm dressing material for burn wound healing.

PubMed

Kshersagar, Jeevitaa; Kshirsagar, Ravi; Desai, Shashikant; Bohara, Raghvendra; Joshi, Meghnad

2018-03-05

Direct application of amnion has greater risk of immunological rejection and infection. Decellularization is an effective method to lower the risk of immune complications and infections. The bioreactor assembly with multiple cassettes was designed for decellurization of multiple amnions with different cell types simultaneously in single run. A detergent-based protocol was modified to remove all cellular components from amnion and diminish the DNA content to render it non-immunogenic. Amnion (n = 10) were treated with 2% sodium dodecyl sulphate (SDS), 5% dimethyl sulfoxide (DMSO) and 2% sodium deoxycholeate (SD). Decellularized amnion samples were analyzed by haematoxylin-eosin staining (HE), Alcian blue pH 1 (AB-pH-1), 4,6-diamnionidino-2-phenylindol (DAPI), Massion's trichrome stain, DNA quantification, mechanical testing and scanning electron microscopy (SEM). Histological analysis showed complete removal of cellular components and the histoarchitecture of scaffold remained intact. Amnion scaffold activated with platelet rich plasma (PRP) and calcium chloride composition supported better adherence to the wound than amnion alone. Only single application showed good healing. In vivo assessment of activated amnion revealed stable dressing. It has good promising outcome. At day 7, histologically the wounds treated with activated amnion were almost closed without scarring and showed well differentiated epidermis, proliferation of keratinocytes, hair follicles and basement membrane as compared to controls and silver nitrate gel dressings in a mouse (Mus musculus). Cryopreservation had no adverse effect on the mechanical properties of the amnion scaffold. Cryopreservation of decellularized amnion by Dulbecco's modified eagle medium (DMEM) was expected to prepare off-the-shelf skin substitutes and preserve them to be immediately available upon request of patients' needs.

Effect of Andrographis paniculata leaf extract on wound healing in rats.

PubMed

Al-Bayaty, Fouad Hussain; Abdulla, Mahmood Ameen; Abu Hassan, Mohamed Ibrahim; Ali, Hapipah Mohd

2012-01-01

This work was carried out to study the effect of topical application of Andrographis paniculata on the rate of wound enclosure and its histological features. A wound was created in four groups of rat in posterior neck region. Blank placebo was applied topically to the wounds of Group 1. Groups 2 and 3 were dressed with placebo containing 5% and 10% extracts of A. paniculata, respectively. Intrasite gel was applied topically to the wounds of Group 4. Macroscopical examination revealed that the rate of wound healing was significantly accelerated in the wound dressed with A. paniculata extract compared to the blank placebo. The wounds dressed with 10% extract or Intrasite gel healed earlier compared to the wounds dressed with placebo containing 5% A. paniculata extract. Histologically, wounds dressed with A. paniculata extracts showed markedly less scar width and contained large amounts of fibroblast proliferation. More collagen and less angiogenesis with absence of inflammatory cells were seen for wounds dressed with 10% A. paniculata compared to the blank placebo. Conclusion, A. paniculata extracts significantly enhanced rate of wound healing in rats.

An evaluation of a silicone adhesive shaped heel dressing.

PubMed

Hampton, Sylvie

Tissue breakdown is complex and involves many factors. Pressure ulcer development in the heels is subject to extrinsic factors such as pressure, shear, friction and moisture. The heels are the most common sites for friction and shear damage, which can lead to blistering, skin erosion and tissue breakdown (Grey et al, 2006). To address the issues of wounds that are painful on dressing removal and friable skin, Smith & Nephew has introduced a soft silicone adhesive dressing to its Allevyn dressing range. Silicone does not adhere to wounded areas and can be removed gently without trauma to the periwound area. This paper discusses the findings of a 20-patient multi-site evaluation examining the performance and acceptability of Allevyn Gentle Border Heel dressing in the management of heel wounds.

A Randomized, Controlled Clinical Trial of Honey-Impregnated Dressing for Treating Diabetic Foot Ulcer.

PubMed

Imran, Muhammad; Hussain, Muhammad Barkaat; Baig, Mukhtiar

2015-10-01

To investigate the effect of Beri-honey-impregnated dressing on diabetic foot ulcer and compare it with normal saline dressing. A randomized, controlled trial. Sughra Shafi Medical Complex, Narowal, Pakistan and Bhatti International Trust (BIT) Hospital, Affiliated with Central Park Medical College, Lahore, from February 2006 to February 2010. Patients with Wagner's grade 1 and 2 ulcers were enrolled. Those patients were divided in two groups; group A (n=179) treated with honey dressing and group B (n=169) treated with normal saline dressing. Outcome measures were calculated in terms of proportion of wounds completely healed (primary outcome), wound healing time, and deterioration of wounds. Patients were followed-up for a maximum of 120 days. One hundred and thirty six wounds (75.97%) out of 179 were completely healed with honey dressing and 97 (57.39%) out of 169 wtih saline dressing (p=0.001). The median wound healing time was 18.00 (6 - 120) days (Median with IQR) in group A and 29.00 (7 - 120) days (Median with IQR) in group B (p < 0.001). The present results showed that honey is an effective dressing agent instead of conventional dressings, in treating patients of diabetic foot ulcer.

The economic benefits of negative pressure wound therapy in community-based wound care in the NHS.

PubMed

Dowsett, Caroline; Davis, Lynn; Henderson, Valerie; Searle, Richard

2012-10-01

The human and economic costs of wounds are of major concern within today's National Health Service. Advances in wound care technology have been shown to be beneficial both in healing and in relation to patient quality of life. Negative pressure has often been associated with high-cost care and restricted to use in the secondary care setting. There is growing use of negative pressure within the community, and this has the potential to benefit the patient and the service by providing quality care in the patient's home setting. Three community sites were chosen to monitor their use of negative pressure wound therapy (NPWT) over a period of 2 years, and this paper presents some of the key findings of this work. The data generated has been used to help target resources and prevent misuse of therapy. Cost per patient episode has been calculated, and this can be compared to similar costs in secondary care, showing significant savings if patients are discharged earlier from secondary care. There is also an increased demand for more patients with complex wounds to be cared for in the community, and in the future, it is likely that community initiated NPWT may become more common. Early analysis of the data showed that the average cost of dressing complex wounds would be significantly less than using traditional dressings, where increased nursing visits could increase costs. There is a compelling argument for more negative pressure to be used and initiated in the community, based not only on improved quality of life for patients but also on the economic benefits of the therapy. © 2012 The Authors. International Wound Journal © 2012 Blackwell Publishing Ltd and Medicalhelplines.com Inc.

Synthesis and characterization of curcumin loaded PLA-Hyperbranched polyglycerol electrospun blend for wound dressing applications.

PubMed

Perumal, Govindaraj; Pappuru, Sreenath; Chakraborty, Debashis; Maya Nandkumar, A; Chand, Dillip Kumar; Doble, Mukesh

2017-07-01

This study is aimed to develop curcumin (Cur) incorporated electrospun nanofibers of a blend of poly (lactic acid) (PLA) and hyperbranched polyglycerol (HPG) for wound healing applications. Both the polymers are synthesized and fabricated by electrospinning technique. The produced nanofibers were characterized by Scanning Electron Microscopy (SEM), X-Ray Diffraction (XRD), Fourier Transform Infrared Spectroscopy (FT-IR), Differential Scanning Colorimetry (DSC) and Thermogravimetric Analysis (TGA). Electrospun scaffolds (PLA/HPG/Cur) exhibits very high hydrophilicity, high swelling and drug uptake and promotes better cell viability, adhesion and proliferation when compared to PLA/Cur electrospun nanofibers. Biodegradation study revealed that the morphology of the nanofibers were unaffected even after 14days immersion in Phosphate Buffered Saline. In vitro scratch assay indicates that migration of the cells in the scratch treated with PLA/HPG/Cur is complete within 36h. These results suggest that PLA/HPG/Cur nanofibers can be a potential wound patch dressing for acute and chronic wound applications. Copyright © 2017 Elsevier B.V. All rights reserved.

In situ synthesis of silver-nanoparticles/bacterial cellulose composites for slow-released antimicrobial wound dressing.

PubMed

Wu, Jian; Zheng, Yudong; Song, Wenhui; Luan, Jiabin; Wen, Xiaoxiao; Wu, Zhigu; Chen, Xiaohua; Wang, Qi; Guo, Shaolin

2014-02-15

Bacterial cellulose has attracted increasing attention as a novel wound dressing material, but it has no antimicrobial activity, which is one of critical skin-barrier functions in wound healing. To overcome such deficiency, we developed a novel method to synthesize and impregnate silver nanoparticles on to bacterial cellulose nanofibres (AgNP-BC). Uniform spherical silver nano-particles (10-30 nm) were generated and self-assembled on the surface of BC nano-fibers, forming a stable and evenly distributed Ag nanoparticles coated BC nanofiber. Such hybrid nanostructure prevented Ag nanoparticles from dropping off BC network and thus minimized the toxicity of nanoparticles. Regardless the slow Ag(+) release, AgNP-BC still exhibited significant antibacterial activities with more than 99% reductions in Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa. Moreover, AgNP-BC allowed attachment and growth of epidermal cells with no cytotoxicity emerged. The results demonstrated that AgNP-BC could reduce inflammation and promote wound healing. Copyright © 2013 Elsevier Ltd. All rights reserved.

Fungating wounds: management and treatment options.

PubMed

Tandler, Suzanne; Stephen-Haynes, Jackie

2017-06-22

This article defines fungating wounds and considers the underlying cause, location and presentation. The clinical challenges presented by fungating wounds are discussed, with reference to evidence-based care delivery. This includes wound assessment, cleansing, debridement and management of malodour, infection, bleeding and exudate. Guidance on the use of wound management dressings is considered in relation to symptom management. The importance of clinical decision-making and educational preparation in the delivery of evidenced-based care for those with fungating wounds is emphasised. A conclusion is made that the clinician can support the patient with a fungating wound by the delivery of evidenced-based care.

Honey in wound care: effects, clinical application and patient benefit.

PubMed

Lay-flurrie, Karen

The use of honey in wound management has enjoyed a resurgence. This is largely due to the growing clinical problem of antibiotic-resistant bacteria and the combined difficulties for the practitioner in managing chronic wound types, such as burns, leg ulcers or surgical wounds, that may become infected, for example, with methicillin-resistant Staphylococcus aureus or Pseudomonas. The associated costs of treating such wounds are escalating as a result. While the use of honey as a wound dressing has been recognized, at least since Egyptian times circa 2000 BC, it is only more recently, due to the development and licensing of modern honey wound dressings, that such dressings have become more widely available and used in wound management. This article focuses on the use of honey in the treatment of infected wounds and burns. It will examine the effects of honey at the wound bed and its clinical applications, along with the current dressings available. Also discussed are the practical considerations, if, like any wound dressing, honey is to be used safely, appropriately and for the benefit of the patient.

Use of tissue adhesive as a field expedient barrier dressing for hand wounds in disaster responders.

PubMed

Levy, Matthew J; Tang, Nelson

2014-02-01

Injuries sustained by disaster responders can impede the affected individuals' ability to perform critical functions and often require the redirection of already scarce resources. Soft-tissue injuries to the hand are commonly experienced by disaster workers and even seemingly mild lacerations can pose the potential for significant complications in such hazard-filled environments. In this report, the authors describe their experience utilizing tissue adhesive to create a functional and effective barrier dressing for a hand injury sustained by a responder at the West, Texas USA fertilizer plant explosion. This technique of wound management allowed the patient to continue performing essential onsite functions for a sustained period following the explosion and the subsequent investigative processes. At the 30-day follow-up, the wound was well healed and without complications. This technique proved to be a valuable method of field expedient wound management and is worthy of consideration in similar future circumstances.

In Vitro Parallel Evaluation of Antibacterial Activity and Cytotoxicity of Commercially Available Silver-Containing Wound Dressings.

PubMed

Yunoki, Shunji; Kohta, Masushi; Ohyabu, Yoshimi; Iwasaki, Tetsuji

2015-01-01

This study evaluated the in vitro antibacterial activity and cytotoxicity of various commercially available silver-containing dressings (Ag dressing). Biohesive Ag (hydrocolloid, silver sulfadiazine), Aquacel® Ag (nonwoven fabric, ionic silver [Ag]), Algisite™ Ag (nonwoven fabric, Ag), Mepilex® Ag (foam, silver sulfate), and PolyMem® Ag (foam, nanocrystalline silver) were tested for characteristics of Ag release, antibacterial activity, and cytotoxicity. The release of Ag was investigated in cell culture medium at immersion periods of 6, 24, and 48 hours. The antibacterial activity against Staphylococcus aureus and Pseudomonas aeruginosa were accessed by a disc diffusion test. The cytotoxicity was evaluated using V79 cells, by an extraction method. The cytotoxicity was not a monotonic function of the antibacterial activity among the Ag dressings and could not be simply explained by Ag-release properties. Biohesive Ag was regarded as a slow-release Ag dressing, showing the lowest cytotoxicity, while the antibacterial activity was classified as "strong" or "significant" against the two species of bacteria. Aquacel Ag and Algisite Ag showed higher antibacterial activity and cytotoxic effects, which were supported by the higher Ag release. Mepilex Ag showed the highest release of Ag, and the cytotoxicity was the highest among the Ag dressings. However, the antibacterial activity was classified as "significant" or "no activity" for P. aeruginosa and S. aureus, respectively. PolyMem Ag showed the lowest Ag release, and the antibacterial activity classified as "significant" or "no activity" for S. aureus and P. aeruginosa, respectively, whereas the cytotoxicity was similar to those of Aquacel Ag and Algisite Ag. The efficacy and adverse effects of the Ag dressings revealed differences that should be considered by clinicians during wound management.

A PEG-Based Hydrogel for Effective Wound Care Management

PubMed Central

Chen, Sen-Lu; Fu, Ru-Huei; Liao, Shih-Fei; Liu, Shih-Ping; Lin, Shinn-Zong; Wang, Yu-Chi

2018-01-01

It is extremely challenging to achieve strong adhesion in soft tissues while minimizing toxicity, tissue damage, and other side effects caused by wound sealing materials. In this study, flexible synthetic hydrogel sealants were prepared based on polyethylene glycol (PEG) materials. PEG is a synthetic material that is nontoxic and inert and, thus, suitable for use in medical products. We evaluated the in vitro biocompatibility tests of the dressings to assess cytotoxicity and irritation, sensitization, pyrogen toxicity, and systemic toxicity following the International Organization for Standardization 10993 standards and the in vivo effects of the hydrogel samples using Coloskin liquid bandages as control samples for potential in wound closure. PMID:29637814

Leptospermum Honey for Wound Care in an Extremely Premature Infant.

PubMed

Esser, Media

2017-02-01

Neonatal wound care is challenging due to the fragility and vulnerable skin structure. Neonates are often left susceptible to the forces of their environment, leaving them open to infection when skin injury occurs. Leptospermum honey has been used successfully in adult patients, with evidence lacking in the neonatal population. This case demonstrates the management of a difficult-to-heal wound in a 23-week gestation infant. Selecting the proper treatment and products for wound healing is challenging, with little evidence-based research available for the treatment of neonatal wounds. Leptospermum honey and other adult-driven dressings have been used for neonatal wound care as well as other adult-driven dressings. This case demonstrates the benefits of Leptospermum honey as an option for neonatal wounds. This case presents the treatment and healing of an extensive wound of a 23-week gestation neonate using a hydrogel product initially and then transitioning to a Leptospermum honey dressing due to suboptimal healing. Results of this treatment included quick healing time, little to no scarring, and no loss of movement or function to the affected extremities. The incorporation of Leptospermum honey for wound care has the potential to promote faster wound healing, with less scarring in the neonatal population. Adult wound care principles have been applied in the face of a weak evidence base relating to neonatal-specific cases. There is a need for continued research related to moist wound healing in the neonatal population, with resulting product and practice recommendations.

Exploratory Development of an Ultrafast-Curing Wound Dressing

DTIC Science & Technology

1991-05-31

mils thick: Formulation 2 and 5 .. 36 17. Elution Rates for the 30% Chlorhexidine Gluconate ADD’s at t=0 and Stored at the Temperature Extremes (400C...determined from the in vivo trials conducted earlier (9). The 6 mil thick dressing (Formulation 2) demonstrated effectiveness when tested on guinea pigs...This dressing released approximately 3000 micrograms/sq. cm. in 72 hours or about 64% of the 12 mil dressing tested for shelf stability (Figure 16

Evidence review: the clinical benefits of Safetac technology in wound care.

PubMed

Davies, Phil; Rippon, Mark

2008-11-01

Common causes of trauma and wound pain include: the removal of dressings that become stuck to the wound bed; skin stripping of peri-wound skin, as a result of the repeated application and removal of adhesive dressings; and tissue excoriation and maceration of the peri-wound skin, due to inadequate management of wound exudate. This supplement outlines how dressings with Safetac adhesive technology can help clinicians to avoid these problems. A review of the clinical and scientific evidence relating to dressings with Safetac clearly demonstrates that they can be used to prevent trauma and minimise pain on a wide range of wound types and skin injuries.

Dressings as an adjunct to pressure ulcer prevention: consensus panel recommendations.

PubMed

Black, Joyce; Clark, Michael; Dealey, Carol; Brindle, Christopher T; Alves, Paulo; Santamaria, Nick; Call, Evan

2015-08-01

The formulation of recommendations on the use of wound dressings in pressure ulcer prevention was undertaken by a group of experts in pressure ulcer prevention and treatment from Australia, Portugal, UK and USA. After review of literature, they concluded that there is adequate evidence to recommend the use of five-layer silicone bordered dressings (Mepilex Border Sacrum(®) and 3 layer Mepilex Heel(®) dressings by Mölnlycke Health Care, Gothenburg, Sweden) for pressure ulcer prevention in the sacrum, buttocks and heels in high-risk patients, those in Emergency Department (ED), intensive care unit (ICU) and operating room (OR). Literature on which this recommendation is based includes one prospective randomised control trial, three cohort studies and two case series. Recommendations for dressing use in patients at high risk for pressure injury and shear injury were also provided. © 2014 The Authors. International Wound Journal © 2014 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Negative-pressure wound therapy I: the paradox of negative-pressure wound therapy.

PubMed

Kairinos, Nicolas; Solomons, Michael; Hudson, Donald A

2009-02-01

Does negative-pressure wound therapy reduce or increase the pressure of wound tissues? This seemingly obvious question has never been addressed by a study on living tissues. The aim of this study was to evaluate the nature of tissue pressure changes in relation to negative-pressure wound therapy. Three negative-pressure wound therapy dressing configurations were evaluated-circumferential, noncircumferential, and those within a cavity-on 15 human wounds, with five wounds in each category. Tissue pressure changes were recorded (using a strain gauge sensor) for each 75-mmHg increment in suction, up to -450 mmHg. In the circumferential and noncircumferential groups, tissue pressure was also measured over a 48-hour period at a set suction pressure of -125 mmHg (n = 10). In all three groups, mean tissue pressure increased proportionately to the amount of suction applied (p < 0.0005). Mean tissue pressure increments resulting from the circumferential dressings were significantly higher than those resulting from the noncircumferential (p < 0.0005) or cavity group (p < 0.0005); however, there was no significant difference between the latter two groups (p = 0.269). Over the 48-hour period, there was a significant mean reduction in the (increased) tissue pressure (p < 0.04 for circumferential and p < 0.0005 for noncircumferential), but in only three of 10 cases did this reduce to pressures less than those before dressing application. Negative-pressure wound therapy increases tissue pressure proportionately to the amount of suction, although this becomes less pronounced over 48 hours. This suggests that negative-pressure wound therapy dressings should be used with caution on tissues with compromised perfusion, particularly when they are circumferential.

Applications of modern sensors and wireless technology in effective wound management.

PubMed

Mehmood, Nasir; Hariz, Alex; Fitridge, Robert; Voelcker, Nicolas H

2014-05-01

The management of chronic wounds has emerged as a major health care challenge during the 21st century consuming, significant portions of health care budgets. Chronic wounds such as diabetic foot ulcers, leg ulcers, and pressure sores have a significant negative impact on the quality of life of affected individuals. Covering wounds with suitable dressings facilitates the healing process and is common practice in wound management plans. However, standard dressings do not provide insights into the status of the wound underneath. Parameters such as moisture, pressure, temperature and pH inside the dressings are indicative of the healing rate, infection, and wound healing phase. But owing to the lack of information available from within the dressings, these are often changed to inspect the wound, disturbing the normal healing process of wounds in addition to causing pain to the patient. Sensors embedded in the dressing would provide clinicians and nurses with important information that would aid in wound care decision making, improve patient comfort, and reduce the frequency of dressing changes. The potential benefits of this enabling technology would be seen in terms of a reduction in hospitalization time and health care cost. Modern sensing technology along with wireless radio frequency communication technology is poised to make significant advances in wound management. This review discusses issues related to the design and implementation of sensor technology and telemetry systems both incorporated in wound dressings to devise an automated wound monitoring technology, and also surveys the literature available on current sensor and wireless telemetry systems. Copyright © 2013 Wiley Periodicals, Inc.

A green salt-leaching technique to produce sericin/PVA/glycerin scaffolds with distinguished characteristics for wound-dressing applications.

PubMed

Aramwit, Pornanong; Ratanavaraporn, Juthamas; Ekgasit, Sanong; Tongsakul, Duangta; Bang, Nipaporn

2015-05-01

Sericin/PVA/glycerin scaffolds could be fabricated using the freeze-drying technique; they showed good physical and biological properties and can be applied as wound dressings. However, freeze-drying is an energy- and time-consuming process with a high associated cost. In this study, an alternative, solvent-free, energy- and time-saving, low-cost salt-leaching technique is introduced as a green technology to produce sericin/PVA/glycerin scaffolds. We found that sericin/PVA/glycerin scaffolds were successfully fabricated without any crosslinking using a salt-leaching technique. The salt-leached sericin/PVA/glycerin scaffolds had a porous structure with pore interconnectivity. The sericin in the salt-leached scaffolds had a crystallinity that was as high as that of the freeze-dried scaffolds. Compared to the freeze-dried scaffolds with the same composition, the salt-leached sericin/PVA/glycerin scaffolds has larger pores, a lower Young's modulus, and faster rates of biodegradation and sericin release. When cultured with L929 mouse fibroblast cells, a higher number of cells were found in the salt-leached scaffolds. Furthermore, the salt-leached scaffolds were less adhesive to the wound, which would reduce pain upon removal. Therefore, salt-leached sericin/PVA/glycerin scaffolds with distinguished characteristics were introduced as another choice of wound dressing, and their production process was simpler, more energy efficient, and saved time and money compared to the freeze-dried scaffolds. © 2014 Wiley Periodicals, Inc.

Retrospective clinical evaluation of gauze-based negative pressure wound therapy.

PubMed

Campbell, Penny E; Smith, Gary S; Smith, Jennifer M

2008-06-01

Negative pressure wound therapy (NPWT) is an established modality in the treatment of challenging wounds. However, most existing clinical evidence is derived from the use of open-cell polyurethane foam at -125 mmHg. Alternative negative pressure systems are becoming available, which use gauze at a pressure of -80 mmHg. This study describes clinical results from a retrospective non comparative analysis of 30 patients treated with Chariker-Jeter gauze-based negative pressure systems (V1STA, Versatile-1 and EZ-Care; Smith & Nephew, Inc.) in a long-term care setting. The mean age of the patients was 72 years. The wounds consisted of chronic (n = 11), surgical dehiscence (n = 11) and surgical incision (n = 8). Wound volume and area were recorded at commencement and at the cessation of therapy. Discontinuation of therapy was instigated upon closure through secondary intention or when size and exudate were sufficiently reduced that the wounds could be managed by conventional wound dressing (median 41 days). An overall median reduction in wound volume of 88.0% (P < 0.001) and a 68.0% reduction in area (P < 0.001) compared with baseline were observed over the course of NPWT. The overall rate of volume reduction (15.1% per week) compares favourably with published data from foam-based systems.

Development of chitosan/poly-γ-glutamic acid/pluronic/curcumin nanoparticles in chitosan dressings for wound regeneration.

PubMed

Lin, Yu-Hsin; Lin, Jui-Hsiang; Hong, Ya-Shiuan

2017-01-01

The hydrophobic polyphenol curcumin has anti-inflammatory, antimicrobial, and wound-healing properties that warrant its pharmacological consideration. We report a curcumin nanoparticle with a tripolymeric composite that can be used as a delivery device for wound healing. The present composite nanoparticles were prepared with three biocompatible polymers of chitosan, poly-γ-glutamic acid, and pluronic using a simple ionic gelation technology. Pluronic was used to enhance the solubility of curcumin in chitosan/poly-γ-glutamic acid nanoparticles, leading to the incorporation of chitosan/poly-γ-glutamic acid/pluronic/curcumin nanoparticles into chitosan membranes, and reduced inflammation and bacterial infection during wound regeneration. Nanoparticles were of 193.1 ± 8.9 nm and had a zeta potential of 20.6 ± 2.4 mV. Moreover, in vitro analyses indicated controlled curcumin release in a simulated skin tissue model. Subsequent in vivo studies show that chitosan wound dressing containing chitosan/poly-γ-glutamic acid/pluronic/curcumin nanoparticles promoted neocollagen regeneration and tissue reconstruction. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 81-90, 2017. © 2015 Wiley Periodicals, Inc.

Films based on soy protein-agar blends for wound dressing: Effect of different biopolymer proportions on the drug release rate and the physical and antibacterial properties of the films.

PubMed

Rivadeneira, Josefina; Audisio, M C; Gorustovich, Alejandro

2018-04-01

No single material can provide all requirements for wound dressings. Here, we evaluated the influence of different soy protein isolate and agar proportions (3:1, 1:1, and 1:3) in blend films on some of their physical-chemical and antibacterial properties to elucidate their potential as wound dressings. The films were synthesized by the gel casting method and ciprofloxacin hydrochloride was incorporated into the films. Films were characterized based on their surface morphology, water uptake ability, and weight loss profile. Also, the ciprofloxacin hydrochloride release kinetics was quantified spectrophotometrically. The antibacterial effect was evaluated against Staphylococcus aureus and Pseudomonas aeruginosa strains. The soy protein isolate-agar ratio affected the water uptake of the films and the release profile of ciprofloxacin hydrochloride but not the weight loss profile. The amount of drug released decreased near 80% because of the decrease in agar content in the films. The release kinetics of ciprofloxacin hydrochloride data best fitted to the Korsmeyer-Peppas model, suggesting that the mechanism of drug release was mainly of the diffusion type. All ciprofloxacin hydrochloride-releasing soy protein isolate-agar films strongly inhibited the cell viability of the bacterial strains studied. We concluded that water uptake and ciprofloxacin hydrochloride release can be controlled by changing the soy protein isolate-agar proportion. The proportions did not lead to changes in the antibacterial strength of the films.

Dextran based herbal nanobiocomposite membranes for scar free wound healing.

PubMed

Singh, Surabhi; Gupta, Amlan; Sharma, Deepika; Gupta, Bhuvanesh

2018-07-01

Dextran based bionanocomposite membranes encapsulating clove oil (CO) and sandalwood oil (SO) that are capable of preventing infection due to their inherent virtue of antibacterial activity and modifying the wound healing cascade for accelerated scar free healing, were developed. A facile solvent casting technique was used to fabricate dextran/nanosoy/glycerol/chitosan (DNG/Ch) nanocomposite membranes followed by subsequent addition of CO and SO to obtain DNG/Ch/CO and DNG/Ch/SO herbal nanodressings. Dressings exhibited >98% antibacterial activity against both Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) at extremely low loadings of 5% and 10% for CO and SO, respectively. This encapsulation strategy allowed controlled diffusion of EO over a period of 72h which was measured in terms of drug efficacy using bacterial reduction count test and serial plate transfer disk diffusion test (SPTDDT). Swelling behavior and mechanical properties were also examined. Bacterial adherence study was performed to demonstrate the efficiency of dressings for arresting microbial invasion. In vivo wound healing studies were conducted using male swiss albino mice of BALB/c strain and DNG/Ch/CO dressings exhibited complete healing within 14days with remarkable efficacy in scar prevention. Histological analysis revealed that CO and SO treatment led to deposition of ordered collagen along with fibroblast migration. Copyright © 2018 Elsevier B.V. All rights reserved.

Effects of Different Types of Burn Wounds and its Dressings on Millimeter-Wave Images

NASA Astrophysics Data System (ADS)

Daniel, Oppelt; Patrick, Korf; Julian, Adametz; Jannis, Groh; Martin, Vossiek; Kristina, Zhuravleva; Ole, Goertz

2018-03-01

Millimeter-wave imaging is a promising technology for diagnosing skin burns, that may make it easier to assess and determine the burn depth in the near future. However, up to now, it has not yet been brought to clinical use due to the lack of clinical trails on patients and a millimeter-wave-aided classification of skin burns. In this paper, in a preliminary step, ex-vivo burned porcine skin is utilized to visualize and quantify skin that has been burned in different ways, and to access its effect on millimeter-wave images. For the first time, a 24 hour study of in-vivo human skin visualizes the effect of wound dressings using a fast imaging system operating at frequencies from 70 to 80 GHz. For validation, the effective relative permittivity of the skin and the dressings are measured using a open-ended coaxial probe. An analytical model is applied to calculate the reflection coefficient which are compared to the intensity of the millimeter-wave images to validate the model.

3D Bioprinting of Carboxymethylated-Periodate Oxidized Nanocellulose Constructs for Wound Dressing Applications.

PubMed

Rees, Adam; Powell, Lydia C; Chinga-Carrasco, Gary; Gethin, David T; Syverud, Kristin; Hill, Katja E; Thomas, David W

2015-01-01

Nanocellulose has a variety of advantages, which make the material most suitable for use in biomedical devices such as wound dressings. The material is strong, allows for production of transparent films, provides a moist wound healing environment, and can form elastic gels with bioresponsive characteristics. In this study, we explore the application of nanocellulose as a bioink for modifying film surfaces by a bioprinting process. Two different nanocelluloses were used, prepared with TEMPO mediated oxidation and a combination of carboxymethylation and periodate oxidation. The combination of carboxymethylation and periodate oxidation produced a homogeneous material with short nanofibrils, having widths <20 nm and lengths <200 nm. The small dimensions of the nanofibrils reduced the viscosity of the nanocellulose, thus yielding a material with good rheological properties for use as a bioink. The nanocellulose bioink was thus used for printing 3D porous structures, which is exemplified in this study. We also demonstrated that both nanocelluloses did not support bacterial growth, which is an interesting property of these novel materials.

3D Bioprinting of Carboxymethylated-Periodate Oxidized Nanocellulose Constructs for Wound Dressing Applications

PubMed Central

Gethin, David T.; Syverud, Kristin; Hill, Katja E.; Thomas, David W.

2015-01-01

Nanocellulose has a variety of advantages, which make the material most suitable for use in biomedical devices such as wound dressings. The material is strong, allows for production of transparent films, provides a moist wound healing environment, and can form elastic gels with bioresponsive characteristics. In this study, we explore the application of nanocellulose as a bioink for modifying film surfaces by a bioprinting process. Two different nanocelluloses were used, prepared with TEMPO mediated oxidation and a combination of carboxymethylation and periodate oxidation. The combination of carboxymethylation and periodate oxidation produced a homogeneous material with short nanofibrils, having widths <20 nm and lengths <200 nm. The small dimensions of the nanofibrils reduced the viscosity of the nanocellulose, thus yielding a material with good rheological properties for use as a bioink. The nanocellulose bioink was thus used for printing 3D porous structures, which is exemplified in this study. We also demonstrated that both nanocelluloses did not support bacterial growth, which is an interesting property of these novel materials. PMID:26090461

Silver-containing foam dressings with Safetac: a review of the scientific and clinical data.

PubMed

Davies, Phil; McCarty, Sara; Hamberg, Kristina

2017-06-01

Background Topical antimicrobials, such as silver dressings, are progressively being used alongside systemic antibiotics to provide adjunctive, antimicrobial therapy to wounds that are clinically infected or at risk of infection. To help improve wound management, dressings that use Safetac soft silicone technology in combination with a silver-impregnated foam dressing material were developed by Mölnlycke Health Care (Gothenburg, Sweden). The range comprises Mepilex Ag, Mepilex Border Ag and Mepilex Transfer Ag. Aims A literature review was undertaken to identify and summarise clinical data from the entire evidence hierarchy, as well as data from in vitro tests, which support the use of silver-containing foam dressings with Safetac. Method The MEDLINE (National Library of Medicine, Bethesda, US) and EMBASE (Elsevier BV, Amsterdam, Netherlands) bibliographic databases were searched. In addition, abstract books and proceedings documents relating to national and international conferences were scanned in order to identify presentations (oral, e-poster and poster) of relevance to the review. Results In vitro test results showed that the silver-containing foam dressings with Safetac have both rapid and sustained activity against a range of wound pathogens, reducing planktonic and established biofilm cultures, and preventing biofilm formation. In numerous clinical studies, silvercontaining foam dressings with Safetac were used to manage wound bioburden effectively and resolve signs of localised infection in both acute wounds (such as surgical, traumatic and burn injuries) and chronic wounds (such as leg ulcers, pressure ulcers (PUs), diabetic foot ulcers (DFUs), and cancerous wounds). Studies reported that silver-containing foam dressings with Safetac are easy to use, provide an optimal environment for wound healing, and are associated with atraumatic and virtually painfree removal. As well as being clinically effective, they are reported to be cost-effective when used on

Optimizing the Moisture Management Tightrope with Wound Bed Preparation 2015©.

PubMed

Sibbald, R Gary; Elliott, James A; Ayello, Elizabeth A; Somayaji, Ranjani

2015-10-01

To provide an overview of moisture management and its importance in wound care. This continuing education activity is intended for physicians and nurses with an interest in skin and wound care. After participating in this educational activity, the participant should be better able to:1. Summarize causes and treatments for moisture balance issues of chronic wounds.2. Recognize the properties of dressings used for treatment for moisture management of chronic wounds and antiseptic agent cytotoxicity.3. Explain study findings of the effectiveness of dressing choices for treatment of chronic wounds. To provide an overview of moisture management and its importance in wound care. The authors evaluate the impact of moisture management for optimal wound care and assess current wound management strategies relating to antisepsis and moist wound healing utilizing the wound bed preparation paradigm 2015 update. The discussion distinguishes the form and function of wound care dressing classes available for optimal moisture management. Moisture management for chronic wounds is best achieved with modern moist interactive dressings if the wound has the ability to heal.

Design, preparation and activity of intelligent cellulose-based protease sensor & modulating/fibroblast promoting (protos-fibro) dressings

USDA-ARS?s Scientific Manuscript database

Chronic wounds are a major clinical problem with an estimated 40 million people suffering from them worldwide, and one of the most costly healthcare problems today. ‘Intelligent’ dressings may be defined as materials that respond to specific changes in the wound environment i.e. exudate volume, and...

Mepilex Ag: an antimicrobial, absorbent foam dressing with Safetac technology.

PubMed

Barrett, Simon

This article examines the role of a unique dressing-Mepilex Ag--that incorporates the rapid and sustained antimicrobial action of ionic silver with the benefits of Safetac soft silicone adhesive technology. The combined attributes of each component of this dressing allow both the control of pain and infection to be achieved simultaneously. This dual approach to the management of wounds is of significance since the evidence suggests that wound infection and the release of pro-inflammatory modulators result in both local pain and delayed healing. In this respect the control and treatment of pain is as important as the treatment of infection itself. A review of the clinical evidence relating to Safetac technology clearly demonstrates that it can be used to prevent dressing-related trauma, minimize pain at dressing change, and control exudate when used on a wide range of wound types and skin injuries. In combination with silver, this technology has been shown in in-vitro studies to have an almost instant and sustainable antimicrobial effect on a broad range of pathogens associated with delayed healing. Finally, in small clinical and case studies, Mepilex Ag has been shown to control wound bioburden and improve healing rates.

Bi-Layer Wound Dressing System for Combat Casualty Care

DTIC Science & Technology

2004-09-01

C. Bonacorsi, M.S.G. Raddi, and I.Z. Carlos. 2004. Cytotoxicity of chlorhexidine digluconate to murine macrophages and its effect on hydrogen...chlorexhidine digluconate or 1 % chloramphenicol, as described previously. Each experimental dressing was then covered with a piece of sterile parafilm...chloramphenicol-loaded dressings were 2-log lower for the first 24 h than when applying the chlorhexidine -loaded dressings (Figure 2). However, there was no

Wound bed preparation: A novel approach using HydroTherapy.

PubMed

Atkin, Leanne; Ousey, Karen

2016-12-01

Wounds that fail to heal quickly are often encountered by community nursing staff. An important step in assisting these chronic or stalled wounds progress through healing is debridement to remove devitalised tissue, including slough and eschar, that can prevent the wound from healing. A unique wound treatment called HydroTherapy aims to provide an optimal healing environment. The first step of HydroTherapy involves HydroClean plus™, this dressing enables removal of devitalised tissue through autolytic debridement and absorption of wound fluid. Irrigation and cleansing provided by Ringer's solution from the dressing further removes any necrotic tissue or eschar. Once effective wound bed preparation has been achieved a second dressing, HydroTac™, provides an ongoing hydrated wound environment that enables re-epithelialisation to occur in an unrestricted fashion. This paper presents 3 case studies of slow healing wounds treated with HydroClean plus™ which demonstrates effective wound debridement.

Effectiveness of bridge V.A.C. dressings in the treatment of diabetic foot ulcers

PubMed Central

Nather, Aziz; Hong, Ng Yau; Lin, Wong Keng; Sakharam, Joshi Abhijit

2011-01-01

Objectives This is a prospective study of the clinical efficacy of the V.A.C. Granufoam Bridge Dressing for the treatment of diabetic foot ulcers. Materials and methods Five consecutive patients with diabetic foot ulcers were treated with V.A.C. Granufoam Bridge Dressings and studied over a period of 22–48 days. The indications for treatment included diabetic patients with open ray amputation wounds and wounds post-drainage for abscess with exposed deep structures. Clinical outcome was measured in terms of reduction in wound dimensions, presence of wound granulation, microbial clearance, and development of wound complications. Results Our results showed that with V.A.C. therapy, wound healing occurred in all patients. The number of dressings required ranged from 8 to 10. The baseline average wound size was 23.1 cm2. Wound areas shrunk by 18.4–41.7%. All subjects achieved 100% wound bed granulation with an average length of treatment of 33 days. Microbial clearance was achieved in all cases. All wounds healed by secondary intention in one case and four cases required split-thickness skin grafting. Conclusion The V.A.C. Granufoam Bridge Dressing is effective in the treatment of diabetic foot ulcers. It promotes reduction of wound area, wound bed granulation, and microbial clearance. By allowing placement of the suction pad outside the foot, it allowed patients to wear protective shoes and to walk non-weight bearing with crutches during V.A.C. therapy. PMID:22396825

Managing burn wounds with SMARTPORE Technology polyurethane foam: two case reports.

PubMed

Imran, Farrah-Hani; Karim, Rahamah; Maat, Noor Hidayah

2016-05-12

Successful wound healing depends on various factors, including exudate control, prevention of microbial contaminants, and moisture balance. We report two cases of managing burn wounds with SMARTPORE Technology polyurethane foam dressing. In Case 1, a 2-year-old Asian girl presented with a delayed (11 days) wound on her right leg. She sustained a thermal injury from a hot iron that was left idle on the floor. Clinical inspection revealed an infected wound with overlying eschar that traversed her knee joint. As her parents refused surgical debridement under general anesthesia, hydrotherapy and wound dressing using SMARTPORE Technology Polyurethane foam were used. Despite the delay in presentation of this linear thermal pediatric burn injury that crossed the knee joint, the patient's response to treatment and its outcome were highly encouraging. She was cooperative and tolerated each dressing change without the need of supplemental analgesia. Her wound was healed by 24 days post-admission. In Case 2, a 25-year-old Asian man presented with a mixed thickness thermal flame burn on his left leg. On examination, the injury was a mix of deep and superficial partial thickness burn, comprising approximately 3% of his total body surface area. SMARTPORE Technology polyurethane foam was used on his wound; his response to the treatment was very encouraging as the dressing facilitated physiotherapy and mobility. The patient rated the pain during dressing change as 2 on a scale of 10 and his pain score remained the same in every subsequent change. His wound showed evidence of epithelialization by day 7 post-burn. There were no adverse events reported. Managing burn wounds with SMARTPORE Technology polyurethane foam resulted in reduced pain during dressing changes and the successful healing of partial and mixed thickness wounds. The use of SMARTPORE Technology polyurethane foam dressings showed encouraging results and requires further research as a desirable management option in

Hypertonic Glucose Combined with Negative Pressure Wound Therapy to Prepare Wounds with Pseudomonas aeruginosa Infection for Skin Grafting: A Report of 3 Cases.

PubMed

Zhao, Jing-Chun; Xian, Chun-Jing; Yu, Jia-Ao; Shi, Kai; Hong, Lei

2015-06-01

Soft tissue losses from acute or chronic trauma are a challenge for surgeons. To explore a method to expedite granulation tissue formation in preparation for a split-thickness skin graft (STSG), the medical records of 3 patients - 2 adult men with wounds related to trauma injury and 1 infant with necrotizing fasciitis, all infected with Pseudomonas aeruginosa - were reviewed. All wounds were surgically debrided and managed by applying gauze soaked in 50% glucose followed by continuous negative pressure wound therapy (NPWT) before definitive skin grafting. NPWT pressure was applied at -80 mm Hg for the 2 adult males (ages 39 and 25 years) and -50 mm Hg for the 7-month-old male infant. The dressings were changed every 2 to 3 days. No adverse events occurred, and wounds were successfully closed with a STSG after an average of 7 days. In 1 case, NPWT was able to help affix dressings in a difficult-to-dress area (genital region). The combination of hypertonic glucose and hand-made, gauze-based NPWT was found to be safe, well-tolerated, and effective in preparing the wound bed for grafting. Prospective, randomized, controlled clinical studies are needed to compare the safety, effectiveness, and efficacy of this method to other treatment approaches for P. aeruginosa-infected wounds.

Silver oxysalts promote cutaneous wound healing independent of infection.

PubMed

Thomason, Helen A; Lovett, Jodie M; Spina, Carla J; Stephenson, Christian; McBain, Andrew J; Hardman, Matthew J

2018-03-12

Chronic wounds often exist in a heightened state of inflammation whereby excessive inflammatory cells release high levels of proteases and reactive oxygen species (ROS). While low levels of ROS play a fundamental role in the regulation of normal wound healing, their levels need to be tightly regulated to prevent a hostile wound environment resulting from excessive levels of ROS. Infection amplifies the inflammatory response, augmenting levels of ROS which creates additional tissue damage that supports microbial growth. Antimicrobial dressings are used to combat infection; however, the effects of these dressing on the wound environment and healing independent of infection are rarely assessed. Cytotoxic or adverse effects on healing may exacerbate the hostile wound environment and prolong healing. Here we assessed the effect on healing independent of infection of silver oxysalts which produce higher oxidative states of silver (Ag 2+ /Ag 3+ ). Silver oxysalts had no adverse effect on fibroblast scratch wound closure whilst significantly promoting closure of keratinocyte scratch wounds (34% increase compared with control). Furthermore, dressings containing silver oxysalts accelerated healing of full-thickness incisional wounds in wild-type mice, reducing wound area, promoting reepithelialization, and dampening inflammation. We explored the mechanisms by which silver oxysalts promote healing and found that unlike other silver dressings tested, silver oxysalt dressings catalyze the breakdown of hydrogen peroxide to water and oxygen. In addition, we found that silver oxysalts directly released oxygen when exposed to water. Collectively, these data provide the first indication that silver oxysalts promote healing independent of infection and may regulate oxidative stress within a wound through catalysis of hydrogen peroxide. © 2018 by the Wound Healing Society.

Fish scale collagen sponge incorporated with Macrotyloma uniflorum plant extract as a possible wound/burn dressing material.

PubMed

Muthukumar, Thangavelu; Prabu, P; Ghosh, Kausik; Sastry, Thotapalli Parvathaleswara

2014-01-01

Application of plant extracts for the burn/wound treatment is followed over the decades as a common practice and it is an important aspect in clinical management. In this study porous collagen sponges (CS) were prepared using fish scales and were incorporated with mupirocin (CSM) and extracts of Macrotyloma uniflorum (CSPE) separately to impart antimicrobial activity to the sponges. The results showed that the addition of plant extract increased the tensile strength of CSPE and stability against collagenase enzyme. FTIR studies have shown the incorporation of plant extract in CSPE, SEM studies have revealed the porous nature of the sponges and XRD patterns have shown the retention of collagen triple helical structure even after the addition of plant extract. CSPE and CSM have exhibited antimicrobial properties. The sponges prepared were analysed for their in vitro biocompatibility studies using fibroblasts and keratinocyte cell lines and the results have shown their biocompatible nature. Based on the results obtained, CS, CSM and CSPE may be tried as a burn/wound dressing materials, initially, in small animals in vivo. Copyright © 2013 Elsevier B.V. All rights reserved.

Advanced textile materials and biopolymers in wound management.

PubMed

Petrulyte, Salvinija

2008-02-01

New generation medical textiles are an important growing field with great expansion in wound management products. Virtually new products are coming but also well known materials with significantly improved properties using advanced technologies and new methods are in the centre of research which are highly technical, technological, functional, and effective oriented. The key qualities of fibres and dressings as wound care products include that they are bacteriostatic, anti-viral, fungistatic, non-toxic, high absorbent, non-allergic, breathable, haemostatic, biocompatible, and manipulatable to incorporate medications, also provide reasonable mechanical properties. Many advantages over traditional materials have products modified or blended with also based on alginate, chitin/chitosan, collagen, branan ferulate, carbon fibres. Textile structures used for modern wound dressings are of large variety: sliver, yarn, woven, non-woven, knitted, crochet, braided, embroidered, composite materials. Wound care also applies to materials like hydrogels, matrix (tissue engineering), films, hydrocolloids, foams. Specialized additives with special functions can be introduced in advanced wound dressings with the aim to absorb odours, provide strong antibacterial properties, smooth pain and relieve irritation. Because of unique properties as high surface area to volume ratio, film thinness, nano scale fibre diameter, porosity, light weight, nanofibres are used in wound care. The aim of this study is to outline and review the latest developments and advance in medical textiles and biopolymers for wound management providing the overview with generalized scope about novelties in products and properties.

Comparison between topical honey and mafenide acetate in treatment of burn wounds

PubMed Central

Maghsoudi, H.; Salehi, F.; Khosrowshahi, M.K.; Baghaei, M.; Nasirzadeh, M.; Shams, R.

2011-01-01

Summary Histological and clinical studies of wound healing were performed in comparable cases of fresh partial-thickness burns treated with honey dressing or mafenide acetate in two groups of 50 randomly allocated patients. Of the patients with honey-treated wounds, 84% showed satisfactory epithelialization by day 7 and 100% by day 21. In wounds treated with mafenide acetate, epithelialization occurred by day 7 in 72% of cases and in 84% by day 21. Histological evidence of reparative activity was observed in 80% of wounds treated with honey dressing by day 7 with minimal inflammation. Fifty-two per cent of the mafenide acetate treated wounds showed reparative activity with inflammatory changes by day 7. Reparative activity reached 100% by day 21 with the honey dressing and 84% with mafenide acetate. Thus, in honey-dressed wounds, early subsidence of acute inflammatory changes, better control of infection, and quicker wound healing were observed, while in mafenide acetate treated wounds a sustained inflammatory reaction was noted even on epithelialization. PMID:22396671