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Wound dressings.  


There are currently hundreds of dressings on the market to aid in wound management. Before selecting a dressing for a particular wound, a practitioner must assess carefully the needs of the wound to understand which dressing would provide maximal benefit. Frequently, there is not one clear best choice, and it is crucial that the pros and cons of each dressing modality be understood. This article has provided a framework to assist in dressing assessment. PMID:12822729

Lionelli, Gerald T; Lawrence, W Thomas



Fatty acid-based polyurethane films for wound dressing applications.  


Fatty acid-based polyurethane films were prepared for use as potential wound dressing material. The polymerization reaction was carried out with or without catalyst. Polymer films were prepared by casting-evaporation technique with or without crosslink-catalyst. The film prepared from uncatalyzed reaction product with crosslink-catalyst gave slightly higher crosslink density. The mechanical tests showed that, the increase in the tensile strength and decrease in the elongation at break is due to the increase in the degree of crosslinking. All films were flexible, and resisted to acid solution. The films prepared without crosslink-catalyst were more hydrophilic, absorbed more water. The highest permeability values were generally obtained for the films prepared without crosslink catalyst. Both the direct contact method and the MMT test were applied for determination of cytotoxicity of polymer films and the polyurethane film prepared from uncatalyzed reaction product without crosslink-catalyst showed better biocompatibility property, closest to the commercial product, Opsite. PMID:18839285

Gultekin, Guncem; Atalay-Oral, Cigdem; Erkal, Sibel; Sahin, Fikret; Karastova, Djursun; Tantekin-Ersolmaz, S Birgul; Guner, F Seniha



In vivo performance of chitosan/soy-based membranes as wound-dressing devices for acute skin wounds.  


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; Reis, Rui L; van Griensven, Martijn



[Collagen based dressings in the treatment of wound healing].  


Collagen is the fundamental protein forming the connective tissues matrix, improves the ability of keratinocytes to migrate to sites that require rebuilding of the damaged epidermis, is one of the component of dressings used to accelerate wound healing. Because of the potential risk of the presence of pathogenic prions in bovine collagen, part of collagen dressings is formed on the basis of porcine collagen. Currently, a least of an immunogenic form of collagen is atelocollagen, which is subjected to enzyme-treated collagen, in which the terminal amino acids are removed from the collagen. It is assumed that in the near future atelocollagen will be used also as a carrier for drugs which support the healing processes. PMID:23984607

Grabska-Liberek, Iwona; Galus, Ryszard; Owczarek, Witold; W?odarsk, Krzysztof; Zabielski, Stanis?aw; Malejczyk, Jacek; Sladowski, Dariusz



Development of a novel antimicrobial seaweed extract-based hydrogel wound dressing.  


The objective of this study was to develop a novel antimicrobial seaweed wound dressing. The seaweed extract was active against nine clinically-relevant wound pathogens. A hydrogel formulation was prepared using polyvinyl alcohol (PVA) and polyvinylpyrrolidone (PVP), followed by addition of 1% seaweed extract. The antimicrobial properties of the novel dressing were tested using agar diffusion assays, with release-profiles examined using gel leaching and gel transfer assays. The dressing was found to be effective against the same microbial strains as the seaweed extract, with similar efficacy to the commonly used silver-based dressing, Acticoat(®). Antimicrobial release-profile assays revealed that the dressing was effective in inhibiting 70-90% of the bacterial population within the first 30min, followed by a long, sustained released up to 97h, without leaving a residue following five subsequent transfers of the dressing. Antimicrobial activity was stable for up to 6 months of storage at 4°C, but activity was reduced slightly after 15 weeks. Following autoclave sterilization, the dressing displayed a slower release profile compared to a non-autoclaved counterpart. Hence, the seaweed dressing may have commercial applications, potentially competing with silver-based dressings at a lower cost per-application. This is the first report of development of a seaweed-based antimicrobial dressing. PMID:23958753

Tan, Shiau Pin; McLoughlin, Peter; O'Sullivan, Laurie; Prieto, Maria Luz; Gardiner, Gillian E; Lawlor, Peadar G; Hughes, Helen



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


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



Antimicrobial Wound Dressing. Phase 1.  

National Technical Information Service (NTIS)

The main objective of Phase I of this SBIR project was to demonstrate the feasibility for successful development of an antimicrobial wound dressing based on a hydrogel sustained release matrix. This goal has been achieved. In vitro studies of drug diffusi...

M. H. Gay E. S. Nuwayser P. D. Blaskovich D. L. Mcafee



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



Wound dressings based on silver sulfadiazine solid lipid nanoparticles for tissue repairing.  


The management of difficult to heal wounds can considerably reduce the time required for tissue repairing and promote the healing process, minimizing the risk of infection. Silver compounds, especially silver sulfadiazine (AgSD), are often used to prevent or to treat wound colonization, also in presence of antibiotic-resistant bacteria. However, AgSD has been shown to be cytotoxic in vitro toward fibroblasts and keratinocytes and consequently to retard wound healing in vivo. Recently, platelet lysate (PL) has been proposed in clinical practice for the healing of persistent lesions. The aim of the present work was the development of wound dressings based on AgSD loaded in solid lipid nanoparticles (SLNs), to be used in association with PL for the treatment for skin lesions. SLN were based on chondroitin sulfate and sodium hyaluronate, bioactive polymers characterized by well-known tissue repairing properties. The encapsulation of AgSD in SLN aimed at preventing the cytotoxic effect of the drug on normal human dermal fibroblasts (NHDFs) and at enabling the association of the drug with PL. SLN were loaded in wound dressings based on hydroxypropylmethyl cellulose (HPMC) or chitosan glutamate (CS glu). These polymers were chosen to obtain a sponge matrix with suitable elasticity and softness and, moreover, with good bioadhesive behavior on skin lesions. Dressings based on chitosan glutamate showed antimicrobial activity with and without PL. Even though further in vivo evaluation could be envisaged, chitosan based dressings demonstrated to be a suitable prototype for the treatment for skin lesions. PMID:23207329

Sandri, Giuseppina; Bonferoni, Maria Cristina; D'Autilia, Francesca; Rossi, Silvia; Ferrari, Franca; Grisoli, Pietro; Sorrenti, Milena; Catenacci, Laura; Del Fante, Claudia; Perotti, Cesare; Caramella, Carla



Testing wound dressings using an in vitro wound model  

PubMed Central

Objective To determine whether or not there are any significant differences in the effects of wound dressings on bacterial bioburden. Method A selection of non-occlusive, non-adhesive dressings was tested for their effect on bacterial bioburden. The dressings selected included two dressings with antimicrobial properties (one containing silver and one containing PHMB), a cotton-based dressing enclosed in a perforated sleeve of poly(ethylene terephthalate), a carboxymethyl cellulose-based dressing, a fibre-free alginate dressing, and a 12-ply 100% cotton gauze. Using the colony-drip flow reactor (DFR) model, a meticillin-resistant Staphylococcus aureus (MRSA) or Pseudomonas aeruginosa biofilm was grown underneath a dressing sample. Biofilm growth was examined via plate counts, fluorescent microscopy and scanning electron microscopy. Results The dressings containing antimicrobial agents had the greatest effect on bacterial load. In the MRSA experiments, both antimicrobial dressings produced lower bacteria counts than the other dressings (p?0.001), while in the P. aeruginosa experiments, only the silver-containing sample had fewer bacteria (p?0.0001). However, neither antimicrobial dressing was able to completely eradicate the bacteria when testing with either microorganism. Conclusion The results presented herein illustrate that bacteria can grow unchallenged within the dressing environment and that an antimicrobial dressing can limit this bacterial growth.

Lipp, C.; Kirker, K.; Agostinho, A.; James, G.; Stewart, P.



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


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 such as gelatin in the presence of borax to give in situ forming hydrogels that are both non-toxic and biodegradable. The composite matrix has the haemostatic effect of gelatin, the wound healing-promoting feature of alginate and the antiseptic property of borax to make it a potential wound dressing material. The hydrogel was found to have a fluid uptake of 90% of its weight which would prevent the wound bed from accumulation of exudates. The water vapour transmission rate (WVTR) of the hydrogel was found to be 2686+/-124 g/m2/day indicating that the hydrogel can maintain a moist environment over wound bed in moderate to heavily exuding wound which would enhance epithelial cell migration during the healing process. The wound healing efficacy of hydrogel was evaluated in experimental full thickness wounds using a rat model which demonstrated that within 2 weeks, the wound covered with gel was completely filled with new epithelium without any significant adverse reactions. These in situ forming hydrogels fulfil many critical elements desirable in a wound dressing material. PMID:15919113

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



Development and evaluation of psyllium seed husk polysaccharide based wound dressing films  

Microsoft Academic Search

In the present study, wound dressing films were fabricated using Seed Husk of Psyllium (SHP) complexed with povidone iodine\\u000a and were evaluated for various physicochemical properties as well as wound healing activity in albino rats. The required film\\u000a properties for the successful wound dressings, such as film elongation (elasticity), tensile strength, water uptake and water\\u000a vapor transmission rates (WVTR) were

Basavaraj S. Patil; Vinayak S. Mastiholimath; Anandrao R. Kulkarni


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


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



An innovative bi-layered wound dressing made of silk and gelatin for accelerated wound healing.  


In this study, the novel silk fibroin-based bi-layered wound dressing was developed. Wax-coated silk fibroin woven fabric was introduced as a non-adhesive layer while the sponge made of sericin and glutaraldehyde-crosslinked silk fibroin/gelatin was fabricated as a bioactive layer. Wax-coated silk fibroin fabrics showed improved mechanical properties compared with the non-coated fabrics, but less adhesive than the commercial wound dressing mesh. This confirmed by results of peel test on both the partial- and full-thickness wounds. The sericin-silk fibroin/gelatin spongy bioactive layers showed homogeneous porous structure and controllable biodegradation depending on the degree of crosslinking. The bi-layered wound dressings supported the attachment and proliferation of L929 mouse fibroblasts, particularly for the silk fibroin/gelatin ratio of 20/80 and 0.02% GA crosslinked. Furthermore, we proved that the bi-layered wound dressings promoted wound healing in full-thickness wounds, comparing with the clinically used wound dressing. The wounds treated with the bi-layered wound dressings showed the greater extent of wound size reduction, epithelialization, and collagen formation. The superior properties of the silk fibroin-based bi-layered wound dressings compared with those of the clinically used wound dressings were less adhesive and had improved biological functions to promote cell activities and wound healing. This novel bi-layered wound dressing should be a good candidate for the healing of full-thickness wounds. PMID:22771972

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



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


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



[Modern wound dressings for the therapy of chronic wounds].  


The incidence of chronic wounds is increasing in developed Western countries. There are many causes for chronic or non-healing wounds. A multidisciplinary diagnostic approach and attention to underlying disorders are essential. A modern, moist, and phase adapted wound therapy is also essential. Modern wound dressings include activated charcoal, alginates, hyaluronic acid, hydrofibers, hydrogels, hydrocolloids, impregnated gauze, collagen, moist methods, proteolytic enzymes, foams, semipermeable membranes and silver dressings. Because of the lack of comparative investigations the phase-adapted use of wound dressings is still empiric. Application of modern wound dressings may help to create an optimized wound milieu and accelerate healing. Treatment of the underlying causes is an absolute requirement for long-term complete healing. PMID:16317552

Dissemond, J



Active wound dressing with artificial capillaries for temporary wound irrigation and skin cell supply.  


Medical treatment of burns and chronic wounds remains a challenge. We discussed a therapy concept that combines skin cell spray transplantation with a novel wound dressing based on artificial hollow fiber membrane capillaries. In skin cell-based therapy development, autologous skin progenitor cells are isolated from a healthy skin area and sprayed onto the wound. A medical device was introduced that uses perfused capillaries, known from clinical plasma separation, as a temporarily applied extracorporeal wound capillary bed. The functions of the dressing are comparable with those of dialysis; the capillaries, however, are applied externally onto the wound. Perfusion with a clinical peripheral nutrition and buffer solution can provide wound irrigation, wound debris removal, cell nutrition, pH regulation, and electrolyte balance while potentially serving to address delivery of regenerative factors and antibiosis. An innovative active skin wound dressing that provides cell support and stimulates regeneration by wound irrigation is discussed. PMID:22074237

Plettig, Jörn; Johnen, Christa M; Bräutigam, Kirsten; Zeilinger, Katrin; Borneman, Reinhard; Gerlach, Jörg C



French national wound management survey: choice criteria of dressings.  


Across Europe, wound care management is organized differently, and in some countries such as the UK or Denmark, wound healing centres have been implemented. In France, a large number of health professionals are not sufficiently educated in wound care management during their vocational training. The rapid evolution of dressings has changed wound management practices and has given rise to new professional recommendations. This national survey was carried out in France in 2009, including 465 health professionals, to determine the criteria they use to choose a dressing and their habits of care with acute or chronic wounds. Around 73% of respondents were nurses and, on average, participants took care of 43 wounds per month. It was also found that 89% of the health professionals who took part prefer the sequential treatment of the wound based on its appearance. Regardless of whether the wound is acute or chronic, the priorities for wound care and the choice of dressing are the management of the exudate and the prevention or treatment of infection. These results put into evidence the adequacy of the recommendations by these practitioners and the good correlation between the choice of dressing and the local therapeutic goal. To reach the same level of expertise, the professional training for health professionals who are less frequently involved in wound care is necessary. PMID:22067931

Meaume, Sylvie; Barrois, Brigitte; Faucher, Nathalie


Colour Duplex imaging through wound dressings.  


Colour flow Duplex scanning is becoming the method of choice to determine patency and haemodynamic status in infrainguinal grafts and native arteries. Due to surgical wounds and ulcers, there are often dressings covering the leg above the vessel to be scanned. There is no data as to the effect of different wound dressings on colour flow Duplex signals. Ten normal superficial femoral arteries were scanned by a blinded operator. Initially the artery was visualised to assess the normal image produced for each artery on B-mode and colour flow ultrasound and a Doppler reading was taken. Then each of five commonly used dressings were applied to the skin above the artery, in random order and the blinded operator graded the signal produced on a linear analogue scale. Primapore, an absorbent material dressing and Spyroflex, a bilaminate membrane dressing, did not transmit ultra-sound at all. Granuflex extra thin allowed a clear B-mode image of each artery to be visualised and an adequate Doppler waveform to be obtained. However colour flow mapping was less than optimal although it was possible in each of the arteries. Opsite and Tegaderm, two thin membrane dressings allowed excellent B-mode and colour flow images, in addition to clear Doppler signals. In patients who require dressings and who may require colour flow Duplex scanning of vessels in the same area, we would suggest the use of a product that permits ultrasound transmission, thus saving the necessity of removing the dressing for the assessment. PMID:8270077

Whiteley, M S; Magee, T R; Harris, R; Horrocks, M



Evaluation of the effect of incorporation of dibutyryl cyclic adenosine monophosphate in an in situ-forming hydrogel wound dressing based on oxidized alginate and gelatin.  


Cyclic adenosine monophosphate (cAMP) has long been regarded as a second messenger and a regulator of human keratinocyte proliferation. To explore more effective wound management, dibutyryl cyclic adenosine monophosphate (DBcAMP), a lipophilic analog of cAMP was incorporated into an in situ-forming hydrogel wound dressing based on periodate-oxidized alginate and gelatin. In vitro release of DBcAMP from the matrix into phosphate buffered saline was slow and increased with time. Only 50-60% of the compound was released into the medium over a period of 2 days suggestive of a sustained release into the wound bed over a period of few days. The wound-healing efficacy of the DBcAMP-incorporated dressing was evaluated on experimental full-thickness wounds in a rat model. It was found that dressing promoted wound healing leading to complete re-epithelialization of wounds within 10 days, whereas control wounds took 15 days for complete re-epithelialization. Data obtained in this study showed that the presence of DBcAMP accelerated healing and re-epithelialization of full-thickness wounds. PMID:16146648

Balakrishnan, Biji; Mohanty, Mira; Fernandez, Adelaide C; Mohanan, Parayanthara V; Jayakrishnan, A



21 CFR 878.4018 - Hydrophilic wound dressing.  

Code of Federal Regulations, 2013 CFR

...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 hydrophilic wound dressing is...



Key principles involved in applying and removing wound dressings.  


This article aims to help practitioners consider a variety of wound dressings and develop their knowledge about the use of dressings to ensure patients are protected and care is cost-effective. The article focuses on which dressing should be used depending on wound type and how different dressings should be applied and removed. Author PMID:21155488

Anderson, Irene


Development of a new wound dressing with antimicrobial delivery capability.  


A bilaminar wound dressing composed of an outer membrane and an inner three-dimensional matrix of a fabric or a sponge may be considered to constitute an ideal structure that promotes wound healing: the outer membrane prevents body fluid loss, controls water evaporation, and protects the wound surface from bacterial invasion, and the inner matrix encourages adherence by tissue growth into the matrix. Using this concept, we developed a biosynthetic wound dressing with a drug delivery capability. This medicated wound dressing is composed of a spongy sheet of a chitosane derivative and collagen mixture that is laminated to an antimicrobial-impregnated polyurethane membrane. In this study, a gentamycin sulfate-impregnated wound dressing was prepared and evaluated. The antimicrobial efficacy of this wound dressing was examined on an agar plate seeded with Pseudomonas aeruginosa. Also, the cytotoxicity of an antimicrobial released from this wound dressing was examined in an in vitro system with cultured skin substitutes. Both in vitro tests have shown that this wound dressing is capable of suppressing bacterial growth and minimizing cellular damage. In addition, in the treatment of wounds inflicted on rats and rabbits, this wound dressing was shown to be efficacious in covering full-thickness and split-thickness skin defects. Finally, the efficacy of this wound dressing was evaluated in a nonrandomized open-label study of 31 clinical cases. In 31 cases treated with this wound dressing, good or excellent wound healing was achieved. PMID:17134381

Kuroyanagi, Y; Shiraishi, A; Shirasaki, Y; Nakakita, N; Yasutomi, Y; Takano, Y; Shioya, N


An investigation of the benefits of Aquacel Hydrofibre wound dressing.  


Aquacel wound dressing, produced by ConvaTec, uses the main ingredient of the hydrocolloid dressing in a new way to produce a hydrofibre dressing. Aquacel is designed for use in moderate to heavily exuding wounds as it absorbs exudate directly into its fibres. It has been shown to be effective in pressure sores, leg ulcers and surgical wounds, producing warm, moist, local wound conditions for optimum wound healing. Aquacel can lock exudate away thus protecting the surrounding skin. PMID:10624199

Williams, C


Biomedical evaluation of a novel nitrogen oxides releasing wound dressing.  


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



Novel silk fibroin/elastin wound dressings.  


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



Exploiting potency of negative pressure in wound dressing using limited access dressing and suction-assisted dressing  

PubMed Central

Role of negative pressure dressing and moist wound healing are well established in the treatment of both acute and chronic wounds with certain advantages and disadvantages in both the techniques. Both these techniques prevents wound colonization, but the negative pressure dressing method has proved to have a greater potency to remove secretions, prevent wound invasion and eradication established infection. In both these techniques there is no accessibility to wound environment. Limited access dressing (LAD) is a moist wound dressing with negative pressure. It provides limited access to the wound through two small ports for both dressers and pathogens. The LAD design has notable advantages like wound isolation that reduces chance of wound colonization and safe disposal of infected materials (important factor to reduce hospital-acquired infections), while avoiding some major disadvantages such as opacity of dressing materials, inaccessible offensive smelling wound environment, and relatively high treatment costs. In LAD a definite intermittent negative pressure regimen is followed. The intermittent negative pressure (cycle of 30 minutes suction and 3½ hours rest) is effective. Overall, the LAD is a safe and effective alternative to conventional dressing methods. LAD is an excellent research tool for wound healing as frequent/continuous record of wound healing is possible without disturbing the wound healing process. LAD is an effective dressing for limb salvage in cases of acute and chronic complex wounds. Leech effect prevents wound related systematic response syndrome and sepsis. Suction-assisted dressing (SAD) is a combination of semiocclusive dressing with negative pressure. It works by removal of fluids by intermittent (like LAD) negative pressure and preventing bacterial invasion. SAD is especially advantageous where soakage is less, there is no dead tissue covering the wound (e.g., following skin grafting), superficial skin wounds (e.g., donor area) and also where LAD is technically difficult to apply over circumferential trunk and neck dressings under anesthesia.

Kumar, Pramod



21 CFR 878.4022 - Hydrogel wound dressing and burn dressing.  

Code of Federal Regulations, 2013 CFR




Flexible chitin films as potential wound-dressing materials: wound model studies.  


Chitin films possessing increased flexibility, softness, transparency, and conformability have been prepared. These attributes enable the potential application of chitin films as occlusive, semipermeable film wound dressings similar to commercial products such as Opsite trade mark. The chitin films are generally nonabsorbent, exhibiting a total weight gain of only up to 120-160% in physiological fluid. Dry chitin films transpire water vapor at a rate of about 600 g/m(2)/24 h, similar to commercial polyurethane-based film dressings, but rises to 2400 g/m(2)/24 h, when wet, which is higher than the water vapor transmission rate of intact skin. The chitin films are nontoxic to human skin fibroblasts, maintaining 70-80% cell viability. Wound studies using a rat model showed no signs of allergenicity or the high inflammatory response associated with biodegradable biomaterials. The chitin films displayed accelerated wound-healing properties. Based on histological examination, wound sites dressed with the chitin films stabilized and healed faster, and appeared stronger than those dressed with Opsite trade mark and gauze dressings after 7 days of healing. PMID:12888991

Yusof, Nealda Leila Binte Muhammad; Wee, Aileen; Lim, Lee Yong; Khor, Eugene



Physical Characteristics and Performance of Synthetic Wound Dressings.  

National Technical Information Service (NTIS)

Five series of composite synthetic wound dressings were fabricated from either films, sponges ands mats of collagen or from hydroxyethyl methacrylate gel and from silicone rubber. Water vapor transmission, surface texture, thickness and wound conformabili...

S. J. Gourlay R. M. Rice A. F. Hegyeli J. C. Eaton J. W. Hodge



Comparison of bacteria-retaining ability of absorbent wound dressings.  


Fibrous materials in some modern absorbent wound dressings have the ability to sequester and retain bacteria; however, this ability varies according to the nature of the fibres. We studied the bacterial retention capacity of alginate and carboxymethylcellulose dressings, using an infected skin ulcer model on the backs of rats. Wound surfaces were inoculated with either Staphylococcus aureus or Pseudomonas aeruginosa at a concentration of 1.5 x 10(6) colony-forming units per wound. AQUACEL; Hydrofiber;, Kaltostat; or Sorbsan; were applied to the contaminated wounds for 12 h. Each dressing was then divided into two pieces. Total viable bacterial count within the dressing was calculated using one piece, and bacterial count released from the dressing into physiological saline was determined using the other piece, enabling bacterial retention rate to be calculated. Bacterial counts in tissue were also determined. Each dressing was tested on each of 10 wounds contaminated with each bacterium. Statistical analyses were performed using one-way analysis of variance (ANOVA) for replicated measures combined with Duncan's multiple comparison test. AQUACEL; Hydrofiber; dressing was most effective in its ability to retain both Staphylococcus aureus and Pseudomonas aeruginosa (p < 0.05). Bacterial counts in tissue showed no significant change with respect to pathogen or the type of dressing used. It can be concluded that the bacterial retaining ability of AQUACEL; Hydrofiber; dressing was found to be significantly higher than that of alginate dressings in an infected animal wound model. PMID:16722876

Tachi, Masahiro; Hirabayashi, Shinichi; Yonehara, Yoshiyuki; Suzuki, Yasutoshi; Bowler, Philip



Production of hydrogel wound dressings using gamma radiation  

Microsoft Academic Search

Hydrogel wound dressings have been prepared using the gamma rays irradiation technique. The dressings are composed of poly(vinyl pyrrolidone) (PVP), poly(ethylene glycol) (PEG) and agar. The influence of some process parameters on the properties of the dressings has been investigated as: the gel fraction, maximum swelling, swelling kinetics, and mechanical properties. The gel fraction increases with increasing PVP concentration due

Z. Ajji; I. Othman; J. M. Rosiak



The local treatment and available dressings designed for chronic wounds.  


The great diversity of wounds and the broad range of available dressings complicate the selection of proper chronic wound treatment. Choosing the right treatment is the essential step in the healing process. In this review, we focus on chronic nonhealing ulcers, which are a critical problem in clinical practice, and current knowledge about persistent wound care. Here, we present the objectives of local treatment with description of several types of dressings and their ingredients, features, indications, and contraindications. These include hydrocolloid, alginate, hydrogel, and dextranomer dressings; polyurethane foam and membrane dressings; semipermeable polyurethane membrane dressings; and TenderWet (Hartmann, Rock Hill, SC) and flax dressings. There is also a brief section on the use of other alternative wound-healing accelerators, such as platelet-rich plasma and light-emitting diode therapy. PMID:21982060

Skórkowska-Telichowska, Katarzyna; Czemplik, Magdalena; Kulma, Anna; Szopa, Jan



Normal saline wound dressing--is it really normal?  


Gauze swabs soaked in normal saline are frequently used as dressing on open wounds. Their exact mechanism of action is not known. This study was designed to assess the hypothesis that normal saline dressings act in part as an osmotic dressing. Ten patients had skin ulcers (n = 10) dressed with normal saline soaked sponges. Acting as controls (n = 10) identical sponges were placed upon intact skin. The sponge fluid osmolarity and electrolyte concentrations were serially assayed to test our hypothesis. In the control group, the osmolarity, sodium and chloride concentrations increased with time as a result of evaporation, altering it from an isotonic to a hypertonic dressing. However, in the ulcer group, the osmolarity, sodium and chloride concentrations in the sponge fluid remained relatively isotonic with time. This result is statistically significant (P< 0.05). We postulate that, as a result of evaporation, the sponge dressing increases its tonicity. This draws fluid from the wound into the dressing so that a dynamic equilibrium occurs and the sponge dressing regains isotonicity. The dressing remains functional provided that the wound fluid is absorbed freely from the wound. This process is terminated when either the dressing completely absorbs the wound fluid or the dressing dries out. The latter often occurs prematurely in a contaminated wound or in a wound where exudate forms a non-permeable barrier which prevents osmosis and allows the remaining water in the dressing to evaporate completely. This correlates with the observation in clinical practice that for maximum efficacy the dressing should be changed regularly. PMID:10657448

Lim, J K; Saliba, L; Smith, M J; McTavish, J; Raine, C; Curtin, P



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


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



Hydrocellular Foam Dressing Promotes Wound Healing along with Increases in Hyaluronan Synthase 3 and PPAR? Gene Expression in Epidermis  

PubMed Central

Background Hydrocellular foam dressing, modern wound dressing, induces moist wound environment and promotes wound healing: however, the regulatory mechanisms responsible for these effects are poorly understood. This study was aimed to reveal the effect of hydrocellular foam dressing on hyaluronan, which has been shown to have positive effects on wound healing, and examined its regulatory mechanisms in rat skin. Methodology/Principal Findings We created two full-thickness wounds on the dorsolateral skin of rats. Each wound was covered with either a hydrocellular foam dressing or a film dressing and hyaluronan levels in the periwound skin was measured. We also investigated the mechanism by which the hydrocellular foam dressing regulates hyaluronan production by measuring the gene expression of hyaluronan synthase 3 (Has3), peroxisome proliferator-activated receptor ? (PPAR?), and CD44. Hydrocellular foam dressing promoted wound healing and upregulated hyaluronan synthesis, along with an increase in the mRNA levels of Has3, which plays a primary role in hyaluronan synthesis in epidermis. In addition, hydrocellular foam dressing enhanced the mRNA levels of PPAR?, which upregulates Has3 gene expression, and the major hyaluronan receptor CD44. Conclusions/Significance These findings suggests that hydrocellular foam dressing may be beneficial for wound healing along with increases in hyaluronan synthase 3 and PPAR? gene expression in epidermis. We believe that the present study would contribute to the elucidation of the mechanisms underlying the effects of hydrocellular foam dressing-induced moist environment on wound healing and practice evidence-based wound care.

Yamane, Takumi; Nakagami, Gojiro; Yoshino, Sawako; Muramatsu, Aimi; Matsui, Sho; Oishi, Yuichi; Kanazawa, Toshiki; Minematsu, Takeo; Sanada, Hiromi



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


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



Use of chitosan\\/polyamine biopolymers based cotton as a model system to prepare antimicrobial wound dressing  

Microsoft Academic Search

The principle aim of this study is to explore and compare the effect of chitosan and linear polyvinyl amine, as biopolymer, on the antibacterial properties of the prepared dressing based cotton. The biopolymer molecules can be covalently fixed on to the cotton by using friendly anchor chemicals like butanetetracarboxylic acid. The treated cotton are characterised through monitoring the susceptibility of

Moustafa M. G. Fouda; R. Wittke; D. Knittel; E. Schollmeyer



Development of a wound dressing composed of hyaluronic acid sponge containing arginine and epidermal growth factor.  


Hyaluronic acid (HA) has the ability to promote wound healing. Epidermal growth factor (EGF) is able to promote the proliferation of various cell types, in addition to epidermal cells. A novel wound dressing was designed using high-molecular-weight hyaluronic acid (HMW-HA) and low-molecular-weight hyaluronic acid (LMW-HA). Spongy sheets composed of cross-linked high-molecular-weight hyaluronic acid (c-HMW-HA) were prepared by freeze-drying an aqueous solution of HMW-HA containing a crosslinking agent. Each spongy sheet was immersed into an aqueous solution of LMW-HA containing arginine (Arg) alone or both Arg and epidermal growth factor (EGF), and were then freeze-dried to prepare two types of product. One was a wound dressing composed of c-HMW-HA sponge containing LMW-HA and Arg (c-HMW-HA/LMW-HA + Arg; Group I). The other was a wound dressing composed of c-HMW-HA sponge containing LMW-HA, Arg and EGF (c-HMW-HA/LMW-HA + Arg + EGF; Group II). The efficacy of these products was evaluated in animal tests using rats. In the first experiment, each wound dressing was applied to a full-thickness skin defect with a diameter of 35 mm in the abdominal region of Sprague-Dawley (SD) rats, leaving an intact skin island measuring 15 mm in diameter in the central area of this skin defect. Commercially available polyurethane film dressing was then applied to each wound dressing as a covering material. In the control group, the wound surface was covered with polyurethane film dressing alone. Both wound dressings (Group I and Group II) potently decreased the size of the full-thickness skin defect and increased the size of the intact skin island, when compared with the control group. The wound dressing in Group II showed particularly potent activity in increasing the distance of epithelization from the intact skin island. This suggests that EGF release from the spongy sheet serves to promote epithelization. The wound dressing in Group II enhanced early-stage inflammation after 1 week, as compared with the other two groups. In the second experiment, each wound dressing was applied to a full-thickness skin defect measuring 35 mm in diameter in the abdominal region of SD rats, after removing necrotic skin caused by dermal burns. Polyurethane film dressing was applied to each wound dressing as a covering material. In the control group, the wound surface was covered with polyurethane film dressing alone. Both wound dressings (Group I and Group II) potently decreased the size of the full-thickness skin defect and increased epithelization from the wound margin, as compared with the control group. The wound dressing in Group II was found to enhance early-stage inflammation after 1 week, as compared with the other two groups. The findings in both experiments indicate that the wound dressing composed of HA-based spongy sheets containing Arg and EGF potently promotes wound healing by inducing moderate inflammation. The release of EGF in the early stages of wound healing induces moderate inflammation. This suggests that wound healing is facilitated directly by topical application of EGF, and indirectly by cytokines derived from inflammatory cells stimulated by EGF. PMID:20482980

Matsumoto, Yasuhiro; Kuroyanagi, Yoshimitsu



Preparation and performance evaluation of tetracycline hydrochloride loaded wound dressing mats based on electrospun nanofibrous poly(lactic acid)\\/poly(Ï?-caprolactone) blends  

Microsoft Academic Search

In this article, we present the drug-release rate, water uptake, water permeability, morphology, and mechanical properties of a series of active wound dressing nanofibrous mats prepared via an electrospinning process of poly(lactic acid) (PLA), poly(Ï?-caprolactone) (PCL), and their (50\\/50) blends loaded with different doses of tetracycline hydrochloride antibiotic. The performance of these active wound dressings in terms of a sustained

P. a Zahedi; Z. a Karami; I. a Rezaeian; S.-H.a Jafari; P. b Mahdaviani; A. H. c d Abdolghaffari; M. b Abdollahi



A prospective randomized evaluation of negative-pressure wound dressings for diabetic foot wounds.  


Optimal treatment for large diabetic foot wounds is ill defined. The purpose of this study was to compare the rate of wound healing with the Vacuum Assisted Closure device trade mark (VAC) to conventional moist dressings in the treatment of large diabetic foot wounds. Diabetics with significant soft tissue defects of the foot were considered for enrollment. Patients were randomized to receive either moist gauze dressings or VAC treatments for 2 weeks, after which they were treated with the alternative dressing for an additional 2 weeks. Wounds were photographed weekly and wound dimensions calculated in a blinded fashion with spatial analysis software. Percent change in wound dimensions were calculated and compared for each weekly assessment and over 2 weeks of therapy with each dressing type. Ten patients were enrolled in the trial, but two were lost to follow-up and two were withdrawn. Complete data were available for analysis on seven wounds in six patients. Average length, width, and depth of the wounds at initiation of the trial was 7.7, 3.5, and 3.1 cm, respectively. Only the wound depth was significantly decreased over the weeks of the trial to 1.2 cm ( p < 0.05). VAC dressings decreased the wound volume and depth significantly more than moist gauze dressings (59% vs. 0% and 49% vs. 8%, respectively). VAC dressings were associated with a decrease in all wound dimensions while wound length and width increased with moist dressings. In summary, over the first several weeks of therapy, VAC dressings decreased wound depth and volume more effectively than moist gauze dressings. Negative-pressure wound treatment may accelerate closure of large foot wounds in the diabetic patient. PMID:14534844

Eginton, Mark T; Brown, Kellie R; Seabrook, Gary R; Towne, Jonathan B; Cambria, Robert A



Compatibility of a protein topical gel with wound dressings.  


The compatibility between several dressing materials and a recombinant human vascular endothelial growth factor (rhVEGF) topical methylcellulose gel formulation was investigated. The dressings being studied were Adaptic, Non-stick Dressing, Conformant 2, Opsite and Tegapore. The criteria to select a compatible dressing include protein stability, absence of leachables from the dressing, and ability to retain gel on wound. An LC-MS method with sample treatment using cellulase was developed to determine protein oxidation in gel formulations. Results showed that rhVEGF was significantly oxidized by Adaptic dressing in 24 h. Protein oxidation was likely due to the peroxides, as determined by FOX assay, released into the protein solution from the dressing. Furthermore, Adaptic dressing caused protein adsorption loss, formation of high MW protein adducts, and released leachables as determined by RP-HPLC, LC-MS, and SEC. No protein oxidation or loss was observed after exposure to the other four alternative dressings. However, unknown leachables were detected in the presence of Opsite and Non-stick Dressing. The pore sizes of the Conformant 2 and Non-stick dressings were too large to hold the topical gel within the wound area, making them unsuitable for patient use. No rhVEGF bioactivity loss was observed in the presence of Tegapore. In conclusion, Tegapore was considered suitable for the rhVEGF topical gel. PMID:18623201

Ji, Junyan A; Borisov, Oleg; Ingham, Erika; Ling, Victor; Wang, Y John



Collagen Dressing Versus Conventional Dressings in Burn and Chronic Wounds: A Retrospective Study  

PubMed Central

Objective: Biological dressings like collagen are impermeable to bacteria, and create the most physiological interface between the wound surface and the environment. Collagen dressings have other advantages over conventional dressings in terms of ease of application and being natural, non-immunogenic, non-pyrogenic, hypo-allergenic, and pain-free. This study aims to compare the efficacy of collagen dressing in treating burn and chronic wounds with that of conventional dressing materials. Materials and Methods: The records of 120 patients with chronic wounds of varied aetiologies and with mean age 43.7 years were collected and analyzed. The patients had been treated either with collagen or other conventional dressing materials including silver sulfadiazine, nadifloxacin, povidone iodine, or honey (traditional dressing material). Patients with co-morbidities that could grossly affect the wound healing like uncontrolled diabetes mellitus, chronic liver or renal disease, or major nutritional deprivation were not included. For the purpose of comparison the patients were divided into two groups; ‘Collagen group’ and ‘Conventional group’, each having 60 patients. For assessment the wound characteristics (size, edge, floor, slough, granulation tissue, and wound swab or pus culture sensitivity results) were recorded. With start of treatment, appearance of granulation tissue, completeness of healing, need for skin grafting, and patients’ satisfaction was noted for each patient in both groups. Results: With two weeks of treatment, 60% of the ‘collagen group’ wounds and only 42% of the ‘conventional group’ wounds were sterile (P=0.03). Healthy granulation tissue appeared earlier over collagen-dressed wounds than over conventionally treated wounds (P=0.03). After eight weeks, 52 (87%) of ‘collagen group’ wounds and 48 (80%) of ‘conventional group’ wounds were >75% healed (P=0.21). Eight patients in the ‘collagen group’ and 12 in the ‘conventional group’ needed partial split-skin grafting (P=0.04). Collagen-treated patients enjoyed early and more subjective mobility. Conclusion: No significant better results in terms of completeness of healing of burn and chronic wounds between collagen dressing and conventional dressing were found. Collagen dressing, however, may avoid the need of skin grafting, and provides additional advantage of patients’ compliance and comfort.

Singh, Onkar; Gupta, Shilpi Singh; Soni, Mohan; Moses, Sonia; Shukla, Sumit; Mathur, Raj Kumar



21 CFR 878.4020 - Occlusive wound dressing.  

Code of Federal Regulations, 2013 CFR




Bi-Layer Wound Dressing System for Combat Casualty Care.  

National Technical Information Service (NTIS)

Burn injuries remain a significant cause of morbidity and mortality during modern military conflicts and peacekeeping operations. Considering that commercially available dressings are not designed to meet the challenges of treating combat burn wounds, DRD...

L. Martineau P. N. Shek



Clinical experience with a new hydrogel wound dressing.  


A new dressing is described which appears to improve wound healing after partial-thickness skin loss. The period between dressing changes is increased and patient discomfort decreased. It has been particularly useful in the treatment of scalds in children. There is no evidence of an increased infection rate. Alternative methods of sterilization may reduce the small number of minor hypersensitivity reactions. PMID:6469314

Yates, D W; Hadfield, J M



Effects of silver-based wound dressings on the bacterial flora in chronic leg ulcers and its susceptibility in vitro to silver.  


Silver-based dressings have been used extensively in wound management in recent years, but data on their antimicrobial activity in the clinical setting are limited. In order to explore their effects on chronic leg ulcer flora, 14 ulcers were cultured after at least 3 weeks treatment with Aquacel Ag(®) or Acticoat(®). Phenotypic and genetic silver resistance were investigated in a total of 56 isolates. Silver-based dressings had a limited effect on primary wound pathogens, which were present in 79% of the cultures before, and 71% after, treatment. One silver-resistant Enterobacter cloacae strain was identified (silver nitrate minimal inhibitory concentration (MIC)?>?512 mg/l, positive for silE, silS and silP). Further studies in vitro showed that inducible silver-resistance was more frequent in Enterobacteriaceae with cephalosporin-resistance and that silver nitrate had mainly a bacteriostatic effect on Staphylococcus aureus. Monitoring of silver resistance should be considered in areas where silver is used extensively. PMID:22215013

Sütterlin, Susanne; Tano, Eva; Bergsten, Agneta; Tallberg, Anna-Britta; Melhus, Asa



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



Production of hydrogel wound dressings using gamma radiation  

NASA Astrophysics Data System (ADS)

Hydrogel wound dressings have been prepared using the gamma rays irradiation technique. The dressings are composed of poly(vinyl pyrrolidone) (PVP), poly(ethylene glycol) (PEG) and agar. The influence of some process parameters on the properties of the dressings has been investigated as: the gel fraction, maximum swelling, swelling kinetics, and mechanical properties. The gel fraction increases with increasing PVP concentration due to increased crosslink density, and decreases with increasing the PEG concentration. PEG seems to act not only as plasticizer but also to modify the gel properties as gelation% and maximum swelling. The prepared hydrogels dressings could be considered as a good barrier against microbes.

Ajji, Z.; Othman, I.; Rosiak, J. M.



Evaluation of a Wound Dressing Composed of Hyaluronic Acid and Collagen Sponge Containing Epidermal Growth Factor in Diabetic Mice.  


This study investigated the effect of a wound dressing composed of hyaluronic acid (HA) and collagen (Col) sponge containing epidermal growth factor (EGF) on wound healing in diabetic mice. High-molecular-weight (HMW) HA aqueous solution, hydrolyzed low-molecular-weight (LMW) HA aqueous solution and heat-denatured Col aqueous solution were mixed, followed by freeze-drying to obtain a spongy sheet. Cross-linkage between Col molecules was induced by UV irradiation to the spongy sheet (Type-I wound dressing). In a similar manner, a spongy sheet containing EGF (Type-II wound dressing) was prepared by freeze-drying the mixed solution of HMW-HA, LMW-HA and Col containing EGF. The efficacy of these products was evaluated in type-II diabetic BKS.Cg-+Lepr(db)/+Lepr(db) (db/db) mice. Wound dressings were applied to a full-thickness, dorsal skin defect measuring 1.5 cm×2.0 cm, showing adipose tissue. In the control group, a commercially available artificial dermis composed of collagen spongy sheet (TERUDERMIS(®)) was used. A commercially available polyurethane film dressing (Bioclusive(®)) was applied over each wound dressing. After 1 week of application, wound conditions were evaluated based on their gross and histological appearances. Type-I and -II wound dressings promoted a decrease in wound size associated with angiogenesis and granulation tissue formation, compared with the artificial dermis. In particular, Type-II wound dressings promoted sufficient re-epithelialization. These findings indicate that the combination of HA, Col and EGF promotes wound healing by stimulating cell activity including cell migration and proliferation on the adipose tissue in a diabetic wound. Type-I and -II wound dressings would be useful to prepare a well-vascularized wound bed acceptable for split-thickness auto-skin grafting. PMID:21943516

Kondo, Shinya; Niiyama, Hayato; Yu, Akane; Kuroyanagi, Yoshimitsu



Comparative Study of Antibacterial Effects and Bacterial Retentivity of Wound Dressings  

PubMed Central

Objectives: We are often confused on selecting a suitable wound dressing for the treatment of infected wounds from huge number of available wound dressings. Then, to help clinicians easily select a wound dressing, we compared the antibacterial effects and bacterial retentivity (ie, potency of keeping absorbed bacteria inside wound dressings and preventing them from leaking out) of wound dressings. Methods: Five wound dressings with antibacterial constituents were compared to research antibacterial effects against nonpathogenic Escherichia coli using an in vitro model. The 5 other wound dressings with no antibacterial constituent were compared to research bacterial retentivity. The relative amount of E coli was determined using cell proliferation reagent WST-1 (11644807001, Roche Applied Science, United States) with time. Results: The results have shown that the antibacterial effects and bacterial retentivity differed among various wound dressings. Silver ions quickly exerted a very strong antibacterial effect, and hydrofibers had a high potency of bacterial retentivity by gelling the absorbed bacteria in wound dressings. Conclusions: The present study indicated the differences of antibacterial strength, time of onset and duration of the antibacterial effect, and bacterial retentivity between each wound dressing. Clinicians should use appropriate wound dressings according the wound condition in consideration of the different characteristics of wound dressings. The present results are helpful for clinicians to select appropriate wound dressing.

Fujiwara, Toshihiro; Hosokawa, Ko; Kubo, Tateki



Development of a continuous finishing chemistry process for manufacture of a phosphorylated cotton chronic wound dressing  

Technology Transfer Automated Retrieval System (TEKTRAN)

A phosphorylated form of cotton gauze for treatment of chronic wounds was designed to improve the wound dressing’s capacity to remove harmful proteases from the wound and facilitate healing. Development of the fabric finishing chemistry of the wound dressing with a process suitable for textile mill...


A review of the applications of the hydrofiber dressing with silver (Aquacel Ag®) in wound care  

PubMed Central

Aquacel Ag® (ConvaTec, Princeton, NJ, USA) is a new hydrofiber wound dressing consisting of soft non-woven sodium carboxymethylcellulose fibers integrated with ionic silver. It is a moisture-retention dressing, which forms a gel on contact with wound fluid and has antimicrobial properties of ionic silver. We present a current literature review on Aquacel Ag®, of both in vitro and in vivo efficacy and clinical applications. In vitro and in vivo studies have demonstrated the wide antimicrobial properties of Aquacel Ag®, and additionally demonstrated the cytotoxicity of ionic silver to keratinocytes and fibroblasts that cause delay in wound re-epithelialization. Clinical studies confirmed that Aquacel Ag® is an effective and safe dressing for a variety of wound types, both acute and chronic. Incorporation of ionic silver into the hydrofibers does not cause undue alteration in the performance properties of the base dressing, which continues to provide favorable wound moisture and exudate management. The addition of ionic silver reduces local pain and dressing changes, and provides significant broad-spectrum antimicrobial properties, with no delay in wound healing.

Barnea, Yoav; Weiss, Jerry; Gur, Eyal



A review of the applications of the hydrofiber dressing with silver (Aquacel Ag) in wound care.  


Aquacel Ag((R)) (ConvaTec, Princeton, NJ, USA) is a new hydrofiber wound dressing consisting of soft non-woven sodium carboxymethylcellulose fibers integrated with ionic silver. It is a moisture-retention dressing, which forms a gel on contact with wound fluid and has antimicrobial properties of ionic silver. We present a current literature review on Aquacel Ag((R)), of both in vitro and in vivo efficacy and clinical applications. In vitro and in vivo studies have demonstrated the wide antimicrobial properties of Aquacel Ag((R)), and additionally demonstrated the cytotoxicity of ionic silver to keratinocytes and fibroblasts that cause delay in wound re-epithelialization. Clinical studies confirmed that Aquacel Ag((R)) is an effective and safe dressing for a variety of wound types, both acute and chronic. Incorporation of ionic silver into the hydrofibers does not cause undue alteration in the performance properties of the base dressing, which continues to provide favorable wound moisture and exudate management. The addition of ionic silver reduces local pain and dressing changes, and provides significant broad-spectrum antimicrobial properties, with no delay in wound healing. PMID:20169033

Barnea, Yoav; Weiss, Jerry; Gur, Eyal



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


This paper addresses the notion of wound care as a technology of skin and other skins imbued with the combined power of technology and science. It presents the discourses of wound care evident in the accounts of patients and nurses concerning this care, and discussions about wounds in wound care interest groups, journals, and advertising material about wound care products. The discussion focuses on wounds and wound dressings as effects immanent in the power relations of discourses of wound care. These effects colour and influence nurses' responses to wounds and wound care products. Moreover, the discourses that portray these practices are evidence of the complex articulation between technoscience and gender. Nurses and patients are fascinated by wound technoscience and lured towards it by its potential for mastery and control over wounds. Such seductions are evident in the texts of nurses, patients, and pharmaceutical advertisements for wound care products. Finally, the ways that these representations are used to talk about and market wound care products are shown as exemplifying the finer points of wound management as a nursing technoscience. PMID:10795270

Rudge, T



Supramolecular elastomer based on polydimethylsiloxanes (SESi) film: synthesis, characterization, biocompatibility, and its application in the context of wound dressing.  


Supramolecular elastomer based on polydimethylsiloxanes (SESi) is a kind of novel elastomer cross-linked by the multihydrogen bonds supplied by the functional groups linked to the end of the PDMS chains, such as amide, imidazolidone, pending urea (1,1-dialkyl urea), and bridging urea (1,3-dialkyl urea). SESi showed lower glass transition temperature (T g) at about -113?°C because of the softer chain of PDMS, and could show real rubber-like elastic behaviors and acceptable water vapor transmission rate under room temperature. The high biocompatibility of SESi in the form of films was demonstrated by the cytotoxicity evaluation (MTT cytotoxicity assay and direct contact assay), hemolysis assay, and skin irritation evaluation. Based on detailed comparisons between commercial Tegaderm(™) film and SESi film using a full-thickness rat skin model experiment, it was found that SESi film showed similar wound contraction rate as that of Tegaderm(™) film on day seven, 10, and 14; only on day five, SESi film showed a significant (p?wound contraction rate. And, the wounds covered with SESi film were filled with new epithelium without any significant adverse reactions, similar with that of Tegaderm(™) film. PMID:24073612

Zhang, Anqiang; Yang, Lin; Lin, Yaling; Lu, Hecheng; Qiu, Yuanhuan; Su, Yanlong



Assessing the effect of an antimicrobial wound dressing on biofilms.  


To date the effect of silver-containing wound dressings on biofilms, known to be present in chronic wounds, has not been determined or documented. In this current study, we aimed to determine the antimicrobial effect of a silver-containing dressing on biofilms grown in a chambered slide model. Before the addition of a wound dressing onto a 24-hour biofilm, composed of either Pseudomonas aeruginosa, Enterobacter cloacae, Staphylococcus aureus, or a mixed bacterial community, a fluorescent dye was applied. This enabled the viability of sessile bacteria to be monitored in real-time, using a rapid form of confocal laser scanning microscopy over a contact time period of 48 hours. By analyzing all the three-dimensional data generated from the confocal time-lapse sequences, 90% of all sessile bacteria within the biofilm were observed to progressively turn red (i.e., died) within 24 hours. Total bacterial kill in the biofilm was achieved after 48 hours. This research has shown that the dressing was effective in killing the tested bacteria evident in both the tested mono and polymicrobial biofilms, which provides valuable evidence that this dressing may have an effect on biofilms found in recalcitrant chronic wounds. PMID:18211579

Percival, Steven L; Bowler, Phil; Woods, Emma J


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


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


Preparation and evaluation of biocomposites as wound dressing material.  


Collagen was isolated from the chrome containing leather waste (CCLW) which is a major solid waste in leather industry. Composite films were made using sago starch (SG), soya protein (SY), and collagen (C) and were cross linked with glutaraldehyde (G).The films prepared were characterized for their physico chemical properties like tensile strength, infrared spectra, thermogravimetric analysis, surface morphology, and water absorption studies. Better mechanical properties and surface morphology were observed for SG-SY-G-C films compared to other films prepared using collagen. The composite films prepared were used as wound dressing material on the experimental wounds of rats and healing pattern was evaluated using planimetric, biochemical, and histopathological studies. These studies have revealed better wound healing capacity of SG-SY-G-C film and utilization of CCLW in the preparation of value added product like wound dressing material. PMID:23015263

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



The role of Sterigel hydrogel wound dressing in wound debridement.  


An increasing number of hydrogel dressings have become available to the practitioner over the last few years. Sterigel (Seton Healthcare) is the latest to be launched. This dressing is able to donate large quantities of fluid and thereby speed up the debridement of slough and necrotic tissue. PMID:9223958

Williams, C


Permeability and Biocompatibility of Novel Medicated Hydrogel Wound Dressings  

Microsoft Academic Search

Hydrogel dressings are being popularized for wound care management because of their softness, tissue compatibility, and ability to enhance wound healing process. PVP-CMC and PVP-CMC-BA hydrogels were prepared using polyvinylpyrrolidone (PVP), sodium-carboxymethylcellulose (CMC), polyethyleneglycol (PEG), agar, glycerine and without\\/with boric acid (BA). Permeability: water vapor transmission and microbe penetration and biocompatibility: cytotoxicity, skin irritation, and skin sensitization tests of hydrogels

Niladri Roy; Nabanita Saha; Petr Humpolicek; Petr Saha



Investigation of lysine acrylate containing poly(N-isopropylacrylamide) hydrogels as wound dressings in normal and infected wounds.  


The design of materials for cutaneous wound dressings has advanced from passive wound covers to bioactive materials that promote skin regeneration and prevent infection. Crosslinked poly(N-isopropylacrylamide) (PNIPAAm)-based hydrogels have been investigated for a number of biomedical applications. While these materials can be used for drug delivery, limited cell interactions restrict their biological activity. In this article, acryoyl-lysine (A-Lys) was incorporated into poly(ethylene glycol) crosslinked PNIPAAm to enhance biological activity. A-Lys could be incorporated into the hydrogels to improve cellular interaction in vitro, while maintaining swelling properties and thermoresponsive behavior. Polyhexamethylene biguanide, an antimicrobial agent, could be encapsulated and released from the hydrogels and resulted in decreased bacteria counts within 2 hours. Two in vivo animal wound models were used to evaluate the hydrogel wound dressing. First, application of the hydrogels to a rodent cutaneous wound healing model resulted in significant increase in healing rate when compared with controls. Moreover, the hydrogels were also able to decrease bacteria levels in an infected wound model. These results suggest that PNIPAAm hydrogels containing A-Lys are promising wound dressings due to their ability to promote healing and deliver active antimicrobial drugs to inhibit infection. PMID:22121043

Jiang, Bin; Larson, Jeffery C; Drapala, Pawel W; Pérez-Luna, Víctor H; Kang-Mieler, Jennifer J; Brey, Eric M



Study of wound dressing structure and hydration\\/dehydration properties  

Microsoft Academic Search

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

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



Biocompatibility study for PVP wound dressing obtained in different conditions  

Microsoft Academic Search

Hydrogels composed of PVP, PEG and agar, produced by simultaneous crosslinking and package sterilization by ionizing radiation, are used mainly as wound dressing. In this study, membranes prepared in different conditions were tested for their properties including in vitro biocompatibility. The results showed that the mechanical properties were in an acceptable range of values and that the membranes can be

O. Z Higa; S. O Rogero; L. D. B Machado; M. B Mathor; A. B Lugão



Increasing the options for management of large and complex chronic wounds with a scalable, closed-system dressing for maggot therapy.  


As reconstructive specialists, burn surgeons are often involved in managing large wounds of various etiologies. Such wounds can pose a management challenge, especially if they are chronic or occur in the setting of critical illness or multiple medical comorbidities. Medical maggots are an effective, selective, and low-risk method for wound debridement. However, their use in large and geometrically complex wounds is limited by the lack of scalability in currently available dressings, which are appropriate for smaller wounds but become cumbersome and ineffective in larger ones. This report describes a novel dressing designed for application of maggot debridement therapy in large and complex wounds. The authors then discuss how use of this dressing may create new management strategies for such wounds by allowing maggots to mechanically debride big, infected wounds. They describe the construction of a maggot containment dressing based on modified components from a negative pressure wound therapy system and provide a case report highlighting its successful clinical use in a large contaminated chronic wound resulting from Fournier's gangrene. In the case described, the novel dressing provided scalability, containment of maggots, control of secretions, and ease of use. The dressing created an environment suitable for maggot survival and allowed effective debridement of a heavily contaminated groin wound. The novel dressing described is shown to function appropriately, allowing controlled use of maggots for effective debridement of large, irregular wounds. Facilitating the use of maggots in such wounds may broaden the algorithm for their management. PMID:21983646

Felder, John M; Hechenbleikner, Elizabeth; Jordan, Marion; Jeng, James


Do Functional Keratin Dressings Accelerate Epithelialization in Human Partial Thickness Wounds? A Randomized Controlled Trial on Skin Graft Donor Sites  

PubMed Central

Objective: To determine if the experimental (keratin-based) dressing accelerates epithelialization rates during healing of partial-thickness wounds, relative to a Standard Care dressing. Method: A randomized control trial was conducted using a Standard Care dressing side by side with the experimental dressing on a sample (n=26) of partial-thickness donor site wounds. The proximal/distal placement of the control and treatment was randomized. Percentage epithelialization after approximately 7 days was estimated from which time to fully epithelialize can be inferred. Patients were grouped into “young” (?50 y/o) and “old” (>50 y/o). Results: For the “old” patients (n=15), the median epithelialization percentage at 7 days is 5% and was significantly (P=.023) greater for the experimental dressing. For the “young” patients (n=11), the median epithelialization percentage at 7 days was 80% and there is no significant difference between the experimental and Standard Care control dressings. Conclusions: The experimental dressing significantly increases the rate of epithelialization of acute, traumatic partial-thickness wounds in older patients. We suggest that the dressing may be clinically useful in similar situations where epithelialization may be delayed because of patient or wound characteristics.

Davidson, Andrew; Jina, N. Hamesh; Marsh, Clive; Than, Martin; Simcock, Jeremy W.



Radiation synthesis of PVP/CMC hydrogels as wound dressing  

NASA Astrophysics Data System (ADS)

Carboxymethyl cellulose (CMC) and poly(N-vinyl pyrrolidone) (PVP) were blended to synthesize hydrogels by 60Co ?-ray irradiation. A series of hydrogels were prepared with three compositions, i.e. PVP:CMC = 5:5, 6:4 and 7:3. The properties of the hydrogels such as gel fraction, gel strength, swelling behavior and moisture retention were investigated. Compared with pure PVP and CMC hydrogels, PVP/CMC blend hydrogels possessed improved gel strength, flexibility and transparency. As the content of PVP in PVP/CMC blend hydrogels increased, the gel fraction increased while the swelling rate decreased. The hydrogels with optimal properties were obtained in a composition of PVP/CMC = 6/4 with sterilization dose (25 kGy) and further characterized by FT-IR and SEM. Properties concerning the application of wound dressing were performed by comparison with a commercial hydrogel wound dressing to find a similar moisture retention capability and improved swelling rate. The improved properties as well as the cheapness of the materials suggest that PVP/CMC blend hydrogel can be good candidate as wound dressing.

Wang, Min; Xu, Ling; Hu, Hui; Zhai, Maolin; Peng, Jing; Nho, Youngchang; Li, Jiuqiang; Wei, Genshuan



A polyurethane dressing is beneficial for split-thickness skin-graft donor wound healing  

Microsoft Academic Search

Few comparative studies have been performed on the various wound-dressing materials or methods proposed for use. To clarify the efficacy of wound dressing, 35 patients (17 females, aged 44.8±26.86 years and 18 males, aged 35.4±29.70) were subjected to a prospective study comparing a polyurethane dressing and a hydrogel dressing for split-thickness skin donors from the lateral thighs. We examined their

Sadanori Akita; Kozo Akino; Toshifumi Imaizumi; Katsumi Tanaka; Kuniaki Anraku; Hiroki Yano; Akiyoshi Hirano



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


The Food and Drug Administration (FDA) is classifying the nonresorbable gauze/sponge for external use, the hydrophilic wound dressing, the occlusive wound dressing, and the hydrogel wound dressing into class I (general controls). FDA is also exempting these devices from premarket notification procedures. This action is being taken under the Federal Food, Drug, and Cosmetic Act (the act), as amended by the Medical Device Amendments of 1976 (the 1976 amendments), the Safe Medical Devices Act of 1990 (SMDA), and the Food and Drug Administration Modernization Act of 1997 (FDAMA). PMID:11010701



[Liberation of drugs from impregnated wound dressings].  


The present paper investigates drugs and polymers intended for the impregnation of textile carriers intended for use as wound covers. Their suitability was evaluated on the basis of the evaluation of the antimicrobial efficacy of a combination of trimetoprim and sulfadimidine with the local anaesthetics carbizocaine and lidocaine, and the immunomodulating substance fungal glucan. A greater inhibitory effect on the growth of microorganisms was shown by a combination of antimicrobial substances with carbizocaine. In the study of liberation of chlorohexidine from hydrophilic macromolecular dispersions its bond to glucan was confirmed. Dispersions of Natrosol proved to be more advantageous; chlorohexidine as well as local anaesthetics were released from them more rapidly than from methylcellulose gels. The dispersions under study are of a non-Newton character with pseudoplastic flow, glucan-containing gels are thixotropic. PMID:10566242

Ducková, K; Kucera, J



An active wound dressing for controlled convective mass transfer with the wound bed.  


Conventional wound dressings-gauze, plastic films, foams, and gels-do not allow for spatial and temporal control of the soluble chemistry within the wound bed, and are thus limited to a passive role in wound healing. Here, we present an active wound dressing (AWD) designed to control convective mass transfer with the wound bed; this mass transfer provides a means to tailor and monitor the chemical state of a wound and, potentially, to aid the healing process. We form this AWD as a bilayer of porous poly(hydroxyethyl methacrylate) (pHEMA) and silicone; the pHEMA acts as the interface with the wound bed, and a layer of silicone provides a vapor barrier and a support for connecting to external reservoirs and pumps. We measure the convective permeability of the pHEMA sponge, and use this value to design a device with a spatially uniform flow profile. We quantify the global coefficient of mass transfer of the AWD on a dissolvable synthetic surface, and compare it to existing theories of mass transfer in porous media. We also operate the AWD on model wound beds made of calcium alginate gel to demonstrate extraction and delivery of low molecular weight solutes and a model protein. Using this system, we demonstrate both uniform mass transfer over the entire wound bed and patterned mass transfer in three spatially distinct regions. Finally, we discuss opportunities and challenges for the clinical application of this design of an AWD. PMID:17106898

Cabodi, Mario; Cross, Valerie L; Qu, Zheng; Havenstrite, Karen L; Schwartz, Suzanne; Stroock, Abraham D



Application of wound dressing Molndal technique in clean and potentially contamined postoperative wounds--initial comparative study.  


Because of a possible delayed wound healing, critical colonization and infection of wounds present a problem for surgeons, particularly in patients with compromised immune system or in case where the wound is heavy contaminated or poorly perfused. Molndal technique of wound dressing has proven to be effective in prevention of infection. In our study we wanted to describe the benefits of the application of Molndal technique wound dressing compared to traditional wound dressing technique at potentially contaminated and clean postoperative wounds. We examined postoperative wound after radical excision of pilonidal sinus and after implantation of partial endoprosthesis in hip fracture. Molndal technique consisted of wound dressing with Aquacel Ag - Hydrofiber. Traditional technique was performed using gauze compresses and hypoallergic adhesives. We analyzed the results of 50 patients after radical excision of pilonidal sinus. 25 patients were treated by Molndal technique and 25 patients by the traditional technique of wound dressing. In the group treated by Molndal technique only 1 (4%) patient has revealed a wound infection, proven by positive microbiological examination and suppuration. In the traditional technique group 4 (16%) patients developed wound infection as inflammation and secretion as a sign of superficial infection. In the other group we analyzed the results of 50 patients after implantation of partial endoprosthesis after hip fracture. 20 patients were treated by Molndal technique and 30 patients by the traditional technique of wound dressing. In the group treated by Molndal technique no patient has revealed a wound infection (0%). In the traditional technique group 4 (13%) patients developed wound infection. All complication in both group were superficial incisional surgical infection (according to HPSC). There was no deep incisional surgical site infection or organ/space surgical site infection. Our results are clearly showing that Molndal technique is effective in preventing the postoperative wound infection. PMID:22220414

Marinovi?, Marin; Cicvari?, Tedi; Grzalja, Nikola; Baci?, Giordano; Radovi?, Endi



Elastic adhesive dressing treatment of bleeding wounds in trauma victims.  


Conventional methods for hemorrhage control in the trauma patient fall short of providing a full solution for the life-threatening bleeding injury. The tourniquet is limited specifically to injuries of the distal limbs. Local pressure or tight bandaging with military bandages is cumbersome and often insufficient. Therefore, we sought a superior method to stop bleeding in emergency situations. Our objective is report and description of our experience with this method. Since 1992 our trauma team repeatedly encountered multiple trauma victims presenting with bleeding wounds. We achieved hemorrhage control by means of an adhesive elastic bandage applied directly over a collection of 4 x 4 gauze pads placed on the wound surface. The roll is then wrapped around the body surface, over the bleeding site, until sufficient pressure is reached to terminate ongoing hemorrhage. Three typical cases are described in detail. Adhesive elastic dressing compression was successful in fully controlling bleeding without compromise of distal blood flow. Our method corresponded to the demand for an immediate, effective and lasting form of hemorrhage control without complications. Furthermore, this technique proved successful even over body surfaces normally recognized as difficult to compress. We experienced equal favorable success while working during transit by either ambulance or helicopter transportation. We find our preliminary experience using elastic adhesive dressing for bleeding control encouraging and suggest that this may substitute existing practices as the selected treatment when indicated. This method is presently underrecognized for this purpose. Development of a single unit bandage may further enhance success in the future. PMID:11103736

Naimer, S A; Chemla, F



Development of gelatin hydrogel pads as antibacterial wound dressings.  


Gelatin hydrogel pads have been prepared from a 10 wt.-% gelatin solution that contained 2.5 wt.-% AgNO(3) in 70% v/v acetic acid by a solvent-casting technique. The AgNO(3)-containing gelatin solution was aged under mechanical stirring for various time intervals to allow for the formation of silver nanoparticles (nAgs). The formation of nAgs was monitored by a UV-vis spectrophotometer. The morphology and size of the nAgs were characterized by transmission electron microscopy (TEM). To improve the water resistance of the hydrogels, various contents of glutaraldehyde (GTA) were added to the AgNO(3)-containing gelatin solution to cross-link the obtained gelatin hydrogels. These hydrogels were tested for their water retention and weight loss behavior, release characteristics of the as-loaded silver, and antibacterial activity against Gram-negative Escherichia coli and Gram-positive Staphylococcus aureus. The AgNO(3)-containing gelatin solution that had been aged for 5 d showed the greatest number of nAgs formed. The size of these particles, based on TEM results, was 10-11 nm. With an increase in the GTA content used to cross-link the hydrogels, the water retention, the weight loss, and the cumulative amount of silver released were found to decrease. Finally, all of the nAg-loaded gelatin hydrogels could inhibit the growth of the tested pathogens, which confirmed their applicability as antibacterial wound dressings. PMID:19530128

Rattanaruengsrikul, Vichayarat; Pimpha, Nuttaporn; Supaphol, Pitt



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


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



A comparison of hydrofibre and alginate dressings on open acute surgical wounds.  


This study aimed to compare the performance of a hydrofibre (Aquacel) and an alginate (Sorbsan) dressing on acute surgical wounds left to heal by secondary intention. A total of 100 patients were prospectively randomised pre-operatively to receive either the hydrofibre or the alginate dressing. Dressing performance was measured at operation, at 24 hours and seven days. Parameters measured included ease of: application and removal of the first dressing; re-application on the first postoperative day; and removal and re-application one week postoperatively. The hydrofibre dressing received higher scores for all of these categories. Patients in this group also experienced less pain (mild or none) on removal of the first dressing and at one week. However, these results did not achieve statistical significance, and should be seen as a trend. Nevertheless, the authors recommend the use of hydrofibre dressings on open acute surgical wounds. PMID:11933488

Foster, L; Moore, P; Clark, S



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.

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



The visualisation and speed of kill of wound isolates on a silver alginate dressing.  


In chronic wound management, alginate dressings are used to absorb exudate and reduce the microbial burden. Silver alginate offers the added benefit of an additional antimicrobial pressure on contaminating microorganisms. This present study compares the antimicrobial activity of a RESTORE silver alginate dressing with a silver-free control dressing using a combination of in vitro culture and imaging techniques. The wound pathogens examined included Candida albicans, Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, ?-haemolytic Streptococcus, and strictly anaerobic bacteria. The antimicrobial efficacy of the dressings was assessed using log(10) reduction and 13-day corrected zone of inhibition (CZOI) time-course assays. Confocal laser scanning microscopy (CLSM) was used to visualise the relative proportions of live/dead microorganisms sequestered into the dressings over 24 hours and estimate the comparative speed of kill. The RESTORE silver alginate dressing showed significantly greater log(10) reductions and CZOIs for all microorganisms compared with the control, indicating the antimicrobial effect of ionic silver. Antimicrobial activity was evident against all test organisms for up to 5 days and, in some cases, up to 12 days following an on-going microbial challenge. Imaging bacteria sequestered in the silver-free dressing showed that each microbial species aggregated in the dressing and remained viable for more than 20 hours. Growth was not observed inside of the dressing, indicating a possible microbiostatic effect of the alginate fibres. In comparison, organisms in the RESTORE silver alginate dressing were seen to lose viability at a considerably greater rate. After 16 hours of contact with the RESTORE silver alginate dressing, >90% of cells of all bacteria and yeast were no longer viable. In conclusion, collectively, the data highlights the rapid speed of kill and antimicrobial suitability of this RESTORE silver alginate dressing on wound isolates and highlights its overwhelming ability to manage a microbial wound bioburden in the management of infected wounds. PMID:22405034

Hooper, Samuel J; Percival, Steven L; Hill, Katja E; Thomas, David W; Hayes, A J; Williams, David W



Use of flow cytometry to compare the antimicrobial efficacy of silver-containing wound dressings against planktonic Staphylococcus aureus and Pseudomonas aeruginosa.  


Silver-impregnated wound dressings continue to be routinely used for the management of infected wounds, or wounds that are at risk of becoming infected. The ability of antimicrobials that have been incorporated into wound dressings to kill microorganisms within the dressing requires appropriate evaluation using in vitro models. In vitro models that have been exploited for this purpose have included the corrected zone of inhibition and the log reduction assay. However, these and other related culturable-based assays are purported to have poor correlation with the overall microbicidal barrier activity of an antimicrobial wound dressing. This is because culturable-based methods only retrospectively indicate bacterial cell death and do not take into account viable but nonculturable states of microorganisms. Consequently, it was the purpose of this study to show that the use of flow cytometry, in conjunction with Syto(®) 9 and propidium iodide, could be used as a method for accurately evaluating and comparing the antimicrobial barrier efficacy of a silver alginate and a silver carboxymethyl cellulose dressing on individual bacterial cells without the need for the use of culturable assays. When a comparison of antimicrobial barrier efficacy on individual planktonic Staphylococcus aureus cells in a simulated wound fluid assay was made between each dressing, enhanced antimicrobial efficacy (as showed by the percentage of dead to alive bacterial cells) of the silver alginate dressing was shown. When Pseudomonas aeruginosa was exposed to both silver-containing dressings, equivalent kill rates were showed for up to 4 days. This result was not significantly different (p<0.05). By utilizing the use of flow cytometric assays, the antimicrobial barrier efficacy of wound dressings can be accurately evaluated enabling differentiation to be achieved between individual dead and live bacteria. The flow cytometric assay is considered a significant advancement to the traditionally used culturable-based methods that are presently used for antimicrobial barrier efficacy testing on planktonic microorganisms. PMID:21518089

Percival, Steven L; Slone, Will; Linton, Sara; Okel, Tyler; Corum, Linda; Thomas, John G



Assessment of a Novel In Situ Forming Wound Dressing for Military Use.  

National Technical Information Service (NTIS)

Presented is an evaluation of the biocompatibility and physical properties of a novel hydrogel which cures in situ to form an effective wound dressing. This dressing has the capability of meeting the needs of both the far forward soldier and for use in ho...

A. Lu J. Jackson S. Shums T. Hirt X. Zhai



Biomedical evaluation of polyvinyl alcohol–gelatin esterified hydrogel for wound dressing  

Microsoft Academic Search

The wound is a biosynthetic environment in which numerous cellular processes are interlinked in the process of repair. Modern\\u000a dressings are designed to facilitate wound healing rather than just to cover it. Hydrogel dressing can protect injured skin\\u000a and keep it appropriately moist to speed the healing process by absorbing exudates while maintaining the products of tissue\\u000a repair, including growth

Kunal Pal; A. K. Banthia; D. K. Majumdar



Exploratory Development of an Ultrafast-Curing Wound Dressing.  

National Technical Information Service (NTIS)

A drug-dispensing field dermal dressing has been developed. The dermal dressing, which can be easily applied by an untrained person, contains antimicrobials to prevent bacterial infection. The medicated dermal dressing is made of an ultra-fast curing poly...

D. Dempsey K. Dasse R. Thirucote



Exploratory Development of an Ultra-Fast-Curing Wound Dressing.  

National Technical Information Service (NTIS)

We are developing a drug-dispensing field dermal dressing. The dermal dressing, which can be easily applied by an untrained person, contains antimicrobials to prevent bacterial infection. The medicated dermal dressing is made of an ultra-fast curing polyu...

K. Dasse D. Dempsey R. Thirucote



Topical application of dressing with amino acids improves cutaneous wound healing in aged rats.  


The principal goal in treating surgical and non-surgical wounds, in particular for aged skin, is the need for rapid closure of the lesion. Cutaneous wound healing processes involve four phases including an inflammatory response with the induction of pro-inflammatory cytokines. If inflammation develops in response to bacterial infection, it can create a problem for wound closure. Reduced inflammation accelerates wound closure with subsequent increased fibroblast function and collagen synthesis. On the contrary, prolonged chronic inflammation results in very limited wound healing. Using histological and immunohistochemical techniques, we investigated the effects of a new wound dressing called Vulnamin that contains four essential amino acids for collagen and elastin synthesis plus sodium ialuronate (Na-Ial), compared with Na-Ial alone, in closure of experimental cutaneous wounds of aged rats. Our results showed that the application of Vulnamin dressings modulated the inflammatory response with a reduction in the number of inflammatory cells and inducible nitric oxide synthase (iNOS) immunolocalisation, while increasing endothelial nitric oxide synthase (eNOS) and transforming growth factor-beta1 (TGF-beta1) immunolocalisation. Furthermore, the dressing increased the distribution density of fibroblasts and aided the synthesis of thin collagen fibers resulting in a reduction in healing time. The nutritive approach using this new wound dressing can provide an efficacious and safe strategy to accelerate wound healing in elderly subjects, simplifying therapeutic procedures and leading to an improved quality of life. PMID:19560799

Corsetti, Giovanni; D'Antona, Giuseppe; Dioguardi, Francesco Saverio; Rezzani, Rita



The effects of silver dressings on chronic and burns wound healing.  


Silver (Ag) has been thought to improve wound healing and reduce instances of associated infections for many years. There are centuries-old records of silver being used in wound treatment, but the past two decades in particular have seen an increasing clinical application of silver-impregnated wound dressings and as such, have seen the number of research articles similarly increase. The majority of these articles focus on the positives and potential negatives (e.g. the toxicity of silver as a heavy metal) of using silver-impregnated dressings in the clinical management of wounds. This article examines the potential advantages and disadvantages of using silver in the management of chronic and burn wounds, and provides a physiological understanding of the body's response to silver absorption. The author also attempts to critically appraise the opposing literature related to the clinical relevance of microbial kill-time and the volume of silver contained in dressings, while investigating the efficacy of silver-impregnated dressings in the management of burns and chronic wounds. In order to collect literature relevant to this review, the author searched CINAHL, Medline, BMJ, Medscape, Journal of Advanced Nursing, the Electronic Medicines Compendium (EMC), and the Cochrane Library, using the terms silver, silver sulfadiazine, impregnated, wound, burn, dressing, review, quantative, efficacy, in vitro, in vivo, nanocrystalline, toxicity, infection, microbial kill-time, and comparison. PMID:20852480

Elliott, Chris


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.



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

Code of Federal Regulations, 2013 CFR

... MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4015 Wound dressing with poly (diallyl...dressing for exuding wounds, 1st and 2d degree burns, and surgical wounds, to secure and prevent movement of a primary...



Controlling wound bioburden with a novel silver-containing Hydrofiber dressing.  


Clinicians now recognize that both aerobic and anaerobic microorganisms have the ability to degrade or damage host tissue at a wound site through the production of a variety of enzymes and toxins. Silver-containing dressings offer one method for controlling this polymicrobial wound bioburden, and research efforts are currently ongoing to determine their efficacy against aerobic, anaerobic, and antibiotic-resistant microorganisms. The current study aimed to determine the antimicrobial activity of a new silver-containing Hydrofiber dressing (AQUACEL Ag) on both aerobic and anaerobic microorganisms, using the zone-of-inhibition method. This method provides a measure of the ability of the dressing to make available a sufficient concentration of silver to have an antimicrobial effect. To some extent this test mimics the clinical use of the dressing and predicts its microbicidal activity at the wound-dressing interface. The results show that the silver-containing dressing makes silver available at a dressing-agar interface at a concentration that is effective against a broad range of aerobic, anaerobic, and antibiotic-resistant microorganisms. In the context of wound healing, the results showing antimicrobial activity against antibiotic-resistant microorganisms are particularly important, as the control and eradication of these organisms is a major concern within the health care profession. PMID:15225207

Jones, Samantha A; Bowler, Philip G; Walker, Michael; Parsons, David


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


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

Stevens, Louise J



[Clinical cases about the therapeutic use of debriding dressing hidrodetersive polyacrylate fibers with TLC and foam dressings TLC-NOSF polyurethane in chronic wounds].  


The treatment of chronic wounds requires the use of highly specific products for different phases of the healing process. This article raises a number of clinical cases with chronic wounds of vascular origin and pressure ulcers. Such cases required a initial debridement because of the large content of fibrin covering the wound bed at this stage was used dressing hidrodetersive polyacrylate fibers with TLC. Once the debridement is continued treatment with a polyurethane foam dressing with TLC-NOSF. PMID:23157065

Blasco García, Carmen; Segovia Gómez, Teresa; Bermejo Martínez, Mariano; Cuesta Cuesta, Juan José; Alventosa Cortés, Ana María



Which dressing do donor site wounds need?: study protocol for a randomized controlled trial  

PubMed Central

Background Donor site wounds after split-skin grafting are rather 'standard' wounds. At present, lots of dressings and topical agents for donor site wounds are commercially available. This causes large variation in the local care of these wounds, while the optimum 'standard' dressing for local wound care is unclear. This protocol describes a trial in which we investigate the effectiveness of various treatment options for these donor site wounds. Methods A 14-center, six-armed randomized clinical trial is being carried out in the Netherlands. An a-priori power analysis and an anticipated dropout rate of 15% indicates that 50 patients per group are necessary, totaling 300 patients, to be able to detect a 25% quicker mean time to complete wound healing. Randomization has been computerized to ensure allocation concealment. Adult patients who need a split-skin grafting operation for any reason, leaving a donor site wound of at least 10 cm2 are included and receive one of the following dressings: hydrocolloid, alginate, film, hydrofiber, silicone dressing, or paraffin gauze. No combinations of products from other intervention groups in this trial are allowed. Optimum application and changes of these dressings are pursued according to the protocol as supplied by the dressing manufacturers. Primary outcomes are days to complete wound healing and pain (using a Visual Analogue Scale). Secondary outcomes are adverse effects, scarring, patient satisfaction, and costs. Outcome assessors unaware of the treatment allocation will assess whether or not an outcome has occurred. Results will be analyzed according to the intention to treat principle. The first patient was randomized October 1, 2009. Discussion This study will provide comprehensive data on the effectiveness of different treatment options for donor site wounds. The dressing(s) that will prevail in effectiveness, satisfaction and costs will be promoted among clinicians dealing with such patients. Thus, we aim to contribute a well-designed trial, relevant to all clinicians involved in the care for donor site wounds, which will help enhance uniformity and quality of care for these patients. Trial registration, NTR1849. Date registered: June 9, 2009



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/cm2 to 411 g/cm2, 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



Microengineered surface topography facilitates cell grafting from a prototype hydrogel wound dressing with antibacterial capability.  


Skin wounds derive therapeutic benefit from redeployment of dermal tissues, whether as split-thickness allo- and autografts or as biological dressings comprising cultured cells. However, the clinical outcome is strongly influenced by the techniques used for cell/tissue grafting and also the microbiological status of the wound. Here we report that microtopography incorporated into the surface of a novel polymeric material, derivatized with fibronectin to promote attachment and encourage motility, improved the efficiency of cell transfer onto de-epithelialized human skin ex vivo. The microtopography had two functions, first as a conduit for migrating cells to cross between the vehicle and recipient surface and second to shield adherent cells from destruction by mechanical shearing during handling and application. Quantitative analysis showed that topographic projections (columns) rather than recesses (pits) in the hydrogel surface achieved the highest efficiency of cell transfer. In order to address the crucial relevance of microbiological contamination to the success of wound grafting, the effect of iodine on several common bacterial pathogens was examined using an XTT+C(Q10) kinetic cell viability assay. Increasing concentrations of iodine initially stressed and after 0.5% v/v were subsequently bacteriocidal for Gram-negative Pseudomonas aeruginosa and Escherichia coli and Gram-positive Bacillus subtillis and Staphylococcus aureus. Slightly higher doses of iodine (approx 1-1.5% v/v) were required to kill HaCaT cells outright, but for both pro- and eukaryotes the major determinant of cytotoxicity was absolute dose rather than duration of exposure. Iodine delivered by the hydrogel at low concentration was bacteriostatic but not apparently cytotoxic to epithelial cells as measured by MTT end-point cell viability assay. Zone of inhibition studies confirmed that bacteriocidal quantities of neomycin, phenol red, and silver could also be delivered using the same hydrogel. This research suggests that grafting cell-based biological dressings to wounds using a topographically modified hydrogel dressing capable of simultaneous reducing the microbiological threat to a successful outcome may be a realistic clinical proposition. PMID:17022681

Smith, Annie G; Din, Abbas; Denyer, Morgan; Crowther, Nicholas J; Eagland, Donald; Vowden, Kath; Vowden, Peter; Britland, Stephen T


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

PubMed Central

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

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



Protease inhibition by oleic acid transfer from chronic wound dressings to albumin.  


High elastase and cathepsin G activities have been observed in chronic wounds to inhibit healing through degradation of growth factors, cytokines, and extracellular matrix proteins. Oleic acid is a non-toxic elastase inhibitor. Cotton wound dressing material was characterized as a transfer carrier for affinity uptake of oleic acid by albumin under conditions mimicking chronic wounds. The mechanism of oleic acid uptake from cotton and binding by albumin was examined with both intact dressings and cotton fiber-designed chromatography. Raman spectra of the albumin-oleic acid complexes under liquid equilibrium conditions revealed fully saturated albumin-oleic acid complexes with a 1:1 weight ratio of albumin:oleic acid. Liquid-solid equilibrium conditions revealed oleic acid transfer from cotton to albumin at 27 mole equivalents of oleic acid per mole albumin. Comparing oleic acid formulated wound dressings for dose dependent ability to lower elastase activity, we found cotton gauze>hydrogel>hydrocolloid. In contrast, the cationic serine protease cathepsin G was inhibited by oleic acid within a narrow range of oleic acid-cotton formulations. 2% albumin was sufficient to transfer quantities of oleic acid necessary to achieve a significant elastase-lowering effect. Oleic acid bound to cotton wound dressings may have promise in the selective lowering of cationic serine protease activity useful in topical application for chronic inflammatory pathogenesis. PMID:17570626

Edwards, J Vincent; Howley, Phyllis; Davis, Rachel; Mashchak, Andrew; Goheen, Steven C



Antimicrobial properties of silver-containing wound dressings: a microcalorimetric study.  


The studies reported here have been undertaken to assess the potential use of isothermal microcalorimetry in studying the antimicrobial efficacy of wound dressings that contain antimicrobial agents. The microcalorimetric technique allows non-invasive and non-destructive analysis to be performed directly on a test sample, regardless of whether it is homogeneous or heterogeneous in nature. Microcalorimetry is an established procedure that offers quantitative measurements and has the distinct advantage over traditional antimicrobial test methodologies in that calorimetric measurements are made continuously over real-time, thus the dynamic response of microorganisms to an antimicrobial agent is observed in situ. The results described in this paper are for interaction of two silver-containing wound care products AQUACEL Ag Hydrofiber (ConvaTec, Deeside, UK) and Acticoat 7 with SILCRYST (Smith and Nephew Healthcare, UK) with the wound pathogenic organisms Staphylococcus aureus and Pseudomonas aeruginosa. Both dressings are shown, microcalorimetrically, to have the capacity to kill these common wound pathogens within 1-2 h of contact. A dose-response study was conducted with the AQUACEL Ag dressing. Microcalorimetry is shown to be rapid, simple and effective in the study of the antimicrobial properties of gel forming wound dressings. PMID:12954181

O'Neill, Michael A A; Vine, George J; Beezer, Anthony E; Bishop, Alistair H; Hadgraft, Jonathan; Labetoulle, Chloé; Walker, Michael; Bowler, Phillip G



Visualisation of bacterial sequestration and bactericidal activity within hydrating Hydrofiber wound dressings.  


The fluid handling and microbiological properties of a non-antimicrobial Hydrofiber(NAH) wound dressing have been compared with those of a silver salt-containing Hydrofiber (SCH). Fluorescent dyes (BacLight, Live/Dead Kit) were added to fresh cultures of two wound pathogens (Pseudomonas aeruginosa and Staphylococcus aureus), and used to visualise their viability. Live bacteria stained green and dead/dying bacteria turned red. When inoculated into samples of the NAH and SCH dressings, the viability of the bacteria could be effectively monitored over time using a rapid form of confocal laser scanning microscopy (RCLSM--Leica UK). When the NAH dressing was hydrated with stained bacterial culture, its fibres swelled quickly, reducing interstitial spaces between the fibres, resulting in the formation of a cohesive gel. Bacteria became immobilised in the gel, forming characteristic clumps, but remained largely green (viable) for more than 20 h with no apparent increase in numbers. The SCH initially behaved in a similar manner, however, using 3-D data from RCLSM time-lapse sequences P. aeruginosa was observed to turn progressively red (i.e. died) within 1.5-3 h and S. aureus similarly turned red within 5-7 h of contact with the SCH dressing. The ability of both Hydrofiber dressings to sequester and immobilise potentially pathogenic wound micro-organisms has been demonstrated. Additionally the SCH dressing was shown to kill immobilised bacteria, as a consequence of the ionic silver bactericide. These properties of the Hydrofiber dressings may contribute to providing an environment that is supportive to wound healing. PMID:16120458

Newman, Geoffrey R; Walker, Michael; Hobot, Jan A; Bowler, Philip G



In Vitro Evaluation of the Antimicrobial Effectiveness and Moisture Binding Properties of Wound Dressings  

PubMed Central

A variety of silver-coated dressings and some impregnated with other chemicals are now available in the market; however, there have been few studies analyzing their comparative efficacies as antimicrobial agents. Moreover, their properties for retaining an appropriate level of moisture that is critical for effective wound healing have never been reported. Five commercially available silver-containing and chlorhexidine dressings, Urgotul SSD®, Bactigras®, Acticoat®, Askina Calgitrol Ag® and Aquacel Ag®, were tested to determine their comparative antimicrobial effectiveness in vitro against five common wound pathogens, namely methicillin-sensitive and -resistant Staphylococcus aureus, Bacillus subtilis, Escherichia coli and Pseudomonas aeruginosa. Mepitel®, a flexible polyamide net coated with soft silicone, was used as a control. The zones of inhibition and both the rapidity and the extent of killing of these pathogens were evaluated. All five antimicrobial dressings investigated exerted some bactericidal activity, particularly against E. coli. The spectrum and rapidity of action ranged widely for the different dressings. Acticoat® had a broad spectrum of action against both Gram-positive and -negative bacteria. Other dressings demonstrated a narrower range of bactericidal activities. Regarding the absorption and release of moisture, Askina Calgitrol Ag® absorbed and released the most moisture from the environment. Aquacel Ag® also exhibited good moisture absorption and moisture release, but to a lower degree. The other tested dressings absorbed or released very little moisture. Askina Calgitrol Ag® and Aquacel Ag® are good alternative dressings for treating wounds with high exudates and pus. An understanding of the characteristics of these dressings will be useful for utilizing them for specific requirements under specified conditions.

Aramwit, Pornanong; Muangman, Pornprom; Namviriyachote, Nantaporn; Srichana, Teerapol



In vitro evaluation of the antimicrobial effectiveness and moisture binding properties of wound dressings.  


A variety of silver-coated dressings and some impregnated with other chemicals are now available in the market; however, there have been few studies analyzing their comparative efficacies as antimicrobial agents. Moreover, their properties for retaining an appropriate level of moisture that is critical for effective wound healing have never been reported. Five commercially available silver-containing and chlorhexidine dressings, Urgotul SSD(®), Bactigras(®), Acticoat(®), Askina Calgitrol Ag(®) and Aquacel Ag(®), were tested to determine their comparative antimicrobial effectiveness in vitro against five common wound pathogens, namely methicillin-sensitive and -resistant Staphylococcus aureus, Bacillus subtilis, Escherichia coli and Pseudomonas aeruginosa. Mepitel(®), a flexible polyamide net coated with soft silicone, was used as a control. The zones of inhibition and both the rapidity and the extent of killing of these pathogens were evaluated. All five antimicrobial dressings investigated exerted some bactericidal activity, particularly against E. coli. The spectrum and rapidity of action ranged widely for the different dressings. Acticoat(®) had a broad spectrum of action against both Gram-positive and -negative bacteria. Other dressings demonstrated a narrower range of bactericidal activities. Regarding the absorption and release of moisture, Askina Calgitrol Ag(®) absorbed and released the most moisture from the environment. Aquacel Ag(®) also exhibited good moisture absorption and moisture release, but to a lower degree. The other tested dressings absorbed or released very little moisture. Askina Calgitrol Ag(®) and Aquacel Ag(®) are good alternative dressings for treating wounds with high exudates and pus. An understanding of the characteristics of these dressings will be useful for utilizing them for specific requirements under specified conditions. PMID:21152279

Aramwit, Pornanong; Muangman, Pornprom; Namviriyachote, Nantaporn; Srichana, Teerapol



21 CFR 878.4022 - Hydrogel wound dressing and burn dressing.  

Code of Federal Regulations, 2010 CFR

...non-sterile device intended to cover a wound, to absorb wound exudate, to control bleeding or fluid loss, and to protect against abrasion, friction, desiccation, and contamination. It consists of a nonresorbable matrix made of...



21 CFR 878.4022 - Hydrogel wound dressing and burn dressing.  

Code of Federal Regulations, 2010 CFR

...non-sterile device intended to cover a wound, to absorb wound exudate, to control bleeding or fluid loss, and to protect against abrasion, friction, desiccation, and contamination. It consists of a nonresorbable matrix made of...



Visualisation of bacterial sequestration and bactericidal activity within hydrating Hydrofiber ® wound dressings  

Microsoft Academic Search

The fluid handling and microbiological properties of a non-antimicrobial Hydrofiber® (NAH) wound dressing have been compared with those of a silver salt-containing Hydrofiber® (SCH). Fluorescent dyes (BacLight™, Live\\/Dead™ Kit) were added to fresh cultures of two wound pathogens (Pseudomonas aeruginosa and Staphylococcus aureus), and used to visualise their viability. Live bacteria stained green and dead\\/dying bacteria turned red. When inoculated

Geoffrey R. Newman; Michael Walker; Jan A. Hobot; Philip G. Bowler



Development of a Wound Dressing Composed of Hyaluronic Acid Sponge Containing Arginine and Epidermal Growth Factor  

Microsoft Academic Search

Hyaluronic acid (HA) has the ability to promote wound healing. Epidermal growth factor (EGF) is able to promote the proliferation of various cell types, in addition to epidermal cells. A novel wound dressing was designed using high-molecular-weight hyaluronic acid (HMW-HA) and low-molecular-weight hyaluronic acid (LMW-HA). Spongy sheets composed of cross-linked high-molecular-weight hyaluronic acid (c-HMW-HA) were prepared by freeze-drying an aqueous

Yasuhiro Matsumoto; Yoshimitsu Kuroyanagi



Fabrication and characterization of a sponge-like asymmetric chitosan membrane as a wound dressing  

Microsoft Academic Search

A novel asymmetric chitosan membrane has been prepared by immersion–precipitation phase-inversion method and evaluated as wound covering. This new type of chitosan wound dressing which consists of skin surface on top-layer supported by a macroporous sponge-like sublayer was designed. The thickness of the dense skin surface and porosity of sponge-like sublayer could be controlled by the modification of phase-separation process

Fwu-Long Mi; Shin-Shing Shyu; Yu-Bey Wu; Sung-Tao Lee; Jen-Yeu Shyong; Rong-Nan Huang



Facilitated wound healing using transparent film dressing following Mohs micrographic surgery.  


Fifty-eight patients participated in a controlled evaluation that compared a transparent film dressing (TFD [Bioclusive]) with a combination of conventional dry gauze dressing (Curity) and antibiotic ointment (Polysporin) in the treatment of fresh skin wounds following Mohs micrographic surgery. The TFD group showed a faster rate of wound contraction and reepithelialization and a shorter total healing time. The TFD was rated better with regard to comfort, ease of use, and ease of dressing removal. At six-month follow-up, the TFD group had scars that were softer, smoother, and showed less thickening and anatomic deformities. Better cosmetic appearance and greater patient acceptance were also noted with the TFD. PMID:3377519

Hien, N T; Prawer, S E; Katz, H I



Irradiation of polyvinyl alcohol and polyvinyl pyrrolidone blended hydrogel for wound dressing  

Microsoft Academic Search

Polyvinyl alcohol and polyvinyl 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

Mirzan T Razzak; Darmawan Darwis; Zainuddin; Sukirno



The Effects of an Oxygen Generating Dressing on Tissue Infection and Wound Healing  

Microsoft Academic Search

Oxygen is a necessary component of norm a l wound healing and is required for multiple cell functions, including the killing of bacte- ria by leuko cytes. A new ox y g e n - g e n e r a t i n g dressing has been developed that prov i d e s i n t e rmittent

Terry E. Wright; Wyatt G. Payne; Francis Ko; Daniel Ladizinsky; Neil Bowlby; Roy Neeley; Brian Mannari; Martin C. Robson



Flexible and Absorbent Cotton-Alginate Wound Dressing  

Technology Transfer Automated Retrieval System (TEKTRAN)

Although low cost and possessing good tensile properties, cotton gauze provides little or no moist healing because it allows rapid evaporation of moisture that results in a dry desiccated wound bed which is a significant issue with burn wounds since water loss tends to occur at a much greater rate e...


Electrospinning of multicomponent ultrathin fibrous nonwovens for semi-occlusive wound dressings.  


This work describes the design and assembly of multifunctional and cost-efficient composite fiber nonwovens as semi-occlusive wound dressings using a simple electrospinning process to incorporate a variety of functional components into an ultrathin fiber. These components include non-hydrophilic poly(L-lactide) (PLLA) as fibrous backbone, hydrophilic poly(vinyl pyrrolidone)-iodine (PVP-I), TiO(2) nanoparticles, zinc chloride as antimicrobial, odor-controlling, and antiphlogistic agents, respectively. The process of synthesis starts with a multicomponent solution of PLLA, PVP, TiO(2) nanoparticles plus zinc chloride, in which TiO(2) nanoparticles are synthesized by in situ hydrolysis of TiO(2) precursors in a PVP solution for the sake of obtaining the particle-uniformly dispersive solution. Subsequent electrospinning generates the corresponding composite fibers. A further iodine vapor treatment to the composite fibers combines iodine with PVP to produce the PVP-I complexes. Experiments indicate that the assembled composite fibers (300-400 nm) possess the ointment-releasing characteristic and the phase-separate, core-sheath structures in which PVP-I residing in fiber surface layer becomes the sheath, and PLLA distributing inside the fiber acts as the core. Based on this design, the structural advantages combining active components endow the assembled composite nonwovens with a variety of functions, especially, the existence of PVP-I, endows the nonwoven with water absorbability, antimicrobial activity, adhesive ability, and transformable characteristic from hydrophilicity to non-hydrophilicity. The multifunctional, cost-efficient, and ointment-releasing characteristics make the multicomponent composite fibrous nonwovens potentially useful in applications such as initial stage of dressing of the cankerous or contaminated wounds. PMID:18431786

Hong, Youliang; Li, Yanan; Zhuang, Xiuli; Chen, Xuesi; Jing, Xiabin



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

SciTech Connect

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

Edwards, J. V.; Howley, Phyllis; Davis, Rachel M.; Mashchak, Andrew D.; Goheen, Steven C.



A comparative study of the cytotoxicity of silver-based dressings in monolayer cell, tissue explant, and animal models.  


Over the past decade, a variety of advanced silver-based dressings have been developed. There are considerable variations in the structure, composition, and silver content of these new preparations. In the present study, we examined five commercially available silver-based dressings (Acticoat, Aquacel Ag, Contreet Foam, PolyMem Silver, Urgotul SSD). We assessed their cytotoxicity in a monolayer cell culture, a tissue explant culture model, and a mouse excisional wound model. The results showed that Acticoat, Aquacel Ag, and Contreet Foam, when pretreated with specific solutes, were likely to produce the most significant cytotoxic effects on both cultured keratinocytes and fibroblasts, while PolyMem Silver and Urgotul SSD demonstrated the least cytotoxicity. The cytotoxicity correlated with the silver released from the dressings as measured by silver concentration in the culture medium. In the tissue explant culture model, in which the epidermal cell proliferation was evaluated, all silver dressings resulted in a significant delay of reepithelialization. In the mouse excisional wound model, Acticoat and Contreet Foam indicated a strong inhibition of wound reepithelialization on the postwounding-day 7. These findings may, in part, explain the clinical observations of delayed wound healing or inhibition of wound epithelialization after the use of certain topical silver dressings. Caution should be exercised in using silver-based dressings in clean superficial wounds such as donor sites and superficial burns and also when cultured cells are being applied to wounds. PMID:17244325

Burd, Andrew; Kwok, Chi H; Hung, Siu C; Chan, Hui S; Gu, Hua; Lam, Wai K; Huang, Lin


Gentamicin-loaded wound dressing with polyvinyl alcohol/dextran hydrogel: gel characterization and in vivo healing evaluation.  


To develop a gentamicin-loaded wound dressing, cross-linked hydrogel films were prepared with polyvinyl alcohol (PVA) and dextran using the freezing-thawing method. Their gel properties such as gel fraction, swelling, water vapor transmission test, morphology, tensile strength, and thermal property were investigated. In vitro protein adsorption test, in vivo wound healing test, and histopathology were performed. Dextran decreased the gel fraction, maximum strength, and thermal stability of hydrogels. However, it increased the swelling ability, water vapor transmission rate, elasticity, porosity, and protein adsorption. The drug gave a little positive effect on the gel properties of hydrogels. The gentamicin-loaded wound dressing composed of 2.5% PVA, 1.13% dextran, and 0.1% drug was more swellable, flexible, and elastic than that with only PVA because of its cross-linking interaction with PVA. In particular, it could provide an adequate level of moisture and build up the exudates on the wound area. From the in vivo wound healing and histological results, this gentamicin-loaded wound dressing enhanced the healing effect more compared to conventional product because of the potential healing effect of gentamicin. Thus, this gentamicin-loaded wound dressing would be used as a potential wound dressing with excellent forming and improved healing effect in wound care. PMID:20607628

Hwang, Ma-Ro; Kim, Jong Oh; Lee, Jeong Hoon; Kim, Yong Il; Kim, Jeong Hoon; Chang, Sun Woo; Jin, Sung Gju; Kim, Jung Ae; Lyoo, Won Seok; Han, Sung Soo; Ku, Sae Kwang; Yong, Chul Soon; Choi, Han-Gon



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


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



Papain incorporated chitin dressings for wound debridement sterilized by gamma radiation  

NASA Astrophysics Data System (ADS)

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

Singh, Durgeshwer; Singh, Rita



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


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



Chemical and physical properties of a hydrogel wound dressing.  


Geliperm hydrogel provides optimal physiological conditions for wound healing. The material is composed of two interlaced networks, one of polyacrylamide and one of agar, and contains about 96% firmly bound water. It is supplied in smooth, elastic, transparent sheets which are impermeable to bacteria but permeable to gases, salts, metabolites and proteins. Geliperm is nontoxic and has no irritative properties. Mechanical properties, water retention and diffusion of dyes and proteins are reported. Bacterial size should preclude penetration of the gel. The hydrogel in granular form represents a coherent material which could be used in deep fissured wounds and for the treatment of injuries with a large amount of exudation and contamination. PMID:2420380

Kickhöfen, B; Wokalek, H; Scheel, D; Ruh, H



Reduced Cellular Toxicity of a New Silver-Containing Antimicrobial Dressing and Clinical Performance in Non-Healing Wounds  

Microsoft Academic Search

Bacterial colonisation of wounds may delay wound healing. Modern silver-containing dressings are antimicrobial, yet cellular toxicity is a serious side-effect. We provide data for a newly formulated silver-containing oint ment dressing, Atrauman Ag, for antimicrobial activity and cytotoxicity. Atrauman Ag effectively killed a panel of commensal skin as well as pathogenic bacterial strains while cytotoxicity for HaCaT keratinocytes was only

K. Ziegler; R. Görl; J. Effing; J. Ellermann; M. Mappes; S. Otten; H. Kapp; P. Zoellner; D. Spaeth; H. Smola



Preparation of gel film from Bombyx mori silk sericin and its characterization as a wound dressing.  


Sericin is a highly hydrophilic protein family acting as the glue in Bombyx mori silk. In order to apply sericin as a wound dressing, a novel sericin film named gel film was prepared by a simple process without using any chemical modifications: sericin solution was gelled with ethanol into a sheet shape and then dried. Infrared analysis revealed that the sericin gel film contained water-stable beta-sheet networks formed in the gelation step. This structural feature rendered the gel film morphologically stable against swelling and gave it good handling properties in the wet state. The sericin gel film rapidly absorbed water, equilibrating at a water content of about 80%, and exhibited elastic deformation up to a strain of about 25% in the wet state. A culture of mouse fibroblasts on the gel film indicated that it had low cell adhesion properties and no cytotoxicity. These characteristics of sericin gel film suggest its potential as a wound dressing. PMID:19060395

Teramoto, Hidetoshi; Kameda, Tsunenori; Tamada, Yasushi



Greenbottle (Lucilia sericata) larval secretions delivered from a prototype hydrogel wound dressing accelerate the closure of model wounds.  


The resurgence of larval biotherapy as a debridement tool in wound management has been accompanied by several clinical reports highlighting concomitant tissue regeneration. Studies employing in vitro cell motility assays have found that purified excretory/secretory (ES) products from Greenbottle larvae (blowfly, Lucilia sericata) are motogenic for human dermal fibroblasts when used as a supplement in culture media. The objective of the present study was to determine whether ES delivered using a prototype hydrogel wound dressing induced similar motogenic effects on fibroblastic (3T3) and epithelial cells (HaCaTs) comprising a scratched-monolayer wound model. Quantitative analysis by MTT assay failed to detect significant mitogenic effects of ES on either cell type. Quantitative image analysis revealed that ES exposure markedly accelerated wound closure through a motogenic effect on both fibroblasts and keratinocytes. Quantitative histochemical analysis detected significantly higher phosphotyrosine (pTyr) expression in ES-exposed cell cultures than in controls; moreover immunocytochemistry revealed conspicuously raised levels of pTyr expression in cells located at the wound margin. By attenuation with a panel of enzyme inhibitors these effects were attributed to the protease components of ES. The present results suggest that controlled delivery of ES as a follow-up to maggot debridement therapy may be an effective therapeutic option for stimulation of tissue regeneration in wound management. PMID:17137319

Smith, Annie G; Powis, Rachel A; Pritchard, David I; Britland, Stephen T


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


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



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


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



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

Microsoft Academic Search

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

N. Himly; D. Darwis; L. Hardiningsih



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


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


Pilot scale-up and shelf stability of hydrogel wound dressings obtained by gamma radiation  

NASA Astrophysics Data System (ADS)

This study is aimed of producing pilot batches of hydrogel wound dressings by gamma radiation and evaluating their shelf stability. Six batches of 3L capacity were prepared based on poly(vinyl pyrrolidone), agar and polyethylene glycol and they were dispensed in polyester trays, covered with polyester films and sealed in two types of materials: polyethylene bags and vacuum polyethylene bags. Dressings were formed in a single step process for the hydrogel formation and sterilization at 25-30 kGy gamma radiation dose in a JS-9500 Gamma Irradiator (Nordion, Canada). The six batches were initially physicochemical characterized in terms of dimensions and appearance, gel fraction, morphology analysis, hydrogel strength, moisture retention capability and swelling capacity. They were kept under two storage conditions: room temperature (T: 30±2 °C/RH: 70± 5%) and refrigerated temperature (T: 5±3 °C) during 24 months and sterility test was performed. The appearance of membranes was transparent, clear, uncut and flexible; the gel fraction of batches was higher than 75% and the hydrogel surface showed a porous structure. There was a slow decrease of the compression rate 20% until 7 h and about 70% at 24 h. Moisture retention capability in 5 h was similar for all the batches, about 40% and 60% at 37 °C and at room temperature respectively. The swelling of hydrogels in acidic media was strong and in alkaline media the weight variation remains almost stable until 24 h and then there is a loss of weight. The six batches remained sterile during the stability study in the conditions tested. The pilot batches were consistent from batch to batch and remained stable during 24 months.

Soler, Dulce María; Rodríguez, Yanet; Correa, Hector; Moreno, Ailed; Carrizales, Lila



Antibacterial effect of dressings containing multivalent silver ion carried by zirconium phosphate on experimental rat burn wounds.  


To evaluate the antibacterial effect of multivalent silver ion carried by zirconium phosphate (ZP-Ag) both in vitro and in an experimental rat burn wound compared with that of sulfadiazine silver (SD-Ag). Firstly, the minimal inhibition concentration and the minimal bactericidal concentration of ZP-Ag to three different strains of bacteria (Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli) were compared with those of SD-Ag in vitro. Following this dressings containing the same mass of ZP-Ag or SD-Ag were applied to wounds in a rat burn model and their antimicrobial activity assayed. The inflammatory response of the wounds managed with the two kinds of dressings was compared. Both the minimal inhibition concentration and minimal bactericidal concentration of ZP-Ag to S. aureus, P. aeruginosa, and E. coli were two to four times lower than those of SD-Ag. In vivo ZP-Ag had a more effective antibacterial action inhibiting the growth of the above three bacterial strains under burn scar, compared with dressings made from the same mass of SD-Ag. Moreover, the antibacterial effect was unchanged after the ZP-Ag dressings were washed 20 times, while it dramatically decreased after the dressings with SD-Ag were washed 20 times. When covered by either regular or washed ZP-Ag dressings, the wounds showed integrity with no visible inflammatory reaction. However, various extents of inflammatory reactions on or around the wounds covered with regular SD-Ag dressing were observed. This study showed that dressings with ZP-Ag had a prominent and relative long-term antibacterial effect. ZP-Ag dressings could be an effective, low-cost management option for burn wounds. PMID:19128251

Luo, Gaoxing; Tang, Jin; He, Weifeng; Wu, Jun; Ma, Bing; Wang, Xihua; Chen, Xiwei; Yi, Shaoxuan; Zhang, Xiaorong; Li, Xianchang; Fitzgerald, Mark


Positively and negatively charged ionic modifications to cellulose assessed as cotton-based protease-lowering and hemostatic wound agents  

Microsoft Academic Search

Recent developments in cellulose wound dressings targeted to different stages of wound healing have been based on structural\\u000a and charge modifications that function to modulate events in the complex inflammatory and hemostatic phases of wound healing.\\u000a Hemostasis and inflammation comprise two overlapping but distinct phases of wound healing wherein different dressing material\\u000a properties are required to bring pathological events under

J. V. Edwards; Phyllis Howley; Nicolette Prevost; Brian Condon; Judy Arnold; Robert Diegelmann



????????????????Qualitative bacteriology in malignant wounds--a prospective, randomized, clinical study to compare the effect of honey and silver dressings.  


???????????????? Between 5% and 10% of cancer patients develop malignant wounds. In vitro and some clinical studies suggest that silver- or honey-coated dressings may have an antibacterial effect in nonmalignant wounds, but their possible antibacterial effect in malignant wounds remains unknown. A prospective, randomized, single-blind controlled clinical study was conducted to evaluate the bacteriology of malignant wounds and compare the effect of a honey-coated (Group A) to a silver-coated (Group B) dressing on the qualitative bacteriology of malignant wounds. All wound interventions were performed by the same healthcare professional. Swab cultures were obtained at baseline and following a 4-week intervention and were evaluated without information about the patient treatment group. Of the 75 patients with advanced cancer and malignant wounds identified, 67 (34 in group A, 33 in group B; median age 64 years, range 47-92) consented to participate and completed the 4-week study. The majority were women (88%) with breast cancer (79%). No statistically significant differences were found between the type and number of different wound pathogens in the wounds during the course of the study or between Group A and Group B. Neither anti-neoplastic nor antibiotic treatment influenced the presence of wound pathogens. Staphylococci were found in 42%, enteric bacteria in 34%, anaerobic bacteria in 16%, Pseudomonas in 10%, and hemolytic streptococci in 6% of wounds at baseline; in total, 25 different bacterial species were identified. Sixty-one percent (61%) of wounds decreased in size following treatment, but no significant differences were observed between the type and variety of wound pathogens and whether wound size decreased. Although quantitative bacteriological changes may have occurred, the possible antibacterial effect of the honey or silver dressing could not be confirmed in these malignant wounds. Routine wound swabbing of malignant wounds is of little value and should be restricted to cases where signs of infection requiring antibiotic intervention are observed or where resistant organisms require special infection control measures. PMID:21904013

Lund-Nielsen, Betina; Adamsen, Lis; Gottrup, Finn; Rorth, Mikael; Tolver, Anders; Kolmos, Hans Jorn



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


Naturally derived materials are becoming widely used in the biomedical field. Soy protein has advantages over various types of natural proteins employed for biomedical applications due to its low price, non-animal origin and relatively long storage time and stability. In the current study soy protein isolate (SPI) was investigated as a matrix for wound dressing applications. The antibiotic drug gentamicin was incorporated into the matrix for local controlled release and, thus, protection against bacterial infection. Homogeneous yellowish films were cast from aqueous solutions. After cross-linking they combined high tensile strength and Young's modulus with the desired ductility. The plasticizer type, cross-linking agent and method of cross-linking were found to strongly affect the tensile properties of the SPI films. Selected SPI films were tested for relevant physical properties and the gentamicin release profile. The cross-linking method affected the degree of water uptake and the weight loss profile. The water vapor transmission rate of the films was in the desired range for wound dressings (?2300 g m(-2) day(-1)) and was not affected by the cross-linking method. The gentamicin release profile exhibited a moderate burst effect followed by a decreasing release rate which was maintained for at least 4 weeks. Diffusion was the dominant release mechanism of gentamicin from cross-linked SPI films. Appropriate selection of the process parameters yielded SPI wound dressings with the desired mechanical and physical properties and drug release behavior to protect against bacterial infection. These unique structures are thus potentially useful as burn and ulcer dressings. PMID:21911084

Peles, Zachi; Zilberman, Meital



An in vitro method for the quantitative determination of the antimicrobial efficacy of silver-containing wound dressings.  


Treatment with silver-containing wound dressings is becoming an increasingly popular strategy to eliminate growth of opportunistic wound pathogens during the healing process. However, there are concerns over the possible side-effects of silver to the patient; coupled to the cost of silver as an ingredient there is a desire to ensure that wound dressings contain the least quantity of active ingredient to ensure the minimum bactericidal concentration (MBC) of silver is maintained in the wound environment. This requires the ability to determine the efficacy of silver directly within the wound environment; an extremely complicated task that is difficult using classical (plate counting) microbiological assays because these cannot be conducted in situ. Here, we report a quantitative method for determining the efficacy of silver in wound dressings using an isothermal calorimetric method. The growth curves of P. aeruginosa (NCIMB 8628) were recorded in growth medium and in growth medium containing AQUACEL Ag Hydrofiber dressing. It was found that 10 mg of dressing was sufficient to ensure no detectable growth of organism in 2.5 mL of medium inoculated to 10(6) cfu/mL. This corresponded to a silver load of 1.1x10(-6) moles (equivalent to 4.4x10(-4) M, in the volume of medium used in the experiment). Experiments conducted with silver nitrate rather than dressing indicated the MBC of silver against P. aeruginosa was 1x10(-4) M. The results suggested that not all of the silver in the dressing was bioavailable, at least over the lifetime of the experiment. One advantage of this effect would be the lack of excess availability of the silver, which allays fears of potential toxicity to the patient and may provide an extended period of time over which the dressing is bactericidal. PMID:18832021

Gaisford, Simon; Beezer, Anthony E; Bishop, Alistair H; Walker, Michael; Parsons, David



[Timing of dressing removal in the healing of surgical wounds by primary intention: a meta-analysis].  


An appropriate postoperative wound management helps to prevent surgical site infections. However, ideal timing of dressing removal is an unresolved issue in current practice. The objective of this systematic review therefore was to provide a comprehensive synthesis of existing evidence concerning the efficacy of different periods of postoperative dressing removal in surgical wounds which are healing by primary intention. We searched MEDLINE, EMBASE, CINAHL, The Cochrane Library (all in August 2011), and hand-searched additional sources. All randomised controlled trials that were comparing different periods of leaving dressings in place, including not dressing the surgical site at all, and covering wounds until suture removal were included. We conducted our systematic review and meta-analysis in accordance with the recommendations of the Cochrane Collaboration. Eight trials with a total of 2097 participants were included in our meta-analysis. All studies were at high or unclear risk of bias. This meta-analysis did not show a higher rate of wound infections or other wound complications associated with an early dressing removal in wounds that are healing by primary intention: risk difference (RD) -0.01; 95%-confidence interval (CI) -0.03, 0.01. However, conclusions are limited due to bad study quality of included studies. Finally more sound research is needed. PMID:23876662

Eberhardt, Doris; Berg, Almuth; Fleischer, Steffen; Langer, Gero



Severe wound traction-blisters after inadequate dressing application following laparoscopic cholecystectomy: case report of a preventable complication  

PubMed Central

Background The inadequate application of postoperative dressings can lead to significant complications, including skin injuries, compartment syndromes, and potential limb loss. To our knowledge, the occurrence of post laparoscopic cholecystectomy related skin complications have not yet been reported in the peer-reviewed literature. Case Presentation Following laparoscopic cholecystectomy for symptomatic gallstone disease, a seventy eight year old healthy white male broke out in painful erythema on either side of his epigastric port site. Vesicles akin to a partial thickness burns were revealed upon removal of dressings. An unusual indentation created by the dressing, and skin traction by the dressing's adhesive edges were implicated, raising questions about technique of its application. Conclusion Incorrect application of wound dressings can disrupt skin architecture, causing painful blistering. This complication should not occur to patients, as it is theoretically 100% preventable. Avoidance of stretching adhesive dressings, and careful adherence to relevant manufacturers' instructions are recommended.



I dressed your wounds, God healed you--a wounded person's psychology according to Ambroise Parè.  


Ambroise Parè (1510-1590) was actively involved in wound treatment, studying wounds from various points of view. Many of his published works provide cutting-edge insights regarding nutrition, pain, and debridement, as well as psychological counsel for wounded persons--advanced thoughts, considering the times. Parè believed the energy of the human body and mind played an active role in wound healing. Parè's stature, as far as wound care is concerned, is a result of his judgment and wisdom in applying knowledge of human principles to medical practice. Detailing and celebrating events in his life relevant to the practice of wound care underscore the skills and compassion vital to healing regardless of the century. The article title is drawn from the engraving on his tombstone. PMID:16234577

Coppi, Cristina



Photocrosslinkable chitosan as a dressing for wound occlusion and accelerator in healing process.  


Application of ultraviolet light (UV-) irradiation to a photocrosslinkable chitosan (Az-CH-LA) aqueous solution resulted in an insoluble, flexible hydrogel like soft rubber within 60 s. The chitosan hydrogel could completely stop bleeding from a cut mouse tail within 30 s of UV-irradiation and could firmly adhere two pieces of sliced skins of mouse to each other. In order to evaluate its accelerating effect on wound healing, full thickness-skin incisions were made on the back of mice and subsequently an Az-CH-LA aqueous solution was added into the wound and irradiated with UV light for 90 s. Application of the chitosan hydrogel significantly induced wound contraction and accelerated wound closure and healing. Histological examinations also have demonstrated an advanced granulation tissue formation and epithelialization in the chitosan hydrogel treated wounds. The chitosan hydrogel due to its accelerating healing ability is considered to become an excellent dressing for wound occlusion and tissue adhesive in urgent hemostasis situations. PMID:11771703

Ishihara, Masayuki; Nakanishi, Kuniaki; Ono, Katsuaki; Sato, Masato; Kikuchi, Makoto; Saito, Yoshio; Yura, Hirofumi; Matsui, Takemi; Hattori, Hidemi; Uenoyama, Maki; Kurita, Akira



Efficacy of a bio-electric dressing in healing deep, partial-thickness wounds using a porcine model ?.  


????????????????Numerous physical modalities have been used in attempts to augment the healing process, including ultrasound, low- energy light therapy, and electrical stimulation (ES). ES has been shown to benefit tissue repair in a variety of wound types, but variations in study designs, administration, and parameters render its application in clinical practice somewhat unconventional. A dressing was designed to generate an electric potential of 0.6 V to 0.7 V in the presence of moisture, thereby delivering a sustained micro-current without the need for an external power source. The purpose of this study was to examine the effects of this bio-electric dressing (BED) on deep, partial-thickness wounds using six female specific pathogen-free animals and a well established porcine model for wound healing. Wounds (10 mm x 7 mm x 0.5 mm) were created in paravertebral and thoracic areas of these animals using a specialized electrokeratome and covered with the active polyester BED and a polyurethane film dressing (n = 30) (treatment) or an inactive polyester and film dressing (n = 30). Using an epidermal migration assay, wounds were assessed daily from day 4 through day 8 post-wounding. Differences in the proportion of wounds healed were statistically significant (P <0.001) on days 5 and 6 post-wounding. These results show BED is more effective than a control dressing treatment with moisture-retentive dressings in this animal model. Controlled clinical studies are warranted to elucidate the potential clinical implications of this treatment modality. PMID:22933701

Harding, Andrew C; Gil, Joel; Valdes, Jose; Solis, Michael; Davis, Stephen C



Treatment of paediatric burns with a nanocrystalline silver dressing compared with standard wound care in a burns unit: a cost analysis.  


Burns are a leading cause of non-natural death in South African infants and children. Conventional care of partial-thickness burns often requires painful, time consuming and costly twice-daily dressing changes to clean the wound and apply antimicrobial topical agents. A new topical nanocrystalline silver-coated NS dressing (Acticoat; Smith & Nephew) has been developed and is the first-line treatment of choice in many burn centres. However, because of its cost the Department of Health has been reluctant to introduce it as a standard of care. We retrospectively studied 4 randomly selected paediatric burn patients, calculating the cost associated with the use of NS dressings and comparing this with the projected costs of three previously standard burn wound treatment regimens. NS dressings were changed every 3 days based on their sustained and slow release of silver ions over 72 hours. Using NS clearly saved costs compared with the three other regimens. The demonstrated cost savings resulted primarily from the decreased number of dressings, and the presumed shorter hospital stay. PMID:22272852

Cox, S G; Cullingworth, L; Rode, H



Randomised clinical trial of Hydrofiber dressing with silver versus povidone-iodine gauze in the management of open surgical and traumatic wounds.  


This prospective, randomised clinical trial compared pain, comfort, exudate management, wound healing and safety with Hydrofiber dressing with ionic silver (Hydrofiber Ag dressing) and with povidone-iodine gauze for the treatment of open surgical and traumatic wounds. Patients were treated with Hydrofiber Ag dressing or povidone-iodine gauze for up to 2 weeks. Pain severity was measured with a 10-cm visual analogue scale (VAS). Other parameters were assessed clinically with various scales. Pain VAS scores decreased during dressing removal in both groups, and decreased while the dressing was in place in the Hydrofiber Ag dressing group (n = 35) but not in the povidone-iodine gauze group (n = 32). Pain VAS scores were similar between treatment groups. At final evaluation, Hydrofiber Ag dressing was significantly better than povidone-iodine gauze for overall ability to manage pain (P < 0.001), overall comfort (P < or = 0.001), wound trauma on dressing removal (P = 0.001), exudate handling (P < 0.001) and ease of use (P < or = 0.001). Rates of complete healing at study completion were 23% for Hydrofiber Ag dressing and 9% for povidone-iodine gauze (P = ns). No adverse events were reported with Hydrofiber Ag dressing; one subject discontinued povidone-iodine gauze due to adverse skin reaction. Hydrofiber Ag dressing supported wound healing and reduced overall pain compared with povidone-iodine gauze in the treatment of open surgical wounds requiring an antimicrobial dressing. PMID:17425549

Jurczak, Florent; Dugré, Thierry; Johnstone, Alison; Offori, Theodor; Vujovic, Zorica; Hollander, Dirk



In vivo and cytotoxic assays of a poly(vinyl alcohol)/clay nanocomposite hydrogel wound dressing.  


In the present work, a nanocomposite hydrogel wound dressing was prepared on the basis of poly(vinyl alcohol) using organically-modified montmorillonite as nanoclay by the freezing-thawing cyclic method. In vivo assays were performed to evaluate its performance as an applicable wound dressing on animals. It showed an improved healing process for wounds covered by the prepared nanocomposite hydrogel compared with control wounds covered by sterile gauze. Significant improvements, such as better creation of moist surfaces on the wound with less scar formation, shorter duration of healing operation and better closing of the wound edges with enhanced tensile properties of the healed wound, i.e., tensile strength and elongation-at-break, were observed using the prepared nanocomposite hydrogel in comparison to the sterile gauze. An in vitro cytotoxic assay was also utilized to determine the biocompatibility of the prepared nanocomposite hydrogel. It showed that the prepared nanocomposite hydrogel is non-toxic and can be used as a biocompatible wound dressing in practical wound management. PMID:20566071

Sirousazar, Mohammad; Kokabi, Mehrdad; Hassan, Zuhair Muhammad



A Prospective, Randomised, Controlled Trial Comparing Wound Dressings Used in Hip and Knee Surgery: Aquacel and Tegaderm Versus Cutiplast  

PubMed Central

INTRODUCTION Cutiplast (absorbent perforated dressing with adhesive border; Smith & Nephew) is commonly used following orthopaedic operation, but complications of its use have been reported. A prospective, randomised, controlled study was performed to compare the efficacy of Cutiplast versus an Aquacel (hydrofibre dressing; ConvaTec) covered with Tegaderm (vapour-permeable dressing; 3M). PATIENTS AND METHODS Two-hundred patients were randomised to receive one of the two dressings following elective and non-elective surgery of the hip and the knee. We were able to study 183 patients. The condition of the wound and any complications such as skin blistering or signs of infection was noted as was the frequency of dressing changes. RESULTS The Aquacel and Tegaderm dressing was 5.8 times more likely to result in a wound with no complications as compared to a Cutiplast dressing (odds ratio, 5.8; 95% CI 2.8–12.5; P < 0.00001). CONCLUSION Aquacel covered by Tegaderm is a superior dressing to Cutiplast following surgery to the hip and knee.

Ravenscroft, MJ; Harker, J; Buch, KA



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


To create a moist environment for rapid wound healing, a hydrosheet composed of alginate, chitin/chitosan, and fucoidan (ACF-HS) has been developed as a functional wound dressing. The aim of this study was to evaluate the accelerating effect of ACF-HS on wound healing for rat mitomycin C-treated healing-impaired wounds. Full-thickness skin defects were made on the back of rats and mitomycin C was applied onto the wound for 10 minutes to prepare a healing-impaired wound. After thoroughly washing out the mitomycin C, ACF-HS was applied to the healing-impaired wounds. The rats were later euthanized and histological sections of the wounds were prepared. The histological examinations showed significantly advanced granulation tissue and capillary formations in the healing-impaired wounds treated with ACF-HS on days 7 and 14, in comparison with that in alginate fiber (Kaltostat), hydrogel wound dressing (DuoACTIVE), and nontreatment (negative control). Furthermore, in cell culture studies, ACF-HS-absorbed serum and fibroblast growth factor-2 was found to be proliferative for fibroblasts and endothelial cells, respectively, and ACF-HS-absorbed serum was found to be chemoattractive for fibroblasts. However, our results may not be strictly comparable with general healing-impaired wound models in humans because of the cell damage by mitomycin C. In addition, more biocompatibility studies of fucoidan are essential due to the possibility of renal toxicity. PMID:20731799

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



Case Report: Treatment of Severe Subcutaneous Emphysema With a Negative Pressure Wound Therapy Dressing  

PubMed Central

Objective: This article describes a patient who developed severe subcutaneous emphysema and a persistent air leak after several attempts at needle thoracostomy for what was thought to be a tension pneumothorax. Subcutaneous emphysema was effectively treated with a topical negative pressure wound therapy dressing applied to a typical subfacial “blowhole” incision. This article aims to describe and contextualize the use of negative pressure wound therapy within the existing treatment options for subcutaneous emphysema. Methods: A case report of the clinical course and technique was drafted, and the relevant literature in PubMed was reviewed. Results: The level of subcutaneous emphysema decreased significantly within 48 hours of negative pressure wound therapy as confirmed with physical examination and computed tomography scans. Negative pressure wound therapy for subcutaneous emphysema has not been previously described in the literature. Conclusions: Negative pressure wound therapy applied over subfascial incisions is a novel technique that effectively and rapidly controlled massive subcutaneous emphysema and persistent air leak. This technique may be efficacious in other cases of subcutaneous emphysema.

Sciortino, Christopher M.; Mundinger, Gerhard S.; Kuwayama, David P.; Yang, Stephen C.; Sussman, Marc S.



A drug-free oral hydrogel wound dressing for pain management in immediate denture patients.  


This article evaluated a drug-free oral hydrogel wound dressing composed entirely of natural food ingredients for its ability to relieve pain in immediate denture patients. Evaluation occurred at a 24-hour postoperative appointment. For this crossover study, 44 patients who were taking oral narcotics evaluated their discomfort (using a scale of 0-10) at 1, 3, 5, and 10 minutes after denture insertion with no topical treatment and again after SockIt! Oral Pain Gel was applied to the dentures. The gel provided statistically significant pain relief at all time points beyond that provided by oral narcotic alone (p < 0.0001). PMID:19903626

Kennedy, Thomas J; Hall, John E


Polysaccharides and cellulose in the design of wound healing materials  

Technology Transfer Automated Retrieval System (TEKTRAN)

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


Polysaccharides and Cellulose in the Design of Wound Healing Materials  

Technology Transfer Automated Retrieval System (TEKTRAN)

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


Development and Characterization of Novel Medicated Hydrogels for Wound Dressing  

Microsoft Academic Search

The medicated hydrogels were prepared aseptically under moist heat treatment using polyvinylpyrrolidone (PVP), sodium-carboxymethylcellulose (CMC), polyethyleneglycol (PEG), agar, glycerin and\\/or boric acid (BA) and designated as PVP-CMC and PVP-CMC-BA. The aim of this study was to develop some medicinal values–based hydrogels. BA was used to build up the medicinal values (antiseptic and antimicrobial properties) within the hydrogels. Optical images, scanning

Niladri Roy; Nabanita Saha; Takeshi Kitano; Petr Saha



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

SciTech Connect

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

Roberts, D.B.; Travis, E.L. [Univ. of Texas M.D. Anderson Cancer Center, Houston, TX (United States)



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


Silk fibroin (SF) has been widely used as a wound dressing material due to its suitable physical and biological characteristics. In this study, a non-adhesive wound dressing which applies to cover the wound surface as an absorbent pad that would absorb wound fluid while accelerate wound healing was developed. The modification of SF fabrics by wax coating was purposed to prepare the non-adhesive wound dressing that is required in order to minimize pain and risk of repeated injury. SF woven fabrics were coated with different types of waxes including shellac wax, beeswax, or carnauba wax. Physical and mechanical properties of the wax-coated SF fabrics were characterized. It was clearly observed that all waxes could be successfully coated on the SF fabrics, possibly due to the hydrophobic interactions between hydrophobic domains of SF and waxes. The wax coating improved tensile modulus and percentage of elongation of the SF fabrics due to the denser structure and the thicker fibers coated. The in vitro degradation study demonstrated that all wax-coated SF fabrics remained up to 90% of their original weights after 7 weeks of incubation in lysozyme solution under physiological conditions. The wax coating did not affect the degradation behavior of the SF fabrics. A peel test of the wax-coated SF fabrics was carried out in the partial- and full-thickness wounds of porcine skin in comparison to that of the commercial wound dressing. Any wax-coated SF fabrics were less adhesive than the control, as confirmed by less number of cells attached and less adhesive force. This might be that the wax-coated SF fabrics showed the hydrophobic property, allowing the loosely adherence to the hydrophilic wound surface. In addition, the in vivo biocompatibility test of the wax-coated SF fabrics was performed in Sprague-Dawley rats with subcutaneous model. The irritation scores indicated that the carnauba wax-coated SF fabric was not irritant while the shellac wax or beeswax-coated SF fabrics were slightly irritant, comparing with the commercial wound dressing. Therefore, SF fabrics coated with waxes, particularly carnauba wax, would be promising choices of non-adhesive wound dressing. PMID:23313451

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



The management of wounds following primary lower limb arthroplasty: a prospective, randomised study comparing hydrofibre and central pad dressings.  


Wound care following lower limb arthroplasty has not been subject to in-depth clinical research, primarily because such wounds usually heal without complication. However, when prosthetic implants are used, serious wound problems can be disastrous (Whitehouse et al. Infect Control Hosp Epidemiol 2002;23:183-9; Lindwell OM. Clin Orthop Relat Res 1986;211:91-103). We report the results of a prospective, randomised, controlled trial comparing a hydrofibre (Aquacel) and central pad (Mepore) dressing in the management of acute wounds following primary total hip or knee arthroplasty left to heal by primary intention. Dressing performance was measured in 61 patients receiving total hip or knee replacements. There was a significant reduction in the requirement for dressing changes before five postoperative days in the hydrofibre group (43% compared with 77% in the central pad group), and there were fewer blisters amongst patients in the hydrofibre group (13% compared with 26% in the central pad group). We conclude that there is a potential role for hydrofibre dressing in the management of arthroplasty wounds. PMID:17007343

Abuzakuk, Tarek M; Coward, Pamela; Shenava, Y; Kumar, V Senthil; Skinner, John A



A retrospective analysis of ambulatory burn patients: focus on wound dressings and healing times  

PubMed Central

INTRODUCTION In this study, we retrospectively analysed healing times of ambulatory burn patients after silver-based dressings were introduced in late December 2005, and compared the results with those obtained before. PATIENTS AND METHODS Data were collected in November–December 2005 and in January–February 2006. We excluded from the study: (i) admitted patients; (ii) patients with mixed superficial partial thickness and deep partial thickness burns; (iii) patients with full-thickness burns; and (iv) operated patients that came for follow-up. We recorded the age, sex, cause (flame vs scald), burn depth, dressings used and healing times. RESULTS We selected 347 patients corresponding to 455 burned areas (64.4% superficial and 35.6% deep; 47.7% treated in 2005 and 52.3% in 2006). During the years 2005 and 2006, there was an increase in the use of silver-based dressings (2005, 9.7%; 2006, 38.7%; chi-squared test, P < 0.001) and a decrease in the use of paraffin gauzes (2005, 66.4%; 2006, 40.3%; chi-squared test, P < 0.001). The healing time of overall burns and of superficial burns showed no significant differences between 2005 and 2006. However, in deep partial thickness burns, a significant reduction was present (2006, 19; 2005, 29 days; Student's t-test, P < 0.01). Among all dressings, paraffin gauzes had the shortest healing times in superficial burns (5 days); with silver-based dressings in deep burns, the healing times were nanocrystalline silver (16 days) and silver carboxymethylcellulose (21 days). CONCLUSIONS Results of our retrospective study would suggest that paraffin gauzes are a valuable option in superficial burns, while silver-based dressings are preferable in deep burns.

Gravante, Gianpiero; Montone, Antonio



Development of a wound dressing composed of a hyaluronic acid sponge containing arginine.  


Spongy sheets composed of cross-linked high-molecular-weight (HMW) hyaluronic acid (HA) were prepared by freeze-drying an aqueous HMW-HA solution containing cross-linking agent (Group I). The Group I sheet was immersed into an aqueous low-molecular-weight (LMW) HA solution with or without L-arginine (Arg) and was then freeze-dried to prepare several types of spongy sheets (Groups II-V). The amount of Arg was 1.0 g, 0.5 g, 0.2 g and 0 g in Groups III, IV, V and II, respectively. In the first experiment, each spongy sheet was applied to a full-thickness skin defect with a diameter of 35 mm in the abdominal region of SD rats, with intact skin in the central area measuring 15 mm in diameter. Commercially available polyurethane film dressing was applied over each spongy sheet as a covering material. The control group was covered with polyurethane film dressing alone. All spongy sheets promoted epithelization, as well as angiogenesis, as compared with controls. These findings indicate that HA and Arg are essential for wound healing. Re-epithelizaion was particularly active in Groups IV and V. In the second experiment, each spongy sheet was applied to a full-thickness burn injury measuring 35 mm in diameter in the abdominal region of SD rats, after necrotic skin was surgically removed. Groups II-V showed decreased wound size when compared with Group I and controls. The present findings indicate that the release of LMW-HA and Arg from a cross-linked HMW-HA spongy sheet effectively stimulates wound healing. PMID:19454165

Matsumoto, Yasuhiro; Arai, Kiwako; Momose, Hitomi; Kuroyanagi, Yoshimitsu



Gentamicin-Loaded Wound Dressing With Polyvinyl Alcohol\\/Dextran Hydrogel: Gel Characterization and In Vivo Healing Evaluation  

Microsoft Academic Search

To develop a gentamicin-loaded wound dressing, cross-linked hydrogel films were prepared with polyvinyl alcohol (PVA) and\\u000a dextran using the freezing–thawing method. Their gel properties such as gel fraction, swelling, water vapor transmission test,\\u000a morphology, tensile strength, and thermal property were investigated. In vitro protein adsorption test, in vivo wound healing test, and histopathology were performed. Dextran decreased the gel fraction,

Ma-Ro Hwang; Jong Oh Kim; Jeong Hoon Lee; Yong Il Kim; Jeong Hoon Kim; Sun Woo Chang; Sung Gju Jin; Jung Ae Kim; Won Seok Lyoo; Sung Soo Han; Sae Kwang Ku; Chul Soon Yong; Han-Gon Choi



Inhibition of Connective Tissue Formation in Dermal Wounds Covered with Synthetic, Moisture Vapor-Permeable Dressings and its Reversal by Transforming Growth Factor-?  

Microsoft Academic Search

An investigation of synthetic, adherent, moisture vapor-permeable dressings (SAM) on dermal wounds healing by secondary intent has yielded the novel observation that SAM dressings severely inhibited the deposition of granulation tissue and subsequent collagenous tissue when compared with air-exposed wounds in mouse and guinea pig systems. Repair tissue was quantitated histomorphometrically in full-thickness wounds covered with SAM or left air-exposed

George A. Ksander; Bruce M. Pratt; Paula Desilets-Avis; Carolyn O. Gerhardt; John M. McPherson



Effects of nitric oxide releasing poly(vinyl alcohol) hydrogel dressings on dermal wound healing in diabetic mice.  


Healing of chronic wounds such as diabetic foot ulcers is a significant clinical problem. Methods of accelerating healing in these difficult lower extremity sites include use of growth factor-loaded gels, hyperbaric oxygen, grafts, and artificial skin replacements. Nitric oxide (NO) has been proposed as a possible active agent for enhancing wound healing. This study examines the in vitro and in vivo responses to a novel hydrogel that produces therapeutic levels of NO. A hydrogel wound dressing was fabricated using ultraviolet light-initiated polymerization from poly(vinyl alcohol) with a NO donor covalently coupled to the polymer backbone. NO release from the NO-modified hydrogel was shown to occur over a time period of up to 48 hours, and there was no associated decrease in fibroblast growth or viability in vitro associated with NO hydrogels. Fibroblasts in culture with NO hydrogels had an increased production of extracellular matrix compared with cells cultured without the NO hydrogels. Preliminary animal studies in a diabetic mouse, impaired wound healing model were conducted comparing low (0.5 mM) and high (5 mM) doses of NO. Time to complete closure was similar in control wounds and NO-treated wounds; however, at 8 days control wounds were significantly smaller than NO-treated wounds. By days 10 to 13 this delay was no longer apparent. Granulation tissue thickness within the wounds at days 8 and 15 and scar tissue thickness after wound closure were increased in animals exposed to higher dose NO hydrogels. The results of this study suggest that exogenous NO released from a hydrogel wound dressing has potential to modulate wound healing. PMID:12406164

Masters, Kristyn S Bohl; Leibovich, S Joseph; Belem, Paula; West, Jennifer L; Poole-Warren, Laura A


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

Technology Transfer Automated Retrieval System (TEKTRAN)

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


[The use of fibrous wound dressing sheets made of carboxymethylcellulose natrium in the postoperative management of tracheostomy].  


Postoperative management of tracheostomy is very important to reduce several complications such as abnormal granulation and subcutaneous abscess. One of the causes is the use of gauzes and a disinfectant because they induce the secondary wound injury and prevention of wound healing. We used a fibrous wound dressing, carboxymethylcellulose natrium sheet (Aquacel) on the postoperative management of tracheostomy for 5 patients. The sheets were very useful to absorb exudates including blood and to make suitable moist and clean surroundings in all patients. PMID:16281857

Tsunezuka, Y; Suzuki, M; Nitta, K; Oda, M



Irradiation of polyvinyl alcohol and polyvinyl pyrrolidone blended hydrogel for wound dressing  

NASA Astrophysics Data System (ADS)

Polyvinyl alcohol and polyvinyl 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 200g/m2/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.; Darwis, D.; Zainuddin,; Sukirno,



Computer-generated virtual reality to control pain and anxiety in pediatric and adult burn patients during wound dressing changes.  


Changing daily wound dressings provokes a substantial amount of pain in patients with severe burn wounds. Pharmacological analgesics alone often are inadequate to solve this problem. This study explored whether immersive virtual reality (VR) can reduce the procedural pain and anxiety during an entire wound care session and compared VR to the effects of standard care and other distraction methods. Nineteen inpatients ages 8 to 65 years (mean, 30 years) with a mean TBSA of 7.1% (range, 0.5-21.5%) were studied using a within-subject design. Within 1 week of admission, standard care (no distraction), VR, or another self-chosen distraction method was administered during the wound dressing change. Each patient received the normal analgesic regimen. Pain was measured with visual analog thermometer scores, and anxiety was measured with the state-version of the Spielberger State Trait Anxiety Inventory. After comparing different distraction methods, only VR and television showed significant pain reductions during wound dressing changes. The effects of VR were superior, but not statistical significant, to that of television. Thirteen of 19 patients reported clinically meaningful (33% or greater) reductions in pain during VR distraction. No side effects were reported. No correlations were found between the reduction in pain ratings and patient variables like age, sex, duration of hospital stay, or percentage of (deep) burns. There was no significant reduction of anxiety ratings. PMID:17667488

van Twillert, Björn; Bremer, Marco; Faber, Albertus W


Curcumin Loaded Poly(?-Caprolactone) Nanofibers: Diabetic Wound Dressing with Antioxidant and Anti-inflammatory Properties  

PubMed Central

1. Curcumin is a naturally occurring poly-phenolic compound with a broad range of favorable biological functions including anti-cancer, anti-oxidant and anti-inflammatory activities. The low bioavailability and in vivo stability of curcumin require the development of suitable carrier vehicles to deliver the molecule in a sustained manner at therapeutic levels. 2. We investigated the feasibility and potential of poly(caprolactone) (PCL) nanofibers as a delivery vehicle for curcumin for wound healing applications. By optimizing the electrospinning parameters, bead-free curcumin loaded PCL nanofibers were developed. 3. The fibers showed sustained release of curcumin for 72 h and could be made to deliver a dosage much lower than the reported cytotoxic concentration while remaining bioactive. Human foreskin fibroblast cells (HFF-1) showed more than 70% viability on curcumin loaded nanofibers. The antioxidant activity of curcumin loaded nanofibers was demonstrated using an ORAC assay and by the ability of the fibers to maintain the viability of HFF-1 cells on the fibers under a condition of oxidative stress. The curcumin loaded nanofibers also reduced inflammatory induction as evidenced by low levels of IL-6 release from mouse monocyte-macrophages seeded on the fibers following stimulation by E.coli-derived lipopolysaccharide (LPS). The in vivo wound healing capability of the curcumin loaded PCL nanofibers was demonstrated by an increased rate of wound closure in a streptozotocin (STZ) induced diabetic mice model. 4. These results demonstrate that curcumin loaded PCL nanofiber matrix is bioactive and has potential as a wound dressing with antioxidant and anti-inflammatory properties.

Merrell, Jonathan G.; McLaughlin, Shaun W.; Tie, Lu; Laurencin, Cato T.; Chen, Alex F.; Nair, Lakshmi S.



Cytotoxicity of silver dressings on diabetic fibroblasts.  


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



Fabrication of Chitosan/Silk Fibroin Composite Nanofibers for Wound-dressing Applications  

PubMed Central

Chitosan, a naturally occurring polysaccharide with abundant resources, has been extensively exploited for various biomedical applications, typically as wound dressings owing to its unique biocompatibility, good biodegradability and excellent antibacterial properties. In this work, composite nanofibrous membranes of chitosan (CS) and silk fibroin (SF) were successfully fabricated by electrospinning. The morphology of electrospun blend nanofibers was observed by scanning electron microscopy (SEM) and the fiber diameters decreased with the increasing percentage of chitosan. Further, the mechanical test illustrated that the addition of silk fibroin enhanced the mechanical properties of CS/SF nanofibers. The antibacterial activities against Escherichia coli (Gram negative) and Staphylococcus aureus (Gram positive) were evaluated by the turbidity measurement method; and results suggest that the antibacterial effect of composite nanofibers varied on the type of bacteria. Furthermore, the biocompatibility of murine fibroblast on as-prepared nanofibrous membranes was investigated by hematoxylin and eosin (H&E) staining and MTT assays in vitro, and the membranes were found to promote the cell attachment and proliferation. These results suggest that as-prepared chitosan/silk fibroin (CS/SF) composite nanofibrous membranes could be a promising candidate for wound healing applications.

Cai, Zeng-xiao; Mo, Xiu-mei; Zhang, Kui-hua; Fan, Lin-peng; Yin, An-lin; He, Chuang-long; Wang, Hong-sheng



Comparision of Vacuum-Asisted Closure and Moist Wound Dressing in the Treatment of Diabetic Foot Ulcers  

PubMed Central

Background: Vacuum-assisted closure (VAC) is a new method in wound care which speeds wound healing by causing vacuum, improving tissue perfusion and suctioning the exudates. This study aims to evaluate its efficacy in the treatment of diabetic foot ulcers. Materials and Methods: Thirteen patients with diabetic foot ulcers were enrolled in the moist dressing group, and 10 patients in the VAC group. The site, size and depth of the wound were inspected and recorded before and every three days during the study period. Patient satisfaction and formation of granulation tissue were also assessed. Results: Improvement of the wound in the form of reducing the diameter and depth and increasing proliferation of granulation tissue was significant in most of the patients of the VAC group after two weeks. Satisfaction of patients in the VAC group was evaluated as excellent as no amputation was done in this group. Wagner score was reduced in both the study groups, although this decrement was not significant in the moist dressing group. Conclusion: VAC appears to be as safe as and more efficacious than moist dressing for the treatment of diabetic foot ulcers.

Ravari, Hassan; Modaghegh, Mohammad-Hadi Saeed; Kazemzadeh, Gholam Hosein; Johari, Hamed Ghoddusi; Vatanchi, Attieh Mohammadzadeh; Sangaki, Abolghasem; Shahrodi, Mohammad Vahedian



A Randomized Control Trial of The Effectiveness of OpSite Wound Versus lV. 3000 In Maintaining An Occlusive Central Line Dressing  

Microsoft Academic Search

The use of both percutaneous and tunnelled central venous catheters in hospitalized patients has increased markedly over the last decade (Camp-Sorrell, 1990). With this increase, there is a clinical need to have an occlusive central line dressing to maintain a barrier to possible site contamination. This randomized control trial examined the use of the transparent dressing OpSite Wound (Smith and

Neufeld Marilyn R. N



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

PubMed Central

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

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



Lidocaine Analgesia for Removal of Wound Vacuum-Assisted Closure Dressings: A Randomized Double-Blinded Placebo-Controlled Trial.  


OBJECTIVES: Wound vacuum-assisted closure (VAC) is a technique used frequently by orthopedic surgeons to facilitate wound closure. Bedside VAC removal can be a source of great pain for patients, which we hypothesize can be decreased by topical lidocaine application. DESIGN: This was a prospective randomized double-blinded, placebo-controlled trial (registered on, utilizing the crossover intervention technique. SETTING: The study was carried out at a level 1 trauma center. PATIENTS/PARTICIPANTS: Nondiabetic, adult patients requiring at least 2 extremity wound VAC dressing changes were involved. INTERVENTION: In a double-blinded fashion, topical lidocaine (1%) was compared with topical normal saline (0.9% NaCl) after injection into the VAC sponge. The crossover intervention technique, wherein each patient received an independent VAC change with lidocaine and saline, served to control for all possible patient characteristics. Randomization determined which sample was given first or second. MAIN OUTCOME MEASUREMENTS: The patients were evaluated for visual analog pain scores, narcotic requirement, and wound characteristics. RESULTS: A total of 11 patients were enrolled for a total of 21 VAC changes (mean wound size 133 cm); 1 patient withdrew after his first VAC dressing was changed with saline. Controlling for pre-VAC change pain, the lidocaine intervention was associated with 2.4 points less on the 0-10 visual analog scale for pain (P value <0.001, -3.0 to -1.7) and 1.7 mg less morphine-equivalents administered (P value <0.001, -2.3 to -1.1) during the VAC sponge removal. CONCLUSIONS: The patients undergoing an extremity wound VAC dressing removal at the bedside should be pretreated with topical lidocaine because it decreases pain and narcotic requirements. PMID:22495520

Christensen, Thomas J; Thorum, Troy; Kubiak, Erik N



A berberine-loaded electrospun poly-(epsilon-caprolactone) nanofibrous membrane with hemostatic potential and antimicrobial property for wound dressing.  


In this study, a berberine-loaded electrospun poly-(epsilon-caprolactone) nanofibrous membrane (B-NFM) was formulated. The B-NFM was composed of uniform nanofibers with the average diameter of 190 +/- 53 nm. Whole blood assay revealed that the B-NFM had higher absorption capacity than gauze wound dressing (GWD) and non-drug-loaded nanofibrous membrane (NFM). Hemostatic studies showed that the B-NFM was more efficient at promoting blood clotting than GWD and NFM. B-NFM was also demonstrated to possess broad-spectrum antimicrobial activity. Biocompatibility studies indicated that B-NFM had good compatibility with skin fibroblast cells. These results suggested that the B-NFM can promote in vitro hemostasis to minimize wound bleeding, absorb biofluid to provide a favorable environment, inhibit on-site microbial agents to prevent wound infection, and support skin cell growth to facilitate wound healing. These data highly suggest a potential clinical use of B-NFM as wound dressing material. PMID:23909131

Bao, Jing; Yang, Bo; Sun, Yuyu; Zu, Youli; Deng, Ying



Fabrication of a novel poly(3-hydroxyoctanoate)/ nanoscale bioactive glass composite film with potential as a multifunctional wound dressing  

SciTech Connect

Fabrication of a composite scaffold of nanobioglass (n-BG) 45S5 and poly(3-hydroxyocatnoate), P(3HO) was studied for the first time with the aim of developing a novel, multifunctional wound dressing. The incorporation of n-BG accelerated blood clotting time and its incorporation in the polymer matrix enhanced the wettability, surface roughness and bio-compatibility of the scaffold.

Rai, Ranjana; Keshavarz, Tajalli; Roy, Ipsita [Department of Molecular and Applied Biosciences, University of Westminster, London W1W 6UW (United Kingdom); Boccaccini, Aldo R. [Department of Materials, Imperial College London, London SW7 2AZ (United Kingdom)] [Department of Materials Science and Engineering, University of Erlangen, Nuremberg Cauestr. 6. 91058 (Germany); Knowles, Jonathan C.; Salih, Vehid; Mordon, Nicola [Division of Biomterials and Tissue Engineering, UCL Eastman Dental Institute, London WCIX 8LD (United Kingdom); Locke, Ian C.; Gordge, Michael P. [Department of Biomedical Sciences, School of Lifesciences, University of Westminster, London W1W 6UW (United Kingdom); McCormick, Aine [Haemophilia Reference Centre, St. Thomas' Hospital, Lambeth Palace Road, London SE1 7EH (United Kingdom)



Fabrication of a novel poly(3-hydroxyoctanoate) / nanoscale bioactive glass composite film with potential as a multifunctional wound dressing  

NASA Astrophysics Data System (ADS)

Fabrication of a composite scaffold of nanobioglass (n-BG) 45S5 and poly(3-hydroxyocatnoate), P(3HO) was studied for the first time with the aim of developing a novel, multifunctional wound dressing. The incorporation of n-BG accelerated blood clotting time and its incorporation in the polymer matrix enhanced the wettability, surface roughness and bio-compatibility of the scaffold.

Rai, Ranjana; Boccaccini, Aldo R.; Knowles, Jonathan C.; Locke, Ian C.; Gordge, Michael P.; McCormick, Aine; Salih, Vehid; Mordon, Nicola; Keshavarz, Tajalli; Roy, Ipsita



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

PubMed Central

Summary 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.

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



The Effectiveness of Using a Lipido-Colloid Dressing for Patients With Traumatic Digital Wounds  

Microsoft Academic Search

This study compares the effect of a daily gauze dressing with that of a lipidocolloid dressing on the time taken to make up the dressing and efficacy of the management of traumatic digitalwounds. This is a randomized controlled trial of 28 patients (16 experimental and 12 control) with injuries to their fingers and loss of tissue. The patients in the

K. K. Ma; M. F. Chan; S. M. C. Pang



Open-label clinical trial comparing the clinical and economic effectiveness of using a polyurethane film surgical dressing with gauze surgical dressings in the care of postoperative surgical wounds.  


Surgical site infection (SSI) is a common postoperative complication and can cause avoidable morbidity and excessive costs for the health service. Novel dressings, designed specifically for postoperative wounds, can help to reduce the risk of SSI and other complications like blistering. This study compared the use of a new polyurethane film surgical dressing (Opsite Post-Op Visible, Smith & Nephew, Hull, UK) with gauze and tape in the management of postoperative wounds. The results show that the polyurethane film dressing results in a significant reduction in SSI (1·4% versus 6·6%, P?=?0·006) as well as a reduction in other postoperative wound complications (e.g. blistering and erythema). Economic analysis conducted alongside the study suggests that these improved outcomes can be achieved at a lower total treatment cost than gauze and tape dressings. The modest incremental cost of the polyurethane film surgical dressing is easily offset by the reduction in the costs associated with treating SSI and other wound complications associated with gauze and tape dressings. PMID:23742125

Abejón Arroyo, Ana; López Casanova, Pabló; Verdú Soriano, José; Torra I Bou, Joan-Enric



Gelation time, homogeneity, and rupture testing of alginate-calcium carbonate-hydrogen peroxide gels for use as wound dressings.  


The care of chronic wounds carries a heavy financial burden on the healthcare industry, with billons being spent annually on their treatment. This, coupled with a decreased quality of life for sufferers, has led to a real urgency in developing inexpensive wound dressings that promote wound healing. Alginate gels for application as wound dressings were formed by varying alginate (0%-6% w/v), calcium carbonate (0%-1% w/v), hydrogen peroxide (0%-3.75% v/v), and hyaluronic acid (0-1.25 mg/L) content. The aging effects on the physical properties of the gels over a 14-day period were also investigated. The results indicated that the concentration of calcium carbonate and hydrogen peroxide, as well as sample age, all had a significant effect on the rupture characteristics and gelation time of the gels. Increased calcium carbonate content caused an increase in rupture force and rupture energy values, whereas increased hydrogen peroxide content and sample age resulted in a decrease in rupture force and rupture energy measurements. Increased calcium carbonate and hydrogen peroxide content produced a decrease in the time required for gel formation. Statistical models were also produced to provide a means of estimating rupture characteristics and gelation times for gels containing other concentrations of these components. © 2011 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2012. PMID:22121142

Alexander, Brendan R; Murphy, Kathleen E; Gallagher, Joanne; Farrell, Garrett F; Taggart, Gertie



Comparative study of the microvascular blood flow in the intestinal wall, wound contraction and fluid evacuation during negative pressure wound therapy in laparostomy using the V.A.C. abdominal dressing and the ABThera open abdomen negative pressure therapy system.  


To compare the changes in microvascular blood flow in the small intestinal wall, wound contraction and fluid evacuation, using the established V.A.C. abdominal dressing (VAC dressing) and a new abdominal dressing, the ABThera open abdomen negative pressure therapy system (ABThera dressing), in negative pressure wound therapy (NPWT). Midline incisions were made in 12 pigs, which were subjected to treatment with NPWT using the VAC or ABThera dressing. The microvascular blood flow in the intestinal wall, were measured before and after the application at topical negative pressures of -50, -75 and -125?mmHg, using laser Doppler velocimetry. Wound contraction and fluid evacuation were also measured. Baseline blood flow was defined as 100% in all settings. The blood flow was significantly reduced, to 64·6?±?6·7% (P?dressing, and to 65·3?±?9·6% (P?dressing. The blood flow was significantly reduced, to 39·6?±?6·7% (P?wound compared to the VAC system. There was no difference between the dressings regarding the reduction in blood flow, but the ABThera dressing afforded better drainage of the abdomen and better wound contraction than the VAC dressing. PMID:23517436

Lindstedt, Sandra; Malmsjö, Malin; Hlebowicz, Joanna; Ingemansson, Richard



Use of Antiseptics in Managing Difficult Wounds  

Microsoft Academic Search

Wound care regimes have changed dramatically over the past 35 years. The principles of most types of wound healing have been investigated in detail and implemented with effect, as part of evidence-based wound healing practice compatible with the science of wound healing physiology. Occlusive dressings are important adjuncts to the armamentarium of the practitioner in charge of open wounds. Topical

Joan Faoagali



Changes to dose at surface and shifts of dose distributions at depth through dry and wet wound dressings for photon and electron beam radiotherapy.  


Wound dressings are used during patient radiotherapy treatments, particularly in cases of radiation induced lesions. Potentially, the presence of a dressing may increase the dose to the skin, further aggravating the skin reaction and decrease the dose at depth. The changes are dependent on linear accelerator beam type and beam quality and were determined for 4 and 10 MV photon energies and 6 and 15 MeV electron energies using a slab phantom and fixed separation parallel plate chambers. Since these dressings have been designed to be used on exuding wounds, measurements were taken under eight different wound dressings in both dry and wet state. Irradiations with photon energies increased the skin dose significantly (max. increase: 68.1 %; average increase: 48 %) with little or no change to dose at depth. Electron beam energies showed little or no change to doses at the surface, but the dose distribution was shifted towards the surface. The maximum decrease in dose at depth was 3.6 % for 6 and 15 MeV through all dressings except one and was therefore considered to be clinically insignificant. A change in dose at surface of 9.7 % and at R(50) of 25.9 %, equivalent to a shift of dose towards the surface of 7.5 mm, was measured for one dressing. This demonstrates that it is possible for a wet dressing to significantly alter electron beam dosimetry. PMID:22733122

Mac Nally, Ciara; Woodings, Simon



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


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

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



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


The main objective of this case-cohort-type observational study conducted at different Surgical Departments of the Charité-Universitätsmedizin in Berlin was to evaluate the sequential use concept first described by Systagenix Wound Management in 2007. Fifty-two patients with different wound healing by secondary intention were treated for 7 weeks at the Charité-Universitätsmedizin in Berlin. A multidisciplinary team worked together to reach consensus in wound assessment; in classification of infection status according to the criteria described by European Wound Management Association (EWMA); in treatment protocol and on dressings to be used to 'cover' wounds. Before dressing application, all wounds were cleaned from debris. Following the sequential use concept, wounds classified as stages 2 and 3 were dressed with SILVERCEL(®) and TIELLE(®) or TIELLE PLUS(®) to 'clean' the wounds. After 2-3 weeks, treatment was changed to PROMOGRAN PRISMA(®) and TIELLE(®) to 'close and cover' wounds, thus providing optimal wound healing. Wounds classified as non infected were dressed with PROMOGRAN PRISMA(®) and TIELLE(®) during the complete treatment period. Patients were asked to evaluate the treatment using a simplified questionnaire developed at the Charité-Universitätsmedizin in Berlin. Wounds comprised 37 surgical procedures, 8 chronic mixed ulcer, 4 pressure sores, 1 diabetic foot ulcer, 1 venous leg ulcer, and 1 mixed arterial/venous ulcer. At baseline, 12 wounds were classified as stage 3, 38 wounds as stage 2 and 2 wounds as stage 1. After 7 weeks of treatment, all patients showed a positive clinical response to the sequential use treatment. Results of wound size showed a high significant progression of wound healing expressed with a profound reduction of wound area (P in all measurements <0·001, chi-square test) and improved granulation. This study summarises the clinical experiences derived from the evaluation of the sequential use concept in the daily clinical practice of wound treatment. On the basis of the wound healing results, patients' evaluation of treatment and the clinicians' and staff experiences, this concept was implemented at different Surgical Departments of the Charité-Universitätsmedizin in Berlin. PMID:21401884

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



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.

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



Biocompatibility evaluation of a new hydrogel dressing based on polyvinylpyrrolidone/polyethylene glycol.  


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



A novel in situ-formed hydrogel wound dressing by the photocross-linking of a chitosan derivative.  


In situ photopolymerized hydrogel dressings create minimally invasive methods that offer advantages over the use of preformed dressings such as conformability in any wound bed, convenience of application, and improved patient compliance and comfort. Here, we report an in situ-formed hydrogel membrane through ultraviolet cross-linking of a photocross-linkable azidobenzoic hydroxypropyl chitosan aqueous solution. The hydrogel membrane is stable, flexible, and transparent, with a bulk network structure of smoothness, integrity, and density. Fluid uptake ability, water vapor transmission rate, water retention, and bioadhesion of the thus resulted hydrogel membranes (0.1 mm thick) were determined to range from 97.0-96.3%, 2,934-2,561 g/m(2)/day, 36.69-22.94% (after 6 days), and 4.8-12.3 N/cm(2), respectively. These data indicate that the hydrogel membrane can maintain a long period of moist environment over the wound bed for enhancing reepithelialization. Specifically, these properties of the hydrogel membrane were controllable to some extent, by adjusting the substitution degree of the photoreactive azide groups. The hydrogel membrane also exhibited barrier function, as it was impermeable to bacteria but permeable to oxygen. In vitro experiments using two major skin cell types (dermal fibroblast and epidermal keratinocyte) revealed the hydrogel membrane have neither cytotoxicity nor an effect on cell proliferation. Taken together, the in situ photocross-linked azidobenzoic hydroxypropyl chitosan hydrogel membrane has a great potential in the management of wound healing and skin burn. PMID:20082682

Lu, Guozhong; Ling, Kai; Zhao, Peng; Xu, Zhenghong; Deng, Cao; Zheng, Hua; Huang, Jin; Chen, Jinghua


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


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



Electrospinning of poly(vinyl pyrrolidone)–iodine complex and poly(ethylene oxide)\\/poly(vinyl pyrrolidone)–iodine complex – a prospective route to antimicrobial wound dressing materials  

Microsoft Academic Search

New nanofibers containing poly(vinyl pyrrolidone)–iodine complex (PVP–iodine) were obtained by electrospinning in order to prepare materials suitable for wound dressings. Different approaches were used: a one-step method based on electrospinning of PVP–iodine or poly(ethylene oxide)\\/PVP–iodine solutions and a three-step method based on electrospinning of PVP or poly(ethylene oxide)\\/PVP mixed solutions followed by photo-mediated crosslinking of the obtained nanofibers and subsequent

Milena Ignatova; Nevena Manolova; Iliya Rashkov



Accelerated epithelization under a highly vapor-permeable wound dressing is associated with increased precipitation of fibrin(ogen) and fibronectin.  


In a previous study we showed that the use of a newly developed, highly water vapor permeable, PEU wound dressing accelerates the epithelization of partial-thickness wounds more than an occlusive wound dressing (OpSite) in comparison with air exposure. The purpose of this study was to investigate the distribution of fibrin(ogen), fibronectin, and type IV collagen during the epithelization process under these three conditions. The breathable PEU film enabled coagulation of the wound exudate, preserving it into a semisolid gelatinous state. This coagulum layer contained an abundant amount of fibrin(ogen) and fibronectin. In wounds occluded with OpSite film, depositions of fibrin(ogen) and fibronectin were less extensive. Migrating keratinocytes contained intracellular depositions of fibrin(ogen), suggesting that these cells phagocytize components of the provisional fibrin matrix during wound healing. It was concluded that accelerated epithelization underneath the highly water vapor permeable polyetherurethane film dressing is associated with the presence of a gelatinous coagulum containing fibrin(ogen) and fibronectin. We speculate that the enhanced healing rate might be caused by an increased concentration of growth-promoting factors present in the residual exudate underneath the PEU dressing. PMID:2179419

Jonkman, M F; Hoeksma, E A; Nieuwenhuis, P



Sterculia crosslinked PVA and PVA-poly(AAm) hydrogel wound dressings for slow drug delivery: mechanical, mucoadhesive, biocompatible and permeability properties.  


The present study deals with the synthesis and characterization of sterculia crosslinked PVA and PVA-AAm hydrogel wound dressings. The hydrogels have been characterized by SEMs, FTIR, TGA and swelling studies. This article also discusses comparison of swelling, drug release and biomedical properties such as blood compatibility, antimicrobial activity, mucoadhesion, tensile strength, burst strength, water vapour permeability, oxygen diffusion and microbial penetration of both hydrogel wound dressings. These polymeric films have absorbed 4.80 ± 0.15 and 6.32 ± 0.15 gram/g of gel of simulated wound fluid respectively and swelling occurred through Case II diffusion mechanism. The release of antibiotic drugs occurred through non-Fickian and Case II diffusion mechanisms, respectively. These polymeric films have been observed to be permeable for oxygen and water vapour but have shown impermeability to the micro-organism. Sterculia-PVA hydrogel wound dressing has shown more blood compatibility as compared to the other film. All these results indicate that these hydrogel films may be used as wound dressings for the slow release of antibiotic drug to the wound. PMID:22498279

Singh, Baljit; Pal, Lok



Albumin Displacement of Oleic Acid from Wound Dressings Promotes an Elastase-Lowering Effect in Chronic Wound Fluid  

Technology Transfer Automated Retrieval System (TEKTRAN)

Human neutrophil elastase (HNE) is elevated in chronic wounds. Oleic acid albumin formulatons that inhibit HNE may be applicable to treatment modalities for chronic wounds. Oleic acid /albumin formulations with mole ratios of 100:1, 50:1, and 25:1 (oleic acid to albumin) were prepared and found to ...


Practical treatment of body and open leg wounds of horses with bovine collagen, biosynthetic wound dressing and cyanoacrylate  

Microsoft Academic Search

Horses with severe and deep lacerations are represented by ten cases in which treatment emphasized the use of bovine collagen preparations to promote controlled second-degree repair. Traumatized areas were tarsal, metatarsal, neck, forearm, metacarpal and pastern. Wound size changes were recorded. Depending on the wound type, the site was treated with antibiotic-steroid ointment, organic acid cream, sterile collagen particles, suspension

Thomas R. Bello



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.  


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


A preliminary investigation of chitosan film as dressing for punch biopsy wounds in rats  

Microsoft Academic Search

Purpose. To investigate the wound healing effi- cacy of two chitosan films, Chit-AA and Chit-LA, in com- parison with a commercial preparation, Omiderm®, using punch biopsy wounds in rats. Methods. The punch biopsy wounds were created in the abdominal region of male Wistar rats. The films were evaluated in terms of transpar- ency, flexibility, adherence property, ease of removal from

Tanveer Ahmad Khan; Kok Khiang Peh


Comparison of in vitro disc diffusion and time kill-kinetic assays for the evaluation of antimicrobial wound dressing efficacy.  


There is a plethora of new silver-containing dressings on the market today. Various manufacturers attempt to show that their dressings are the most efficacious and therefore should be preferentially employed by health care workers based on the results of their in vitro tests. However, there have been no studies that clearly identify which tests are appropriate for comparison purposes. The purpose of this study was to determine which in vitro test is most appropriate for evaluating the antimicrobial efficacy of silver-containing dressings. This was done by testing seven silver-containing dressings and two non-silver-containing topical agents against 17 clinically relevant microorganisms using zone of inhibition assays and time-kill kinetic assays in complex media. The results for the two assays were then correlated to determine whether the methods generated similar results. It was determined that the two methods do not correlate at all. This is most likely a result of the silver interacting with the media in the zone of inhibition test, thus invalidating the results of this test. We therefore conclude that zone of inhibition data generated for silver-containing dressings is of little value when assessing antimicrobial efficacy and that time-kill assays are of greater use. PMID:16008731

Gallant-Behm, Corrie L; Yin, Hua Q; Liu, Shijie; Heggers, John P; Langford, Rita E; Olson, Merle E; Hart, David A; Burrell, Robert E


Experiences with biosynthetic dressings.  


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



A Case Report of the Use of Nanocrystalline Silver Dressing in the Management of Acute Surgical Site Wound Infected With MRSA to Prevent Cutaneous Necrosis Following Revision Surgery  

Microsoft Academic Search

The authors report the use of nanocrystalline silver (Acticoat 7, Smith and Nephew, London, UK) in an acute surgical wound to prevent localized skin necrosis due to infection, thereby avoiding skin grafting as a secondary procedure. Two patients were successfully treated with Acticoat 7 dressings without using systemic antimicrobials after developing methicillin-resistant Staphylococcus aureus infection in the surgical site. Despite

Mayukh Bhattacharyya; Helen Bradley



Composite electrospun nanomembranes of fish scale collagen peptides/chito-oligosaccharides: antibacterial properties and potential for wound dressing  

PubMed Central

Purpose: The objective of the present investigation was to evaluate the antibacterial properties and the biocompatibility of composite electrospun nanofibrous membranes (NFMs) with low-molecular-weight fish scale collagen peptides (FSCP) and chito-oligosaccharide (COS), to determine their potential for use as wound dressings. Methods: Low-molecular-weight FSCP were combined with COS to prepare nanofibers by electrospinning, and polyvinyl alcohol (PVA) was used for enhancing fiber-forming ability. Transmission electron microscope and scanning electron microscope methods were used to observe bacterial adhesion and the bacterial cell membrane. Fibroblast cell viability was determined using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Results: The best FSCP/COS mass ratio for electrospinning was 2:1, and the nanofibers had small dimensions ranging from 50 to 100 nm. The NFM showed good antibacterial activities against Gram-positive Staphylococcus aureus and Gram-negative Escherichia coli. The antibacterial activity against S. aureus was higher than against E. coli. The pili and adhesive fimbriae of E. coli promoted bacterial adhesion to the NFM surfaces, and S. aureus biofilms aided S. aureus adhesion on the surface of NFMs. Damage to the bacterial cell membrane indicates that the NFMs could lead to the release of intracellular materials, particularly with S. aureus. In addition, FSCP/COS NFM rapidly increased the permeability of the outer membranes of E. coli. The electrospun NFM with FSCP and COS had good biocompatibility in vitro and supported proliferation of human skin fibroblasts. Conclusion: FSCP are superior to mammalian collagen, and have feasibility and potency for wound dressings. FSCP/COS NFMs had good anti-bactericidal activity that improved with increased COS, and showed good biocompatibility in vitro and supported the proliferation of fibroblasts.

Wang, Yan; Zhang, Chen-lu; Zhang, Qun; Li, Ping



Curcumin-loaded poly(epsilon-caprolactone) nanofibres: diabetic wound dressing with anti-oxidant and anti-inflammatory properties.  


1. Curcumin is a naturally occurring poly-phenolic compound with a broad range of favourable biological functions, including anti-cancer, anti-oxidant and anti-inflammatory activities. The low bioavailability and in vivo stability of curcumin require the development of suitable carrier vehicles to deliver the molecule in a sustained manner at therapeutic levels. 2. In the present study, we investigated the feasibility and potential of poly(caprolactone) (PCL) nanofibres as a delivery vehicle for curcumin for wound healing applications. By optimizing the electrospinning parameters, bead-free curcumin-loaded PCL nanofibres were developed. 3. The fibres showed sustained release of curcumin for 72 h and could be made to deliver a dose much lower than the reported cytotoxic concentration while remaining bioactive. Human foreskin fibroblast cells (HFF-1) showed more than 70% viability on curcumin-loaded nanofibres. 4. The anti-oxidant activity of curcumin-loaded nanofibres was demonstrated using an oxygen radical absorbance capacity (ORAC) assay and by the ability of the fibres to maintain the viability of HFF-1 cells under conditions of oxidative stress. 5. The curcumin-loaded nanofibres also reduced inflammatory induction, as evidenced by low levels of interleukin-6 release from mouse monocyte-macrophages seeded onto the fibres following stimulation by Escherichia coli-derived lipopolysaccharide. 6. The in vivo wound healing capability of the curcumin loaded PCL nanofibres was demonstrated by an increased rate of wound closure in a streptozotocin-induced diabetic mice model. 7. These results demonstrate that the curcumin-loaded PCL nanofibre matrix is bioactive and has potential as a wound dressing with anti-oxidant and anti-inflammatory properties. PMID:19473187

Merrell, Jonathan G; McLaughlin, Shaun W; Tie, Lu; Laurencin, Cato T; Chen, Alex F; Nair, Lakshmi S



Comparison of healing time of the 2nd degree burn wounds with two dressing methods of fundermol herbal ointment and 1% silver sulfadiazine cream  

PubMed Central

BACKGROUND: Burn wounds are one of the health problems in modern societies that are associated with irreparable harms and many side problems for patients and their families. Infection due to burn wounds is the main cause of death in such patients. One of the methods to prevent infection of burn wounds is topical antibiotic ointments. This study aimed to investigate and identify effective ointments to treat burn wounds. For this purpose, the effects of two types of ointment, fundermol and 1% silver sulfadiazine cream on second degree burn wounds were compared. METHODS: This was a clinical trial study conducted in 2008. Using convenient and continuous sampling method, 50 patients referred to Imam Mousa Kazem Burn Injury Clinic in Isfahan, Iran with 2nd degree burn wounds in 1% to 10% surface area were enrolled. The patients were randomly divided into two groups of treatment with fundermol and sulfadiazine and the dressing was changed once a day. The healing time for burn wounds in each patient was recorded in a checklist and data were analyzed by independent t-test via SPSS software. RESULTS: The healing time of burn wounds in the group treated with fundermol was shorter than that in the group treated with sulfadiazine (p < 0.001). CONCLUSIONS: The present study showed that fundermol ointment accelerates burn wound healing. Therefore, fundermol can be introduced as a good replacement for current treatments of burn wounds.

Daryabeigi, Reza; Heidari, Mohammad; Hosseini, Sayed Abbas; Omranifar, Mahmoud



Electrospun nanofibrous polymeric scaffold with targeted drug release profiles for potential application as wound dressing.  


We have successfully fabricated a dual drug release electrospun scaffold containing an anesthetic, lidocaine, and an antibiotic, mupirocin. Two drugs with different lipophilicities were electrospun from a poly-l-lactic acid (PLLA) solution with a dual spinneret electrospinning apparatus into a single scaffold. The release of the drugs from the scaffold showed different profiles for the two drugs. Lidocaine hydrochloride exhibited an initial burst release (80% release within an hour) followed by a plateau after the first few hours. Mupirocin exhibited only a 5% release in the first hour before experiencing a more sustained release to provide antibacterial action for over 72 h. For comparative purposes, both drugs were spun from a single spinneret and evaluated to determine their release profiles. The scaffold maintained its antibiotic activity throughout the processes of electrospinning and gas sterilization and supported cell viability. It has been reported in the literature that interactions between polymer and drug are known to govern the pattern of drug release from electrospun scaffolds. Here, it was found that the presence of the two drugs in the same polymer matrix altered the release kinetics of at least one drug. Based on the release profiles obtained, the dual spinneret technique was the preferred method of scaffold fabrication over the single spinneret technique to obtain a prototype wound healing device. PMID:18771719

Thakur, R A; Florek, C A; Kohn, J; Michniak, B B



Evaluation of the disinfective efficacy of povidone-iodine with the use of the transparent film dressing OpSite Wound.  


To determine the duration of efficacy of disinfection with povidone-iodine (PVP-I) conducted before application of OpSite Wound (Smith and Nephew, UK), bacteriological evaluation was carried out. In 9 healthy adults, 3 sites on the forearms or other parts were chosen for application of OpSite Wound after adequate disinfection with PVP-I. As compared to the bacterial count score of 1.67-2.00 before disinfection, a significant reduction of the score was observed on removal of OpSite Wound on days 1, 2 and 3. The score of 0.5-0.67 immediately after disinfection did not change or deteriorate until removal of OpSite Wound. This finding supports the fact that unnecessary dressing changes could be avoided postoperatively for at least 3 days by disinfection with PVP-I and application of OpSite Wound particularly for operations categorized as 'clean surgery'. PMID:12011523

Takahashi, Koichi; Muratani, Tetsuro; Saito, Masami; Ohno, Natsumi; Matsumoto, Tetsuro



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


The human and economic costs of wounds are of major concern within today's National Health Service. Advances in wound care technology have been shown to be beneficial both in healing and in relation to patient quality of life. Negative pressure has often been associated with high-cost care and restricted to use in the secondary care setting. There is growing use of negative pressure within the community, and this has the potential to benefit the patient and the service by providing quality care in the patient's home setting. Three community sites were chosen to monitor their use of negative pressure wound therapy (NPWT) over a period of 2 years, and this paper presents some of the key findings of this work. The data generated has been used to help target resources and prevent misuse of therapy. Cost per patient episode has been calculated, and this can be compared to similar costs in secondary care, showing significant savings if patients are discharged earlier from secondary care. There is also an increased demand for more patients with complex wounds to be cared for in the community, and in the future, it is likely that community initiated NPWT may become more common. Early analysis of the data showed that the average cost of dressing complex wounds would be significantly less than using traditional dressings, where increased nursing visits could increase costs. There is a compelling argument for more negative pressure to be used and initiated in the community, based not only on improved quality of life for patients but also on the economic benefits of the therapy. PMID:22321132

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



Use of electron beam for the production of hydrogel dressings  

Microsoft Academic Search

The electron beam irradiation technique has been utilized to prepare hydrogel wound dressings. The composition of the dressings is based on polyvinylpyrrolidone (PVP), poly(ethylene glycol) (PEG), and agar. Increasing the irradiation dose leads to an increase in the gel fraction; this increase is due to increased crosslink density. The gel fraction% decreases as the PEG concentration increases. The maximum swelling%

Z. Ajji; G. Mirjalili; A. Alkhatab; H. Dada



The effect of multifunctional polymer-based gels on wound healing in full thickness bacteria-contaminated mouse skin wound models.  


We determined whether a two-part space-conforming polyethylene glycol/dopa polymer-based gel promoted healing of contaminated wounds in mice. This silver-catalysed gel was previously developed to be broadly microbiocidal in vitro while being biocompatible with human wound cell functioning. Full-thickness wounds were created on the backs of mice. The wounds were inoculated with 10(4) CFU of each of four common skin wound contaminants, Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter baumanii and Clostridium perfringens. The wounds were then treated with our multifunctional polymer-based gel, the commercially available NewSkin product, or left to heal untreated. The untreated wounds were overtly infected, and presented detectable bacterial loads over the entire 21-day healing period, while the gel and NewSkin groups presented significantly smaller rises in bacterial levels and were cleared of detectable colonies by the third week, with the gel group clearing the bacteria earlier. While all three groups healed their wounds, the polymer-based gel-treated group demonstrated significantly earlier re-epithelialization and dermal maturation (P<0.05). This was reflected in a quick regain of tensile strength. This accelerated dermal maturation and regain in strength was noted in mice treated with the polymer-based gel when compared to wound treated with the commercially available Aquacel-Ag dressing (P<0.05). What distinguishes the polymer-based gel from these other products is that it is incorporated within the healing wound. These preclinical studies show that the anti-microbial polymer gel not only supports but also accelerates healing of bacterially contaminated wounds. PMID:17561250

Yates, Cecelia C; Whaley, Diana; Babu, Ranjith; Zhang, Jianying; Krishna, Priya; Beckman, Eric; Pasculle, A William; Wells, Alan



Systems-based approaches toward wound healing  

PubMed Central

Wound healing in the pediatric patient is of utmost clinical and social importance, since hypertrophic scarring can have aesthetic and psychological sequelae, from early childhood to late adolescence. Wound healing is a well-orchestrated reparative response affecting the damaged tissue at the cellular, tissue, organ, and system scales. While tremendous progress has been made towards understanding wound healing at the individual temporal and spatial scales, its effects across the scales remain severely understudied and poorly understood. Here we discuss the critical need for systems-based computational modeling of wound healing across the scales, from short-term to long-term and from small to large. We illustrate the state of the art in systems modeling by means of three key signaling mechanisms: oxygen tension regulating angiogenesis and revascularization; TGF-? kinetics controlling collagen deposition; and mechanical stretch stimulating cellular mitosis and extracellular matrix remodeling. The complex network of biochemical and biomechanical signaling mechanisms and the multi-scale character of the healing process make systems modeling an integral tool in exploring personalized strategies for wound repair. A better mechanistic understanding of wound healing in the pediatric patient could open new avenues in treating children with skin disorders such as birth defects, skin cancer, wounds, and burn injuries.

Buganza-Tepole, Adrian; Kuhl, Ellen



A HACCP-based approach to hygienic slaughter and dressing of lamb carcasses  

Microsoft Academic Search

Aims. This paper compares changes in visible and microbiological contamination on lamb carcasses dressed using one system which includes process factors previously identified as potential critical control points for HACCP-based approaches to hygienic slaughter and dressing, and another system which excludes those factors.Methods. Longitudinal changes in microbiological and visible contamination of lamb carcasses were quantified in two slaughterhouses, one utilising

M. E. Biss; S. C. Hathaway



Morphofunctional Evaluation of the Effect of Collagen1Based Dressing on Skin Regeneration after Burn Trauma in Mice of Two Genetic Strains  

Microsoft Academic Search

Morphofunctional evaluation of the effect of biological dressing with collagen-1 on healing of 3A degree burn wound in outbred\\u000a and mutant Hr\\u000a hrHrhr (hairless) mice was carried out by the histological method and optic radioautography. A pronounced stimulatory effect of\\u000a the dressing on skin regeneration in mice was demonstrated. According to radioautography data, early dressing of the burn\\u000a wounds in

E. G. Kolokolchikova; E. A. Zhirkova; P. K. Golovatenko-Abramov; E. S. Platonov; V. S. Botcharova; V. B. Khvatov



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


Three institutions enrolled 38 patients who required bilateral skin graft donor sites into a safety and efficacy study of a new synthetic donor site dressing. Bilateral donor sites were randomized to receive either a new, synthetic donor site dressing or an impregnated gauze dressing. Wounds were assessed by time to healing, pain, and patient preference. Synthetic dressing wounds were treated 7.9 days compared with 10.2 days for gauze dressing wounds (p < 0.001), and synthetic dressing wounds were more completely epithelialized. Visual analogue pain analysis revealed significantly less donor site pain with synthetic dressing (2.94) versus gauze dressing (4.64) (p < 0.001). Synthetic dressing had fewer treatment-related adverse experiences than gauze dressing (2 vs 7) and was judged by recipients to be superior to gauze dressing in comfort, pain relief, cosmetic appeal, ease of ambulation, and overall acceptance. PMID:7929519

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


[In vitro and in vivo studies of a temporary absorbable dressing].  


The major advantage of biodegradable synthetic wound dressings compared to other synthetic materials and biological tissue derivatives is avoidance of the necessity to change the dressing. The copolymer films used in this study were made of lactic and caproic acid. They pose no problems concerning immunology or transmission of diseases. Moreover, the substances released by degradation may possibly influence the process of wound healing. The material proved to be non-toxic and was used successfully as a carrier for cell culture with keratinocytes. The permeability for bacteria is determined by degradation. Evaluation of the bacteriological studies indicates secure protection against secondary contamination of the films for at least 15 days, however. Concerning application, dressing properties, wound healing and wound retraction, no disadvantages were found in comparison with the results of the competition's film Opsite. Based on these findings, the films are now used in a clinical study as a wound dressing for split-skin donor sites. PMID:7761873

Jürgens, C; Beuchel, M; Bisgwa, F; Dekker, A; Hafemann, B; Kortmann, H R; Niendorf, A; Partecke, B D; Porte, T; Schultz, J H



A comparison of a modified form of Granuflex (Granuflex Extra Thin) and a conventional dressing in the management of lacerations, abrasions and minor operation wounds in an accident and emergency department.  

PubMed Central

A clinical study of 96 patients compared a new hydrocolloid dressing (Granuflex Extra Thin) with a non-adherent dressing (perforated film absorbent dressing) in the management of lacerations, abrasions and minor operation incisions at the Accident and Emergency (A&E) Department of the University College Hospital, Galway. While time to heal was similar for both groups, the patients using Granuflex Extra Thin experienced less pain (P < 0.001), required less analgesia (P = 0.0154) and were able to carry out their normal daily activities including bathing or showering without affecting the dressing or the wound. Patient satisfaction with the new dressing appeared to be very high especially in those patients who pursued an active lifestyle.

Heffernan, A; Martin, A J



Cyanoacrylate Glue Dressing for Hypospadias Surgery  

PubMed Central

Background: Hypospadias repair is a common pediatric operation. Several kinds of dressings are currently available, with their benefits and side effects. Aim: The aim of our study was to introduce a new method of dressing, by pouring several layers of cyanoacrylate (CA) glue as the dressing, in hypospadias surgery. Materials and Methods: Twenty out of the 61 patients with hypospadias, with a mean age of 13.5 months, were enrolled in this study. Forty-one had conventional dressing (pressure wrap dressing), while CA glue was used in 20 patients. CA glue was applied around the penis and its base four times and each time it took one minute to dry. All patients were followed postoperatively for two weeks and six to twelve months, for early and late complications, respectively. Results: One out of 20 developed wound hematoma, one had skin necrosis with infection, and edema was present in all. All these were easily diagnosed and managed rapidly. In the group treated with conventional methods, there were five infections, seven hematomas, all the patients in the group had edema and painful removal of the dressing, and 10 needed repeat dressing. Conclusions: CA glue is impermeable to urine and stool, and prevents edema and hematoma. Used in several layers, it is a good alternative dressing in hypospadias surgery.

Hosseini, Seyed Mohammad Vahid; Rasekhi, Ahmad Reza; Zarenezhad, Mohammad; Hedjazi, Arya



Significant Characteristics of Medical-Grade Polymer Sheets and their Efficiency in Protecting Hydrogel Wound Dressings: A Soft Polymeric Biomaterial  

Microsoft Academic Search

Hydrogel dressings are soft biomaterials that need protection from external influences. Polymer sheets such as breathable film (BF) or breathable laminate (BL) were characterized in respect of water vapor transmission, water contact angle, microbial penetrability, and antimicrobial property to protect hydrogel dressings. The mechanical property and water retention ability of hydogels PVP-CMC and PVP-CMC-BA with and without BF and BL

Niladri Roy; Nabanita Saha; Takeshi Kitano; Marian Lehocky; Eva Vitkova; Petr Saha



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



Evaporative water loss and epidermis regeneration in partial-thickness wounds dressed with a fluid-retaining versus a clot-inducing wound covering in guinea pigs.  


The effects of a new high vapour permeable poly-(ether urethane) (PEU) wound covering on evaporative water loss (EWL) and epidermis regeneration in partial-thickness wounds in guinea pigs were investigated and compared with an occlusive wound covering (OpSite) and air-exposed controls. It was also assessed whether the EWL reflected the phases of epidermis regeneration. In PEU-covered wounds, the initially raised EWL of 100 gm-2h-1 decreased in four days to 30 gm-2h-1, the same level as in occluded wounds. In control wounds this level was only reached after seven days, reflecting slower epidermis regeneration. The results showed that triphasic EWL behaviour corresponded to the sequence of wound healing. There was (1) a constant raised EWL until epidermal resurfacing is complete, (2) a fast EWL decrease during parakeratotic keratinization, and (3) a gradual normalization of the EWL during maturation of the stratum corneum. In wounds covered with OpSite this phasic EWL behaviour did not occur, owing to forced reduction because of the relatively impermeable covering. It was concluded that the PEU wound covering has an ideal water vapour permeance of 22.2 gm-2h-1 kPa-1, as can be seen in the accelerated epidermis regeneration and fast EWL reduction in partial thickness wounds in guinea pigs. PMID:2740844

Jonkman, M F; Molenaar, I; Nieuwenhuis, P; Klasen, H J



Repeated use of immersive virtual reality therapy to control pain during wound dressing changes in pediatric and adult burn patients.  


The current study explored whether immersive virtual reality (VR) continues to reduce pain (via distraction) during more than one wound care session per patient. Thirty-six patients aged 8 to 57 years (mean age, 27.7 years), with an average of 8.4% TBSA burned (range, 0.25-25.5 TBSA) received bandage changes, and wound cleaning. Each patient received one baseline wound cleaning/debridement session with no-VR (control condition) followed by one or more (up to seven) subsequent wound care sessions during VR. After each wound care session (one session per day), worst pain intensity was measured using a visual analog thermometer, the dependent variable. Using a within-subjects design, worst pain intensity during wound care with no-VR (baseline, day 0) was compared with pain during wound care while using immersive VR (up to 7 days of wound care during VR). Compared with pain during no-VR baseline (day 0), pain ratings during wound debridement were statistically lower when patients were in VR on days 1, 2, and 3, and although not significant beyond day 3, the pattern of results from days 4, 5, and 6 are consistent with the notion that VR continues to reduce pain when used repeatedly. Results from the present study suggest that VR continues to be effective when used for three (or possibly more) treatments during severe burn wound debridement. PMID:23970314

Faber, Albertus W; Patterson, David R; Bremer, Marco


The effect of multifunctional polymer-based gels on wound healing in full thickness bacteria-contaminated mouse models  

PubMed Central

We determined whether a two part space-conforming polyethyleneglycol/dopa polymer-based gel promoted healing of contaminated wounds in mice. This silver-catalysed gel was previously developed to be broadly microbiocidal in vitro while being biocompatible with human wound cell functioning. Full-thickness wounds were created on the backs of mice. The wounds were inoculated with 104 CFU of each of four common skin wound contaminants, Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter baumanii and Clostridium perfringens. The wounds were then treated with our multifunctional polymer-based gel, the commercially-available NewSkin product, or left to heal untreated. The untreated wounds were overtly infected, and presented detectable bacterial loads over the entire 21 day healing period, while the gel and NewSkin groups presented significantly smaller rises in bacterial levels and were cleared of detectable colonies by the third week, with the gel group clearing the bacteria earlier. While all three groups healed their wounds, the polymer-based gel treated group demonstrated signficantly earlier re-epithelialization and dermal maturation (P < 0.05). This was reflected in a quick regain of tensile strength. This accelerated dermal maturation and regain in strength was noted in mice treated with the polymer-based gel when compared to wound treated with the commercially-available Aquacel-Ag dressing (P < 0.05). What distinguishes the polymer-based gel from these other products is that is incorporated within the healing wound. These preclinical studies show that the anti-microbial polymer gel not only supports but also accelerates healing of bacterially contaminated wounds.

Yates, Cecelia Christina; Whaley, Diana; Babu, Ranjith; Zhang, Jianying; Krishna, Priya; Beckman, Eric; Pasculle, A. William; Wells, Alan



Cost-effective faster wound healing with a sustained silver-releasing foam dressing in delayed healing leg ulcers--a health-economic analysis.  


The aim of this analysis was to examine the cost-effectiveness of Contreet Foam (A) in comparison with three other commonly used venous leg ulcer treatment protocols: Aquacel Ag (B), Actisorb Silver (C) and Iodoflex (D). A health-economic analysis reflecting the UK treatment practice and cost structure was performed. The analysis was set up to assess the cost of relative wound area reduction over a 4-week treatment period. The model was validated by a UK expert panel consisting of four wound care specialists. To assure that the 4-week model had a realistic link to cost-effectiveness of complete wound healing, a Markov analysis was also performed. Sensitivity analyses were carried out to ensure validity. Protocol A and C proved to be the most effective treatments. The mean relative reduction in wound area after 4 weeks of treatment was 50.2% (protocol A), 23.9% (protocol B), 44.6% (protocol C) and 36.0% (protocol D). Cost-effectiveness ratios showed that protocol A proved to be the most cost-effective treatment, and protocol B the least. The cost per percentage reduction in wound area was 9.50 UK pounds for protocol A, compared to 16.50-17.60 UK pounds for the other treatment options. The cost-effectiveness of complete healing (Markov analysis) and sensitivity analyses confirmed these results. Using Contreet Foam instead of the other dressing alternatives may imply savings of 2.2-4.4 million UK pounds per year to the National Health Service. PMID:16722864

Scanlon, Elizabeth; Karlsmark, Tonny; Leaper, David J; Carter, Kate; Poulsen, Peter B; Hart-Hansen, Kristian; Hahn, Tina W



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


Treatment of burns and chronic wounds using a new cell transfer dressing for delivery of autologous keratinocytes  

Microsoft Academic Search

This study describes a new methodology for delivering cultured autologous keratinocytes to wounds on a sterile medical grade polymer coated with a chemically defined plasma polymerised functional surface containing 20% carboxylic acid (referred to as PPS). Seven patients (two acute major burns and five chronic non-healing wounds) were treated with applications of autologous keratinocytes delivered on a 6 cm diameter medical

N. Zhu; R. M. Warner; C. Simpson; M. Glover; C. A. Hernon; J. Kelly; S. Fraser; T. M. Brotherston; D. R. Ralston; S. MacNeil



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


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



[Wound management in patients with chronic wounds in ambulatory nursing--a pilot study].  


Currently relevant data about prevalence of chronic wounds and wound management in home care nursing services are not available for Germany. In this study 38 home care nursing services were surveyed by means of a questionnaire. Response rate was 61%. Results showed that almost 9% of the home care nursing services treated patients suffering from chronic wounds. The most common wound was the pressure ulcer with a prevalence of 4.1%, followed by leg ulcer (2.7%) and the diabetic foot (1%). The questionnaire about wound management was completed for 47 patients of 24 home care services. 29 of the patients were females and 18 males. The average age of the patients was 78 years. Important diagnostic information about the nature and the recurrence rate of the wounds was not available to the nursing staff. The average time that a wound existed was 6.7 years with a range of 3 weeks to 45 years. 87% of the patients had their wound dressings on a daily basis. The average time needed for wound dressing was 17 minutes. Wound management often occurred in a idiosyncratic way and did not always follow evidence based practice. Wound management can be significantly improved by the use of modern wound dressing, reduction of the frequency of wound dressings, standardized wound documentation and better co-operation with doctors, nursing experts and health insurance organisations. Basis on the convenience nature of the sample results of this survey should be generalized and interpreted with caution. This study gives clear indications of the significance of the problem. More studies with representative samples are needed. PMID:12244826

Panfil, Eva-Maria; Mayer, Herbert; Junge, Wolfram; Laible, Jochen; Lindenberg, Eveline; Trümner, Andrea; Wordel, Anja; Evers, Georges C M



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.  


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



Meeting the challenges of wound care in Danish home care.  


Objective: To evaluate a community-based educational intervention to improve wound-care practice, and thereby reduce the costs of care, in four communities in Denmark. Method: Annual wound care audits recorded patients' ages, the number and types of wounds being treated, wound duration (days unhealed), frequency of dressing changes and nurse time per dressing change. Data were available at year 1 and year 3 post-intervention. A statistical analysis was performed, testing for changes in a range of variables between these years. Results: In the post-intervention period, significant reductions were found in the proportion of chronic wounds, the proportion of wounds requiring a daily dressing change, mean frequency of dressing change, mean nurse time spent in wound care per week, and the total cost of wound care per week. Conclusion: These results suggest that it is possible to improve wound-care practice and reduce the resource costs of wound care through a systematic programme of education and training, tailored to suit the needs of local communities. Declaration of interest: S.F. Jørgensen and R. Nygaard are partners of KvaliCare ApS. J. Posnett was commissioned by KvaliCare ApS to undertake the analysis of audit data. PMID:24142076

Jørgensen, S F; Nygaard, R; Posnett, J



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



Design of a new hydrocolloid dressing.  


Hydrocolloid dressings composed of dextran, phospholipid, glycerol and sodium lauryl sulphate have been formulated. A ventilated hygrometer system has been used to study the evaporative water loss (EWL) from the excised wound of rats with and without these dressings. A statistical experimental design has been used to locate a formulation which is flexible and semiocclusive in nature. The phospholipid component of the dressing has a significant role in controlling water vapour permeability of the dressing. The EWL from the excised wound covered with the optimized dressing has been compared with that for two commercial products. PMID:2483054

Nangia, A; Hung, C T



[Nursing management of wound care pain].  


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



Sea cucumber (Stichopus hermanii) based hydrogel to treat burn wounds in rats.  


Malaysian sea cucumber was incorporated into hydrogel formulation by using electron beam irradiation technique and was introduced as novel cross-linked Gamat Hydrogel dressing. This study investigated whether Gamat Hydrogel enhanced repair of deep partial skin thickness burn wound in rats and its possible mechanism. Wounds were treated with either Gamat Hydrogel, control hydrogel, OpSite® film dressing or left untreated. Skin samples were taken at 7, 14, 21, and 28 days post burn for histological and molecular evaluations. Gamat Hydrogel markedly enhanced wound contraction and improved histological reorganization of the regenerating tissue. Furthermore, the dressing modulated the inflammatory responses, stimulated the activation and proliferation of fibroblasts, and enhanced rapid production of collagen fiber network with a consequently shorter healing time. The level of proinflammatory cytokines; IL-1?, IL-1?, and IL-6, were significantly reduced in Gamat Hydrogel treated wounds compared with other groups as assessed by reverse transcription-polymerase chain reaction (RT-PCR). In summary, our results showed that Gamat Hydrogel promoted burn wound repair via a complex mechanism involving stimulation of tissue regeneration and regulation of pro-inflammatory cytokines. The resultant wound healing effects were attributed to the synergistic effect of the hydrogel matrix and incorporated sea cucumber. PMID:21504052

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



Acemannan hydrogel dressing versus saline dressing for pressure ulcers. A randomized, controlled trial.  


Aloe vera has been used for centuries as a topical treatment for various conditions and as a cathartic. An amorphous hydrogel dressing derived from the aloe plant (Carrasyn Gel Wound Dressing, Carrington Laboratories, Inc., Irving, TX) is approved by the Food and Drug Administration for the management of Stages I through IV pressure ulcers. To evaluate effectiveness of this treatment, 30 patients were randomized to receive either daily topical application of the hydrogel study dressing (acemannan hydrogel wound dressing) or a moist saline gauze dressing. Complete healing of the study ulcer occurred in 19 of 30 subjects (63%) during the 10-week observation period. No difference was observed in complete healing between the experimental and the control groups (odds ratio 0.93, 95% CI 0.16, 5.2). This study indicates that the acemannan hydrogel dressing is as effective as, but is not superior to, a moist saline gauze wound dressing for the management of pressure ulcers. PMID:10326343

Thomas, D R; Goode, P S; LaMaster, K; Tennyson, T



Cloth Simulation Based Motion Capture of Dressed Humans  

NASA Astrophysics Data System (ADS)

Commonly, marker based as well as markerless motion capture systems assume that the tracked person is wearing tightly fitting clothes. Unfortunately, this restriction cannot be satisfied in many situations and most preexisting video data does not adhere to it either. In this work we propose a graphics based vision approach for tracking humans markerlessly without making this assumption. Instead, a physically based simulation of the clothing the tracked person is wearing is used to guide the tracking algorithm.

Hasler, Nils; Rosenhahn, Bodo; Seidel, Hans-Peter


Cloth Simulation Based Motion Capture of Dressed Humans  

Microsoft Academic Search

\\u000a Commonly, marker based as well as markerless motion capture systems assume that the tracked person is wearing tightly fitting\\u000a clothes. Unfortunately, this restriction cannot be satisfied in many situations and most preexisting video data does not adhere\\u000a to it either. In this work we propose a graphics based vision approach for tracking humans markerlessly without making this\\u000a assumption. Instead, a

Nils Hasler; Bodo Rosenhahn; Hans-Peter Seidel



Community Based Tourism in Namibia: ‘Reality Show’ or ‘Window Dressing’?  

Microsoft Academic Search

Since the 1970s, the African continent has experienced exponential growth in tourism, where growth in numbers of visitors has not necessarily meant economic, social or environmental benefits for the host community. A review of the literature concerning tourism development and its effects on local communities forms the basis for the investigation of the reasons behind community based tourism (CBT) being

Marina Novelli; Kathrin Gebhardt



Chitosan-based Dressing for the Treatment of External/Accessible Bleedings in Children With Bleeding Tendency.  


INTRODUCTION:: Bleeding episodes in patients with congenital or acquired bleeding disorders are usually managed with factor concentrates or blood products. However, external and accessible bleeds may effectively be managed with topical hemostasis. MATERIALS AND METHODS:: After the application of the Hemcon, a Food and Drug Administration-approved chitosan-based hemostatic dressing was used as the "last resort" to successfully control external bleeds in 2 patients with severe bleeding disorders. We describe a single-center experience with this dressing, including its use in pediatric patients as the first mode of therapy. RESULTS:: A total of 5 patients (median age 2 y) with severe bleeding disorders were treated with topical chitosan-based dressing for a total of 6 bleeding episodes. The dressing was used either after the failure of extensive systemic therapy or as the first choice of treatment. In 4 of the 6 episodes, bleeding ceased immediately alleviating the need for systemic therapy. There was no rebleeding after the removal of the dressing and no adverse events or local skin reactions were recorded. CONCLUSION:: Hemostatic dressings, such as the chitosan, should be encouraged for the treatment of external/accessible bleeds, especially among the pediatric patients with bleeding tendency. PMID:23588337

Misgav, Mudi; Kenet, Gili; Martinowitz, Uriel



Complex Mining and Dressing Systems Match of Regional Mine Based on CAS Theory  

Microsoft Academic Search

Complex mining and dressing systems match of regional mine is a kind of specify systems composed by mining and ore dressing agent in regional mine, in certain scopes or environments, and realize every kind of ore resources optimum match under certain constraints. we have studied mining and dressing systems match of regional mine applied complex adaptive system theory creatively, analyzed

Chen Junzhi; Ren Chunfang; Guo Tao



Recent advances in topical wound care  

PubMed Central

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

Sarabahi, Sujata



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


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



A comparison of wound environments.  


A comparison of a system of moist wound dressings to traditional normal saline wet-to-dry dressings was conducted on OB/GYN patients with open abdominal incisions. The moist wound products included in this study were a hydrogel (Intrasite Gel) and a foam wound cavity filler (Allevyn), manufactured by Smith & Nephew United, Inc. of Largo, FL, and a transparent cover (Bioclusive), manufactured by Johnson & Johnson Medical, Inc. of Arlington, TX. The results indicated that those incisions treated with the moist wound environment dressings experienced fewer complaints of pain, a decrease in healing time and a significant cost savings. PMID:1482522

Gates, J L; Holloway, G A



Community Analysis of Chronic Wound Bacteria Using 16S rRNA Gene-Based Pyrosequencing: Impact of Diabetes and Antibiotics on Chronic Wound Microbiota  

Microsoft Academic Search

BackgroundBacterial colonization is hypothesized to play a pathogenic role in the non-healing state of chronic wounds. We characterized wound bacteria from a cohort of chronic wound patients using a 16S rRNA gene-based pyrosequencing approach and assessed the impact of diabetes and antibiotics on chronic wound microbiota.Methodology\\/Principal FindingsWe prospectively enrolled 24 patients at a referral wound center in Baltimore, MD; sampled

Lance B. Price; Cindy M. Liu; Johan H. Melendez; Yelena M. Frankel; David Engelthaler; Maliha Aziz; Jolene Bowers; Rogan Rattray; Jacques Ravel; Chris Kingsley; Paul S. Keim; Gerald S. Lazarus; Jonathan M. Zenilman; Adam J. Ratner



Sterile versus nonsterile clean dressings  

PubMed Central

BACKGROUND Many patients cannot afford sterile dressings. In St John, New Brunswick, clean dressings have been used instead of sterile dressings for years, with no apparent ill effects. No previous studies have compared the sterility and cost of clean versus sterile dressing materials. OBJECTIVES The goals of the present study were to answer the following questions: how much more sterile are sterile dressings than clean dressings; and how much does this extra sterility cost? METHODS Sterility and cost of sterile gauze, panty liners, sanitary napkins, diapers and Coban tape (3M, USA) were compared. Samples, 2 cm × 2 cm in size, were cut out of each material under aseptic conditions, and delivered to the microbiology laboratory in sterile urine containers. The samples were then cultured and organisms were identified using conventional means. RESULTS The cost for one month, using one 20 cm × 5 cm wound dressing daily, was calculated and compared with panty liners ($2.43), sanitary napkins ($5.55), diapers ($9.39) and Coban tape ($0.66), which were much cheaper than sterile dressings ($16.50). How sterile were the dressings? None of the 20 sanitary napkins grew bacteria, one of the 20 panty liners grew bacteria (coagulase-negative Staphylococcus), two of 20 sterile dressings grew bacteria (one coagulase-negative Staphylococcus and one nonhemolytic Streptococcus), 15 of 20 diapers grew bacteria (all bacillus) and two of five Coban rolls grew bacteria (one bacillus and one coagulase-negative Staphylococcus). CONCLUSION The panty liners, sanitary napkins and Coban tape studied were cheaper than, and had a comparible sterility with, the sterile gauze examined.

Alqahtani, Moraya; Lalonde, Donald H



How to make a hospital-based wound center financially viable: The Georgetown University Hospital model  

Microsoft Academic Search

As the medical need and expenditure for chronic wound care have increased markedly over the past decade, wound centers have grown exponentially throughout the country. They can be community-based or hospital-based, and in either case, can be run by the facility or by a national chain. The wound center's viability is dependent on generated revenue, and its clinical effectiveness is

Christopher E. Attinger; Han Hoang; John Steinberg; Kara Couch; Katherine Hubley; Linda Winger; Margaret Kugler



Management of Superficial to Partial-Thickness Wounds  

PubMed Central

Reference/Citation: Wiechula R. The use of moist wound-healing dressings in the management of split-thickness skin graft donor sites: a systematic review. Int J Nurs Pract. 2003; 9:S9–S17. Clinical Question: Do rates of healing, infection, and pain differ depending on whether nonmoist or moist dressings are used to manage superficial to partial-thickness wounds? Data Sources: Investigations were identified by CINAHL, MEDLINE, Pre-MEDLINE, Cochrane Library, Current Contents, Health STAR, EMBASE, Expanded Academic Index, and Dissertation Abstracts International searches. The search terms included skin, graft, and donor. Additional searches were performed with reference lists and bibliographies of retrieved studies. Study Selection: To be included in the review, each study had to fulfill the following criteria: it had to be an intraindividual or prospective randomized controlled trial of human subjects; it had to include patients with postharvest split-thickness skin graft donor sites; it had to evaluate the effectiveness of primary and secondary wound dressings; and it had to have outcome measures that included healing (objective), infection (subjective), and pain (objective). Data Extraction: Data extraction and study quality assessment procedures were developed specifically for this review based on Cochrane Collaboration, Centre for Reviews and Dissemination, and Joanna Briggs Institute protocols and were performed independently by the author. Details of the procedures were not fully explained. The principal outcome measures were healing (proportion of sites healed within the study period or time to complete healing), rate of infection, and pain scores. The studies were grouped according to broad dressing type (nonmoist and moist) and specific types of moist dressings (hydrocolloids and polyurethane semipermeable transparent films). When comparable, study results were pooled and analyzed with a fixed-effects model. Data within broader dressing categories (nonmoist and moist) were analyzed with a random-effects model. ? 2 analysis was used to determine heterogeneity among the studies. RevMan software (version 4.04; Cochrane Centre, Oxford, UK) was used for statistical analysis. Main Results: The searches identified 111 studies and 1 integrative review, of which 58 studies met the inclusion and exclusion criteria. Inconsistency and variation in outcome measures and incomplete reporting of results prevented analysis of many studies. Wound healing was measured by days to complete healing (when dressings could be removed without trauma and pain) and wounds healed by day X (removal of dressings at regular intervals). Wound infection was subjectively measured based on clinical signs of infection (edema, heat, pain, or smell). Visual analog scales were used to measure pain levels. Among the broad categories of nonmoist (sterile gauze, fine mesh gauze, Xerofoam [Tyco Healthcare Group LP, Mansfield, MA]) and moist (DuoDERM hydrocolloid [ConvaTec, Princeton, NJ], Tegaderm transparent film [3M Health Care, St Paul, MN], Opsite transparent film [Smith & Nephew, London, UK]) dressings, the outcomes of healing, infection, and pain were analyzed. In 6 studies, the findings significantly favored moist dressings, compared with nonmoist dressings, for days to complete healing (weighted mean difference [WMD] = ?3.97, 95% confidence interval [CI] = ?5.91, ?2.02). In 9 studies, wounds healed by day X (day 7, 8, 9, 10, or 12) were analyzed. The results were varied and inconclusive because of a small number of trials and subjects. Among 10 studies, no significant difference was noted in infection rates between nonmoist and moist dressings (odds ratio [OR] = 0.41, 95% CI = 0.14, 1.18). Three studies using visual analog scales for the outcome of pain were converted into a uniform scale of 1 to 10 (10 representing most painful). The findings significantly favored moist dressings over nonmoist dressings (WMD = ?1.75, 95% CI = ?2.94, ?0.56). Among nonmoist and specific types of moist dressings,

Beam, Joel W



Simplifying modern wound management for nonprofessional caregivers.  


Nonprofessional caregivers currently are participating in managing pressure ulcers at home. As this can be a stressful experience, innovative and easy-to-use products are needed to support caregiver confidence. A multicenter, randomized clinical trial was conducted to compare clinical performance and case of instruction of a change indicator dressing (SIG) and a hydrocolloid alginate dressing (HAD) in the management of pressure ulcers in the home and long-term care settings. SIG and HAD were randomized to 17 and 18 partial- or full-thickness pressure ulcers respectively. During five dressing changes, wound area, dressing application, maintenance, appearance, removal, wear time, ease of teaching, and caregiver understanding of each dressing's instructions were measured. Both dressings were rated highly regarding ease of teaching, ease of use, appearance, maintenance, and helpfulness in signaling the need for dressing change by both professional and nonprofessional wound caregivers. Average dressing wear time was 3.2 days for SIG and 2.7 days for HAD. Of these wounds managed in a moist environment, 6 of 17 (35%) subjects whose wounds were dressed with SIG, and 1 of 18 (6%) dressed with HAD healed during the course of the study (alpha < 0.04). Percent wound reduction in area per day of care was also greater for SIG (alpha < 0.01). Innovative dressings may help caregivers provide consistent quality pressure ulcer care and improve wound-healing outcomes. PMID:11189544

Seaman, S; Herbster, S; Muglia, J; Murray, M; Rick, C



Negative pressure wound therapy: Evidence-based treatment for complex diabetic foot wounds  

Microsoft Academic Search

Negative pressure therapy is a novel technology used for the promotion of wound healing and has emerged as the standard care\\u000a in the management of problem wounds. Negative pressure wound therapy has been met with rapid clinical success and widespread\\u000a acceptance. The literature is replete with case series, small trials, and noncomparative studies; however, there are few prospective,\\u000a randomized, human

Jennifer J. Suess; Paul J. Kim; John S. Steinberg



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


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



Liquid Collagen Wound Coverings.  

National Technical Information Service (NTIS)

A stabilized collagen gel is disclosed as are methods of making this collagen gel which is useful as a wound dressing to prevent dehydration of the subject being treated and infection of the wound. The collagen gel of the invention is stabilized by combin...



Scanning electron microscopic examination of bacterial immobilisation in a carboxymethyl cellulose (AQUACEL) and alginate dressings.  


Dressings have been applied to open wounds for centuries. Traditionally they have been absorbent, permeable materials, i.e. gauze that could adhere to desiccated wound surfaces, inducing trauma on removal. With the advent of modern wound care products many dressings are now capable of absorbing large volumes of exudate whilst still continuing to provide a moist wound healing environment. Equally important is their ability to lock exudate in the dressing (i.e. bacterial retention within the dressing matrix) such that upon removal from a wound surface bacterial dispersion is minimised. In these studies detailed scanning electron microscopy techniques have demonstrated the fluid controlling properties of alginate wound dressings and a carboxymethylated cellulose wound dressing (AQUACEL) Hydrofiber) dressing (CMCH)). It was demonstrated that following hydration of the latter wound dressing, the subsequent formation of a cohesive gel was effective in encapsulating large populations of potentially pathogenic bacteria such as Psuedomonas aeruginosa and Staphylococcus aureus under the gelled surface, as well as being immobilised within the swollen fibres. In contrast, hydrated alginate wound dressings did not form a uniform, cohesive gel structure, with the result that fewer bacteria were immobilised within the gel matrix. Many bacteria were trapped on individual, non-hydrated fibres. The unique absorbent gelling properties of the CMCH dressing appears to provide an ideal environment for immobilising bacteria. PMID:12485806

Walker, M; Hobot, J A; Newman, G R; Bowler, P G



Stimulation of wound healing by helium atmospheric pressure plasma treatment  

NASA Astrophysics Data System (ADS)

New experiments using atmospheric pressure plasma have found large application in treatment of living cells or tissues, wound healing, cancerous cell apoptosis, blood coagulation on wounds, bone tissue modification, sterilization and decontamination. In this study an atmospheric pressure plasma jet generated using a cylindrical dielectric-barrier discharge was applied for treatment of burned wounds on Wistar rats' skin. The low temperature plasma jet works in helium and is driven by high voltage pulses. Oxygen and nitrogen based impurities are identified in the jet by emission spectroscopy. This paper analyses the natural epithelization of the rats' skin wounds and two methods of assisted epithelization, a classical one using polyurethane wound dressing and a new one using daily atmospheric pressure plasma treatment of wounds. Systemic and local medical data, such as haematological, biochemical and histological parameters, were monitored during entire period of study. Increased oxidative stress was observed for plasma treated wound. This result can be related to the presence in the plasma volume of active species, such as O and OH radicals. Both methods, wound dressing and plasma-assisted epithelization, provided positive medical results related to the recovery process of burned wounds. The dynamics of the skin regeneration process was modified: the epidermis re-epitelization was accelerated, while the recovery of superficial dermis was slowed down.

Vasile Nastuta, Andrei; Topala, Ionut; Grigoras, Constantin; Pohoata, Valentin; Popa, Gheorghe



Health policy and the delivery of evidence-based wound care using regional wound teams  

Microsoft Academic Search

As clinicians practicing wound management in all three sectors of the healthcare system, the authors have articulated specific issues relating to wound management. There is a lack of awareness of the extent of the problem. Best practice guidelines have been developed, however, their adoption and transfer into practice have been inconsistent. Basic education in the field is minimal or absent

Karen Campbell; Laura Teague; Theresa Hurd; John King



Silver-coated nylon dressings for pediatric burn victims  

PubMed Central

BACKGROUND: Silver dressings are a proven method for burn treatment. Current challenges associated with burn treatment include pain management and limited hospital resources. A new silver-coated nylon dressing was used at the Montreal Children’s Hospital (Montreal, Quebec) to help reduce traumatic dressing changes and cost. METHODS: Burn victims in a pediatric patient population were followed over two years. Patients were excluded if they were evaluated more than 48 h postburn or if the burn affected less than 5% of the total body surface area. The same burn team admitted and treated all case subjects, and one dressing nurse recorded and monitored all progress throughout the study to ensure standardization. RESULTS: Fifteen patients were included in the study. The average number of dressing changes needed was 4.13, with a median of three changes. The average total body surface area burned was 8%, with a mean of 13.9 days before superficial wounds were re-epithelialized. The average length of in-hospital stay was four days. The cost was $388 less for silver-coated nylon dressings than for silver sulfadiazine cream for seven days of treatment. Silver-coated nylon dressings did not leave any residue or pseudoeschar on the wounds and were easily maintained at home. CONCLUSION: The silver-coated nylon dressings are as effective as other silver dressings used for pediatric burn victims. The dressings are less traumatic, require fewer resources and do not leave wound residue compared with other dressings.

Borsuk, Daniel E; Gallant, Michel; Richard, Diane; Williams, H Bruce



Health policy and the delivery of evidence-based wound care using regional wound teams.  


As clinicians practicing wound management in all three sectors of the healthcare system, the authors have articulated specific issues relating to wound management. There is a lack of awareness of the extent of the problem. Best practice guidelines have been developed, however, their adoption and transfer into practice have been inconsistent. Basic education in the field is minimal or absent across all disciplines. Institutions and agencies lack the infrastructure and financial resources to support optimal healthcare delivery in wound prevention and management. As a result, there are significant problems and inconsistencies in access to wound care across Ontario. This paper reviews the issues and background as related to pressure ulcer, diabetic foot ulcer and venous leg ulcer. Finally, the authors make specific health policy recommendations regarding the implementation of regional wound care teams. PMID:17017760

Campbell, Karen; Teague, Laura; Hurd, Theresa; King, John



A newly developed hydrofibre dressing, in the treatment of partial-thickness burns.  


A newly developed, carboxymethylcellulose based hydrofibre dressing, Aquacel, was tested for the treatment of partial thickness burns. In this study 84 patients with mainly partial thickness burns were included, 76 patients received 1 or 2 days pre-treatment with a topical antimicrobial agent. Clinical behaviour showed a strong resemblance with cadaver skin treatment with respect to adherence to the wound. Adverse reactions, incidence of clinical wound infection, healing time and the need for wound excision and grafting were analysed, as was the final outcome using the 'Vancouver Scar Scale'. The mean size of the wounds treated with the hydrofibre dressing was 6.0% body surface area (min: 1%, max: 18%). Two patients clinically showed signs of a wound infection during treatment, but in general wound cultures were low or negative. In 42 patients (50%) the wounds healed completely within 10 days, in six patients (7%) small defects remained that healed by further treatment with a topical antimicrobial cream. In 36 patients (43%) excision and grafting of the remaining deeper parts of the wounds was performed as this is the standard therapy in the centre for all burned areas that have not healed within 2-3 weeks post-injury. The extent of the surgical procedures was limited since 66.1% of the wound area had healed already at the end of the hydrofibre treatment. In 54 patients the outcome of the treatment after 2-3 months was analysed by means of the Vancouver Scar Scale, which showed favourable results in general, and especially for patients who did not require surgery. Compared to earlier experience with allograft skin it was concluded that hydrofibre dressing is a safe, suitable and easy to use material for treatment of partial thickness burns. PMID:11226656

Vloemans, A F; Soesman, A M; Kreis, R W; Middelkoop, E



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.

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



The use of a hydrofibre dressing in fulminating necrotizing fasciitis.  


This article describes a case of necrotizing fasciitis in a 52-year-old man with previously undiagnosed diabetes. Treatment involved massive debridement and subsequent dressing of the open surgical wound. A modern hydrofibre dressing (Aquacel) was inserted intraoperatively and subsequently continued postoperatively. Wound healing occurred over 3 months and the patient was discharged with no disability. The dressing managed the exudate level and kept the wound moist. It also was well tolerated by the patient, was comfortable and easy for the nurses to remove and apply. PMID:12146180

Foster, L; Smith, E; Moore, P; Turton, P


Simultaneous detections of 27 cytokines during cerebral wound healing by multiplexed bead-based immunoassay for wound age estimation.  


Quantification of 27 cytokines following cerebral wounding was performed for wound age estimation. The cytokines evaluated included interleukin (IL)-1alpha, IL-1beta, IL-2, IL-3, IL-4, IL-5, IL-6, IL-10, IL-12 p40, IL-12 p70, IL-15, IL-17, IL-18, basic fibroblast growth factor (bFGF), granulocyte-colony stimulating factor (G-CSF), granulocyte macrophage-colony stimulating factor (GM-CSF), Interferon-gamma (IFN-gamma), keratinocyte derived cytokine (KC), leukemia inhibitory factor (LIF), macrophage-colony stimulating factor (M-CSF), monokine inducible by interferon gamma (MIG), macrophage inflammatory protein (MIP)-1 alpha, MIP 2, platelet-derived growth factor BB (PDGF BB), regulated upon activation, normal T-cell expressed, and secreted (Rantes), tumor necrosis factor-alpha (TNF-alpha), and vascular endothelial growth factor (VEGF). The proliferation of glial cells as well as the infiltration of inflammatory cells were also evaluated. Although astroglia proliferated from 72 hours post-injury, inflammatory cell dynamics were generally steady. Among cytokines analyzed in the present study, IL-1beta, IL-5, IL-6, IL-12 p40, G-CSF, IFN-gamma, KC, LIF, MIP2, and PDGF BB increased during the early phase of cerebral wound healing, and M-CSF increased during the middle phase, while IL-15, IL-18, and MIG increased during the late phase. In contrast, IL-1alpha, IL-10, IL-12 p70, and TNF-alpha were suppressed throughout the cerebral wound healing process. Based on our findings, quantitative cytokine analyses at the cerebral wound site may be a useful tool for wound age estimation. Further, this study suggests that multiplex data gained from the same sample using a single methodology demonstrates highly accurate cytokine interactions during the process of cerebral wound healing. PMID:18159995

Takamiya, Masataka; Fujita, Sachiko; Saigusa, Kiyoshi; Aoki, Yasuhiro



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




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.

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



[The effect of the composition of stomatological dressings on Carbopol 971P and methylocelullose base on pharmaceutical availability of metronidazole].  


The carried out studies allowed to propose composition of stomatological dressing makes opportunity to ensure preferable physiochemicals features for dosage forms. According to results formulations contain 1.5% Carbopol 971P, 0.13% methylocelullose and various quantity of glycerol, 1,2-propylene glycol and polyethylene glycol 400 were prepared. To compare formulation consists of only polymers dispersion (Carbopol 971P and methylocelullose) was prepared. Next to produced compound triethanoloamine to pH range 5.5-6.5 and 1% metronidazole added. Kinetics test of metronidazole release was performed in vitro using Hanson's cells and semipermable membrane. The quantity of the release metronidazole was determined by spectrophotometric method. Gel consists of 98% polymers dyspersion with 2% glycerol characterized by the largest pharmaceutical availability. The addition of 2% PEG 400 resulted in the decrease of the percentage of released substance in comparison to formulation without hydrophylisers. Metronidazole releasing was more efficient for dressings with 2% glycerol as well propylene glycol. For preparations contains glycerol (2 and 5%) as well propylene glycol as adiuvants, it was found that gels prepared on Carbopol 971P and methylocelullose revealed higher pharmaceutical availability than analogical dressings prepared with only one polymer base. PMID:22046825

Kida, Dorota; Pluta, Janusz



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


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



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.

Chuangsuwanich, Apirag; Kangwanpoom, Jupaporn



Evidence-Based Medicine and the Management of the Chronic Wound: Is It Enough?  

Microsoft Academic Search

Evidence-based medicine has become ubiquitous in modern-day medicine, including wound care. However, the application of evidence-based medicine into the arena of chronic wounds has not been uniformly performed and measured. Most wound care studies are plagued by inconsistencies in inclusion criteria, data measurements, and endpoint reporting. Furthermore, the small sample sizes prohibit drawing effective conclusions. However, that does not imply

Thanh Dinh; Aristidis Veves



Novel peptidoglycan-based diagnostic devices for detection of wound infection.  


Detection of wound infection is based on evaluation of the well-known signs of inflammation like rubor (redness), calor (heat), tumor (swelling), and dolor (pain) by medical doctors and/or time-consuming procedures requiring special machinery. There is currently no rapid diagnostic device available for the indication of wound infection, which would especially be helpful in home care of chronic ulcer patients. In this study, a new concept for a fast diagnostic tool for wound infection based on lysozyme and elastase triggered release of dye from a peptidoglycan matrix was investigated. The matrix consisted of alginate/agarose and peptidoglycan covalently labeled with Remazol brilliant blue. Lysozyme activity in postoperative wounds and decubitus wound fluids was significantly elevated upon infection (4830 ± 1848 U mL(-1)) compared to noninfected wounds (376 ± 240 U mL(-1)). Consequently, incubation of 8% (w/v) labeled agarose/peptidoglycan blend layers with infected wound fluid samples for 2 h at 37 °C resulted in a 4-fold higher amount of dye released than measured for noninfected wounds. For alginate/peptidoglycan beads, a 7-fold higher amount of dye was released in case of infected wound fluid samples compared to noninfected ones. Apart from lysozyme, proteases [i.e., gelatinase matrix metalloproteinase MMP-2 and MMP-9 and elastase] were detected in wound fluids (e.g., using Western blotting). When dosed in ratios typical for wounds, a slight synergistic effect was measured for peptidoglycan hydrolysis (i.e., dye release) between lysozyme and these proteases. Incubation of a double-layer system consisting of stained and nonstained peptidoglycan with infected wound fluids resulted in a color change from yellow to blue, thus allowing simple visual detection of wound infection. PMID:21388768

Hasmann, Andrea; Wehrschuetz-Sigl, Eva; Kanzler, Gertraud; Gewessler, Ulrike; Hulla, Elisabeth; Schneider, Konstantin P; Binder, Barbara; Schintler, Michael; Guebitz, Georg M



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



The evidence based wound healing activity of Lawsonia inermis Linn.  


The ethanol extract of Lawsonia inermis (200 mg/kg/day) was used to evaluate the wound healing activity on rats using excision, incision and dead space wound models. The animals were divided into three groups of six each in the excision model and two groups of six each in the incision model and dead space models. The topical application was made in the case of excision wound model, whereas, oral treatment was done with incision and dead space wound models. The following differences were noted in the group of experimental animals which were treated with an extract of L. inermis when compared with the control and reference standard animals: a high rate of wound contraction (p < 0.001), a decrease in the period of epithelialization (p < 0.001), high skin breaking strength (p < 0.001), a significant increase in the granulation tissue weight (p < 0.001) and hydroxyproline content (p < 0.05). The extract-treated animals showed 71% reduction in the wound area when compared with controls which was 58%. Histological studies of the tissue obtained on day 10 from the extract-treated group showed increased well organized bands of collagen, more fibroblasts and few inflammatory cells when compared with the controls which showed inflammatory cells, scanty collagen fibres and fibroblasts. Enhanced wound contraction, increased skin breaking strength, hydroxyproline and histological findings suggest the use of L. inermis in the management of wound healing. PMID:17533628

Nayak, B Shivananda; Isitor, Godwin; Davis, E M; Pillai, G K



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.

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



Modified cotton gauze dressings that selectively absorb neutrophil elastase activity in solution.  


Dressings for chronic human wounds have been aimed at protection, removal of exudate, and improved appearance. However since the time of ancient Greece wound care and dressing strategies have primarily relied on empiricism. Recent studies have shown that chronic wounds contain high levels of tissue and cytokine destroying proteases including collagenase and neutrophil elastase. Therefore we sought to develop an effective wound dressing that could absorb elastase through affinity sequestration. Cotton gauze was modified by oxidation, phosphorylation, and sulfonation to enhance elastase affinity by ionic or active site uptake. Type VII absorbent cotton gauze was oxidized to dialdehyde cotton which was subsequently converted in part to the bisulfite addition product. Gauze preparations were also phosphorylated and carboxymethylated. Modified cotton gauzes were compared with untreated gauze for reduction of elastase activity in buffered saline. Solutions of elastase that were soaked in oxidized, sulfonated, and phosphorylated cotton gauze showed reduced elastase activity. The initial velocities (v(o)) and turnover rates of elastase showed significant decreases compared with solutions taken from untreated gauze. The reduction in enzyme activity with dialdehyde cotton gauze was confirmed in solution by determining elastase inhibition with dialdehyde starch. The dialdehyde cotton gauze also decreased elastase activity in human wound fluid in a dose response relation based on weight of gauze per volume of wound fluid. Absorbency, pH, air permeability and strength properties of the modified gauze were also compared with untreated cotton gauze. This report shows the effect of reducing elastase activity in solution with cotton containing aldehydic or negatively charged cellulose fibers that may be applicable to treatment modalities in chronic wounds. PMID:11350640

Edwards, J V; Yager, D R; Cohen, I K; Diegelmann, R F; Montante, S; Bertoniere, N; Bopp, A F


Novel protease-based diagnostic devices for detection of wound infection.  


A gelatinase-based device for fast detection of wound infection was developed. Collective gelatinolytic activity in infected wounds was 23 times higher (p???0.001) than in noninfected wounds and blisters according to the clinical and microbiological description of the wounds. Enzyme activities of critical wounds showed 12-fold elevated enzyme activities compared with noninfected wounds and blisters. Upon incubation of gelatin-based devices with infected wound fluids, an incubation time of 30 minutes led to a clearly visible dye release. A 32-fold color increase was measured after 60 minutes. Both matrix metalloproteinases and elastases contributed to collective gelatinolytic enzyme activity as shown by zymography and inhibition experiments. The metalloproteinase inhibitor 1,10-phenanthroline (targeting matrix metalloproteinases) and the serine protease inhibitor phenylmethlysulfonyl fluoride (targeting human neutrophil elastase) inhibited gelatinolytic activity in infected wound fluid samples by 11-37% and 60-95%, respectively. Staphylococcus aureus and Pseudomonas aeruginosa, both known for gelatinase production, were isolated in infected wound samples. PMID:23627267

Heinzle, Andrea; Papen-Botterhuis, Nicole E; Schiffer, Doris; Schneider, Konstantin P; Binder, Barbara; Schintler, Michael; Haaksman, Ingrid K; Lenting, Herman B; Gübitz, Georg M; Sigl, Eva



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


Common causes of trauma and wound pain include: the removal of dressings that become stuck to the wound bed; skin stripping of peri-wound skin, as a result of the repeated application and removal of adhesive dressings; and tissue excoriation and maceration of the peri-wound skin, due to inadequate management of wound exudate. This supplement outlines how dressings with Safetac adhesive technology can help clinicians to avoid these problems. A review of the clinical and scientific evidence relating to dressings with Safetac clearly demonstrates that they can be used to prevent trauma and minimise pain on a wide range of wound types and skin injuries. PMID:19252457

Davies, Phil; Rippon, Mark



PolyMem® Wic® Silver® Rope: A Multifunctional Dressing for Decreasing Pain, Swelling, and Inflammation  

PubMed Central

Problem Choosing the most appropriate dressing to meet the complex needs of patients with narrow deep wounds, such as tunnels, fistulas, and cysts, is a daunting task. Such wounds are difficult to cleanse and tend to be extremely painful. Wound patients need a drug-free dressing that handles exudates, decreases the need for traumatic cleansing during dressing changes, and addresses wound pain, inflammation, and swelling. Solution Multifunctional PolyMem® dressings (the generic name is polymeric membrane dressings) contain ingredients that work synergistically to continuously cleanse wounds and bring about rapid healing. Nonadherent PolyMem provides atraumatic dressing changes. PolyMem also decreases persistent wound pain. PolyMem Silver provides effective antimicrobial action without destructive silver toxicity. New Technology PolyMem Wic® Silver® Rope is a new strong, but exceedingly supple, dressing comprised of PolyMem Wic Silver reinforced with embedded surgical mesh. Insertion and removal is so simple that patients often change their dressings themselves. The unique features of PolyMem combine to make the nonadherent dressings not only extremely comfortable, but also anti-inflammatory, thus addressing both persistent and procedural wound pain. Indications for Use PolyMem Wic Silver Rope is especially appropriate for deep wounds with narrow openings, such as tunnels, fistulas, and cysts, but it can be used in any acute or chronic wound, even in the presence of infection. Caution PolyMem dressings enhance autolytic debridement, which often results in production of large quantities of pale yellow enzyme- and nutrient-rich wound fluid during the first treatment week. Extra-absorbent PolyMem Max secondary dressings can contain excess fluid.

Benskin, Linda L.L.



Moist wound healing compared with standard care of treatment of primary closed vascular surgical wounds: a prospective randomized controlled study.  


This study was a randomized-controlled trial comparing the standard type of dry dressing, Mepore, with moist wound healing, using a hydrofiber dressing, Aquacel, in primary closed wounds after vascular surgery. The endpoints were patient comfort, cost-effectiveness, infections, wound complications, and length of hospital stay. One hundred and sixty patients were randomized to receive either Mepore or Aquacel dressing. There was no significant difference in patient comfort between the two groups, but a higher cost in the Aquacel group despite significantly fewer changes of dressings in these patients. No difference in the infection rate (13% vs. 11%, p=0.73), length of hospital stay, or wound complications was noted between the two groups. We conclude that although the Aquacel dressing needed significantly fewer changes than the conventional dressing, this did not influence the patient comfort. Moreover, the traditional dressing scheme was significantly less expensive. PMID:17971007

Vogt, Katja C; Uhlyarik, M; Schroeder, Torben V


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



Graphene-based composite materials beneficial to wound healing.  


We use electrospinning to prepare chitosan-PVA nanofibers containing graphene. The nanofibers can be directly used in wound healing: graphene, as an antibacterial material, can be beneficial for this. A possible antibacterial mechanism for graphene is presented. PMID:22453925

Lu, Bingan; Li, Ting; Zhao, Haitao; Li, Xiaodong; Gao, Caitian; Zhang, Shengxiang; Xie, Erqing



Graphene-based composite materials beneficial to wound healing  

NASA Astrophysics Data System (ADS)

We use electrospinning to prepare chitosan-PVA nanofibers containing graphene. The nanofibers can be directly used in wound healing: graphene, as an antibacterial material, can be beneficial for this. A possible antibacterial mechanism for graphene is presented.

Lu, Bingan; Li, Ting; Zhao, Haitao; Li, Xiaodong; Gao, Caitian; Zhang, Shengxiang; Xie, Erqing



A transparent dressing in free-flap surgery.  


The authors have developed a technique for postoperative monitoring of transferred free flaps, making the removal of gauze dressings unnecessary. Their technique involves the transparent, hydrogel wound dressing, Clear Site. A Doppler probe can also be directly applied over this material, to examine the patency of the vascular pedicle. An adhesive border on the sheeted material keeps the flap aseptic, thus providing fewer opportunities for wound infection. A wider use of this transparent dressing technique in free-flap surgery is expected. PMID:7965997

Yamamoto, Y; Minakawa, H; Yoshida, T



Mepitel One: a wound contact layer with Safetac technology.  


This article examines the use of Mepitel One, a wound contact layer that promotes wound healing by using the clinical benefits of Safetac technology. A wide range of clinical evidence shows that dressings with Safetac prevent trauma, minimise wound pain and associated psychological stress, while facilitating undisturbed wound healing. Mepitel One has been developed as a highly transparent wound contact layer with Safetac on the wound contact surface alone; this makes it easy to apply without sticking to gloves, and allows it to be used with a choice of secondary dressings. The dressing can stay in place for up to 14 days and allows examination of the wound without removal. The clinical evidence reviewed here shows that Mepitel One is a versatile option for use on a wide range of wound types to promote undisturbed healing and minimise pain at dressing changes. PMID:23469510

Barrett, Simon


Distribution assessment comparing continuous and periodic wound instillation in conjunction with negative pressure wound therapy using an agar-based model.  


Negative pressure wound therapy (NPWT) is a widely accepted and effective treatment for various wound types, including complex wounds. Negative pressure with instillation was initially used as a gravity-fed system whereby reticulated, open-cell foam in the wound bed was periodically exposed to cycles of soaking with instillation solution followed by NPWT. Recent publications have alluded to positive outcomes with continuous instillation, where fluid is delivered simultaneously with negative pressure. To evaluate the distribution of instillation solutions to wound beds in conjunction with negative pressure, agar-based models were developed and exposed to coloured instillation solutions to identify exposure intensity via agar staining. This model allowed comparison of continuous- versus periodic-instillation therapy with negative pressure. Continuous instillation at a rate of 30 cc/hour with negative pressure showed isolated exposure of instillation fluid to wound beds in agar wound models with and without undermining and tunnelling. In contrast, periodic instillation illustrated uniform exposure of the additive to the entire wound bed including undermined and tunnel areas, with increased staining with each instillation cycle. These findings suggest that periodic instillation facilitates more uniform exposure throughout the wound, including tunnels and undermining, to instillation solutions, thereby providing therapy consistent with the clinician-ordered treatment. PMID:22487428

Rycerz, Anthony M; Slack, Paul; McNulty, Amy K



Opsite, a synthetic burns dressing.  


Opsite, a sterile, occlusive, adherent, polyurethane film has been used in a prospective study involving 150 cases of partial thickness burns. All cases were admitted to the Department of Plastic Surgery, Singapore General Hospital. The patients' ages ranged from infants to the elderly. All sites of the body were tried on Opsite except the head and face and total burns areas applied with opsite varied from less than 5% to 25%. 80% of cases did well, 20% had to have the dressing discontinued for various reasons, the most common being infection. The advantages were in the ease of wound observation, patient comfort, early mobilisation and relative economy. Opsite is a suitable burns dressing for the partial thickness burns especially of the trunk and limbs and is very useful in children. The complications are relatively few and minor. PMID:4037698

Fong, P H; Wong, K L



???????Developing evidence-based algorithms for negative pressure wound therapy in adults with acute and chronic wounds: literature and expert-based face validation results.  


Negative pressure wound therapy (NPWT) is used extensively in the management of acute and chronic wounds, but concerns persist about its efficacy, effectiveness, and safety. Available guidelines and algorithms are wound type-specific, not evidence-based, and many lack clearly described relative and absolute contraindications and stop criteria. The purpose of this research was to: (1) develop evidence-based algorithms for the safe use of NPWT in adults with acute and chronic wounds by nonwound expert clinicians, and (2) obtain face validity for the algorithms. Using NPWT meta-analyses and systematic reviews (n = 10), NPWT guidelines of care (n = 12), general evidence-based guidelines of wound care (n = 11), and a framework for transitioning between moisture-retentive and NPWT care (n = 1), a set of three algorithms was developed. Literature-based validity for each of the 39 discreet algorithm steps/decision points was obtained by reviewing best available evidence from systematic literature reviews (n = 331 publications) and abstraction of all NPWT-relevant publications (n = 182) using the patient-oriented Strength of Recommendation (SORT) taxonomy. Of the 182 NPWT studies abstracted, 25 met criteria for level 1 and 2 evidence but only one general assessment step had both level 1 evidence and an "A" strength of recommendation. Next, an Institutional Review Board-approved, cross-sectional mixed methods survey design face validation pilot study was conducted to solicit comments on, and rate the validity of, the 51 discreet algorithm-related statements, including the 39 decisions/steps. Twelve (12) of the 15 invited interdisciplinary wound experts agreed to participate. The overall algorithm content validity index (CVI) was high (0.96 out of 1). Helpful design suggestions to ensure safe use were made, and participants suggested an examination of commonly used wound definitions in follow-up studies. Results of the literature-based face validation confirm that the evidence base for using NPWT remains limited, especially for chronic wounds, and that safety guidance may be affected by the fact that evidence-based ratings cannot accurately reflect relative or absolute product contraindications because they simply are not included in clinical studies. These findings, the positive expert panel comments, and the high CVI confirm the need for an algorithm with explicit NPWT start-and-stop criteria and suggest that follow-up content and construct validation of these algorithms is warranted. PMID:22466133

Beitz, Janice M; van Rijswijk, Lia



Wound healing activity of topical application forms based on ayurveda.  


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 resin, Yashada bhasma as study materials. For preliminary efficacy evaluation of the anti-aging activity we chose excision and incision wound healing animal models and studied the parameters including wound contraction, collagen content and skin breaking strength which in turn is indicative of the tissue cell regeneration capacity, collagenation capacity and mechanical strength of skin. The group treated with the formulations containing Yashada bhasma along with Shorea robusta resin and flax seed oil showed significantly better wound contraction (P?

Datta, Hema Sharma; Mitra, Shankar Kumar; Patwardhan, Bhushan



Hydroalcoholic extract based-ointment from Punica granatum L. peels with enhanced in vivo healing potential on dermal wounds  

Microsoft Academic Search

The present study reports for the first time, the in vivo wound healing potential of Punica granatum L. peels. A 5% (w\\/w) methanolic extract based-ointment was formulated and evaluated for its wound healing in guinea pigs. The ointment was applied in vivo on the paravertebral area of twelve excised wounded models once a day for 10 consecutive days. The ointment

E. A. Hayouni; K. Miled; S. Boubaker; Z. Bellasfar; M. Abedrabba; H. Iwaski; H. Oku; T. Matsui; F. Limam; M. Hamdi



Community Analysis of Chronic Wound Bacteria Using 16S rRNA Gene-Based Pyrosequencing: Impact of Diabetes and Antibiotics on Chronic Wound Microbiota  

PubMed Central

Background Bacterial colonization is hypothesized to play a pathogenic role in the non-healing state of chronic wounds. We characterized wound bacteria from a cohort of chronic wound patients using a 16S rRNA gene-based pyrosequencing approach and assessed the impact of diabetes and antibiotics on chronic wound microbiota. Methodology/Principal Findings We prospectively enrolled 24 patients at a referral wound center in Baltimore, MD; sampled patients' wounds by curette; cultured samples under aerobic and anaerobic conditions; and pyrosequenced the 16S rRNA V3 hypervariable region. The 16S rRNA gene-based analyses revealed an average of 10 different bacterial families in wounds—approximately 4 times more than estimated by culture-based analyses. Fastidious anaerobic bacteria belonging to the Clostridiales family XI were among the most prevalent bacteria identified exclusively by 16S rRNA gene-based analyses. Community-scale analyses showed that wound microbiota from antibiotic treated patients were significantly different from untreated patients (p?=?0.007) and were characterized by increased Pseudomonadaceae abundance. These analyses also revealed that antibiotic use was associated with decreased Streptococcaceae among diabetics and that Streptococcaceae was more abundant among diabetics as compared to non-diabetics. Conclusions/Significance The 16S rRNA gene-based analyses revealed complex bacterial communities including anaerobic bacteria that may play causative roles in the non-healing state of some chronic wounds. Our data suggest that antimicrobial therapy alters community structure—reducing some bacteria while selecting for others.

Price, Lance B.; Liu, Cindy M.; Melendez, Johan H.; Frankel, Yelena M.; Engelthaler, David; Aziz, Maliha; Bowers, Jolene; Rattray, Rogan; Ravel, Jacques; Kingsley, Chris; Keim, Paul S.; Lazarus, Gerald S.; Zenilman, Jonathan M.



Functional biopolymer-based matrices for modulation of chronic wound enzyme activities.  


Collagen, collagen/hyaluronic acid (HA) and collagen/HA/chitosan (CS) sponges loaded with epigallocatechin gallate (EGCG), catechin (CAT) and gallic acid (GA) were developed and evaluated as active chronic wound dressings. Their physico-mechanical properties, biostability, biocompatibility and ability to inhibit in vitro myeloperoxidase (MPO) and collagenase--major enzymes related with the persistent inflammation in chronic wounds--were investigated as a function of the biopolymer composition and the polyphenolic compound used. The results demonstrated that the molecular weight of HA influences significantly the bulk properties of the obtained materials: higher elastic modulus, swelling ability and biostability against collagenase were measured when HA with higher molecular weights (830 and 2000 kDa) were added to the collagen matrices. The addition of CS and the polyphenols increased further the biostability of the sponges. Preliminary in vitro tests with fibroblasts revealed that the cells were able to adhere to all sponges. Cell viability was not affected significantly by the addition of the polyphenols; however, the presence of CS or high molecular weight HA in the sponge composition was associated with lower cellular viability. Finally, all specimens containing polyphenols efficiently inhibited the MPO activity. The highest inhibition capacity was observed for EGCG (IC??=15±1?M) and it was coupled to the highest extent of binding to the biopolymers (>80%) and optimal release profile from the sponges that allowed for prolonged (up to 3-5 days) effects. PMID:23072830

Francesko, Antonio; Soares da Costa, Diana; Reis, Rui L; Pashkuleva, Iva; Tzanov, Tzanko



Dressings with Safetac® technology: A new 'ideal' for burns.  


In all wounds, there is an overriding need to protect damaged tissues from further injury, from ingress of bacteria, to relieve pain and, ultimately, provide the optimal wound-healing environment. Dressings have been used to provide such protection for millennia, with varying degrees of success. However, early research by Winter scientifically identified that a moist wound-healing environment should be provided in order to optimise healing.1. PMID:22990401

Butcher, Martyn; Rippon, Mark; Davies, Phil



Simplified Negative Pressure Wound Therapy in Pediatric Hand Wounds  

PubMed Central

Negative pressure wound therapy (NPWT) is commonly used as a bolster for skin grafts. The technique offers the benefit of negative pressure as well as reduced dressing changes. Skin grafting of the hand provides a unique challenge, and currently, the only commercially available NPWT hand dressings are adult-sized, precluding their use in small children. We present our custom NPWT “mitten” technique for use with skin grafts on the pediatric hand.

Kasukurthi, Rahul



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

PubMed Central

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

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



The Examination of Antimicrobial Soft Silicone Foam Dressing with Regards to Partial Thickness Burns  

Microsoft Academic Search

BACKGROUND: Examination of the burn wound has been an integral aspect of treatment, since this allows for wound progression to be monitored. This is hindered by treatments that either leaves a residue, or becomes adherent which prevents inspection of the wound. Mepilex ® Ag, manufactured by Molnlycke Health Care, utilizes soft silicone (Safetac ® Technology) to provide a dressing that

Herbert Meites; Mason Jett; Stephen Gauthier; Kenna Wilson; Paul Silverstein



Design, Preparation and Activity of Cotton Gauze for Use in Chronic Wound Research  

Microsoft Academic Search

We consider the rational design and chemical modification of cotton gauze, which is used widely in chronic wounds, to improve wound dressing fibers for application to chronic wound healing. Cotton gauze may be tailored to more effectively enhance the biochemistry of wound healing. The presence of elevated levels of elastase in non-healing wounds has been associated with the degradation of

J. V. Edwards; Dorne Yager; Alvin Bopp; Robert F. Diegelmann; Steven C. Goheen; I. K. Cohen



Redoable Tie-Over Dressing Using Multiple Loop Silk Threads  

PubMed Central

After skin grafting, to prevent hematoma or seroma collection at the graft site, a tie-over dressing has been commonly used. However, although the conventional tie-over dressing by suture is a useful method for securing a graft site, refixation is difficult when repeated tie-over dressing is needed. Therefore, we recommend a redoable tie-over dressing technique with multiple loops threads and connecting silk threads. After the raw surface of each of our cases was covered with a skin graft, multiple loop silk thread attached with nylon at the skin graft margin. We applied the ointment gauze and wet cotton/fluffy gauze over the skin graft, then fixed the dressing by connecting cross-counter multiple loop thread with connecting silk threads. When we opened the tie-over dressing by cutting the connecting silk threads, we repeated the tie-over dressing with the same method. The skin graft was taken successfully without hematoma or seroma collection or any other complications. In conclusion, we report a novel tie-over dressing enabling simple fixation of the dressing to maintain proper tension for wounds that require repetitive fixation. Further, with this reliable method, the skin grafts were well taken.

Jo, Hyeon Jong; Kim, Jun Sik; Kim, Nam Gyun; Choi, Jae Hoon



Amniotic membrane is an effective burn dressing material  

Microsoft Academic Search

Human amniotic membrane is a readily available biological dressing material used to treat burns. It not only prevents oozing\\u000a of plasma from burn wounds but also relieves pain and controls sepsis. We used human amniotic membrane to treat fifteen burn\\u000a patients, and this material was effective. The application of this cost-free dressing material warrants further study as it\\u000a can be

Subhash Chandra Sharma; Madan Mojan Bagree; Ami Lal Bhat; Brij Bhushan Banga; Mahendra Pratap Singh



Role of the surgical glove in modified vacuum-assisted wound healing.  


Vacuum-assisted wound healing has been proven to be more efficacious than conventional dressings. Vacuum dressing has been frequently modified given the restrictions in resources available. Here we present a modified method of vacuum dressing by using surgical or gynaecological gloves for lower and upper limb wounds. Vacuum dressing was applied with parts of a surgical or gynaecological glove and Opsite with T-tailing of the suction outlet. Vacuum-assisted wound healing using the surgical gloves showed relatively good wound healing in the amputation stump, finger, arm, and leg in the cases studied. PMID:24086822

Hemmanur, Shankar Ram; Siddha, Loka Vijayan



Role of the Surgical Glove in Modified Vacuum-Assisted Wound Healing  

PubMed Central

Vacuum-assisted wound healing has been proven to be more efficacious than conventional dressings. Vacuum dressing has been frequently modified given the restrictions in resources available. Here we present a modified method of vacuum dressing by using surgical or gynaecological gloves for lower and upper limb wounds. Vacuum dressing was applied with parts of a surgical or gynaecological glove and Opsite with T-tailing of the suction outlet. Vacuum-assisted wound healing using the surgical gloves showed relatively good wound healing in the amputation stump, finger, arm, and leg in the cases studied.

Hemmanur, Shankar Ram



???Disaster management, triage-based wound care, and patient safety: reflections on practice following an earthquake.  


??Triage is the process of prioritizing patient care based on need and available resources. Clinicians in wound clinics triage daily because time and resources never seem to be sufficient. The triage concept is taken to an extreme when a disaster strikes--the clinical goal of patient care transforms from the individual patient to providing the greatest good for the greatest number of patients. Situational awareness of system resources is of paramount importance in a disaster. Planning for surge capacity while simultaneously attending to patients who require immediate attention is a must. The recent earthquake in Haiti provided an opportunity to test those skill sets. Scores of clinicians volunteered their time and expertise, elevating wound care to the status of a clinical division. The experience of providing quality wound care despite a myriad of situational limitations suggests that busy wound clinics can learn valuable lessons from the realm of disaster management. The rate of under- and over-triage in wound clinics can be reduced by utilizing commonly collected outcomes and operational data. Patient safety improves when the hierarchy is flattened, communication is open, checklists are used, debriefings are held, and teamwork is encouraged. Reflecting on the working conditions in Haiti, it is clear that patients and clinicians benefit when success is measured by patient outcomes instead of individual accomplishments. PMID:21131698

Ennis, William J



Wound cleansing: which solution, what technique?  

Microsoft Academic Search

Cleansing is a vital component of wound management. However, there is limited research to inform protocols. Although research has focussed on types of dressings, little attention has been given to the solutions and techniques to be used for cleansing purposes. The available evidence about the effectiveness of solutions and techniques in the prevention of wound infection and the promotion of

Ritin S Fernandez; Rhonda D Griffiths



Economic aspects of deep sternal wound infections  

Microsoft Academic Search

Objectives: Surgical-site infections are a very expensive complication in cardiac surgery. Thus, the total costs for coronary artery bypass grafting (CABG) surgery may substantially increase when a deep sternal wound infection (DSWI) occurs. This may be due to an extended length of stay (LOS), the need for additional surgical procedures, vacuum-assisted wound dressing and antibiotic therapy. This study compares the

Karolin Graf; Ella Ott; Ralf-Peter Vonberg; Christian Kuehn; Axel Haverich; Iris Freya Chaberny



Bioburden-responsive antimicrobial PLGA ultrafine fibers for wound healing.  


Despite innovation in the design and functionalization of polymer nanofiber wound healing materials, information on their interaction with the biochemical wound environment is lacking. In an earlier study, we have reported the interaction of fusidic acid-loaded PLGA ultrafine fibers (UFs) with wound bacteria. Massive bacterial colonization and the formation of a dense biofilm throughout the mat were demonstrated. This was associated with a marked enhancement of initial drug release at concentrations allowing eradication of planktonic bacteria and considerable suppression of biofilm. The present study aimed at extending earlier findings to gain more mechanistic insights into the potential response of the fusidic acid-laden UFs under study to controlled microbial bioburden. Initial drug release enhancement was shown to involve surface erosion of the ultrafibrous mats likely mediated by microbial esterase activity determined in the study. Release data could be correlated with microbial bioburden over the inoculum size range 10³-10? CFU/ml, suggesting a bioburden-triggered drug release enhancement mechanism. Moreover, the effectiveness of fusidic acid-laden UFs in the healing of either lightly contaminated or Staphylococcus aureus heavily infected wounds in a rat model suggested in-use relevant antimicrobial release patterns. Findings indicated active participation of polymer ultrafine wound dressings in a dynamic interaction with the wound milieu, which affects their structure-function relationship. Understanding such an interaction is fundamental to the characterization and performance assessment of wound materials under biorelevant conditions and the design of polymer-based infection-responsive biomaterials. PMID:21924354

Said, Somiraa S; El-Halfawy, Omar M; El-Gowelli, Hanan M; Aloufy, Affaf K; Boraei, Nabila A; El-Khordagui, Labiba K



Simultaneous detection of eight cytokines in human dermal wounds with a multiplex bead-based immunoassay for wound age estimation.  


We performed quantification of IL 2, IL 4, IL 6, IL 8, IL 10, GM-CSF, IFN gamma, and TNF alpha in human dermal wounds for wound age estimation. The proliferation of dermal cells and infiltration of inflammatory cells were also analyzed. Neutrophils and macrophages were detected from 2 h post-injury, and strong infiltrations were seen at 33-49 h. T and B lymphocytes also infiltrated simultaneously from 71 h. Strong proliferation of fibroblasts were shown from 246 h, and thickening of the epidermis from 71 h. IL 10, GM-CSF, IFNgamma, and TNF alpha increased from the early phase of dermal wound healing, IL 6 exclusively in the middle phase, IL 2, IL 4, and IL 8 from the middle phase to the late phase. Among the cytokines analyzed in the present study, IL 6, IL 8, IFNgamma, and TNF alpha were strongly expressed. Results of the present study suggest that multiplex cytokine analysis at the wound site can be useful for wound age estimation. In addition, multiplex data obtained from the same sample with a single method would demonstrate more accurate interactions of cytokines during dermal wound healing. Although the present study was oriented to practical forensic pathology, the data obtained would be informative for various fields of medicine. PMID:17724607

Takamiya, Masataka; Fujita, Sachiko; Saigusa, Kiyoshi; Aoki, Yasuhiro



Second-degree burn healing: the effect of occlusive dressings and a cream.  


Because occlusive dressings and some creams have been found to speed epithelialization of blade-induced wounds, we studied the effect of two occlusive dressings and a polyglycerylmethacrylate cream containing low concentration of fibronectin on epithelialization in second-degree burn wounds. Cylindrical brass rods were heated in a boiling water bath, removed, wiped dry, and placed (6 sec) on the skin of domestic pigs. The burned epidermis was removed and each burn wound was assigned to one of the following treatment groups: (1) air-exposed, (2) DuoDERM (hydrocolloid dressing; Squibb Co., New Jersey), (3) Opsite (polyurethane dressing; Smith & Nephew, New Jersey), or (4) experimental cream. Several burn wounds were excised from each treatment group on Days 6 to 14 after wounding. The excised burn wounds were incubated in 0.5 M NaBr for 24 hr which allowed separation of the epidermis from the dermis. The epidermis was examined macroscopically for defects in the area of the burn. Specimens were considered healed when a defect was not present. Neither of the occlusive dressings changed the rate of epithelialization as compared to air exposure. Wounds which were treated with the experimental cream epithelialized faster than the air-exposed wounds (P less than 0.025). PMID:2314098

Davis, S C; Mertz, P M; Eaglstein, W H



High-tech/high-touch team-centered care provides best outcomes for wound prevention in critically ill patients.  


The management of problem wounds by critical care nurses is a particular challenge in that their primary responsibilities revolve around emergent care and resuscitation of patients. However, with the identification of pressure wound development as a "never event" by Centers for Medicare & Medicaid Services and the escalating costs to more than $5 billion annually for treating chronic wounds in the US population, wound management has become a clinical imperative. The essence of nursing as a healing, caring profession should drive our efforts at reducing and/or eliminating any untoward complication that threatens the very being of our patients. Problem wounds represent such a challenge. This article examines wound management from both the science and art of nursing care. The science comprises advanced wound therapies including hyperbaric oxygen therapy, recombinant DNA growth factor therapy, human skin equivalents, V.A.C. Therapy, advanced support surfaces, and state-of-the-art dressings. The art of wound management resides in the development of a comprehensive wound center with both outpatient and inpatient capabilities including a hospital-based wound team of nursing specialists. The challenge of healing problem wounds requires a multidisciplinary approach, a dedication to measurable outcomes, and a passion for holistic, patient-centered interventions. PMID:20827064

Lyon, Karen C


Using Simultaneous Prompting within an Activity-Based Format to Teach Dressing Skills to Preschoolers with Developmental Delay.  

ERIC Educational Resources Information Center

|A multiple probe across skills, single-subject research design was used to evaluate the effectiveness of a simultaneous prompting procedure with a physical guidance controlling prompt to teach three dressing skills to two preschoolers with disabilities. Both students maintained skills with 90% accuracy up to six weeks following acquisition.…

Sewell, Teena J.; Collins, Belva C.; Hemmeter, Mary Louise; Schuster, John W.



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



The comparison of two negative-pressure wound therapy systems in a porcine model of wound healing.  


The purpose of this study was to compare two negative-pressure wound healing systems (NPWT), -75?mmHg with a silicone-coated (SC) dressing and -125?mmHg with polyurethane foam dressing (standard of care). In addition, this study compared the effects of two different dressing interfaces, SC dressing and gauze, with -75?mmHg pressure. For both comparisons, two groups of five pigs were evaluated over a 21-day time course. Two excisional wounds were made on each animal and NPWT dressings were applied. A canvas saddle was constructed to hold the NPWT device so the animal had free range of the pen. Dressings were changed twice a week and wound measurements were taken. Specimens for histology and gene expression analyses were taken on day 7 and 21. These data show that there is increased expression in a few genes associated with remodeling and inflammatory processes in the NPWT-125 with polyurethane foam as compared with the NPWT-75 with SC dressing. These two systems, however, are equivalent with respect to wound healing, histology, and gene expression over 21 days of healing. Further, we demonstrate that there is no difference in measure of healing between the SC dressing and a basic gauze dressing. PMID:23926906

Davis, Kathryn E; Lafontaine, Javier; Bills, Jessica; Noble, Deborah; Wight-Carter, Mary; Oni, Georgette; Rohrich, Rod J; Lavery, Lawrence A



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



The role of hyaluronan in wound healing.  


The polysaccharide hyaluronan (HA) (synonyms - hyaluronic acid, hyaluronate) is a versatile, polymorphic, glycosoaminoglycan with vast biological functions. HA is found throughout the body, primarily residing in skin, thus playing a large role in wound healing. Research regarding HA's function has changed over the years, primarily focussing on a particular aspect or function. The contribution HA has in each stage of normal wound healing will be examined as well as its clinical wound dressing applications. PMID:22891615

Frenkel, Joseph S



Surgical wound management made easier and more cost-effective  

PubMed Central

Evidence-based guidelines for the prevention of surgical site infection (SSI) have been published by the U.S. Centers for Disease Control and Prevention (CDC). According to these guidelines, a wound should usually be covered with a sterile dressing for 24 to 48 h when a surgical incision is closed primarily. However, it is not recommended that an incision be covered by a dressing beyond 48 h. In this study, patients were stratified into two groups for analysis: patients whose surgical wound was sterilized and whose gauze was changed once daily until postoperative day 7 (7POD; group A); and patients whose surgical wound was sterilized and whose gauze was changed once daily until 2POD (group B). We evaluated the incidence of SSI, nursing hours and cost implications. The results showed that there was no significant difference in SSI occurrence between the two groups (group A, 10% vs. group B, 7.3%). By contrast, the average nursing time differed by 2.8 min (group A, 3.8 min vs. group B, 0.9 min). The material costs per patient were also reduced by $14.70 (group A, $61.80 vs. group B, $47.10). In conclusion, we applied our knowledge of the evidence-based CDC guidelines to determine whether 48-h wound management can be made easier, more uniform and more cost-effective compared to conventional wound management. The results of the present study showed that surgical wound management methods can be more convenient and inexpensive.




Efficient SVM classifier based on color and texture region features for wound tissue images  

NASA Astrophysics Data System (ADS)

This work is part of the ESCALE project dedicated to the design of a complete 3D and color wound assessment tool using a simple hand held digital camera. The first part was concerned with the computation of a 3D model for wound measurements using uncalibrated vision techniques. This article presents the second part, which deals with color classification of wound tissues, a prior step before combining shape and color analysis in a single tool for real tissue surface measurements. We have adopted an original approach based on unsupervised segmentation prior to classification, to improve the robustness of the labelling stage. A database of different tissue types is first built; a simple but efficient color correction method is applied to reduce color shifts due to uncontrolled lighting conditions. A ground truth is provided by the fusion of several clinicians manual labellings. Then, color and texture tissue descriptors are extracted from tissue regions of the images database, for the learning stage of an SVM region classifier with the aid of a ground truth resulting from. The output of this classifier provides a prediction model, later used to label the segmented regions of the database. Finally, we apply unsupervised color region segmentation on wound images and classify the tissue regions. Compared to the ground truth, the result of automatic segmentation driven classification provides an overlap score, (66 % to 88%) of tissue regions higher than that obtained by clinicians.

Wannous, Hazem; Lucas, Yves; Treuillet, Sylvie



[Current situation of negative-pressure wound therapy].  


Negative-pressure wound therapy (NPWT) has been used to help wound healing since early 1970s, and it has been used increasingly for treating a wide variety of wounds since the early 1990s and started to popularize in China near the mid 1990s. This technique is different from conventional dressing change, as it controls local humidity, alleviates edema, and improves local circulation all by negative pressure. The method generally involves the application of a dressing on the wound surface, connecting the dressing to a vacuum pump through a tube, and then sealing the wound with adhesive films. Most of the clinicians in China believe that NPWT is helpful in accelerating wound healing, though as yet there is no strong evidence to support it. Therefore, it is necessary to conduct more research to further clarify the mechanism and therapeutic effect of NPWT. PMID:22097299

Zhou, Ye-ping



A new high water vapor permeable polyetherurethane film dressing.  


This study summarizes the Ph.D.-research project concerning the development of a new high water vapor permeable wound dressing. The dressing is composed of a 15 microns thin polyetherurethane (PEU) film, which has many non-interconnected cavities to enable a high water vapor permeability up to 20.1 g.m-2.h-1.kPa-1. Since only water vapor permeates through the PEU dressing, the wound exudate underneath is condensed into a gelatinous coagulum. Epithelialization was accelerated by 25% under the clot-permissive PEU film compared with the fluid retaining OpSite film. In clinical situations on donor sites and grafted full-thickness burn wounds, the PEU film indeed prevented fluid accumulation and induced the formation of a "red" coagulum underneath. It furthermore reduces pain significantly compared to conventional paraffin gauze dressing. In conclusion, the optimum environment for epithelialization is a wound, in which the exudate is permitted to gelatinize between moist and dry. PMID:2384861

Jonkman, M F; Bruin, P



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


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


The inhibition of matrix metalloproteinase activity in chronic wounds by a polyacrylate superabsorber  

Microsoft Academic Search

Excessive matrix metalloproteinase (MMP) levels have been observed in wound fluid of impaired healing wounds. This is thought to interfere with granulation tissue formation as newly formed extracellular matrix and cytokines are degraded and the wound becomes deadlocked, unable to progress to the next healing stages. In the cleansing phase, associated with high MMP activity levels, hydroactive wound dressings containing

Sabine Eming; Hans Smola; Berenike Hartmann; Gebhart Malchau; Ronny Wegner; Thomas Krieg; Sigrun Smola-Hess



Polyethylene oxide gel. A new intranasal dressing after septorhinoplasty.  


The purpose of intranasal dressings after septorhinoplasty is to absorb secretions, stop bleeding, act as an internal splint, discourage adhesions, and facilitate nasal hygiene. The ideal dressing should conform to the irregularities of the nasal cavity and resist adherence to the wounds of the nasal lining so it can be easily removed. It should be nonirritating, antiseptic, and economical. The failure of previously reported dressings in one or more of these requirements led us to evaluate a new alternative. Polyethylene oxide gel (Vigilon) was identified as a potential improvement and investigated in 48 patients over 17 months. There were no significant complications. Polyethylene oxide gel appears superior to previously described dressings, primarily because of comfort for the patient at removal. PMID:1845263

Salassa, J R; Pearson, B W



Polyethylene oxide gel: a new dressing after endoscopic sinus surgery.  


The purpose of dressings after endoscopic sinus surgery is to absorb secretions, tamponade bleeding, discourage adhesions, and facilitate sinus and nasal hygiene. The ideal dressing should conform to the irregularities of the nasal-sinus cavity and resist adherence to the wounds so it can be easily removed. It should be economical, non-irritating, and antiseptic. The failure of previous dressings to fulfill all of these criteria led the author to evaluate a new alternative. Polyethylene oxide gel (Vigilon) was identified as a potential improvement and investigated in a clinical trial of 60 cases. This paper presents the author's observations and technique for application. Polyethylene oxide gel resulted in no significant complications. It appears superior to previously described dressings, primarily because of patient comfort at removal. PMID:1579809

Salassa, J R



Dermagraft: Use in the Treatment of Chronic Wounds  

PubMed Central

Problem Lower limb ulceration is a common problem in clinical practice. A variety of metabolic and physical causes can lead to a diversity of chronic ulcer types, including diabetic foot ulcers (DFUs) and venous leg ulcers (VLUs). Solution A wide variety of technologies have been developed to treat chronic wounds, with varying levels of success. Depending upon the type and severity of the wound being treated, treatments may include systemic or local antibiotic therapy, application of fillers such as collagen sponges, use of negative wound pressure, hyperbaric oxygen therapy, application of select growth factors, advanced wound dressings, and more recently, the use of cell-based tissue-engineered products. New Technology Dermagraft® is a sterile, cryopreserved, human fibroblast–derived dermal substitute generated by the culture of neonatal dermal fibroblasts onto a bioabsorbable polyglactin mesh scaffold. During the product-manufacturing process, the human fibroblasts proliferate to fill the interstices of this scaffold and secrete collagen, other extracellular matrix proteins, growth factors, and cytokines, creating a three-dimensional human tissue containing metabolically active living cells. Indications for Use Dermagraft has been approved for marketing in the United States for the treatment of DFUs. In addition, the product is in active development for the treatment of VLUs and has been clinically used in a variety of other indications to stimulate wound healing. Caution When treating DFUs, Dermagraft should be used in conjunction with standard wound care regimens and in patients who have adequate blood supply to the involved foot.

Hart, Charles E.; Loewen-Rodriguez, Andrea; Lessem, Jan



[Lay more stress on the study and application of covering materials for wounds].  


Skin is the largest organ in human body. It guards the underlying muscles, bones, ligaments, and internal organs. The skin faces the environment, and it is the first line to defend against the assaults of external physical, chemical, and micro-organic factors. The other functions of skin include systemic metabolism, temperature regulation, sensation, and production of vitamin D and folate. Skin injury usually leads to barrier function damage. Extensive skin injury would induce a series of problems such as water-electrolyte disorder, hypoproteinemia, and severe infection. Thus it is important to choose a suitable wound dressing when the skin is severely injured. The characteristics of wound dressings have undergone repeated and noticeable changes over the last several years. Compared with that of the traditional dressing, the ability of new dressings is improved obviously in the properties of wound protection, infection prevention, and wound healing promotion. This article deals with an overview on the characteristics of different wound dressings. PMID:23290754

Hu, Da-hai; Wang, Yun-chuan



Wound age estimation by simultaneous detection of 9 cytokines in human dermal wounds with a multiplex bead-based immunoassay: an estimative method using outsourced examinations.  


Wound age estimation for human dermal wounds was performed based on quantification of interleukin 1beta (IL 1beta), IL 5, IL 7, IL 12 p70, IL 13, IL 17, granulocyte colony-stimulating factor (G-CSF), monocyte chemoattractant protein 1 (MCP 1), and macrophage inflammatory protein 1beta (MIP 1beta). IL 5, IL 12 p 70, IL 13, and IL 17 increased from the early phase, MCP 1 exclusively in the middle phase, and IL 1beta, G-CSF, and MIP 1beta from the middle phase to the late phase. IL 7 decreased from the early phase. Among the cytokines analyzed in the present study, MCP 1 was the most plentiful cytokine. In addition, an outsourced examination, which could be available to any forensic institute, was performed in two cases for confirmative purposes. Many factors have been proposed as markers for dermal wound age estimation, but the set of cytokines selected for the outsourced examination in the present study wound be useful in daily forensic practice. PMID:19419898

Takamiya, Masataka; Biwasaka, Hitoshi; Saigusa, Kiyoshi; Nakayashiki, Nori; Aoki, Yasuhiro



Wound care in the neonatal intensive care unit.  


The skin is a vital organ with key protective functions. Infants in the NICU are at risk for skin injury because of developmental immaturity and intensive care treatments. When skin injury occurs, the neonatal nurse is challenged to provide wound care to optimize functional and cosmetic healing. Optimal wound care requires basic knowledge of the mechanisms of injury, physiology of wound healing, host factors affecting wound healing, and wound assessment. This knowledge provides the basis for determining appropriate wound treatment, including dressing selection. Attention to pain issues associated with wound care is difficult because of the infant's developmental stage, but is essential because of the potentially negative life-long impact of pain. The premature infant's propensity for skin stripping limits the selection of appropriate dressing, as does the paucity of research examining wound care products in this population. PMID:21846624

Fox, Miriam D


[Diabetic, neuropathic, arteriopathic foot and dressing choice].  


The definition for the diabetic foot is infection, ulceration or destruction of deep tissues of the foot associated with neuropathy or peripheral vascular disease in the lower extremity of people with diabetes. Non-diabetic patients may suffer the same risks when neuropathy and arteriopathy are present. Knowing that 85% of amputations are preceded by foot ulcers, prevention is primordial. At the onset of an ulcer, immediate treatment must be undertaken and preferably by an interdisciplinary team. Delayed healing and increased risk of infection are often due to an associated vascular disease. While the array of dressings is expansive there is no «gold standard» treatment or «miracle dressing» described for foot ulcers. The management consists of wound analysis, debridement, woundcare and especially offloading. PMID:23147605

Lowe, S; Kayoumi, M



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.

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



Protein matrices for improved wound healing: elastase inhibition by a synthetic peptide model.  


The unique properties of silk fibroin were combined with keratin to develop new wound-dressing materials. Silk fibroin/keratin (SF/K) films were prepared to reduce high levels of elastase found on chronic wounds. This improved biological function was achieved by the incorporation of a small peptide synthesized based on the reactive-site loop of the Bowman-Birk Inhibitor (BBI) protein. In vitro degradation and release were evaluated using porcine pancreatic elastase (PPE) solution as a model of wound exudate. It was found that biological degradation and release rate are highly dependent on film composition. Furthermore, the level of PPE activity can be tuned by changing the film composition, thus showing an innovative way of controlling the elastase-antielastase imbalance found on chronic wounds. PMID:20690591

Vasconcelos, Andreia; Pêgo, Ana Paula; Henriques, Lara; Lamghari, Meriem; Cavaco-Paulo, Artur



A cost-effective transparency-based digital imaging for efficient and accurate wound area measurement.  


Wound measurement is an objective and direct way to trace the course of wound healing and to evaluate therapeutic efficacy. Nevertheless, the accuracy and efficiency of the current measurement methods need to be improved. Taking the advantages of reliability of transparency tracing and the accuracy of computer-aided digital imaging, a transparency-based digital imaging approach is established, by which data from 340 wound tracing were collected from 6 experimental groups (8 rats/group) at 8 experimental time points (Day 1, 3, 5, 7, 10, 12, 14 and 16) and orderly archived onto a transparency model sheet. This sheet was scanned and its image was saved in JPG form. Since a set of standard area units from 1 mm(2) to 1 cm(2) was integrated into the sheet, the tracing areas in JPG image were measured directly, using the "Magnetic lasso tool" in Adobe Photoshop program. The pixel values/PVs of individual outlined regions were obtained and recorded in an average speed of 27 second/region. All PV data were saved in an excel form and their corresponding areas were calculated simultaneously by the formula of Y (PV of the outlined region)/X (PV of standard area unit) × Z (area of standard unit). It took a researcher less than 3 hours to finish area calculation of 340 regions. In contrast, over 3 hours were expended by three skillful researchers to accomplish the above work with traditional transparency-based method. Moreover, unlike the results obtained traditionally, little variation was found among the data calculated by different persons and the standard area units in different sizes and shapes. Given its accurate, reproductive and efficient properties, this transparency-based digital imaging approach would be of significant values in basic wound healing research and clinical practice. PMID:22666449

Li, Pei-Nan; Li, Hong; Wu, Mo-Li; Wang, Shou-Yu; Kong, Qing-You; Zhang, Zhen; Sun, Yuan; Liu, Jia; Lv, De-Cheng



Lamotrigine induced DRESS syndrome.  


Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a rare and life-threatening delayed drug hypersensitivity reaction characterized by skin eruption, fever, lymphadenopathies, and visceral involvement. Here, we are presenting a 12 year old boy, who developed rare but life threatening DRESS syndrome due to Lamotrigine. Early detection and treatment led to his rapid recovery. This case is presented to highlight the importance of early detection of rare fatal syndrome. PMID:23248415

Naveen, Kikkeri Narayanasetty; Ravindra, Mysore Satyanarayana; Pai, Varadraj V; Rai, Vijetha; Athanikar, Sharatchandra B; Girish, Meravanige


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.



Evaluation of Lyophilised, Gamma-Irradiated Amnion as a Biological Dressing  

Microsoft Academic Search

Burns, non-healing wounds and pressure sores cause extensive damage to the skin leading to infection and loss of precious body fluids. Despite advances in burn management the mortality rate continues to be high and the search for an economical and easily available dressing to control burn wound infection continues. Autologous skin has limited availability and is associated with additional scarring.

Kalpesh Gajiwala; Astrid Lobo Gajiwala



Designing polysaccharide-based antibacterial biomaterials for wound healing applications  

PubMed Central

In this study, the development and characterization of novel polymer blends based on chitosan-poly (vinyl alcohol) and physically cross-linked by freeze-thaw method for possible use in a variety of biomedical application is reported. The present investigation deals with designing savlon-loaded blend hydrogels (coined as cryogels) of poly (vinyl alcohol) (PVA) and chitosan by repeated freeze-thaw method and their characterization by SEM and FTIR techniques. The FTIR spectra clearly reveal that savlon-loaded chitosan and PVA blends are bonded together through hydrogen bonding. The SEM analysis suggests that cryogels show a well-defined porous morphology. The prepared cryogels were also investigated for swelling and deswelling behaviors. The results reveal that both the swelling and deswelling behaviors greatly depend on factors like chemical composition of the cryogels, number of freeze-thaw cycles, pH and temperature of the swelling bath. The savlon-loaded blends were also investigated for their in vitro blood compatibility and antibacterial activity.

Chhatri, Amita; Bajpai, Jaya; Bajpai, A.K.



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.

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



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


Application of wound closure Molndal technique after laparoscopic cholecystectomy--initial comparative study.  


Because of a possible delayed wound healing, critical colonization and infection of wounds present a problem for surgeons. Colonized and infected wounds are a potential source for cross-infection. Molndal technique of wound dressing has proven to be effective in prevention of infection. Also the wound heal better and faster. In our study we wanted to describe the benefits of the Molndal technique wound dressing after laparoscopic cholecistectomy compared to traditional wound dressing technique. Molndal technique consisted of wound dressing with Aquacel Ag--Hydrofiber (ConvaTec, Dublin, Ireland). Traditional technique was performed using gauze compresses and hypoallergic adhesives. We analyzed the results of 100 patients after laparoscopic cholecystectomy. 50 patients were treated by Molndal technique and 50 patients by the traditional technique of wound dressing. In the group treated by Molndal technique only 1 (2%) patient has revealed a wound infection, proven by positive microbiological examination and suppuration, mostly in the subumbilical incision. In the traditional technique group 7 (14%) patients developed wound infection also predominantly in the subumbilical incision. The difference was statistically significant (p < 0.01). Our results are clearly showing that Molndal technique is effective in preventing the infection of subumbilical incision wound and is to by recommend for regular use at designated site after laparoscopic cholecistectomy. PMID:21305739

Marinovi?, Marin; Cicvari?, Tedi; Jureti?, Iva; Grzalja, Nikola; Medved, Igor; Ahel, Juraj



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


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



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 NCT01181206. Date of registration: 11 August 2010; date of first patient randomized: 8 September 2010



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.



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



[The surgical procedure in blind gunshot wounds of the skull base].  


Personal clinical observations during the recent years allow the authors to confirm the indisputable value of surgical experience got during the Great Patriotic War (1941-1945) and in particular, the "fourfold" scheme proposed by V. I. Voiachek for the diagnosis and treatment of blind gunshot wounds to the skull base. Computed tomography considerably increases the probability of detection of the exact localization of foreign bodies in complex anatomical structures of the skull and thus facilitates choosing the most rational surgical management. The use of the electro-optical transducer for the extraction of foreign bodies from almost inaccessible areas of the skull base decreases the risk of operation. PMID:9915062

Gofman, V R; Kiselev, A S



'Indirect VAC': a novel technique of applying vacuum-assisted closure dressing.  


Vacuum-assisted closure (VAC) wound dressing is increasingly used to assist closure in various wounds ranging from simple finger pulp defect to complex wounds such as laparostomy or infected sternotomy. The traditional application of direct vacuum therapy can cause discomfort and put the patient at risk of injuring the affected area while mobilising. We describe a novel technique of applying VAC therapy indirectly which is much more comfortable and convenient for the patient while mobilising. PMID:18983066

Durai, Rajaraman; Hoque, Happy; Davies, Tony W



Mechanisms of action of microdeformational wound therapy.  


Microdeformational Wound Therapy (MDWT) is a class of medical devices that have revolutionized the treatment of complex wounds over the last 20 years. These devices, are a subset of Negative Pressure Wound Therapy (NPWT), in which there is a highly porous interface material placed between the wound and a semi-occlussive dressing and connected to suction. The porous interface material acts to deform the wound on a micro scale promoting cellular proliferation. These devices appear to significantly improve the speed of healing in many wounds, facilitate granulation tissue formation and reduce the complexity of subsequent reconstructive operations. The mechanisms through which such effects are obtained are beginning to be better understood through basic research and clinical trials. Further work in this field is likely to yield devices that are designed to treat specific wound types. PMID:23036531

Lancerotto, Luca; Bayer, Lauren R; Orgill, Dennis P



Comparative evaluation of silver-containing antimicrobial dressings and drugs.  


Wound dressings containing silver as antimicrobial agents are available in various forms and formulations; however, little is understood concerning their comparative efficacy as antimicrobial agents. Eight commercially available silver-containing dressings, Acticoat 7, Acticoat Moisture Control, Acticoat Absorbent, Silvercel, Aquacel Ag, Contreet F, Urgotol SSD and Actisorb, were tested to determine their comparative antimicrobial effectiveness in vitro and compared against three commercially available topical antimicrobial creams, a non treatment control, and a topical silver-containing antimicrobial gel, Silvasorb. Zone of inhibition and quantitative testing was performed by standard methods using Escherichia coli, Pseudomonas aeruginosa, Streptococcus faecalis and Staphylococcus aureus. Results showed all silver dressings and topical antimicrobials displayed antimicrobial activity. Silver-containing dressings with the highest concentrations of silver exhibited the strongest bacterial inhibitive properties. Concreet F and the Acticoat dressings tended to have greater antimicrobial activity than did the others. Topical antimicrobial creams, including silver sulfadiazine, Sulfamylon and gentamicin sulfate, and the topical antimicrobial gel Silvasorb exhibited superior bacterial inhibition and bactericidal properties, essentially eliminating all bacterial growth at 24 hours. Silver-containing dressings are likely to provide a barrier to and treatment for infection; however, their bactericidal and bacteriostatic properties are inferior to commonly used topical antimicrobial agents. PMID:17651227

Castellano, Joseph J; Shafii, Susan M; Ko, Francis; Donate, Guillermo; Wright, Terry E; Mannari, Rudolph J; Payne, Wyatt G; Smith, David J; Robson, Martin C



Central venous catheter - dressing change  


... To change your dressings, you will need: Sterile gloves Cleaning solution A special sponge A special patch, ... paper towel. Put on a pair of clean gloves. Gently peel off the old dressing and Biopatch. ...


Advances in Wound Healing: A Review of Current Wound Healing Products  

PubMed Central

Successful wound care involves optimizing patient local and systemic conditions in conjunction with an ideal wound healing environment. Many different products have been developed to influence this wound environment to provide a pathogen-free, protected, and moist area for healing to occur. Newer products are currently being used to replace or augment various substrates in the wound healing cascade. This review of the current state of the art in wound-healing products looks at the latest applications of silver in microbial prophylaxis and treatment, including issues involving resistance and side effects, the latest uses of negative pressure wound devices, advanced dressings and skin substitutes, biologic wound products including growth factor applications, and hyperbaric oxygen as an adjunct in wound healing. With the abundance of available products, the goal is to find the most appropriate modality or combination of modalities to optimize healing.

Murphy, Patrick S.; Evans, Gregory R. D.



Wound botulism.  


All published cases of wound botulism were reviewed to describe the epidemiology, clinical manifestations, diagnosis, and treatment of this rare infection. The MEDLINE data base of English-language literature was searched from 1966 to 1992, using the keywords "wound botulism". Cases published during this period were identified, and the bibliographies of these articles were used to identify cases published before MEDLINE's search limit of 1966. Because of the limited number of published cases, all were reviewed. Data related to epidemiology, clinical manifestations, diagnosis and treatment were collected on each case. When possible, cross-references from case series or reviews were used to corroborate and supplement data for a given case. There were 40 cases identified as wound botulism. The case fatality rate was 10%. The 36 survivors had significant morbidity requiring prolonged medical care. Wound botulism is a rare life-threatening complication of trauma and i.v. drug abuse. The diagnosis should be considered in any patient with either of these risk factors who develop paresis of cranial nerves and a descending pattern of weakness. Treatment, including administration of antitoxin, should be initiated prior to definitive diagnosis by microbiologic laboratory tests. PMID:8066973

Mechem, C C; Walter, F G



Comparison of silver-coated dressing (Acticoat™), chlorhexidine acetate 0.5% (Bactigrass ®), and fusidic acid 2% (Fucidin ®) for topical antibacterial effect in methicillin-resistant Staphylococci-contaminated, full-skin thickness rat burn wounds  

Microsoft Academic Search

Acticoat™, chlorhexidine acetate 0.5%, and fusidic acid 2% were compared to assess the antibacterial effect of an application on experimental 15% BSA, full-thickness burn wounds in rats swabbed 24h earlier with a 108 standard strain of methicillin-resistant Staphylococci.The swabbed organism was recovered from the eschar of all groups except the fusidic acid group. While there were significant differences between treatment

Ersin Ülkür; Oral Oncul; Huseyin Karagoz; Esma Yeniz; Bahattin Çeliköz



Puncture Wounds  


... wound during a puncture, along with dirt and debris from the object. All puncture wounds are dirty ... as a rusty nail, the more dirt and debris are dragged into the wound, increasing the chance ...


Use of a keratin-based hydrogel in the management of recessive dystrophic epidermolysis bullosa.  


A new keratin-based hydrogel wound dressing was applied to the neck of a patient who was suffering from recessive dystrophic epidermolysis bullosa. A significant improvement was observed in the robustness of skin in this area: reduced propensity to blister and improved healing of blisters. The improvement allowed the cessation of use of secondary dressings for this area. The factors gave a significant improvement in quality of life for the patient. PMID:22208480

Than, Martin P; Smith, Robert Allen; Cassidy, Sharon; Kelly, Robert; Marsh, Clive; Maderal, Andrea; Kirsner, Robert S



Dressing according to the weather  

NSDL National Science Digital Library

What should I wear so that I am comfortable outside? Get this Organizer 1. Go here Song for Telling the weather 2. Then here The weather today is? 3. Next play this Dressing Teddy Bear Game 4. Then play this game Dressing for the seasons! 5. Last play this game Dressing Caillou ...

Holland, Ms.



Comparison of the effects of semi-occlusive polyurethane dressings and hydrocolloid dressings on dermal repair: 1. Cellular changes.  


The effects on dermal repair of two wound dressings, one the semi-occlusive polyurethane sheet Opsite, the other the hydrocolloid Granuflex, were compared in full-thickness excised lesions on porcine skin during the period from 5 d to 6 months after injury. Quantitative studies were made of changes in the populations of polymorphonuclear leucocytes, macrophages, fibroblasts, and endothelial cells. The progress of repair in the wounds covered with the semi-occlusive dressing showed a decrease in the number of inflammatory cells (polymorphonuclear leukocytes and macrophages) from 5 to 60 d, whereas the number of proliferative phase cells (fibroblasts and endothelial cells) increased from 5 to 7 d. The total cellularity per unit area showed an increase between 5 and 7 d, that is, during the proliferative phase of repair, and then progressively decreased as the proliferative phase was succeeded by the remodeling phase. In contrast, the repair process in the hydrocolloid-dressed wounds was more complex. The number of inflammatory cells remained relatively high throughout and there were consistently fewer endothelial cells present throughout. Fibroblast number showed an initial fall from 5 to 14 d but then started to increase in number from 21 to 60 d. This chronic inflammatory reaction appeared to be in response to particulate matter that had been incorporated into the wound bed and hypodermis, and was still apparent 6 months after injury, when hydrocolloid particles were detectable microscopically in the hypodermis. PMID:1823536

Young, S R; Dyson, M; Hickman, R; Lang, S; Osborn, C



Wound Care Management: Proper Protocol Differs From Athletic Trainers' Perceptions  

PubMed Central

As research techniques in wound care management improve, treatment protocols for the care of wounds must also change to ensure safe and optimal healing. In this study, I surveyed current practices of athletic trainers regarding the care of athletic wounds and compared the findings to current literature. I contacted 501 athletic trainers, including all NATA curricular undergraduate directors. Overall response rate was 58%; 78% of the athletic trainers from the curricular schools responded. Wet-to-dry, irrigation, and soaks were the three most common methods used to debride and cleanse a wound. Povidone-iodine (Betadine) and hydrogen peroxide were the two most popular cleansing agents. Conventional gauze was the primary dressing used by 67% of the athletic trainers, while 20% of those surveyed used occlusive dressings. Although povidone-iodine and hydrogen peroxide are commonly used, both are toxic to cells involved in the wound-healing process and delay healing. Research indicates that the best method of cleansing and debriding a wound is to irrigate it with saline. Occlusive dressings have a lower infection rate, are viral barriers, and are associated with faster wound healing and less pain than gauze dressings. Athletic trainers need to assess their wound care protocols so that they give the best possible care to their athletes.

Goldenberg, Michael S.



Vacuum-assisted Wound Closure after Resection of Musculoskeletal Tumors  

Microsoft Academic Search

Resection of musculoskeletal tumors may result in large soft tissue defects that cannot be closed primarily and require prolonged dressing changes and complex surgical interven- tions for wound coverage. We retrospectively reviewed 23 patients with such defects treated with a vacuum-assisted wound closure system and compared the outcome of these patients with a control group. The study group included 15

Jacob Bickels; Yehuda Kollender; James C. Wittig; Nir Cohen; Isaac Meller; Martin M. Malawer



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


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



DRESS syndrome: Part II. Management and therapeutics.  


The appropriate management of the drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is paramount because it is associated with significant morbidity and mortality. This syndrome shares clinical features with other dermatologic conditions, including other severe cutaneous drug reactions, requiring the clinician to carefully examine the proposed criteria to make the appropriate diagnosis. Once the diagnosis of DRESS syndrome has been established, the next step in management is immediate cessation of the causative medication(s). In cases in which the culprit drug is not obvious, clinicians must use their clinical judgment to select which medication to discontinue. They may also utilize patch or lymphocyte transformation tests to aid in identification when appropriate. Topical corticosteroids can be used for symptomatic relief, but systemic steroid therapy is generally required. Other immunosuppressants have also been employed in treatment and show promise in future therapy. Patients with DRESS syndrome should be managed in an intensive care or burn unit for appropriate care and infection control. In addition, appropriate specialists should be consulted based on the affected organ systems. Most patients recover completely after drug withdrawal and appropriate therapy. However, some patients with DRESS syndrome suffer from chronic complications and approximately 10% die, primarily from visceral organ compromise. Controlled clinical trials investigating the most appropriate therapies and their risks, particularly intravenous corticosteroids, are lacking, and would be invaluable in determining the optimal future treatment regimen for DRESS syndrome. PMID:23602183

Husain, Zain; Reddy, Bobby Y; Schwartz, Robert A



"Who Wore the Pants?" Dress, Gender, and Power, 1850-1914.  

ERIC Educational Resources Information Center

Presents a study of historical documents focusing on the complex relationship between dress, gender, and power in North America in the late nineteenth and early twentieth centuries. Examines social rules governing dress and appearance, providing examples of how people dressed to comply with social expectations. Loosely based on a Smithsonian…

Bennet, Paul W.



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.

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



Phases of wound healing.  


The phases of wound healing--inflammatory, fibroblastic, and maturation--are continuous, though they overlap and do not always occur in an orderly fashion. Wound healing may be retarded by age, diabetes, smoking, immunosuppression, poor nutrition, cell hypoxia, dehydration, bacteria, and other factors. Bacteria and pus may be so great at the inflammatory phase that the wound remains at that phase. It is important that the nurse recognize when pus is a major factor in an unhealed wound and initiate local care to assist in cleaning the wound bed. It is also important to recognize a clean wound and to initiate appropriate local care that facilitates wound healing. New information about wound healing at the cellular level continues to become available. Epidermal growth factors, platelet-derived growth factors, and the growth hormone somatomedin are being studied, and new methods based on these studies may change local wound care measures. It is essential to understand the phases of wound healing to determine appropriate wound care measures for individual patients. PMID:1823567

Gilmore, M A



A prospective, multi-centre, randomised, open label, parallel, comparative study to evaluate effects of AQUACEL® Ag and Urgotul® Silver dressing on healing of chronic venous leg ulcers.  


This study compared wound healing efficacy of two silver dressings, AQUACEL(®) Ag and Urgotul(®) Silver, against venous ulcers at risk of infection, over 8 weeks of treatment. The primary objective was to show non inferiority of AQUACEL(®) Ag to Urgotul(®) Silver. Patients (281) were randomised into two groups. The AQUACEL(®) Ag group had 145 patients treated with AQUACEL(®) Ag for 4 weeks followed by AQUACEL for another 4 weeks. TheUrgotul(®) Silver group had 136 patients treated with Urgotul(®) Silver for 4 weeks followed by Urgotul(®) for another 4 weeks. In both groups, ulcer size and depth, safety events and ulcer healing were compared. After 8 weeks of treatment, the AQUACEL(®) Ag group had a relative wound size reduction (49·65% ± 52·53%) compared with the Urgotul(®) Silver group (42·81% ± 60·0%). The non inferiority of the AQUACEL(®) Ag group to the Urgotul(®) Silver group was established based on the difference between them (6·84% ± 56·3%, 95% confidence interval -6·56 to 20·2) and the pre-defined non inferiority margin (-15%). Composite wound healing analysis showed that the AQUACEL(®) Ag group had statistically higher percentage of subjects with better wound progression (66·9% versus 51·9%, P = 0·0108). In general, both dressings were effective at promoting healing of venous ulcers. PMID:22066961

Harding, Keith; Gottrup, Finn; Jawie?, Arkadiusz; Mikosi?ski, Jacek; Twardowska-Saucha, Krystyna; Kaczmarek, S?awomir; Sopata, Maciej; Shearman, Cliff; Pieronne, Alaine; Kommala, Dheerendra



Dextran hydrogel scaffolds enhance angiogenic responses and promote complete skin regeneration during burn wound healing.  


Neovascularization is a critical determinant of wound-healing outcomes for deep burn injuries. We hypothesize that dextran-based hydrogels can serve as instructive scaffolds to promote neovascularization and skin regeneration in third-degree burn wounds. Dextran hydrogels are soft and pliable, offering opportunities to improve the management of burn wound treatment. We first developed a procedure to treat burn wounds on mice with dextran hydrogels. In this procedure, we followed clinical practice of wound excision to remove full-thickness burned skin, and then covered the wound with the dextran hydrogel and a dressing layer. Our procedure allows the hydrogel to remain intact and securely in place during the entire healing period, thus offering opportunities to simplify the management of burn wound treatment. A 3-week comparative study indicated that dextran hydrogel promoted dermal regeneration with complete skin appendages. The hydrogel scaffold facilitated early inflammatory cell infiltration that led to its rapid degradation, promoting the infiltration of angiogenic cells into the healing wounds. Endothelial cells homed into the hydrogel scaffolds to enable neovascularization by day 7, resulting in an increased blood flow significantly greater than treated and untreated controls. By day 21, burn wounds treated with hydrogel developed a mature epithelial structure with hair follicles and sebaceous glands. After 5 weeks of treatment, the hydrogel scaffolds promoted new hair growth and epidermal morphology and thickness similar to normal mouse skin. Collectively, our evidence shows that customized dextran-based hydrogel alone, with no additional growth factors, cytokines, or cells, promoted remarkable neovascularization and skin regeneration and may lead to novel treatments for dermal wounds. PMID:22171002

Sun, Guoming; Zhang, Xianjie; Shen, Yu-I; Sebastian, Raul; Dickinson, Laura E; Fox-Talbot, Karen; Reinblatt, Maura; Steenbergen, Charles; Harmon, John W; Gerecht, Sharon



Dextran hydrogel scaffolds enhance angiogenic responses and promote complete skin regeneration during burn wound healing  

PubMed Central

Neovascularization is a critical determinant of wound-healing outcomes for deep burn injuries. We hypothesize that dextran-based hydrogels can serve as instructive scaffolds to promote neovascularization and skin regeneration in third-degree burn wounds. Dextran hydrogels are soft and pliable, offering opportunities to improve the management of burn wound treatment. We first developed a procedure to treat burn wounds on mice with dextran hydrogels. In this procedure, we followed clinical practice of wound excision to remove full-thickness burned skin, and then covered the wound with the dextran hydrogel and a dressing layer. Our procedure allows the hydrogel to remain intact and securely in place during the entire healing period, thus offering opportunities to simplify the management of burn wound treatment. A 3-week comparative study indicated that dextran hydrogel promoted dermal regeneration with complete skin appendages. The hydrogel scaffold facilitated early inflammatory cell infiltration that led to its rapid degradation, promoting the infiltration of angiogenic cells into the healing wounds. Endothelial cells homed into the hydrogel scaffolds to enable neovascularization by day 7, resulting in an increased blood flow significantly greater than treated and untreated controls. By day 21, burn wounds treated with hydrogel developed a mature epithelial structure with hair follicles and sebaceous glands. After 5 weeks of treatment, the hydrogel scaffolds promoted new hair growth and epidermal morphology and thickness similar to normal mouse skin. Collectively, our evidence shows that customized dextran-based hydrogel alone, with no additional growth factors, cytokines, or cells, promoted remarkable neovascularization and skin regeneration and may lead to novel treatments for dermal wounds.

Sun, Guoming; Zhang, Xianjie; Shen, Yu-I; Sebastian, Raul; Dickinson, Laura E.; Fox-Talbot, Karen; Reinblatt, Maura; Steenbergen, Charles; Harmon, John W.; Gerecht, Sharon



Vancomycin-Induced DRESS Syndrome in a Female Patient  

Microsoft Academic Search

Background: DRESS syndrome (drug rash with eosinophilia and systemic symptoms) is a hypersensitivity reaction with skin rashes, eosinophilia, fever, lymph node enlargement and internal organ involvement. Case Report: A 60-year-old diabetic woman was hospitalized at the University Hospitals of Geneva for mid-leg amputation due to peripheral arterial occlusive disease. No drug allergy was reported. Because of a wound infection by

Laetitia Vauthey; Ilker Uçkay; Sophie Abrassart; Louis Bernard; Mathieu Assal; Tristan Ferry; Marina Djordjevic; Constantinos Roussos; Pierre Vaudaux



Vacuum-assisted closure therapy in patients with large postoperative wounds complicated by multiple fistulas  

PubMed Central

Vacuum-assisted closure (VAC) therapy is a widely acknowledged method for chronic and traumatic wound healing. The feasibility of VAC therapy used for the treatment of intestinal fistulas is still a subject of debate. Complex postoperative wounds pose significant therapeutic problems, especially when there are several fistula openings in the wound area and other sites, usually at the site of previous drains. This paper describes the treatment of three patients in a critical condition, with complex postoperative wounds complicated by multiple fistulas. Vacuum-assisted closure therapy was based on effective drainage of the biggest fistula opening and ensuring conditions promoting the healing process of other fistulas and the wound. A considerable improvement in general condition and wound healing was noted within 2-4 weeks and both the number of fistulas and the volume of excreted contents decreased. After 5-7 weeks a significant improvement in wound healing was observed in all patients. Once the general condition of all patients was considered satisfactory (2-6 months), they underwent surgery aimed at restoration of the digestive tract continuity.In our opinion, VAC therapy used for the treatment of postoperative wounds with multiple fistulas in the wound area and other sites should aim mainly at the improvement of patients’ general condition, limitation of the number of fistulas as well as accelerated wound healing. This may lead to formation of one stoma-type fistula, which can be dressed and cared for by patients until the continuity of the digestive tract has been surgically restored.

Borejsza-Wysocki, Maciej; Meissner, Wiktor; Malinger, Stanislaw; Szmeja, Jacek; Koscinski, Tomasz; Ratajczak, Andrzej; Drews, Michal



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 identifier: http://NCT01148823.



A study to evaluate primary dressings for the application of cultured keratinocytes.  


Despite the recent improvements in cell culture and dermal regeneration methods, tissue engineering of skin has yet to receive widespread acceptance in the management of burn injuries. The reasons for this are complex and include not only the inherent costs of (particularly) setting up and running such a system but also the continuing difficulties in achieving successful engraftment of the neoepidermis. The latter has previously been addressed in a number of ways, including improving the recipient bed and using pre-confluent delivery systems to allow earlier application of cells to that wound bed. One area that has received little attention is that of the optimal wound dressing to use with this technology; the cells are very poorly attached at early time points, and, in this context, the traditional dressing of paraffin gauze has never been formally assessed in comparison with newer materials. Using a porcine acute wound chamber model, we performed a prospective randomised trial to assess four different wound dressings with reference to the amount of epidermal cover gained and the histological quality of the regenerated skin after 3 weeks. Out of the four materials tested, polyurethane foam (Allevyn) was superior histologically (although equal in take rate with paraffin gauze), whilst polythene sheet (Opsite) and silicone sheet were substantially inferior. We conclude that the traditional dressing used with this technology should be compared with polyurethane foam in a clinical trial. In the future, novel dressings should be formally tested against traditional methods before being adopted. PMID:11728112

Price, R D; Das-Gupta, V; Frame, J D; Navsaria, H A



Draconian dress act repealed.  


The Dress Act was put into place in Malawi by the government of President Kamuzu Banda after the long period of direct colonialism. The act made it illegal for women in Malawi to be seen publicly wearing dresses which did not completely cover their knees or wearing pants; men had to wear their hair short. Police officers even scrutinized women's attire at private house parties and in homes. The autocratic political structure established by Banda, however, was voted out in a referendum June 14, 1993. Pressure by opposition forces such as the United Democratic Front forced a repeal of the act on November 16 of the same year. The repeal was vigorously attacked by female Parliament members as a move which would result in moral degradation and an increase in the level of sexual harassment against women. Other citizens and tourists have generally detested the act. The act has most certainly kept many potential visitors from vacationing in Malawi. Some expert observers think that repeals of the Dress Act, the Forfeiture Act, and legislation which allowed the government to detain opposition figures without trial were done to garner support from the Paris Club for the resumption of balance of payments support suspended due to the country's poor human rights record. PMID:12318566

Mhone, C



Achieving international consensus for the prevention of orthopaedic wound blistering: results of a Delphi survey.  


This article presents the results of an international 2 stage Delphi survey carried out via e-mail to achieve consensus as to the most effective postoperative wound management to prevent blistering and other complications. Seventeen prospective participants were invited to be members of the Delphi Panel of which 13 agreed to be involved. The panel suggested that an ideal wound dressing would conform easily to the wound, be easy to apply and remove, allow for swelling and minimise pain on removal. Participants were in agreement that the primary wound dressing should be left in situ for as long as possible, providing there was no excessive oozing or signs of infection. The authors recognise that the Delphi Panel was relatively compact; however, the study arguably provides some useful data that can be used to identify the consequences of wound blistering and important factors that need to be considered when choosing a wound dressing to prevent blistering. PMID:22405132

Ousey, Karen; Gillibrand, Warren; Stephenson, John



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


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



The enhanced Total Body Wrap-The new frontier in dressing care for burns.  


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



Prospective, double-blinded, randomised controlled trial assessing the effect of an Octenidine-based hydrogel on bacterial colonisation and epithelialization of skin graft wounds in burn patients  

PubMed Central

Background: Moist wound treatment improves healing of skin graft donor site wounds. Microbial colonised wounds represent an increased risk of wound infection; while antimicrobially active, topical antiseptics may impair epithelialization. Objectives: The aim of this prospective randomised controlled clinical trial was to examine the influence of an Octenidine-dihydrochloride (OCT) hydrogel on bacterial colonisation and epithelialization of skin graft donor sites. Methods: The study was designed as a randomised, double-blinded, controlled clinical trial. Skin graft donor sites from a total of 61 patients were covered either with 0.05% OCT (n=31) or an OCT-free placebo wound hydrogel (n=30). Potential interaction with wound healing was assessed by measuring the time until 100% re-epithelialization. In addition, microbial wound colonisation was quantitatively determined in all skin graft donor sites. Results: There was no statistically significant difference in the time for complete epithelialization of skin graft donor sites in the OCT and the placebo group (7.3±0.2 vs. 6.9±0.2 days; p=0.236). Microbial wound colonisation was significantly lower in the OCT group than in the placebo group (p=0.014). Conclusions: The OCT-based hydrogel showed no delay in wound epithelialization and demonstrated a significantly lower bacterial colonisation of skin graft donor site wounds.

W, Eisenbeiss; F, Siemers; G, Amtsberg; P, Hinz; B, Hartmann; T, Kohlmann; A, Ekkernkamp; U, Albrecht; O, Assadian; A, Kramer



Accelerating the aesthetic benefit of wound healing by triterpene.  


Intention of the study (EudraCT No 2009-017418-56) is a proof of aesthetic benefit of triterpene treatment in superficial wounds. In an open, prospective, controlled, randomized, blindly evaluated multicentre phase II clinical trial a triterpene ointment (OG-S10) is compared intra individually with a state-of-the-art moist wound healing dressing (Mepilex(®)) in split thickness skin graft donor sites. The graft wound areas at the upper leg were divided into two equal halves, one proximal and one distal site. Decided by randomization the one site was treated with triterpene and the other in comparison with moist dressing. Triterpene treatment went on for 14 days as covering the wound at every change of wound dressing with the ointment (100 mg/cm(2)). The comparative treatment went on as covering the site by this dressing alone. The outcome of these different treatments was evaluated by two blindly observing distant experts on the basis of photographs of the wound healing progress. Photographs were taken day 14, 3 month and 1 year after treatment. The only criterion for evaluation of the two sites was similarity of the wound area to the surrounding skin in terms of colour and texture: which of the two sites, the proximal or the distal, was aesthetically superior in normal skin appearance after 14 days at the end of treatment, after 3 month of follow up and 1 year after treatment? The descriptive comparison is demonstrating quite a remarkable advantage of the ointment versus the moist wound dressing in promoting wound healing: even having in mind the small number of 24 patients within the protocol, the superiority of aesthetic benefit by triterpene treatment after 14 days (22 out of 24 patients), after 3 month (15 out of 19 patients) and after 1 year (8 out of 10 patients) is obvious. PMID:21872485

Metelmann, Hans Robert; Brandner, Johanna; Schumann, Hauke; Bross, Felix; Hoffmann, Marco; Podmelle, Fred



Peripherally inserted central catheter - dressing change  


To change your dressings, you will need: Sterile gloves A cleaning solution (such aschlorhexidine) in a single- ... old dressing. Put on a pair of clean gloves. Follow these steps to remove the dressing and ...


Health service pathways for patients with chronic leg ulcers: identifying effective pathways for facilitation of evidence based wound care  

PubMed Central

Background Chronic leg ulcers cause long term ill-health for older adults and the condition places a significant burden on health service resources. Although evidence on effective management of the condition is available, a significant evidence-practice gap is known to exist, with many suggested reasons e.g. multiple care providers, costs of care and treatments. This study aimed to identify effective health service pathways of care which facilitated evidence-based management of chronic leg ulcers. Methods A sample of 70 patients presenting with a lower limb leg or foot ulcer at specialist wound clinics in Queensland, Australia were recruited for an observational study and survey. Retrospective data were collected on demographics, health, medical history, treatments, costs and health service pathways in the previous 12 months. Prospective data were collected on health service pathways, pain, functional ability, quality of life, treatments, wound healing and recurrence outcomes for 24 weeks from admission. Results Retrospective data indicated that evidence based guidelines were poorly implemented prior to admission to the study, e.g. only 31% of participants with a lower limb ulcer had an ABPI or duplex assessment in the previous 12 months. On average, participants accessed care 2–3 times/week for 17 weeks from multiple health service providers in the twelve months before admission to the study clinics. Following admission to specialist wound clinics, participants accessed care on average once per week for 12 weeks from a smaller range of providers. The median ulcer duration on admission to the study was 22 weeks (range 2–728 weeks). Following admission to wound clinics, implementation of key indicators of evidence based care increased (p?based care was significantly related to improved healing outcomes (p?based wound care for adults with chronic leg or foot ulcers. Results demonstrate that access to wound management expertise can promote streamlined health services and evidence based wound care, leading to efficient use of health resources and improved health.



Evaluation of a new hydrocolloid occlusive dressing for central catheters used in total parenteral nutrition.  


Catheter-related sepsis still remains one of the most frequent and serious complication of total parenteral nutrition. Strategies for preventing contamination of central venous lines have focused on decreasing the number of micro-organisms around the exit site and inhibiting their entry into the catheter wound. This prospective study compares a new occlusive hydrocolloid dressing (Visiband; Convatec Squibb) with that of a polyurethane film dressing for nutritional catheters. Dressings were changed either on day 3 or day 5 after application. Swab smears of the catheter exit site at each dressing change were stained by Gram's method before inoculation onto a blood agar plate, a chocolate agar plate and a MacConkey agar plate. Significantly less colonisation occurred under the former dressing at day 3 and day 5 dressing changes. In addition, the polyurethane film dressing was associated with a significant increase in skin colonisation (P = 0.04) and the number of positive Gram-stain microbes if left unchanged for 5 days (P = 0.0018). Staphylococcus aureus catheter-related sepsis occurred in 1 patient on day 18 in the polyurethane film dressing group. In addition, Candida albicans colonisation was confined to patients with the polyurethane film dressing. While the type of dressing applied to the catheter exit site may influence the incidence of catheter colonisation and infection, it must be emphasised that strict adherence to aseptic technique during catheter insertion and manipulation of the dressing is vital in the prevention of catheter-related sepsis during total parenteral nutrition. PMID:1763392

Haffejee, A A; Moodley, J; Pillay, K; Singh, B; Thomson, S; Bhamjee, A



Physiology of the chronic wound.  


There is as yet no unified mechanism that explains the pathophysiology of every nonhealing wound. This is largely because many of the basic biological investigations in this area have only been undertaken seriously in the past few years and many phenomena remain unexplained. As new data become available, these theoretical models undoubtedly will continue to evolve. However, a clear understanding of the facts presently available should provide the clinician with a good scientific basis for rational clinical interventions. There is an urgent need to bridge the gap that often exists between laboratory research and clinical practice. A number of wound care practices, which have been shown to be ineffective or harmful, are still widely used. This includes the application of toxic wound cleansing agents, inappropriate use of topical antibiotics, and the practice of wet-to-dry dressings. The past 2 decades have witnessed an unprecedented proliferation of wound care products, few of which have be proven to be consistently superior to simpler and more cost-effective measures. For the foreseeable future, the search for the magic wound 'portions and lotions' probably will continue to revolve around topical growth factor and antiprotease therapy. However, such efforts will only come to fruition when we truly understand the pathophysiologic basis for abnormal wound healing. PMID:9696897

Nwomeh, B C; Yager, D R; Cohen, I K



A guide to wound managment in palliative care.  


Wound management in palliative patients is often a very challenging area of care. There are many unique issues that can combine to produce complicated wound management scenarios, including the types of wounds and wound symptoms most commonly affecting palliative care patients, as well as the presence of concurrent disease and associated treatment. Problems exist with the availability of suitable dressings and balancing life expectancy with the goals of wound care. A significant, and possibly under-recognized, issue is the emotional and social distress experienced by these patients, which can be directly attributed to their wound. These problems must all be recognized and addressed in order to manage wounds effectively in this patient population. This article aims to explore these issues and offer advice on the management of wound-related symptoms, with the ultimate goal of improving patients' quality of life. PMID:16471044

Naylor, Wayne A



Occlusion versus air exposure on full-thickness biopsy wounds.  


The benefits of moisture-retaining dressings on wound healing are well documented in experimental animal models but not in humans. To examine the effect of occlusion, the effects of three brands of synthetic occlusive dressings (Comfeel Plus, DuoDerm CGF, OpSite) were compared with air exposure in epithelial resurfacing and proliferation in acute, full-thickness skin wounds in humans. In 10 healthy males, four 4 mm standardised wounds were made with a sterile punch biopsy on each lower extremity. Epithelialisation of the wounds was assessed histologically and blindly postwounding on days 7 and 14. Wound margin epidermal proliferation was evaluated immunohistochemically with Ki67. Epithelial percentage coverage increased significantly (p = 0.007) with the occlusive dressings (62 +/- 6%, mean +/- SEM), compared with air exposure, (39 +/- 7%) on day 7 but not on day 14 (p = 0.500). Epidermal cell proliferation showed no significant intergroup difference on either day. Treatment with occlusive dressings increased early epithelial migration of acute full-thickness biopsy wounds compared with air exposure in healthy men. PMID:12964332

Agren, M S; Karlsmark, T; Hansen, J B; Rygaard, J



From nesting to dressing  

SciTech Connect

In integrable field theories the S-matrix is usually a product of a relatively simple matrix and a complicated scalar factor. We make an observation that in many relativistic integrable field theories the scalar factor can be expressed as a convolution of simple kernels appearing in the nested levels of the nested Bethe ansatz. We formulate a proposal, up to some discrete ambiguities, how to reconstruct the scalar factor from the nested Bethe equations and check it for several relativistic integrable field theories. We then apply this proposal to the AdS asymptotic Bethe ansatz and recover the dressing factor in the integral representation of Dorey, Hofman, and Maldacena.

Janik, Romuald A.; Lukowski, Tomasz [Institute of Physics, Jagellonian University, ulica Reymonta 4, 30-059 Krakow (Poland)



Hydroalcoholic extract based-ointment from Punica granatum L. peels with enhanced in vivo healing potential on dermal wounds.  


The present study reports for the first time, the in vivo wound healing potential of Punica granatum L. peels. A 5% (w/w) methanolic extract based-ointment was formulated and evaluated for its wound healing in guinea pigs. The ointment was applied in vivo on the paravertebral area of twelve excised wounded models once a day for 10 consecutive days. The ointment significantly enhanced the wound contraction and the period of epithelialization as assessed by the mechanical (contraction rate, tensile strength), the biochemical (increasing of collagen, DNA and proteins synthesis) and the histopathological characteristics. Such investigation was encouraged by the efficiency of the methanolic extract as antimicrobial and antioxidant. Indeed, the extract showed antioxidant activity as strong as natural and synthetic compounds (Trolox, BHA, Quercetin). Furthermore, the extract exhibited significant antibacterial and antifungal activity against almost all tested bacteria: Pseudomonas aeruginosa ATCC 9027, Staphylococcus aureus ATCC 25923, Escherichia coli ATCC 25922, Klebsiella pneumoniae, Salmonella anatum, Salmonella typhimurium, Streptococcus pneumoniae, and fungi Candida albicans, Candida glabrata, Trichopyton rubrum and Aspergillus niger. The formulated ointment might well find use as skin repair agent without hazard to human health based on these results and on the fact that it has been well established that the extracts of pomegranate used in conditions similar to those applied by traditional medicine, showed no toxic effects. PMID:21466954

Hayouni, E A; Miled, K; Boubaker, S; Bellasfar, Z; Abedrabba, M; Iwaski, H; Oku, H; Matsui, T; Limam, F; Hamdi, M



Dressed spin of polarized {sup 3}He in a cell  

SciTech Connect

We report a measurement of the modification of the effective precession frequency of polarized {sup 3}He atoms in response to a dressing field in a room-temperature cell. The {sup 3}He atoms were polarized using the metastability spin-exchange method. An oscillating dressing field was then applied perpendicular to the constant magnetic field. Modification of the {sup 3}He 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.

Chu, P.-H.; Esler, A. M.; Peng, J. C.; Beck, D. H.; Chandler, D. E.; Clayton, S.; Williamson, S.; Yoder, J. [Department of Physics, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801 (United States); Hu, B.-Z. [Department of Physics, Soochow University, Taipei, Taiwan (China); Ngan, S. Y.; Sham, C. H. [Department of Physics, The Chinese University of Hong Kong, Hong Kong (China); So, L. H. [Department of Physics, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801 (United States); Department of Physics, The Chinese University of Hong Kong, Hong Kong (China)



Test of Surfactant-Based Dermal Wound Cleansers on Sulfur Mustard- Exposed Human Keratinocytes in an In Vitro Wound Healing Model.  

National Technical Information Service (NTIS)

Sulfur mustard is a chemical warfare agent that causes vesication in human skin. These blisters make the victims more susceptible to infection and delay healing of the skin. The first step in treating wounds is to cleanse the wound to prevent infection. M...

A. H. Chuang A. L. Adkins C. L. Henemyre-Harris J. S. Graham



Gauze-based negative pressure wound therapy: a valid method to manage pyoderma gangrenosum?  


Pyoderma gangrenosum (PG) is an uncommon ulcerative, non infective chronic inflammatory skin disorder of unknown etiology. Systemic therapies are necessary to control the associated medical diseases and, due to the inflammatory nature of PG, topical or systemic immunosuppressant agents are effective, but wound healing is usually slow. Negative wound pressure therapy (NPWT) has become an important tool for the management of complex skin ulcers and usage in PG has been recently described in literature: we present four cases of classic PG in which NPWT in association with systemic therapy achieved wound healing and a drastic pain reduction. PMID:22891652

Fraccalvieri, Marco; Fierro, Maria Teresa; Salomone, Marco; Fava, Paolo; Zingarelli, Enrico M; Cavaliere, Giovanni; Bernengo, Maria G; Bruschi, Stefano



Clinical comparative study of aquacel and paraffin gauze dressing for split-skin donor site treatment.  


The management of split-thickness skin graft donor sites is targeted towards promoting the healing process, while minimizing adverse effects and complications. The aim of this study was to compare donor site treatment outcome between Aquacel, a carboxymethylcellulose-based hydrofiber dressing, and the standard mesh paraffin gauze dressing. The study included 23 adult patients. Half of the skin graft donor site in the proximal thigh was dressed with paraffin gauze and the rest with Aquacel. The results indicated that patients treated with Aquacel experienced significantly less pain and a more rapid rate of epithelialization compared with patients treated with mesh paraffin gauze dressing. Final scarring (ie, after the 1-year follow-up) was significantly better with the Aquacel dressing. We conclude that Aquacel dressing is superior to the standard mesh paraffin gauze dressing for split-thickness donor site area in pain relief, ease of treatment, promotion of epithelialization, and the quality of scarring. PMID:15269581

Barnea, Yoav; Amir, Aharon; Leshem, David; Zaretski, Arik; Weiss, Jerry; Shafir, Raphael; Gur, Eyal



Occlusive dressing for large soft tissue defects following soft tissue tumor excision  

Microsoft Academic Search

Background  Reconstructive surgery using pedicles or free muscle-skin flaps and skin grafting reduces wound complications and promotes\\u000a favorable limb function; however, the sacrifice of normal tissue remains problematic and complicated. Occlusive dressings\\u000a are widely employed for management of injuries, burns, and surgical wounds. However, their effectiveness for treating soft\\u000a tissue defects following a soft tissue tumor excision has not been fully

Akihiko Takeuchi; Hiroyuki Tsuchiya; Toshiharu Shirai; Katsuhiro Hayashi; Hideji Nishida; Katsuro Tomita



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.

Muangman, Pornprom; Nitimonton, Sooksan; Aramwit, Pornanong



Effect of synthetic peptide thrombin receptor agonist encapsulated in microparticles based on lactic and glycolic acid copolymer on healing of experimental skin wounds in mice.  


PAR1 peptide thrombin receptor agonist (PAR1-AP) was encapsulated in microcorpuscles based on lactic and glycolic acid copolymer. The desorption profile of the preparation was studied in vitro and its wound-healing effects were studied on a model of cut skin wound in mice. The study showed that 90% PAR1-AP was desorbed over 6 h, but the peptide was detected in eluates from the microparticle surface after 23 h. The desorbed peptide retained its physiological activity and was capable of activating PAR1 receptors on human platelets. The study of the dynamics of experimental skin wound healing in mice showed lower number of macrophages in the wounds treated with PAR1-AP microparticles compared to the control (open wounds and wounds covered with microparticles) and higher number of fibroblasts on day 3 of tissue reparation. Hence, PAR1-AP desorbed from microparticles shortened the inflammation phase in the wound. On day 7 the best healing parameters were also observed in wounds treated with PAR1-AP microparticles, which attests to shortening of the proliferation phase and acceleration of wound healing. PMID:15723127

Dugina, T N; Kiseleva, E V; Lange, M A; Vasil'eva, T V; Grandfils, C; Markvicheva, E A; Bespalova, Zh D; Pal'keeva, M E; Strukova, S M



[Gunshot wounds by military weapons].  


The review is based on 34 recent publications. Bullet-wounds by military weapons either in drill or war are to be regarded as special kinds of wounds, needing profound knowledge of wound ballistic. However, the therapy of late developing complications may lead to problems. PMID:437659

Fischer, H



Biological evaluation of ChuangYuLing dressing-a multifunctional medicine carrying biomaterial.  


The safety of Chuangyuling (CYL) dressing-a multifunctional medicine carrying biomaterial was evaluated in order to provide foundation for the application of CYL as material used in the wound healing. The traditional Chinese medicine (TCM) extract solution was compounded with scaffolds (gelatin and Bletilla hyacinthine gum), and then frozen and dried to form spongy and porous material CYL. According to the standard of biological evaluation of medical devices that was instituted by the ministry of health of China, the biological evaluation of CYL dressing was conducted. The results showed that all the contents of biological evaluation test consisting of acute toxicity, skin irritation, sensitization and cytotoxicity met the requirement of standards. It was concluded that the biomaterial carrying TCM (CYL dressing) is safe for application of wound healing. PMID:15934313

Peng, Rui; Zheng, Qixin; Hao, Jie; Zou, Yang; Cheng, Jie



A new useful and renewable tie-over dressing method using package bands and bra hooks.  


The purposes of the tie-over dressing are to secure a skin graft toward the wound bed to avoid complications such as fluid or blood accumulation and to prevent graft movements over the wound bed. When there is a concern of uneventful graft take because of infection or blood accumulation underneath the graft, it is necessary to check the status of the graft at the postoperative first and subsequent days. Therefore, an ideal tie-over dressing method should not only ensure adequate immobilization and pressure but also be able to be renewed simply and quickly. We developed a new tie-over dressing method by using bra hooks and packing rubber bands to solve these problematic issues. PMID:16929209

Do?an, Fatih; Ozyazgan, Irfan; Eskita?ço?lu, Teoman



Silver-containing hydrofiber dressing is an effective adjunct in the treatment of pemphigus vulgaris.  


Pemphigus vulgaris is a life-threatening autoimmune bullous dermatosis and its management represents a major challenge to medical teams. The primary treatments for pemphigus vulgaris are oral steroids and immunosuppressants, but topical approaches also play a role in disease management. Here, we report a patient with pemphigus vulgaris involving 62% of the total body surface area, with initial poor clinical response to systemic steroids and topical silver sulfadiazine therapy. However, a marked improvement in wound healing and decreased patient discomfort were observed after application of silver-containing hydrofiber dressings (Aquacel-Ag). Therefore, silver-containing hydrofiber dressings may offer an effective adjunct in the treatment of patients with pemphigus vulgaris with extensive skin involvement. Our encouraging experience with these dressing patches may be extended to manage other large exudation wounds. PMID:19858043

Wu, Chieh-Shan; Hsu, Hui-Yu; Hu, Stephen Chu-Sung; Chiu, Hsiu-Hui; Chen, Gwo-Shing



Assessment of Gauze-Based Negative Pressure Wound Therapy in the Split-Thickness Skin Graft Clinical Pathway--An Observational Study  

PubMed Central

Objectives: Negative pressure wound therapy (NPWT) is a useful therapy in the preparation of wounds prior to application of a split-thickness skin graft (STSG) both “pregraft” and “postgraft” on top of the STSG. Customarily, a foam-based NPWT has been used, but gauze-based therapy is finding an increasing use. Gauze is easy to apply and forgiving of complicated wound geometries so it can be an ideal material in this indication. The aim of this study was to quantitatively assess the clinical efficacy of gauze-based NPWT as an adjunctive therapy to STSG procedures. Methods: A prospective, noncomparative, multicenter evaluation was carried out to assess the performance of gauze-based NPWT. Twenty-one patients had NPWT applied prior to definitive closure by STSG or flap techniques (pregraft group). A further 21 patients underwent an STSG procedure and had gauze-based NPWT placed immediately on top of the STSG (postgraft group). Negative pressure was applied at ?80 mm Hg. Results: In the pregraft group, NPWT was used for a median of 12 days. Improvement in quality of wound bed with decreased nonviable tissue (from 20% to 0% median wound area) and increased granulation tissue (from 20% to 90% median wound area) was observed. In the postgraft group, median duration of therapy was 5 days at which point median percentage skin graft-take was 96%. Conclusions: Gauze-based NPWT appears to be an effective addition to the care and management of wounds intended for definitive closure by STSG.

Dunn, Raymond M.; Ignotz, Ron; Mole, Trevor; Cockwill, John; Smith, Jennifer M.



Chitosan Acetate Bandage as a Topical Antimicrobial Dressing for Infected Burns  

Microsoft Academic Search

An engineered chitosan acetate bandage preparation (HemCon) is used as a hemostatic dressing, and its chemical structure suggests that it should also be antimicrobial. We previously showed that when a chitosan acetate bandage was applied to full-thickness excisional wounds in mice that had been infected with pathogenic bioluminescent bacteria (Pseudomonas aeruginosa, Proteus mirabilis, and Staphylococcus aureus), it was able to

Tianhong Dai; George P. Tegos; Marina Burkatovskaya; Ana P. Castano; Michael R. Hamblin



Accelerated healing of carbon dioxide laser burns in rats treated with composite polyurethane dressings.  


Healing time, infection rate, and residual scar formation were compared in carbon dioxide laser burns in rats treated in four ways: Spandra composite dressing, OpSite composite dressing, Petrolatum Gauze (USP), and no treatment. There were no infections and no differences in scar formation among the treatment groups. The mean healing times were ten days for the polyurethane dressings (Spandra and OpSite), 13 days for Petrolatum Gauze, and 16 days for the untreated group. Spandra was easier to apply and handle than OpSite. These findings suggest that synthetic gas-permeable dressings promote healing after cutaneous carbon dioxide laser surgery more effectively than conventional treatments of ointment-impregnated gauze or leaving the wound exposed to the air. PMID:3115190

Chan, P; Vincent, J W; Wangemann, R T



Quantum control by ultrafast dressed states tailoring  

Microsoft Academic Search

Strong field quantum control using shaped intense femtosecond laser pulses is investigated. The physical mechanism relies on selective population of dressed states (SPODS). With time resolved photoelectron spectroscopy the ultrafast dressed state population dynamics during the ionization of potassium atoms is directly observed. High selectivity of the dressed state population and tunability of the dressed state energies is demonstrated experimentally.

M. Wollenhaupt; D. Liese; A. Prakelt; C. Sarpetudoran; T. Baumert



Antimicrobial PLGA ultrafine fibers: interaction with wound bacteria.  


The structure and functions of polymer nanofibers as wound dressing materials have been well investigated over the last few years. However, during the healing process, nanofibrous mats are inevitably involved in dynamic interactions with the wound environment, an aspect not explored yet. Potential active participation of ultrafine fibers as wound dressing material in a dynamic interaction with wound bacteria has been examined using three wound bacterial strains and antimicrobial fusidic acid (FA)-loaded electrospun PLGA ultrafine fibers (UFs). These were developed and characterized for morphology and in-use pharmaceutical attributes. In vitro microbiological studies showed fast bacterial colonization of UFs and formation of a dense biofilm. Interestingly, bacterial stacks on UFs resulted in a remarkable enhancement of drug release, which was associated with detrimental changes in morphology of UFs in addition to a decrease in pH of their aqueous incubation medium. In turn, UFs by allowing progressively faster release of bioactive FA eradicated planktonic bacteria and considerably suppressed biofilm. Findings point out the risk of wound reinfection and microbial resistance upon using non-medicated or inadequately medicated bioresorbable fibrous wound dressings. Equally important, data strongly draw attention to the importance of characterizing drug delivery systems and establishing material-function relationships for biomedical applications under biorelevant conditions. PMID:21396444

Said, Somiraa S; Aloufy, Affaf K; El-Halfawy, Omar M; Boraei, Nabila A; El-Khordagui, Labiba K



Multidrug-resistant organisms, wounds and topical antimicrobial protection.  


Multidrug-resistant organisms (MDROs) are increasingly implicated in both acute and chronic wound infections. The limited therapeutic options are further compromised by the fact that wound bacteria often co-exist within a biofilm community which enhances bacterial tolerance to antibiotics. As a consequence, topical antiseptics may be an important consideration for minimising the opportunity for wound infections involving MDROs. The objective of this research was to investigate the antimicrobial activity of a silver-containing gelling fibre dressing against a variety of MDROs in free-living and biofilm states, using stringent in vitro models designed to simulate a variety of wound conditions. MDROs included Acinetobacter baumannii, community-associated methicillin-resistant Staphylococcus aureus, and extended-spectrum beta-lactamase-producing bacteria. Clostridium difficile was also included in the study because it carries many of the characteristics seen in MDROs and evidence of multidrug resistance is emerging. Sustained in vitro antimicrobial activity of the silver-containing dressing was shown against 10 MDROs in a simulated wound fluid over 7 days, and inhibitory and bactericidal effects against both free-living and biofilm phenotypes were also consistently shown in simulated colonised wound surface models. The in vitro data support consideration of the silver-containing gelling fibre dressing as part of a protocol of care in the management of wounds colonised or infected with MDROs. PMID:22640181

Bowler, Philip G; Welsby, Sarah; Towers, Victoria; Booth, Rebecca; Hogarth, Andrea; Rowlands, Victoria; Joseph, Alexis; Jones, Samantha A



Applied health informatics: a multi-year international effort to implement and maintain evidence-based practice for chronic-wound treatment  

Microsoft Academic Search

This paper describes a multi-year attempt to develop, implement and maintain an evidence-based international clinical decision support system for preventing and treating chronic wounds. Incidental to implementation efforts, over 37,000 wound assessments, risk assessments and treatment events were accumulated. These data allowed further confirmation of the evidence on which protocols and algorithms were based as well as empirically based rationales

Patrick McNees



[Bleeding control in stab wounds to the great vessels at the neck base].  


Stab wounds of the neck are a great challenge for every surgeon. Approximately 25% of penetrating neck injuries results in a vascular lesion. Wounds being situated below the cricoid cartilage are associated with the great mortality and morbidity, having a global mortality between 12-20%. 2/3 of the vascular wounds at this level have a tragic end. We are going to present 3 cases of cervical stab wounds in zone 1 of the neck, with vascular lesions, in which we succeeded to control the hemorrhages throw a midline sternotomy combined with different extensions. After this small experience we think that in patients with wounds situated in zone 1 of the neck, who reach the hospital hemodynamically unstable or with active bleeding, urgent midline sternotomy combined with cervicotomy, or section of the clavicle, is the best way to control the hemorrhages. Using blunt digital dissection we can avoid unpleasant situations that can appear using instrumental dissection into the mediastinal hematoma. PMID:16607750

Moro?anu, C; Lunca, S; Romede?, S N; Roat?, C; Buga, Carmen; Ciuhodaru, Laura


Spectroscopy of Burn Wounds.  

National Technical Information Service (NTIS)

This research seeks to develop non-invasive techniques for evaluating burn depth based upon non-contacting visible and near-infrared spectroscopic measurement of the wounds. In previous years, we demonstrated that features of the optical reflection spectr...

J. B. Callis M. A. Afromowitz



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.



Cell population-based model of dermal wound invasion with heterogeneous intracellular signaling properties  

PubMed Central

A deterministic model of dermal wound invasion, which accounts for the platelet-derived growth factor (PDGF) gradient sensing mechanism in fibroblasts mediated by cell surface receptors and the phosphoinositide 3-kinase (PI3K) signal transduction pathway, was previously described (Biophys J 2006; 90:2297–308). Here, we extend that work and implement a hybrid modeling strategy that treats fibroblasts as discrete entities endowed with heterogeneous properties, namely receptor, PI3K and 3? phosphoinositide phosphatase expression levels. Analysis of the model suggests that the wound environment fosters the advancement of cells within the population that are better fit to migrate and/or proliferate in response to PDGF stimulation. Thus, cell-to-cell variability results in a significantly higher rate of wound invasion as compared with the deterministic model, in a manner that depends on the way in which individual cell properties are sampled or inherited upon cell division.

Monine, Michael I



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


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



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.

Al-Mobeeriek, Azizah



Wound healing effect of Haruan (Channa striatus) spray.  


Haruan (Channa striatus) is a type of fresh water fish in Malaysia that is known to promote wound healing. Haruan water extract has been formulated in an aerosol system which can produce a film for wound dressing. As topical preparation, Haruan spray needs to be evaluated in terms of the possibility to cause irritation reaction or toxic response. Three experiments were carried out to evaluate the safety of Haruan spray which are Primary Skin Irritation test, Intracutaneous test and Systemic Injection test. The result shows that Haruan spray gave no significant responses to all the