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1

Drug carrying hydrogel base wound dressing  

NASA Astrophysics Data System (ADS)

A special drug carrying hydrogel base wound dressing by radiation preparation is developed for hospital uses. The dressing possesses high water absorption property. Radiation preparation is carried out using a Van de Graaff Accelerator as an electron radiation source. The effect of absorbed dose and cmount of crosslinking agent on the gel fraction and swelling ratio of the hydrogel were determined respectively. As a bio-medical material, standard tests were made. Results showed properties conforming with requirements for clinical applications. Results obtained from clinical tests were good.

Chen, Jie; Yang, Yueqi; Qian, Pingbo; Ma, Zueteh; Wu, Weibin; Sung, Peizhi; Wang, Xingguo; Li, Jinghui

1993-10-01

2

Cyclodextrin-based hydrogels toward improved wound dressings.  

PubMed

Abstract Optimal wound dressings should be capable of mechanical wound protection and also facilitate the healing process via maintenance of suitable environmental conditions and the controlled delivery of bioactive molecules. Hydrogels present suitable properties for wound-dressing applications such as good biocompatibility, together with a high water content, the latter of which is important for the maintenance of a moist environment and ready removal from the wound with a minimal level of associated pain. However, their properties as drug delivery systems can be improved by the use of cyclodextrins as cross-linking agents. Cyclodextrins have been extensively used as "carriers" on food, textile, cosmetic and, most especially, in the pharmaceutical industry in view of their powerful complexation abilities and biocompatibilities, together with further desirable characteristics. The conjugation of cyclodextrins with hydrogels may allow the achievement of an optimal wound-dressing material, because the hydrogel component will maintain the moist environment required for the healing process, and the cyclodextrin moiety has the ability to protect and modulate the release of bioactive molecules. Therefore, this review aims to gather information regarding cyclodextrin-based hydrogels for possible wound-dressing applications. PMID:23919239

Pinho, Eva; Grootveld, Martin; Soares, Graça; Henriques, Mariana

2014-12-01

3

In Vivo Performance of Chitosan/Soy-Based Membranes as Wound-Dressing Devices for Acute Skin Wounds  

PubMed Central

Wound management represents a major clinical challenge on what concerns healing enhancement and pain control. The selection of an appropriate dressing plays an important role in both recovery and esthetic appearance of the regenerated tissue. Despite the wide range of available dressings, the progress in the wound care market relies on the increasing interest in using natural-based biomedical products. Herein, a rat wound-dressing model of partial-thickness skin wounds was used to study newly developed chitosan/soy (cht/soy)-based membranes as wound-dressing materials. Healing and repair of nondressed, cht/soy membrane-dressed, and Epigard®-dressed wounds were followed macroscopically and histologically for 1 and 2 weeks. cht/soy membranes performed better than the controls, promoting a faster wound repair. Re-epithelialization, observed 1 week after wounding, was followed by cornification of the outermost epidermal layer at the second week of dressing, indicating repair of the wounded tissue. The use of this rodent model, although in impaired healing conditions, may enclose some drawbacks regarding the inevitable wound contraction. Moreover, being the main purpose the evaluation of cht/soy-based membranes' performance in the absence of growth factors, the choice of a clinically relevant positive control was limited to a polymeric mesh, without any growth factor influencing skin healing/repair, Epigard. These new cht/soy membranes possess the desired features regarding healing/repair stimulation, ease of handling, and final esthetic appearance—thus, valuable properties for wound dressings. PMID:23083058

Santos, Tírcia C.; Höring, Bernhard; Reise, Kathrin; Marques, Alexandra P.; Silva, Simone S.; Oliveira, Joaquim M.; Mano, João F.; Castro, António G.; van Griensven, Martijn

2013-01-01

4

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

Microsoft Academic Search

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

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

2007-01-01

5

Preparation and characterization of antimicrobial wound dressings based on silver, gellan, PVA and borax.  

PubMed

Silver-loaded dressings are designed to provide the same antimicrobial activity of topical silver, with the advantages of a sustained silver release and a reduced number of dressing changes. Moreover, such type of dressing must provide a moist environment, avoiding fiber shedding, dehydration and adherence to the wound site. Here we describe the preparation of a novel silver-loaded dressing based on a Gellan/Hyaff(®) (Ge-H) non woven, treated with a polyvinyl alcohol (PVA)/borax system capable to enhance the entrapment of silver in the dressing and to modulate its release. The new hydrophilic non woven dressings show enhanced water uptake capability and slow dehydration rates. A sustained silver release is also achieved. The antibacterial activity was confirmed on Staphylococcus aureus and Pseudomonas aeruginosa. PMID:22939352

Cencetti, C; Bellini, D; Pavesio, A; Senigaglia, D; Passariello, C; Virga, A; Matricardi, P

2012-10-15

6

Wound Healing and the Dressing*  

PubMed Central

The evolution of surgical dressings is traced from 1600 b.c. to a.d. 1944. The availability of an increasing variety of man-made fibres and films from 1944 onwards has stimulated work on wound dressings, and some of the more important contributions, both clinical and experimental, are discussed. The functions of a wound dressing and the properties which the ideal wound dressing should possess are given. The necessity for both histological and clinical evaluation of wound dressings in animals and in man is stressed. Wound dressings are the most commonly used therapeutic agents, but there is no means whereby their performance can be assessed. An attempt should be made either nationally or internationally to establish a standard method of assessing the performance of wound dressings. For this it is necessary to have an internationally agreed standard dressing which could be used as a reference or control dressing in all animal and human work. The only animal with skin morphologically similar to that of man is the domestic pig. Three types of wounds could be used: (1) partial-thickness wounds; (2) full-thickness excisions; and (3) third-degree burns. The development of standard techniques for the assessment of the efficiency of wound dressings would be of considerable benefit to the research worker, the medical profession, the patient, and the surgical dressings industry. PMID:13976490

Scales, John T.

1963-01-01

7

Evaluation of an in situ forming hydrogel wound dressing based on oxidized alginate and gelatin  

Microsoft Academic Search

Wound dressings that can be formed in situ offer several advantages over the use of preformed dressings such as conformability without wrinkling or fluting in the wound bed, ease of application and improved patient compliance and comfort. Here we describe such an in situ forming hydrogel wound dressing from gelatin, oxidized alginate and borax. Periodate oxidized alginate rapidly cross-links proteins

Biji Balakrishnan; M. Mohanty; P. R. Umashankar; A. Jayakrishnan

2005-01-01

8

[Dressing and wound care pain].  

PubMed

Wound care is an important step for promoting wound healing. Nevertheless it is also a major source of pain for patients with wounds. The results of a survey showed that not only burn patients but also non-burn ones suffered from wound care pain which occurred in inpatients and outpatients. One of the significant factors causing wound care pain was that the dressing adhered to the wound bed. Although some agencies claimed that particular dressings with low adhesion can result in painless removal, the actual effects needed to be verified. Results of clinical trials revealed that for relieving wound care pain of certain kinds of wound, it was recommended to use particular dressings, such as banana leaf dressing, boiled potato peel bandage, Acticoat, Mepital or Mefix. PMID:17160873

Chin, Yen-Fan

2006-12-01

9

Dressings and Products in Pediatric Wound Care  

PubMed Central

Significance: The increasing complexity of medical and surgical care provided to pediatric patients has resulted in a population at significant risk for complications such as pressure ulcers, nonhealing surgical wounds, and moisture-associated skin damage. Wound care practices for neonatal and pediatric patients, including the choice of specific dressings or other wound care products, are currently based on a combination of provider experience and preference and a small number of published clinical guidelines based on expert opinion; rigorous evidence-based clinical guidelines for wound management in these populations is lacking. Recent Advances: Advances in the understanding of the pathophysiology of wound healing have contributed to an ever-increasing number of specialized wound care products, most of which are predominantly marketed to adult patients and that have not been evaluated for safety and efficacy in the neonatal and pediatric populations. This review aims to discuss the available data on the use of both more traditional wound care products and newer wound care technologies in these populations, including medical-grade honey, nanocrystalline silver, and soft silicone-based adhesive technology. Critical Issues: Evidence-based wound care practices and demonstration of the safety, efficacy, and appropriate utilization of available wound care dressings and products in the neonatal and pediatric populations should be established to address specific concerns regarding wound management in these populations. Future Directions: The creation and implementation of evidence-based guidelines for the treatment of common wounds in the neonatal and pediatric populations is essential. In addition to an evaluation of currently marketed wound care dressings and products used in the adult population, newer wound care technologies should also be evaluated for use in neonates and children. In addition, further investigation of the specific pathophysiology of wound healing in neonates and children is indicated to promote the development of wound care dressings and products with specific applications in these populations. PMID:24761363

King, Alice; Stellar, Judith J.; Blevins, Anne; Shah, Kara Noelle

2014-01-01

10

CCMR: Wound Dressing Tool and Wound Analysis  

NSDL National Science Digital Library

The goal of our project is to develop a Wound Dressing Tool (WDT) that in addition to extracting overabundant chemicals like the VAC system does, can also allow for variable rates of mass transfer as well as a way for clinicians to monitor the fluid chemical composition of the wound bed during the healing and treatment processes.

Men, Shannon

2005-08-17

11

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

NASA Astrophysics Data System (ADS)

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.

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

2007-01-01

12

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

PubMed

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. PMID:24792978

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

2014-08-25

13

Gelam (Melaleuca spp.) Honey-Based Hydrogel as Burn Wound Dressing  

PubMed Central

A novel cross-linked honey hydrogel dressing was developed by incorporating Malaysian honey into hydrogel dressing formulation, cross-linked and sterilized using electron beam irradiation (25?kGy). In this study, the physical properties of the prepared honey hydrogel and its wound healing efficacy on deep partial thickness burn wounds in rats were assessed. Skin samples were taken at 7, 14, 21, and 28 days after burn for histopathological and molecular evaluations. Application of honey hydrogel dressings significantly enhanced (P < 0.05) wound closure and accelerated the rate of re-epithelialization as compared to control hydrogel and OpSite film dressing. A significant decrease in inflammatory response was observed in honey hydrogel treated wounds as early as 7 days after burn (P < 0.05). Semiquantitative analysis using RT-PCR revealed that treatment with honey hydrogel significantly (P < 0.05) suppressed the expression of proinflammatory cytokines (IL-1?, IL-1?, and IL-6). The present study substantiates the potential efficacy of honey hydrogel dressings in accelerating burn wound healing. PMID:21941590

Mohd Zohdi, Rozaini; Abu Bakar Zakaria, Zuki; Yusof, Norimah; Mohamed Mustapha, Noordin; Abdullah, Muhammad Nazrul Hakim

2012-01-01

14

Gelam (Melaleuca spp.) Honey-Based Hydrogel as Burn Wound Dressing.  

PubMed

A novel cross-linked honey hydrogel dressing was developed by incorporating Malaysian honey into hydrogel dressing formulation, cross-linked and sterilized using electron beam irradiation (25?kGy). In this study, the physical properties of the prepared honey hydrogel and its wound healing efficacy on deep partial thickness burn wounds in rats were assessed. Skin samples were taken at 7, 14, 21, and 28 days after burn for histopathological and molecular evaluations. Application of honey hydrogel dressings significantly enhanced (P < 0.05) wound closure and accelerated the rate of re-epithelialization as compared to control hydrogel and OpSite film dressing. A significant decrease in inflammatory response was observed in honey hydrogel treated wounds as early as 7 days after burn (P < 0.05). Semiquantitative analysis using RT-PCR revealed that treatment with honey hydrogel significantly (P < 0.05) suppressed the expression of proinflammatory cytokines (IL-1?, IL-1?, and IL-6). The present study substantiates the potential efficacy of honey hydrogel dressings in accelerating burn wound healing. PMID:21941590

Mohd Zohdi, Rozaini; Abu Bakar Zakaria, Zuki; Yusof, Norimah; Mohamed Mustapha, Noordin; Abdullah, Muhammad Nazrul Hakim

2012-01-01

15

Collagen-based wound dressings for the treatment of diabetes-related foot ulcers: a systematic review  

PubMed Central

Background Diabetic foot ulcers are a major source of morbidity, limb loss, and mortality. A prolonged inflammatory response, extracellular matrix degradation irregularities, and increased bacteria presence have all been hypothesized as major contributing factors in the delayed healing of diabetic wounds. Collagen components such as fibroblast and keratinocytes are fundamental to the process of wound healing and skin formation. Wound dressings that contain collagen products create a biological scaffold matrix that supports the regulation of extracellular components and promotes wound healing. Methods A systematic review of studies reporting collagen wound dressings used in the treatment of Diabetic foot ulcers was conducted. Comprehensive searches were run in Ovid MEDLINE, PubMed, EMBASE, and ISI Web of Science to capture citations pertaining to the use of collagen wound dressings in the treatment of diabetic foot ulcers. The searches were limited to human studies reported in English. Results Using our search strategy, 26 papers were discussed, and included 13 randomized designs, twelve prospective cohorts, and one retrospective cohort, representing 2386 patients with diabetic foot ulcers. Our design was not a formal meta-analysis. In those studies where complete epithelialization, 58% of collagen-treated wounds completely healed (weighted mean 67%). Only 23% of studies reported control group healing with 29% healing (weighted mean 11%) described for controls. Conclusion Collagen-based wound dressings can be an effective tool in the healing of diabetic foot wounds. The current studies show an overall increase in healing rates despite limitations in study designs. This study suggests that future works focus on biofilms and extracellular regulation, and include high risk patients. PMID:23357897

Holmes, Crystal; Wrobel, James S; MacEachern, Mark P; Boles, Blaise R

2013-01-01

16

Evaluation of bacterial nanocellulose-based uniform wound dressing for large area skin transplantation.  

PubMed

Bacterial nanocellulose (BNC) was biosynthesized by Gluconacetobacter xylinus. The surface area, physicochemical structure and morphology of the materials were characterized. Here provides a method for an efficient production of uniform BNC, which is beneficial for the fast characterization and evaluation of BNC. In vitro cytotoxicity of the materials was evaluated by the proliferation, the adhesion, the viability and the morphology of NIH/3T3 cells. Low cytotoxicity of the BNC was observed, and micrographs demonstrate a good proliferation and adhesion of NIH/3T3 cells on BNC. Large area full-thickness skin defects were made on the back of C57BL/6 mice in animal surgery. The wounds were transplanted with BNC films and the results compared to those in a control group. The rehabilitation of the wound surfaces and the pathological sections of mice were investigated and are discussed. Histological examinations demonstrated faster and better healing effect and lower inflammatory response in the BNC group than those in the control group. Preliminary results on wound dressings from BNC show a curative effect promoting the healing of epithelial tissue. BNC is a promising natural polymer with medical applications in wound dressings. PMID:23623124

Fu, Lina; Zhou, Ping; Zhang, Shengmin; Yang, Guang

2013-07-01

17

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

PubMed

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. PMID:23228898

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

2013-01-30

18

Human amniotic membrane: a versatile wound dressing.  

PubMed Central

Human amniotic membrane proved to be a versatile and useful temporary biologic dressing in studies involving 120 patients. Wounds, both traumatic and nontraumatic in origin, responded to a protocol that allowed coverage of tissues as diverse as exposed bowel, pleura, pericardium, blood vessels, tendon, nerve and bone. Wounds unresponsive to usual therapeutic measures responded to membrane application. Ease of availability, negligible cost and facilitated wound healing make this temporary biologic dressing generally superior to either cadaver skin allograft or pigskin xenograft. Human amniotic membrane dressings are therefore a useful adjunct in the care of the complicated wound. Images FIG. 1A FIG. 1B FIG. 1C FIG. 2A FIG. 2B FIG. 3 PMID:647542

Gruss, J. S.; Jirsch, D. W.

1978-01-01

19

Silver dressings: their role in wound management.  

PubMed

Dressings have a part to play in the management of wounds; whether they are sutured or open, usually chronic wounds of many aetiologies which are healing by secondary intention. They traditionally provide a moist wound environment, but this property has been extended through simple to complex, active dressings which can handle excessive exudate, aid in debridement, and promote disorganised, stalled healing. The control of infection remains a major challenge. Inappropriate antibiotic use risks allergy, toxicity and most importantly resistance, which is much reduced by the use of topical antiseptics (such as povidone iodine and chlorhexidine). The definition of what is an antimicrobial and the recognition of infection has proven difficult. Although silver has been recognised for centuries to inhibit infection its use in wound care is relatively recent. Evidence of the efficacy of the growing number of silver dressings in clinical trials, judged by the criteria of the Cochrane Collaboration, is lacking, but there are good indications for the use of silver dressings, to remove or reduce an increasing bioburden in burns and open wounds healing by secondary intention, or to act as a barrier against cross contamination of resistant organisms such as MRSA. More laboratory, and clinical data in particular, are needed to prove the value of the many silver dressings which are now available. Some confusion persists over the measurement of toxicity and antibacterial activity but all dressings provide an antibacterial action, involving several methods of delivery. Nanocrystalline technology appears to give the highest, sustained release of silver to a wound without clear risk of toxicity. PMID:17199764

Leaper, David J

2006-12-01

20

CCMR: Developing a convection asisted wound dressing  

NSDL National Science Digital Library

To develop an improved bandage containing an artificial vascular structure that will effectively treat severe burn wounds. Nutrients injected into the artificial vascular system from outside the body will reach the new cells growing over the wound, and thus allow them to proliferate. With the new cells proliferating, the wound may heal, and a new vascular structure will grow inside the skin to replace the destroyed structure. Since in the bandage, convection is being used to transport nutrients, we call this bandage a convection assisted wound dressing.

Baker, Wesley

2004-08-17

21

Wound dressings: an evolving art and science.  

PubMed

Keeping abreast of the numerous wound dressings available for patient care is an ambitious task. Being able to differentiate among the various treatment options, when and how to apply them, in what combinations, and when to change them has become a challenge for all healthcare practitioners. PMID:22258219

Baranoski, Sharon; Ayello, Elizabeth A

2012-02-01

22

Antibacterial efficacy testing of a bioelectric wound dressing against clinical wound pathogens.  

PubMed

Silver-based wound dressings have been developed for the control of bioburden in wounds. However, the popularity and extensive use of silver-based dressings has been associated with emerging microbial resistances to silver. In this study we examined in vitro antibacterial efficacy of a bioelectric dressing containing silver and zinc against various wound pathogens. Antibiotic-sensitive clinical wound isolates showed a 100% reduction in bacterial growth, except that Enterococcus faecalis isolate was shown to survive with a bacterial log10 reduction rate of less than 10(2) CFU. We also investigated antibacterial efficacy against the extended spectrum ?-lactamase (ESBL) bacteria, multidrug-resistant (MDR) bacteria, and methicillin-resistant Staphylococcus aureus (MRSA). The bioelectric dressing was effective in killing wound pathogens including ESBL, MDR, and MRSA in vitro. Furthermore, based on the primary results against E. faecalis, we carried out extensive studies against several nosocomial Enterococcus species including vancomycin-resistant species. Overall, the vancomycin-sensitive or -resistant Enterococcus species were resistant to this dressing at up to 48 h, except for the vancomycin-resistant Enterococcus raffinosus isolate only showing a 100% bacterial reduction at 48 h, but not at 24 h. The results demonstrated the effective bactericidal activity of a bioelectric dressing against antibiotic-sensitive and MDR strains, but Enterococcus species are bacteriostatic. PMID:24627730

Kim, Hosan; Makin, Inder; Skiba, Jeff; Ho, Amy; Housler, Greggory; Stojadinovic, Alexander; Izadjoo, Mina

2014-01-01

23

Antibacterial Efficacy Testing of a Bioelectric Wound Dressing Against Clinical Wound Pathogens  

PubMed Central

Silver-based wound dressings have been developed for the control of bioburden in wounds. However, the popularity and extensive use of silver-based dressings has been associated with emerging microbial resistances to silver. In this study we examined in vitro antibacterial efficacy of a bioelectric dressing containing silver and zinc against various wound pathogens. Antibiotic-sensitive clinical wound isolates showed a 100% reduction in bacterial growth, except that Enterococcus faecalis isolate was shown to survive with a bacterial log10 reduction rate of less than 102 CFU. We also investigated antibacterial efficacy against the extended spectrum ?-lactamase (ESBL) bacteria, multidrug-resistant (MDR) bacteria, and methicillin-resistant Staphylococcus aureus (MRSA). The bioelectric dressing was effective in killing wound pathogens including ESBL, MDR, and MRSA in vitro. Furthermore, based on the primary results against E. faecalis, we carried out extensive studies against several nosocomial Enterococcus species including vancomycin-resistant species. Overall, the vancomycin-sensitive or -resistant Enterococcus species were resistant to this dressing at up to 48 h, except for the vancomycin-resistant Enterococcus raffinosus isolate only showing a 100% bacterial reduction at 48 h, but not at 24 h. The results demonstrated the effective bactericidal activity of a bioelectric dressing against antibiotic-sensitive and MDR strains, but Enterococcus species are bacteriostatic. PMID:24627730

Kim, Hosan; Makin, Inder; Skiba, Jeff; Ho, Amy; Housler, Greggory; Stojadinovic, Alexander; Izadjoo, Mina

2014-01-01

24

Biomedical evaluation of a novel nitrogen oxides releasing wound dressing.  

PubMed

Chronic wounds are a major cause for both suffering and economical losses. Management of chronic non-healing wounds requires multipronged approach. They are polymicrobial and agonizing for the patient due to associated pain. Moist dressing providing antimicrobial action is a highly desirable chronic wound management option. Here we report a hydrogel based dressing that possesses the antimicrobial properties of acidified sodium nitrite and the homeostatic property of a hydrogel. The dressing was developed by combining citric acid cross-linked cotton gauze and sodium nitrite loaded gelatin. The cotton gauze was cross-linked with citric acid by pad-dry-curing in presence of nano-titania catalyst. The cotton gauze-gelatin hydrogel combination was gamma-irradiated and freeze-dried. At the time of application, the freeze-dried dressing is wetted by sodium nitrite solution. The dressing has a fluid uptake ability of 90 % (w/v) and the water vapour evaporation rate was estimated to be 2,809 ± 20 g/m(2)/day. The dressing showed significant antimicrobial activity against both planktonic and biofilm forms and was effective during consecutive re-uses. Cytotoxicity study showed inhibition of fibroblasts, but to a lesser extent than clinically administered concentrations of antiseptic like povidone iodine. Storage at 37 °C over a 3 month period resulted in no significant loss of its antimicrobial activity. PMID:23001289

Dave, Rachna N; Joshi, Hiren M; Venugopalan, Vayalam P

2012-12-01

25

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

NASA Astrophysics Data System (ADS)

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.

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

2012-12-01

26

Novel silk fibroin/elastin wound dressings.  

PubMed

Silk fibroin (SF) and elastin (EL) scaffolds were successfully produced for the first time for the treatment of burn wounds. The self-assembly properties of SF, together with the excellent chemical and mechanical stability and biocompatibility, were combined with elastin protein to produce scaffolds with the ability to mimic the extracellular matrix (ECM). Porous scaffolds were obtained by lyophilization and were further crosslinked with genipin (GE). Genipin crosslinking induces the conformational transition from random coil to ?-sheet of SF chains, yielding scaffolds with smaller pore size and reduced swelling ratios, degradation and release rates. All results indicated that the composition of the scaffolds had a significant effect on their physical properties, and that can easily be tuned to obtain scaffolds suitable for biological applications. Wound healing was assessed through the use of human full-thickness skin equivalents (EpidermFT). Standardized burn wounds were induced by a cautery and the best re-epithelialization and the fastest wound closure was obtained in wounds treated with 50SF scaffolds; these contain the highest amount of elastin after 6 days of healing in comparison with other dressings and controls. The cytocompatibility demonstrated with human skin fibroblasts together with the healing improvement make these SF/EL scaffolds suitable for wound dressing applications. PMID:22546517

Vasconcelos, Andreia; Gomes, Andreia C; Cavaco-Paulo, Artur

2012-08-01

27

A vapour-permeable film dressing used on superficial wounds.  

PubMed

Films are an extremely versatile dressing type that can be effectively used in the treatment of many superficial wounds, such as skin grafts, surgical wounds and superficial burns; they provide an optimal moist environment to promote healing, act as a barrier to bacteria, and afford protection from urine and faecal contamination. Unfortunately, many film dressings are difficult to handle and use traditional adhesives, which can cause trauma to the wound and surrounding skin, as well as increased wound pain at dressing removal. Mepitel® Film is a new, easy-to-use wound dressing designed with Safetac® technology that helps to minimise dressing-related trauma and pain and assist undisturbed wound healing. This article presents case studies that examine Mepitel Film's use on a variety of wounds, and reviews the findings of research that was undertaken to evaluate the benefits of using this recently developed dressing. PMID:25117599

Meuleneire, Frans

2014-08-12

28

[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

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. PMID:14999922

Ohura, Takehiko; Sanada, Hiromi; Mino, Yoshio

2004-01-01

29

The Efficacy of Gelam Honey Dressing towards Excisional Wound Healing  

PubMed Central

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

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

2012-01-01

30

The Efficacy of Gelam Honey Dressing towards Excisional Wound Healing.  

PubMed

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

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

2012-01-01

31

Removal of adhesive wound dressing and its effects on the stratum corneum of the skin: comparison of eight different adhesive wound dressings.  

PubMed

In recent years, adhesive wound dressings have been increasingly applied postoperatively because of their ease of use as they can be kept in place without having to cut and apply surgical tapes and they can cover a wound securely. However, if a wound dressing strongly adheres to the wound, a large amount of stratum corneum is removed from the newly formed epithelium or healthy periwound skin. Various types of adhesives are used on adhesive wound dressings and the extent of skin damage depends on how much an adhesive sticks to the wound or skin surface. We quantitatively determined and compared the amount of stratum corneum removed by eight different wound dressings including polyurethane foam using acrylic adhesive, silicone-based adhesive dressing, composite hydrocolloid and self-adhesive polyurethane foam in healthy volunteers. The results showed that wound dressings with silicone adhesive and self-adhesive polyurethane foam removed less stratum corneum, whereas composite hydrocolloid and polyurethane foam using acrylic adhesive removed more stratum corneum. PMID:22883604

Matsumura, Hajime; Imai, Ryutaro; Ahmatjan, Niyaz; Ida, Yukiko; Gondo, Masahide; Shibata, Dai; Wanatabe, Katsueki

2014-02-01

32

Enhancement of burn wounds healing by platelet dressing  

PubMed Central

Background and aims: The goal of this study was to evaluate the efficacy of platelet dressing in the treatment of burn wounds and compare its results with silver sulfadiazine dressing. Material and methods: Between 21 march 2011 to 21 September, 50 patients with burn injuries were selected by a randomized double-blind controlled trial. In order to eliminate the biological and personal variables among the various treated burn wounds, in the same patient, distal or proximal, lateral or medial part of burn wound were selected for dressing with platelet or silver sulfadiazine. All patients were designated for homologous component use. The dressing was repeated every day up to complete healing. Results: The results indicated that treatment with platelet enhanced epithelialization and accelerate epithelialization and granulation tissue formation. Platelet dressing to be most significant in this respect compared with silver sulfadiazine dressing. Conclusion: It is concluded that topical application of platelet enhanced the wound healing process in burn patients. PMID:23638327

Maghsoudi, Hemmat; Nezami, Nariman; Mirzajanzadeh, Mehdi

2013-01-01

33

Comparison of silver nylon wound dressing and silver sulfadiazine in partial burn wound therapy.  

PubMed

The study aims to perform a comparative assessment of two types of burn wound treatment. To do the assessment, patients with partial thickness burn wounds with total body surface area <40% were simple randomised to treat with nanocrystalline silver nylon wound dressing or silver sulfadiazine cream. Efficacy of treatment, use of analgesics, number of wound dressing change, wound infection and final hospitalisation cost were evaluated. The study showed silver nylon wound dressing significantly reduced length of hospital stay, analgesic use, wound infection and inflammation compared with silver sulfadiazine. PMID:22734483

Abedini, Fereydoon; Ahmadi, Abdollah; Yavari, Akram; Hosseini, Vahid; Mousavi, Sarah

2013-10-01

34

Clinical efficacy and cost-effectiveness of a new synthetic polymer sheet wound dressing.  

PubMed

Stage II and III pressure ulcers present product development and product choice challenges to manufacturers and professional wound care clinicians respectively. We evaluated the clinical performance and cost of use associated with a new synthetic polymer dressing for the management of these wounds. A total of 10 home healthcare patients, each with a Stage II or III pressure ulcer, were enrolled and randomized for wound treatment using either the new polymer hydrogel wound dressing or the leading market hydrocolloid dressing. Dressings were changed on an as needed basis only. The wounds were assessed weekly and parameters recorded using the Bates-Jensen Pressure Sore Status Tool. In addition, the clinical performance of the dressing and treatment costs were evaluated. The overall healing rate for the two groups was similar. However the new polymer hydrogel dressing was found to have a more favorable overall clinical performance evaluation based largely on its more favorable support of autolytic debridement. The new polymeric dressing also had a more favorable cost of use based on the evaluation. We conclude that the new polymer dressing may be a favorable alternative to the leading market hydrocolloid dressing for the treatment of Stage II and III pressure ulcers due to a better clinical performance and the substantially lower treatment costs associated with its use. PMID:10687651

Motta, G; Dunham, L; Dye, T; Mentz, J; O'Connell-Gifford, E; Smith, E

1999-10-01

35

Burn wound dressing with human amniotic membrane.  

PubMed Central

The use of amniotic membrane as a biological dressing for thermal injury is simple and cheap and has been found to be superior to allograft and xenograft. The membrane prevents heat and water loss from the wound surface and acts as a barrier against bacterial contamination, thus aiding the healing process and reducing morbidity. Another clinically significant and important property of the membrane is its ability to offer marked relief from pain. Over a period of 30 months amniotic membrane was used to treat 15 cases of burn in a small hospital, with uniformly satisfactory results. The practical aspects of this method of treatment can easily be adopted by any hospital regardless of its available facilities. PMID:496235

Bose, B.

1979-01-01

36

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

PubMed

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

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

2012-01-01

37

21 CFR 878.4018 - Hydrophilic wound dressing.  

Code of Federal Regulations, 2011 CFR

...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. (a) Identification. A...

2011-04-01

38

21 CFR 878.4018 - Hydrophilic wound dressing.  

Code of Federal Regulations, 2013 CFR

...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. (a) Identification. A...

2013-04-01

39

21 CFR 878.4018 - Hydrophilic wound dressing.  

Code of Federal Regulations, 2012 CFR

...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. (a) Identification. A...

2012-04-01

40

21 CFR 878.4018 - Hydrophilic wound dressing.  

...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. (a) Identification. A...

2014-04-01

41

21 CFR 878.4020 - Occlusive wound dressing.  

Code of Federal Regulations, 2013 CFR

...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) Identification. An...

2013-04-01

42

21 CFR 878.4020 - Occlusive wound dressing.  

Code of Federal Regulations, 2012 CFR

...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) Identification. An...

2012-04-01

43

Importance of moisture balance at the wound-dressing interface.  

PubMed

This paper considers the significance of achieving the correct moisture balance--neither too moist nor too dry--at the wound-dressing interface and discusses the importance of using new dressing formats designed with this in mind. PMID:12715483

Bishop, S M; Walker, M; Rogers, A A; Chen, W Y J

2003-04-01

44

Slow release of wound healing drug from hydrogel wound dressing prepared by radiation crosslinking method  

NASA Astrophysics Data System (ADS)

The hydrogel wound dressing was prepared by radiation crosslinking. It was used of on patients in the Navy 411 Hospital and some other hospitals. From sixty case studies of the clinical effects, the results showed that: 1. drug releasing slowly releives the pain effectively for prolonged period of application; 2. The dressing can reduce the oozing liquid from the wound and make the wound heal faster; 3. The number of the dressing change is greatly reduced. All the data indicates that the dressing is superior to the conventional kinds.

Weibin, Wu; Peizhi, Sung; Xingguo, Wang; Jinghui, Li; Jie, Chen; Yueqi, Yang; Yihao, Shen; Zueteh, Ma

1993-10-01

45

Natural and synthetic polymers for wounds and burns dressing.  

PubMed

In the last years, health care professionals faced with an increasing number of patients suffering from wounds and burns difficult to treat and heal. During the wound healing process, the dressing protects the injury and contributes to the recovery of dermal and epidermal tissues. Because their biocompatibility, biodegradability and similarity to macromolecules recognized by the human body, some natural polymers such as polysaccharides (alginates, chitin, chitosan, heparin, chondroitin), proteoglycans and proteins (collagen, gelatin, fibrin, keratin, silk fibroin, eggshell membrane) are extensively used in wounds and burns management. Obtained by electrospinning technique, some synthetic polymers like biomimetic extracellular matrix micro/nanoscale fibers based on polyglycolic acid, polylactic acid, polyacrylic acid, poly-?-caprolactone, polyvinylpyrrolidone, polyvinyl alcohol, polyethylene glycol, exhibit in vivo and in vitro wound healing properties and enhance re-epithelialization. They provide an optimal microenvironment for cell proliferation, migration and differentiation, due to their biocompatibility, biodegradability, peculiar structure and good mechanical properties. Thus, synthetic polymers are used also in regenerative medicine for cartilage, bone, vascular, nerve and ligament repair and restoration. Biocompatible with fibroblasts and keratinocytes, tissue engineered skin is indicated for regeneration and remodeling of human epidermis and wound healing improving the treatment of severe skin defects or partial-thickness burn injuries. PMID:24368109

Mogo?anu, George Dan; Grumezescu, Alexandru Mihai

2014-03-25

46

Gabapentin for Pain Control in Cancer Patients' Wound Dressing Care  

Microsoft Academic Search

A patient with mycosis fungoides illustrates the problem of pain management during wound care and suggests the utility of a novel treatment, gabapentin. Skin lesions, be they induced through necrosis of tumor, therapy (e.g., radiotherapy), or by pressure ulceration, are often the cause of continuous pain or acute wound dressing pain. Optimizing the analgesic treatment in those patients is thus

Jacques Devulder; Jo Lambert; Jean Marie Naeyaert

2001-01-01

47

Histological evaluation of wound healing performance of electrospun poly(vinyl alcohol)/sodium alginate as wound dressing in vivo.  

PubMed

Poly(vinyl alcohol)/sodium alginate nanofibrous mats were produced by electrospinning method at optimum process parameters. Evaluation of alginate-based electrospun nanofibrous mats as a wound dressing material and their comparison to commercially available wound dressings produced with conventional methods were carried out in vivo. Tissue specimens were examined histopathologically on 4th, 6th, 15th, 21st postoperative days. In contrast to other dressings it was observed that nanofibrous mat could survive on the wound crust in early stages of healing. In terms of epithelization, epidermis characteristics, vascularization and formation of hair follicles, nanofibrous mat showed the best healing performance. This could be explained with presence of nanofibrous mat acting as an artificial skin on the wound region until new tissue regenerated. PMID:24642979

Co?kun, Gökçe; Karaca, Esra; Ozyurtlu, Mustafa; Ozbek, Serhat; Yermezler, Aysun; Cavu?o?lu, Ilkin

2014-01-01

48

Antibiofilm Efficacy of DispersinB® Wound Spray Used in Combination with a Silver Wound Dressing  

PubMed Central

Chronic wounds including diabetic foot ulcers, pressure ulcers, and venous leg ulcers are a worldwide health problem. As the traditional methods of treatment have proven ineffective against chronic wounds involving biofilms, there is an unmet clinical need for developing products with an antibiofilm component that inhibits and/or disrupts biofilms and thus make the biofilm-embedded bacteria more susceptible to antimicrobial therapy. We developed a DispersinB® antibiofilm enzyme-based wound spray for treating chronic wounds in conjunction with an antimicrobial. Under in vitro conditions, the DispersinB® and Acticoat™ combination performed significantly better (P < 0.05) than Acticoat™ alone, indicating the synergy between the two compounds because of DispersinB® enhancing the antimicrobial activity of Acticoat™. Furthermore, DispersinB® wound spray enhanced the antimicrobial activity of Acticoat™ in a chronic wound mouse model of methicillin-resistant Staphylococcus aureus (MRSA) infection. Thus, this novel combination of DispersinB® and Acticoat™, an antimicrobial dressing, prompts clinical evaluation for potential applications in biofilm-based chronic wound management. PMID:24826078

Gawande, Purushottam V; Clinton, Allie P; LoVetri, Karen; Yakandawala, Nandadeva; Rumbaugh, Kendra P; Madhyastha, Srinivasa

2014-01-01

49

Extremity trauma, dressings, and wound infection: should every acute limb wound have a silver lining?  

PubMed

The manner in which high-energy transfer limb injuries are dressed can alter the wound environment through manipulation of the bacterial burden, thus minimizing tissue degradation and influencing healing potential. Infection is the principal complication of such wounds, and antiseptic soaked gauze is accepted in early coverage of extremity wounds despite a lack of evidence to support this practice. There has been resurgence in the use of silver in acute wounds, through dressings manipulated to deliver sustained elemental silver to the wound interface. In vitro and in vivo experimentation of silver dressings are characterized however by methodological compromise, primarily through lack of similarity of models to the physiology of the healing wound. Results from in vitro studies caution against the use of silver because of evidence of cytotoxicity, but this is not reproduced in in vivo or clinical experimentation, leading to ambiguity. Review of silver dressing application in burns and chronic wound studies fails to support its use over other dressing systems. Similarly, evidence for the use of silver in acute limb wounds is lacking. This article provides a comprehensive overview of the use of silver dressings in acute wound care and highlights in particular the paucity of evidence regarding its routine use in extremity injury. PMID:23008343

Eardley, William G P; Watts, Sarah A; Clasper, Jon C

2012-09-01

50

Application of wound dressings in dermatology laser procedures  

NASA Astrophysics Data System (ADS)

High powered lasers have been used in dermatological procedures such as tattoo removal. This use is associated with a potential, biological hazard of high speed tissue particles from the laser field. It has been proposed that by applying a clear dermatological would dressing directly over the laser treatment site, it may be possible to completely trap the potentially airborne tissue particles from the procedure. Some important questions must be addressed prior to the implementation of such a technique. While the use of a wound dressing may significantly reduce the airborne materials during the laser procedures, new problems may arise: 1 . The wound dressing or some of its components may absorb excessive amount of light energy. This would result in a very localized temperature rise which may be harmful to the patient; 2. The smooth surface of the wound dressing material could induce specular reflection of the incident laser beam, thus introducing a laser hazard to the staff and patient. To address these possible problems, we studied a series of ClearSite Wound Dressings which have been reportedly tested for such laser procedures. The objective of the studies were, to determine if the use of ClearSite in conjunction with laser procedures poses a possible hazard to either the patient or to the Operating Room personnel, and to determine the effect of the ClearSite dressing on the optical characteristics of the light beam. The latter includes light absorption and transmittance for various wavelengths.

Hetzel, Fred W.; Chen, Qun; Hoskins, Greg

1995-05-01

51

Morphology, drug release, antibacterial, cell proliferation, and histology studies of chamomile-loaded wound dressing mats based on electrospun nanofibrous poly(?-caprolactone)/polystyrene blends.  

PubMed

For the first time, it has been tried to achieve optimum conditions for electrospun poly(?-caprolactone)/polystyrene (PCL/PS) nanofibrous samples as active wound dressings containing chamomile via D-optimal design approach. In this work, systematic in vitro and in vivo studies were carried out by drug release rate, antibacterial and antifungal evaluations, cell culture, and rat wound model along with histology observation. The optimized samples were prepared under the following electrospinning conditions: PCL/PS ratio (65/35), PCL concentration 9%(w/v), PS concentration 14%(w/v), distance between the syringe needle tip and the collector 15.5 cm, applied voltage 18 kV, and solution flow rate 0.46 mL h(-1) . The FE-SEM micrographs showed electrospun PCL/PS (65/35) nanofibrous sample containing 15% chamomile had a minimum average diameter (?175 nm) compared to the neat samples (?268 nm). The drug released resulted in a gradual and high amount of chamomile from the optimized PCL/PS nanofibrous sample (?70%) in respect to PCL and PS nanofibers after 48 h. This claim was also confirmed by antibacterial and antifungal evaluations in which an inhibitory zone with a diameter of about 7.6 mm was formed. The rat wound model results also indicated that the samples loaded with 15% chamomile extract were remarkably capable to heal the wounds up to 99?±?0.5% after 14 days post-treatment periods. The adhesion of mesenchymal stem cells and their viability on the optimized samples were confirmed by MTT analysis. Also, the electrospun nanofibrous mats based on PCL/PS (65/35) showed a high efficiency in the wound closure and healing process compared to the reference sample, PCL/PS nanofibers without chamomile. Finally, the histology analysis revealed that the formation of epithelial tissues, the lack of necrosis and collagen fibers accumulation in the dermis tissues for the above optimized samples. PMID:24259351

Motealleh, Behrooz; Zahedi, Payam; Rezaeian, Iraj; Moghimi, Morvarid; Abdolghaffari, Amir Hossein; Zarandi, Mohammad Amin

2014-07-01

52

Nanocrystalline silver dressings in wound management: a review  

PubMed Central

This paper describes the properties of nanocrystalline silver products (Acticoat™) and their applications and examines available evidence supporting their use in wound management. Acticoat utilizes nanotechnology to release nanocrystalline silver crystals. Acticoat releases 30 times less silver cations than silversulfadiazine cream or 0.5% silver nitrate solution but more of the silver released (by Acticoat). Silver-impregnated slow-release dressings release minute concentrations of silver which are quickly bound up by the chloride in the wound exudate. While extrapolations from in vitro and animal studies are cautious, evidence from these studies suggests Acticoat is: effective against most common strains of wound pathogens; can be used as a protective covering over skin grafts; has a broader antibiotic spectrum activity; and is toxic to keratinocytes and fibroblasts. Animal studies suggest a role for nanocrystalline silver in altering wound inflammatory events and facilitation of the early phase of wound healing. Quality human clinical trials into nanocrystalline silver are few. However, evidence suggests using Acticoat in wound management is cost effective, reduces wound infection, decreases the frequency of dressing changes and pain levels, decreases matrix metalloproteinase activity, wound exudate and bioburden levels, and promotes wound healing in chronic wounds. Although there is no in vivo evidence to suggest nanocrystalline silver is toxic to human keratinocytes and fibroblasts, there is in vitro evidence to suggest so; thus these dressings should be used cautiously over epithelializing and proliferating wounds. Future clinical research, preferably randomized controlled trials into nanocrystalline silver technology, may provide clinicians a better understanding of its applications in wound management. PMID:17722278

Fong, Joy; Wood, Fiona

2006-01-01

53

Bio-Conjugated Polycaprolactone Membranes: A Novel Wound Dressing  

PubMed Central

Background The combination of polycaprolactone and hyaluronic acid creates an ideal environment for wound healing. Hyaluronic acid maintains a moist wound environment and accelerates the in-growth of granulation tissue. Polycaprolactone has excellent mechanical strength, limits inflammation and is biocompatible. This study evaluates the safety and efficacy of bio-conjugated polycaprolactone membranes (BPM) as a wound dressing. Methods 16 New Zealand white rabbits were sedated and local anaesthesia was administered. Two 3.0×3.0 cm full-thickness wounds were created on the dorsum of each rabbit, between the lowest rib and the pelvic bone. The wounds were dressed with either BPM (n=12) or Mepitel (n=12) (control), a polyamide-silicon wound dressing. These were evaluated macroscopically on the 7th, 14th, 21st, and 28th postoperative days for granulation, re-epithelialization, infection, and wound size, and histologically for epidermal and dermal regeneration. Results Both groups showed a comparable extent of granulation and re-epithelialization. No signs of infection were observed. There was no significant difference (P>0.05) in wound size between the two groups. BPM (n=6): 8.33 cm2, 4.90 cm2, 3.12 cm2, 1.84 cm2; Mepitel (n=6): 10.29 cm2, 5.53 cm2, 3.63 cm2, 2.02 cm2; at the 7th, 14th, 21st, and 28th postoperative days. The extents of epidermal and dermal regeneration were comparable between the two groups. Conclusions BPM is comparable to Mepitel as a safe and efficacious wound dressing.

Cai, Elijah Zhengyang; Teo, Erin Yiling; Jing, Lim; Koh, Yun Pei; Qian, Tan Si; Wen, Feng; Lee, James Wai Kit; Hing, Eileen Chor Hoong; Yap, Yan Lin; Lee, Hanjing; Lee, Chuen Neng; Teoh, Swee-Hin; Lim, Jane

2014-01-01

54

Design of antibiotic containing hydrogel wound dressings: biomedical properties and histological study of wound healing.  

PubMed

Keeping in view the antioxidant nature of the acacia gum and mucoadhesive nature of carbopol hydrogels, in the present studies, an attempt has been made to explore the potential of these materials in designing new hydrogel wound dressings meant for slow release of gentamicin, an antibiotic drug, and to enhance the wound healing potential. The hydrogel films were characterized by SEM, FTIR, XRD and swelling studies. Biomedical properties of hydrogel films like blood compatibility, antioxidant activity, mucoadhesion, antimicrobial activity, oxygen/water vapour permeability, microbial penetration and mechanical properties (tensile strength, burst strength, resilience, relaxation, and folding endurance) have been evaluated. The histological studies of wound healing were also carried out on swiss albino mice of strain Balb C and it has been observed that in case of wounds covered with hydrogel dressings shown faster wound healing, formation of well developed fibroblasts and blood capillaries as compared to open wounds. The results of biomedical properties indicated that hydrogel films are non-thrombogenic, non-haemolytic, antioxidant and mucoadhesive in nature, and are permeable to oxygen and moisture while impermeable to micro-organisms. The hydrogel wound dressings have absorbed (8.772 ± 0.184 g/g film) simulated wound fluid. Release of gentamicin drug from wound dressings occurred through Fickian diffusion mechanism in simulated wound fluid. PMID:24075861

Singh, Baljit; Sharma, Sushma; Dhiman, Abhishek

2013-11-30

55

Microbicidal properties of a silver-containing hydrofiber dressing against a variety of burn wound pathogens.  

PubMed

Partial-thickness burns are often characterized by microbial contamination and copious exudate produced during the early postburn period. Consequently, topical wound management often relies on the use of antimicrobial agents and absorbent dressings, and an AQUACEL Hydrofiber Dressing containing ionic silver has been designed to meet such needs. To assess the antimicrobial properties of the AQUACEL Hydrofiber dressing, samples were challenged with a wide variety of recognized burn wound pathogens in a simulated wound fluid model. Dressing samples were inoculated with the challenge organisms at time zero and then reinoculated on days 4 and 9 to mimic the worst-case clinical scenario. The dressing was shown to be microbicidal against aerobic and anaerobic bacteria (including antibiotic-resistant strains), yeasts, and filamentous fungi during a 14-day test period. Based on our results, the silver-containing dressing is likely to provide a barrier to infection, in addition to providing proven fluid-handling benefits of the AQUACEL Hydrofiber dressing, in the management of partial-thickness burns. PMID:15091147

Bowler, P G; Jones, S A; Walker, M; Parsons, D

2004-01-01

56

Influencing dressing choice and supporting wound management using remote 'tele-wound care'.  

PubMed

This article describes a local involvement in a project to evaluate a remote system of wound management, incorporating the use of digital and mobile technology. It outlines how this involvement influenced the current system of 'tele wound care' (remote wound management) in a large community organisation. The system allows remote wound assessment, management advice and ongoing monitoring of wounds to ensure that the dressing choice remains appropriate and that timely wound care support can be provided to community nurses, practice nurses and GPs. PMID:24912832

King, Brenda

2014-06-01

57

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

PubMed

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-? (p<0.01) and IL-1? (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. PMID:24161538

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

58

Wound dressings containing bFGF-impregnated microspheres.  

PubMed

The primary objective was to synthesize a novel wound dressing containing basic fibroblast growth factor (bFGF)-loaded microspheres for promoting healing and tissue regeneration. Gelatin sponge was chosen as the underlying layer and elastomeric polyurethane membranes were used as the external layer. To achieve prolonged release, bFGF addition was loaded in microspheres. The microspheres were characterized for particle size, in vitro protein release and bioactivity. The bilayer dressings were tested in in vivo experiments on full-thickness skin defects created on pigs. Average size of the microspheres was 14.36 +/- 3.56 microm and the network sponges were characterized with an average pore size of 80-160 microm. Both the in vitro release efficiency and the protein bioactivity revealed that bFGF was released in a controlled manner and it was biologically active as assessed by its ability to induce the proliferation of fibroblasts. It was observed that sustained release of bFGF provided a higher degree of reduction in the wound areas. Histological investigations showed that the dressings were biocompatible and did not cause any mononuclear cell infiltration or foreign body reaction. The structure of the newly formed dermis was almost the same as that of the normal skin. The application of these novel bilayer wound dressings provided an optimum healing milieu for the proliferating cells and regenerating tissues in pig's skin defect models. PMID:16801240

Huang, Sha; Deng, Tianzheng; Wu, Hong; Chen, Faming; Jin, Yan

2006-05-01

59

Chitin membranes containing silver nanoparticles for wound dressing application.  

PubMed

Silver nanoparticles are gaining importance as an antimicrobial agent in wound dressings. Chitin is a biopolymer envisioned to promote rapid dermal regeneration and accelerate wound healing. This study was focused on the evaluation of chitin membranes containing silver nanoparticles for use as an antimicrobial wound dressing. Silver nanoparticles were synthesised by gamma irradiation at doses of 50 kGy in the presence of sodium alginate as stabiliser. The UV-Vis absorption spectra of nanoparticles exhibited an absorption band at 415-420 nm, which is the typical plasmon resonance band of silver nanoparticles. The peaks in the X-ray diffraction (XRD) pattern are in agreement with the standard values of the face-centred cubic silver. Transmission electron microscopy (TEM) images indicate silver nanoparticles with spherical morphology and small particle size in the range of 3-13 nm. In vitro antimicrobial tests were performed using Pseudomonas aeruginosa and Staphylococcus aureus to determine the antimicrobial efficiency of the chitin membranes containing 30, 50, 70 and 100 ppm nanosilver. No viable counts for P. aeruginosa were detected with 70 ppm silver nanoparticles dressing after 1-hour exposure. A 2-log reduction in viable cell count was observed for S. aureus after 1 hour and a 4-log reduction after 6 hours with 100 ppm nanosilver chitin membranes. This study demonstrates the antimicrobial capability of chitin membranes containing silver nanoparticles. The chitin membranes with 100 ppm nanosilver showed promising antimicrobial activity against common wound pathogens. PMID:22958740

Singh, Rita; Singh, Durgeshwer

2014-06-01

60

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

PubMed

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, TNF? 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 expression compared to control. This study has demonstrated that both Acticoat(®) and Inadine(®) dressings can reduce the bacteria burden in a heavily contaminated soft tissue wound and so they may offer utility in the clinical setting particularly where surgical treatment is delayed. PMID:24908627

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

2014-08-01

61

Wound dressings and other topical treatment modalities in bioburden control.  

PubMed

Reduction of wound bioburden has traditionally been achieved by the use of topical antimicrobial agents, such as bactericidal antiseptics or antibiotics. This has worked well for many years, however, concerns about toxicity and resistance have prompted research into other mechanisms. There are various means of removing bacteria from the wound, without recourse to chemical agents; for example, larvae (maggots) ingest bacteria, together with the devitalised tissue of the wound, while the control of exudate restricts the availability of free water, impeding the growth of water-loving bacteria. The discovery that some materials selectively adsorb, or sequester, bacteria has led to the development of bacteriostatic dressing materials, which do not rely on antiseptics for their action. These are designed to physically remove microorganisms, such as bacteria, from the wound, thus reducing bioburden. However, this still demands validation as a clinically relevant mechanism. Until that time, it remains a fascinating theoretical concept. This is a chapter taken from the book Microbiology of Wounds, published by CRC Press in 2010. PMID:22068142

White, R

2011-09-01

62

A rapid screening method for wound dressing by cell-on-a-chip device.  

PubMed

This report demonstrates an in vitro method for screening wound dressing candidates that can minimize the use of animals for developing better methods for wound care. The development of materials and formulations for wound dressings, an important application of biomaterials, is laboriously and ethically challenging because of the use of a large number of animals. A method for rapid and effective screening of wound dressings in vitro, therefore, is in great need. A cell-on-a-chip model was used to simulate the cutaneous wound in vitro and screen the performances of several electrospun fibrous wound dressings in enhancing wound healing. For comparison, the performances of wound dressings were also evaluated in a rat model. It was found that the results acquired by microchip model corroborates well with animal experiments. It is the first time, as far as we know, that a good correlation between in vitro and in vivo results is reported for fibrous wound dressings. The cell-on-a-chip wound model we developed here may change the way that scientists screen candidates for wound dressings. PMID:23184790

Zhao, Qilong; Wang, Shiwen; Xie, Yunyan; Zheng, Wenfu; Wang, Zhuo; Xiao, Le; Zhang, Wei; Jiang, Xingyu

2012-09-01

63

The use of silver coated dressings on donor site wounds: a prospective, controlled matched pair study.  

PubMed

Acticoat, a new silver-coated dressing, produces a moist healing environment along with the sustained release of ionic silver for improved microbial control. These properties suggest that Acticoat might be a useful donor site dressing. However, there are no human studies which assess Acticoat for this use. The purpose of this study was to compare the healing of human skin graft donor sites dressed with Acticoat, to the healing of those dressed with Allevyn, an occlusive moist-healing environment material, which is our standard donor site dressing. In burn patients who had undergone burn excision and grafting, identical side-by-side split thickness donor site wound pairs were dressed with Allevyn and Acticoat. Re-epithelialization was directly assessed daily by a single observer from post-operative day 6 onward, and by four independent observers who rated the extent of re-epithelialization by viewing standardized digital images of the wounds that had been obtained on post-operative days 6, 8, 10,and 12. Donor sites were swabbed for bacterial culture on days 3, 6, and 9. Subsequently, each study donor site scar was rated by a blinded observer using the Vancouver Scar Scale at 1, 2, and 3 months. Sixteen paired sites in 15 patients (3 female, 12 male) were studied. Donor sites dressed with Allevyn were >90% re-epithelialized at a mean of 9.1+/-1.6 days while donor sites dressed with Acticoat required a mean of 14.5+/-6.7 days to achieve >90% re-epithelialization (P=0.004). The Allevyn sites had significantly greater estimated re-epithelialization at days 6, 8, 10 and 12 than the Acticoat sites based on the observations of the digital images. There were no significant differences in the incidence of positive bacterial cultures with either dressing at days 3, 6, and 9. Donor sites dressed with Acticoat had significantly worse scars at 1 and 2 months but this difference resolved by 3 months. Our findings do not support the use of Acticoat as a skin graft donor site dressing. PMID:11525858

Innes, M E; Umraw, N; Fish, J S; Gomez, M; Cartotto, R C

2001-09-01

64

Use of skin staples to fix film dressings on scalp donor wounds in patients with burns  

Microsoft Academic Search

Split-thickness skin grafts (STSGs) from the scalp have been used in large burns. The donor site wounds are usually covered using occlusive dressings, such as film dressings because they contribute to reduce donor site pain and infection under exudative crust and to enhance re-epithelialization. However, it is not always easy to fix such film dressings to the scalp because of

Reiji Morita; Naotaka Ishikura; Shigehiko Kawakami; Takaya Heshiki; Kenichi Shimada; Tomoko Kurosawa

2002-01-01

65

Silicone-coated non-woven polyester dressing enhances reepithelialisation in a sheep model of dermal wounds.  

PubMed

Negative-pressure wound therapy (NPWT) also known as V.A.C. (Vacuum-assisted closure), is widely used to manage various type of wounds and accelerate healing. NPWT has so far been delivered mainly via open-cell polyurethane (PU) foam or medical gauze. In this study an experimental setup of sheep wound model was used to evaluate, under NPWT conditions, the performance of a silicone-coated non-woven polyester (N-WPE) compared with PU foam and cotton hydrophilic gauze, used as reference materials. Animals were anesthetized with spontaneous breathing to create three 3 × 3 cm skin defects bilaterally; each animal received three different samples on each side (n = 6 in each experimental group) and was subjected to negative and continuous 125 mmHg pressure up to 16 days. Wound conditions after 1, 8 and 16 days of treatment with the wound dressings were evaluated based on gross and histological appearances. Skin defects treated with the silicone-coated N-WPE showed a significant decrease in wound size, an increase of re-epithelialization, collagen deposition and wound neovascularisation, and a minimal stickiness to the wound tissue, in comparison with gauze and PU foam. Taken all together these findings indicate that the silicone-coated N-WPE dressing enhances wound healing since stimulates higher granulation tissue formation and causes minor tissue trauma during dressing changes. PMID:22692367

Losi, Paola; Briganti, Enrica; Costa, Manolo; Sanguinetti, Elena; Soldani, Giorgio

2012-09-01

66

Management of fasciotomy wounds--does the dressing matter?  

PubMed

Fasciotomy is a limb-saving procedure in the management of ischemic extremities. Little evidence exists as to the best method of fasciotomy wound management. We hypothesized that the use of vacuum dressing (VAC) or creation of dynamic tension (DYN) would increase rates of primary closure, reducing the need for split thickness skin grafting (STSG). The records of a large urban Level I trauma center were used to identify fasciotomy recipients over a 10-year period and were retrospectively analyzed. Data collected included injury characteristics, wound management, and outcomes. Wound management was dictated by surgeon preference, and categorized as gauze packing, DYN, or VAC. The primary outcome was primary closure versus need for STSG. Wound management cohorts were compared using logistic regression. Fisher's exact test and ?(2) were performed to compare proportions and categorical variables respectively. From 2000 to 2009, 227 patients had a fasciotomy performed. Mechanism, age, and incidence of fracture were different between the groups. There was a trend towards increased primary closure with DYN (83%). Average length of stay (LOS) was 21 days for those receiving primary closure and 27 days for STSG. There was a significant decrease in LOS for the DYN group (average 16 days) when compared with gauze packing and VAC. In this series of 227 patients who underwent fasciotomy, no technique of wound management produced a significant improvement in primary closure rate. A trend toward more primary closure was seen in the DYN group. LOS was longer for patients receiving STSG. The DYN cohort had a significantly shorter LOS. PMID:22273225

Matt, Sarah E; Johnson, Laura S; Shupp, Jeffrey W; Kheirbek, Tareq; Sava, Jack A

2011-12-01

67

Histological effects of occlusive dressing on healing of incisional skin wounds.  

PubMed

Occlusive dressing is widely accepted and used to manage skin ulcers. However, with respect to its application to incisional wounds, most studies have been conducted about the clinical effects on incisional healing of surgical sites. Studies of the histological effects of occlusive dressing for incisional wounds have been few. The aim of this study was to clarify the histological effects of occlusive dressings on healing of incisional skin wounds. Rat dorsal skin was incised down to the panniculus and sutured immediately. Dressing types included 2-octyl cyanoacrylate and hydrocolloid materials as occlusive dressings and no-dressing as the open therapy. Histological examination and dermoscopic observation were performed 1, 2, 4 and 7 days after surgery. The findings from each dressing type were compared. In the open therapy group, the upper portion of the edge of incision was necrosed minimally and finally healed with wide scar formation. However, in the occlusive dressing groups, micronecrosis of the incision edge seen in the no-dressing group was not observed, healing was more rapid and the remaining scar was finer. Occlusive dressing can prevent micronecrosis of the incision edge, resulting in rapid and excellent healing. This study shows that the efficacy of and supports the use of occlusive dressing in incisional wound management. PMID:23279979

Yamamoto, Naoto; Kiyosawa, Tomoharu

2014-12-01

68

Multifunctional medicated lyophilised wafer dressing for effective chronic wound healing.  

PubMed

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. PMID:24700434

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

2014-06-01

69

Negative-pressure wound dressings to secure split-thickness skin grafts in the perineum.  

PubMed

Several researches have shown that negative-pressure wound dressings can secure split-thickness skin grafts and improve graft survival. However, in anatomically difficult body regions such as the perineum it is questionable whether these dressings have similar beneficial effects. In this study, we evaluated the effects of negative-pressure wound dressings on split-thickness skin grafts in the perineum by comparing wound healing rate and complication rate with that of tie-over dressings. A retrospective chart review was performed for the patients who underwent a split-thickness skin graft to reconstruct perineal skin defects between January 2007 and December 2011. After grafting, the surgeon selected patients to receive either a negative-pressure dressing or a tie-over dressing. In both groups, the initial dressing was left unchanged for 5 days, then changed to conventional wet gauze dressing. Graft success was assessed 2 weeks after surgery by a single clinician. A total of 26 patients were included in this study. The mean age was 56·6 years and the mean wound size was 273·1 cm(2). Among them 14 received negative-pressure dressings and 12 received tie-over dressings. Negative-pressure dressing group had higher graft taken rate (P = 0·036) and took shorter time to complete healing (P = 0·01) than tie-over dressing group. The patients with negative-pressure dressings had a higher rate of graft success and shorter time to complete healing, which has statistical significance. Negative-pressure wound dressing can be a good option for effective management of skin grafts in the perineum. PMID:22958590

Lee, Kyeong-Tae; Pyon, Jai-Kyong; Lim, So-Young; Mun, Goo-Hyun; Oh, Kap Sung; Bang, Sa-Ik

2014-04-01

70

Impact of Silver-Containing Wound Dressings on Bacterial Biofilm Viability and Susceptibility to Antibiotics during Prolonged Treatment ?  

PubMed Central

The long-term antimicrobial efficacy of silver dressings against bacterial biofilms was investigated in a 7-day treatment in vitro model where the protein-rich medium was refreshed daily in order to mimic the conditions found in a wound bed. The use of plate-to-plate transfer assays demonstrated measurable differences in the effectivenesses of several silver dressings on the viability of biofilm bacteria and their susceptibility to antibiotics. Whereas after the first day of treatment, all dressings used resulted in a significant reduction in the number of viable cells in the biofilms and disruption of the biofilm colonies, during prolonged treatment, the efficacy of dressings with hydrophilic base materials diminished with daily transfers, and bacterial populations recovered. For dressings with hydrophobic base materials, the level of efficacy correlated with the silver species loaded. Biofilm bacteria, which survived the initial silver treatment, were susceptible to tobramycin, ciprofloxacin, and trimethoprim-sulfamethoxazole, in contrast to untreated biofilms, which were highly tolerant to the same antibiotics. This acquired susceptibility was unaffected by the longevity of pretreatment with the silver dressings but depended on the dressing used. The antimicrobial efficacy of the dressings correlated with the type of the dressing base material and silver species loaded. PMID:20855737

Kostenko, Victoria; Lyczak, Jeffrey; Turner, Katherine; Martinuzzi, Robert John

2010-01-01

71

Potential of quaternization-functionalized chitosan fiber for wound dressing.  

PubMed

Quaternization-functionalized chitosan fibers were successfully prepared by using 2,3-epoxypropyl trimethyl ammonium chloride as a quaternized reagent reacted with chitosan fiber. FTIR and (1)H NMR were used to characterize the structure of quaternized chitosan fibers (QCFs). The swelling behavior and mechanical property of QCFs were studied. The results showed that, QCFs had higher liquid absorption capacity than chitosan fiber, while the tensile strength and elongation at break of QCFs were lower than those of chitosan fiber. The antibacterial activity of the QCF had been evaluated by Gram-positive bacteria Staphylococcus aureus (S. aureus). The results indicated that, the antibacterial activity of QCF against S. aureus was stronger than that of chitosan fiber. Indirect cytotoxicity assessment of the fibers indicated that QCF was nontoxic to the L929 cell with relatively low extraction concentration. This novel fiber would be used as potential wound dressing for skin regeneration. PMID:23089086

Zhou, Yingshan; Yang, Hongjun; Liu, Xin; Mao, Jun; Gu, Shaojin; Xu, Weilin

2013-01-01

72

Wound infection, dressings and pain, is there a relationship in the chronic wound?  

PubMed

The focus on quality of life issues in wound care has justly taken a far greater importance. With the acceptance that pain can be a major factor to the patient, and in particular, pain at dressing change comes the opportunity for avoidance and/or reduction strategies. Whilst pain has been associated with wound infection for millennia, it is only much more recently that this has received due attention from research and clinical practice. In this study, the nature of pain, changes in pain and pain associated with infection are the focal points. A Delphi approach, now a frequently used tool in wound care research, has been used to obtain expert opinion on these aspects of management. PMID:22630139

Cutting, K F; White, R J; Mahoney, P

2013-02-01

73

Synthesis of carboxymethyl chitosan and coating on wound dressing gauze for wound healing.  

PubMed

Wound healing is a long and complex process. To improve wound healing, the wound dressing cotton gauze can be functionalized by imparting moisture holding and antibacterial ability. Moisture is an important factor for wound healing and the absence of microbial intervention can accelerate wound healing process. Direct alkylation method was used to synthesis carboxymethylated chitosan with water solubility, biocompatibility and antibacterial activity. Calcium alginate was used along with modified chitosan as moisture gaining polymeric agent. Pad-dry-cure method was employed to coat both the polymers on cotton gauze surface, which was weaved using 40s Ne cotton yarn. After coating, the cotton was analysed for its polymer add-on percentage, antibacterial action against Staphylococcus aureus ATCC 6538 and Escherichia coli ATCC 10229. The persistence analysis of antibacterial activity ensures the polymer withstanding ability on cotton gauze surface. SEM detection of polymers with cotton threads confirms their presence. Wound healing action of the polymer coated cotton gauze was determined using albino rats as animal model. PMID:24511685

Venkatrajah, B; Malathy, V Vanitha; Elayarajah, B; Rajendran, R; Rammohan, Ram

2013-11-15

74

Access to wound dressings for patients living with epidermolysis bullosa - an Australian perspective.  

PubMed

Epidermolysis Bullosa (EB) is a rare genetic skin disorder characterised by fragility and blistering of skin and mucous membranes. Skin can blister and shear away from minimal friction, trauma and every day activities. The disease causes a wide range of complications but wound care is the major challenge to severe EB, and good wound care is an essential part of wound management. The goal of wound care was to choose a product that protects the fragile skin, limits friction, decreases pain and promotes healing. However, access to wound dressings for those people living with EB is challenging. This article discusses the availability of EB dressings in a number of countries around the world and also describes an innovative National Epidermolysis Bullosa Dressings Scheme (NEBDS) in Australia, which aims to improve the quality of life of people with EB, by reducing the financial burden associated with the provision of dressings accordingly. PMID:23174001

Stevens, Louise J

2014-10-01

75

The Controlled Induction of Distributed Microdeformation in Wounded Tissue via a Microchamber Array Dressing  

PubMed Central

Mechanical stimuli are known to play an important role in determining the structure and function of living cells and tissues. Recent studies have highlighted the role of mechanical signals in mammalian dermal wound healing. However, the biological link between mechanical stimulation of wounded tissue and the subsequent cellular response has not been fully determined. The capacity for researchers to study this link is partially limited by the lack of instrumentation capable of applying controlled mechanical stimuli to wounded tissue. The studies outlined here tested the hypothesis that it was possible to control the magnitude of induced wound tissue deformation using a microfabricated dressing, comprised of an array of open-faced, hexagonally-shaped microchambers rendered in a patch of silicone rubber. By connecting the dressing to a single vacuum source, the underlying wounded tissue was drawn up into each of the microchambers, thereby inducing tissue deformation. For these studies, the dressings were applied to full thickness murine dermal wounds with 200 mmHg vacuum for 12 hours. The studies demonstrated that the dressing was capable of inducing wound tissue deformation with values ranging from 11 to 29 %. Through statistical analysis, the magnitude of the induced deformation was shown to be a function of both microchamber height and width. These results demonstrated that the dressing was capable of controlling the amount of deformation imparted in the underlying tissue. By allowing the application of mechanical stimulation with varying intensity, such a dressing will enable the performance of sophisticated mechanobiology studies in dermal wound healing. PMID:20607869

Kane, Bartholomew J.; Younan, George; Helm, Douglas; Dastouri, Pouya; Prentice-Mott, Harrison; Irimia, Daniel; Chan, Rodney K.; Toner, Mehmet; Orgill, Dennis P.

2010-01-01

76

Clinical evaluation of TIELLE* Plus dressing in the management of exuding chronic wounds.  

PubMed

This clinical evaluation, which was carried out between May 2000 and January 2001, measured the efficacy and safety of TIELLE* Plus dressing, a novel hydropolymer dressing with super-absorbent properties. In total 2121 patients with leg ulcers (59.1%), pressure ulcers (20.7%), diabetic foot ulcers (10.9%) or other chronic wounds (9.4%) were included in the study. These were recruited by 624 physicians in a German post-marketing study. All wounds had been present for at least 4 weeks prior to treatment with TIELLE* Plus dressings and many had been treated with other dressings previously. Within the observation period of 12 weeks, 43% of the wounds healed and 50.4% were considered as 'improved'. With this combined total of about 95% the subjects clearly benefited from a change in therapy from conventional regimes (in Germany) such as ointments and gauze, but also from modern, moist wound healing dressings such as hydrocolloids. The frequency of side-effects was low at 4.8%. Over 90% of the patients rated the TIELLE* Plus dressing therapy as 'much better' or 'better' tolerated than the previous treatment regime. For the large majority of the patients the quality of life also improved. On the basis of the positive experiences with respect to effectiveness, safety and handling, 96.8% (604) of the participating doctors wanted to adopt TIELLE* Plus dressings in their therapy plan. TIELLE* Plus dressings can be considered as an effective, safe and simple-to-handle wound dressing for therapy of chronic wounds in daily practice. The shortening of healing time and the less frequent change of dressing also make this therapy regime attractive on cost grounds. PMID:15115220

Schulze, H J

2003-01-01

77

Absorbent alginate fibres modified with hydrolysed chitosan for wound care dressings--II. Pilot scale development.  

PubMed

Fibres have been used extensively in wound dressing applications as they provide a high surface area for absorption, ease of fabrication and softness. It is common practice for commercial wound dressings to be produced from natural materials, such a marine polysaccharides, as they are predominantly biocompatible, non-toxic, and often display bioactive properties, such as inherent antimicrobial activity. In this study hydrolysed chitosans were utilised as a sole coagulant for the production of alginate-chitosan fibres via a one-step, direct wet-spinning extrusion process. The levels of chitosan incorporated into the fibres were analysed quantitatively via elemental analysis and qualitatively by staining using Amido Black 10B. It was estimated that the fibres contained between 4.50 and 5.10% (wt.%) chitosan. The presence of chitosan improved tensile properties such as elongation and tenacity of the base alginate fibres. The increased incorporation of chitosan into the fibres also improved the absorption of the fibres in both saline and distilled water; reaching maximum of >30 g/g and >50 g/g, respectively. This work suggests that the observed hydrolysed chitosan content within the fibre may be optimal for the preparation of a novel fibre for wound care application. PMID:24507364

Sweeney, I R; Miraftab, M; Collyer, G

2014-02-15

78

Study of wound dressing structure and hydration/dehydration properties  

NASA Astrophysics Data System (ADS)

Hydrogels manufactured by radio-induced crosslinking and simultaneous sterilisation of hydrogels of PVP, PEG and agar, according to the Rosiak method, have many desirable properties for using as wound dressings. However, some properties need to be improved or better controlled. The membranes need to be strong enough to be freely used. Another important property to be controlled is the capacity of absorption of exudate and the kinetics of drying. Therefore, it was necessary to understand the role of main parameters (agar, PVP, PEG concentration and dose) in the structure of the net and in the hydration and dehydration properties. The structure of the membranes was studied by sol analysis and the hydrating/dehydrating properties were studied by isothermal thermogravimetric analysis. The gel content for all samples were always in agreement with expected values considering that only PVP undergoes crosslinking. The hydrating and dehydration results did not show variation with the tested parameters. It was concluded that the network was solely composed of crosslinked PVP plasticezed by the other compounds. The properties of hydration/dehydration is related rather to diffusion than to capillarity or osmose and to the chemical retention of water in the polymeric matrix.

Lugão, A. B.; Machado, L. D. B.; Miranda, L. F.; Alvarez, M. R.; Rosiak, J. M.

1998-06-01

79

Antimicrobial and release study of drug loaded PVA/PEO/CMC wound dressings.  

PubMed

The aim of the present study was to develop PVA/PEO/CMC/aloe vera (PPCAV) and PVA/PEO/CMC/curcumin (PPCCu) dressings with nonwoven polyester fabric as the support layer via freeze-drying (FD) approach. Tetracycline hydrochloride drug (TC) was loaded along with curcumin and aloe vera on these dressings. The morphology of the dressings was characterized by scanning electron microscopy. The swelling behavior, water vapor transmission rate (WVTR), in vitro drug release and antimicrobial nature were analyzed to assess the applicability of these freeze-dried membranes as wound dressing materials. The results show that these dressings made from PPCAVTC and PPCCuTC were highly porous with three-dimensional interconnected porous morphology. The cumulative release of drug from the dressings increases with increasing immersion time and continued up to 24 h, after that it gets leveled off. These dressings evidenced wonderful antimicrobial nature in vitro. These dressings were found to have more than 900 % PBS uptake, WVTR was found to be in the range 2,000-2,500 gm(-2) day(-1). These dressings possess many characteristics desirable in an ideal wound dressing material. PMID:24599552

Gupta, Bhuvanesh; Agarwal, Roopali; Sarwar Alam, M

2014-06-01

80

Preparation of Silver Nanoparticles Incorporated Electrospun Polyurethane Nano-fibrous Mat for Wound Dressing  

Microsoft Academic Search

Polyurethane foam is currently used as an exudate absorptive wound dressing material. In this study silver (Ag) nanoparticles were incorporated into electrospun polyurethane (PU) nanofiber to enhance the antibacterial as well as wound healing properties. The electrospinning parameters were optimized for PU with and without silver nanoparticles. Silver nanoparticles were synthesized by aqueous and organic methods. The water absorption, antibacterial

Lakshmi R. Lakshman; K. T. Shalumon; Sreeja V. Nair; R. Jayakumar

2010-01-01

81

Dress.com: A CBIR-Based Digital Paper Doll System for Real-Life Dressing  

E-print Network

1 Dress.com: A CBIR-Based Digital Paper Doll System for Real-Life Dressing Chueh-Min CHENG and Chun-Wei LIU Abstract--We present the "Dress.com" system, a digital paper doll system which helps users of traditional paper doll. Note that the images of paper dresses listed on the right are shown as if the dresses

Ouhyoung, Ming

82

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

NASA Astrophysics Data System (ADS)

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.

Varshney, Lalit

2007-02-01

83

Use of a new silver barrier dressing, ALLEVYN Ag in exuding chronic wounds.  

PubMed

Recognising and managing wounds at risk of infection is vital in wound management. ALLEVYN Ag dressings have been designed to manage exudate in chronic wounds that are at risk of infection; are displaying signs of local infection; or where a suspected increase in bacterial colonisation is delaying healing. They combine an absorbent silver sulfadiazine containing hydrocellular foam layer, with a perforated wound contact layer and highly breathable top film. The results presented are from a multi-centre clinical evaluation of 126 patients conducted to assess the performance of ALLEVYN Ag (Adhesive, Non Adhesive and Sacrum dressings) in a range of indications. Clinicians rated the dressings as acceptable for use in various wound types in 88% of patients. The majority of clinical signs of infection reduced between the initial and the final assessment. The condition of wound tissue and surrounding skin was observed to improve, and there was significant evidence of a reduction in the level of exudate from initial to final assessment (p < 0.001). Clinicians rated ALLEVYN Ag as satisfying or exceeding expectations in over 90% of patients. The evaluation showed the dressings to offer real benefits to patients and clinicians across multiple indications when used in conjunction with local protocols. PMID:19538192

Kotz, Paula; Fisher, Jane; McCluskey, Pat; Hartwell, Samantha D; Dharma, Hussein

2009-06-01

84

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

PubMed Central

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

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

2013-01-01

85

Tetracycline Hydrate and Gentamicine Sulfate Containing Carboxymethylated Cotton Fabric Suitable for Moist Wound Healing Dressings: Properties and Evaluation  

Microsoft Academic Search

In order to prepare moist healing wound dressings based on cotton gauze fabrics, the latter are carboxymethylated to carboxyl contents of 72, 170, and 220meq\\/100g. In contrast to the other two samples, the first sample showed no gelling in phosphate buffered saline (PBS) at 37°C. The carboxyl contents of the gelling samples are made in Ca\\/Na forms in 3% degree

M. H. Abo-Shosha; H. M. Fahmy; F. H. Hassan; Adel M. Ashour; A. A. Khalil

2009-01-01

86

Mechanical properties and water vapour permeability of film from Haruan (Channa striatus) and fusidic acid spray for wound dressing and wound healing.  

PubMed

Aerosol is a new dosage form for wound dressing and wound healing. Concentrate of aerosols which were prepared for wound dressing and wound healing will produced films after sprayed onto the surface of wounds. The aim of this study is to evaluate the mechanical and water vapour permeability properties of the films from the aerosol concentrates. Film forming dispersions contained Haruan extract and Fusidic acid as the active ingredients, hydroxypropyl methylcellulose (HPMC) as polymer and polyethylene glycol (PEG) 400, glycerin and propylene glycol as plasticizers. Haruan extract is used to promote healing and Fusidic acid is added in formula as antibiotic to prevent the infections. The films were prepared by using casting technique. Based on the results, it is concluded that films produced from Formula E1, E2 and F4 possessed good elongation at break but low tensile strength. All Formula E, Formula F4 and F5 were permeable but Formula F5 was brittle and would peel off by themselves from the Petri dish. PMID:20363692

Febriyenti; Noor, Azmin Mohd; Bai, Saringat Bin

2010-04-01

87

Dynamics of silver nanoparticle release from wound dressings revealed via in situ nanoscale imaging.  

PubMed

The use of silver nanoparticles (AgNPs) in textiles for enhanced anti-microbial properties has led to concern about their release and impact on both human and environmental health. Here a novel method for in situ visualization of AgNP release from silver-impregnated wound dressings is introduced. By combining an environmental scanning electron microscope, a gaseous analytical detector and a peltier cooling stage, this technique provides near-instantaneous nanoscale characterization of interactions between individual water droplets and AgNPs. We show that dressings with different silver application methods have very distinct AgNP release dynamics. Specifically, water condensation on dressings with AgNP deposited directly on the fiber surface resulted in substantial and rapid AgNP release. By comparison, AgNP release from wound dressing with nanoparticles grown, not deposited, from the fiber surface was either much slower or negligible. Our methodology complements standard bulk techniques for studying of silver release from fabrics by providing dynamic nanoscale information about mechanisms governing AgNP release from individual fibers. Thus coupling these nano and macro-scale methods can provide insight into how the wound dressing fabrication could be engineered to optimize AgNP release for different applications. PMID:25011499

Holbrook, R David; Rykaczewski, Konrad; Staymates, Matthew E

2014-11-01

88

Potential of wound dressing composed of hyaluronic acid containing epidermal growth factor to enhance cytokine production by fibroblasts.  

PubMed

This study aimed to investigate the potential of a wound dressing composed of hyaluronic acid (HA) containing epidermal growth factor (EGF) to enhance cytokine production by fibroblasts. The present wound dressing has a two-layered spongy structure: an upper layer composed of crosslinked high-molecular-weight HA, and a lower layer composed of low-molecular-weight HA containing arginine (Arg) and vitamin C derivative (VC) with or without EGF. Human fibroblast-embedded collagen gel sheet (cultured dermal substitute: CDS) was elevated to the interface between the air and culture medium to create a wound surface model onto which each wound dressing was placed, which was followed by culture for 7 days. The EGF dressing (with EGF, Arg, VC) significantly enhanced the production of vascular endothelial growth factor (VEGF) and hepatocyte growth factor (HGF) by CDS as compared to the EGF-free dressing (with Arg, VC). To evaluate if this enhanced production of VEGF and HGF achieved with the EGF dressing is sustained, a second experiment was conducted using a wound surface model. Each wound dressing was placed on the CDS in the wound surface model. Culture was then performed for 3 days (first period), after which each dressing was placed on another CDS for a further 3-day culture period (second period). The EGF dressing enhanced the production of VEGF and HGF by CDS during the first and second periods as compared to the corresponding production when using the EGF-free dressing. These results suggest that EGF can be maintained in the hydrated layer of a wound dressing composed of crosslinked high-molecular-weight HA. PMID:24013475

Yamamoto, Akiko; Shimizu, Nahoko; Kuroyanagi, Yoshimitsu

2013-12-01

89

Bioactive electrospun silver nanoparticles-containing polyurethane nanofibers as wound dressings.  

PubMed

Nanofibrous membrane (NFM) intended as wound dressing was prepared by electrospinning polyurethane (PU) solution containing silver ion, followed by reduction of silver ion to silver nanoparticles. The electrospun PU membrane has high surface area-to-volume ratio, controlled evaporative water transmission rate, good fluid drainage ability, and excellent antimicrobial activity. With an aim to promote wound healing, collagen was grafted to fiber surface by low temperature oxygen plasma treatment, which could improve surface hydrophilicity and facilitate covalent binding of collagen molecules to the plasma-treated PU surface. A NFM with no bead formation was obtained with fiber diameters around 159 nm. The presence of embedded silver nanoparticles and surface-grafted collagen was confirmed qualitatively and quantitatively. After modification, the NFM's antimicrobial activity improved to approximately 100% inhibition of bacterial growth with concomitant increase of membrane water absorption ability, which facilitates its use as a functional wound dressing. From animal studies, the NFM was better than gauze and commercial collagen sponge wound dressing in wound healing rate. PMID:21137982

Chen, Jyh-Ping; Chiang, Yun

2010-11-01

90

Effect of hydrogel grafting, water and surfactant wetting on the adherence of PET wound dressings.  

PubMed

Traditional wound dressings, including cotton gauze, absorbent pads and bandages, can cause trauma and pain to wounds during dressing changes, leading to a variety of physical and psychosocial sequelae. The aim of this study was to adapt an in vitro model of adherence to evaluate the effects of various methods to theoretically reduce the adherence of wound dressings. Gelatin in liquid form was cast onto poly(ethylene terephthalate) (PET) fabric and allowed to solidify and progressively dry to simulate wound desiccation in the clinical setting. A 180° peel test of PET from the gelatin slab yielded adherence data of peeling energy. The peeling energy of PET increased with the drying time. It was possible to reduce the force by drying at 75% relative humidity (RH). After drying for 24h, either 500?L of water or surfactant solution was added onto the PET surface (16×60mm(2)). The peeling energy decreased dramatically with wetting and there was no significant difference between water and surfactant. As a long-term strategy for decreasing adherence, a thin layer of polyacrylamide (PAM) hydrogel was deposited onto PET fabric via UV irradiation. This resulted in a much lower peeling energy without severely compromising fabric flexibility. This hydrogel layer could also serve as a reservoir for bioactive and antimicrobial agents which could be sustainably released to create a microbe-free microenvironment for optimized wound healing. PMID:24485358

Ning, Chenxi Coco; Logsetty, Sarvesh; Ghughare, Shivkumar; Liu, Song

2014-09-01

91

Active and passive distraction in children undergoing wound dressings.  

PubMed

The aim of this study was to test how distraction influences pain, distress and anxiety in children during wound care. Sixty participants aged 5-12 years were randomized to three groups: serious gaming, the use of lollipops and a control group. Self-reported pain, distress, anxiety and observed pain behaviour were recorded in conjunction with wound care. Serious gaming, an active distraction, reduced the observed pain behaviour and self-reported distress compared with the other groups. A sense of control and engagement in the distraction, together, may be the explanation for the different pain behaviours when children use serious gaming. PMID:22819747

Nilsson, Stefan; Enskär, Karin; Hallqvist, Carina; Kokinsky, Eva

2013-04-01

92

Beauveria bassiana (Ascomycota: Hypocreales) wound dressing for the control of Euzophera pinguis (Lepidoptera: Pyralidae).  

PubMed

Injury to olive tree trunks and branches because of biotic and abiotic factors, such as pruning and mechanical harvesting, attracts the olive pyralid moth Euzophera pinguis Haworth (Lepidoptera: Pyralidae). This moth has become increasingly important in the Mediterranean region during recent years. The use of an entomopathogenic fungus for wound dressing for pest control is reported for the first time in this study. Beauveria bassiana (Ascomycota: Hypocreales) strain EABb 08/04-Ep was originally obtained from a diseased E. pinguis larva and has shown effective E. pinguis control in an olive crop in Jaén, Andalusia, Spain, under field conditions during the spring and fall of 2008 and 2009 and the spring of 2011. Experimental artificial 30 by 30-mm square wound cages were large enough to allow the E. pinguis females to oviposit. Approximately 80 and 40-60% of the control wounds contained live larvae in the experiments that occurred during the spring and fall, respectively. The B. hassiana wound dressing gave similar results as the chlorpyrifos wound dressing throughout the experiment, with efficacies reaching 80-85% in the spring and 90-95% in the autumn. The B. bassiana fungus was recovered from 60-90% of the wounds at the completion of the experiments and after 60 d of treatment. These data indicate that strain EABb 08/04-Ep applied to the pruning wounds can be an effective tool for the microbial control of E. pinguis in olive crops. Moreover, B. bassiana may be used within integrated pest management strategies to minimize chemicals, depending on the population density of the pyralid moth. PMID:24020271

Quesada-Moraga, E; Yousef, M; Ortiz, A; Ruíz-Torres, M; Garrido-Jurado, I; Estévez, A

2013-08-01

93

Impregnation of silver sulfadiazine into bacterial cellulose for antimicrobial and biocompatible wound dressing.  

PubMed

Silver sulfadiazine (SSD) is a useful antimicrobial agent for wound treatment. However, recent findings indicate that conventional SSD cream has several drawbacks for use in treatments. Bacterial cellulose (BC) is a promising material for wound dressing due to its outstanding properties of holding water, strength and degradability. Unfortunately, BC itself exhibits no antimicrobial activity. A combination of SSD and BC is envisaged to form a new class of wound dressing with both antimicrobial activity and biocompatibility, which has not been reported to date. To achieve antimicrobial activity, SSD particles were impregnated into BC by immersing BC into SSD suspension after ultrasonication, namely SSD-BC. Parameters influencing SSD-BC impregnation were systematically studied. Optimized conditions of sonication time for no less than 90 min and the proper pH value between 6.6 and 9.0 were suggested. The absorption of SSD onto the BC nanofibrous network was revealed by XRD and SEM analyses. The SSD-BC membranes exhibited significant antimicrobial activities against Pseudomonas aeruginosa, Escherichia coli and Staphylococcus aureus evaluated by the disc diffusion method. In addition, the favorable biocompatibility of SSD-BC was verified by MTT colorimetry, epidermal cell counting method and optical microscopy. The results demonstrate the potential of SSD-BC membranes as a new class of antimicrobial and biocompatible wound dressing. PMID:23182757

Luan, Jiabin; Wu, Jian; Zheng, Yudong; Song, Wenhui; Wang, Guojie; Guo, Jia; Ding, Xun

2012-12-01

94

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

Code of Federal Regulations, 2011 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4015 Wound dressing with poly (diallyl dimethyl ammonium chloride)...

2011-04-01

95

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

Code of Federal Regulations, 2013 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4015 Wound dressing with poly (diallyl dimethyl ammonium chloride)...

2013-04-01

96

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

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4015 Wound dressing with poly (diallyl dimethyl ammonium chloride)...

2014-04-01

97

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

Code of Federal Regulations, 2012 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4015 Wound dressing with poly (diallyl dimethyl ammonium chloride)...

2012-04-01

98

Silver-doped self-assembling di-phenylalanine hydrogels as wound dressing biomaterials.  

PubMed

Chronic and acute wounds can be quickly contaminated and infected by microorganisms such as bacteria, multi-resistant organisms or fungi. The introduction of silver as anti-microbial agent into wound management has widely been demonstrated to be effective and contribute to wound healing. As a consequence, many approaches and different materials have been employed to synthesize antibacterial silver-hydrogels. In this work the introduction of silver particles into the fibrillar structure of self-assembling aromatic di-phenylalanine derivatives modified with aromatic groups such as 9-fluorenylmethoxycarbonyl is proposed to produce antibacterial wound dressings. Hydrogels doped with increasing amounts of silver were tested and adopted to modify flax textiles. The influence of silver on the structure of hydrogels was studied using light and confocal microscopy, while SEM-EDX allowed the characterization of the hydrogel coating on the surface of the textile substrates as well as the identification and distribution of silver nanoparticles. The antibacterial potential of the treated flax was demonstrated through microbiological tests on Staphylococcus aureus. The combination of the physico-chemical and anti-bacterial properties, together with the ease of preparation of these biomaterials, fulfils the requirement of clinically-effective wound dressings. PMID:23793492

Paladini, Federica; Meikle, S T; Cooper, I R; Lacey, J; Perugini, V; Santin, M

2013-10-01

99

Preparation of a silk fibroin spongy wound dressing and its therapeutic efficiency in skin defects.  

PubMed

A novel silk fibroin spongy wound dressing (SFSD) incorporated with nano-Ag particles was prepared by coagulating with 1.25-5.0% (v/v) poly(ethylene glycol diglycidyl ether) (PGDE). The mechanical properties, moisture permeability and hygroscopicity of SFSD, and the nano-Ag release behavior from SFSD were evaluated. The results showed that the soft SFSD had satisfying tensile strength and flexibility, as well as excellent moisture permeability and absorption capability of wound exudates. The moisture permeability was 101 g/m(2) per h and the water absorption capacity of SFSD was 595.2% and 251.9% of its own weight in dry and wet states, respectively. The nano-Ag in the SFSD was released continuously at a relatively stable rate in PBS resulting in a remarkable antibacterial property. A rabbit model was used to dynamically observe the healing process of full-thickness skin defects. Full-thickness wounds were created on the dorsal side of rabbits, which were covered with SFSD and porcine acellular dermal matrix (PADM) for comparison. The mean healing time of the wounds covered with SFSD was 17.7 ± 2.4 days, significantly shorter than that with PADM. The histological analysis showed that the epidermal cell layer formed with SFSD was very similar to normal skin, suggesting that SFSD may provide a good component for the development of new wound dressings. PMID:21176393

Min, Sijia; Gao, Xin; Han, Chunmao; Chen, Yu; Yang, Mingying; Zhu, Liangjun; Zhang, Haiping; Liu, Lin; Yao, Juming

2012-01-01

100

Commonly used topical oral wound dressing materials in dental and surgical practice--a literature review.  

PubMed

A small number of medicaments are used in oral and maxillofacial surgery to dress wounds, relieve pain, prevent infection and promote healing. While these materials are routinely used, their constituents, uses and effects on oral tissues are rarely discussed. This literature review provides an overview of the constituents, uses and effects of the common materials--oxidised regenerated cellulose, Whitehead's varnish, Carnoy's solution, bismuth iodoform paraffin paste (BIPP), zinc oxide eugenol (ZOE) and Alvogyl. PMID:24156211

Freedman, Michael; Stassen, Leo F A

2013-01-01

101

Electrospun in-situ hybrid polyurethane\\/nano-TiO 2 as wound dressings  

Microsoft Academic Search

By combining the organic-inorganic hybridization, wet phase inversion, and electrospinning, novel electrospun polyurethane\\u000a (PU) membranes with in-situ generated nano-TiO2 were prepared, which satisfied the requirements of an ideal wound dressing. The morphology of the PU-TiO2 mats and the cross sectional morphologies of the membranes were characterized by a scanning electron microscopy (SEM). The\\u000a average diameter of the individual fibers obtained

Lidan Yan; Shaoxiong Si; Yi Chen; Tun Yuan; Haojun Fan; Yongyi Yao; Qiyi Zhang

2011-01-01

102

Antibacterial Efficacy of Silver-Impregnated Polyelectrolyte Multilayers Immobilized on a Biological Dressing in a Murine Wound Infection Model  

PubMed Central

Objective To investigate the antibacterial effect of augmenting a biological dressing with polymer films containing silver nanoparticles. Background Biological dressings, such as Biobrane, are commonly used for treating partial-thickness wounds and burn injuries. Biological dressings have several advantages over traditional wound dressings. However, as many as 19% of wounds treated with Biobrane become infected, and, once infected, the Biobrane must be removed and a traditional dressing approach should be employed. Silver is a commonly used antimicrobial in wound care products, but current technology uses cytotoxic concentrations of silver in these dressings. We have developed a novel and facile technology that allows immobilization of bioactive molecules on the surfaces of soft materials, demonstrated here by augmentation of Biobrane with nanoparticulate silver. Surfaces modified with nanometer-thick polyelectrolyte multilayers (PEMs) impregnated with silver nanoparticles have been shown previously to result in in vitro antibacterial activity against Staphylococcus epidermidis at loadings of silver that are noncytotoxic. Methods We demonstrated that silver-impregnated PEMs can be nondestructively immobilized onto the surface of Biobrane (Biobrane-Ag) and determined the in vitro antibacterial activity of Biobrane-Ag with Staphylococcus aureus. In this study, we used an in vivo wound infection model in mice induced by topical inoculation of S aureus onto full-thickness 6-mm diameter wounds. After 72 hours, bacterial quantification was performed. Results Wounds treated with Biobrane-Ag had significantly (P < 0.001) fewer colony-forming units than wounds treated with unmodified Biobrane (more than 4 log10 difference). Conclusions The results of our study indicate that immobilizing silver-impregnated PEMs on the wound-contact surface of Biobrane significantly reduces bacterial bioburden in full-thickness murine skin wounds. Further research will investigate whether this construct can be considered for human use. PMID:22609841

Guthrie, Kathleen M.; Agarwal, Ankit; Tackes, Dana S.; Johnson, Kevin W.; Abbott, Nicholas L.; Murphy, Christopher J.; Czuprynski, Charles J.; Kierski, Patricia R.; Schurr, Michael J.; McAnulty, Jonathan F.

2012-01-01

103

Wound Healing and Nutrition: Going Beyond Dressings With a Balanced Care Plan  

PubMed Central

As the largest organ of the body, the human skin protects all subcutaneous tissues. Despite its many attributes, the skin is vulnerable to pressure ulcers. The number of pressure ulcers and venous leg ulcers is on the rise, but healing rates have not improved over the past decade. The reason may be a tendency to focus on one or two fundamentals of wound healing, but not on all 3 fundamentals equally. The 3 fundamentals of wound healing are (1) pressure relief and nursing care, (2) dressings, and (3) nutrition. Nutrition is the area that is most often overlooked, which commonly causes the care plan to be out of balance. In the United States, few clinicians would consider malnutrition to be an issue in the homecare and long-term care setting, yet nutritional status and risk for pressure ulcer formation are well documented and strongly correlated. Our aging population will continue to survive previously catastrophic events, only to present with pressure ulcers or the potential for developing pressure ulcers. Clinicians caring for residents with pressure ulcers must strike a balance between pressure relief, dressings, and nutrition. Functional gastrointestinal-tract impairments must be diagnosed and addressed. Wounds must be treated aggressively with high-protein calorically-balanced diets because wounds heal from the inside out. PMID:24527147

Gruen, Douglas

2010-01-01

104

Synthesis and evaluation of novel absorptive and antibacterial polyurethane membranes as wound dressing.  

PubMed

Preparation and evaluation of new polyurethane membranes for wound dressing application was considered in this work. The membranes were prepared through amine curing reaction of epoxy-terminated polyurethane prepolymers and an antibacterial epoxy-functional quaternary ammonium compound (glycidyltriehtylammonium chloride, GTEACl. To render the prepared membranes to be highly absorptive of wound exudates, poly (ethylene glycol) polyols were introduced into the polyurethane networks. Evaluation of biocompatibity via both MTT assay and direct contact with two different cell lines (fibroblast and epidermal keratinocytes) reveled that membranes with appropriate loading of GTEACl showed proper biocompatibility. Promising antibacterial activity of the prepared membranes against Staphylococcus aureus and Escherichia coli bacteria was confirmed by both agar diffusion and shaking flask methods. The membranes with balanced crosslink density and ionic groups' concentration possessed appropriate hydrophilicity and water vapor transmission rate; therefore, they could prevent the accumulation of exudates and decrease the surface inflammation in the wounded area. PMID:22639152

Yari, Abbas; Yeganeh, Hamid; Bakhshi, Hadi

2012-09-01

105

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

PubMed

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. PMID:24360348

Levy, Matthew J; Tang, Nelson

2014-02-01

106

Study on hydrophilic properties of gelatin as a clinical wound dressing. I. Hydrophilic properties of gelatin as a wound dressing.  

PubMed

A basic study on hydrophilicity of gelatin was made of the fitness, water-absorbing ability, water-holding ability, affinity and stability of included water in order to utilize it as a protective covering for medical use. Gelatin No. 3, being highly viscous and having a lower jelly strength, was strongly viscous and flexible, and thus, it stuck close to the surface of a lesioned site such as a wound or a burn. Since the melting point of a gelatin containing 50% water was in the range of 43 to 45 degrees C, the gelatin will be fully used as a protective covering for a wound. Below 20% relative humidity, water molecules were bound to the polar amino acid side chains of gelatin and the bound water caused a swelling of the gelatin, which is maintained by capillary sorption of water into its collagen-like four-dimensional structure. The amount of water sorbed at a relative humidity of 80% at 11 degrees C was higher by 50 to 80 mg/g compared to that at 37 degrees C. Gelatin No. 3 had a very high water-holding ability and it was very hard for it to release the sorbed water at a relative humidity of 80 to 90%. Water molecules were bound to the strong active sites of the gelatin at low relative humidity. The gelatin swelled and then, newly active sites appeared on the surface of the gelatin. The hydrophilic activity decreased with an increase in moisture content, whereas the stability of water molecules in the gelatin increased.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8184412

Takahashi, H; Miyoshi, T; Boki, K

1993-12-01

107

Radiation synthesis of PVP/alginate hydrogel containing nanosilver as wound dressing.  

PubMed

Hydrogels with polyvinyl pyrrolidone (PVP) and alginate were synthesized and silver nanoparticles were incorporated in hydrogel network using gamma radiation. PVP (10 and 15 %) in combination with 0.5 and 1 % alginate was gamma irradiated at different doses of 25 and 40 kGy. Maximum gel percent was obtained with 15 % PVP in combination with 0.5 % alginate. The fluid absorption capacity for the PVP/alginate hydrogels was about 1881-2361 % at 24 h. Moisture vapour transmission rate (MVTR) of hydrogels containing nanosilver at 24 h was 278.44 g/(m(2)h). The absorption capacity and moisture permeability of the PVP/alginate-nanosilver composite hydrogel dressings show the ability of the hydrogels to prevent fluid accumulation in exudating wound. The hydrogels containing nanosilver demonstrated strong antimicrobial effect and complete inhibition of microbial growth was observed with 70 ppm nanosilver dressings. PVP/alginate hydrogels containing nanosilver with efficient fluid handling capacity and antimicrobial activity was found suitable for use as wound dressing. PMID:22886579

Singh, Rita; Singh, Durgeshwer

2012-11-01

108

Suction assisted pulse lavage: randomised controlled studies comparing its efficacy with conventional dressings in healing of chronic wounds.  

PubMed

Chronic, open, non-healing wounds pose a continual challenge in medicine as the treatment is variable and there are no documented consistent responses. Although wound aetiologies vary and there are a number of factors that affect chronic wound pathogenesis, wound ischaemia and bacterial colonisation of wounds are the chief concerns among them. Conventionally, pulse lavage has been used primarily as a wound debriding device. To address both the critical factors of wound ischaemia and bacterial burden, a couple of technical points were proposed and applied in this study. The objective of our study was to evaluate pulse lavage therapy's ability to improve the healing rate of chronic wounds compared to that of the traditional saline-wet-to-moist dressings. The study period was from 1 August 2010 to 31 January 2012 and was conducted in our institution. Thirty patients with 31 chronic, non-healing wounds were enrolled in the study after obtaining proper consent. Subjects were randomised (15 patients each) to the pulse lavage group and the control group. Patients in the test group were subjected to irrigation of their wounds with pulsed lavage at 10 to 15 psi pressure. In the control group, wound was closed by applying moist betadine saline gauze dressings after cleaning with saline. Wounds treated with pulse lavage system significantly reduced in size, had better control of bacterial contamination and had overall faster healing rates. Efficacy of pulse lavage can be increased by correct method of administration of the irrigant. PMID:22943586

Shetty, Rahul; Barreto, Elvino; Paul, Kingsly M

2014-02-01

109

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

NASA Astrophysics Data System (ADS)

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.

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

1993-10-01

110

Wound closure after split-thickness skin grafting is accelerated with the use of continuous direct anodal microcurrent applied to silver nylon wound contact dressings.  

PubMed

Wound healing after graft closure of excised burn wounds is a critical factor in the recovery process after thermal injury. Processes that speed time to stable wound closure should lead to improved outcomes, shorter lengths of hospital stays, and decreased complications. A randomized clinical trial to test the ability of continuous direct anodal microcurrent application to silver nylon wound contact dressings was designed. Time for wound closure after split-thickness skin grafting was observed. Thirty patients with full-thickness thermal burns were randomized into two groups. The control group received postoperative dressing care using moistened silver nylon fabric covered with gauze after tangential burn wound excision and split-thickness skin grafting. The study group received an identical protocol with the addition of continuous direct anodal microcurrent application. Time to 95% wound closure was measured using digital photography. The digital photographs were evaluated by a burn surgeon blinded to the patient's randomization. An independent t-test was used to analyze the data. The study group experienced a 36% reduction in time to wound closure (mean of 4.6 days) as compared to the control group (mean of 7.2 days). This was statistically significant at a P value of <.05. The use of continuous direct anodal microcurrent decreased time to wound closure after split-thickness skin grafting. PMID:17667128

Huckfeldt, Roger; Flick, A Bart; Mikkelson, Debbie; Lowe, Cindy; Finley, Phillip J

2007-01-01

111

Novel copper (II) alginate hydrogels and their potential for use as anti-bacterial wound dressings.  

PubMed

The incorporation of a metal ion, with antimicrobial activity, into an alginate dressing is an attractive approach to minimize infection in a wound. In this work, copper (II) cross-linked alginate hydrogels were successfully prepared using a two-step cross-linking procedure. In the first step, solid alginate films were prepared using a solvent-casting method from soft gels of alginate solutions that had been lightly cross-linked using a copper (II) (Cu(2+)) sulfate solution. In the second step, the films were further cross-linked in a corresponding Cu(2+) sulfate solution using a dipping method to further improve their dimensional stability. Alginate solution (at 2%w/v) and Cu(2+) sulfate solution (at 2%w/v) in acetate buffer at a low pH provided soft films with excellent swelling behavior. An increase in either Cu(2+) ion concentration or cross-linking time led to hydrogels with more densely-cross-linked networks that limited water absorption. The hydrogels clearly showed antibacterial activity against Escherichia coli, Staphylococcus aureus, methicillin-resistant Staphylococcus aureus (MRSA), Staphylococcus epidermidis and Streptococcus pyogenes, which was proportional to the Cu(2+) ion concentration. Blood coagulation studies showed that the tested copper (II) cross-linked alginate hydrogels had a tendency to coagulate fibrin, and possibly had an effect on pro-thrombotic coagulation and platelet activation. Conclusively, the prepared films are likely candidates as antibacterial wound dressings. PMID:25029588

Klinkajon, Wimonwan; Supaphol, Pitt

2014-08-01

112

Modern wound care for the poor: a randomized clinical trial comparing the vacuum system with conventional saline-soaked gauze dressings  

Microsoft Academic Search

BackgroundA clinical randomized trial was performed to determine whether a simple homemade wound vacuum-dressing system (HM-VAC) is a feasible alternative to the use of conventional saline-soaked gauze dressings (WET) for the treatment of complex wounds in a resource-poor hospital.

Daniel Perez; Matthias Bramkamp; Chauvet Exe; Christian von Ruden; Anna Ziegler

2010-01-01

113

Efficacy of silver-loaded nanofiber dressings in Candida albicans-contaminated full-skin thickness rat burn wounds.  

PubMed

In this experimental study, the effects of nanofiber dressings containing different forms of silver on full-thickness rat burn contaminated with Candida albicans was analyzed. A full-thickness skin burn was formed on a total of 32 Sprague-Dawley rats. After the burn wound was seeded with a 10 colony-forming units/ml standard strain of Candida albicans ATCC90028, the animals were divided into four groups. The effects of topical silver sulfadiazine and two recently designed nanofiber dressings containing nanosilver and silversulfadiazine as active materials were compared with the control group. There was a significant difference in the Candida growth on the burn eschar tissue among the groups. The difference for Candida growth in the burn eschar between the control group and the 1% silver sulfadiazine-containing nanofiber dressing group was statistically significant (P< 0.01). Silver sulfadiazine-containing nanofiber dressing was the most effective agent in the treatment of Candida albicans-contaminated burn wounds. Because of their regenerative potential, silver-loaded nanofiber dressings could be a good alternative for infected burn wounds. PMID:25118002

Ciloglu, N Sinem; Mert, A Irem; Do?an, Zarife; Demir, Ali; Cevan, Simin; Aksaray, Sebahat; Tercan, Mustafa

2014-01-01

114

Irradiation of poly (vinyl alcohol) and poly (vinyl pyrrolidone) blended hydrogel for wound dressing  

E-print Network

Poly (vinyl alcohol) and poly (vinyl pyrrolidone) (PVA-PVP) blended hydrogel for wound dressing has been prepared by using gamma rays irradiation technique. The gel fraction, mechanical properties, the water content and water absorption performance of the hydrogels were measured. It was found that the gel fraction increases with increasing irradiation dose but never reaches 100% of gel. The PVA/PVP blended hydrogel has a water content in the range between 60% and 80% and water absorption between 40% and 250%. The water vapor transmission rate value (WVTR) of the PVA/PVP blended hydrogel varies between 50 and 200 g/m sup 2 /h. The hydrogel could be considered as good barrier against microbes. According to in vitro assessment it was found that the PVA/PVP blended hydrogel was very useful material that can meet the efficacy requirement and its healing rate was comparable with sterilized gauze and sofratulle.

Razzak, M T; Sukirno; Zainuddin, H

1996-01-01

115

2,3-Dihydroxybenzoic Acid-Containing Nanofiber Wound Dressings Inhibit Biofilm Formation by Pseudomonas aeruginosa  

PubMed Central

Pseudomonas aeruginosa forms biofilms in wounds, which often leads to chronic infections that are difficult to treat with antibiotics. Free iron enhances biofilm formation, delays wound healing, and may even be responsible for persistent inflammation, increased connective tissue destruction, and lipid peroxidation. Exposure of P. aeruginosa Xen 5 to the iron chelator 2,3-dihydroxybenzoic acid (DHBA), electrospun into a nanofiber blend of poly(d,l-lactide) (PDLLA) and poly(ethylene oxide) (PEO), referred to as DF, for 8 h decreased biofilm formation by approximately 75%. This was shown by a drastic decline in cell numbers, from 7.1 log10 CFU/ml to 4.8 log10 CFU/ml when biofilms were exposed to DF in the presence of 2.0 mM FeCl3 6H2O. A similar decline in cell numbers was recorded in the presence of 3.0 mM FeCl3 6H2O and DF. The cells were more mobile in the presence of DHBA, supporting the observation of less biofilm formation at lower iron concentrations. DHBA at MIC levels (1.5 mg/ml) inhibited the growth of strain Xen 5 for at least 24 h. Our findings indicate that DHBA electrospun into nanofibers inhibits cell growth for at least 4 h, which is equivalent to the time required for all DHBA to diffuse from DF. This is the first indication that DF can be developed into a wound dressing to treat topical infections caused by P. aeruginosa. PMID:24449781

Ahire, Jayesh J.

2014-01-01

116

Dual-functional Polyurea Microcapsules for Chronic Wound Care Dressings: Sustained Drug Delivery and Non-leaching Infection Control  

NASA Astrophysics Data System (ADS)

A new design of dual-functional polyurea microcapsules was proposed for chronic wound dressings to provide both non-leaching infection control and sustained topical drug delivery functionalities. Quaternary ammonium functionalized polyurea microcapsules (MCQs) were synthesized under mild conditions through an interfacial crosslinking reaction between branched polyethylenimine (PEI) and 2,4-toluene diisocyanate (TDI) in a dimethylformamide/cyclohexane emulsion. An in-situ modification method was developed to endow non-leaching surface antimicrobial properties to MCQs via bonding antimicrobial surfactants to surface isocyanate residues on the polyurea shells. The resultant robust MCQs with both non-leaching antimicrobial properties and sustained drug releasing properties have potential applications in medical textiles, such as chronic wound dressings, for infection control and drug delivery.

He, Wei

117

Cytotoxicity of silver dressings on diabetic fibroblasts.  

PubMed

A large number of silver-based dressings are commonly used in the management of chronic wounds that are at risk of infection, including diabetic foot ulcers. However, there are still controversies regarding the toxicity of silver dressings on wound healing. The purpose of this study was to objectively test the cytotoxicity of silver dressings on human diabetic fibroblasts. Human diabetic fibroblasts were obtained from the foot skin of four diabetic foot ulcer patients and cultured. The effect of five silver-containing dressing products (Aquacel Ag, Acticoat*Absorbent, Medifoam Ag, Biatain Ag and PolyMem Ag) and their comparable silver-free dressing products on morphology, proliferation and collagen synthesis of the cultured human diabetic fibroblasts were compared in vitro. In addition, extracts of each dressing were tested in order to examine the effect of other chemical components found in the dressings on cytotoxicity. The diabetic fibroblasts cultured with each silver-free dressing adopted the typical dendritic and fusiform shape. On the other hand, the diabetic fibroblasts did not adopt this typical morphology when treated with the different silver dressings. All silver dressings tested in the study reduced the viability of the diabetic fibroblasts and collagen synthesis by 54-70 and 48-68%, respectively, when compared to silver-free dressings. Silver dressings significantly changed the cell morphology and decreased cell proliferation and collagen synthesis of diabetic fibroblasts. Therefore, silver dressings should be used with caution when treating diabetic wounds. PMID:22533495

Zou, Shi-Bo; Yoon, Won-Young; Han, Seung-Kyu; Jeong, Seong-Ho; Cui, Zheng-Jun; Kim, Woo-Kyung

2013-06-01

118

Sericin-carboxymethyl cellulose porous matrices as cellular wound dressing material.  

PubMed

In this study, porous three-dimensional (3D) hydrogel matrices are fabricated composed of silk cocoon protein sericin of non-mulberry silkworm Antheraea mylitta and carboxymethyl cellulose. The matrices are prepared via freeze-drying technique followed by dual cross-linking with glutaraldehyde and aluminum chloride. The microstructure of the hydrogel matrices is assessed using scanning electron microscopy and biophysical characterization are carried out using Fourier transform infrared spectroscopy and X-ray diffraction. The transforming growth factor ?1 release from the cross-linked matrices as a growth factor is evaluated by immunosorbent assay. Live dead assay and 3-[4,5-dimethylthiazolyl-2]-2,5-diphenyl tetrazolium bromide assay show no cytotoxicity of blended matrices toward human keratinocytes. The matrices support the cell attachment and proliferation of human keratinocytes as observed through scanning electron microscope and confocal images. Gelatin zymography demonstrates the low levels of matrix metalloproteinase 2 (MMP-2) and insignificant amount of MMP-9 in the culture media of cell seeded matrices. Low inflammatory response of the matrices is indicated through tumor necrosis factor alpha release assay. The results indicate that the fabricated matrices constitute 3D cell-interactive environment for tissue engineering applications and its potential use as a future cellular biological wound dressing material. PMID:23853114

Nayak, Sunita; Kundu, S C

2014-06-01

119

Antimicrobial wound dressing and anti-inflammatory efficacy of silver nanoparticles.  

PubMed

Powdered silver nanoparticles (AgNPs) were successfully prepared through addition of AgNO3 to alkali dissolved starch followed by precipitation with ethanol. AgNPs aqueous suspensions were prepared from powder AgNPs by dispersion and dilution with water. Wound dressings were obtained by treating cotton fabrics with different concentrations of AgNPs aqueous suspensions (60, 125 and 250 ppm). The as prepared AgNPs were characterized using UV-vis spectroscopy, transmission electron microscopy (TEM), particle size analyzer, polydispersity index (PdI), zeta potential. The prepared AgNPs powder had particle size value (22 nm), polydispersity index (0.163) and zeta potential (-28 mV) indicating the formed AgNPs had small and well stabilized particles. The treated cotton fabrics were characterized by making use of SEM-EDX. Cotton fabrics containing 250 ppm AgNPs were more effective against different species of organisms than those containing 60 and 125 ppm. The results of potent healing using fabrics treated with 250 ppm AgNPs indicate that it leads to similar results compared with that of the Dermazin cream. Moreover, the anti-inflammatory effect AgNPs is nearly similar to 20 ml dose of the reference indomethacin drug. PMID:24530328

Hebeish, A; El-Rafie, M H; El-Sheikh, M A; Seleem, Amany A; El-Naggar, Mehrez E

2014-04-01

120

A prospective, open-label study to assess the clinical performance of a foam dressing in the management of chronic wounds.  

PubMed

Polyurethane foam dressings are used to help absorb wound exudate while maintaining a moist wound environment. To assess the clinical performance of a foam dressing, a prospective, open-label evaluation of 57 outpatients (mean age 69 years) with delayed/non-healing wounds (one per patient, average duration 1.4 +/- 4.1 years) of different etiologies was conducted in 15 medical centers in Germany. Physicians assessed the clinical appearance of the wound bed, periwound skin, and exudate level at the beginning and final evaluation and dressing performance characteristics were rated. Patients were asked to assess their wound pain as none, mild, moderate, or strong. After three dressing changes (performed approximately 3 days apart), slough and necrotic tissue on the wound surface changed from an average of 54% (+/- 33%) to 29% (+/- 25%). At baseline, granulation tissue covered an average of 41% (+/- 31%) of the wound bed compared to 59% (+/- 24%) at the final assessment and the proportion of wounds assessed as heavily exudating decreased from 32% to 11%. During the evaluation, the proportion of patients without periwound skin problems increased from 49% to 66% and the percentage of patients with wound pain decreased from 45% to 26%. Between 80% and 90% of the participating physicians rated the product attributes assessed as "very good" or "good." PMID:16687768

Zoellner, Petra; Kapp, Holger; Smola, Hans

2006-05-01

121

Comparison of vacuum and conventional wound dressings for full thickness skin grafts in the minipig model  

Microsoft Academic Search

The aim of this study was to compare vacuum and conventional dressings and to follow revascularization with laser-Doppler spectroscopy and histological evaluations. In six minipigs, full thickness skin grafts were harvested on both sides of the back and transplanted to the contralateral site. One site was covered with a classical cotton dressing, the other with a vacuum dressing. For 10

S. T. Becker; H.-O. Rennekampff; I. Alkatout; J. Wiltfang; H. Terheyden

2010-01-01

122

Advantages of collagen based biological dressings in the management of superficial and superficial partial thickness burns in children.  

PubMed

Collagen based dressings for acute burn wound management have been extensively used in India, particularly in the city of Chennai. Due to the high levels of humidity in our city, closed dressings become infected and treatment with topical antimicrobials, like Silver Sulfadiazine cream, quickly become desiccated. Collagen membrane dressings were manufactured by the biomaterial laboratory of the Central Leather Research Institute (CLRI), Government of India in Chennai, and then the process was patented. Collagen was extracted from bovine skin and Achilles tendons, and then reconstituted. This was used on burn wounds as dressings after clearance from the Institutional Review Board and Ethics Committees of the Hospital and CLRI. Continued research in this field to enable resulted in the design of silver sulphadiazine loaded alginate microspheres which were embedded in the reconstituted collagen. Controlled delivery of silver sulphadiazine. This collagen membrane was used in chronic infected burns. Low molecular weight heparin was given subcutaneously to improve wound healing in burn injuries and collagen membrane dressings were also applied. After several trials the process technology was patented. The advantages and disadvantages of the collagen membrane cover is elaborated in a group of 487 pediatric burn patients. The trial was conducted at the burn unit of Kanchi Kamakoti Childs Trust Hospital (KKCTH) in Chennai, India. PMID:24133405

Mathangi Ramakrishnan, K; Babu, M; Mathivanan; Jayaraman, V; Shankar, J

2013-06-30

123

Effect of chitosan-gluconic acid conjugate/poly(vinyl alcohol) cryogels as wound dressing on partial-thickness wounds in diabetic rats.  

PubMed

We previously developed chitosan cryogels from chitosan-gluconic acid conjugate without using toxic additives for wound care. In this study, we improved physiological characteristics of the previous cryogels by incorporating poly(vinyl alcohol) that also form cryogels. Mechanical strength of the cryogels was more than two times higher than that of the previous cryogels. Furthermore, the incorporation of poly(vinyl alcohol) enhanced water retention and resistance to degradation of the gels by lysozyme. The cryogels retained the favorable biological properties of the previous cryogels that they accelerate infiltration of inflammatory cells into wound sites. Time period for repairing 50 % of initial area of partial-thickness skin wound treated with the cryogels (4.0 ± 1.1 days) was shorter than those with gauze (6.5 ± 0.3 days) or a commercial hydrogel dressing (5.7 ± 0.3 days). Finally, we confirmed that incorporation of basic fibroblast growth factor into the cryogels was effective to further accelerate wound healing (2.7 ± 1.0 days). These results demonstrate that the cryogels in this study are promising for wound care. PMID:23801501

Takei, Takayuki; Nakahara, Hideki; Tanaka, Sadao; Nishimata, Hiroto; Yoshida, Masahiro; Kawakami, Koei

2013-10-01

124

Evaluation of Human Amniotic Membrane as a Wound Dressing for Split-Thickness Skin-Graft Donor Sites  

PubMed Central

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 (?SMA: 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. PMID:25003117

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

125

Negative pressure wound therapy with Bio-Dome dressing technology in the treatment of complex wounds: a case series.  

PubMed

The treatment of complex wounds is difficult and not always effective. Various treatment options are used with varying degrees of success. Negative pressure wound therapy (NPWT) is a cost-efficient and effective way to help treat these wounds. The use of a vacuum device applies the negative pressure to the site of the wound and promotes waste removal and increases circulation and tissue formation. While various NPWT systems are currently on the market, we utilised the ConvaTec Engenex® system with Bio-DomeTM technology; however, our case study is not intended to advocate the specific use of this system, but instead focuses on the use of NPWT as a viable option for wound healing. Each of the following case study patients presented with difficult-to-heal wounds that failed traditional therapeutic approaches. Through the use of NPWT, our patients saw major wound size reductions. Each patient exhibited at least a 94% reduction in wound area, wound volume or both. PMID:24762555

Penny, H L; Spinazzola, J; Green, A; Rifkah, M; Faretta, M; Youshaw, D; Weaver, A; Zaki, P

2014-04-01

126

In situ forming antibacterial dextran blend hydrogel for wound dressing: SAA technology vs. spray drying.  

PubMed

This study focuses on designing microparticulate carriers based on high-mannuronic alginate and amidated pectin blend loaded with gentamicin sulphate able to move rapidly from dry to soft hydrogel. Supercritical assisted atomization was used to produce microparticles in form of dry powder and characteristics were compared with those obtained by spray-drying. Particles with very high encapsulation efficiency (approximately 100%) and small diameter (less than 2 ?m) showed good flowability and high fluid uptake enabling wound site filling and limiting bacterial proliferation. Moisture transmission of the in situ formed hydrogel was about 95 g/m(2)h, ideal to avoid wound dehydration or occlusion phenomena. All formulations presented a burst effect, suitable to prevent infection spreading at the beginning of the therapy, followed by prolonged release (4-10 days) related to drug/polymers ratio. Antimicrobial tests showed stronger effect than pure GS over time (up-to 24 days) and the ability to degrade preformed biofilms, essential to properly treat infected wounds. PMID:24299894

De Cicco, Felicetta; Reverchon, Ernesto; Adami, Renata; Auriemma, Giulia; Russo, Paola; Calabrese, Elena C; Porta, Amalia; Aquino, Rita P; Del Gaudio, Pasquale

2014-01-30

127

Biocompatibility Evaluation of a New Hydrogel Dressing Based on Polyvinylpyrrolidone/Polyethylene Glycol  

PubMed Central

The composition of the dressings is based on polyvinylpyrrolidone (PVP), polyethylene glycol (PEG), and agar. The electron beam irradiation technique has been used to prepare hydrogel wound dressings. The in vitro biocompatibility of the hydrogel was investigated by check samples (hydrocolloid Comfeel), antibacterial test (Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, Escherichia Coli k12), anti fungal test (Candida Albicans) and cytotoxicity test (Fibroblast L929). Results have shown cell attachment characteristics and nontoxicity of all samples. Antibacterial testing also showed that the antibacterial effect of the hydrogel sample to the check sample increased to 30%. Also, investigation of antifungal analysis did not show any trace of fungi growth on the surface of the hydrogel, whereas antifungal effect did not observe on the surface of the check sample. Finally, this hydrogel sample showed a good in vitro biocompatibility. PMID:21860588

Biazar, Esmaeil; Roveimiab, Ziba; Shahhosseini, Gholamreza; Khataminezhad, Mohammadreza; Zafari, Mandana; Majdi, Ali

2012-01-01

128

Pain and quality of life for patients with venous leg ulcers: proof of concept of the efficacy of Biatain-Ibu, a new pain reducing wound dressing.  

PubMed

Wound pain is a serious problem for elderly patients suffering from chronic leg ulcers, and it may lead to reduced wound healing rates and reduced quality of life. Biatain-Ibu Non-adhesive (Coloplast A/S), a new pain-reducing moist wound healing dressing containing ibuprofen was tested for pain reduction, safety, and efficacy on 10+2 patients in a single-blinded crossover study against Biatain Non-adhesive (Coloplast A/S). Pain was measured with a Numeric Box Scale before, during, and after dressing change. Quality of life was measured using the World Health Organization-5 Well-Being Index. Dressing moist wound healing properties such as absorption capacity and leakage were tested together with assessment of wound exudate and blood plasma content of ibuprofen. Use of the Biatain-Ibu foam dressing correlated with a decrease in pain intensity scores from 7 in the run-in period to approximately 2.5 in the Biatain-Ibu treatment phase. Quality of life measures were improved which together with the reduced pain could contribute to faster wound healing. The moist wound healing properties of Biatain-Ibu were similar to that of the Biatain Non-adhesive and ulcer size was reduced by 24% during the treatment period. Neither side effects nor systemic plasma concentrations of ibuprofen were observed. These data indicate that Biatain-Ibu could reduce persistent and temporary wound pain, increase Quality of life, was found safe to use, and had excellent moist wound healing properties. PMID:16808800

Jørgensen, Bo; Friis, Gitte Juel; Gottrup, Finn

2006-01-01

129

Mechanical and biocompatible characterization of a cross-linked collagen-hyaluronic acid wound dressing  

PubMed Central

Collagen scaffolds have been widely employed as a dermal equivalent to induce fibroblast infiltrations and dermal regeneration in the treatment of chronic wounds and diabetic foot ulcers. Cross-linking methods have been developed to address the disadvantages of the rapid degradation associated with collagen-based scaffolds. To eliminate the potential drawbacks associated with glutaraldehyde cross-linking, methods using a water soluble carbodiimide have been developed. In the present study, the glycosaminoglycan (GAG) hyaluronic acid (HA), was covalently attached to an equine tendon derived collagen scaffold using 1-ethyl-3-(3-dimethyl aminopropyl) carbodiimide (EDC) to create ntSPONGE™. The HA was shown to be homogeneously distributed throughout the collagen matrix. In vitro analyses of the scaffold indicated that the cross-linking enhanced the biological stability by decreasing the enzymatic degradation and increasing the thermal denaturation temperature. The material was shown to support the attachment and proliferation of mouse L929 fibroblast cells. In addition, the cross-linking decreased the resorption rate of the collagen as measured in an intramuscular implant model in rabbits. The material was also shown to be biocompatible in a variety of in vitro and in vivo assays. These results indicate that this cross-linked collagen-HA scaffold, ntSPONGE™, has the potential for use in chronic wound healing. PMID:23896569

Kirk, James F; Ritter, Gregg; Finger, Isaac; Sankar, Dhyana; Reddy, Joseph D; Talton, James D; Nataraj, Chandra; Narisawa, Sonoko; Millan, Jose Luis; Cobb, Ronald R

2013-01-01

130

Systematic review of the use of honey as a wound dressing  

Microsoft Academic Search

OBJECTIVE: To investigate topical honey in superficial burns and wounds though a systematic review of randomised controlled trials. DATA SOURCES: Cochrane Library, MEDLINE, EMBASE, PubMed, reference lists and databases were used to seek randomised controlled trials. Seven randomised trials involved superficial burns, partial thickness burns, moderate to severe burns that included full thickness injury, and infected postoperative wounds. REVIEW METHODS:

Owen A Moore; Lesley A Smith; Fiona Campbell; Kate Seers; Henry J McQuay; R Andrew Moore

2001-01-01

131

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

PubMed

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. PMID:24507345

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

2014-02-15

132

Experiences with biosynthetic dressings.  

PubMed

Almost all documented clinical experience shows that occlusively dressed wounds heal more quickly and with less pain, tenderness, and swelling than undressed wounds. Clinical experience with occlusive skin dressings on acute and chronic wounds, on diseased skin, and on normal skin is reviewed. This report presents the effects of some of the newest oxygen-permeable and oxygen-nonpermeable occlusive dressings: three polyurethane adhesive films (Bioclusive, Op-Site, and Tegaderm), a polyethylene oxide hydrogel dressing (Vigilon), and a hydroactive polymer dressing (DuoDerm). PMID:3973143

Eaglstein, W H

1985-02-01

133

All-natural composite wound dressing films of essential oils encapsulated in sodium alginate with antimicrobial properties.  

PubMed

We present natural polymeric composite films made of essential oils (EOs) dispersed in sodium alginate (NaAlg) matrix, with remarkable anti-microbial and anti-fungal properties. Namely, elicriso italic, chamomile blue, cinnamon, lavender, tea tree, peppermint, eucalyptus, lemongrass and lemon oils were encapsulated in the films as potential active substances. Glycerol was used to induce plasticity and surfactants were added to improve the dispersion of EOs in the NaAlg matrix. The topography, chemical composition, mechanical properties, and humidity resistance of the films are presented analytically. Antimicrobial tests were conducted on films containing different percentages of EOs against Escherichia coli bacteria and Candida albicans fungi, and the films were characterized as effective or not. Such diverse types of essential oil-fortified alginate films can find many applications mainly as disposable wound dressings but also in food packaging, medical device protection and disinfection, and indoor air quality improvement materials, to name a few. PMID:24211443

Liakos, Ioannis; Rizzello, Loris; Scurr, David J; Pompa, Pier Paolo; Bayer, Ilker S; Athanassiou, Athanassia

2014-03-25

134

Wound-dressing materials with antibacterial activity from electrospun polyurethane-dextran nanofiber mats containing ciprofloxacin HCl.  

PubMed

Dextran is a versatile biomacromolecule for preparing electrospun nanofibrous membranes by blending with either water-soluble bioactive agents or hydrophobic biodegradable polymers for biomedical applications. In this study, an antibacterial electrospun scaffold was prepared by electrospinning of a solution composed of dextran, polyurethane (PU) and ciprofloxacin HCl (CipHCl) drug. The obtained nanofiber mats have good morphology. The mats were characterized by various analytical techniques. The interaction parameters between fibroblasts and the PU-dextran and PU-dextran-drug scaffolds such as viability, proliferation, and attachment were investigated. The results indicated that the cells interacted favorably with the scaffolds especially the drug-containing one. Moreover, the composite mat showed good bactericidal activity against both of Gram-positive and Gram-negative bacteria. Overall, our results conclude that the introduced scaffold might be an ideal biomaterial for wound dressing applications. PMID:22944448

Unnithan, Afeesh R; Barakat, Nasser A M; Pichiah, P B Tirupathi; Gnanasekaran, Gopalsamy; Nirmala, R; Cha, Youn-Soo; Jung, Che-Hun; El-Newehy, Mohamed; Kim, Hak Yong

2012-11-01

135

Chitosancellulose composite for wound dressing material. Part 2. Antimicrobial activity, blood absorption ability, and biocompatibility  

E-print Network

insufficiency of the lower extremities, pressure ulcers, and wounds that commonly occur from neuropathy and/or compromised blood perfusion in the diabetic foot, generally are inhibited from healing owing to persistent

Reid, Scott A.

136

Silicone foam sponge for pilonidal sinus: a new technique for dressing open granulating wounds.  

PubMed Central

A silicone foam sponge has been used to replace the daily packing of deep granulating wounds with moist sterile gauze. In the treatment of pilonidal sinus use of the sponge demands less nursing time and is more comfortable for the patient than the excision and open granulation technique. Patients can usually return to work soon after operation. The method has many applications in surgery, and widespread application of the technique to the management of granulating wounds could result in considerable savings to the NHS in money and skilled nursing time. Images FIG 1 FIG 2 PMID:1191965

Wood, R A; Hughes, L E

1975-01-01

137

Electrospun antibacterial polyurethane-cellulose acetate-zein composite mats for wound dressing.  

PubMed

In this study, an antibacterial electrospun nanofibrous scaffolds with diameters around 400-700 nm were prepared by physically blending polyurethane (PU) with two biopolymers such as cellulose acetate (CA) and zein. Here, PU was used as the foundation polymer, was blended with CA and zein to achieve desirable properties such as better hydrophilicity, excellent cell attachment, proliferation and blood clotting ability. To prevent common clinical infections, an antimicrobial agent, streptomycin sulfate was incorporated into the electrospun fibers and its antimicrobial ability against the gram negative and gram positive bacteria were examined. The interaction between fibroblasts and the PU-CA and PU-CA-zein-drug scaffolds such as viability, proliferation, and attachment were characterized. PU-CA-zein-drug composite nanoscaffold showed enhanced blood clotting ability in comparison with pristine PU nanofibers. The presence of CA and zein in the nanofiber membrane improved its hydrophilicity, bioactivity and created a moist environment for the wound, which can accelerate wound recovery. PMID:24507360

Unnithan, Afeesh Rajan; Gnanasekaran, Gopalsamy; Sathishkumar, Yesupatham; Lee, Yang Soo; Kim, Cheol Sang

2014-02-15

138

Wound-dressing materials with antibacterial activity from electrospun gelatin fiber mats containing silver nanoparticles  

Microsoft Academic Search

Ultrafine gelatin fiber mats with antibacterial activity against some common bacteria found on burn wounds were prepared from a gelatin solution (22%w\\/v in 70vol% acetic acid) containing 2.5wt% AgNO3. Silver nanoparticles (nAg), a potent antibacterial agent, first appeared in the AgNO3-containing gelatin solution after it had been aged for at least 12h, with the amount of nAg increasing with increasing

Pim-on Rujitanaroj; Nuttaporn Pimpha; Pitt Supaphol

2008-01-01

139

Sodium alginate/poly(vinyl alcohol)/nano ZnO composite nanofibers for antibacterial wound dressings.  

PubMed

Sodium alginate (SA)/poly (vinyl alcohol) (PVA) fibrous mats were prepared by electrospinning technique. ZnO nanoparticles of size ?160nm was synthesized and characterized by UV spectroscopy, dynamic light scattering (DLS), XRD and infrared spectroscopy (IR). SA/PVA electrospinning was further carried out with ZnO with different concentrations (0.5, 1, 2 and 5%) to get SA/PVA/ZnO composite nanofibers. The prepared composite nanofibers were characterized using FT-IR, XRD, TGA and SEM studies. Cytotoxicity studies performed to examine the cytocompatibility of bare and composite SA/PVA fibers indicate that those with 0.5 and 1% ZnO concentrations are less toxic where as those with higher concentrations of ZnO is toxic in nature. Cell adhesion potential of this mats were further proved by studying with L929 cells for different time intervals. Antibacterial activity of SA/PVA/ZnO mats were examined with two different bacteria strains; Staphylococcus aureus and Escherichia coli, and found that SA/PVA/ZnO mats shows antibacterial activity due to the presence of ZnO. Our results suggest that this could be an ideal biomaterial for wound dressing applications once the optimal concentration of ZnO which will give least toxicity while providing maximum antibacterial activity is identified.f. PMID:21635916

Shalumon, K T; Anulekha, K H; Nair, Sreeja V; Nair, S V; Chennazhi, K P; Jayakumar, R

2011-10-01

140

A direct-electrospinning process by combined electric field and air-blowing system for nanofibrous wound-dressings  

NASA Astrophysics Data System (ADS)

An electrospinning process has been introduced to fabricate micro/nanofiber membranes having high porosity and specific surface area. When constantly/uniformly depositing the micro/nanofiber membrane on a target, the electrospun fibers require flushing out of the high charge and excessive remaining solvent built up, since these factors can interrupt the constant deposition rate of the electrospun fibers on substrates. These limitations can be overcome with a direct-electrospinning process, which can lower the charges of the electrospun fibers through a window of guiding electrodes and remaining solvent of the electrospun fibers during the spinning process by an air-blowing system. Because of the reduced charge accumulation of the electrospun fibers, the micro/nanofibers can be deposited on any kind of target, which may be a conductive or a non-conductive material. The fabricated membrane had a dramatically reduced charge, remaining solvent concentration, sufficient tensile modulus, and small pore-size distribution. To observe the possibility as a biomedical wound-dressing material, a bacteria-shielding test of the fabricated membrane was conducted.

Kim, Geun Hyung; Yoon, Hyeon

2008-03-01

141

Preparation, optimisation and characterisation of novel wound healing film dressings loaded with streptomycin and diclofenac.  

PubMed

Streptomycin (STP) and diclofenac (DLF) loaded film dressings were prepared by blending Polyox(®) (POL) with four hydrophilic polymers [hydroxypropylmethylcellulose (HPMC), carrageenan (CAR), sodium alginate (SA) or chitosan (CS)] using glycerol (GLY) as plasticiser. The films were characterised by scanning electron microscopy (SEM), differential scanning calorimetry (DSC), X-ray diffraction (XRD) and Fourier transform infrared (FTIR) spectroscopy, texture analysis (tensile and swelling characteristics) and in vitro dissolution profiles using Franz diffusion cell. SEM showed homogeneous morphology for both blank (BLK) and drug loaded (DL) films. Films prepared by blending of POL with the other polymers showed a reduction in the crystallisation of POL in descending order of SA>CS>HPMC>CAR respectively. DSC and XRD showed no crystalline peaks of STP and DLF suggesting molecular dispersion of both drugs as well as possible drug interaction with negatively charged sulphate ions present in CAR. The DL films did not show any IR bands of both drugs, confirming the DSC and XRD results. POL-CAR-BLK films showed higher tensile strength (12.32±1.40 MPa) than the POL-CAR-DL films (9.52±1.12 MPa). DL films plasticised with 25%w/w GLY revealed soft and tough (tensile strength 1.02±0.28 MPa, % elongation 1031.33±16.23) formulations. The swelling capacities of POL-CAR-BLK and POL-CAR-DL films were (733.17±25.78%) and (646.39±40.39%), increasing to (1072.71±80.30%) and (1051±86.68%) for POL-CAR-BLK-25% GLY and POL-CAR-DL-25% GLY respectively. POL-CAR-DL films showed significantly (n=3, p<0.0318) lower cumulative release of STP and DLF (52.11±1.34, 55.26±2.25) compared to POL-CAR-DL-25% GLY films (60.07±1.56, 63.39±1.92) respectively. PMID:23006557

Pawar, H V; Tetteh, J; Boateng, J S

2013-02-01

142

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

PubMed

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. PMID:23848976

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

2013-09-01

143

Potentials of chitosan-based delivery systems in wound therapy: bioadhesion study.  

PubMed

Chitosan is currently proposed to be one of the most promising polymers in wound dressing development. Our research focuses on its potential as a vehicle for nano-delivery systems destined for burn therapy. One of the most important features of wound dressing is its bioadhesion to the wounded site. We compared the bioadhesive properties of chitosan with those of Carbopol, a synthetic origin polymer. Chitosan-based hydrogels of different molecular weights were first analyzed by texture analysis for gel cohesiveness, adhesiveness and hardness. In vitro release studies showed no difference in release of model antimicrobial drug from the different hydrogel formulations. Bioadhesion tests were performed on pig ear skin and the detachment force, necessary to remove the die from the skin, and the amount of remaining formulation on the skin were determined. Although no significant difference regarding detachment force could be seen between Carbopol-based and chitosan-based formulations, almost double the amount of chitosan formulation remained on the skin as compared to Carbopol formulations. The findings confirmed the great potential of chitosan-based delivery systems in advanced wound therapy. Moreover, results suggest that formulation retention on the ex vivo skin samples could provide deeper insight on formulation bioadhesiveness than the determination of detachment force. PMID:24956514

Hurler, Julia; Skalko-Basnet, Nataša

2012-01-01

144

Anionic polymers and 10 nm Fe?O?@UA wound dressings support human foetal stem cells normal development and exhibit great antimicrobial properties.  

PubMed

The aims of this study were the development, characterization and bioevaluation of a novel biocompatible, resorbable and bio-active wound dressing prototype, based on anionic polymers (sodium alginate--AlgNa, carboximethylcellulose--CMC) and magnetic nanoparticles loaded with usnic acid (Fe?O?@UA). The antimicrobial activity was tested against Staphylococcus aureus grown in biofilms. The biocompatibility testing model included an endothelial cell line from human umbilical vein and human foetal progenitor cells derived from the amniotic fluid, that express a wide spectrum of surface molecules involved in different vascular functions and inflammatory response, and may be used as skin regenerative support. The obtained results demonstrated that CMC/Fe?O?@UA and AlgNa/Fe?O?@UA are exhibiting structural and functional properties that recommend them for further applications in the biomedical field. They could be used alone or coated with different bio-active compounds, such as Fe?O?@UA, for the development of novel, multifunctional porous materials used in tissues regeneration, as antimicrobial substances releasing devices, providing also a mechanical support for the eukaryotic cells adhesion, and exhibiting the advantage of low cytotoxicity on human progenitor cells. The great antimicrobial properties exhibited by the newly synthesized nano-bioactive coatings are recommending them as successful candidates for improving the implanted devices surfaces used in regenerative medicine. PMID:23994366

Grumezescu, Alexandru Mihai; Holban, Alina Maria; Andronescu, Ecaterina; Mogo?anu, George Dan; Vasile, Bogdan Stefan; Chifiriuc, Mariana Carmen; Lazar, Veronica; Andrei, Eugen; Constantinescu, Andrei; Maniu, Horia

2014-03-25

145

Chitosan containing PU\\/Poly(NIPAAm) thermosensitive membrane for wound dressing  

Microsoft Academic Search

Hydroxyl-terminated polybutadiene (HTPB) based polyurethane (PU) solution was prepared and then the PU solution was modified with N-isopropyl acrylamide by UV radiation without degassing to get thermo-sensitive membrane (PUNIPAAm). Then chitosan was impregnated onto the PUNIPAAm surface and treated by freeze-drying to get chitosan containing PUNIPAAm (PUNIPAAm-chi). Wettability on the various membranes was determined. The measurement of water vapor transmission

Jen Ming Yang; Shu Jyuan Yang; Hao Tzu Lin; Te-Hsing Wu; Haw-Jan Chen

2008-01-01

146

The effect of moist and moist exposed dressings on healing and barrier function restoration of partial thickness wounds  

Microsoft Academic Search

Improved healing of full- and partial-thickness cutaneous wounds in wet and moist environments is due primarily to retention of biological fluids over the wound preventing desiccation of denuded dermis or deeper tissues. This also allows faster and unimpeded migration of keratinocytes over the wound surface and enables the naturally occurring cytokines and growth factors to exert their beneficial effect on

B. S. Atiyeh; C. A. Al-Amm; K. A. El-Musa; A. Sawwaf; R. Dham

2003-01-01

147

Barrier Dressings for Wounds  

Microsoft Academic Search

\\u000a The skin is the largest human organ and is the essential interface between the host and its environment. Among the major functions\\u000a of this organ are mechanisms that provide heat loss or heat retention; water loss or water retention; elimination of waste\\u000a via exfoliation; protection against penetration of ultraviolet light; touch location of physical objects; and, perhaps most\\u000a obviously, protection

Jan W. Gooch

148

Neomycin-loaded poly(styrene sulfonic acid-co-maleic acid) (PSSA-MA)/polyvinyl alcohol (PVA) ion exchange nanofibers for wound dressing materials.  

PubMed

In this study, poly(styrene sulfonic acid-co-maleic acid) (PSSA-MA) blended with polyvinyl alcohol (PVA) was electrospun and then subjected to thermal crosslinking to produce PSSA-MA/PVA ion exchange nanofiber mats. The cationic drug neomycin (0.001, 0.01, and 0.1%, w/v) was loaded onto the cationic exchange fibers. The amount of neomycin loaded and released and the cytotoxicity of the fiber mats were analyzed. In vivo wound healing tests were also performed in Wistar rats. The results indicated that the diameters of the fibers were on the nanoscale (250 ± 21 nm). The ion exchange capacity (IEC) value and the percentage of water uptake were 2.19 ± 0.1 mequiv./g-dry fibers and 268 ± 15%, respectively. The loading capacity was increased upon increasing the neomycin concentration. An initial concentration of 0.1% (w/v) neomycin (F3) showed the highest loading capacity (65.7 mg/g-dry fibers). The neomycin-loaded nanofiber mats demonstrated satisfactory antibacterial activity against both Gram-positive and Gram-negative bacteria, and an in vivo wound healing test revealed that these mats performed better than gauze and blank nanofiber mats in decreasing acute wound size during the first week after tissue damage. In conclusion, the antibacterial neomycin-loaded PSSA-MA/PVA cationic exchange nanofiber mats have the potential for use as wound dressing materials. PMID:23510799

Nitanan, Todsapon; Akkaramongkolporn, Prasert; Rojanarata, Theerasak; Ngawhirunpat, Tanasait; Opanasopit, Praneet

2013-05-01

149

Electrospun blends of gelatin and gelatin-dendrimer conjugates as a wound-dressing and drug-delivery platform.  

PubMed

In this work, we report a new nanofiber construct based on electrospun blends of gelatin and gelatin-dendrimer conjugates. Highly branched star-shaped polyamidoamine (PAMAM) dendrimer G3.5 was covalently conjugated to gelatin via EDC/NHS chemistry. Blends of gelatin and gelatin-dendrimer conjugates mixed with various loading levels of silver acetate (0, 0.83, 1.65, and 3.30% w/w) were successfully electrospun into nanofiber constructs (NCs). The NCs were further converted into semi-interpenetrating networks (sIPNs) with photoreactive polyethylene glycol diacrylate (Mn = 575 g mol(-1)) (PEG DA575). They were characterized in terms of fiber morphology, diameter, pore size, permeability, degradation, and mechanical properties. The resulting sIPN NCs retained nanofiber morphology, possessed similar fiber diameters to counterpart NCs, and gained improved structural stability. The sIPN NCs also showed good swelling capacity owing to porous structures and were permeable to aqueous solutions. Silver-containing sIPN NCs allowed sustained silver release and showed antimicrobial activity against two common types of pathogens, Staphylococcus aureus and Pseudomonas aeruginosa. Incorporation of dendrimers into the gelatin nanofibers through covalent conjugation not only expands drug loading capacity of nanofiber constructs but also provides tremendous flexibility for developing multifunctional electrospun dressing materials. PMID:24127747

Dongargaonkar, Alpana A; Bowlin, Gary L; Yang, Hu

2013-11-11

150

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

PubMed

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. PMID:19864074

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

2010-08-01

151

Evidence-based Management Strategies for Treatment of Chronic Wounds  

Microsoft Academic Search

The care and management of patients with chronic wounds and their far-reaching effects challenge both the patient and the practitioner. Further complicating this situation is the paucity of evidence-based treatment strategies for chronic wound care. After searching both MEDLINE and Cochrane databases, we reviewed currently available articles con- cerning chronic wound care. Utilizing this information, we have outlined a review

Frank Werdin; Hans-Eberhardt Schaller; Hans-Oliver Rennekampff

152

Dressing psychic wounds: Clothing as metaphor in Paule Marshall's Praisesong for the widow and Leslie Marmon Silko's Ceremony  

Microsoft Academic Search

I investigate the function of dress as it relates to cultural retention in Paule Marshall's Praisesong for the Widow and Leslie Marmon Silko's Ceremony, drawing upon the work of fashion theorists Joanne Entwistle, Alison Lurie and Anne Hollander. My examination of the two novels is informed by several excellent scholarly works which hold that characters' well being is determined by

Angela D Tartaglia

2009-01-01

153

A new method of microskin autografting with a Vaseline-based moisture dressing on granulation tissue.  

PubMed

In the conventional method of microskin autografting, aggressive early excision is adopted, followed by coverage with a microskin-allograft complex to close extensive burn wounds. However, early excision is always associated with a defect of viable tissue, resulting in massive blood loss and causing high risk to aged patients or those with other systemic diseases. We developed a new method in which an eschar thinning operation was first adopted, followed by raising granulation tissue and microskin autografting, which was covered by a Vaseline-based moisture dressing. A total of 52 patients were included in this study and randomly assigned to the control group (n=26) and the experimental group (n=26) for the conventional method and the new method, respectively. The re-epithelisation rate on the 21st day after autografting indicated that there was no significant difference between both groups. There was also no significant difference between the two groups when the re-epithelialisation rate was compared with the type of organisms cultured. However, the Vancouver Burn Skin Score (VBSS) results demonstrated a significant improvement of cosmetic appearance in the experimental group (score=2.1) as compared to the control group (score=3.9). The new method also showed other advantages, including less blood loss, shorter surgical duration and lower cost of surgery. From this prospective study, it can be concluded that the new method can be an alternative to the conventional microskin autografting procedure. PMID:24041518

Xiao, Houan; Li, Chongan; Zhou, Xiaoqian; Wang, Xuqiang; Wu, Zhouhu; Zhang, Li; Liu, Chen; Wang, Zhenhua; An, Hongzhao; Wang, Yu; Gao, Shuping; Zhang, Yongjie

2014-03-01

154

Surgical Wound Case Studies With the Versatile 1 Wound Vacuum System for Negative Pressure Wound Therapy  

Microsoft Academic Search

Negative pressure wound therapy consists of a wound dressing, a drainage tube inserted into the dressing, an occlusive trans- parent film, and a connection to a vacuum source that supplies the negative pressure. A new product called the Versatile 1 Wound Vacuum System (BlueSky Medical, La Costa, Calif) is available for negative pressure wound therapy. This article de- scribes the

Penny E. Campbell; Phyllis A. Bonham

2006-01-01

155

Electrical Stimulation Technologies for Wound Healing  

PubMed Central

Objective: To discuss the physiological bases for using exogenously applied electric field (EF) energy to enhance wound healing with conductive electrical stimulation (ES) devices. Approach: To describe the types of electrical currents that have been reported to enhance chronic wound-healing rate and closure. Results: Commercial ES devices that generate direct current (DC), and mono and biphasic pulsed current waveforms represent the principal ES technologies which are reported to enhance wound healing. Innovation: Wafer-thin, disposable ES technologies (wound dressings) that utilize mini or micro-batteries to deliver low-level DC for wound healing and antibacterial wound-treatment purposes are commercially available. Microfluidic wound-healing chips are currently being used with greater accuracy to investigate the EF effects on cellular electrotaxis. Conclusion: Numerous clinical trials described in subsequent sections of this issue have demonstrated that ES used adjunctively with standard wound care (SWC), enhances wound healing rate faster than SWC alone. PMID:24761348

Kloth, Luther C.

2014-01-01

156

Development of fibroblast culture in three-dimensional activated carbon fiber-based scaffold for wound healing.  

PubMed

This work developed a novel bi-layer wound dressing composed of 3D activated carbon fibers that allows facilitates fibroblast cell growth and migration to a wound site for tissue reconstruction, and the gentamicin is incorporated into a poly(?-glutamic acid)/gelatin membrane to prevent bacterial infection. In an in vitro, field emission scanning electron microscopy shows that rat skin fibroblasts appeared and spread on the surface of activated carbon fibers, and penetrated the interior and exterior of the 3D activated carbon fiber construct to a depth of roughly 200 ?m. An in vivo analysis shows that fibroblast cells containing the proposed 3D scaffold had the potential of a biologically functionalized dressing to accelerate wound closure. Additionally, fibroblasts migrated to the wound site in a bi-layer wound dressing containing fibroblasts, enhancing fibronectin and type I collagen expression, resulting in faster skin regeneration than that achieved with a Tegaderm™ hydrocolloid dressing or gauze. PMID:22415364

Huang, Wen-Ying; Yeh, Chia-Lin; Lin, Jui-Hsiang; Yang, Jai-Sing; Ko, Tse-Hao; Lin, Yu-Hsin

2012-06-01

157

Wound care centers  

MedlinePLUS

... multiple types of dressings as your wound heals. Hyperbaric oxygen therapy Depending on the type of wound, your doctor may recommend hyperbaric oxygen therapy . Oxygen is important for healing. During this treatment, ...

158

Bi-layer composite dressing of gelatin nanofibrous mat and poly vinyl alcohol hydrogel for drug delivery and wound healing application: in-vitro and in-vivo studies.  

PubMed

Present investigation involves the development of a bi-layer dressing of gelatin nanofibrous mat loaded with epigallocatechin gallate (EGCG)/poly vinyl alcohol (PVA) hydrogel and its in-vivo evaluation on full-thickness excision wounds in experimental Wistar rats. Nanomorphological observation, porosity, effect of crosslinking on tensile strength, physical stability and drug release profile in phosphate buffer and biocompatibility aspects of electrospun nanomat were investigated by various physico-chemical tools. EGCGa release profile was found to increase from 2-4 days with decreasing crosslinking time from 15 to 5 min. PVA hydrogels were prepared by freeze-thaw method and has been utilized as a protective and hydrating outer layer of the bi-layer dressing. Topical application of bi-layer composite dressing loaded with EGCG improve the healing rate in experimental rats as acute wounds model which was evidenced by significant increase in DNA (approximately 42%), total protein (approximately 32%), hydroxyproline (approximately 26%) and hexosamine approximately 24%) contents. A faster wound contraction was observed in wounds treated with composite dressing from approximately 14% to 47%. Histopathological examination revealed significant improvement in angiogenesis, re-epithelialization and less inflammatory response in comparison to control. Van-Gieson's collagen stains revealed matured, compact and parallel deposition of collagen fibrils on day 12. These results were supported by up-regulated expressions of matrix metalloproteinase (MMPs-2 and 9) by gelatin zymography. Control release of EGCG, 3D porous architecture of nanofibrous scaffolds as well as moist microenvironment provides ideal conditions for uninterrupted wound healing. PMID:23980498

Jaiswal, Maneesh; Gupta, Asheesh; Agrawal, Ashwini K; Jassal, Manjeet; Dinda, Amit Kr; Koul, Veena

2013-09-01

159

Calcium-Based Nanoparticles Accelerate Skin Wound Healing  

PubMed Central

Introduction Nanoparticles (NPs) are small entities that consist of a hydroxyapatite core, which can bind ions, proteins, and other organic molecules from the surrounding environment. These small conglomerations can influence environmental calcium levels and have the potential to modulate calcium homeostasis in vivo. Nanoparticles have been associated with various calcium-mediated disease processes, such as atherosclerosis and kidney stone formation. We hypothesized that nanoparticles could have an effect on other calcium-regulated processes, such as wound healing. In the present study, we synthesized pH-sensitive calcium-based nanoparticles and investigated their ability to enhance cutaneous wound repair. Methods Different populations of nanoparticles were synthesized on collagen-coated plates under various growth conditions. Bilateral dorsal cutaneous wounds were made on 8-week-old female Balb/c mice. Nanoparticles were then either administered intravenously or applied topically to the wound bed. The rate of wound closure was quantified. Intravenously injected nanoparticles were tracked using a FLAG detection system. The effect of nanoparticles on fibroblast contraction and proliferation was assessed. Results A population of pH-sensitive calcium-based nanoparticles was identified. When intravenously administered, these nanoparticles acutely increased the rate of wound healing. Intravenously administered nanoparticles were localized to the wound site, as evidenced by FLAG staining. Nanoparticles increased fibroblast calcium uptake in vitro and caused contracture of a fibroblast populated collagen lattice in a dose-dependent manner. Nanoparticles also increased the rate of fibroblast proliferation. Conclusion Intravenously administered, calcium-based nanoparticles can acutely decrease open wound size via contracture. We hypothesize that their contraction effect is mediated by the release of ionized calcium into the wound bed, which occurs when the pH-sensitive nanoparticles disintegrate in the acidic wound microenvironment. This is the first study to demonstrate that calcium-based nanoparticles can have a therapeutic benefit, which has important implications for the treatment of wounds. PMID:22073267

Ishise, Hisako; Carre, Antoine Lyonel; Nishimoto, Soh; Longaker, Michael; Lorenz, H. Peter

2011-01-01

160

Study on hydrophilic properties of gelatin as a clinical wound dressing. II. Water-absorbing property and hemostatic effect of gelatin.  

PubMed

For clinical use of gelatin as a dressing, we determined the water-absorbing capacity of gelatin for isotonic sodium chloride solution (ISCS) and bovine serum albumin-isotonic sodium chloride solution (BSA-ISCS). There was no significant difference between water absorption of gelatin with ISCS and with BSA-ISCS. The water-absorbing capacity of gelatin increased with increasing viscosity: gelatins No. 1 > No. 2 > No. 3. Enormous spaces of 20 to 30 microns or approximately 10 microns in size were observed on the gelatin surface. Scaly materials of 10 to 20 microns in size were also observed. The pores of 10 A in radius were predominant in all the gelatins studied. Since the sizes of cellular blood components range between 2 and 17 microns, they can enter the spaces but not the pores of 10 A in radius. On the other hand, water molecules, the major component of plasma, can enter the pores. Of theoretical sorption isotherms, Henderson's and Chung-Pfost's equations were fitted within the range of relative humidity between 1.5 and 75%. Gelatin No. 1 had the smallest constants n, K, B, and C followed by gelatins No. 2 and No. 3, suggesting that gelatin No. 1 is the most flexible for water and thus is fitted most easily to a raw area such as a wound or burn surface. The study of hemostatic effects of gelatin in rats demonstrated that when used at concentrations more than 50% of the bleeding amount, gelatin absorbed water from blood, and was stuck to and covered the wound surface. PMID:8184413

Takahashi, H; Miyoshi, T; Boki, K

1993-12-01

161

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

Microsoft Academic Search

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

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

2010-01-01

162

The cost-effectiveness of wound management protocols of care.  

PubMed

A European cost-effectiveness study has been conducted using published clinical trial data from multinational studies on chronic venous leg ulcers and pressure sores. Data relevant to UK chronic wound management practice have been extracted and are presented here. A total of 15 pressure sore studies involving 519 wounds, and 12 leg ulcer studies involving 843 ulcers were used in a pooled analysis. The study objectives included the calculation of comparative costs in pound sterling for three different treatment protocols for each wound type. The protocols have been adapted for UK clinical practice in both hospital and community settings and are based on primary dressings and nurse time costs, wound cleansing and debridement, the use of fillers, and compression as appropriate. The focus of the study has been the cost-effectiveness comparison (as measured by cost per healed wound) of two modern dressings - Granuflex(R) hydrocolloid dressing and Apligraf(R) skin replacement - and traditional gauze dressings in the treatment of venous leg ulcers and, in the case of pressure sores, comparison of Granuflex(R) Comfeel(R) hydrocolloid dressings and traditional saline gauze dressings. The choice of dressings studied was dictated by the available published literature. The construction of treatment protocols and assumptions on treatments otherwise missing from published papers has been achieved through the use of an expert panel. Results show Granuflex(R) to be 50% more cost-effective, at 422 pounds per healed wound, than Comfeel(R) (643 pounds) and 500% more so than saline gauze (2548 pounds) in the treatment of pressure sores. Granuflex(R) at 342 pounds was also more cost-effective than gauze (541 pounds) or Apligraf(R) (6741 pounds) in the treatment of venous leg ulcers. These data will provide a valuable adjunct to published clinical evidence, offering further information upon which carers can base their choice of wound dressing. PMID:12271239

Harding, K; Cutting, K; Price, P

2000-10-01

163

[Nursing management of wound care pain].  

PubMed

Wound care is an important step in promoting wound healing, but it may cause wound care pain. This article aims to explore factors influencing wound care pain and the effectiveness of various interventions to alleviate it. Five major factors that influence wound care pain include inappropriate dressing change techniques, inflammation response, emotion, cognition, and social-cultural factors. Nurses should apply appropriate dressings and dressing change techniques to relieve wound care pain. Music therapy and aromatherapy can alleviate wound pain after dressing change. But distraction techniques should be used in conjunction with consideration of the needs of the individual subject. PMID:17554674

Chin, Yen-Fan

2007-06-01

164

Depletion flocculation effects in egg-based model salad dressing emulsions  

Microsoft Academic Search

The influence of dehydrated egg white (DEW) addition on the droplet aggregation of yolk-based model salad dressing emulsions was studied in an attempt to investigate the role of the egg albumen fraction in the physicochemical changes that take place during the storage of acidic emulsions containing whole egg. Analysis of the adsorbed protein in emulsion by the application of SDS–PAGE

Antonios Drakos; Vassilis Kiosseoglou

2008-01-01

165

Use of negative pressure wound therapy in the treatment of neonatal and pediatric wounds: a retrospective examination of clinical outcomes.  

PubMed

The clinical effectiveness of negative pressure wound therapy for the management of acute and chronic wounds is well documented in the adult population but information regarding its use in the pediatric population is limited. A retrospective, descriptive study was conducted to examine the clinical outcomes of using negative pressure wound therapy in the treatment of pediatric wounds. The medical records of 24 consecutive pediatric patients receiving negative pressure wound therapy were reviewed. Demographic data, wound etiology, time to closure, closure method, duration of negative pressure wound therapy, complications, dressing change frequency, dressing type used, and pressure settings were analyzed. All categorical variables in the dataset were summarized using frequency (count and percentages) and all continuous variables were summarized using median (minimum, maximum). The 24 pediatric patients (mean age 8.5 years [range 14 days to 18 years old]) had 24 wounds - 12 (50%) were infected at baseline. Sixteen patients had hypoalbuminemia and six had exposed hardware and bone in their wounds. Twenty-two wounds reached full closure in a median time of 10 days (range 2 to 45) following negative pressure wound therapy and flap closure (11), split-thickness skin graft (three), secondary (four), and primary (four) closure. Pressures used in this population ranged from 50 to 125 mm Hg and most wounds were covered with reticulated polyurethane foam. One patient developed a fistula during the course of negative pressure wound therapy. When coupled with appropriate systemic antibiotics, surgical debridement, and medical and nutritional optimization, in this population negative pressure wound therapy resulted in rapid granulation tissue and 92% successful wound closure. Future neonatal and pediatric negative pressure wound therapy usage registries and prospective studies are needed to provide a strong evidence base from which treatment decisions can be made in the management of these challenging cases, especially pertaining to the safety and efficacy of pressure settings, dressings, and interposing contact layer selection. PMID:17586874

Baharestani, Mona Mylene

2007-06-01

166

[Construction and operation of the wound care technology platform].  

PubMed

Chronic wounds are a major healthcare problem costing billions of dollars a year over the world. However, it is regrettable that a large number of chronic wounds are still treated simply by conventional dressing change in local clinics, lacking of definite diagnosis and personalized care. This situation results in a low wound healing rate, unsatisfied life quality of the patients, and higher medical cost for the prolonged promiscuous care. We should not only emphasize the importance of wound care in clinical practice, but also emphasize the importance of establishing wound care centers. With the experience of our practice in wound care center, the construction of wound care technology platform is strongly suggested. This platform could act as an education base to train more professional wound care doctors, nurses, and care workers, as well as resolve many technical difficulties involved in the treatment of many complicated chronic wounds. PMID:22097298

Hu, Da-hai; Zhou, Qin; Han, Jun-tao

2011-08-01

167

Micromechanical Modeling of Filament Wound Cement-Based Composites  

E-print Network

Micromechanical Modeling of Filament Wound Cement-Based Composites B. Mobasher, M.ASCE1 Abstract. The micromechanical model simulates the mechanical response of a multilayer cement-based composite laminate under: Micromechanics; Cements; Composite materials. Introduction Response of cement-based composites to load

Mobasher, Barzin

168

Wound healing.  

PubMed

Wound healing is a dynamic biologic process of repairing insults to the integumentary system. It is commonly divided into three phases: inflammatory, proliferative, and maturation. Each phase has unique cellular and substance constituents without which it cannot progress normally. A large variety of factors may influence any part of wound healing, including local factors such as bacteria, oxygen tension, and bleeding, and systemic factors such as the mental and physical health of the patient. There are also extrinsic factors that can be influenced by the caretakers of the wound to enhance wound healing. Areas of intervention include using antiseptic technique when one is dealing with the wound, using good surgical technique, choosing the appropriate wounding method and repair for the individual patient, and using antibiotics and special wound dressings. Modern science and technology are giving us new insights into wound healing and leading us to exciting new ways of influencing it, including the topical use of growth factors, artificial skins, cultured epithelium with and without dermal components, and electrical stimulation. The future of wound healing holds a better understanding of the complexities of the physiologic events that occur and a translation of that into a biologically active and interactive wound care. PMID:7794680

Waldorf, H; Fewkes, J

1995-01-01

169

Collagen-Based Biomaterials for Wound Healing Sayani Chattopadhyay,1  

E-print Network

Review Collagen-Based Biomaterials for Wound Healing Sayani Chattopadhyay,1 Ronald T. Raines1,2 1: With its wide distribution in soft and hard connective tissues, collagen is the most abundant of animal pro- teins. In vitro, natural collagen can be formed into highly organized, three-dimensional scaffolds

Raines, Ronald T.

170

Dress MattersChange and Continuity in the Dress Practices of Bosnian Muslim Refugee Women  

Microsoft Academic Search

Dress serves as a discursive daily practice of gender, and this article explains the dress practices of Bosnian Muslim refugee women living in Vermont. These dress practices tend toward elaborate, carefully cultivated styles for hair, makeup, and dress. Based on participant observation, in-depth interviews, and secondary historical sources, the authors seek to explain the meanings and practice of these dress

Kimberly Huisman; Pierrette Hondagneu-Sotelo

2005-01-01

171

An open, prospective, randomized pilot investigation evaluating pain with the use of a soft silicone wound contact layer vs bridal veil and staples on split thickness skin grafts as a primary dressing.  

PubMed

An open, prospective, randomized, pilot investigation was implemented to evaluate the pain, cost-effectiveness, ease of use, tolerance, efficacy, and safety of a soft silicone wound contact layer (Mepitel One) vs Bridal Veil and staples used on split thickness skin grafts in the treatment of deep partial or full-thickness thermal burns. Individuals aged between 18 and 70 years with deep partial or full-thickness thermal burns (1-25% TBSA) were randomized into two groups and treated for 14 days or until greater than 95% graft take was achieved, whichever occurred first. Data were obtained and analyzed on pain experienced before, during, and after dressing removal. Secondary considerations included the overall cost (direct), graft take and healing, the ease of product use, overall experience of the dressing, and adverse events. A total of 43 subjects were recruited. There were no significant differences in burn area profiles within the groups. The pain level during dressing removal was significant between the groups (P = .0118) with the removal of Mepitel One being less painful. The staff costs were lower in the group of patients treated with Mepitel One (P = .0064) as reflected in the shorter time required for dressing removal (P = .0005), with Mepitel One taking on average less than a quarter of the time to remove. There was no significant difference in healing between the two groups, with 99.0% of the Mepitel One group and 93.1% of the Bridal Veil and staples group showing greater than 95% graft take at post-op day 7 (+/-1) (P = .2373). Clinicians reported that the soft silicone dressing was easier to use, more conformable, and demonstrated better ability to stay in place, compared with the Bridal Veil and staples regime. Both treatments were well tolerated, with no serious adverse events in either treatment group. Mepitel One was at least as effective in the treatment of patients as the standard care (Bridal Veil and staples). In addition, the group of patients treated with the soft silicone dressing demonstrated decreased pain and lower costs associated with treatment. PMID:23817002

Patton, Mary Lou; Mullins, Robert Fred; Smith, David; Korentager, Richard

2013-01-01

172

Postoperative dressing and management strategies for transtibial amputations: a critical review.  

PubMed

Postamputation management is an important determinant of recovery from amputation. However, consensus on the most effective postoperative management strategies for individuals undergoing transtibial amputation (TTA) is lacking. Dressings can include simple soft gauze dressings, thigh-high rigid cast dressings, shorter removable rigid dressings, and prefabricated pneumatic dressings. Postoperative prosthetic attachments can be added to all but simple soft dressings. These dressings address the need to cleanly cover a fresh surgical wound, but not all postoperative dressings are designed to facilitate the strategic goals of preventing knee contractures, reducing edema, protecting from external trauma, or facilitating early weight bearing. The type of dressing and management strategy often overlap and are certainly interrelated. Current protocols and decisions are based on local practice, skill, and intuition. The current available literature is challenging, and difficulties include variations in healing potential, in comorbidity, in surgical-level selection, in techniques and skill, in experience with postoperative strategies, and with poorly defined outcome criteria. This paper reviews the published literature and compares measures of safety, efficacy, and clinical outcomes of the various techniques. Analysis of 10 controlled studies supported only 4 of the 14 claims cited in uncontrolled, descriptive studies. PMID:14582525

Smith, Douglas G; McFarland, Lynne V; Sangeorzan, Bruce J; Reiber, Gayle E; Czerniecki, Joseph M

2003-01-01

173

[Surgical hygroscopic bandages for amputations, secreting wounds and diabetes foot].  

PubMed

The authors adopt in clinical practice using of sterile hygroscopic wound dressings 'pampers type'. They use these dressings in 113 patients. The appropriate patients are these with limbs amputations, diabetic foot, suppurative and plenty secreting deep wounds, atonite and decubital wounds. The dressings are sterilised using paraformaldehyde sterilization which do not injure the synthetic materials. The hygroscopic dressings are non- allergic and are well tolerated by the patients. Using these dressings facilitate the medical team work and help to reduce the contamination of the hospital linen and the patients coverlet. They help for accelerating the wound healing process. They are also economic effective by reducing the amount of used dressing material. PMID:21972719

Topolav, J; Kirov, G; Markov, G; Girov, K; Nedkov, P; Georgieva, A

2010-01-01

174

Non-adenine based purines accelerate wound healing  

Microsoft Academic Search

Wound healing is a complex sequence of cellular and molecular processes that involves multiple cell types and biochemical\\u000a mediators. Several growth factors have been identified that regulate tissue repair, including the neurotrophin nerve growth\\u000a factor (NGF). As non-adenine based purines (NABPs) are known to promote cell proliferation and the release of growth factors,\\u000a we investigated whether NABPs had an effect

Shucui Jiang; Caleb C. J. Zavitz; Jian Wang; Amit Saraf; Robert Zielinski; James D. Ramsbottom; Patrizia Ballerini; Iolanda D’Alimonte; Silvia Romano; Gemma Fischione; Ugo Traversa; Eva S. Werstiuk; Michel P. Rathbone

2006-01-01

175

Potential dermal wound healing agent in Blechnum orientale Linn  

PubMed Central

Background Blechnum orientale Linn. (Blechnaceae) is used ethnomedicinally to treat wounds, boils, blisters or abscesses and sores, stomach pain and urinary bladder complaints. The aim of the study was to validate the ethnotherapeutic claim and to evaluate the effects of B. orientale water extract on wound healing activity. Methods Water extract of B. orientale was used. Excision wound healing activity was examined on Sprague-Dawley rats, dressed with 1% and 2% of the water extract. Control groups were dressed with the base cream (vehicle group, negative control) and 10% povidone-iodine (positive control) respectively. Healing was assessed based on contraction of wound size, mean epithelisation time, hydroxyproline content and histopathological examinations. Statistical analyses were performed using one way ANOVA followed by Tukey HSD test. Results Wound healing study revealed significant reduction in wound size and mean epithelisation time, and higher collagen synthesis in the 2% extract-treated group compared to the vehicle group. These findings were supported by histolopathological examinations of healed wound sections which showed greater tissue regeneration, more fibroblasts and angiogenesis in the 2% extract-treated group. Conclusions The ethnotherapeutic use of this fern is validated. The water extract of B. orientale is a potential candidate for the treatment of dermal wounds. Synergistic effects of both strong antioxidant and antibacterial activities in the extract are deduced to have accelerated the wound repair at the proliferative phase of the healing process. PMID:21835039

2011-01-01

176

Death of Salmonella, Escherichia coli O157:H7, and Listeria monocytogenes in shelf-stable, dairy-based, pourable salad dressings.  

PubMed

The objectives of this study were to determine the death rates of Salmonella, Escherichia coli O157:H7, and Listeria monocytogenes in three commercially manufactured full-fat ranch salad dressings, three reduced-fat ranch salad dressings, two full-fat blue cheese salad dressings, and two reduced-fat blue cheese salad dressings and to affirm the expectation that these dressings do not support the growth of these pathogens. The respective initial pH values of the four types of shelf-stable, dairy-based, pourable dressings were 2.87 to 3.72, 2.82 to 3.19, 3.08 to 3.87, and 2.83 to 3.49, respectively. Dressings were inoculated with low (2.4 to 2.5 log CFU/g) and high (5.3 to 5.9 log CFU/g) populations of separate five-strain mixtures of each pathogen and stored at 25 degrees C for up to 15 days. Regardless of the initial inoculum population, all test pathogens rapidly died in all salad dressings. Salmonella was undetectable by enrichment (<1 CFU/25-ml sample in three replicate trials) in all salad dressings within 1 day, and E. coli O157:H7 and L. monocytogenes were reduced to undetectable levels by enrichment between 1 and 8 days and 2 and 8 days, respectively. E. coli O157:H7 was not detected in 4 of the 10 salad dressings stored for 2 or more days and 9 of the 10 dressings stored for 6 or more days after inoculation. L. monocytogenes was detected in 9 of the 10 salad dressings stored for 3 days but in only one dressing, by enrichment, at 6 days, indicating that it had the highest tolerance among the three pathogens to the acidic environment imposed by the dressings. Overall, the type of dressing (i.e., ranch versus blue cheese) and level of fat in the dressings did not have a marked effect on the rate of inactivation of pathogens. Total counts and populations of lactic acid bacteria and yeasts and molds remained low or undetectable (<1.0 log CFU/ml) throughout the 15-day storage period. Based on these observations, shelf-stable, dairy-based, pourable ranch and blue cheese salad dressings manufactured by three companies and stored at 25 degrees C do not support the growth of Salmonella, E. coli O157:H7, and L. monocytogenes and should not be considered as potentially hazardous foods (time-temperature control for safety foods) as defined by the U.S. Food and Drug Administration Food Code. PMID:16629022

Beuchat, Larry R; Ryu, Jee-Hoon; Adler, Barbara B; Harrison, M David

2006-04-01

177

A fitted neoprene garment to cover dressings in swine models.  

PubMed

Domesticated porcine species are commonly used in studies of wound healing, owing to similarities between porcine skin and human skin. Such studies often involve wound dressings, and keeping these dressings intact on the animal can be a challenge. The authors describe a novel and simple technique for constructing a fitted neoprene garment for pigs that covers dressings and maintains their integrity during experiments. PMID:23246889

Mino, Matthew J; Mauskar, Neil A; Matt, Sara E; Pavlovich, Anna R; Prindeze, Nicholas J; Moffatt, Lauren T; Shupp, Jeffrey W

2012-12-17

178

Hand burn management: minimising pain and trauma at dressing change.  

PubMed

The aim of wound management in hand burn injuries is to restore function and prevent problem scars, so a key consideration in wound healing is the removal of dressings without causing pain and further trauma as well as preserving function. Conventionally, wound dressings such as paraffin gauze were used for burn injuries, but this led to pain and trauma on removal, as well as drying out. This study looks at the use of Mepitel® One on hand burns; this dressing incorporates all the benefits of Mepitel, however, it only has Safetac technology on the wound contact side, allowing easy handling and application. PMID:24225512

Edwards, Jacky; Mason, Sally

179

Dressing symmetries  

NASA Astrophysics Data System (ADS)

We study the group of dressing transformations in soliton theories. We show that it is generated by the monodromy matrix. This provides a new proof of their Lie-Poisson property. We treat in detail the examples of the Toda field theories and the Heisenberg model. We show that the group of dressing transformations is the classical precursor of the various manifestations of quantum groups in these models, e.g. algebraic Bethe ansatz, non-local currents, or quantum group symmetries. Finally, we define field multiplets supporting a linear representation of the dressing group and we show that their exchange algebras are encoded in the classical double.

Babelon, Olivier; Bernard, Denis

1992-10-01

180

Cost-Effective Use of Silver Dressings for the Treatment of Hard-to-Heal Chronic Venous Leg Ulcers  

PubMed Central

Aim To estimate the cost-effectiveness of silver dressings using a health economic model based on time-to-wound-healing in hard-to-heal chronic venous leg ulcers (VLUs). Background Chronic venous ulceration affects 1–3% of the adult population and typically has a protracted course of healing, resulting in considerable costs to the healthcare system. The pathogenesis of VLUs includes excessive and prolonged inflammation which is often related to critical colonisation and early infection. The use of silver dressings to control this bioburden and improve wound healing rates remains controversial. Methods A decision tree was constructed to evaluate the cost-effectiveness of treatment with silver compared with non-silver dressings for four weeks in a primary care setting. The outcomes: ‘Healed ulcer’, ‘Healing ulcer’ or ‘No improvement’ were developed, reflecting the relative reduction in ulcer area from baseline to four weeks of treatment. A data set from a recent meta-analysis, based on four RCTs, was applied to the model. Results Treatment with silver dressings for an initial four weeks was found to give a total cost saving (£141.57) compared with treatment with non-silver dressings. In addition, patients treated with silver dressings had a faster wound closure compared with those who had been treated with non-silver dressings. Conclusion The use of silver dressings improves healing time and can lead to overall cost savings. These results can be used to guide healthcare decision makers in evaluating the economic aspects of treatment with silver dressings in hard-to-heal chronic VLUs. PMID:24945381

Jemec, Gregor B. E.; Kerihuel, Jean Charles; Ousey, Karen; Lauemøller, Sanne Lise; Leaper, David John

2014-01-01

181

The design, characteristics, and application of polyurethane dressings using the electrospinning process  

Microsoft Academic Search

In general, a dressing is used to protect and help heal wounds. There are several types of dressings on the market such as hydrocolloid, hydrogel, and medicated dressings. One technique for making a dressing is electrospinning, which is a very simple procedure used to produce fibers. Due to much smaller fiber-diameters than produced with the conventional technique, the fibers from

Piyaporn Kampeerapappun

2008-01-01

182

Thiolated Carboxymethyl-Hyaluronic-Acid-Based Biomaterials Enhance Wound Healing in Rats, Dogs, and Horses  

PubMed Central

The progression of wound healing is a complicated but well-known process involving many factors, yet there are few products on the market that enhance and accelerate wound healing. This is particularly problematic in veterinary medicine where multiple species must be treated and large animals heal slower, oftentimes with complicating factors such as the development of exuberant granulation tissue. In this study a crosslinked-hyaluronic-acid (HA-) based biomaterial was used to treat wounds on multiple species: rats, dogs, and horses. The base molecule, thiolated carboxymethyl HA, was first found to increase keratinocyte proliferation in vitro. Crosslinked gels and films were then both found to enhance the rate of wound healing in rats and resulted in thicker epidermis than untreated controls. Crosslinked films were used to treat wounds on forelimbs of dogs and horses. Although wounds healed slower compared to rats, the films again enhanced wound healing compared to untreated controls, both in terms of wound closure and quality of tissue. This study indicates that these crosslinked HA-based biomaterials enhance wound healing across multiple species and therefore may prove particularly useful in veterinary medicine. Reduced wound closure times and better quality of healed tissue would decrease risk of infection and pain associated with open wounds. PMID:23738117

Yang, Guanghui; Prestwich, Glenn D.; Mann, Brenda K.

2011-01-01

183

ANGIOGENESIS IN WOUNDS TREATED BY MICRODEFORMATIONAL WOUND THERAPY  

PubMed Central

Summary Background Data Mechanical forces play an important role in tissue neovascularisation and are a constituent part of modern wound therapies. The mechanisms by which Vacuum Assisted Closure (VAC) modulates wound angiogenesis are still largely unknown. Objective To investigate how VAC treatment affects wound hypoxia and related profiles of angiogenic factors as well as to identify the anatomical characteristics of the resultant, newly formed vessels. Methods Wound neovascularization was evaluated by morphometric analysis of CD31- stained wound cross sections as well as by corrosion casting analysis. Wound hypoxia and mRNA expression of HIF-1? and associated angiogenic factors were evaluated by pimonidazole hydrochloride staining and quantitative RT-PCR, respectively. VEGF protein levels were determined by western blot analysis. Results VAC-treated wounds were characterized by the formation of elongated vessels aligned in parallel and consistent with physiologically function, compared to occlusive dressing control wounds that showed formation of tortuous, disoriented vessels. Moreover, VAC-treated wounds displayed a well-oxygenated wound bed, with hypoxia limited to the direct proximity of the VAC-foam interface, where higher VEGF levels were found. By contrast, occlusive dressing control wounds showed generalized hypoxia, with associated accumulation of HIF-1? and related angiogenic factors. Conclusions The combination of established gradients of hypoxia and VEGF expression along with mechanical forces exerted by VAC therapy was associated with the formation of more physiological blood vessels compared to occlusive dressing control wounds. These morphological changes are likely a necessary condition for better wound healing. PMID:21217515

Erba, Paolo; Ogawa, Rei; Ackermann, Maximilian; Adini, Avner; Miele, Lino F; Dastouri, Pouya; Helm, Doug; Mentzer, Steven J; D'Amato, Robert J; Murphy, George F; Konerding, Moritz A; Orgill, Dennis P

2012-01-01

184

A one hospital study of the effect of wound dressings and other related factors on skin blistering following total hip and knee arthroplasty  

Microsoft Academic Search

Skin blisters occur when the epidermis is separated from the dermis. This occurs as a result of continued friction. Blisters occurring lateral to the surgical incision of patients following orthopaedic surgery have been observed for many years. There is, however, a lack of empirical evidence indicating the causation of wound blistering. The aim of the study was to identify the

Rebecca Jester; Lin Russell; Sheila Fell; Suzanna Williams; Catherine Prest

2000-01-01

185

Effect of dressing choice on outcomes after hip and knee arthroplasty: a literature review.  

PubMed

Selecting the right dressing for these wounds can prevent blistering, maceration and the risk of infection. Ideally, the dressing should be permeable, waterproof, transparent, absorbent and flexible enough to withstand joint movement. PMID:19901873

Tustanowski, J

2009-11-01

186

Smoking, Chronic Wound Healing, and Implications for Evidence-Based Practice  

PubMed Central

Chronic wounds are rising in prevalence and creating significant socioeconomic burdens for patients and healthcare systems worldwide. Therefore, it is now more important than ever that clinicians follow evidence-based guidelines for wound care when developing personalized treatment plans for their patients with chronic wounds. Evidence-based guidelines for treating venous leg ulcers, diabetic foot ulcers, and pressure ulcers, the 3 main categories of chronic wounds, focus primarily on biologic therapies. However, there are also evidence-based guidelines for treating behavioral risks to poor healing, such as smoking, which should be incorporated into treatment plans when appropriate. The purpose of this article was to review the mechanisms through which smoking adversely impacts the wound healing process, and propose strategies for incorporating evidence-based guidelines for treating tobacco dependence into treatment plans for patients with chronic wounds who smoke. PMID:25188797

McDaniel, Jodi C.; Browning, Kristine K.

2014-01-01

187

Smoking, chronic wound healing, and implications for evidence-based practice.  

PubMed

Chronic wounds are rising in prevalence and creating significant socioeconomic burdens for patients and healthcare systems worldwide. Therefore, it is now more important than ever that clinicians follow evidence-based guidelines for wound care when developing personalized treatment plans for their patients with chronic wounds. Evidence-based guidelines for treating venous leg ulcers, diabetic foot ulcers, and pressure ulcers, the 3 main categories of chronic wounds, focus primarily on biologic therapies. However, there are also evidence-based guidelines for treating behavioral risks to poor healing, such as smoking, which should be incorporated into treatment plans when appropriate. The purpose of this article was to review the mechanisms through which smoking adversely impacts the wound healing process, and propose strategies for incorporating evidence-based guidelines for treating tobacco dependence into treatment plans for patients with chronic wounds who smoke. PMID:25188797

McDaniel, Jodi C; Browning, Kristine K

2014-01-01

188

Wound management following orbital exenteration surgery.  

PubMed

Exenteration of the orbital contents is a rare but mutilating surgical procedure which can have a profound effect on a patient's life. As a specialist nurse working within the oculoplastics team at Manchester Royal Eye Hospital, the author has taken a particular interest in the wound management of post-operative exenteration patients. Using evidence-based practice relating to cavity wound healing as a cornerstone, he has developed guidelines for the post-operative wound management of these patients both for nurses and other allied professionals. Several surgical approaches to the exenteration of the orbital contents are outlined. The implications for wound healing and other elements of the post operative care for these patients are also explored. Selected dressing products which may be used in patients having undergone orbital exenteration surgery ar reviewed, and practice recommendations and guidelines proposed. PMID:19374038

Cooper, John

189

State-of-the-art treatment of chronic leg ulcers: a randomized controlled trial comparing vacuum-assisted closure (V.A.C.) with modern wound dressings  

Microsoft Academic Search

Background: Current treatment modalities for chronic leg ulcers are time consuming, expensive, and only moderately successful. Recent data suggest that creating a subatmospheric pressure by vacuum-assisted closure (V.A.C., KCI Concepts, San Antonio, Texas) therapy supports the wound healing process. Methods: The efficacy of vacuum-assisted closure in the treatment of chronic leg ulcers was prospectively studied in a randomized controlled trial

Jeroen D. D. Vuerstaek; Tryfon Vainas; Jan Wuite; Patty Nelemans; Martino H. A. Neumann; Joep C. J. M. Veraart

190

A review of the literature informing affordable, available wound management choices for rural areas of tropical developing countries.  

PubMed

Health professionals are often absent in rural areas of tropical developing countries. Current wound management in this environment is costly and largely ineffective. Achieving effective wound management in this setting will require educating the lay health providers who manage wounds in villages. Two extensive literature searches were conducted using CINAHL and Medline with no date, geographic, or language restrictions. The question, "What is the evidence base for topical wound treatments and dressings that are affordable and available in developing countries?" was addressed by critically evaluating all 18 identified clinical studies and reviews. The results suggest that a moist wound environment can be maintained using improvised dressings such as banana leaves, saline-soaked furniture foam, and food wrap, and that these choices are superior to many commercial dressings. Some varieties of honey, papaya pulp, EUSOL, and lubricating jelly are effective, affordable substances for treating and debriding wounds. Papaya pulp can be unsafe if not very closely monitored. No studies addressing the second question, "What are the topical wound management interventions currently being used in rural areas of tropical developing countries?" were found. However, 13 articles that could guide the design of research studies in this field were identified and are reviewed here. This literature describes a wide variety of wound prevention and management methods, some known to be deleterious for healing. These two literature reviews reveal the large gaps in the evidence base on available and affordable wound treatment options for rural patients in developing countries. Future research should address these gaps. PMID:24106254

Benskin, Linda L L

2013-10-01

191

Functionalized Silk Biomaterials for Wound Healing  

PubMed Central

Silk protein-biomaterial wound dressings with epidermal growth factor (EGF) and silver sulfadiazine were studied with a cutaneous excisional mouse wound model. Three different material designs (silk films, lamellar porous silk films, electrospun silk nanofibers) and two different drug functionalization techniques (drug coatings or drug loading into the materials) were studied to compare wound healing responses. Changes in wound size and histological assessments of wound tissues over time confirmed that functionalized silk biomaterial wound dressings increased wound healing rate, including reepithelialization, dermis proliferation, collagen synthesis, epidermal differentiation into hair follicles and sebaceous glands, and reduced scar formation, when compared to air-permeable Tegaderm™ tape (3M) (? control) and a commercially sold wound dressing (Tegaderm™ Hydrocolloid dressing) (+ control). All silk biomaterials studied were effective for wound healing, while the porous features of the silk biomaterials (lamellar porous films and electrospun nanofibers) and the incorporation of EGF/silver sulfadiazine, via drug loading or coating, provided the most rapid wound healing responses. This systematic approach to evaluate functionalized silk biomaterial wound dressings demonstrates a useful strategy to select formulations for further study towards new treatment options for chronic wounds. PMID:23184644

Gil, Eun Seok; Panilaitis, Bruce; Bellas, Evangelia

2013-01-01

192

Antibacterial properties of tualang honey and its effect in burn wound management: a comparative study  

PubMed Central

Background The use of honey as a natural product of Apis spp. for burn treatment has been widely applied for centuries. Tualang honey has been reported to have antibacterial properties against various microorganisms, including those from burn-related diagnoses, and is cheaper and easier to be absorbed by Aquacel dressing. The aim of this study is to evaluate the potential antibacterial properties of tualang honey dressing and to determine its effectiveness as a partial thickness burn wound dressing. Methods In order to quantitate the bioburden of the swabs, pour plates were performed to obtain the colony count (CFU/ml). Swabs obtained from burn wounds were streaked on blood agar and MacConkey agar for bacterial isolation and identification. Later, antibacterial activity of Aquacel-tualang honey, Aquacel-Manuka honey, Aquacel-Ag and Aquacel- plain dressings against bacteria isolated from patients were tested (in-vitro) to see the effectiveness of those dressings by zone of inhibition assays. Results Seven organisms were isolated. Four types of Gram-negative bacteria, namely Enterobacter cloacae, Klebsiella pneumoniae, Pseudomonas spp. and Acinetobacter spp., and three Gram-positive bacteria, namely Staphylococcus aureus, coagulase-negative Staphylococcus aureus (CONS) and Streptococcus spp., were isolated. Total bacterial count decreased on day 6 and onwards. In the in-vitro antibacterial study, Aquacel-Ag and Aquacel-Manuka honey dressings gave better zone of inhibition for Gram positive bacteria compared to Aquacel-Tualang honey dressing. However, comparable results were obtained against Gram negative bacteria tested with Aquacel-Manuka honey and Aquacel-Tualang honey dressing. Conclusions Tualang honey has a bactericidal as well as bacteriostatic effect. It is useful as a dressing, as it is easier to apply and is less sticky compared to Manuka honey. However, for Gram positive bacteria, tualang honey is not as effective as usual care products such as silver-based dressing or medical grade honey dressing. PMID:20576085

2010-01-01

193

Evaluation of a Novel Polihexanide-Preserved Wound Covering Gel on Dermal Wound Healing  

Microsoft Academic Search

Objective: Daily wound assessment, including dressing changes and the removal of old ointments causes discomfort for the patient. We therefore developed a new thermoreversible and transparent gel formulation that allows for filling wounds of different shapes and depths. The aim of the study was to investigate the effect of a wound covering gel on wound healing and the skin’s microcirculation.

O. Goertz; A. Ring; U. Knie; C. Abels; A. Daigeler; H.-U. Steinau; L. Steinstraesser; S. Langer

2010-01-01

194

Composite poly(vinyl alcohol)/poly(vinyl acetate) electrospun nanofibrous mats as a novel wound dressing matrix for controlled release of drugs.  

PubMed

The aim of this study was to develop novel biomedicated nanofiber electrospun mats for controlled drug release, especially drug release directly to an injury site to accelerate wound healing. Nanofibers of poly(vinyl alcohol) (PVA), poly(vinyl acetate) (PVAc), and a 50:50 composite blend, loaded with ciprofloxacin HCl (CipHCl), were successfully prepared by an electrospinning technique for the first time. The morphology and average diameter of the electrospun nanofibers were investigated by scanning electron microscopy. X-ray diffraction studies indicated an amorphous distribution of the drug inside the nanofiber blend. Introducing the drug into polymeric solutions significantly decreased solution viscosities as well as nanofiber diameter. In vitro drug release evaluations showed that both the kind of polymer and the amount of drug loaded greatly affected the degree of swelling, weight loss, and initial burst and rate of drug release. Blending PVA and PVAc exhibited a useful and convenient method for electrospinning in order to control the rate and period of drug release in wound healing applications. Also, the thickness of the blend nanofiber mats strongly influenced the initial release and rate of drug release. PMID:21720511

Jannesari, Marziyeh; Varshosaz, Jaleh; Morshed, Mohammad; Zamani, Maedeh

2011-01-01

195

Composite poly(vinyl alcohol)/poly(vinyl acetate) electrospun nanofibrous mats as a novel wound dressing matrix for controlled release of drugs  

PubMed Central

The aim of this study was to develop novel biomedicated nanofiber electrospun mats for controlled drug release, especially drug release directly to an injury site to accelerate wound healing. Nanofibers of poly(vinyl alcohol) (PVA), poly(vinyl acetate) (PVAc), and a 50:50 composite blend, loaded with ciprofloxacin HCl (CipHCl), were successfully prepared by an electrospinning technique for the first time. The morphology and average diameter of the electrospun nanofibers were investigated by scanning electron microscopy. X-ray diffraction studies indicated an amorphous distribution of the drug inside the nanofiber blend. Introducing the drug into polymeric solutions significantly decreased solution viscosities as well as nanofiber diameter. In vitro drug release evaluations showed that both the kind of polymer and the amount of drug loaded greatly affected the degree of swelling, weight loss, and initial burst and rate of drug release. Blending PVA and PVAc exhibited a useful and convenient method for electrospinning in order to control the rate and period of drug release in wound healing applications. Also, the thickness of the blend nanofiber mats strongly influenced the initial release and rate of drug release. PMID:21720511

Jannesari, Marziyeh; Varshosaz, Jaleh; Morshed, Mohammad; Zamani, Maedeh

2011-01-01

196

Unveiling the mechanisms of dressed-photon-phonon etching based on hierarchical surface roughness measure  

NASA Astrophysics Data System (ADS)

Dressed-photon-phonon (DPP) etching is a disruptive technology in planarizing material surfaces because it completely eliminates mechanical contact processes. However, adequate metrics for evaluating the surface roughness and the underlying physical mechanisms are still not well understood. Here, we propose a two-dimensional hierarchical surface roughness measure, inspired by the Allan variance, that represents the effectiveness of DPP etching while conserving the original two-dimensional surface topology. Also, we build a simple physical model of DPP etching that agrees well with the experimental observations, which clearly shows the involvement of the intrinsic hierarchical properties of dressed photons, or optical near-fields, in the surface processing.

Naruse, Makoto; Yatsui, Takashi; Nomura, Wataru; Kawazoe, Tadashi; Aida, Masaki; Ohtsu, Motoichi

2013-02-01

197

Developing a Wound Management Orientation Program Using Evidence-Based Guidelines  

Microsoft Academic Search

Staff development specialists and certified wound, ostomy, continence nurses must be leaders in the design of orientation programs that will assist nurses new to the practice of home health care develop wound care management skills. An orientation developed on evidence-based practice is essential to ensure quality, safe patient outcomes, and positive fiscal outcomes. This article describes the basic elements essential

Margaret Cullen; Fran Cox

2005-01-01

198

OASIS wound matrix versus Hyaloskin in the treatment of difficult-to-heal wounds of mixed arterial/venous aetiology.  

PubMed

Mixed arterial/venous (A/V) ulcers are difficult to treat and slow to heal likely as a result of deficiencies in molecular and cellular elements in the wound bed. Recently, biomaterials have been developed that replace extracellular matrix (ECM) molecules and growth factors critical to the normal healing process. In this study, the effects of OASIS and Hyaloskin were evaluated to compare the effectiveness of these two ECM-based products in their ability to achieve complete wound healing of mixed A/V ulcers. After 16 weeks of treatment, patients in each group were evaluated on four criteria: complete wound healing, time to dressing change, pain and comfort. Complete wound closure was achieved in 82.6% of OASIS-treated ulcers compared with 46.2% of Hyaloskin-treated ulcers (P < 0.001). Statistically significant differences favouring the OASIS treatment group were also reported for time to dressing change (P < 0.05), pain (P < 0.05) and patient comfort (P < 0.01). Overall, OASIS was superior to Hyaloskin for the treatment of patients with mixed A/V ulcers, a population in which standard treatment options largely consist of moist wound dressings and compression therapy is typically not an option. OASIS is a useful and well-tolerated treatment for mixed A/V ulcers that has the potential to improve quality of life and reduce costs associated with standard of care. PMID:17425543

Romanelli, Marco; Dini, Valentina; Bertone, Mariastefania; Barbanera, Sabrina; Brilli, Cinzia

2007-03-01

199

Cost-Effectiveness Analysis in Comparing Alginate Silver Dressing with Silver Zinc Sulfadiazine Cream in the Treatment of Pressure Ulcers  

PubMed Central

Background The treatment of pressure ulcers is complicated, given the various wound dressing products available. The cost of different treatments varies and the cost-effectiveness of each product has not been thoroughly evaluated. We compare two wound dressing protocols-alginate silver dressing (AlSD) and silver zinc sulfadiazine cream (AgZnSD) with regard to wound healing and cost-effectiveness. Methods Patients with grade III or IV sacral or trochanteric pressure ulcers were eligible for this prospective, randomized controlled trial. The patients were randomized to receive one of the two dressings for an eight-week period. The criteria of efficacy were based on the Pressure Ulcer Scale for Healing (PUSH) scoring tool. The cost of treatment was also assessed. Results Twenty patients (12 women and 8 men) were randomly assigned to receive either AlSD (n=10) or AgZnSD cream (n=10). The demographic data and wound characteristics were comparable in the two groups. The two groups showed no significant difference in the reduction of PUSH score, wound size, or volume of exudate. The tissue type score was significantly lower in the AlSD group (3.15±0.68-1.85±0.68 vs. 2.73±0.79-2.2±0.41; P=0.015). The cost of treatment was significantly lower in the AlSD group (377.17 vs. 467.74 USD, respectively; P<0.0001). Conclusions Alginate silver dressing could be effectively used in the treatment of grade III and IV pressure ulcers. It can improve wound tissue characteristics and is cost-effective. PMID:24086815

Chuangsuwanich, Apirag; Kangwanpoom, Jupaporn

2013-01-01

200

An introduction to the biopsychosocial complexities of managing wound pain.  

PubMed

Using the Manchester pain management model (PAIN), this review discusses the care of acute and chronic wounds, focussing on the particular skills required to manage pain associated with different types of wounds, and addressing the important area of dressing change. Acute and chronic wounds can be associated with either acute or chronic pain, making management of wound pain a significant challenge. Pain can be of either nociceptive or neuropathic origin, and the longer it has been present, the more likely that psychological, social or cultural determinants influence the reactions seen in the patient. Understanding the biopsychosocial and cultural elements of pain enables the practitioner to prepare, assess, intervene and normalise effectively, during all aspects of wound care management. Utilising individualised evidence-based practice is essential to ensure that high-quality care is delivered in this key area. PMID:22886291

Richardson, C

2012-06-01

201

Amniotic membranes as a biological dressing.  

PubMed

Amniotic membrane dressings were tested in the treatment of 30 patients. Fifteen of them had burns, 5 had chronic varicose ulcers, and 10 had decubitus ulcers or other open infected wounds. No effort was made to separate the chorion from the amnion. Dressings were changed every 48 hours, and treatment was, in some cases, partially ambulatory. Good results were obtained in the treatment of 2nd- and 3rd-degree burns and of other open, infected wounds, both in the preparation of the patients for autografting and in consequent treatment. PMID:847586

Eldad, A; Stark, M; Anais, D; Golan, J; Ben-Hur, N

1977-02-26

202

Burn wound: How it differs from other wounds?  

PubMed Central

Management of burn injury has always been the domain of burn specialists. Since ancient time, local and systemic remedies have been advised for burn wound dressing and burn scar prevention. Management of burn wound inflicted by the different physical and chemical agents require different regimes which are poles apart from the regimes used for any of the other traumatic wounds. In extensive burn, because of increased capillary permeability, there is extensive loss of plasma leading to shock while whole blood loss is the cause of shock in other acute wounds. Even though the burn wounds are sterile in the beginning in comparison to most of other wounds, yet, the death in extensive burns is mainly because of wound infection and septicemia, because of the immunocompromised status of the burn patients. Eschar and blister are specific for burn wounds requiring a specific treatment protocol. Antimicrobial creams and other dressing agents used for traumatic wounds are ineffective in deep burns with eschar. The subeschar plane harbours the micro-organisms and many of these agents are not able to penetrate the eschar. Even after complete epithelisation of burn wound, remodelling phase is prolonged. It may take years for scar maturation in burns. This article emphasizes on how the pathophysiology, healing and management of a burn wound is different from that of other wounds. PMID:23162236

Tiwari, V. K.

2012-01-01

203

Negative Pressure Wound Therapy  

PubMed Central

Executive Summary Objective This review was conducted to assess the effectiveness of negative pressure wound therapy. Clinical Need: Target Population and Condition Many wounds are difficult to heal, despite medical and nursing care. They may result from complications of an underlying disease, like diabetes; or from surgery, constant pressure, trauma, or burns. Chronic wounds are more often found in elderly people and in those with immunologic or chronic diseases. Chronic wounds may lead to impaired quality of life and functioning, to amputation, or even to death. The prevalence of chronic ulcers is difficult to ascertain. It varies by condition and complications due to the condition that caused the ulcer. There are, however, some data on condition-specific prevalence rates; for example, of patients with diabetes, 15% are thought to have foot ulcers at some time during their lives. The approximate community care cost of treating leg ulcers in Canada, without reference to cause, has been estimated at upward of $100 million per year. Surgically created wounds can also become chronic, especially if they become infected. For example, the reported incidence of sternal wound infections after median sternotomy is 1% to 5%. Abdominal surgery also creates large open wounds. Because it is sometimes necessary to leave these wounds open and allow them to heal on their own (secondary intention), some may become infected and be difficult to heal. Yet, little is known about the wound healing process, and this makes treating wounds challenging. Many types of interventions are used to treat wounds. Current best practice for the treatment of ulcers and other chronic wounds includes debridement (the removal of dead or contaminated tissue), which can be surgical, mechanical, or chemical; bacterial balance; and moisture balance. Treating the cause, ensuring good nutrition, and preventing primary infection also help wounds to heal. Saline or wet-to-moist dressings are reported as traditional or conventional therapy in the literature, although they typically are not the first line of treatment in Ontario. Modern moist interactive dressings are foams, calcium alginates, hydrogels, hydrocolloids, and films. Topical antibacterial agents—antiseptics, topical antibiotics, and newer antimicrobial dressings—are used to treat infection. The Technology Being Reviewed Negative pressure wound therapy is not a new concept in wound therapy. It is also called subatmospheric pressure therapy, vacuum sealing, vacuum pack therapy, and sealing aspirative therapy. The aim of the procedure is to use negative pressure to create suction, which drains the wound of exudate (i.e., fluid, cells, and cellular waste that has escaped from blood vessels and seeped into tissue) and influences the shape and growth of the surface tissues in a way that helps healing. During the procedure, a piece of foam is placed over the wound, and a drain tube is placed over the foam. A large piece of transparent tape is placed over the whole area, including the healthy tissue, to secure the foam and drain the wound. The tube is connected to a vacuum source, and fluid is drawn from the wound through the foam into a disposable canister. Thus, the entire wound area is subjected to negative pressure. The device can be programmed to provide varying degrees of pressure either continuously or intermittently. It has an alarm to alert the provider or patient if the pressure seal breaks or the canister is full. Negative pressure wound therapy may be used for patients with chronic and acute wounds; subacute wounds (dehisced incisions); chronic, diabetic wounds or pressure ulcers; meshed grafts (before and after); or flaps. It should not be used for patients with fistulae to organs/body cavities, necrotic tissue that has not been debrided, untreated osteomyelitis, wound malignancy, wounds that require hemostasis, or for patients who are taking anticoagulants. Review Strategy The inclusion criteria were as follows: Randomized controlled trial (RCT) with a sample size of 20 or more Human s

2006-01-01

204

Management of External Hemorrhage in Tactical Combat Casualty Care: Chitosan-Based Hemostatic Gauze Dressings - TCCC Guidelines-Change 13-05.  

PubMed

Hemorrhage remains the leading cause of combat death and a major cause of death from potentially survivable injuries. Great strides have been made in controlling extremity hemorrhage with tourniquets, but not all injuries are amenable to tourniquet application. Topical hemostatic agents and dressings have also contributed to success in controlling extremity and compressible junctional hemorrhage, and their efficacy continues to increase as enhanced products are developed. Since the addition of Combat Gauze™ (Z-Medica Corporation, Wallingford, CT, USA; http://www.z-medica.com/) in April 2008 to the Tactical Combat Casualty Care (TCCC) Guidelines, there are consistent data from animal studies of severe hemorrhage that chitosan-based hemostatic gauze dressings developed for battlefield application are, at least, equally efficacious as Combat Gauze. Successful outcomes are also reported using newer chitosan-based dressings in civilian hospital-based surgical case reports and prehospital (battlefield) case reports and series. Additionally, there have been no noted complications or safety concerns in these cases or across many years of chitosan-based hemostatic dressing use in both the military and civilian prehospital sectors. Consequently, after a decade of clinical use, there is added benefit and a good safety record for using chitosan-based gauze dressings. For these reasons, many specific US military Special Operations Forces, NATO militaries, and emergency medical services (EMS) and law enforcement agencies have already implemented the widespread use of these new recommended chitosan-based hemostatic dressings. Based on the past battlefield success, this report proposes to keep Combat Gauze as the hemostatic dressing of choice along with the new addition of Celox™ Gauze (Medtrade Products Ltd., Crewe, UK; http://www.celoxmedical.com/usa/products /celox-gauze/) and ChitoGauze® (HemCon Medical Technologies, Portland, OR, USA; http://www.hemcon.com/) to the TCCC Guidelines. PMID:25344707

Bennett, Brad L; Littlejohn, Lanny F; Kheirabadi, Bijan S; Butler, Frank K; Kotwal, Russ S; Dubick, Michael A; Bailey, Jeffrey A

2014-01-01

205

A Simulation-Based Training System for Surgical Wound Debridement  

E-print Network

to 80 hours a week. Although this action was intended to improve patient safety, it also reduced solution to maintain sterility. Research and development issues currently under investigation include, wound debridement, training Introduction In 1999, The Institute of Medicine issued a report estimating

McKenzie, Rick

206

Cavity wounds management: a multicentre pilot study.  

PubMed

The objective of this study was to assess acceptability (based on pain at removal), efficacy and tolerance of an absorbent and cohesive rope(UrgoClean Rope, Laboratoires Urgo) in the local management of deep cavity wounds. This study was a prospective, multicentre (13), non comparative clinical study. Patients presenting with an acute or chronic non-infected cavity wound were followed up for four weeks and assessed weekly with a physical examination, in addition to volumetric,planimetric and photographic evaluations. Pain at removal was the primary criterion, assessed on a Visual Analogic Scale. The percentage of the wound surface area reduction and volumetric reduction were considered as secondary efficacy criteria. Forty three patients were included in this study. After one week of treatment dressing removal was painless and continued to be so throughout the period of the trial(four weeks). Median surface area at baseline was 7.74 cm2 and was reduced by 54.5% at week 4 (relative area reduction). Median wound volumetric value was noted 12 ml at baseline and was reduced by 72.7% by the end of treatment. The cohesiveness of the new rope was considered very good by health professionals. No residue was observed on the wound bed during the dressing change with the new rope. There were no adverse events related to the tested rope, during this trial.Pain-free removal associated with good efficacy and tolerance were observed with this new cohesive rope in the healing process of deep cavity wounds and could represent a therapeutic alternative to the usual ropes used in such indications. PMID:24180023

Meaume, Sylvie; Facy, Olivier; Munoz-Bongrand, Nicolas; Ribemont, Annie-Claude; Sigal, Michele-Lea; Couffinhal, Jean-Claude; Trial, Chloe; Tacca, Olivier; Bohbot, Serge

207

Wound Healing Activity of Topical Application Forms Based on Ayurveda  

Microsoft Academic Search

The traditional Indian medicine—Ayurveda, describes various herbs, fats, oils and minerals with anti-aging as well as wound healing properties. With aging, numerous changes occur in skin, including decrease in tissue cell regeneration, decrease in collagen content, loss of skin elasticity and mechanical strength. We prepared five topical anti-aging formulations using cow ghee, flax seed oil, Phyllanthus emblica fruits, Shorea robusta

Hema Sharma Datta; Shankar Kumar Mitra; Bhushan Patwardhan

2009-01-01

208

An experimental comparison of hydrocolloid and alginate dressings, and the effect of calcium ions on the behaviour of alginate gel.  

PubMed

Gel-forming dressings, which absorb the wound exudate to form a non-adherent gel, accelerate wound healing in a moist environment. The most commonly used of these dressings are calcium alginate and hydrocolloid membranes. This study was designed to evaluate the physical properties of these dressings, including fluid retaining ability, gel formation, and the dissolution process to clarify the mechanisms that promote healing. A simple immersion method was used for measurement. This technique was useful for the quantitative assessment of gel-forming dressings and may help to evaluate potential application of these dressings. A comparative analysis showed that alginate dressings remained gelled longer than hydrocolloid dressings. This result was consistent with previously reported clinical features of these dressings. The absence of calcium in wound fluid induced rapid resolution of alginate gel while the presence of a certain concentration of calcium prevented degradation of the gel for as long as one month. PMID:9785436

Ichioka, S; Harii, K; Nakahara, M; Sato, Y

1998-09-01

209

Gunshot Wound Contamination with Squirrel Tissue: Wound Care Considerations  

PubMed Central

While report of animal bites contaminating wounds is reported commonly, direct wound contamination with squirrel flesh has never been reported in the literature. The patient suffered an accidental self-inflicted gunshot wound that drove squirrel flesh and buck shot deep within his right buttock. This case outlines his hospital course and wound treatment. The patient was treated with ten days of broad spectrum antibiotics, extensive debridement of the wound in the operating room, and further treatment of the wound with a vacuum dressing system. While squirrel tissue and buckshot had to be removed from the wound on day six of the hospital stay, the patient remained afebrile without signs or symptoms of systemic illness. PMID:24851187

Maerz, Porter W.; Falgiani, Tricia B.; Hoelle, Robyn M.

2014-01-01

210

Evaluation of Six Split-thickness Skin Graft Donor-site Dressing Materials in a Swine Model  

PubMed Central

Background: Numerous dressings for split-thickness skin graft donor sites are commercially available with no conclusive evidence-based consensus regarding the optimal dressing choice. This study was conducted to identify which of 5 commonly used materials promotes wound healing most effectively for use on split-thickness donor sites in comparison with our standard dressing, Xeroform (petrolatum gauze). Methods: Twenty-four partial-thickness wounds were created on the backs of 4 pigs using a dermatome. Wounds (n = 4 per dressing type per pig) were treated with Xeroform, Opsite (polyurethane film), Kaltostat ( calcium sodium alginate), DuoDERM (hydrocolloid), Aquacel (hydrofiber), and Mepilex (silicone foam). Full-thickness skin samples were excised at 3 or 5 days and evaluated histologically for reepithelialization and inflammation. Comparisons also included incidence of infection, ease of use, and cost analyses. Results: DuoDERM elicited the greatest percent reepithelialization (81%) and Mepilex the lowest (33%) after 3 days (P = 0.004). All dressings demonstrated complete reepithelialization except Mepilex (85%) at 5 days. There were no infections and inflammation was mild among all treatments. Mepilex was easiest to use, whereas Aquacel, Kaltostat, and Opsite were most difficult (P = 0.03). Xeroform was most cost-effective and Aquacel most expensive. Combined scoring revealed DuoDERM = Xeroform > Opsite = Mepilex > Kaltostat > Aquacel. Conclusions: DuoDERM and Xeroform were most effective overall. DuoDERM tended to outperform all dressings in reepithelialization at 3 days, while Xeroform was least expensive, easy to use, and demonstrated rapid reepithelialization. These findings suggest that Xeroform may be preferred for use on large donor-site areas. DuoDERM may be more appropriate for small donor sites when healing time is a priority.

Masella, Pamela C.; Balent, Eric M.; Carlson, Terri L.; Lee, Karen W.

2013-01-01

211

Cultured keratinocytes as biological wound dressings  

Microsoft Academic Search

Human epidermal keratinocytes now can be grown reliably and reproducibly in vitro to form multilayered epithelium. These sheets of cultured keratinocytes have been used successfully to autograft patients with severe burns, leg ulcers and following excision of extensive congenital naevi. Whilst the technique carries the obvious advantage of huge expansion of the initial skin biopsy, thus removing the need for

Richard J Pye

1988-01-01

212

Systematic review of the use of prophylactic dressings in the prevention of pressure ulcers.  

PubMed

This systematic review considers the evidence supporting the use of prophylactic dressings for the prevention of pressure ulcer. Electronic database searches were conducted on 25 July 2013. The searches found 3026 titles and after removal of duplicate records 2819 titles were scanned against the inclusion and exclusion criteria. Of these, 2777 were excluded based on their title and abstract primarily because they discussed pressure ulcer healing, the prevention and treatment of other chronic and acute wounds or where the intervention was not a prophylactic dressing (e.g. underpads, heel protectors and cushions). Finally, the full text of 42 papers were retrieved. When these 42 papers were reviewed, 21 were excluded and 21 were included in the review. The single high-quality randomised controlled trial (RCT) and the growing number of cohort, weak RCT and case series all suggest that the introduction of a dressing as part of pressure ulcer prevention may help reduce pressure ulcer incidence associated with medical devices especially in immobile intensive care unit patients. There is no firm clinical evidence at this time to suggest that one dressing type is more effective than other dressings. PMID:24472394

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

2014-10-01

213

Dressing-related trauma: clinical sequelae and resource utilization in a UK setting  

PubMed Central

Background Dressings are the mainstay of wound care management; however, adherence of the dressing to the wound or periwound skin is common and can lead to dressing-related pain and trauma. Dressing-related trauma is recognized as a clinical and economic burden to patients and health care providers. This study was conducted to garner expert opinion on clinical sequelae and resource use associated with dressing-related trauma in a UK setting. Methods This was an exploratory study with two phases: qualitative pilot interviews with six wound care specialists to explore dressing-related trauma concepts, sequelae, and resource utilization; and online quantitative research with 30 wound care specialists to validate and quantify the concepts, sequelae, and resource utilization explored in the first phase of the study. Data were collected on mean health care professional time, material costs, pharmaceutical costs, and inpatient management per sequela occurrence until resolution. Data were analyzed to give total costs per sequela and concept occurrence. Results The results demonstrate that dressing-related trauma is a clinically relevant concept. The main types of dressing-related trauma concepts included skin reactions, adherence to the wound, skin stripping, maceration, drying, and plugging of the wound. These were the foundation for a number of clinical sequelae, including wound enlargement, increased exudate, bleeding, infection, pain, itching/excoriation, edema, dermatitis, inflammation, and anxiety. Mean total costs range from £56 to £175 for the complete onward management of each occurrence of the six main concepts. Conclusion These results provide insight into the hidden costs of dressing-related trauma in a UK setting. This research successfully conceptualized dressing-related trauma, identified associated clinical sequelae, and quantified resource utilization associated with a typical occurrence of each trauma concept. Further research is warranted into dressing-related trauma and the associated costs. PMID:24855382

Charlesworth, Bruce; Pilling, Claire; Chadwick, Paul; Butcher, Martyn

2014-01-01

214

Wound healing and cost-saving benefits of combining negative-pressure wound therapy with silver.  

PubMed

A 20-patient case series is presented, demonstrating the incorporation of a silver antimicrobial negative-pressure dressing and a negative-pressure wound therapy device for improved healing outcomes, decreased nursing time expenditure, and decreased cost expenditure. PMID:24253213

Karr, Jeffrey C; de Mola, Fernando Loret; Pham, Tri; Tooke, Leslie

2013-12-01

215

Safety and utility of a PMMA-based tissue adhesive for closure of surgical incision wounds.  

PubMed

This study aimed to investigate the safety and utility of the polymethylmethacrylate (PMMA)-based tissue adhesive (PMMA-ta) for wound closure. This product is composed of 4-methacryloyloxyethyl trimellitate anhydride and methylmethacrylate as monomers, tri-n-butylborane as initiator, and PMMA powder as filler. These components are mixed at the time of use. This resulting paste hardens within several minutes. The safety of PMMA-ta was evaluated in an internal wound model using a cultured dermal substitute (CDS), i.e. a fibroblast-embedded collagen gel sheet. PMMA-ta was applied to one CDS, covered with a second CDS, and then cultured for 1?week (group II). A commercially available 2-octyl cyanoacrylate-based tissue adhesive (OCA) was used for comparative purposes (group I). No tissue adhesive was applied to the CDSs in the control group. Fibroblast viability was measured using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. Cell viability in the group I was 36%, and cell viability in the group II was 84%, of that in the control group. These results indicate that PMMA-ta has lower cytotoxicity than OCA. Next, the usefulness of PMMA-ta as a tissue adhesive was evaluated in three different wound models using Sprague-Dawley rats: (1) a thin skin incision wound, (2) a thick skin incision wound, and (3) a full-thickness incision wound through the abdominal wall. The third experiment is the surgical incision model with the most severe condition. The comparative study using OCA was conducted only in the third experiment. Each wound healing process was evaluated macroscopically and histologically after 1?week, 2?weeks, and 3?months. An excellent macroscopic wound appearance was observed with both PMMA-ta and OCA, with only a slightly visible fine-line scar. Histologically, a typical primary healing was observed for both adhesives. Considering its safety and utility, PMMA-ta is therefore promising for use as a tissue adhesive in wound closure. PMID:23565648

Suzuki, Ryusuke; Kuroyanagi, Yoshimitsu

2013-01-01

216

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

PubMed

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. PMID:24142514

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

2014-05-01

217

Antibiofilm and antimicrobial efficacy of DispersinB®-KSL-W peptide-based wound gel against chronic wound infection associated bacteria.  

PubMed

The medical importance of bacterial biofilms has increased with the recognition of biofilms as one of the major contributors to the slow or non-healing chronic wounds such as diabetic foot ulcers, venous leg ulcers, and pressure ulcers. Being a protected community of microorganisms, biofilms are notoriously refractory to antibiotic treatments. As the conventional treatment modalities have proven ineffective, this study provides the in vitro evidence to support the use of a novel combination of DispersinB(®) antibiofilm enzyme that inhibits biofilm formation and disperses preformed biofilm, and thus making the biofilm bacteria more susceptible to a broad-spectrum KSL-W antimicrobial peptide. The combination of DispersinB(®) and KSL-W peptide showed synergistic antibiofilm and antimicrobial activity against chronic wound infection associated biofilm-embedded bacteria such as Methicillin-resistant Staphylococcus aureus (MRSA), Staphylococcus epidermidis, Coagulase-negative Staphylococci (CoNS), and Acinetobacter baumannii. In addition, the wound gel formulation comprising DispersinB(®), KSL-W peptide, and a gelling agent Pluronic F-127 showed a broad-spectrum and enduring antimicrobial activity against test organisms. Furthermore, as compared to commercial wound gel Silver-Sept™, DispersinB(®)-KSL-W peptide-based wound gel was significantly more effective in inhibiting the biofilm-embedded MRSA, S. epidermidis, CoNS, Vancomycin-resistant Enterococci, A. baumannii, Klebsiella pneumoniae, and Pseudomonas aeruginosa (P < 0.05). Thus, this study provides promising evidence for the potential application of antibiofilm-antimicrobial DispersinB(®)-KSL-W wound gel in chronic wound management. PMID:24445333

Gawande, Purushottam V; Leung, Kai P; Madhyastha, Srinivasa

2014-05-01

218

Progress towards cell-based burn wound treatments.  

PubMed

Cell therapy as part of the concept of regenerative medicine represents an upcoming platform technology. Although cultured epidermal cells have been used in burn treatment for decades, new developments have renewed the interest in this type of treatment. Whereas early results were hampered by long culture times in order to produce confluent sheets of keratinocytes, undifferentiated proliferating cells can nowadays be applied on burns with different application techniques. The application of cells on carriers has improved early as well as long-term results in experimental settings. The results of several commercially available epidermal substitutes for burn wound treatment are reviewed in this article. These data clearly demonstrate a lack of randomized comparative trials and application of measurable outcome parameters. Experimental research in culture systems and animal models has demonstrated new developments and proof of concepts of further improvements in epidermal coverage. These include combinations of epidermal cells and mesenchymal stem cells, and the guidance of both material and cell interactions towards regeneration of skin appendages as well as vascular and nerve structures. PMID:24750061

Gardien, Kim L M; Middelkoop, Esther; Ulrich, Magda M W

2014-03-01

219

Dress and Identity  

Microsoft Academic Search

Development of a theoretical framework for understanding linkages between identity and dress depends on careful selection and definition of terms and development of a broad, holistic view of Social Aspects of Dress. A comprehensive definition of dress includes both body modifications and supplements to the body. Properties of these modifications and supplements can be cross-classified with sensory responses they evoke.

Mary Ellen Roach-Higgins; Joanne B. Eicher

1992-01-01

220

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

PubMed Central

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

Payne, Caroline; Edwards, Daren

2014-01-01

221

Mayonnaise, Salad Dressing and Related Products 1971.  

National Technical Information Service (NTIS)

The report is based on the 44th annual survey of the mayonnaise, salad dressing and related products industry in the United States. It covers operations of all known manufacturers of mayonnaise, salad dressing and related products. The 146 reporting units...

1972-01-01

222

Salad Dressing, Mayonnaise and Related Products: 1969.  

National Technical Information Service (NTIS)

The report is based on the 42nd annual survey of the salad dressing, mayonnaise, and related products industry in the United States. The Survey covered operations of all known manufacturers of salad dressing, mayonnaise, and related products. The 155 repo...

E. L. Herbert, R. Bacon

1970-01-01

223

Update on Tissue-Engineered Biological Dressings  

Microsoft Academic Search

Tissue-engineered biological dressings offer promise in the treatment of burns, chronic ulcers, donor site and other surgical wounds, and a variety of blistering and desquamating dermatologic conditions. For example, the prevalence of diabetic foot ulcers ranges from 4.4% to 10.5% of diabetics, resulting in 82,000 lower extremity amputations annually; venous leg ulcers affect 0.18% to 1.35% of the population; and

M. Ehrenreich; Z. Ruszczak

2006-01-01

224

Modern wound care - practical aspects of non-interventional topical treatment of patients with chronic wounds.  

PubMed

The treatment of patients with chronic wounds is becoming increasingly complex. It was therefore the aim of the members of the working group for wound healing (AGW) of the German Society of Dermatology (DDG) to report on the currently relevant aspects of non-interventional, topical wound treatment for daily practice. -Beside necessary procedures, such as wound cleansing and débridement, we describe commonly used wound dressings, their indications and practical use. Modern antiseptics, which are currently used in wound therapy, usually contain polyhexanide or octenidine. Physical methods, such as negative-pressure treatment, are also interesting options. It is always important to objectify and adequately treat pain symptoms which often affect these patients. Modern moist wound therapy may promote healing, reduce complications, and improve the quality of life in patients with chronic wounds. Together with the improvement of the underlying causes, modern wound therapy is an important aspect in the overall treatment regime for patients with chronic wounds. PMID:24813380

Dissemond, Joachim; Augustin, Matthias; Eming, Sabine A; Goerge, Tobias; Horn, Thomas; Karrer, Sigrid; Schumann, Hauke; Stücker, Markus

2014-07-01

225

Super-absorbent dressings: how do they perform in vitro?  

PubMed

The free swell and absorption capacity under compression of six wound dressings that are indicated for moderately to highly exuding wounds was investigated. Measuring in vitro the absorptive capacity and retention under compression is important in terms of clinical efficacy and efficiency. This in vitro comparative study demonstrated that sorbion sachet EXTRA had the highest free swell capacity of the six test dressings and absorbed more than twice the volume (126%) of the test solution than its nearest competitor. When measuring capacity under compression, sorbion sachet EXTRA absorbed 88% more fluid than the nearest competitor. PMID:23131912

F Cutting, Keith; Westgate, Samantha J

226

Effect of surgical incision management on wound infections in a poststernotomy patient population.  

PubMed

Skin breakdown and infiltration of skin flora are key causative elements in poststernotomy wound infections. We hypothesised that surgical incision management (SIM) using negative pressure wound therapy over closed surgical incisions for 6-7?days would reduce wound infections in a comprehensive poststernotomy patient population. 'All comers' undergoing median sternotomy at our institution were analysed prospectively from 1 September to 15 October 2013 (study group, n?=?237) and retrospectively from January 2008 to December 2009 (historical control group, n?=?3508). The study group had SIM (Prevena™ Therapy) placed immediately after skin suturing and applied at -125 mmHg for 6-7?days, whereas control group received conventional sterile wound tape dressings. Primary endpoint was wound infection within 30 days. Study group had a significantly lower infection rate than control group: 1·3% (3 patients) versus 3·4% (119 patients), respectively (P?dressing was removed after 6-7?days, the incision was primarily closed in 234 of 237 patients (98·7%). SIM over clean, closed incisions for the first 6-7 postoperative days significantly reduced the incidence of wound infection after median sternotomy. Based on these data SIM may be cost-effective in patients undergoing cardiac surgery. PMID:24851729

Grauhan, Onnen; Navasardyan, Artashes; Tutkun, Baris; Hennig, Felix; Müller, Peter; Hummel, Manfred; Hetzer, Roland

2014-06-01

227

An improved flexible telemetry system to autonomously monitor sub-bandage pressure and wound moisture.  

PubMed

This paper presents the development of an improved mobile-based telemetric dual mode sensing system to monitor pressure and moisture levels in compression bandages and dressings used for chronic wound management. The system is fabricated on a 0.2 mm thick flexible printed circuit material, and is capable of sensing pressure and moisture at two locations simultaneously within a compression bandage and wound dressing. The sensors are calibrated to sense both parameters accurately, and the data are then transmitted wirelessly to a receiver connected to a mobile device. An error-correction algorithm is developed to compensate the degradation in measurement quality due to battery power drop over time. An Android application is also implemented to automatically receive, process, and display the sensed wound parameters. The performance of the sensing system is first validated on a mannequin limb using a compression bandage and wound dressings, and then tested on a healthy volunteer to acquire real-time performance parameters. The results obtained here suggest that this dual mode sensor can perform reliably when placed on a human limb. PMID:25412216

Mehmood, Nasir; Hariz, Alex; Templeton, Sue; Voelcker, Nicolas H

2014-01-01

228

Taurine improves the wound healing process in cutaneous leishmaniasis in mice model, based on stereological parameters  

PubMed Central

Background: Cutaneous Leishmaniasis is a self-limiting disease caused by protozoan parasites of the genus Leishmania, which affects the skin with full-thickness wounds, which are prone to scar formation even after treatment. Taurine (Tu) is one of the most abundant amino acids that has antioxidant and anti-inflammatory effects, which play an important role in the process of wound healing. Herein, we have investigated the effects of Tu on cutaneous Leishmaniasis wounds and L. major promastigotes. Materials and Methods: Eighteen mice were induced with Leishmaniasis wounds (with L. Major) on the base of their tails and divided into three groups, T1: Treated with Tu injection, T2: Treated with Tu gel, and C: No treatment. Treatments were carried out every 24 hours for 21 days. The volume densities of the collagen bundles and vessels, vessel's length density and diameter, and fibroblast populations were estimated by stereological methods. Flow cytometry was used in order to investigate the direct Tu effect on parasites. The Mann-Whitney U test was used and P ? 0.05 was considered to be statistically significant. Results: The numerical density of the fibroblasts, volume density of the collagen bundles, and length densities of the vessels in groups T1 and T2 were significantly higher than in group C (P < 0.05). The fibroblast numerical density of group T1 was higher than that of group T2 (P = 0.02). Incidentally, Tu had no direct effect on L. major parasites according to the flow cytometry analysis. Conclusion: Tu showed the ability to improve the wound healing process and tissue regeneration although it had no direct anti-leishmaniasis effect. PMID:25337534

Ashkani-Esfahani, Soheil; Zarifi, Fariba; Asgari, Qasem; Samadnejad, Asal Zargari; Rafiee, Shima; Noorafshan, Ali

2014-01-01

229

Proteases and Delayed Wound Healing  

PubMed Central

Significance Proteases and their inhibitors contribute to the balance between extracellular matrix (ECM) degradation and deposition, creating an equilibrium that is essential for the timely and coordinated healing of cutaneous wounds. However, when this balance is disrupted, wounds are led into a state of chronicity characterized by abundant levels of proteases and decreased levels of protease inhibitors. Recent Advances Researchers have sought to investigate the roles of proteases within both acute and chronic wounds and how the manipulation of protease activity may aid healing. Indeed, numerous wound dressings have been developed that target such proteases in an attempt to promote wound healing. Critical Issues The normal tissue response to injury involves a complex interaction between cells and cellular mediators. In particular, the inflammatory response is augmented in chronic wounds which are characterized by elevated levels of proinflammatory cytokines and proteases. While controlling levels of inflammation and protease expression is a critical part of normal wound healing, elevated and prolonged expression of proteases produced during the inflammatory phase of healing can lead to excessive ECM degradation associated with impaired healing. Future Directions It seems plausible that future research should aim to investigate the ways in which proteases may be targeted as an alternative therapeutic approach to wound management and to assess the benefits and draw-backs of utilizing wound fluids to assess wound progression in terms of proteolytic activity. PMID:24688830

McCarty, Sara M.; Percival, Steven L.

2013-01-01

230

Wound bed preparation from a clinical perspective  

PubMed Central

Wound bed preparation has been performed for over two decades, and the concept is well accepted. The ‘TIME’ acronym, consisting of tissue debridement, infection or inflammation, moisture balance and edge effect, has assisted clinicians systematically in wound assessment and management. While the focus has usually been concentrated around the wound, the evolving concept of wound bed preparation promotes the treatment of the patient as a whole. This article discusses wound bed preparation and its clinical management components along with the principles of advanced wound care management at the present time. Management of tissue necrosis can be tailored according to the wound and local expertise. It ranges from simple to modern techniques like wet to dry dressing, enzymatic, biological and surgical debridement. Restoration of the bacterial balance is also an important element in managing chronic wounds that are critically colonized. Achieving a balance moist wound will hasten healing and correct biochemical imbalance by removing the excessive enzymes and growth factors. This can be achieved will multitude of dressing materials. The negative pressure wound therapy being one of the great breakthroughs. The progress and understanding on scientific basis of the wound bed preparation over the last two decades are discussed further in this article in the clinical perspectives. PMID:23162216

Halim, A. S.; Khoo, T. L.; Saad, A. Z. Mat

2012-01-01

231

Comparative effectiveness of the SNaP™ Wound Care System.  

PubMed

Diabetic lower extremity wounds cause substantial burden to healthcare systems, costing tens of thousands of dollars per episode. Negative pressure wound therapy (NPWT) devices have been shown to be cost-effective at treating these wounds, but the traditional devices use bulky electrical pumps that require a durable medical equipment rental-based procurement process. The Spiracur SNaP™ Wound Care System is an ultraportable NPWT system that does not use an electric pump and is fully disposable. It has superior healing compared to standard of care with modern dressings and comparable healing to traditional NPWT devices while giving patients greater mobility and giving clinicians a simpler procurement process. We used a mathematical model to analyse the costs of the SNaP™ system and compare them to standard of care and electrically powered NPWT devices. When compared to standard of care, the SNaP™ system saves over $9000 per wound treated and more than doubles the number of patients healed. The SNaP system has similar healing time to powered NPWT devices, but saves $2300 in Medicare payments or $2800 for private payers per wound treated. Our analysis shows that the SNaP™ system could save substantial treatment costs in addition to allowing patients greater freedom and mobility. PMID:21385320

Hutton, David W; Sheehan, Peter

2011-04-01

232

Pressure ulcer management in home health care: efficacy and cost effectiveness of moisture vapor permeable dressing.  

PubMed

This prospective randomized study was conducted in the home care setting to compare healing rates and costs of two different dressings for pressure ulcers: the gauze and tape dressing and the transparent moisture vapor permeable dressing (MVP). Demographic variables, healing rates, and cost of treatment were statistically analyzed for 77 pressure ulcers (48 patients). Each wound was randomly assigned to either a gauze dressing or a MVP dressing. Initial ulcer grade (Shea criteria) and measurements were determined at the start of treatment and weekly for an eight-week period. Photographs of the wound were taken at the beginning and end of treatment. The same protocol for irrigating the wound and relieving pressure was followed for both dressing groups. The median improvement for the grade II group was 100% for the MVP (n = 22) and 52% for gauze (n = 12), p less than 0.05 (Wilcoxon rank sum test). The healing rates for grade III ulcers were not significantly different in the two dressing groups. The mean (eight-week) labor and supply cost per ulcer using the MVP was $845, while that for gauze treatments was $1359, p less than 0.05 (Wilcoxon rank sum test). The cost difference for grade III ulcers was not significant in the two dressing groups. The MVP improved the healing rate and was more cost effective for grade II ulcers. Both gauze and MVP dressings proved effective for the treatment of grade III ulcers. PMID:3533007

Sebern, M D

1986-10-01

233

Affinity based multilayered polymeric self-assemblies for oral wound applications.  

PubMed

Oral mucositis, a painful and debilitating ulcerative wound condition, is a frequently occurring complication following chemo- and/or radiotherapy. While the current standards of therapy (e.g., gels and mouth rinses) provide temporary relief, there is still an unmet need for a robust, long acting barrier that can provide lubricating protection in oral wounds, thereby enhancing the wound healing response. It is proposed that an affinity based layer-by-layer (LBL) self-assembly that can be administered as a series of mouth rinses could permit the formation of protective barriers, providing a modular approach to regenerative oral therapy. In this study, biotinylated poly(acrylic acid) was synthesized for developing LBL assemblies using biotin-streptavidin affinity linkages. To explore the ability of developed LBL assemblies to potentially resist the harsh intraoral environment, in vitro chemical and ex vivo mechanical tests were performed. The stability results demonstrated significant LBL barrier stability with wear resistance. From statistical analyses, it was deduced that polymer MW and the number of LBL layers contributed significantly to chemical barrier stability. Also, the extent of biotin conjugation played a key role for LBL development and in mechanical barrier stability. Thus, the proposed affinity based LBLs with their excellent barrier properties offer a modular treatment approach in oral mucosal injuries. PMID:23335358

Authimoolam, Sundar P; Puleo, David A; Dziubla, Thomas D

2013-07-01

234

Skin tissue engineering for the infected wound site: biodegradable PLA nanofibers and a novel approach for silver ion release evaluated in a 3D coculture system of keratinocytes and staphylococcus aureus.  

PubMed

Wound infection presents a challenging and growing problem. With the increased prevalence and growth of multidrug-resistant bacteria, there is a mounting need to reduce and eliminate wound infections using methodologies that limit the ability of bacteria to evolve into further drug-resistant strains. A well-known strategy for combating bacterial infection and preventing wound sepsis is through the delivery of silver ions to the wound site. High surface area silver nanoparticles (AgNPs) allowing extensive silver ion release have therefore been explored in different wound dressings and/or skin substitutes. However, it has been recently shown that AgNPs can penetrate into the stratum corneum of skin or diffuse into the cellular plasma membrane, and may interfere with a variety of cellular mechanisms. The goal of this study was to introduce and evaluate a new type of high surface area metallic silver in the form of highly porous silver microparticles (AgMPs). Polylactic acid (PLA) nanofibers were successfully loaded with either highly porous AgMPs or AgNPs and the antimicrobial efficacy and cytotoxicity of the two silver-based wound dressings were assessed and compared. To better mimic the physiological environment in vivo where both human cells and bacteria are present, a novel coculture system combining human epidermal keratinocytes and Staphylococcus aureus bacteria was designed to simultaneously evaluate human skin cell cytotoxicity with antimicrobial efficacy in a three-dimensional environment. We found that highly porous AgMPs could be successfully incorporated in nanofibrous wound dressings, and exhibited comparable antimicrobial efficacy and cytotoxicity to AgNPs. Further, PLA nanofibers containing highly porous AgMPs exhibited steady silver ion release, at a greater rate of release, than nanofibers containing AgNPs. The replacement of AgNPs with the newly introduced AgMPs overcomes concerns regarding the use of nanoparticles and holds great promise as skin substitutes or wound dressings for infected wound sites. PMID:24494739

Mohiti-Asli, Mahsa; Pourdeyhimi, Behnam; Loboa, Elizabeth G

2014-10-01

235

Dress Codes and Uniforms.  

ERIC Educational Resources Information Center

Students do not always make choices that adults agree with in their choice of school dress. Dress-code issues are explored in this Research Roundup, and guidance is offered to principals seeking to maintain a positive school climate. In "Do School Uniforms Fit?" Kerry White discusses arguments for and against school uniforms and summarizes the…

Lumsden, Linda; Miller, Gabriel

2002-01-01

236

In vivo and in vitro cellular response to PEG-based hydrogels for wound repair  

NASA Astrophysics Data System (ADS)

Biomaterials are continuously being explored as a means to support, improve, or influence wound healing processes. Understanding the determining factors controlling the host response to biomaterials is crucial in developing strategies to employ materials for biomedical uses. In order to evaluate the host response to poly(ethylene glycol) (PEG)-based hydrogels, both in vivo and in vitro studies were performed to determine its efficacy as a dermal wound treatment and to investigate the mechanisms controlling cell-material interaction, respectively. The results of an in vivo study using a full thickness wound in a rat model demonstrated that both soluble and immobilized bioactive factors could be incorporated into a PEG-based semi-interpenetrating network (sIPN) to enhance the rate and the quality of dermal wound healing. To gain a better understanding of the results observed in vivo, in vitro studies were then conducted to examine the dynamics and mechanisms of the cell-material interaction. Degradation of the sIPN was explored as an influential factor in both mediating cellular response and controlling solute transport from the material. As degradation through gelatin dissolution could be influenced by simple alterations to the material formulation, these results provide facile guidelines to control the delivery of high molecular weight compounds. Further investigation of the cellular response to PEG-based biomaterials focused on key factors influencing cell-material interaction. Specifically, the role of the beta1 integrin subunit and several serum proteins (TGF-aalpha, IL-1beta and PDGF-BB) in mediating cellular response was explored. As cell-material interactions are based on commonly occurring interfaces between cells and molecules of the native extracellular environment, these studies provided insight into the mechanisms controlling the observed cellular response. Finally, the inflammatory response of primary monocytes to biomaterials was examined. Monocytes/Macrophages have long been recognized as key players in inflammation and wound healing and are often employed in vitro to gain an understanding of the inflammatory response to biomaterials. The observed occurrence of primary monocyte apoptosis and necrosis as well as active detachment from a material surface has implications not only in in vitro study, but also in the translation of the in vitro inflammatory response of these cells to in vivo applications.

Waldeck, Heather

237

Wound care in the geriatric client  

PubMed Central

With our aging population, chronic diseases that compromise skin integrity such as diabetes, peripheral vascular disease (venous hypertension, arterial insufficiency) are becoming increasingly common. Skin breakdown with ulcer and chronic wound formation is a frequent consequence of these diseases. Types of ulcers include pressure ulcers, vascular ulcers (arterial and venous hypertension), and neuropathic ulcers. Treatment of these ulcers involves recognizing the four stages of healing: coagulation, inflammation, proliferation, and maturation. Chronic wounds are frequently stalled in the inflammatory stage. Moving past the inflammation stage requires considering the bacterial burden, necrotic tissue, and moisture balance of the wound being treated. Bacterial overgrowth or infection needs to be treated with topical or systemic agents. In most cases, necrotic tissue needs to be debrided and moisture balance needs to be addressed by wetting dry tissue and drying wet tissue. Special dressings have been developed to accomplish these tasks. They include films, hydrocolloids, hydrogel dressings, foams, hydrofibers, composite and alginate dressings. PMID:19554098

Gist, Steve; Tio-Matos, Iris; Falzgraf, Sharon; Cameron, Shirley; Beebe, Michael

2009-01-01

238

Misapplying Equity Theories: Dress Codes at Work  

Microsoft Academic Search

This Article provides a new perspective on Title VII caselaw concerning employer-mandated, sex-specific dress codes. With few exceptions, courts have held that employer dress codes do not constitute sex discrimination even when they expressly differentiate based solely on an employee's sex. In other contexts, courts readily acknowledge that facially sex-based practices and policies are presumptively unlawful under Title VII. When

Jennifer L. Levi

2008-01-01

239

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

PubMed

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. PMID:20081669

Barrett, Simon

240

Loxoscelism and negative pressure wound therapy (vacuum-assisted closure): an experimental study.  

PubMed

Brown recluse spider (Loxosceles) bites cause lesions ranging from chronic necrotic ulcers to acute life-threatening sepsis. Based on our experience in treating acute and chronic wounds with negative pressure, we postulated that vacuum-assisted closure (VAC) would be valuable in this application. Chester pigs were procured and injected with purified brown recluse spider venom, 1 µl of venom in two anterior sites and 0·1 µl of venom in two posterior sites on their dorsum. For each concentration of venom, treatment consisted of either VAC or dry, non adherent dressings (control group). Each day, the wounds were inspected and measured. For wounds receiving 1·0 µl of venom, the control wounds decreased in surface area to 50% of initial size after 7 days and none had healed, whereas VAC-treated wounds were less than 50% after 48 hours and completely healed and reepithelialised after 8 days. Wounds with 0·1 µl of venom had 50% reduction after 5 days with no complete healing for control wounds, and the VAC wounds were 50% after 48 hours and all had closed and reepithelialised after 5 days. Our experimental study showed an accelerated healing time in the animals treated with the VAC as compared with controls. PMID:20666855

Wong, S Lindsey; Schneider, Andrew M; Argenta, Louis C; Morykwas, Michael J

2010-12-01

241

Standard abdominal wound edge protection with surgical dressings vs coverage with a sterile circular polyethylene drape for prevention of surgical site infections (BaFO): study protocol for a randomized controlled trial  

PubMed Central

Background Postoperative surgical site infections cause substantial morbidity, prolonged hospitalization, costs and even mortality and remain one of the most frequent surgical complications. Approximately 14% to 30% of all patients undergoing elective open abdominal surgery are affected and methods to reduce surgical site infection rates warrant further investigation and evaluation in randomized controlled trials. Methods/design To investigate whether the application of a circular plastic wound protector reduces the rate of surgical site infections in general and visceral surgical patients that undergo midline or transverse laparotomy by 50%. BaFO is a randomized, controlled, patient-blinded and observer-blinded multicenter clinical trial with two parallel surgical groups. The primary outcome measure will be the rate of surgical site infections within 45?days postoperative assessed according to the definition of the Center for Disease Control. Statistical analysis of the primary endpoint will be based on the intention-to-treat population. The global level of significance is set at 5% (2 sided) and sample size (n?=?258 per group) is determined to assure a power of 80% with a planned interim analysis for the primary endpoint after the inclusion of 340 patients. Discussion The BaFO trial will explore if the rate of surgical site infections can be reduced by a single, simple, inexpensive intervention in patients undergoing open elective abdominal surgery. Its pragmatic design guarantees high external validity and clinical relevance. Trial registration http://www.clinicaltrials.gov NCT01181206. Date of registration: 11 August 2010; date of first patient randomized: 8 September 2010 PMID:22587425

2012-01-01

242

Effect of chitosan acetate bandage on wound healing in infected and noninfected wounds in mice  

PubMed Central

HemCon® bandage is an engineered chitosan acetate preparation designed as a hemostatic dressing, and is under investigation as a topical antimicrobial dressing. We studied its effects on healing of excisional wounds that were or were not infected with Staphylococcus aureus, in normal mice or mice previously pretreated with cyclophosphamide (CY). CY significantly suppressed wound healing in both the early and later stages, while S. aureus alone significantly stimulated wound healing in the early stages by preventing the initial wound expansion. CY plus S. aureus showed an advantage in early stages by preventing expansion, but a significant slowing of wound healing in later stages. In order to study the conflicting clamping and stimulating effects of chitosan acetate bandage on normal wounds, we removed the bandage from wounds at times after application ranging from 1 hour to 9 days. Three days application gave the earliest wound closure, and all application times gave a faster healing slope after removal compared with control wounds. Chitosan acetate bandage reduced the number of inflammatory cells in the wound at days 2 and 4, and had an overall beneficial effect on wound healing especially during the early period where its antimicrobial effect is most important. PMID:18471261

Burkatovskaya, Marina; Castano, Ana P.; Demidova-Rice, Tatiana N.; Tegos, George P.; Hamblin, Michael R.

2010-01-01

243

Dress Like a Frog  

NSDL National Science Digital Library

In this activity, learners will discover what it takes to be a frog. By dressing up like one, learners can visualize how each part of the frog plays an important role in surviving its habitat. This is a demonstration that would involve a volunteer dressing like a frog to show the various adaptations but can be adapted for small groups of learners. Ribbit not included.

Aquariums, Association O.

2009-01-01

244

Biological Effects of a Disposable, Canisterless Negative Pressure Wound Therapy System  

PubMed Central

Objective: Recent developments of negative pressure wound therapy (NPWT) systems have focused on making pumps smaller, lighter, and more portable. The recently introduced PICO system manages wound fluid through a highly breathable film within the dressing, thereby negating the need for a canister, which allows greater mobility and patient concordance. The aim of this study is to compare the biological effects of this system compared to a traditional NPWT system. Methods: Laboratory tests were carried out to demonstrate the fluid handling properties of the PICO™ system. Porcine full thickness defect wounds and sutured incisional wounds were used to compare the biological effects. Wounds were treated with PICO dressings or traditional NPWT dressings and connected to either a PICO device or a traditional NPWT device. Results: The PICO dressing manages exudate predominantly through evaporative loss (up to 85% of all fluid entering the dressing). Both traditional NPWT and the PICO system maintained therapeutic levels of negative pressure in all wounds. Both NPWT systems produced similar effects on wound edge contraction and microvascular blood flow in defect wounds. No significant changes in blood flow or wound contraction were noted in incision wounds for any NPWT combinations tested. Conclusions: The disposable, canisterless PICO NPWT system functions in the same manner as the traditional NPWT systems with regard to fluid handling, pressure transmission to the wound bed, tissue contraction, and changes in blood flow. PMID:24741386

Malmsjo, Malin; Huddleston, Elizabeth; Martin, Robin

2014-01-01

245

Management of Traumatic Wounds and a Novel Approach to Delivering Wound Care in Children  

PubMed Central

Significance: The costs and morbidity of pediatric traumatic wounds are not well known. The literature lacks a comprehensive review of the volume, management, and outcomes of children sustaining soft tissue injury. We briefly review the existing literature for traumatic wounds such as open fractures and burns. Such injuries require dedicated wound care and we propose a novel approach for more efficient and more effective delivery of dedicated pediatric wound care. Recent Advances: New pediatric literature is emerging regarding the long-term effects of wound care pain in traumatic injuries—especially burns. A variety of wound dressings and alternative management techniques exist and are geared toward reducing wound care pain. Our institution utilizes a unique model to provide adequate sedation and pain control through a dedicated pediatric wound care unit. We believe that this model reduces the cost of wound care by decreasing emergency department and operating room visits as well as hospital length of stay. Critical Issues: First, medical costs related to pediatric traumatic wound care are not insignificant. The need for adequate pain control and sedation in children with complex wounds is traditionally managed with operating room intervention. Afterward, added costs can be from a hospital stay for ongoing acute wound management. Second, morbidities of complex traumatic wounds are shown to be related to the acute wound care received. Future Directions: Further guidelines are needed to determine the most effective and efficient care of complex traumatic soft tissue injuries in the pediatric population. PMID:24761364

Bernabe, Kathryn Q.; Desmarais, Thomas J.; Keller, Martin S.

2014-01-01

246

Pressure ulcers--randomised controlled trial comparing hydrocolloid and saline gauze dressings.  

PubMed

An open comparative randomised study comparing the performance of hydrocolloid dressings (DuoDERM CGF) to saline gauze dressings in the treatment of pressure ulcers was done to evaluate the overall dressing performance, wound healing and cost effectiveness. Thirty-four subjects were enrolled at the University Hospital, Kuala Lumpur over a 643 days period. Inclusion criteria were Stage II or III pressure ulcers, at least 18 years of age and written informed consent. Only one pressure ulcer per subject was enrolled in the study. Patients with infected pressure ulcers, diabetes mellitus, an immuno-compromised status and known sensitivity to the study dressings were excluded. Subjects who met the enrollment criteria were randomised to one of the two dressing regimes. They were expected to participate in the study for a maximum of eight weeks or until the pressure ulcer healed, which ever occurred first. Overall subject age averaged 58 years and the mean duration of pressure ulcer existence was about 1 month. Twenty-one of the thirty-four ulcers enrolled were stage II and thirteen were stage III. The majority of the ulcers (88%) were located in the sacral area and seventeen subjects (50%) were incontinent. In the evaluation of dressing performance in terms of adherence to wound bed, exudate handling ability, overall comfort and pain during dressing removal; all favoured the hydrocolloid dressing by a statistically significant margin (p < 0.001). Subjects assigned the hydrocolloid dressing experienced a mean 34% reduction from their baseline surface area measurement compared to a mean 9% increase by subjects assigned gauze dressings. This was not statistically significant (p = 0.2318). In cost evaluation of the study products, there was no statistical significance in the total cost of wound management per subject. When only labour time and cost was evaluated, there was a statistically significant advantage towards hydrocolloid dressings. PMID:10971989

Chang, K W; Alsagoff, S; Ong, K T; Sim, P H

1998-12-01

247

Development of novel smart device based application for serial wound imaging and management.  

PubMed

Burn wound photography has diverse clinical applications; however, inherent technological limitations mitigate its utility. Limitations include lack of quality control, serial imaging, complexity, and expense. With the performance gap between smart devices and digital cameras rapidly narrowing, and computing performance increasing, smart devices are poised to uniquely address these limitations and enhance the field of wound photography. To this end, we developed a proof-of-concept smart device application addressing the limitations of traditional photography and meeting the needs of burn clinicians. The result was an innovative smart device application providing user-friendly serial imaging and informatics capabilities at the patient bedside. The application generated images with significantly higher brightness (2.4±1.07 vs. 3.8±1.69, n=15, p<0.05) and higher contrast (255±0.00 vs. 236.3±5.64, n=15, p<0.0001), more consistent positioning (1.22±0.03 vs. 2.08±0.61, n=15, p<0.0001) and zoom (18.14 vs. 14.29, n=15, p<0.0001) compared to those taken by a basic compact digital camera using default settings. Surveyed clinician end-users reported greater functionality (20 vs. 0, n=20, p<0.001), and a more intuitive interface (18 vs. 2, n=20, p<0.001) with the application. We report consistent serial wound imaging and informatics are both feasible on a smart device platform. These findings will pave the way for new smart device-based clinical applications. PMID:23768708

Godwin, Zachary R; Bockhold, Jennifer C; Webster, Luke; Falwell, Stephanie; Bomze, Laura; Tran, Nam K

2013-11-01

248

Wound closure and wound management  

PubMed Central

Wound closure and infection control are the primary goal of wound management. A variety of disinfectants and antimicrobial agents are widely available today and routinely achieve infection control. On the contrary, wound closure still remains a challenging goal. Cell adhesion, migration and contraction play significant roles in creating contractile force of patent wound margins and in contributing to wound closure. Modulations of these cellular behaviors have been investigated in the context of wound contraction; however, therapeutic strategy to achieve wound closure has not been established. Recently, we have reported that a previously unknown cytoskeleton molecule, wound inducible transcript-3.0 (wit3.0) also known as fibroblast growth factor receptor 1 oncogene partner 2 (FGFR1OP2), can significantly modulate fibroblast-driven wound closure in vitro and in vivo. The dynamic role of cytoskeleton in different experimental models may provide a novel platform for designing the therapeutic target of wound management. PMID:20448469

Lin, Audrey; Hokugo, Akishige

2010-01-01

249

Magnetite nanoparticles for functionalized textile dressing to prevent fungal biofilms development  

NASA Astrophysics Data System (ADS)

The purpose of this work was to investigate the potential of functionalized magnetite nanoparticles to improve the antibiofilm properties of textile dressing, tested in vitro against monospecific Candida albicans biofilms. Functionalized magnetite (Fe3O4/C18), with an average size not exceeding 20 nm, has been synthesized by precipitation of ferric and ferrous salts in aqueous solution of oleic acid (C18) and NaOH. Transmission electron microscopy, X-ray diffraction analysis, and differential thermal analysis coupled with thermo gravimetric analysis were used as characterization methods for the synthesized Fe3O4/C18. Scanning electron microscopy was used to study the architecture of the fungal biofilm developed on the functionalized textile dressing samples and culture-based methods for the quantitative assay of the biofilm-embedded yeast cells. The optimized textile dressing samples proved to be more resistant to C. albicans colonization, as compared to the uncoated ones; these functionalized surfaces-based approaches are very useful in the prevention of wound microbial contamination and subsequent biofilm development on viable tissues or implanted devices.

Anghel, Ion; Grumezescu, Alexandru Mihai; Andronescu, Ecaterina; Anghel, Alina Georgiana; Ficai, Anton; Saviuc, Crina; Grumezescu, Valentina; Vasile, Bogdan Stefan; Chifiriuc, Mariana Carmen

2012-09-01

250

Magnetite nanoparticles for functionalized textile dressing to prevent fungal biofilms development.  

PubMed

The purpose of this work was to investigate the potential of functionalized magnetite nanoparticles to improve the antibiofilm properties of textile dressing, tested in vitro against monospecific Candida albicans biofilms. Functionalized magnetite (Fe3O4/C18), with an average size not exceeding 20?nm, has been synthesized by precipitation of ferric and ferrous salts in aqueous solution of oleic acid (C18) and NaOH. Transmission electron microscopy, X-ray diffraction analysis, and differential thermal analysis coupled with thermo gravimetric analysis were used as characterization methods for the synthesized Fe3O4/C18. Scanning electron microscopy was used to study the architecture of the fungal biofilm developed on the functionalized textile dressing samples and culture-based methods for the quantitative assay of the biofilm-embedded yeast cells. The optimized textile dressing samples proved to be more resistant to C. albicans colonization, as compared to the uncoated ones; these functionalized surfaces-based approaches are very useful in the prevention of wound microbial contamination and subsequent biofilm development on viable tissues or implanted devices. PMID:22950367

Anghel, Ion; Grumezescu, Alexandru Mihai; Andronescu, Ecaterina; Anghel, Alina Georgiana; Ficai, Anton; Saviuc, Crina; Grumezescu, Valentina; Vasile, Bogdan Stefan; Chifiriuc, Mariana Carmen

2012-01-01

251

Magnetite nanoparticles for functionalized textile dressing to prevent fungal biofilms development  

PubMed Central

The purpose of this work was to investigate the potential of functionalized magnetite nanoparticles to improve the antibiofilm properties of textile dressing, tested in vitro against monospecific Candida albicans biofilms. Functionalized magnetite (Fe3O4/C18), with an average size not exceeding 20?nm, has been synthesized by precipitation of ferric and ferrous salts in aqueous solution of oleic acid (C18) and NaOH. Transmission electron microscopy, X-ray diffraction analysis, and differential thermal analysis coupled with thermo gravimetric analysis were used as characterization methods for the synthesized Fe3O4/C18. Scanning electron microscopy was used to study the architecture of the fungal biofilm developed on the functionalized textile dressing samples and culture-based methods for the quantitative assay of the biofilm-embedded yeast cells. The optimized textile dressing samples proved to be more resistant to C. albicans colonization, as compared to the uncoated ones; these functionalized surfaces-based approaches are very useful in the prevention of wound microbial contamination and subsequent biofilm development on viable tissues or implanted devices. PMID:22950367

2012-01-01

252

The Effect of Camellia sinensis on Wound Healing Potential in an Animal Model  

PubMed Central

Camellia sinensis (tea) is reported to have health benefits, including the building of healthy skin. This study evaluated the effects of topical application of Camellia sinensis extract on the rate of wound closure and the histology of wound area. A uniform area of 2.00?cm in diameter was excised from the neck of adult male Sprague Dawley rats. The animals were topically treated with 0.2?mL of vehicle (CMC), Intrasite gel (positive control), or 200 and 400?mg/mL of extract. Wounds dressed with the extract and Intrasite gel healed significantly earlier than those with vehicle. Histological analysis of the wound area after 10 days showed that wounds dressed with the extract had less scar width when compared to the control. The tissue contained less inflammatory cells and more collagen and angiogenesis, compared to wounds dressed with vehicle. In this study, Camellia sinensis showed high potential in wound healing activity. PMID:23864889

Kanthimathi, M. S.; Sanusi, Junedah

2013-01-01

253

Some Modest Proposals for Challenging Established Dress Code Jurisprudence  

Microsoft Academic Search

Historically, most courts have sustained employer-imposed, gender-based dress codes. Two well-established exceptions to the rule exist for dress codes that either (1) objectify or sexualize women or (2) allow for flexibility of standards for male employees' appearance but require stricter rules for women. A third, still-evolving exception has recently developed regarding challenges to dress codes by transgender litigants. Despite this

Jennifer L. Levi

2007-01-01

254

Some Modest Proposals for Challenging Established Dress Code Jurisprudence  

Microsoft Academic Search

Two well-established exceptions to the rule exist for dress codes that either (1) objectify or sexualize women1 or (2) allow for flexibility of standards for male employees' appearance but require stricter rules for women.2 A third, still-evolving exception has recently developed regarding challenges to dress codes by transgender litigants.3 Despite this recent progress, however, the classical gender-based dress code-requiring women

Jennifer Levi

2007-01-01

255

Active Silver Nanoparticles for Wound Healing  

PubMed Central

In this preliminary study, the silver nanoparticle (Ag NP)-based dressing, Acticoat™ Flex 3, has been applied to a 3D fibroblast cell culture in vitro and to a real partial thickness burn patient. The in vitro results show that Ag NPs greatly reduce mitochondrial activity, while cellular staining techniques show that nuclear integrity is maintained, with no signs of cell death. For the first time, transmission electron microscopy (TEM) and inductively coupled plasma mass spectrometry (ICP-MS) analyses were carried out on skin biopsies taken from a single patient during treatment. The results show that Ag NPs are released as aggregates and are localized in the cytoplasm of fibroblasts. No signs of cell death were observed, and the nanoparticles had different distributions within the cells of the upper and lower dermis. Depth profiles of the Ag concentrations were determined along the skin biopsies. In the healed sample, most of the silver remained in the surface layers, whereas in the unhealed sample, the silver penetrated more deeply. The Ag concentrations in the cell cultures were also determined. Clinical observations and experimental data collected here are consistent with previously published articles and support the safety of Ag NP-based dressing in wound treatment. PMID:23455461

Rigo, Chiara; Ferroni, Letizia; Tocco, Ilaria; Roman, Marco; Munivrana, Ivan; Gardin, Chiara; Cairns, Warren R. L.; Vindigni, Vincenzo; Azzena, Bruno; Barbante, Carlo; Zavan, Barbara

2013-01-01

256

The prevalence, aetiology and management of wounds in a community care area in Ireland.  

PubMed

This study aimed to establish the prevalence and aetiology of wounds, allowing an insight into the management of wound care, the use of dressings and the nursing time allocated to the provision of wound care in a community setting in Ireland. A cross-sectional survey was used, with data collected on all clients in the community who received treatment from public health nurses or community registered general nurses for wound care over a 1-week period in April 2013. A 98.9% response rate was realised, and 188 people were identified as having wounds, equating to a crude prevalence of 5% of the active community nursing caseload. A total of 60% (n=112) had leg ulcers, 22% (n=42) had pressure ulcers, 16% (n=30) had an acute wound (surgical or traumatic wounds), 1% (n=2) had a diabetic foot wound and a further 1% (n=2) had wounds of other aetiologies. The mean duration of wounds was 5.41 months. A total of 18% of wounds were identified as infected; however, 60% (n=112) of wounds had antimicrobial products in use as either a primary or secondary dressing. The study established that there is a significant prevalence of wounds in this community care area. There was absence of a clinical diagnosis in many cases, and evidence of inappropriate dressing use, risking an increase in costs and a decrease in good clinical outcomes. It also highlighted the importance of ongoing education and auditing in the provision of wound care. PMID:24912830

Skerritt, Louise; Moore, Zena

2014-06-01

257

Nanofiber Microenvironment and Diabetic Wound Healing  

Cancer.gov

Diabetic nonhealing wounds represent a major public health problem. Diabetic wounds are characterized by altered wound microenvironment, unbalanced proteolytic activity, prolonged inflammation, and insufficient neovascularization. The efficacy of conventional therapies is unsatisfactory and often results in recurrence of wounds at characteristically predisposed sites, as a direct consequence of poor wound repair. Skin substitutes based on novel biocomposite materials represent the most promising bioengineering technology today and may offer an exciting new treatment strategy in management of chronic wounds.

258

Effect of Acticoat(®) and Cutinova Hydro(®) on wound healing.  

PubMed

In this study, the effects of the wound-covering materials, Acticoat(®) and Cutinova Hydro(®) , on wound healing have been studied in rabbit models with open and tissue-lost wounds with full-thickness flank excisions. Rabbits were used as subjects with three groups of four rabbits each, and trial periods of 7, 14 and 21{\\uns}days. Four circular wounds, of 1.5 cm diameter were made two on the right (one of them control) and two on the left (one of them control) of the dorsal sides of the abdomen. Acticoat(®) and Cutinova Hydro(®) were applied on the wounds with suture for a period of 21 days and one each placed on the right and left sides as control with gauze. Biopsy specimens were taken from the animals at the end of the research period to check the length of the epithelium, epithelial thickness, size of wounds, wound granulation tissue formation and histopathological evaluation for clarity. The Acticoat(®) group showed better healing and scar formation compared to the Cutinova Hydro(®) group by macroscopic examination. Epithelial wound length and clarity in terms of statistical difference occurred on day 21 (P <0.05); while the length of the wound epithelium decreased patency, epithelial thickness on days~7, 14 and 21, showed no statistical differences (P >0.05). As a result, the Acticoat(®) wound dressing was determined as a more reliable for the early wound healing. This study has shown the short-term clinical benefits of hydroactive, polyurethane dressings in the management of acute wounds. However, longer periods of wound healing procedure should be planned for reliable and safe results of wound dressing. It has also been concluded that microbiological analyses should be included for more robust and reliable comparisons. PMID:22682153

Ar?can, Mustafa; Hatipoglu, Fatih; Uyaroglu, Aysen; Ozdemir, Ozgur; Ozkan, Kadircan

2013-10-01

259

Digital photography and transparency-based methods for measuring wound surface area.  

PubMed

To compare and determine a credible method of measurement of wound surface area by linear, transparency, and photographic methods for monitoring progress of wound healing accurately and ascertaining whether these methods are significantly different. From April 2005 to December 2006, 40 patients (30 men, 5 women, 5 children) admitted to the surgical ward of Shree Sayaji General Hospital, Baroda, had clean as well as infected wound following trauma, debridement, pressure sore, venous ulcer, and incision and drainage. Wound surface areas were measured by these three methods (linear, transparency, and photographic methods) simultaneously on alternate days. The linear method is statistically and significantly different from transparency and photographic methods (P value <0.05), but there is no significant difference between transparency and photographic methods (P value >0.05). Photographic and transparency methods provided measurements of wound surface area with equivalent result and there was no statistically significant difference between these two methods. PMID:24426404

Bhedi, Amul; Saxena, Atul K; Gadani, Ravi; Patel, Ritesh

2013-04-01

260

From model to molecules: the development and experimental manipulation of an in vivo contaminated extremity war wound.  

PubMed

Wound infection is a key determinant of outcome in survivors of armed conflict. One factor having potential for promoting healing, decreasing bacterial burden and influencing prognosis is the dressing that covers the ballistic-injured extremity. Although antiseptic and silver dressings are applied to acute wounds, evidence to support their use is scarce with no controlled studies reported of antimicrobial wound dressings in extremity trauma. Given the recent burden of ballistic extremity injury, the requirement to investigate the role of antimicrobial dressings in contaminated wounds is transparent. This paper details a programme of work undertaken at the Defence Science and Technology Laboratory of developing and trialling a recovery model to investigate the early management of contaminated war wounds. A New Zealand White rabbit flexor carpi ulnaris muscle belly, isolated and then injured by a drop rig mechanism, was contaminated with Staphylococcus aureus to provide a reproducible contaminated muscle wound. This model was developed to support a series of randomised controlled trials to determine the impact of antimicrobial dressings on decreasing the bacterial burden of combat related extremity wounds. The results of the initial trial indicated that over a 48-h period, dressings augmented with antiseptic or silver offer no advantage over saline-soaked gauze in reducing the bacterial burden of a contaminated soft tissue injury. The model has subsequently been used to investigate the efficacy of dressings over a 7-day study period and impact of antibiotics and to evaluate biofilm formation and wound cytokines. PMID:24599972

Eardley, Will G P; Guthrie, H C

2014-06-01

261

Mesenchymal Stem Cells: A Multimodality Option for Wound Healing  

PubMed Central

Background Although significant resources are invested in wound care and healing annually, chronic wounds remain a major medical problem as they often present a more difficult challenge than the underlying disease. Current treatment options include a multitude of dressing materials, topical agents including antibiotics, enzymatic debriders, and growth factors, mechanical debridement, and optimization of medical comorbidities. The Problem Even under optimal circumstances, the healing process leads to some form of fibrosis and scarring. Basic/Clinical Science Advances Studies suggest that mesenchymal stem/stromal cells (MSCs) isolated from these diverse tissues possess similar biological characteristics, differentiation potential, and immunological properties. Enthusiasm about MSCs for use in reconstruction and regenerative medicine has been fueled by evidence that these cells possess the ability to participate in the tissue repair process through a variety of paracrine mechanisms affecting tissue regeneration and inflammation. Clinical Care Relevance Recent advances in stem cell immunobiology have led to increased interest in MSCs as a new therapeutic modality to address chronic wounds and other inflammatory pathology. Conclusion A thorough understanding of the immunobiology of MSCs is necessary to realize the complement of pathological processes that could be affected by MSC-based therapy. The novel methods reviewed here are highly promising, with the collective goal of identifying new therapeutic approaches to wound healing that are broadly applicable to many chronic diseases, and can safely accelerate the transition of basic research findings into clinical advances in many areas of regenerative medicine and reconstructive surgery. PMID:24527297

Hanson, Summer E.

2012-01-01

262

Collagen sheet dressings for cutaneous lesions of toxic epidermal necrolysis.  

PubMed

Toxic epidermal necrolysis (TEN) is associated with a significant mortality of 30-50% and long-term sequelae. Treatment includes early admission to a burn unit, where management with precise fluid, electrolyte, protein, and energy supplementation, moderate mechanical ventilation, and expert wound care can be provided. Specific treatment with immunosuppressive drugs or immunoglobulins did not show an improved outcome in most studies and remains controversial. We have treated the cutaneous lesions of seven patients of TEN with collagen sheet dressings and have found a significant reduction in morbidity. The sheets are a one-time dressing, easy to apply and they reduce fluid loss, prevent infection, reduce pain, avoid repeated dressings and gradually peal off as the underlying lesions heal. PMID:22279282

Bhattacharya, S; Tripathi, H N; Gupta, V; Nigam, Bharti; Khanna, A

2011-09-01

263

Nanocrystalline silver dressings as an efficient anti-MRSA barrier: a new solution to an increasing problem.  

PubMed

The emergence of multi-drug-resistant strains of bacteria represents a particular challenge in the field of wound management. The aim of the current study was to investigate whether nanocrystalline silver dressings possess the physical properties to act as a barrier to the transmission of methicillin-resistant Staphylococcus aureus (MRSA) in the laboratory setting and in a clinical setting. Initially, MRSA suspension and colony culture experiments were performed showing that nanocrystalline silver dressings act as potent and sustained antimicrobial agents, efficiently inhibiting MRSA penetration. Subsequently, a double-centre clinical trial was initiated using nanocrystalline silver dressings as a cover for 10 MRSA colonized wounds in a total of seven patients. By delineating the MRSA load on the upper side of the dressing and the wound bed each time the dressing was changed (i.e. after 1, 24, 48 and 72 h), nanocrystalline silver dressings were found to provide a complete, or almost complete, barrier to the penetration/spread of MRSA in 95% of readings. In addition, 67% of all wound observations showed a decrease in the MRSA load with an eradication rate of 11%. We believe that nanocrystalline silver dressings may become an important part of local MRSA management, with cost benefits to both patients and the healthcare system. PMID:15896880

Strohal, R; Schelling, M; Takacs, M; Jurecka, W; Gruber, U; Offner, F

2005-07-01

264

Wound care with traditional, complementary and alternative medicine  

PubMed Central

Wound care is constantly evolving with the advances in medicine. Search for the ideal dressing material still continues as wound care professionals are faced with several challenges. Due to the emergence of multi-resistant organisms and a decrease in newer antibiotics, wound care professionals have revisited the ancient healing methods by using traditional and alternative medicine in wound management. People's perception towards traditional medicine has also changed and is very encouraging. The concept of moist wound healing has been well accepted and traditional medicine has also incorporated this method to fasten the healing process. Several studies using herbal and traditional medicine from different continents have been documented in wound care management. Honey has been used extensively in wound care practice with excellent results. Recent scientific evidences and clinical trials conducted using traditional and alternative medicine in wound therapy holds good promise in the future. PMID:23162243

Dorai, Ananda A.

2012-01-01

265

Evolution or revolution? Adapting to complexity in wound management.  

PubMed

Wound clinics are seeing an increase in the number of 'complex' wounds, which arise as the result of the interaction between multiple coexisting systemic pathologies, environmental factors and local wound factors. These complex wounds require an approach to diagnosis and management that can encapsulate all these factors. Unified wound assessment approaches such as HEIDI (History, Examination, Investigations, Diagnosis and management plan), wound bed preparation and applied wound management systems are essential to reach a definitive diagnosis and to ensure that management is agreed between the various clinical specialities that may be involved. A series of case histories is presented that illustrate the benefits of a unified approach to wound management. Results of a study into the cost-effectiveness of an improved foam dressing are presented, and the problems of demonstrating the ability to make long-term savings through short-term expenditure are discussed. PMID:17543040

Harding, Keith; Gray, David; Timmons, John; Hurd, Theresa

2007-06-01

266

ERK and phosphoinositide 3-kinase temporally coordinate different modes of actin-based motility during embryonic wound healing.  

PubMed

Embryonic wound healing provides a perfect example of efficient recovery of tissue integrity and homeostasis, which is vital for survival. Tissue movement in embryonic wound healing requires two functionally distinct actin structures: a contractile actomyosin cable and actin protrusions at the leading edge. Here, we report that the discrete formation and function of these two structures is achieved by the temporal segregation of two intracellular upstream signals and distinct downstream targets. The sequential activation of ERK and phosphoinositide 3-kinase (PI3K) signalling divides Xenopus embryonic wound healing into two phases. In the first phase, activated ERK suppresses PI3K activity, and is responsible for the activation of Rho and myosin-2, which drives actomyosin cable formation and constriction. The second phase is dominated by restored PI3K signalling, which enhances Rac and Cdc42 activity, leading to the formation of actin protrusions that drive migration and zippering. These findings reveal a new mechanism for coordinating different modes of actin-based motility in a complex tissue setting, namely embryonic wound healing. PMID:23986484

Li, Jingjing; Zhang, Siwei; Soto, Ximena; Woolner, Sarah; Amaya, Enrique

2013-11-01

267

The application of new biosynthetic artificial skin for long-term temporary wound coverage  

Microsoft Academic Search

Temporary dressings protect wounds from desiccation and infection. In our previous study, we used meshed acellular porcine dermis (APD) to enhance wound healing and decrease wound contraction; however, the wounds showed meshed scar [Wang HJ, Chen TM, Cheng TY. Use of a porcine dermis template to enhance widely expanded mesh autologous split-thickness skin graft growth: preliminary report. J Trauma 1997;42(2):177–82].

Hsian-Jenn Wang; Trong-Duo Chou; Tai-Li Tsou; Tim-Mo Chen; Shao-Liang Chen; Shyi-Gen Chen; Lin-Gwei Wei; Kuan-Jeh Yeh; Yao-Huang Ko; Chi-Shyran Wang; Wei-Hwa Lee

2005-01-01

268

The enhanced total body wrap--the new frontier in dressing care for burns.  

PubMed

The management of extensive burns with their associated high fluid exudate following burn excision and skin grafting has always posed a challenge in burn wound care. The ideal dressing should protect the wound from physical damage and micro-organisms; be comfortable and durable; allow high humidity at the wound; and be able to allow maximal activity for wound healing without retarding or inhibiting any stage of the process. The dressing technique described in this paper fulfils all the criteria above and at the same time provides an efficient channel to effectively clear the excessive exudate produced while keeping the wounds moist. Advantages conferred include accurate charting of wound exudate; reduced frequency of dressing changes; lower infection rates through prevention of strike-through; and securing and improving the viability of skin grafts. An enhancement to a technique previously described by us through the use of long thin strips of VAC sponges to transmit negative pressure, the enhanced Total Body Wrap aims to provide ideal conditions to promote healing in burns. Using negative pressure wound therapy (NPWT), this technique is simple and straightforward enough to be applied in majority of tertiary centres around the world. PMID:23742730

Low, O-Wern; Chong, Si Jack; Tan, Bien-Keem

2013-11-01

269

Prospective clinical study of Hydron, a synthetic dressing, in delivery of an antimicrobial drug to second-degree burns.  

PubMed

This clinical trial prospectively evaluates the potential beneficial effects of antimicrobial drug delivery from a synthetic dressing (Hydron-AgSD) formed on second-degree burn wounds. A paste composed of polyethylene glycol-400, poly 2-OH ethylmethacrylate, and silver sulfadiazine (AgSD 1%-3%) matured within one hour to form a solid dressing. In 27 patients, comparable areas of second-degree wounds on the same patient were selected at random for test and control (silver sulfadiazine 1% only) sites. The mean total time of the synthetic dressing application per patient was about nine days, and each dressing remained in place for nearly four days. During this interval the control sites required four dressings changes. In 17 tests for infections, the control areas were contaminated but no bacteria were detected under the synthetic dressing; in three tests, the controls had no bacteria, whereas the synthetic dressing did. Healing of burns was similar under both types of dressing. Benefits of Hydron treatment included increased patient comfort because of the reduced number of dressing changes and, in some cases, greater freedom from contaminating bacteria. PMID:3301861

Fang, C H; Nathan, P; Robb, E C; Alexander, J W; MacMillan, B G

1987-01-01

270

Dressing wear time after breast reconstruction: study protocol for a randomized controlled trial  

PubMed Central

Background One of the major risk variables for surgical site infection is wound management. Understanding infection risk factors for breast operations is essential in order to develop infection-prevention strategies and improve surgical outcomes. The aim of this trial is to assess the influence of dressing wear time on surgical site infection rates and skin colonization. Patients’ perception at self-assessment will also be analyzed. Methods/Design This is a two-arm randomized controlled trial. Two hundred breast cancer patients undergoing immediate or delayed breast reconstruction will be prospectively enrolled. Patients will be randomly allocated to group I (dressing removed on postoperative day one) or group II (dressing removed on postoperative day six). Surgical site infections will be defined by standard criteria from the Centers for Disease Control and Prevention (CDC). Skin colonization will be assessed by culture of samples collected at predefined time points. Patients will score dressing wear time with regard to safety, comfort and convenience. Discussion The evidence to support dressing standards for breast surgery wounds is empiric and scarce. CDC recommends protecting, with a sterile dressing for 24 to 48 hours postoperatively, a primarily closed incision, but there is no recommendation to cover this kind of incision beyond 48 hours, or on the appropriate time to shower or bathe with an uncovered incision. The results of the ongoing trial may support standard recommendations regarding dressing wear time after breast reconstruction. Trial registration ClinicalTrials.gov identifier: http://NCT01148823. PMID:23432779

2013-01-01

271

The effect of different biologic and biosynthetic wound covers on keratinocyte growth, stratification and differentiation in vitro  

PubMed Central

The purpose of this study was to compare, by means of in vitro cultivation technique, five marketed brands of wound covers used in the treatment of burns and other skin defects (Biobrane®, Suprathel®, Veloderm®, Xe-Derma®, and Xenoderm®) for their ability to stimulate the keratinocyte growth, stratification, and differentiation. In three independent experiments, human keratinocytes were grown on the tested covers in organotypic cultures by the 3T3 feeder layer technique. Vertical paraffin sections of the wound covers with keratinocytes were processed using hematoxylin–eosin staining and immunostaining for involucrin. Keratinocyte populations on the dressings were assessed for (1) number of keratinocyte strata (primary variable), (2) quantitative growth, (3) thickness of the keratinocyte layer, and (4) cell differentiation. The Xe-Derma wound cover provided the best support to keratinocyte proliferation and stratification, with the number of keratinocyte strata significantly (p?dressings. The results of this in vitro study show that the brands based on porcine dermal matrix possess the strongest effect on keratinocyte proliferation and stratification. The distinctive position of Xe-Derma may be related to its composition, where natural dermal fibers form a smooth surface, similar to the basement membrane. Furthermore, the results indicate that in vitro evaluation of effects on epithelial growth may accelerate the development of new bio-engineering-based wound covers. PMID:25383177

Mestak, Ondrej

2014-01-01

272

Rydberg dressing evolution via Rabi frequency control in thermal atomic vapors.  

PubMed

We report for the first time the theoretical and experimental research on Rydberg electromagnetically induced transparency and second-order fluorescence dressing evolution by Rabi frequency control in thermal atomic vapors, in which the controlled results are well explained by the dressing effect and the Rydberg excitation blockade. Based on the certification of the Rydberg excitation blockade fraction through the dependence on principle quantum number n, we obtain dressing evolution curves, consisting of single-dressing and double-dressing in local and nonlocal blockade samples by scanning the probe and dressing fields. In addition, the competition between the Rydberg dressing second-order fluorescence and fourth-order fluorescence is first investigated. A corresponding theory is presented, which is consistent with the experimental results. Such blockade evolution regularity has potential applications in quantum control, and the Rydberg dressing may be useful for investigating multiple-body interactions, as well as for inducing short range interactions in Bose-Einstein condensates. PMID:25078686

Che, Junling; Zheng, Huaibin; Zhang, Zhaoyang; Yao, Xin; Li, Cheng; Wu, Zhenkun; Zhang, Yanpeng

2014-09-21

273

Early healing events in a porcine model of contaminated wounds: effects of nanocrystalline silver on matrix metalloproteinases, cell apoptosis, and healing.  

PubMed

A porcine model of wound healing was employed to examine the impact of nanocrystalline silver-coated dressings on specific wound healing events. Full-thickness wounds were created on the backs of pigs, contaminated with an experimental inoculum containing Pseudomonas aeruginosa, Fusobacterium sp., and coagulase-negative staphylococci, and covered with dressing products either containing silver or not. Nanocrystalline silver-coated dressings promoted rapid wound healing, particularly during the first several days post-injury. Healing was characterized by rapid development of well vascularized granulation tissue that supported tissue grafting 4 days post-injury, unlike control dressed wounds. The proteolytic environment of wounds treated with nanocrystalline silver was characterized by reduced levels of matrix metalloproteinases. Matrix metalloproteinases have been shown to be present in chronic ulcers at abnormally high levels, as compared with acute wounds, and may contribute to the nonhealing nature of these wounds. Cellular apoptosis occurred at a higher frequency in the nanocrystalline silver-treated wounds than in wounds dressed with other products. The results suggest that nanocrystalline silver may play a role in altering or compressing the inflammatory events in wounds and facilitating the early phases of wound healing. These benefits are associated with reduced local matrix metalloproteinase levels and enhanced cellular apoptosis. PMID:12100375

Wright, J Barry; Lam, Kan; Buret, Andre G; Olson, Merle E; Burrell, Robert E

2002-01-01

274

Bacterial cellulose/acrylic acid hydrogel synthesized via electron beam irradiation: Accelerated burn wound healing in an animal model.  

PubMed

Natural polymer-based hydrogels are of interest to health care professionals as wound dressings owing to their ability to absorb exudates and provide hydration for healing. The aims of this study were to develop and characterize bacterial cellulose/acrylic acid (BC/AA) hydrogels synthesized by electron beam irradiation and investigate its wound healing potential in an animal model. The BC/AA hydrogels were characterized by SEM, tensile strength, water absorptivity, and water vapor transmission rate (WVTR). The cytotoxicity of the hydrogels was investigated in L929 cells. Skin irritation and wound healing properties were evaluated in Sprague-Dawley rats. BC/AA hydrogels had a macroporous network structure, high swelling ratio (4000-6000% at 24h), and high WVTR (2175-2280g/m(2)/day). The hydrogels were non-toxic in the cell viability assay. In vivo experiments indicated that hydrogels promoted faster wound-healing, enhanced epithelialization, and accelerated fibroblast proliferation compared to that in the control group. These results suggest that BC/AA hydrogels are promising materials for burn dressings. PMID:25263896

Mohamad, Najwa; Mohd Amin, Mohd Cairul Iqbal; Pandey, Manisha; Ahmad, Naveed; Rajab, Nor Fadilah

2014-12-19

275

A web-based e-learning application for wound diagnosis and treatment.  

PubMed

Pressure ulcers (PrU) are considered as one of the most challenging problems that Nursing professionals have to deal with in their daily practice. Nowadays, the education on PrUs is mainly based on traditional lecturing, seminars and face-to-face instruction, sometimes with the support of photographs of wounds being used as teaching material. This traditional educational methodology suffers from some important limitations, which could affect the efficacy of the learning process. This current study has been designed to introduce information and communication technologies (ICT) in the education on PrU for undergraduate students, with the main objective of evaluating the advantages an disadvantages of using ICT, by comparing the learning results obtained from using an e-learning tool with those from a traditional teaching methodology. In order to meet this major objective, a web-based learning system named ePULab has been designed and developed as an adaptive e-learning tool for the autonomous acquisition of knowledge on PrU evaluation. This innovative system has been validated by means of a randomized controlled trial that compares its learning efficacy with that from a control group receiving a traditional face-to-face instruction. Students using ePULab gave significantly better (p<0.01) learning acquisition scores (from pre-test mean 8.27 (SD 1.39) to post-test mean 15.83 (SD 2.52)) than those following traditional lecture-style classes (from pre-test mean 8.23 (SD 1.23) to post-test mean 11.6 (SD 2.52)). In this article, the ePULab software is described in detail and the results from that experimental educational validation study are also presented and analyzed. PMID:25015566

Veredas, Francisco J; Ruiz-Bandera, Esperanza; Villa-Estrada, Francisca; Rufino-González, Juan F; Morente, Laura

2014-10-01

276

Comparative Clinical Study of Bactigras and Telfa AMD for Skin Graft Donor-Site Dressing  

PubMed Central

The Bactigras® paraffin tulle coated with chlorhexidine is normally used for the treatment of donor-site wounds in burn patients who received split-thickness skin grafts in several centers. It has some disadvantages, such as adhesion to wound surfaces and pain from the irritation caused by this dressing. The Telfa AMD®, a non-adherent wound dressing which consists of absorbent cotton fibers impregnated with polyhexamethylene biguanide enclosed in a sleeve of thermoplastic polymers, is a new option for donor-site wound care which causes less adherence to the wound. The purpose of this study was to compare clinical efficacy of these two dressings for the management of donor-site wounds. Thirty-two patients who received split-thickness skin grafts by donor site harvesting from the thigh were enrolled in this study and randomized into two groups receiving either the Bactigras® or the Telfa AMD® wound treatment. Re-epithelialization, pain, infection and cost-effectiveness analyses were compared between both groups. The results showed that there was no significant difference in age, area of donor sites or length of hospital stays between the groups (p > 0.05). However, the day of re-epithelialization (?90%) was significantly shorter in patients treated with the Telfa AMD® compared to the Bactigras® group (14.00 ± 3.05 vs. 9.25 ± 1.88 days for Bactigras® and Telfa AMD® groups, respectively, p < 0.001). The average pain score was also significantly lower in the Telfa AMD® group (1.57 ± 0.55 vs. 4.70 ± 1.16, p < 0.001). There was no difference in the cost of treatment between the groups (4.64 ± 1.97 vs. 5.72 ± 2.54 USD, p = 0.19). This study indicated that the Telfa AMD® was an effective dressing for the treatment of donor-site wounds. PMID:21954342

Muangman, Pornprom; Nitimonton, Sooksan; Aramwit, Pornanong

2011-01-01

277

Beyond Wet-to-Dry: A Rational Approach to Treating Chronic Wounds  

PubMed Central

Objective: This article reviews the current recommendations for the classification and treatment of chronic wounds. With a rational approach and a thorough understanding of available treatment options, plastic surgeons can provide better-quality and more cost-effective wound care. Methods: The authors reviewed the literature on the history of wound care and on recent advancements in wound care and also summarized the current clinical practices of the Johns Hopkins Wound Center. Results: n/a. Conclusions: Optimized wound dressings decrease pain, diminish morbidity, and improve healing times. PMID:19436765

Lee, Johnson C.; Kandula, Swetha; Sherber, Noelle S.

2009-01-01

278

5.NF Salad Dressing  

NSDL National Science Digital Library

This is a task from the Illustrative Mathematics website that is one part of a complete illustration of the standard to which it is aligned. Each task has at least one solution and some commentary that addresses important asects of the task and its potential use. Here are the first few lines of the commentary for this task: Aunt Barbâs Salad Dressing Recipe $\\frac13$ cup olive oil $\\frac16$ cup balsamic vinegar a pinch of herbs a pinch of salt Makes 6 servings How many cup...

279

[From the history of wound care].  

PubMed

Wound care in ancient times was based on many techniques: Bandages soaked with antibiotics, Sutures continuous or in separate stitches, apply of poultices around the wounds, honey and propolis as antibiotics in the treatment of wounds, surgical drainage of pus with a piece of tin pipe etc. The oldest wound clamp is shown with the jaws of ants holding together the edges of a wound. Finally are discussed the cauterization and the principles of Antisepsis and Asepsis. PMID:10929654

Benedum, J

2000-01-01

280

Effects of myrrh on intra-oral mucosal wounds compared with tetracycline- and chlorhexidine-based mouthwashes  

PubMed Central

Aim To evaluate the effect of myrrh compared with chlorhexidine gluconate- and tetracycline-containing mouthwashes on wound healing over time in an animal model. Methods A unilateral incision on the right buccal mucosa was made, and the wound was irrigated with myrrh-, chlorhexidine gluconate-, or tetracycline-based mouthwashes at various time intervals. Clinical and histological examination was performed for all the groups. Results It was found that the myrrh suspension promotes healing and repair of damaged tissue when used over a short period of time (less than 2 weeks) and in a low-concentration suspension; however, it can have harmful effects if used in excess or over a long period of time. Conclusion Further studies will also be required to study these effects and their mechanism of action in detail. PMID:23674915

Al-Mobeeriek, Azizah

2011-01-01

281

Cell suspensions of autologous keratinocytes or autologous fibroblasts accelerate the healing of full thickness skin wounds in a diabetic porcine wound healing model.  

PubMed

Autologous dermal fibroblasts may be useful in the treatment of diabetic skin wounds. We hypothesized that cultured fibroblasts or cultured keratinocytes would not only survive in a hyperglycemic wound environment but also enhance the rate of re-epithelialization. We previously developed a new porcine model of delayed cutaneous wound healing in the diabetic pig. Full thickness wounds were created on the dorsum and dressed with polyurethane chambers to keep the wounds wet and to allow for wound fluid monitoring. Suspensions of either autologous fibroblasts or autologous keratinocytes were injected into full thickness wounds and compared with wounds treated in a wet environment in normal saline. Serum glucose and wound fluid glucose concentrations were monitored daily. Wound contraction was monitored and biopsies taken on day 12. Transplantation of suspensions of autologous fibroblasts or autologous keratinocytes enhanced re-epithelialization of cutaneous full thickness wounds. Wounds treated with autologous fibroblasts showed a re-epithelialization rate of 86.75% and wounds treated with autologous keratinocytes showed a re-epithelialization rate of 91.3%. This is compared with a re-epithelialization rate of 56.8% seen in the normal saline treated wounds. While previous studies have shown fibroblasts suspension to have little effect in the treatment of full thickness wounds in nondiabetic wounds, this study shows a clear beneficial effect in the use of fibroblast or keratinocyte suspensions for the cutaneous healing of diabetic wounds in pigs. PMID:19589541

Velander, Patrik; Theopold, Christoph; Bleiziffer, Oliver; Bergmann, Juri; Svensson, Henry; Feng, Yao; Eriksson, Elof

2009-11-01

282

Research Advances: DNA Computing Targets West Nile Virus, Other Deadly Diseases, and Tic-Tac-Toe; Marijuana Component May Offer Hope for Alzheimer's Disease Treatment; New Wound Dressing May Lead to Maggot Therapy--Without the Maggots  

ERIC Educational Resources Information Center

This article presents three reports of research advances. The first report describes a deoxyribonucleic acid (DNA)-based computer that could lead to faster, more accurate tests for diagnosing West Nile Virus and bird flu. Representing the first "medium-scale integrated molecular circuit," it is the most powerful computing device of its type to…

King, Angela G.

2007-01-01

283

Effective healing of diabetic skin wounds by using nonviral gene therapy based on minicircle vascular  

E-print Network

- sent a powerful tool for the treatment of diabetic foot ulcers and other diseases that are refractory to treatment. Copyright © 2012 John Wiley & Sons, Ltd. Keywords gene therapy; foot ulcer; minicircle DNA; nonviral gene delivery carrier; PAM-RG4; VEGF; wound healing Introduction Foot ulcers are one of the most

Park, Jong-Sang

284

Polycaprolactone-based fused deposition modeled mesh for delivery of antibacterial agents to infected wounds  

Microsoft Academic Search

Infections represent a significant source of site morbidity following tissue trauma. Scarring and tissue adhesion remain the challenging issues yet to be solved. Prolonged inflammation and morphology of the re-epithelisated layer are important considerations. We hypothesized that the solution lies not only in the biochemistry of biomaterial but also the micro-architecture of the scaffold used as the matrix for wound

Erin Yiling Teo; Shin-Yeu Ong; Mark Seow Khoon Chong; Zhiyong Zhang; Jia Lu; Shabbir Moochhala; Bow Ho; Swee-Hin Teoh

2011-01-01

285

A review of the local pathophysiologic bases of burn wound progression.  

PubMed

Burn wound progression refers to the phenomenon of continued tissue necrosis in the zone of stasis after abatement of the initial thermal insult. A multitude of chemical and mechanical factors contribute to the local pathophysiologic process of burn wound progression. Prolonged inflammation results in an accumulation of cytotoxic cytokines and free radicals, along with neutrophil plugging of dermal venules. Increased vascular permeability and augmentations of interstitial hydrostatic pressure lead to edema with vascular congestion. Hypercoagulability with thrombosis further impairs blood flow, while oxidative stress damages endothelial cells and compromises vascular patency. A number of studies have investigated the utility of various agents in modulating these mechanisms of burn wound progression. However, as many of studies have used animal models of burn injury, often with administration of therapy preburn, obscuring the clinical applicability of the results to burn patients is of questionable benefit. An understanding of the complex, interrelated mediators of burn wound progression and their ultimate point of convergence in effecting tissue necrosis—cell apoptosis or oncosis—will allow for the future development of therapeutic interventions. PMID:21105319

Shupp, Jeffrey W; Nasabzadeh, Teresa J; Rosenthal, Dean S; Jordan, Marion H; Fidler, Philip; Jeng, James C

2010-01-01

286

ELECTRIC SHIP PROPULSION SYSTEM BASED ON WOUND ROTOR SYNCHRONOUS MACHINE SUPPLIED BY MULTILEVEL CONVERTER  

Microsoft Academic Search

In this paper a new electric ship propulsion system is proposed as combination of a double generator set with a double inverter feeding a wound rotor synchronous machine (WR-SM). Each generator set is composed by a diesel engine directly coupled to a compact, permanent magnet, synchronous generator. A diode rectifier connects the output of the generator to a variable voltage

Gabriele Grandi; Claudio Rossi; Domenico Casadei; Gaetano Messina; Angelo Gaetani

287

In vivo wound healing and antibacterial performances of electrospun nanofibre membranes.  

PubMed

In this work, nanofibre membranes have been produced from polyvinyl alcohol (PVA), polycaprolactone (PCL), polyacrylonitrile (PAN), poly (vinylidene fluoride-co-hexafluoropropene) (PVdF-HFP), and polymer blend of PAN and polyurethane (PEU) using an electrospinning technique, and wound healing performance of the as-spun nanofibre membranes was examined in vivo using female Sprague-Dawley rats. To understand the nutrition effect, a wool protein was coated on PVA and PCL nanofibres and incorporated into PVA nanofibres via coelectrospinning of a PVA solution containing the wool protein. Silver nanoparticles were also applied to PVA nanofibres to improve antibacterial activity. It was found that the wound healing performance is mainly influenced by the porosity, air permeability, and surface wettability of the nanofibre membranes. A nanofibre membrane with good hydrophilicity and high porosity considerably facilitates the healing of wound especially at the early healing stage. However, the fiber diameter and antibacterial activity have little effect on the wound healing efficiency. As pores in nanofibre membranes are typically smaller than that of conventional cotton gauze, the nanofibre membrane should be able to decontaminate and prevent exogenous infections via sieve effect. This work provides basic understanding of material structure-property relationship for further design of efficient nanofibre-based wound dressing materials. PMID:20186775

Liu, Xin; Lin, Tong; Fang, Jian; Yao, Gang; Zhao, Hongqiong; Dodson, Michael; Wang, Xungai

2010-08-01

288

Bioinspired porous membranes containing polymer nanoparticles for wound healing.  

PubMed

Skin damages covering a surface larger than 4 cm(2) require a regenerative strategy based on the use of appropriate wound dressing supports to facilitate the rapid tissue replacement and efficient self-healing of the lost or damaged tissue. In the present work, A novel biomimetic approach is proposed for the design of a therapeutic porous construct made of poly(l-lactic acid) (PLLA) fabricated by thermally induced phase separation (TIPS). Biomimicry of ECM was achieved by immobilization of type I collagen through a two-step plasma treatment for wound healing. Anti-inflammatory (indomethacin)-containing polymeric nanoparticles (nps) were loaded within the porous membranes in order to minimize undesired cell response caused by post-operative inflammation. The biological response to the scaffold was analyzed by using human keratinocytes cell cultures. In this work, a promising biomimetic construct for wound healing and soft tissue regeneration with drug-release properties was fabricated since it shows (i) proper porosity, pore size, and mechanical properties, (ii) biomimicry of ECM, and (iii) therapeutic potential. © 2014 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 102A: 4394-4405, 2014. PMID:24522948

Ferreira, Ana M; Mattu, Clara; Ranzato, Elia; Ciardelli, Gianluca

2014-12-01

289

Dressed Spin of Polarized 3He in a Cell  

E-print Network

We report a measurement of the modification of the effective precession frequency of polarized 3He atoms in response to a dressing field in a room temperature cell. The 3He atoms were polarized using the metastability spin-exchange method. An oscillating dressing field is then applied perpendicular to the constant magnetic field. Modification of the 3He effective precession frequency was observed over a broad range of the amplitude and frequency of the dressing field. The observed effects are compared with calculations based on quantum optics formalism.

P. H. Chu; A. M. Esler; J. C. Peng; D. H. Beck; D. E. Chandler; S. Clayton; B. Z. Hu; S. Y. Ngan; C. H. Sham; L. H. So; S. Williamson; J. Yoder

2010-08-24

290

Leg ulcer treatment outcomes with new ovine collagen extracellular matrix dressing: a retrospective case series.  

PubMed

The purpose of this study was to describe the rate of closure observed in venous leg ulcers during treatment with ovine collagen extracellular matrix dressings and compression. Fourteen patients with 23 wounds were retrospectively evaluated with respect to healing rates, time to closure, and weekly facility charge fees. PMID:25198432

Bohn, Gregory A; Gass, Kimberly

2014-10-01

291

Economic Evaluation of Collagenase-Containing Ointment and Hydrocolloid Dressing in the Treatment of Pressure Ulcers  

Microsoft Academic Search

Objective: To evaluate the efficacy and cost effectiveness of two treatments of pressure sores on the heel: a collagenase-containing ointment and a hydrocolloid dressing. Design: Study and cost data were collected prospectively in a randomised clinical trial in The Netherlands by counting the resource use for each patient until wound healing occurred. Study participants: All 24 female study participants were

Elvira Muller; Martin W. F. van Leen; Rito Bergemann

2001-01-01

292

Infection in conflict wounded  

PubMed Central

Although mechanisms of modern military wounding may be distinct from those of ancient conflicts, the infectious sequelae of ballistic trauma and the evolving microbial flora of war wounds remain a considerable burden on both the injured combatant and their deployed medical systems. Battlefield surgeons of ancient times favoured suppuration in war wounding and as such Galenic encouragement of pus formation would hinder progress in wound care for centuries. Napoleonic surgeons eventually abandoned this mantra, embracing radical surgical intervention, primarily by amputation, to prevent infection. Later, microscopy enabled identification of microorganisms and characterization of wound flora. Concurrent advances in sanitation and evacuation enabled improved outcomes and establishment of modern military medical systems. Advances in medical doctrine and technology afford those injured in current conflicts with increasing survivability through rapid evacuation, sophisticated resuscitation and timely surgical intervention. Infectious complications in those that do survive, however, are a major concern. Addressing antibiotic use, nosocomial transmission and infectious sequelae are a current clinical management and research priority and will remain so in an era characterized by a massive burden of combat extremity injury. This paper provides a review of infection in combat wounding from a historical setting through to the modern evidence base. PMID:21149356

Eardley, W. G. P.; Brown, K. V.; Bonner, T. J.; Green, A. D.; Clasper, J. C.

2011-01-01

293

A serum amyloid P-binding hydrogel speeds healing of partial thickness wounds in pigs  

PubMed Central

During wound healing, some circulating monocytes enter the wound, differentiate into fibroblast-like cells called fibrocytes, and appear to then further differentiate into myofibroblasts, cells that play a key role in collagen deposition, cytokine release, and wound contraction. The differentiation of monocytes into fibrocytes is inhibited by the serum protein serum amyloid P (SAP). Depleting SAP at a wound site thus might speed wound healing. SAP binds to some types of agarose in the presence of Ca2+. We found that human SAP binds to an agarose with a KD of 7×10?8M and a Bmax of 2.1 ?g SAP/mg wet weight agarose. Mixing this agarose 1: 5 w/v with 30 ?g/mL human SAP (the average SAP concentration in normal serum) in a buffer containing 2mM Ca2+ reduced the free SAP concentration to ~0.02 ?g/mL, well below the concentration that inhibits fibrocyte differentiation. Compared with a hydrogel dressing and a foam dressing, dressings containing this agarose and Ca2+ significantly increased the speed of wound healing in partial thickness wounds in pigs. This suggests that agarose/Ca2+ dressings may be beneficial for wound healing in humans. PMID:19660048

Gomer, Richard H.; Pilling, Darrell; Kauvar, Lawrence M.; Ellsworth, Stote; Ronkainen, Sanna D.; Roife, David; Davis, Stephen C.

2010-01-01

294

Effects of Three Types of Japanese Honey on Full-Thickness Wound in Mice  

PubMed Central

Although many previous studies reported that honey promotes wound healing, no study has examined the effects of Japanese honey. The aim of this study was to investigate the effects of three types of Japanese honey, Acacia, Buckwheat flour, and Chinese milk vetch honey, on wound healing in comparison with hydrocolloid dressing. Circular full-thickness skin wounds were produced on male mice. Japanese honey or hydrocolloid dressing was applied daily to the mice for 14 days. The ratio of wound area for the hydrocolloid dressing group increased initially in the inflammatory and early proliferative phases and then decreased rapidly to heal with scarring. However, the ratios of wound area for the Japanese honey groups decreased in the inflammatory phase, increased in the proliferative phase, and decreased in the proliferative phase, and some wounds were not completely covered with new epithelium. These findings indicate that using Japanese honey alone has limited benefit, but since it reduces wound size in the inflammatory phase, it is possible to apply a combined treatment in which Japanese honey is applied only in the inflammatory phase, followed by hydrocolloid dressing from the proliferative phase, which would effectively contract the wound. PMID:23401714

Nakajima, Yukari; Nakano, Yuki; Fuwano, Sono; Hayashi, Natsumi; Hiratoko, Yukiho; Kinoshita, Ayaka; Miyahara, Megumi; Mochizuki, Tsuyoshi; Nishino, Kasumi; Tsuruhara, Yusuke; Yokokawa, Yoshika; Iuchi, Terumi; Kon, Yuka; Mukai, Kanae; Kitayama, Yukie; Murakado, Naoko; Okuwa, Mayumi; Nakatani, Toshio

2013-01-01

295

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

PubMed Central

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

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

2011-01-01

296

Postdischarge surveillance for nosocomial wound infection: Does judicious monitoring find cases?  

Microsoft Academic Search

From 1988 through 1992, we conducted a prospective study of postdischarge surgical wound infection surveillance in our institution. A total of 6604 patients were seen after discharge in a centralized outpatient clinic, supervised by the infection control commission. Wounds were inspected, stitches were removed, and dressings were changed. This care was followed by referral of patients to the appropriate specialized

Edmundo Machado Ferraz; Alvaro Antonio Bandeira Ferraz; Helena Suely Torres D'Albuquerque Coelho; Valdilene Pereira Viana; Suzemires Marcia Lopes Sobral; Maria das Dores Marques Maia Vasconcelos; Tercio Souto Bacelar

1995-01-01

297

A prospective, randomized clinical trial to assess the cost-effectiveness of a modern foam dressing versus a traditional saline gauze dressing in the treatment of stage II pressure ulcers.  

PubMed

Modern dressings such as hydrocolloids, gels, and foams are typically more expensive than traditional dressings such as gauze. However, if modern dressings require fewer changes, the overall cost of treatment may be lower despite the higher initial purchase price. If healing rates are comparable or better, modern dressings also may be cost-effective. A 4-week, prospective, randomized clinical trial to assess differences in treatment costs and cost-effectiveness between a modern foam dressing and saline-soaked gauze was conducted among 36 patients (22 men, 14 women, mean age 72.8 years) with a Stage II pressure ulcer (mean duration 35 weeks) at five centers in the United States. Participants were randomized to treatment with a self-adhesive polyurethane foam (n = 20) or saline-soaked gauze dressing (n = 16). No difference in time to wound closure was observed (P = 0.817). Patients in the foam group had less frequent dressing changes (P <0.001). Total cost over the study period was lower by $466 per patient (P = 0.055) and spending on dressings was lower by $92 per patient in the foam group (P = 0.025). Cost per ulcer healed was lower by $1,517 and cost per ulcer-free day was lower by $80 for patients in the foam group. On the evidence of this study, the foam dressing is a more cost-effective treatment than saline-soaked gauze for the treatment of Stage II pressure ulcers. PMID:19246785

Payne, Wyatt G; Posnett, John; Alvarez, Oscar; Brown-Etris, Marie; Jameson, Gayle; Wolcott, Randall; Dharma, Hussein; Hartwell, Samantha; Ochs, Diane

2009-02-01

298

Business Services Business Casual Dress Policy  

E-print Network

Business Services Business Casual Dress Policy A business casual dress policy calls for everyone general parameters for proper business casual dress within Business Services and to help you make appropriate dress decisions. Keep in mind that business casual does not mean weekend or sport casual

Holland, Jeffrey

299

Topical application of a film-forming emulgel dressing that controls the release of stratifin and acetylsalicylic acid and improves/prevents hypertrophic scarring.  

PubMed

Here, we evaluate the efficacy of an emulgel dressing to control the release of an antifibrogenic factor, stratifin (SFN), along with an anti-inflammatory drug, acetylsalicylic acid (ASA), to be used as a wound dressing with hypertrophic scar reducing features. Emulgel dressings were prepared by dispersing positively charged submicron vesicles in carboxymethyl cellulose gel. Release kinetics of SFN/ASA and toxicity for primary skin cells were assessed in vitro. Antifibrogenic efficacy of medicated emulgel dressings was tested on a rabbit ear fibrotic model. Following topical application on the wounds, emulgels formed an occlusive film and controlled the release of SFN and ASA for 7 and 24 hours, respectively. Wounds treated with SFN/ASA-containing emulgel dressings showed an 80% reduction in scar elevation compared with untreated controls. Topical formulations were nontoxic for cultured human keratinocytes and fibroblasts. Inflammation was significantly controlled in treated wounds, as shown by a reduced number of infiltrated CD3(+) T cells (p?wounds showed a significantly higher (p?dressings that control the release of antifibrogenic and anti-inflammatory factors provide an excellent treatment option for postburn hypertrophic scar management. PMID:23126516

Rahmani-Neishaboor, Elham; Jallili, Reza; Hartwell, Ryan; Leung, Victor; Carr, Nicholas; Ghahary, Aziz

2013-01-01

300

Amish burn ointment and burdock leaf dressings: assessments of antimicrobial and cytotoxic activities.  

PubMed

Amish burn wound ointment (ABO) contains honey, lanolin, oils, glycerin, bees wax, and other natural additives. Although there are many anecdotal reports that this ointment covered with a burdock leaf (BL) dressing promotes burn wound healing, little scientific testing of this treatment has occurred. The goal of this study was to evaluate in vitro some of the components of this treatment modality for antimicrobial and cytotoxic activities. The ABO was tested for sterility using standard microbiological techniques. Because of the semisolid, lipid-based nature of the salve, the at-use product could not be tested in bioassays. Samples of BL and the dry ingredients (DI) used in the ointment were provided by the Amish vendor. Aqueous extracts of the DI and of the BL were prepared and freeze dried. The freeze-dried extracts were reconstituted, filtered, and tested separately on keratinocyte and fibroblast cell cultures for cytotoxicity (growth inhibition assay) and against a panel of susceptible and resistant microbes for antimicrobial activity (Nathan's agar-well diffusion assay) in a series of concentrations (% wt/vol). Neither DI nor BL extracts demonstrated antimicrobial activity against any of organisms tested. The DI extract inhibited growth of both keratinocytes and fibroblasts at the 0.1% concentration. The 0.1 and 0.03% concentrations of the BL extract were cytotoxic to both keratinocytes and fibroblasts. Although tests for microbial growth from the at-use preparation of the ABO were negative, extracts of the DI and BL did not demonstrate any antimicrobial activity. Additionally, both extracts inhibited the growth of skin cells in vitro at higher concentrations. These results suggest caution in the use of ABO and BL dressings if there is more than a minimal risk of complications from the burn injury. PMID:24043243

Rieman, Mary T; Neely, Alice N; Boyce, Steven T; Kossenjans, William J; Durkee, Paula J; Zembrodt, Jacquelyn M; Puthoff, Barbara K; Kagan, Richard J

2014-01-01

301

Electrospun gelatin\\/polyurethane blended nanofibers for wound healing  

Microsoft Academic Search

In this study, we prepared a blended nanofiber scaffold using synthetic and natural polymers, polyurethane (PU) and gelatin respectively, using the electrospinning method to prepare a material for wound dressing. In order to confirm the properties of this gelatin\\/PU blended nanofiber scaffold, we performed scanning electron microscopy, atomic force microscopy, attenuated total reflectance Fourier-transform infrared spectroscopy, thermal gravimetric analysis, contact

Sung Eun Kim; Dong Nyoung Heo; Jung Bok Lee; Jong Ryul Kim; Sang Hyuk Park; Seong Ho Jeon; Il Keun Kwon

2009-01-01

302

Advanced textile materials and biopolymers in wound management  

Microsoft Academic Search

New generation medical textiles are important growing field with great ex- pansion in wound management products. Virtually new products are com- ing but also well known materials with significantly improved properties us- ing 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

Salvinija Petrulyte

2008-01-01

303

Excitation transport through Rydberg dressing  

NASA Astrophysics Data System (ADS)

We show how to create long-range interactions between alkali atoms in different hyperfine ground states, with the goal of coherent quantum transport. The scheme uses off-resonant dressing with atomic Rydberg states. We demonstrate coherent migration of electronic excitation through dressed dipole-dipole interaction by full solutions of models with four essential states per atom and give the structure of the spectrum of dressed states for a dimer. In addition, we present an effective (perturbative) Hamiltonian for the ground-state manifold and show that it correctly describes the full multi-state dynamics. We discuss excitation transport in detail for a chain of five atoms. In the presented scheme, the actual population in the Rydberg state is kept small. Dressing offers many advantages over the direct use of Rydberg levels: it reduces ionization probabilities and provides an additional tuning parameter for lifetimes and interaction strengths.

Wüster, S.; Ates, C.; Eisfeld, A.; Rost, J. M.

2011-07-01

304

Central venous catheter - dressing change  

MedlinePLUS

... not working correctly. You may be receiving kidney dialysis. You may be receiving cancer drugs. Dressings are special bandages that block germs and keep your catheter site dry and clean. You will learn how ...

305

Dressed Quark Mass Dependence of Pion and Kaon Form Factors  

E-print Network

The structure of hadrons is described well by the Nambu--Jona-Lasinio (NJL) model, which is a chiral effective quark theory of QCD. In this work we explore the electromagnetic structure of the pion and kaon using the three-flavor NJL model, including effects of confinement and a pion cloud at the quark level. In the calculation there is only one free parameter, which we take as the dressed light quark ($u$ and $d$) mass. In the regime where the dressed light quark mass is approximately $0.25\\,$GeV, we find that the calculated values of the kaon decay constant, current quark masses, and quark condensates are consistent with experiment and QCD based analyses. We also investigate the dressed light quark mass dependence of the pion and kaon electromagnetic form factors, where comparison with empirical data and QCD predictions also favors a dressed light quark mass near $0.25\\,$GeV.

Y. Ninomiya; W. Bentz; I. C. Cloët

2014-06-27

306

Management of gunshot wounds  

SciTech Connect

Management of Gunshot Wounds provides a review of wound ballistics and a systemic review of gunshot wound management of all major body areas and systems. This volume includes information on pre-hospital care, nursing care, and care of infants, children, and the elderly patient with gunshot wounds. This volume also features information on: lead toxicity; complications of gunshot wounds; socioeconomic aspects of gunshot wounds; the forensic and pathological aspects of gunshot wounds; future directions in the care of gunshot wounds.

Ordog, G.; Drew, R.

1987-01-01

307

[New directions of research related to chronic wound healing].  

PubMed

Optimal nutrition, immunological state and psychological condition play an important role in the process of chronic wound healing. Infections caused by pathogens resistant to commonly used antibiotics additionally complicate and disturb regeneration of wounds. As part of the treatment, modern wound dressings are used, for example designed on the basis of alginates, dextranomers, hydrogels, hydrofiber, polyurethanes foams, hydrocolloids and liquids for wound debridement such us 0.9% NaCl, the PWE liquid, Ringer's liquid, octenidine. Owing to their features, treatment in accordance with TIME concept could be realized, because they provide moisture wound bed, protection against contamination, gas exchange, protection of wound edges and infection control. Repairing process in chronic wounds is dependent on blood flow in tissues, which may be insufficient. The result is a permanent hypoxia. Natural occurring antioxidants are becoming more crucial in chronic wound treatment. They decrease oxygen radical concentration, increase angiogenesis, reduce inflammatory response, stimulate fibroblasts and keratinocytes proliferation, possess antibacterial properties against chemotherapeutic resistant strains. There are a lot of antioxidants in honey, papaya fruit (Carrica papaia L.), transgenic flax (Linum usitatissimum), and in orange oil (Citrus sinensis), stem of acanthus (Acanthus ebracteatus), leafs of tea (Camellia sinensis). Application of biologically active, natural derived compounds is nowadays a direction of intense in vitro and in vivo research focused on the chronic wound treatment. Results suggest beneficial influence of antioxidant on wound repairing process. Clinical research are needed to state effective influence of natural compound in the chronic wound treatment. PMID:24377187

Rusak, Agnieszka; Rybak, Zbigniew

2013-01-01

308

Wounded Warriors  

Microsoft Academic Search

Soldiers have been killed and wounded in wars throughout history. With new medical technologies, more soldiers survive their injuries and return home. Unfortunately, those injuries often include permanent disabilities either through loss of limb(s) or brain injury or post-traumatic stress disorder, among other possibilities. Perhaps equally unfortunate is the way that soldiers with disabilities and persons with disabilities generally are

Marilyn Martone

2008-01-01

309

War wounds of the foot and ankle: causes, characteristics, and initial management.  

PubMed

Foot and ankle trauma sustained in the Global War on Terror have unique causes and characteristics. At least one-quarter of all battle injuries involve the lower extremity. These severe lower extremity wounds require specialized early treatment. Ballistic mechanisms cause almost all injuries, and as such, most combat foot and ankle wounds are open in nature. Wounds are characteristically caused by blast mechanisms, but high velocity gunshot injuries are also common. The severe and polytraumatic nature of injuries sustained frequently call for damage control orthopaedics to be utilized. Cautious early treatment of irregular and highly exudative ballistic wounds with subatmospheric wound dressings may ease their early management. PMID:20189114

Bluman, Eric M; Ficke, James R; Covey, Dana C

2010-03-01

310

Silver Nanoparticles as Real Topical Bullets for Wound Healing  

PubMed Central

Nanotechnology is on the threshold of providing a host of new materials and approaches, revolutionizing the medical and pharmaceutical fields. Several areas of medical care are already profiting from the advantage that nanotechnology offers. Recently, silver nanoparticles are attracting interest for a clinical application because of its potential biological properties such as antibacterial activity, anti-inflammatory effects, and wound healing efficacy, which could be exploited in developing better dressings for wounds and ulcers. This article reviews the role of silver nanoparticles in wound healing. PMID:24527370

Gunasekaran, Thirumurugan; Nigusse, Tadele; Dhanaraju, Magharla Dasaratha

2012-01-01

311

Surgical dressings and turbulent years of cotton industry.  

PubMed

Everyday use of a simple cotton bud should remind us of our not so distant past and of the appalling trade in people. Harvesting this precious commodity required forced labour eventually leading to a key turning point in the history of surgery, as civil war raged in America during the 1860s. The fight to end slavery was to reveal a new weapon against disease and certain death. A material used in this struggle against wound infection was the available stockpiles of redundant cotton. Once boiled to make softer, its use on patients in military hospitals proved to be the first clinical application of sterile surgical dressings. PMID:18710130

Stephens-Borg, Keith

2008-07-01

312

Unna's boot vs polyurethane foam dressings for the treatment of venous ulceration. A randomized prospective study.  

PubMed

Recent reports have suggested that polyurethane foam dressings provide a more rapid and comfortable healing of venous stasis cutaneous ulcerations than standard semirigid impregnated gauze dressings. This multi-institutional study consists of a randomized, prospective comparison of 36 consecutive patients who were treated with either polyurethane foam dressings (group 1, n = 17) or Unna's boot (group 2, n = 19) for venous ulceration of the lower extremities. Ulcer size ranged from 6.0 to 270 cm2 (mean, 32.2 cm2) for group 1 and 0.2 to 600 cm2 (mean, 76.0 cm2) for group 2. Nine (52.9%) of 17 group 1 patients withdrew from the study due to wound odor, while there was 100% compliance in group 2. Overall wound healing was superior in group 2 (18 [94.7%] of 19) as compared with group 1 (7 [41.2%] of 17) (chi 2 = 8.2). The rate of healing was also better in group 2 (0.5 cm2/d) than in group 1 (0.07 cm2/d). Contrary to published European trials, impregnated gauze dressings exhibited superior treatment results when compared with polyurethane foam dressings in the current study. PMID:2181975

Rubin, J R; Alexander, J; Plecha, E J; Marman, C

1990-04-01

313

Amniotic membrane induces epithelialization in massive posttraumatic wounds.  

PubMed

Large-surface or deep wounds often become senescent in the inflammatory or proliferation stages and cannot progress to reepithelialization. This failure makes intervention necessary to provide the final sealing epithelial layer. The best current treatment is autologous skin graft, although there are other choices such as allogenic or autologous skin substitutes and synthetic dressings. Amniotic membrane (AM) is a tissue of interest as a biological dressing due to its biological properties and immunologic characteristics. It has low immunogenicity and beneficial reepithelialization effects, with antiinflammatory, antifibrotic, antimicrobial, and nontumorigenic properties. These properties are related to its capacity to synthesize and release cytokines and growth factors. We report the use of AM as a wound dressing in two patients with large and deep traumatic wounds. Negative pressure wound therapy followed by AM application was capable of restoring skin integrity avoiding the need for skin graft reconstruction. AM induced the formation of a well-structured epidermis. To understand this effect, we designed some assays on human keratinocyte-derived HaCaT cells. AM treatment of HaCaT induced ERK1/2 and SAP/JNK kinases phosphorylation and c-jun expression, a gene critical for keratinocytes migration; however, it did not affect cell cycle distribution. These data suggest that AM substantially modifies the behavior of keratinocytes in chronic wounds, thereby allowing effective reepithelialization. PMID:20636551

Insausti, Carmen L; Alcaraz, Antonia; García-Vizcaíno, Eva M; Mrowiec, Anna; López-Martínez, María C; Blanquer, Miguel; Piñero, Antonio; Majado, María J; Moraleda, José M; Castellanos, Gregorio; Nicolás, Francisco J

2010-01-01

314

Wound contraction effects and antibacterial properties of Tualang honey on full-thickness burn wounds in rats in comparison to hydrofibre  

PubMed Central

Background Full-thickness burn wounds require excision and skin grafting. Multiple surgical procedures are inevitable in managing moderate to severe full-thickness burns. Wound bed preparations prior to surgery are necessary in order to prevent wound infection and promote wound healing. Honey can be used to treat burn wounds. However, not all the honey is the same. This study aims to evaluate the wound contraction and antibacterial properties of locally-produced Tualang honey on managing full-thickness burn wounds in vivo. Methods Thirty-six female Sprague Dawley rats were randomly divided into three groups. Under anaesthesia, three full-thickness burn wounds were created on the dorsum of the rats. The full-thickness burn wounds were inoculated with a specific organism (104), namely Pseudomonas aeruginosa (n = 12), Klebsiella pneumoniae (n = 12), or Acinetobacter baumannii (n = 12). The three burn wounds were dressed with Tualang honey, hydrofibre and hydrofibre silver respectively. Swab samples were obtained every 3 days (day 3, 6, 9, 12, 15, 18 and 21) for quantitative and semi-quantitative microbiological analyses. Clinical assessments, including observations concerning the appearance and wound size, were measured at the same time. Results There was a rapid 32.26% reduction in wound size by day 6 (p = 0.008) in the Tualang honey-treated wounds, and 49.27% by day 15 (p = 0.005). The wounds remained smaller by day 18 (p < 0.032). Tualang honey-treated rats demonstrated a reduction in bacterial growth in Pseudomonas aeruginosa inoculated wounds (p = 0.005). However, hydrofibre silver and hydrofibre-treated wounds are superior to honey-treated wounds with Acinetobacter baumannii (p = 0.035). There was no statistical significant of antibacterial property in Klebsiella pneumonia inoculated wounds. Conclusions Tualang honey has better results with regards to its control of Pseudomonas aeruginosa and its wound contraction effects on full-thickness burn wound in vivo. PMID:20815896

2010-01-01

315

BURN WOUND HEALING ACTIVITY OF Euphorbia hirta.  

PubMed

The Ethanolic extract of whole plant of Euphorbia hirta was screened for burn wound healing activity in rats as 2% W/W cream. The study was carried out based on the assessment of percentage reduction in original wound. It showed significant burn wound healing activity. PMID:22557201

Jaiprakash, B; Chandramohan; Reddy, D Narishma

2006-01-01

316

Sutures versus staples for wound closure in orthopaedic surgery: a randomized controlled trial  

PubMed Central

Background A recently published meta-analysis comparing metallic staples to sutures in orthopaedic procedures revealed three fold increase in risk for infection in stapled wounds. The studies included in the meta-analysis are at risk of bias due to experimental design limitations. A large randomized controlled trial is proposed to direct orthopaedic surgeons in their choice of wound closure material. Methods/Design A parallel group randomized controlled trial with institutional review board approval will be conducted. Patients will be randomized intraoperatively to have skin wounds closed with sutures or staples. Dressings will be used to maintain blinding outcome assessors. The primary outcome measure will be a composite all-cause wound complication outcome measure composed of: infection, wound drainage, wound necrosis, blistering, dehiscence, suture abscess and material sensitivity reaction. An independent review board blinded to treatment assignment will adjudicate suspected complications based on clinical data. All deceased patients will also be reviewed. An interim analysis of complications will take place after half of the patients have been recruited. All data will be analyzed by a blinded statistician. Dichotomous primary and secondary outcome measures will be analyzed using the Chi-squared statistic. Continuous outcome measures will be analyzed using Student's?t-test. Subgroup analysis will compare infection rates using sutures versus staples in each anatomic area (upper extremity, pelvis/acetabulum, hip/femur, knee, ankle). A further subgroup analysis will be conducted comparing trauma patients to elective surgery patients. Non-infected revision surgery will also be compared to primary surgery. Discussion Wound closure material is an afterthought for many orthopaedic surgeons. The combined results of several comparative trials suggests that the choice of wound closure materials may have an impact on the rate of surgical site infections. However, the strength of the evidence is poor given the heterogeneity of the methods employed in previous studies. The following study protocol aims to guide surgeons in their choice of wound closure material by determining if there is a difference in complication rates in sutured and stapled wounds. Trial Registration This trial was registered at ClinicalTrials.gov under the identifier NCT01146236 (registered June 14, 2010) PMID:22672186

2012-01-01

317

Lessons from Equal Opportunity Harasser Doctrine: Challenging Sex-Specific Appearance and Dress Codes  

Microsoft Academic Search

Importing interpretations of Title VII developed from the equal opportunity harasser doctrine to dress code cases-which also fall under the purview of Title VII-would allow courts to focus on the sex-based underpinnings of employer dress codes that construct women as generally inferior to men and the harm that dress codes present to individuals who deviate from accepted gender norms, without

Deborah Zalesne

2007-01-01

318

A prospective, randomized trial of silver containing hydrofiber dressing versus 1% silver sulfadiazine for the treatment of partial thickness burns.  

PubMed

Silver sulfadiazine has been used as a topical burn wound treatment for many years. Pain associated with dressing changes is a common problem in burn wounds. Aquacel Ag, a hydrofiber dressing coated with ionic silver has been reported to reduce burn wound infection and promote antimicrobial activity. The purpose of this study was to show the benefits of Aquacel Ag for the treatment of partial thickness burns. This prospective randomized study was conducted in 70 patients who had partial thickness burns less than 15% of total body surface area and were treated at Siriraj outpatient burn clinic during December 2006-February 2008. Patients were divided into two groups: Aquacel Ag-treated group with dressing changes every 3 days (35 patients) and 1% silver sulfadiazine-treated group, with daily dressing changes (35 patients). There was no difference in demographic data including age, gender, burn percentage between groups. Time-to-wound healing pain score during dressing change and cost of treatment were compared between both groups. Time-to-wound closure was significantly shorter in the Aquacel Ag-treated group (10 +/- 3 versus 13.7 +/- 4 days, P < 0.02) as well as pain scores at days 1, 3 and 7 (4.1 +/- 2.1, 2.1 +/- 1.8, 0.9 +/- 1.4 versus 6.1 +/- 2.3, 5.2 +/- 2.1, 3.3 +/- 1.9, respectively, P < 0.02). Total cost of treatment was 52 +/- 29 US dollars for the Aquacel Ag-treated group versus 93 +/- 36 US dollars for the silver sulfadiazine-treated group. This study showed that Aquacel Ag increased time to healing, decreased pain symptoms and increased patient convenience because of limiting the frequency of replacement of the dressing at lower total cost. This study confirms the efficacy of Aquacel Ag for the treatment of partial thickness burns at an outpatient clinic. PMID:20528992

Muangman, Pornprom; Pundee, Chanin; Opasanon, Supaporn; Muangman, Saipin

2010-08-01

319

Medical Honey for Wound Care—Still the ‘Latest Resort’?  

PubMed Central

While the ancient Egyptians and Greeks used honey for wound care, and a broad spectrum of wounds are treated all over the world with natural unprocessed honeys from different sources, Medihoney™ has been one of the first medically certified honeys licensed as a medical product for professional wound care in Europe and Australia. Our experience with medical honey in wound care refers only to this product. In this review, we put our clinical experience into a broader perspective to comment on the use of medical honey in wound care. More prospective randomized studies on a wider range of types of wounds are needed to confirm the safety and efficacy of medical honey in wound care. Nonetheless, the current evidence confirming the antibacterial properties and additional beneficial effects of medical honey on wound healing should encourage other wound care professionals to use CE-certified honey dressings with standardized antibacterial activity, such as Medihoney™ products, as an alternative treatment approach in wounds of different natures. PMID:18955301

Traynor, Kirsten; Santos, Kai; Blaser, Gisela; Bode, Udo; Molan, Peter

2009-01-01

320

Self-Assembling Peptide Nanofiber Scaffolds Accelerate Wound Healing  

PubMed Central

Cutaneous wound repair regenerates skin integrity, but a chronic failure to heal results in compromised tissue function and increased morbidity. To address this, we have used an integrated approach, using nanobiotechnology to augment the rate of wound reepithelialization by combining self-assembling peptide (SAP) nanofiber scaffold and Epidermal Growth Factor (EGF). This SAP bioscaffold was tested in a bioengineered Human Skin Equivalent (HSE) tissue model that enabled wound reepithelialization to be monitored in a tissue that recapitulates molecular and cellular mechanisms of repair known to occur in human skin. We found that SAP underwent molecular self-assembly to form unique 3D structures that stably covered the surface of the wound, suggesting that this scaffold may serve as a viable wound dressing. We measured the rates of release of EGF from the SAP scaffold and determined that EGF was only released when the scaffold was in direct contact with the HSE. By measuring the length of the epithelial tongue during wound reepithelialization, we found that SAP scaffolds containing EGF accelerated the rate of wound coverage by 5 fold when compared to controls without scaffolds and by 3.5 fold when compared to the scaffold without EGF. In conclusion, our experiments demonstrated that biomaterials composed of a biofunctionalized peptidic scaffold have many properties that are well-suited for the treatment of cutaneous wounds including wound coverage, functionalization with bioactive molecules, localized growth factor release and activation of wound repair. PMID:18183291

Schneider, Aurore; Garlick, Jonathan A.; Egles, Christophe

2008-01-01

321

Wound Care in Buruli Ulcer Disease in Ghana and Benin  

PubMed Central

Buruli ulcer (BU) is a disease affecting the skin, subcutaneous fat, and bone tissues. Wound care is important in the prevention of disabilities. Awareness of current wound care practices in BU-endemic regions is necessary for future wound care interventions. Thirty-one health care workers in Ghana and Benin were interviewed with a semi-structured interview, complemented by structural observations. Quantitative data were analyzed through t tests and one-way analysis of variance, and qualitative data through descriptive statistics. There appeared to be a general understanding of wound assessment. A large variety of different topical antiseptics was reported to be used, pressure irrigation was never reported. Gauze was the main dressing type and a moist environment was preferred, but could not be maintained. Bleeding and pain were observed frequently. Standard of wound care differed importantly between health care personnel and between institutions and adherence to World Health Organization guidelines was low. PMID:24914002

Velding, Kristien; Klis, Sandor-Adrian; Abass, Kabiru M.; Tuah, Wilson; Stienstra, Ymkje; van der Werf, Tjip

2014-01-01

322

Wound care in Buruli ulcer disease in Ghana and Benin.  

PubMed

Buruli ulcer (BU) is a disease affecting the skin, subcutaneous fat, and bone tissues. Wound care is important in the prevention of disabilities. Awareness of current wound care practices in BU-endemic regions is necessary for future wound care interventions. Thirty-one health care workers in Ghana and Benin were interviewed with a semi-structured interview, complemented by structural observations. Quantitative data were analyzed through t tests and one-way analysis of variance, and qualitative data through descriptive statistics. There appeared to be a general understanding of wound assessment. A large variety of different topical antiseptics was reported to be used, pressure irrigation was never reported. Gauze was the main dressing type and a moist environment was preferred, but could not be maintained. Bleeding and pain were observed frequently. Standard of wound care differed importantly between health care personnel and between institutions and adherence to World Health Organization guidelines was low. PMID:24914002

Velding, Kristien; Klis, Sandor-Adrian; Abass, Kabiru M; Tuah, Wilson; Stienstra, Ymkje; van der Werf, Tjip

2014-08-01

323

Wound Healing & Management Node: Titles list Version 1 1 July 2010 Publication list of Evidence Summary titles available in the Wound Healing and Management Node of the JBI COnNECT+ database as at 31 December 2011.  

E-print Network

Autolytic debridement for chronic wounds 20/10/2009 3451 Chemical debridement for venous leg ulcers 19/05/2010 3454 Enzymatic debridement for venous leg ulcers 13/10/2009 3455 Hydrogel dressings in treating Mechanical debridement of chronic wounds 21/01/2010 3458 Pentoxifylline for venous leg ulcers 27

324

Relationship between type of treatment and degree of wound healing among institutionalized geriatric patients with stage II pressure ulcers.  

PubMed

The prevention and treatment of pressure ulcers has always been of paramount concern to geriatric health care providers. The purpose of this study was to examine the relationship between two types of treatments and the degree of wound healing among status post-cerebral vascular accident (CVA) institutionalized geriatric patients with stage II pressure ulcers. Wound dressings were evaluated according to the National Pressure Advisory Panels Pressure Ulcer Scale for Healing (NPUAP, 1997). Fifty long-term care residents were recruited for the study in Queens, New York. A convenience sample was randomly assigned to either of the treatment protocols: polymeric membrane dressing (polymem) or the antibiotic ointment and dry clean dressing (DCD). The findings from the study revealed a significant difference in wound healing scores in the polymeric membrane-dressing group. These findings are limited due to the small sample size and they cannot be generalized to other populations. As this is an initial study, further research is recommended PMID:16294574

Yastrub, Diane J

2004-01-01

325

Polyvinyl pyrrolidone-iodine liposome hydrogel improves epithelialization by combining moisture and antisepis. A new concept in wound therapy.  

PubMed

Moist treatment of wounds has been shown to improve epithelialization, however at an increased risk of bacterial infection. In this monocentric, randomized, open, phase II pilot study of polyvinyl pyrrolidone-iodine, a well-established topical antiseptic was tested in a new liposomal complexed form in patients receiving meshed skin grafts after burns or reconstructive procedures. Mesh skin graft sites of 36 patients were dressed either with the new polyvinyl-pyrrolidone-iodine liposome hydrogel formulation (Betasom hydrogel) (n = 21), or chlorhexidine-gauze (n = 15). After the first dressing change, wounds were assessed daily and documented every other day until they were healed. Methods of analysis included clinical assessment, photoplanimetry (rate of epithelialization), impedance measurement (moisture of surface and wound healing quality), patient's assessment of pain and other sensations, and thyroid hormones (T3, T4, and TSH). The rate of epithelialization was improved with Betasom hydrogel compared to chlorhexidine-gauze on day 11 (96.3% vs. 75.9% p = 0.056) and significantly on day 13 (100% vs. 82.3% p = 0.005), respectively. Impedance measurements showed an earlier return to normal values (day 9) in Betasom-hydrogel-treated wounds as opposed to chlorhexidine treatment (day 11). Clinical assessment indicated significantly better antiseptic efficacy (p = 0.002) and wound healing quality (p = 0.004) of Betasom hydrogel. Graft loss occurred at a significantly lower rate in Betasom treatment (n = 1; 5%), than in chlorhexidine treatment (n = 5; 35.7%) (p = 0.001). No relevant adverse events or clinically relevant changes of thyroid hormones were observed with Betasom hydrogel. The rationale of this new polyvinyl pyrrolidone-iodine liposomal formulation was based on the properties of liposomes that provide higher moisture to the wound surface, release PVP-iodine at a low rate, and target the substance more exactly by interaction with the cell surface. These initial clinical results show earlier epithelialization and better healing in wounds treated with polyvinyl pyrrolidone-iodine liposome hydrogel, which combines moisture and antisepsis, compared to wounds treated with a conventional antiseptic chlorhexidine-gauze. PMID:11350649

Vogt, P M; Hauser, J; Rossbach, O; Bosse, B; Fleischer, W; Steinau, H U; Reimer, K

2001-01-01

326

Molecular and Culture-Based Assessment of the Microbial Diversity of Diabetic Chronic Foot Wounds and Contralateral Skin Sites  

PubMed Central

Wound debridement samples and contralateral (healthy) skin swabs acquired from 26 patients attending a specialist foot clinic were analyzed by differential isolation and eubacterium-specific PCR-denaturing gradient gel electrophoresis (DGGE) in conjunction with DNA sequencing. Thirteen of 26 wounds harbored pathogens according to culture analyses, with Staphylococcus aureus being the most common (13/13). Candida (1/13), pseudomonas (1/13), and streptococcus (7/13) were less prevalent. Contralateral skin was associated with comparatively low densities of bacteria, and overt pathogens were not detected. According to DGGE analyses, all wounds contained significantly greater eubacterial diversity than contralateral skin (P < 0.05), although no significant difference in total eubacterial diversity was detected between wounds from which known pathogens had been isolated and those that were putatively uninfected. DGGE amplicons with homology to Staphylococcus sp. (8/13) and S. aureus (2/13) were detected in putatively infected wound samples, while Staphylococcus sp. amplicons were detected in 11/13 noninfected wounds; S. aureus was not detected in these samples. While a majority of skin-derived DGGE consortial fingerprints could be differentiated from wound profiles through principal component analysis (PCA), a large minority could not. Furthermore, wounds from which pathogens had been isolated could not be distinguished from putatively uninfected wounds on this basis. In conclusion, while chronic wounds generally harbored greater eubacterial diversity than healthy skin, the isolation of known pathogens was not associated with qualitatively distinct consortial profiles or otherwise altered diversity. The data generated support the utility of both culture and DGGE for the microbial characterization of chronic wounds. PMID:22553231

Oates, Angela; Bowling, Frank L.; Boulton, Andrew J. M.

2012-01-01

327

Labeling of Ready-Made Street Dresses.  

E-print Network

This bulletin reports consumers' interest in and Labels on dresses costing under $20 pr use of label information on ready-made street more of the needed information than dresses dresses, the availability of such information and in- $20 or more.... dustry practices in the provision of labels. The data were obtained in 1956-57 by interviews with 992 ur- Both retailers and manufacturers emp' ban who bought ready-made dresses in the the importance of label information concernin year previous...

Drake, Phyllis; Grimes, Mary Anna

1959-01-01

328

Antibiotic eluting clay mineral (Laponite(®)) for wound healing application: an in vitro study.  

PubMed

Different materials in form of sponge, hydrogel and film have been developed and formulated for treating and dressing burn wounds. In this study, the potential of Laponite, a gel forming clay, in combination with an antimicrobial agent (mafenide), as a wound dressing material was tested in vitro. Laponite/mafenide (Lap/Maf) hydrogel was formulated in three different ratios of Lap/Maf 1:1, 1:2, 1:3. Laponite/mafenide/alginate (Lap/Maf/Alg) film was also formulated by combining Lap/Maf gel (1:1) with alginate. Intercalation rate of mafenide into the layers of Laponite nanoparticles and physico-chemical properties, including wound dressing characteristics of materials were studied using various analytical methods. Furthermore, the degradation of materials and the release profile of mafenide were investigated in simulated wound exudates fluid and antibacterial effectiveness of the eluted mafenide was tested on a range of bacterial species. The cytotoxicity of materials was also evaluated in skin fibroblast culture. The results showed that mafenide molecules were intercalated between the nano-sized layers of Laponite. The eluted mafenide showed active antibacterial effects against all three tested bacteria. All intercalated mafenide released from Lap/Maf 1:1 and 1:2 gel formulations and nearly 80 % release from 1:3 formulation during test period. No significant difference was observed in release profile of mafenide between Lap/Maf/Alg film and Lap/Maf formulations. Wound dressing tests on Lap/Maf/Alg film showed it is a breathable dressing and has capacity to absorb wound exudates. The study showed that prepared Lap/Maf composite has the potential to be used as an antibiotic eluting gel or film for wound healing application. Additionally, Laponite has shown benefits in wound healing processes by releasing Mg(2+) ions and thereby reducing the cytotoxic effect of mafenide on fibroblast cells. PMID:25027303

Ghadiri, M; Chrzanowski, W; Rohanizadeh, R

2014-11-01

329

School Dress Codes and Uniform Policies.  

ERIC Educational Resources Information Center

Opinions abound on what students should wear to class. Some see student dress as a safety issue; others see it as a student-rights issue. The issue of dress codes and uniform policies has been tackled in the classroom, the boardroom, and the courtroom. This Policy Report examines the whole fabric of the debate on dress codes and uniform policies…

Anderson, Wendell

2002-01-01

330

The use of Biobrane(R) to dress split-thickness skin graft in paediatric burns  

PubMed Central

Summary Biobrane® is commonly used in paediatric burns to cover partial thickness burns and donor sites of split thickness skin (SSG). The purpose of this study is to evaluate the use of Biobrane® in dressing SSG adjacent to skin graft donor sites or partial thickness burns. A retrospective review was undertaken to determine the use of Biobrane® in dressing SSG, where the grafted areas were adjacent to donor sites or partial thickness burns. Between 2009 and 2012, we reported five cases of using Biobrane® to dress SSG, where the grafted areas were adjacent to partial thickness burns and two cases where the grafted areas were adjacent to donor sites. Biobrane® promoted adherence of the SSG to the wound, prevented shearing, and allowed fluid drainage. At the same time, Biobrane® also facilitated healing of the adjacent donor sites or partial thickness burns. PMID:24133404

Farroha, A.; Frew, Q.; El-Muttardi, N.; Philp, B.; Dziewulski, P.

2013-01-01

331

The Effects of Customers' Dress on Salesperson's Service in Large-Sized Clothing Specialty Stores  

Microsoft Academic Search

Our research, based on symbolic interaction, was designed to investigate customer-salesperson interactions as a function of unmanipulated customer dress within retail settings using fieldwork. Th rough structured observations in three apparel stores for large size women, we rated customers' dress and friendliness of salespeople and promptness of service. MANOVA results showed that both friendliness and promptness of service were affected

Minjeong Kim; Sharron J. Lennon

2005-01-01

332

Dressings and healing with honey.  

PubMed

Two milestones have revolutionised the management of wounds. First, the introduction of antibiotics, and second, the work carried out by Winter in 1962, introducing the concept that a warm moist environment encouraged healing. PMID:24690746

Belcher, Judy

333

New advances in instillation therapy in wounds at risk for compromised healing.  

PubMed

Combined use of adjunctive negative pressure wound therapy (NPWT) and instillation of topical wound solutions and suspensions (NPWTi) has proven to be an effective next-generation NPWT technique for wounds at risk for compromised healing. Fluid instillation has been shown to enhance exudate and debris removal, provide regular cleansing of the wound bed, and add moisture to the wound. Positive results have been demonstrated with NPWTi in assisting healing of stalled wounds and treating painful wounds as well as wounds at high risk for amputation. NPWTi has been used instead of conventional NPWT in wounds with thick exudate and slough content, acute traumatic wounds, wounds acutely debrided due to infected soft tissue, large areas of post-debrided exposed bone, and cases of critical bacterial colonization. Instilled solutions have included topical solutions such as saline, topical wound cleansers, and antiseptics. While various systems that combine instillation or irrigation with NPWT have been commercialized during the past decade, until very recently these have been relatively cumbersome to use and limited in their ability to regulate solution volume delivery. Recent advances in NPWTi technology (V.A.C. VeraFlo™ Therapy, KCI, San Antonio, TX) include automated volumetrically controlled delivery of fluids and upgraded foam dressing technology to provide better control and delivery of solutions to the wound bed. This article describes the latest NPWTi technology and provides recommendations for successful application of NPWTi in an effort to inform clinicians about product decision-making and practice. PMID:24700215

Gabriel, Allen; Kahn, Kevin M

2014-03-01

334

Laser Dressed Scattering of an Attosecond Electron Wave Packet  

E-print Network

We theoretically investigate the scattering of an attosecond electron wave packet launched by an attosecond pulse under the influence of an infrared laser field. As the electron scatters inside a spatially extended system, the dressing laser field controls its motion. We show that this interaction, which lasts just a few hundreds of attoseconds, clearly manifests itself in the spectral interference pattern between different quantum pathways taken by the outgoing electron. We find that the Coulomb-Volkov approximation, a standard expression used to describe laser-dressed photoionization, cannot properly describe this interference pattern. We introduce a quasi-classical model, based on electron trajectories, which quantitatively explains the laser-dressed photoelectron spectra, notably the laser-induced changes in the spectral interference pattern.

Justin Gagnon; Ferenc Krausz; Vladislav S. Yakovlev

2010-08-13

335

Laser-dressed scattering of an attosecond electron wave packet  

SciTech Connect

We theoretically investigate the scattering of an attosecond electron wave packet launched by an attosecond pulse under the influence of an infrared laser field. As the electron scatters inside a spatially extended system, the dressing laser field controls its motion. We show that this interaction, which lasts just a few hundreds of attoseconds, clearly manifests itself in the spectral interference pattern between different quantum pathways taken by the outgoing electron. We find that the Coulomb-Volkov approximation, a standard expression used to describe laser-dressed photoionization, cannot properly describe this interference pattern. We introduce a quasiclassical model, based on electron trajectories, which quantitatively explains the laser-dressed photoelectron spectra, notably the laser-induced changes in the spectral interference pattern.

Gagnon, Justin; Krausz, Ferenc; Yakovlev, Vladislav S. [Max-Planck-Institut fuer Quantenoptik, Hans-Kopfermann-Strasse 1, D-85748 Garching (Germany) and Ludwig-Maximilians-Universitaet Muenchen, Am Coulombwall 1, D-85748 Garching (Germany)

2010-09-15

336

Management of radiation-induced moist skin desquamation using hydrocolloid dressing  

SciTech Connect

Moist skin desquamation has been of concern to radiation oncologists, nurses and patients since the inception of this mode of therapy. As radiation treatment machines became more sophisticated, severe reactions became less of a problem. However, with the increasing use of chemotherapy and radiation as combined modalities, moist skin reaction is occurring with greater frequency. A noncomparative study of 20 patients using a hydrocolloid occlusive dressing (Duoderm) was initiated. The purpose of the study was to determine whether moist occlusive healing would be beneficial. The dressing was evaluated on the basis of healing time, safety, wound temperature, bacterial growth, and comfort. Data were collected using photographs, bacterial cultures, temperature probes, and patient evaluations. Eighteen patients completed the study. All patients' skin reactions healed. There were no wound infections evident. Mean healing time was 12 days, with mean wound temperature relative to body core -0.8 degree C on day 1 and -1.2 degrees C on the healed site. Patient results on comfort were: 8 of 18 excellent, 7 of 18 good, 3 of 18 fair, and 0 of 18 poor. The results of this study indicate that a hydrocolloid occlusive dressing can be effective in the healing process of moist skin reaction that is due to radiation therapy.

Margolin, S.G.; Breneman, J.C.; Denman, D.L.; LaChapelle, P.; Weckbach, L.; Aron, B.S. (Univ. of Cincinnati Medical Center, OH (USA))

1990-04-01

337

Dressed-atom multiphoton analysis of anomalous electromagnetically induced absorption.  

PubMed

A method to interpret probe spectra of driven degenerate atomic systems is discussed. The dressed-atom multiphoton spectroscopy (DAMS) is based on a dressing of the atomic system with the strong coupling field, followed by a perturbative treatment of the probe field interaction. As an example, we apply the DAMS to provide a clear interpretation for anomalous electromagnetically induced absorption (EIA), which cannot be explained by spontaneous transfer of coherence. We show that anomalous EIA arises from quantum interference among competing two-photon transitions and explain the different dependences on the coupling field strength observed for various angular momentum setups. PMID:20867096

Chou, Hsiang-Shun; Evers, Jörg

2010-05-28

338

Dressed-Atom Multiphoton Analysis of Anomalous Electromagnetically Induced Absorption  

NASA Astrophysics Data System (ADS)

A method to interpret probe spectra of driven degenerate atomic systems is discussed. The dressed-atom multiphoton spectroscopy (DAMS) is based on a dressing of the atomic system with the strong coupling field, followed by a perturbative treatment of the probe field interaction. As an example, we apply the DAMS to provide a clear interpretation for anomalous electromagnetically induced absorption (EIA), which cannot be explained by spontaneous transfer of coherence. We show that anomalous EIA arises from quantum interference among competing two-photon transitions and explain the different dependences on the coupling field strength observed for various angular momentum setups.

Chou, Hsiang-Shun; Evers, Jörg

2010-05-01

339

Exposing the dressed quark's mass  

E-print Network

This snapshot of recent progress in hadron physics made in connection with QCD's Dyson-Schwinger equations includes: a perspective on confinement and dynamical chiral symmetry breaking (DCSB); a pre'cis on the physics of in-hadron condensates; results on the hadron spectrum, including dressed-quark-core masses for the nucleon and Delta, their first radial excitations, and the parity-partners of these states; an illustration of the impact of DCSB on the electromagnetic pion form factor, thereby exemplifying how data can be used to chart the momentum-dependence of the dressed-quark mass function; and a prediction that F_1^{p,d}/F_1^{p,u} passes through zero at Q^2\\approx 5m_N^2 owing to the presence of nonpointlike scalar and axial-vector diquark correlations in the nucleon.

H. L. L. Roberts; L. Chang; I. C. Cloet; C. D. Roberts

2010-07-21

340

Development of a Porcine Delayed Wound-Healing Model and Its Use in Testing a Novel Cell-Based Therapy  

SciTech Connect

Purpose: A delayed full-thickness wound-healing model was developed and used for examining the capacity of adipose-derived stem cells (ASCs), either alone or in platelet-rich fibrin gels, to promote healing. Methods and Materials: Four pigs received electron beam radiation to the dorsal skin surface. Five weeks after radiation, subcutaneous fat was harvested from nonirradiated areas and processed to yield ASCs. Two weeks later, 28 to 30 full-thickness 1.5-cm{sup 2} wounds were made in irradiated and nonirradiated skin. Wounds were treated with either saline solution, ASCs in saline solution, platelet-rich plasma (PRP) fibrin gel, ASCs in PRP, or non-autologous green fluorescence protein-labeled ASCs. Results: The single radiation dose produced a significant loss of dermal microvasculature density (75%) by 7 weeks. There was a significant difference in the rate of healing between irradiated and nonirradiated skin treated with saline solution. The ASCs in PRP-treated wounds exhibited a significant 11.2% improvement in wound healing compared with saline solution. Enhancement was dependent on the combination of ASCs and PRP, because neither ASCs nor PRP alone had an effect. Conclusions: We have created a model that simulates the clinically relevant late radiation effects of delayed wound healing. Using this model, we showed that a combination of ASCs and PRP improves the healing rates of perfusion-depleted tissues, possibly through enhancing local levels of growth factors.

Hadad, Ivan, E-mail: ihadad@iupui.ed [Department of Surgery, Indiana University School of Medicine, Indianapolis, IN (United States); Johnstone, Brian H. [Indiana Center for Vascular Biology and Medicine, Indianapolis, IN (United States); Brabham, Jeffrey G. [Division of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN (United States); Blanton, Matthew W. [Department of Surgery, Indiana University School of Medicine, Indianapolis, IN (United States); Rogers, Pamela I.; Fellers, Cory; Solomon, James L.; Merfeld-Clauss, Stephanie [Indiana Center for Vascular Biology and Medicine, Indianapolis, IN (United States); DesRosiers, Colleen M.; Dynlacht, Joseph R. [Division of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN (United States); Coleman, John J. [Division of Plastic Surgery, Indiana University School of Medicine, Indianapolis, IN (United States); March, Keith L. [Indiana Center for Vascular Biology and Medicine, Indianapolis, IN (United States)

2010-11-01

341

Use of a fibrin-based system for enhancing angiogenesis and modulating inflammation in the treatment of hyperglycemic wounds.  

PubMed

The complex pathophysiology of chronic ulceration in diabetic patients is poorly understood; diabetes-related lower limb amputation is a major health issue, which has limited effective treatment regimes in the clinic. This study attempted to understand the complex pathology of hyperglycemic wound healing by showing profound changes in gene expression profiles in wounded human keratinocytes in hyperglycemic conditions compared to normal glucose conditions. In the hyper-secretory wound microenvironment of hyperglycemia, Rab18, a secretory control molecule, was found to be significantly downregulated. Using a biomaterial platform for dual therapy targeting the two distinct pathways, this study aimed to resolve the major dysregulated pathways in hyperglycemic wound healing. To complement Rab18, and promote angiogenesis eNOS was also targeted, and this novel Rab18-eNOS therapy via a dynamically controlled 'fibrin-in-fibrin' delivery system, demonstrated enhanced wound closure, by increasing functional angiogenesis and reducing inflammation, in an alloxan-induced hyperglycemic preclinical ear ulcer model of compromised wound healing. PMID:24331702

Kulkarni, M; O'Loughlin, A; Vazquez, R; Mashayekhi, K; Rooney, P; Greiser, U; O'Toole, E; O'Brien, T; Malagon, Maria M; Pandit, A

2014-02-01

342

Prevention of post-operative infections after surgical treatment of bite wounds.  

PubMed

After reviewing the literature about the microbial spectrum, the risk factors of post-operative infections, and the results of surgical interventions, the following recommendation can be made for the management of bite wounds:FRESH, OPEN WOUNDS: surgical debridement, if appropriate, then an antiseptic lavage with a fluid consisting of povidone iodine and ethanol (e.g., Betaseptic(®)), no antibiotics, primary wound closurenearly closed fresh wounds (e.g., cat bites): surgical debridement, if appropriate, dressing with an antiseptic-soaked compress for ~60 minutes with repeated soaking (e.g., Betaseptic(®)), no antibioticsolder wounds after ~4 hours: surgical debridement, if appropriate, dressing with an antiseptic-soaked compress or bandage for ~60 minutes with repeated soaking (e.g., Betaseptic(®)), at the same time intravenous or dose-adapted oral antibiotics (Amoxicillin and/or clavulanic acid)older wounds after ~24 hours: surgical debridement, then antiseptic lavage (Betaseptic(®)), in case of clinically apparent infection or inflammation surgical revision with opening of wound and treatment with antibiotics according to resistogram (empirical start with Amoxicillin and/or clavulanic acid).For each kind of bite wound, the patient's tetanus immunization status as well as the risk of exposure to rabies have to be assessed. Similarly, the possibility of other infections, such as lues (Syphilis), hepatitis B (HBV), hepatitis C (HBC), hepatitis D (HDV) and HIV, in the rare case of a human bite wound, has to be taken into account. PMID:20941334

Kramer, Axel; Assadian, Ojan; Frank, Matthias; Bender, Claudia; Hinz, Peter

2010-01-01

343

Enoxaparin-Induced DRESS Syndrome  

PubMed Central

Low-molecular-weight heparins are widely used for the prophylaxis and treatment of venous thromboembolism. However, they can induce adverse skin reactions. The most common reactions are delayed-type hypersensitivity reactions at injection sites. Rare systemic reactions have been reported. We report, to our knowledge, the first case of a drug reaction with eosinophilia and systemic symptoms syndrome (DRESS) due to enoxaparin which belongs to the low-molecular-weight heparins class. PMID:23185158

Ronceray, Sophie; Dinulescu, Monica; Le Gall, Francois; Polard, Elisabeth; Dupuy, Alain; Adamski, Henri

2012-01-01

344

Protection of grapevine pruning wounds from infection by Eutypa lata using Trichoderma harzianum and Fusarium lateritium  

Microsoft Academic Search

.  \\u000a Trichoderma harzianum applied to grapevine pruning wounds in a spore suspension and in the commercial formulations of Trichoseal, Trichoseal spray\\u000a and Vinevax pruning wound dressing reduced recovery of Eutypa lata in the glasshouse and in the field. Recovery of E. lata was significantly reduced (P T. harzianum 2 or 7 days before inoculation with ascospores of the pathogen in

S. John; T. J. Wicks; J. S. Hunt; M. F. Lorimer; H. Oakey; E. S. Scott

2005-01-01

345

[Gunshot wounds, firearms and wound ballistics].  

PubMed

In the Netherlands the majority of gunshot wounds are caused by hand guns with a low firing velocity, such as pistols and revolvers, in which the severity of the injuries caused is primarily determined by whether or not vital structures are hit. With these sorts of wounds the removal of debris as equally the bullet is not usually necessary. For firearms with a high firing velocity the wounds are more severe due to the greater quantity of kinetic energy transferred to the tissues. As a result of this, cavitations and damage due to secondary projectiles can occur. The extensive removal of debris can be necessary in such cases. The severity of the wounds caused by a shotgun depends mainly on the distance from the shooter. For shotgun wounds incurred at a short distance it is necessary to ascertain whether the plastic pellet has ended up in the wound. PMID:12138671

Verleisdonk, E J M M

2002-07-01

346

Bacterial resistance to silver in wound care.  

PubMed

Ionic silver exhibits antimicrobial activity against a broad range of micro-organisms. As a consequence, silver is included in many commercially available healthcare products. The use of silver is increasing rapidly in the field of wound care, and a wide variety of silver-containing dressings are now commonplace (e.g. Hydrofiber dressing, polyurethane foams and gauzes). However, concerns associated with the overuse of silver and the consequent emergence of bacterial resistance are being raised. The current understanding of the biochemical and molecular basis behind silver resistance has been documented since 1998. Despite the sporadic evidence of bacterial resistance to silver, there have been very few studies undertaken and documented to ascertain its prevalence. The risks of antibacterial resistance developing from the use of biocides may well have been overstated. It is proposed that hygiene should be emphasized and targeted towards those applications that have demonstrable benefits in wound care. It is the purpose of this review to assess the likelihood of widespread resistance to silver and the potential for silver to induce cross-resistance to antibiotics, in light of its increasing usage within the healthcare setting. PMID:15823649

Percival, S L; Bowler, P G; Russell, D

2005-05-01

347

Evidence-Based Recommendations for the Use of Topical Oxygen Therapy in the Treatment of Lower Extremity Wounds  

PubMed Central

Topical oxygen therapy provides another tool in the armamentarium of clinicians treating refractory lower extremity wounds. Devices suitable for providing topical oxygen therapy in a clinical setting have recently become available. This article reviews the evidence to justify the use of this treatment modality, including in vitro, preclinical data, and clinical data. It also provides a protocol for how to administer topical oxygen therapy as well as guidance on patient selection and management to optimize outcomes. Randomized controlled trials are not yet reported and clearly necessary. The current body of evidence suggests that topical oxygen therapy may be considered as a second line of therapy for refractory wounds. PMID:19443899

Gordillo, Gayle M.; Sen, Chandan K.

2013-01-01

348

Controlling methicillin resistant Staphyloccocus aureus and Pseudomonas aeruginosa wound infections with a novel biomaterial.  

PubMed

Wound infections, especially those associated with methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa, offer considerable challenges for clinicians. Our laboratory has recently developed novel composite biomaterials (DRDC) for wound dressing applications, and demonstrated their in vitro bactericidal efficacy. In the present study, we assessed the proliferation of planktonic and sessile Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus in porcine full-thickness wounds covered for up to 48 h with either saline- or mafenide acetate-loaded DRDC puffs and meshes. All biomaterials were applied 4 h following bacterial inoculation of the wounds with methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa, to allow colonization of the tissues and initiation of biofilm formation. The drug-loaded biomaterials eradicated both the planktonic and biofilm bacteria in the wounds within 24 h (p <. 05), irrespective of the bacterial strain or architecture of the dressing. While the wound bioburdens increased in the ensuing 24 h, they remained approximately 2 log(10) colony-forming units (CFU) below (p <. 05) their respective baseline values. Similarly, less than 4 log(10) CFU was recovered in the drug-loaded DRDC biomaterials throughout the study. These data show that the DRDC puffs and meshes are effective in delivering certain medications, such as antimicrobial agents, to the wound bed, suggesting considerable value of this material for treating wounds, especially those with irregular shapes, contours, and depths. PMID:17710602

Martineau, Lucie; Davis, Stephen C; Peng, Henry T; Hung, Andy

2007-01-01

349

Extracorporeal shock wave therapy as an adjunct wound treatment: a systematic review of the literature.  

PubMed

Standard care procedures for complex wounds are sometimes supported and reinforced by physical treatment modalities such as extracorporeal shock wave therapy (ESWT). To evaluate available evidence of ESWT effectiveness in humans, a systematic review of the literature was conducted using MEDLINE, PubMed, Scopus, EBSCOhost, and PEDro databases. Of the 393 articles found, 13 met the publication date (year 2000-2013), study type (clinical study), language (English only), and abstract availability (yes) criteria. The 13 studies (n = 919 patients with wounds of varying etiologies) included seven randomized controlled trials that were evaluated using Cochrane Collaboration Group standards. Only studies with randomization, well prepared inclusion/exclusion criteria protocol, written in English, and full version available were analyzed. An additional six publications reporting results of other clinical studies including a total of 523patients were identified and summarized. ESWT was most commonly applied once or twice a week using used low or medium energy, focused or defocused generator heads (energy range 0.03 to 0.25 mJ/mm2; usually 0.1 mJ/mm2), and electrohydraulic or electromagnetic sources. Few safety concerns were reported, and in the controlled clinical studies statistically significant differences in rates of wound closure were reported compared to a variety of standard topical treatment modalities, sham ESWT treatment, and hyperbaric oxygen therapy. Based on this analysis, ESWT can be characterized as noninvasive, mostly painless, and safe. Controlled, randomized, multicenter, blind clinical trials still are required to evaluate the efficacy and cost-effectiveness of ESWT compared to sham control, other adjunctive treatments, and commonly used moisture-retentive dressings. In the future, ESWT may play an important role in wound care once evidence-based practice guidelines are developed. PMID:25019247

Dymarek, Robert; Halski, Tomasz; Ptaszkowski, Kuba; Slupska, Lucyna; Rosinczuk, Joanna; Taradaj, Jakub

2014-07-01

350

Wound Healing Essentials: Let There Be Oxygen  

PubMed Central

The state of wound oxygenation is a key determinant of healing outcomes. From a diagnostic standpoint, measurements of wound oxygenation are commonly used to guide treatment planning such as amputation decision. In preventive applications, optimizing wound perfusion and providing supplemental O2 in the peri-operative period reduces the incidence of post-operative infections. Correction of wound pO2 may, by itself, trigger some healing responses. Importantly, approaches to correct wound pO2 favorably influence outcomes of other therapies such as responsiveness to growth factors and acceptance of grafts. Chronic ischemic wounds are essentially hypoxic. Primarily based on the tumor literature, hypoxia is generally viewed as being angiogenic. This is true with the condition that hypoxia be acute and mild to modest in magnitude. Extreme near-anoxic hypoxia, as commonly noted in problem wounds, is not compatible with tissue repair. Adequate wound tissue oxygenation is required but may not be sufficient to favorably influence healing outcomes. Success in wound care may be improved by a personalized health care approach. The key lies in our ability to specifically identify the key limitations of a given wound and in developing a multifaceted strategy to specifically address those limitations. In considering approaches to oxygenate the wound tissue it is important to recognize that both too little as well as too much may impede the healing process. Oxygen dosing based on the specific need of a wound therefore seems prudent. Therapeutic approaches targeting the oxygen sensing and redox signaling pathways are promising. PMID:19152646

Sen, Chandan K.

2009-01-01

351

General principles and approaches to wound prevention and care at end of life: an overview ?.  

PubMed

????????????????The incidence and prevalence of wounds in persons at the end of life is largely unknown, but wounds are estimated to occur in at least one third of hospice patients. At the end of life, healthcare professionals must help the patient and/ or family decide whether the goals of wound prevention and care should focus on healing or palliation. At all times, it is important to consider that a palliative approach does not negate the potential for wound improvement or even closing before death. A review of the literature suggests that, in general, few differences exist between the general principles of wound prevention and care and an optimal palliative care plan. For example, maintenance of a moist wound environment is recommended to facilitate healing in general protocols of care. In end-of-life patients, dressings should be used for general comfort and prevention of skin exposure to wound exudate and to reduce the number of potentially painful dressing changes. Risk factors for tissue breakdown and pressure ulcer development are also similar. Palliative care patients with limited mobility and physical activity are at highest risk for developing pressure ulcers, but measures to help prevent these wounds may have to be adjusted to meet the overall goals of palliative care for a particular patient. Wounds encountered mainly in cancer patients - eg, fungating and radiation wounds - can pose important challenges for healthcare professionals and are very stressful for the patient. Pressure ulcers, fungating, and radiation wounds at the end of life are to be managed palliatively with the overall goal to minimize pain and odor, enhance comfort, and potentially improve the condition of the ulcer. Although research remains limited, it is clear the clinician and patient must balance best wound prevention and management practices while promoting patient dignity, self-esteem, and quality of life. PMID:22562937

Langemo, Diane

2012-05-01

352

Wound Healing and Care  

MedlinePLUS

... there's a risk that a wound might pull apart if it gets too wet. Avoid picking or ... Tetanus Dealing With Cuts and Wounds Dealing With Falls Sports and Exercise Safety Contact Us Print Additional ...

353

Role Conflict and Conformity in Dress.  

ERIC Educational Resources Information Center

Examined conflict regarding what form of dress is appropriate for Roman Catholic priest. Data from 5,475 American Catholic priests revealed that priests who conformed to church regulations regarding dress differed from nonconformists in beliefs about their roles as priests and in their opinions of church reform, commitment to the priesthood,…

Jasper, Cynthia R.; Roach-Higgins, Mary Ellen

1988-01-01

354

How does xanthan stabilise salad dressing?  

Microsoft Academic Search

The creaming behaviour of model pourable salad dressings has been studied over a wide range of xanthan and oil phase concentrations. They were produced by mixing a colloidally stable emulsion with xanthan solutions. The model dressings were completely flocculated by depletion at all xanthan concentrations >0.1 g\\/l. Creaming behaviour was in three phases: an initial delay phase, followed by more

Alan Parker; Paul A. Gunning; Kim Ng; Margaret M. Robins

1995-01-01

355

Atom as a "Dressed" Nucleus  

E-print Network

It is shown that the electrostatic potential of atomic nucleus "seen" by a fast charged projectile at short distances is smeared quantum mechanically due to nucleus motion around the atomic center of inertia. For example, the "positive charge cloud" size in the Hydrogen ground state is much larger than the proper proton size. It is even bigger for the target atoms in excited initial states. The elastic scattering at large angles is generally weaker than the Rutherford one since the effective potential at short distances is softer than the Colombian one due to a natural "cutoff". In addition, the large angle scattering leads to the target atom excitations due to pushing the nucleus (=> inelastic processes). The Rutherford cross section is in fact the inclusive rather than the elastic one. These results are analogous to the QED ones. The difference and the value of presented below non relativistic atomic calculations is in non perturbatively (exact) nucleus "dressing" that immediately leads to correct physical results and to significant technical simplifications. In these respects the nucleus bound in an atom is a simple but a rather realistic model of a "dressed" charge in the QFT. This idea is briefly demonstrated on the real electron model (electronium) that is made free from infinities.

Vladimir Kalitvianski

2008-06-16

356

Evaluation of silver-containing activated carbon fiber for wound healing study: In vitro and in vivo.  

PubMed

Silver has antiseptic properties, anti-inflammatory properties, and is a broad-spectrum antibiotic for multidrug-resistant strains of bacteria. The commercially available product, Silverlon®, is a silver-plated three-dimensional polyamide fabric with a high silver concentration of 546 mg/100 cm(2). Thus, fibroblast cell growth is affected when exposed to the Silverlon® treated cell medium. Our study produced an activated carbon fiber wound dressing that incorporated various silver concentrations (in cooperation of Bio-Medical Carbon Technology) to examine antimicrobial properties and determine fibroblast cell viability upon exposure to the silver impregnated dressing material as compared to other commercially available products such as calcium alginate dressing, Sorbalgon®, and silver-polyamide fabric dressing, Silverlon®. The silver impregnated activated carbon fiber dressing induced less damage to fibroblast cells compared to the effect produced by Silverlon® and exhibited similar antibacterial abilities in vitro. An in vivo analysis showed that various silver concentrations impregnated activated carbon fiber dressings promoted tissue reconstruction for wound healing in rats with Pseudomonas aeruginosa infected wounds. PMID:22987792

Lin, Yu-Hsin; Lin, Jui-Hsiang; Wang, Shih-Hao; Ko, Tse-Hao; Tseng, Guan-Chin

2012-11-01

357

Clinical update: gunshot wound ballistics.  

PubMed

Although firearm related injury and mortality actually may be declining, gunshot trauma remains a significant cause of morbidity and socioeconomic cost with 115,000 missile injuries annually and as many as 40,000 deaths. Wounds typically are classified as low-velocity (< 2000 feet/second) or high-velocity (> 2000 feet/second). However, these terms can be misleading. More important is the efficiency of energy transfer, which is dependent on the projectile's physical characteristics including deformation and fragmentation, kinetic energy, stability, entrance profile, path traveled through the body, and the biologic characteristics of the tissues. Therefore, the decision whether to explore the wound should not be based solely on the involvement of a high-velocity or low-velocity weapon. The majority of low-velocity gunshot wounds can be treated safely nonoperatively with local wound care and outpatient treatment. Treatment of associated fractures generally is dictated by the bony injuries, which have similar personalities to closed fractures. Because contamination is not always apparent, routine antibiotic prophylaxis still is recommended. The soft tissues assume a more crucial role in high-velocity and shotgun fractures, whereas high-energy injuries and grossly contaminated wounds mandate irrigation, appropriate debridement, and the use of open fracture protocols. However, a patient with a high-velocity wound with limited soft tissue disruption, no significant functional deficits, no evidence of bullet fragmentation, and minimal bony involvement can be a candidate for simple wound care. When exploration is indicated, decompression and excision of necrotic tissue is the rule with color, consistency, contractility, and capacity to bleed providing valuable information regarding muscle viability. PMID:12616039

Bartlett, Craig S

2003-03-01

358

Intralesional administration of epidermal growth factor-based formulation (Heberprot-P) in chronic diabetic foot ulcer: treatment up to complete wound closure.  

PubMed

Previous studies have shown that an epidermal growth factor-based formulation (Heberprot-P) can enhance granulation of high-grade diabetic foot ulcers (DFU). The aim of this study was to explore the clinical effects of this administration up to complete wound closure. A pilot study in 20 diabetic patients with full-thickness lower extremity ulcers of more than 4 weeks of evolution was performed. Mean ulcer size was 16.3 +/- 21.3 cm(2). Intralesional injections of 75 microg of Heberprot-P three times per week were given up to complete wound healing. Full granulation response was achieved in all 20 patients in 23.6 +/- 3.8 days. Complete wound closure was obtained in 17 (85%) cases in 44.3 +/- 8.9 days. Amputation was not necessary in any case and only one relapse was notified. The most frequent adverse events were tremors, chills, pain and odour at site of administration and local infection. The therapeutic scheme of intralesional Heberprot-P administration up to complete closure can be safe and suitable to improve the therapeutic goal in terms of healing of chronic DFU. PMID:19291119

Fernández-Montequín, José I; Betancourt, Blas Y; Leyva-Gonzalez, Gisselle; Mola, Ernesto L; Galán-Naranjo, Katia; Ramírez-Navas, Mayte; Bermúdez-Rojas, Sergio; Rosales, Felix; García-Iglesias, Elizeth; Berlanga-Acosta, Jorge; Silva-Rodriguez, Ricardo; Garcia-Siverio, Marianela; Martinez, Luis H

2009-02-01

359

The microbiome in wound repair and tissue fibrosis.  

PubMed

Bacterial colonization occurs in all wounds, chronic or acute, and the break in epithelium integrity that defines a wound impairs the forces that shape and constrain the microbiome at that site. This review highlights the interactions between bacterial communities in the wound and the ultimate resolution of the wound or development of fibrotic lesions. Chronic wounds support complex microbial communities comprising a wide variety of bacterial phyla, genera, and species, including some fastidious anaerobic bacteria not identified using culture-based methods. Thus, the complexity of bacterial communities in wounds has historically been underestimated. There are a number of intriguing possibilities to explain these results that may also provide novel insights into changes and adaptation of bacterial metabolic networks in inflamed and wounded mucosa, including the critical role of biofilm formation. It is well accepted that the heightened state of activation of host cells in a wound that is driven by the microbiota can certainly lead to detrimental effects on wound regeneration, but the microbiota of the wound may also have beneficial effects on wound healing. Studies in experimental systems have clearly demonstrated a beneficial effect for members of the gut microbiota on regulation of systemic inflammation, which could also impact wound healing at sites outside the gastrointestinal tract. The utilization of culture-independent microbiology to characterize the microbiome of wounds and surrounding mucosa has raised many intriguing questions regarding previously held notions about the cause and effect relationships between bacterial colonization and wound repair and mechanisms involved in this symbiotic relationship. PMID:23042513

Scales, Brittan S; Huffnagle, Gary B

2013-01-01

360

Nanofeatured silk fibroin membranes for dermal wound healing applications.  

PubMed

As an effort to create the next generation of improved skin graft materials, in this study, we modified the surfaces of a previously investigated material, silk fibroin, using a NaOH alkaline treatment to obtain a biologically inspired nanofeatured surface morphology. Such surfaces were characterized for roughness, energy, and chemistry. In addition, keratinocyte (skin-forming cells) adhesion and proliferation on such nanofeatured silk fibroin wound dressings were studied in an initial attempt to determine the promotion of an epidermal cover on the wound bed to form a new epidermal barrier. Dermal fibroblast adhesion and proliferation were also studied to assess the ability of nanostructured silk fibroin to replace damaged dermal tissue in chronic wounds (i.e., for diabetic foot ulcers). Results demonstrated for the first time that keratinocyte and fibroblast cell density was greater on nanofeatured silk fibroin membranes compared with non-treated silk fibroin surfaces. The enhancement in cellular functions was correlated with an increase in silk surface nanotopography, wettability and change in chemistry after NaOH treatment. Due to the present promising results, the newly developed nanofeatured silk fibroin membranes are exciting alternative skin graft materials which should be further studied for various skin patch and wound dressing applications. © 2014 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 103A: 135-144, 2015. PMID:24616219

Karahalilo?lu, Zeynep; Ercan, Batur; Denkba?, Emir B; Webster, Thomas J

2015-01-01

361

Wounds and survival in cancer patients  

Microsoft Academic Search

A number of validated and objectively based prognostic models are available for use in cancer care. The quest for additional prognostic factors continues in order to increase their accuracy. To date, none has considered the effect that wounds may contribute to assessing survival. This study serves to demonstrate that certain wound classes affecting cancer patients carry associations with survival. As

Vincent Maida; Marguerite Ennis; Craig Kuziemsky; Jason Corban

2009-01-01

362

Evaluations of bacterial contaminated full thickness burn wound healing in Sprague Dawley rats Treated with Tualang honey  

PubMed Central

Aim: The effect of Tualang honey on wound healing in bacterial contaminated full-thickness burn wounds was evaluated in 36 male Sprague Dawley rats. Materials and Methods: The rats were randomly divided into three groups (n = 12/group). Three full-thickness burn wounds were created on each rat. Each group of rats was inoculated with a different organism in the burn wounds: Group A was inoculated with Pseudomonas aeruginosa, Group B was inoculated with Klebsiella pneumoniae and Group C was inoculated with Acinetobacter baumannii. One wound on each rat was dressed with either Tualang honey, Chitosan gel or Hydrofibre silver. Each wound size was measured on day 3, 6, 9, 12, 15, 18 and 21 of the study. Results: The mean wound size of the Tualang honey-treated wounds was not statistically different than that of the Chitosan gel or Hydrofibre silver-treated wounds when the wounds were compared throughout the entire experiment (P > 0.05). However, comparing the mean wound size on day 21 alone revealed that the Tualang honey-treated wounds were smaller in comparison to that of the Chitosan gel and Hydrofibre silver-treated groups. Conclusions: This study shows that topical application of Tualang honey on burn wounds contaminated with P. aeruginosa and A. baumannii gave the fastest rate of healing compared with other treatments. PMID:21713196

Sukur, Salmi Mohamed; Halim, Ahmad Sukari; Singh, Kirnpal Kaur Banga

2011-01-01

363

Negative pressure wound therapy: treating a venomous insect bite.  

PubMed

Reports of spider bites appear throughout North America. Bites associated with the brown recluse spider (Loxosceles recluse) cause serious medical complications because the venom of this spider contains a powerful necrotising agent with the potential to cause severe cutaneous necrosis. Although not much is known regarding the application of negative pressure wound therapy (NPWT) to spider bites, this therapy has considerable literature support for its efficacy, cost-effectiveness and ease of use in chronic, difficult-to-heal wounds. A case study using NPWT to successfully treat a non healing upper arm wound presumed due to a venomous spider bite is presented here. The patient was successfully treated with a new, less costly NPWT product called the Versatile 1 and a new combination drain plus dressing called the Miller DermiVex drain, both manufactured by Blue Sky Medical (Carlsbad, CA). PMID:17425551

Miller, Michael S; Ortegon, Marta; McDaniel, Cheryl

2007-03-01

364

In Vitro Models in Biocompatibility Assessment for Biomedical-Grade Chitosan Derivatives in Wound Management  

PubMed Central

One of the ultimate goals of wound healing research is to find effective healing techniques that utilize the regeneration of similar tissues. This involves the modification of various wound dressing biomaterials for proper wound management. The biopolymer chitosan (?-1,4-D-glucosamine) has natural biocompatibility and biodegradability that render it suitable for wound management. By definition, a biocompatible biomaterial does not have toxic or injurious effects on biological systems. Chemical and physical modifications of chitosan influence its biocompatibility and biodegradability to an uncertain degree. Hence, the modified biomedical-grade of chitosan derivatives should be pre-examined in vitro in order to produce high-quality, biocompatible dressings. In vitro toxicity examinations are more favorable than those performed in vivo, as the results are more reproducible and predictive. In this paper, basic in vitro tools were used to evaluate cellular and molecular responses with regard to the biocompatibility of biomedical-grade chitosan. Three paramount experimental parameters of biocompatibility in vitro namely cytocompatibility, genotoxicity and skin pro-inflammatory cytokine expression, were generally reviewed for biomedical-grade chitosan as wound dressing. PMID:19399250

Keong, Lim Chin; Halim, Ahmad Sukari

2009-01-01

365

Permanent restoration of human skin treated with cultured epithelium grafting wound healing by stem cell based tissue engineering -  

Microsoft Academic Search

The technique of epidermal cell culture developed by Green and colleagues made a breakthrough in the treatment of massive\\u000a wounds in vivo with grown cells in vitro. In the past two decades, progress of culture methods and clinical practice have\\u000a been made and now it is possible to treat extensive skin defect with large amounts of cultured epithelium. Since 1985,

Hideo Oshima; Hajime Inoue; Kyouichi Matsuzaki; Masayoshi Tanabe; Norio Kumagai

2002-01-01

366

3D hybrid wound devices for spatiotemporally controlled release kinetics.  

PubMed

This paper presents localized and temporal control of release kinetics over 3-dimensional (3D) hybrid wound devices to improve wound-healing process. Imaging study is performed to extract wound bed geometry in 3D. Non-Uniform Rational B-Splines (NURBS) based surface lofting is applied to generate functionally graded regions. Diffusion-based release kinetics model is developed to predict time-based release of loaded modifiers for functionally graded regions. Multi-chamber single nozzle solid freeform dispensing system is used to fabricate wound devices with controlled dispensing concentration. Spatiotemporal control of biological modifiers thus enables a way to achieve target delivery to improve wound healing. PMID:22672934

Ozbolat, Ibrahim T; Koc, Bahattin

2012-12-01

367

Combination Therapy Accelerates Diabetic Wound Closure  

PubMed Central

Background Non-healing foot ulcers are the most common cause of non-traumatic amputation and hospitalization amongst diabetics in the developed world. Impaired wound neovascularization perpetuates a cycle of dysfunctional tissue repair and regeneration. Evidence implicates defective mobilization of marrow-derived progenitor cells (PCs) as a fundamental cause of impaired diabetic neovascularization. Currently, there are no FDA-approved therapies to address this defect. Here we report an endogenous PC strategy to improve diabetic wound neovascularization and closure through a combination therapy of AMD3100, which mobilizes marrow-derived PCs by competitively binding to the cell surface CXCR4 receptor, and PDGF-BB, which is a protein known to enhance cell growth, progenitor cell migration and angiogenesis. Methods and Results Wounded mice were assigned to 1 of 5 experimental arms (n?=?8/arm): saline treated wild-type, saline treated diabetic, AMD3100 treated diabetic, PDGF-BB treated diabetic, and AMD3100/PDGF-BB treated diabetic. Circulating PC number and wound vascularity were analyzed for each group (n?=?8/group). Cellular function was assessed in the presence of AMD3100. Using a validated preclinical model of type II diabetic wound healing, we show that AMD3100 therapy (10 mg/kg; i.p. daily) alone can rescue diabetes-specific defects in PC mobilization, but cannot restore normal wound neovascularization. Through further investigation, we demonstrate an acquired trafficking-defect within AMD3100-treated diabetic PCs that can be rescued by PDGF-BB (2 ?g; topical) supplementation within the wound environment. Finally, we determine that combination therapy restores diabetic wound neovascularization and accelerates time to wound closure by 40%. Conclusions Combination AMD3100 and PDGF-BB therapy synergistically improves BM PC mobilization and trafficking, resulting in significantly improved diabetic wound closure and neovascularization. The success of this endogenous, cell-based strategy to improve diabetic wound healing using FDA-approved therapies is inherently translatable. PMID:24651576

Allen Jr., Robert J.; Soares, Marc A.; Haberman, Ilyse D.; Szpalski, Caroline; Schachar, Jeffrey; Lin, Clarence D.; Nguyen, Phuong D.; Saadeh, Pierre B.; Warren, Stephen M.

2014-01-01

368

Toxicity and Antimicrobial Activity of a Hydrocolloid Dressing Containing Silver Particles in an ex vivo Model of Cutaneous Infection  

Microsoft Academic Search

In the present study we examined the effects of two hydrocolloid wound dressings (conventional silver-free Comfeel®, silver-incorporating Contreet-H®) on uninfected and Candida albicans- ormethicillin-resistant Staphylococcus aureus-infected reconstituted human epithelium (RHE). The morphological alterations of the keratinocytes caused by infection and by treatment were analysed with light and electron microscopy. As a measure of epithelial cell damage the release of lactate

M. Schaller; J. Laude; H. Bodewaldt; G. Hamm; H. C. Korting

2004-01-01

369

Honey: A Potential Therapeutic Agent for Managing Diabetic Wounds  

PubMed Central

Diabetic wounds are unlike typical wounds in that they are slower to heal, making treatment with conventional topical medications an uphill process. Among several different alternative therapies, honey is an effective choice because it provides comparatively rapid wound healing. Although honey has been used as an alternative medicine for wound healing since ancient times, the application of honey to diabetic wounds has only recently been revived. Because honey has some unique natural features as a wound healer, it works even more effectively on diabetic wounds than on normal wounds. In addition, honey is known as an “all in one” remedy for diabetic wound healing because it can combat many microorganisms that are involved in the wound process and because it possesses antioxidant activity and controls inflammation. In this review, the potential role of honey's antibacterial activity on diabetic wound-related microorganisms and honey's clinical effectiveness in treating diabetic wounds based on the most recent studies is described. Additionally, ways in which honey can be used as a safer, faster, and effective healing agent for diabetic wounds in comparison with other synthetic medications in terms of microbial resistance and treatment costs are also described to support its traditional claims. PMID:25386217

Islam, Md. Asiful; Gan, Siew Hua; Khalil, Md. Ibrahim

2014-01-01

370

[Errors in wound management].  

PubMed

Chronic ulcers have adverse effects on the patient quality of life and productivity, thus posing financial burden upon the healthcare system. Chronic wound healing is a complex process resulting from the interaction of the patient general health status, wound related factors, medical personnel skill and competence, and therapy related products. In clinical practice, considerable improvement has been made in the treatment of chronic wounds, which is evident in the reduced rate of the severe forms of chronic wounds in outpatient clinics. However, in spite of all the modern approaches, efforts invested by medical personnel and agents available for wound care, numerous problems are still encountered in daily practice. Most frequently, the problems arise from inappropriate education, of young personnel in particular, absence of multidisciplinary approach, and inadequate communication among the personnel directly involved in wound treatment. To perceive them more clearly, the potential problems or complications in the management of chronic wounds can be classified into the following groups: problems mostly related to the use of wound coverage and other etiology related specificities of wound treatment; problems related to incompatibility of the agents used in wound treatment; and problems arising from failure to ensure aseptic and antiseptic performance conditions. PMID:25326993

Filipovi?, Marinko; Novinscak, Tomislav

2014-10-01

371

Wound currents and wound healing in the newt, Notophthalmus viridescens  

Microsoft Academic Search

Wounded amphibian skin heals initially by a migration of epithelial cells from the cut edge towards the center of the wound. The density of currents leaving wounds made in Notophthalmus viridescens skin was manipulated in order to determine whether electrical fields associated with these currents might have a significant role in promoting this cell migration during wound healing. Wounds were

Lynette R. Robinson Rhodes; John J. Turek; Edward J. Cragoe Jr; Joseph W. Vanable Jr

1990-01-01

372

Extent of iron pick-up in deforoxamine-coupled polyurethane materials for therapy of chronic wounds  

Microsoft Academic Search

Polyurethane net substrates (PNS) coupled with deferoxamine (DFO) have been studied to determine the extent of Fe2+ pick-up for use in chronic wound therapy. A m solution of ferrous sulphate (FeSO4) was used to generate ferrous ions similar to those found in chronic wounds. The concentration of Fe as a function of position through the dressings was evaluated using a

Jennifer E. Taylor; Peter R. Laity; John Hicks; Steven S. Wong; Keith Norris; Peck Khunkamchoo; Anthony F. Johnson; Ruth E. Cameron

2005-01-01

373

Acute wound management: revisiting the approach to assessment, irrigation, and closure considerations  

PubMed Central

Background As millions of emergency department (ED) visits each year include wound care, emergency care providers must remain experts in acute wound management. The variety of acute wounds presenting to the ED challenge the physician to select the most appropriate management to facilitate healing. A complete wound history along with anatomic and specific medical considerations for each patient provides the basis of decision making for wound management. It is essential to apply an evidence?based approach and consider each wound individually in order to create the optimal conditions for wound healing. Aims A comprehensive evidence?based approach to acute wound management is an essential skill set for any emergency physician or acute care practitioner. This review provides an overview of current evidence and addresses frequent pitfalls. Methods A systematic review of the literature for acute wound management was performed. Results A structured MEDLINE search was performed regarding acute wound management including established wound care guidelines. The data obtained provided the framework for evidence?based recommendations and current best practices for wound care. Conclusion Acute wound management varies based on the wound location and characteristics. No single approach can be applied to all wounds; however, a systematic approach to acute wound care integrated with current best practices provides the framework for exceptional wound management. PMID:21373312

Ayello, Elizabeth A.; Woo, Kevin; Nitzki-George, Diane; Sibbald, R. Gary

2010-01-01

374

Dress, dementia and the embodiment of identity.  

PubMed

The article explores the significance of dress in the embodied experience of dementia, exploring questions of identity, memory and relationship. It suggests that clothing and dress are important in the analysis of the day-to-day experiences of people with dementia, giving access to dimensions of selfhood often ignored in over-cognitive accounts of being. As a result clothing and dress can be significant to the provision of person-centred dementia care. These arguments are explored through ideas of embodied identity, the materialisation of memories, and the maintenance, or otherwise, of appearance in care. The article forms part of the background to an ESRC-funded empirical study exploring the role of clothing and dress in the everyday lives of people with dementia, living at home or in care homes, and of their relatives. PMID:24336855

Twigg, Julia; Buse, Christina E

2013-05-01

375

Mayonnaise, Salad Dressings, and Related Products, 1973.  

National Technical Information Service (NTIS)

The 1973 survey included 132 industry reporting units, which represent operations of all known manufacturers of mayonnaise, salad dressings and related products. In addition to the shipment, oil consumption, sales concentration, container usage and export...

1974-01-01

376

Telemedicine for wound management  

PubMed Central

The escalating physiological, psychological, social and financial burdens of wounds and wound care on patients, families and society demand the immediate attention of the health care sector. Many forces are affecting the changes in health care provision for patients with chronic wounds, including managed care, the limited number of wound care therapists, an increasingly ageing and disabled population, regulatory and malpractice issues, and compromised care. The physician is also faced with a number of difficult issues when caring for chronic wound patients because their conditions are time consuming and high risk, represent an unprofitable part of care practice and raise issues of liability. Telemedicine enhances communication with the surgical wound care specialist. Digital image for skin lesions is a safe, accurate and cost-effective referral pathway. The two basic modes of telemedicine applications, store and forward (asynchronous transfer) and real-time transmission (synchronous transfer, e.g. video conference), are utilized in the wound care setting. Telemedicine technology in the hands of an experienced physician can streamline management of a problem wound. Although there is always an element of anxiety related to technical change, the evolution of wound care telemedicine technology has demonstrated a predictable maturation process. PMID:23162242

Chittoria, Ravi K.

2012-01-01

377

Influence of various treatments including povidone-iodine and healing stimulatory reagents in a rabbit ear wound model.  

PubMed

Selecting an appropriate treatment for a given case of skin wound is crucial for inducing optimal healing. We used an animal model developed from normal rabbit ears in order to assess the efficacy of treatments for skin wounds with or without a wet dressing, anti microbial reagent or topical wound-stimulatory reagents. The degree of healing in each group was evaluated and compared using four histological parameters: (i) degree of reepithelialisation, (ii) amount of granulation tissue formation, and (iii) the number of capillary lumens and (iv) fibroblasts in the granulation tissue. Treatment using wet dressings resulted in an increase in capillary number compared with the open dry wound. Although the retention of povidone-iodine (PI) in wound tissue after application significantly inhibited reepithelialisation (P < 0.05), rinsing PI off with saline was comparable in effect to using only a wet dressing. The three topical reagents, namely, basic fibroblast growth factor, prostaglandin E1 and dibutyryl cyclic adenosine monophosphate, significantly improved reepithelialisation (P < 0.05). In conclusion, wounds should be kept hydrated by applying topical reagents. If there are any signs of bacterial infection, PI can be applied and rinsed later with saline in order to minimise its cytotoxic effects. PMID:22776519

Arai, Keitaro; Yamazaki, Masashi; Maeda, Tatsuo; Okura, Takaaki; Tsuboi, Ryoji

2013-10-01

378

Understanding methods of wound debridement.  

PubMed

Autolytic debridement describes the body's natural method of wound-bed cleansing, helping it to prepare the wound bed for healing. In acute wounds, autolytic debridement occurs automatically and often does not require intervention, as during the inflammatory stage of a wound, neutrophils and macrophages digest and removes devitalised tissue, cell debris and contaminants, clearing the wound of any cellular barriers to healing. In chronic wounds, by contrast, healing is often delayed, frequently because of inadequate debridement. The autolytic process becomes overwhelmed by high levels of endotoxins released from damaged tissue (Broadus, 2013). Therefore wound debridement becomes an integral part of chronic-wound management and practitioners involved in wound care must be fully competent at wound-bed assessment and have an awareness of the options available for debridement. This article will review wound-bed assessment, highlighting variations in devitalised tissue, and explore options available for wound debridement, taking into consideration patients’ pain and quality of life. PMID:25075385

Atkin, Leanne

379

Dressed for success? The NBA's dress code, the workings of whiteness and corporate culture  

Microsoft Academic Search

This paper explores the constitutive power relations and representational politics produced through the advent of a dress-code policy instituted by the National Basketball Association (NBA) in 2005. Using the methodology of contextual cultural studies this analysis suggests that far from a simple policy that requires a particular style of dress, narratives and practices surrounding the policy are embedded in an

Mary G. McDonald; Jessica Toglia

2010-01-01

380

Periodontal dressing after surgical crown lengthening: A randomized clinical trial.  

PubMed

Abstract Objective. The aim of the present study was to evaluate the effect of periodontal dressing on post-operative pain and swelling after surgical crown lengthening. Materials and methods. A blind, randomized, clinical trial was carried out with 36 patients. Following surgical crown lengthening, the individuals were randomly allocated to the periodontal dressing group (PDG) and control group (CG, non-placement of periodontal dressing). Pain and discomfort were analyzed using a visual analog scale (VAS), verbal scale (VS) and the number of analgesics consumed in 7 days post-operatively. Post-operative infection, stability of the gingival margin and type of healing were also evaluated. Results. The PDG had a significantly higher percentage of responses of 'strong pain' on the VS in the first day post-operatively (33.3% vs 5.3%, p = 0.03) and greater pain on the first and second days post-operatively based on the VAS. Moreover, a significant difference between groups was found regarding gingival swelling after 7 days. However, gingival recession was found in 57.8% of the sites in the CG and only 5.5% of sites in the PDG. No change in condition was found among individuals with conjunctive tissue/bone exposure in the CG in the immediate post-operative period and 80% of the patients in the PDG had healing by first intention after 7 days. Conclusion. The use of periodontal dressing seems to be preferable following surgical crown lengthening with connective tissue/bone exposure. However, adequate post-operative analgesic strategies should be employed due to the possibility of intense pain in the first 24 hours. PMID:25139226

Antoniazzi, Raquel Pippi; Vieira, Alessandra Ramires; Da Rosa, Joana Luz; Ferrazo, Kivia Linhares; Zanatta, Fabricio Batistin; Feldens, Carlos Alberto

2014-11-01

381

The Society for Vascular Surgery Lower Extremity Threatened Limb Classification System: risk stratification based on wound, ischemia, and foot infection (WIfI).  

PubMed

Critical limb ischemia, first defined in 1982, was intended to delineate a subgroup of patients with a threatened lower extremity primarily because of chronic ischemia. It was the intent of the original authors that patients with diabetes be excluded or analyzed separately. The Fontaine and Rutherford Systems have been used to classify risk of amputation and likelihood of benefit from revascularization by subcategorizing patients into two groups: ischemic rest pain and tissue loss. Due to demographic shifts over the last 40 years, especially a dramatic rise in the incidence of diabetes mellitus and rapidly expanding techniques of revascularization, it has become increasingly difficult to perform meaningful outcomes analysis for patients with threatened limbs using these existing classification systems. Particularly in patients with diabetes, limb threat is part of a broad disease spectrum. Perfusion is only one determinant of outcome; wound extent and the presence and severity of infection also greatly impact the threat to a limb. Therefore, the Society for Vascular Surgery Lower Extremity Guidelines Committee undertook the task of creating a new classification of the threatened lower extremity that reflects these important considerations. We term this new framework, the Society for Vascular Surgery Lower Extremity Threatened Limb Classification System. Risk stratification is based on three major factors that impact amputation risk and clinical management: Wound, Ischemia, and foot Infection (WIfI). The implementation of this classification system is intended to permit more meaningful analysis of outcomes for various forms of therapy in this challenging, but heterogeneous population. PMID:24126108

Mills, Joseph L; Conte, Michael S; Armstrong, David G; Pomposelli, Frank B; Schanzer, Andres; Sidawy, Anton N; Andros, George

2014-01-01

382

Contact dermatitis presenting as non-healing wound: case report.  

PubMed

Topical antiseptics are commonly used in the management of minor wounds, burns, and infected skin. These agents are widely used by health professionals and are often self-prescribed by patients as they are easily available over-the-counter. This case illustrates a 73 year old man who presented with a non-healing wound on his right forearm for 4 weeks. The wound started from an insect bite and progressively enlarged with increasing pruritus and burning sensation. Clinically an ill-defined ulcer with surrounding erythema and erosion was noted. There was a yellow crust overlying the center of the ulcer and the periphery was scaly. Further inquiry revealed history of self treatment with a yellow solution to clean his wound for 3 weeks. Patient was provisionally diagnosed to have allergic contact dermatitis secondary to acriflavine. Topical acriflavine was stopped and the ulcer resolved after treatment with non-occlusive saline dressing. Skin patch test which is the gold standard for detection and confirmation of contact dermatitis showed a positive reaction (2+) to acriflavine. Acriflavine is widely used as a topical antiseptic agent in this part of the world. Hence, primary care physicians managing a large variety of poorly healing wounds should consider the possibility of contact allergy in recalcitrant cases, not responding to conventional treatment. Patient education is an important aspect of management as this would help curb the incidence of future contact allergies. PMID:21575147

Leelavathi, M; Le, Yy; Tohid, H; Hasliza, Ah

2011-01-01

383

Use of a portable, single-use negative pressure wound therapy device in home care patients with low to moderately exuding wounds: a case series.  

PubMed

Negative pressure wound therapy (NPWT) is widely used in the management of acute and chronic wounds. The purpose of this 8-week study was to evaluate outcomes of using a new canisterless, portable, single-use NPWT system in patients with wounds treated in a Canadian community healthcare setting. The device is designed to provide negative pressure at 80±20 mm Hg, 24 hours a day of continuous usage, for a maximum wear time of 7 days. Data on wound outcomes, including exudate levels, wound appearance, and wound area, were collected weekly by a Registered Nurse as part of routine practice. When treatment was discontinued, patients and nurses were asked to rate their satisfaction with the device. Data from patients who had used a conventional NPWT device to manage their wounds were retrospectively abstracted from their medical records. In the prospective study, conducted between October 2011 and July 2012, 326 patients (median age=61 years; range 17-91 years) with wounds of mixed etiology (53 pressure ulcers, 21 venous leg ulcers, 16 diabetic foot ulcers, and 15 traumatic and 221 surgical wounds) were treated for a maximum of 8 weeks with the portable NPWT device. The majority of patients (228 out of 326; 68%) achieved complete wound closure within 8 weeks of treatment. The Kaplan-Meier estimate of median time to healing of all wounds was 9 weeks. The majority of patients (318 patients, 97%) reported they were pleased or satisfied with the dressing performance. Nurses indicated satisfaction with the dressing performance for all but two patients (99%). The majority (89%) of patients managed with conventional NPWT (n=539) had an open surgical wound with moderate or high levels of exudate. Healing rates in the portable and conventional NPWT group were similar (10% to 11% per week). Portable, single-use NPWT has the potential to deliver good wound outcomes in community care settings and simplify the use of negative pressure for nurses and patients. Additional research is needed to evaluate treatment efficacy and cost effectiveness. PMID:24610558

Hurd, Theresa; Trueman, Paul; Rossington, Alan

2014-03-01

384

Neutron electric dipole moment and dressed spin  

NASA Astrophysics Data System (ADS)

The neutron electric dipole moment (EDM) experiment has played a unique role in examining the violation of fundamental symmetries and understanding the nature of electroweak and strong interaction. A non-zero neutron EDM is one of direct evidence for CP and T violation and has the potential to reveal the origin of CP violation and to explore physics beyond the Standard Model. A new neutron EDM experiment will be built to improve a factor of 100 by using a novel technique of ultra-cold neutrons(UCN) in superfluid 4He at the Spallation Neutron Source (SNS) at the Oak Ridge National Laboratory (ORNL). In the experiment, 3He in the measurement cell will be used as a neutron spin analyzer and a comagnetometer. The absorption between UCN and 3He atoms will emit scintillation light in the superfluid 4He depending on the angle between nuclear spins of two particles. Consequently, the neutron precession frequency can be derived by the scintillation light amplitude. Furthermore, the 3He precession frequency can be measured by the superconducting quantum interference device (SQUID). A dressed-spin technique will also be applied to measure the small precession frequency change due to a non-zero neutron EDM. The dressed-spin technique is used to modify the effective precession frequencies of neutrons and 3He atoms to make them equal by applying an oscillatory field (dressing field) that is perpendicular to the static magnetic field. The phenomenon of the dressed spin for 3He in a cell should be demonstrated before the proposed neutron EDM experiment. A successful measurement over a broad range of the amplitude and frequency of the dressing field was done at the University of Illinois. The observed effects can be explained by using quantum optics formalism. The formalism is diagonalized to solve the solution and confirms the data. In addition, the application of the dressed-spin technique was investigated. The modulation and the feedback loop technique should be considered with the dressed-spin technique for the measurement of the small EDM effect. The modulation of the dressing field arbitrarily changes the relative precession frequency between UCN and 3He. Through the feedback loop, the effective neutron precession frequency can be measured. The corresponding sensitivity of neutron EDM will be estimated. A future neutron EDM experiment could be improved if the dressed-spin technique can be carefully considered and applied.

Chu, Ping-Han

385

Citrate-Linked Keto- and Aldo-Hexose Monosaccharide Cellulose Conjugates Demonstrate Selective Human Neutrophil Elastase-Lowering Activity in Cotton Dressings  

PubMed Central

Sequestration of harmful proteases as human neutrophil elastase (HNE) from the chronic wound environment is an important goal of wound dressing design and function. Monosaccharides attached to cellulose conjugates as ester-appended aldohexoses and ketohexoses were prepared on cotton gauze as monosccharide-citrate-cellulose-esters for HNE sequestration. The monosaccharide-cellulose analogs demonstrated selective binding when the derivatized cotton dressings were measured for sequestration of HNE. Each monosaccharide-cellulose conjugate was prepared as a cellulose citrate-linked monosaccharide ester on the cotton wound dressing, and assayed under wound exudate-mimicked conditions for elastase sequestration activity. A series of three aldohexose and four ketohexose ester cellulose conjugates were prepared on cotton gauze through citric acid-cellulose cross linking esterification. The monosaccharide portion of the conjugate was characterized by hydrolysis of the citrate-monosaccharide ester bond, and subsequent analysis of the free monosaccharide with high performance anion exchange chromatography. The ketohexose and aldohexose conjugate levels on cotton were quantified on cotton using chromatography and found to be present in milligram/gram amounts. The citrate-cellulose ester bonds were characterized with FTIR. Ketohexose-citrate-cellulose conjugates sequestered more elastase activity than aldohexose-citrate-cellulose conjugates. The monosaccharide cellulose conjugate families each gave distinctive profiles in elastase-lowering effects. Possible mechanisms of elastase binding to the monosaccharide-cellulose conjugates are discussed. PMID:24955952

Edwards, Judson V.; Caston-Pierre, Sonya

2013-01-01

386

[Basic of wound healing in thoracic surgery].  

PubMed

Wound condition changes from moment to moment. It is important to understand what is happening on the wound to evaluate and treat it. Wound can be classified into low contaminated wound, contaminated wound, colonized woun