Comparison of two silver dressings for wound management in pediatric burns.
Jester, Ingo; Bohn, Ingo; Hannmann, Thorsten; Waag, Karl-Ludwig; Loff, Steffan
2008-11-01
Purpose. Silver wound dressings are widely used in the treatment of burns. Dressings differ in material characteristics, various antimicrobial activities, and ease of use. The purpose of this study was to evaluate both dressing performance and amount of pain during the dressing changes of 2 silver dressings Urgotul SSD® (Laboratoires Urgo, Chenove, France), and Contreet Ag® (Coloplast, Minneapolis, MN) in children. A retrospective cohort study was performed with 2 groups of 20 burns treated with Urgotul SSD and Contreet Ag until the wounds were healed or grafted. Seventy dressing changes in the Contreet Ag group and 67 dressing changes in the Urgotul group were evaluated. Every dressing change was assessed regarding the dressing performance (exudate, adherence, bleeding, and dressing application/removal), and pain. Pain was "absent or slight" in 61 (92%) dressing changes with Urgotul SSD, and in 60 (85%) of the dressing changes with Contreet Ag. Dressing application in the Urgotul group was more often "very easy" (n = 33; 49%) or "easy" (n = 32; 48%) than in the Contreet Ag group, "very easy" (n = 25; 35%), and "easy" (n = 42; 60%). Contreet Ag had a greater ability to absorb exudate ("very good" n = 60; 85%, and "good" n = 11; 15%) than Urgotul SSD ("very good" n = 34; 51%, and "good" n = 13; 19%). Urgotul SSD and Contreet Ag are comparable regarding pain during dressing change. The dressings differ in their ability to absorb exudate and ease of application. Both dressings provided nearly painless wound management, and therefore were highly accepted by the nurses and especially the children being treated.
Effect of different wound dressings on cell viability and proliferation.
Paddle-Ledinek, Joanne E; Nasa, Zeyad; Cleland, Heather J
2006-06-01
Many new dressings have been developed since the early 1980s. Wound healing comprises cleansing, granulation/vascularization, and epithelialization phases. An optimum microenvironment and the absence of cytotoxic factors are essential for epithelialization. This study examines the effect of extracts of different wound dressings on keratinocyte survival and proliferation. Keratinocyte cultures were exposed for 40 hours to at least three extracts of each of the following wound dressings, which were tested in octuplicate: Acticoat, Aquacel-Ag, Aquacel, Algisite M, Avance, Comfeel Plus transparent, Contreet-H, Hydrasorb, and SeaSorb. Silicone extract provided the reference material. Controls were included of cells cultured in medium that had been incubated under conditions identical to those used with the extracts. Cell survival (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide reduction) and proliferation (5-bromo-2':-deoxyuridine incorporation) were measured. Extracts of silver-containing dressings (Acticoat, Aquacel-Ag, Contreet-H, and Avance) were most cytotoxic. Extracts of Hydrasorb were less cytotoxic but markedly affected keratinocyte proliferation and morphology. Extracts of alginate-containing dressings (Algisite M, SeaSorb, and Contreet-H) demonstrated high calcium concentrations, markedly reduced keratinocyte proliferation, and affected keratinocyte morphology. Extracts of Aquacel and Comfeel Plus transparent induced small but significant inhibition of keratinocyte proliferation. The principle of minimizing harm should be applied to the choice of wound dressing. Silver-based dressings are cytotoxic and should not be used in the absence of infection. Alginate dressings with high calcium content affect keratinocyte proliferation probably by triggering terminal differentiation of keratinocytes. Such dressings should be used with caution in cases in which keratinocyte proliferation is essential. All dressings should be tested in vitro before clinical application.
Matiasek, J; Domig, K J; Djedovic, G; Babeluk, R; Assadian, O
2017-05-02
The aim of this study was to investigate the bacterial bioburden in experimental in vitro wounds during the application of conventional negative pressure wound therapy (NPWT), with and without antimicrobial dressings (polyhexanide, silver), against NPWT instillation of octenidine. Experimental wounds produced in an in vitro porcine wound model were homogenously contaminated with bacterial suspension and treated with NPWT and different options. Group A: non-antimicrobial polyurethane foam dressing; group B: antimicrobial polyurethane foam dressing containing silver; group C: antimicrobial gauze dressing containing polyhexanide; group D: non-antimicrobial polyurethane foam dressing intermittently irrigated with octenidine; group E: negative control (non-antimicrobial polyurethane foam dressing without NPWT). Standard biopsies were harvested after 24 and 28 hours. This study demonstrated that the use of NPWT with intermitted instillation of octenidine (group D) or application of silver-based polyurethane foam dressings (group B) is significantly superior against Staphylococcus aureus colonisation in experimental wounds compared with non-antimicrobial polyurethane foam dressing (group A) after 48 hours. Surprisingly, the polyhexanide-based dressing (group C) used in this model showed no statistical significant effect compared with the control group (group E) after 24 or 48 hours of treatment. Both intermitted instillation of octenidine and silver-based dressings in standard NPWT were significantly superior compared with non-antimicrobial polyurethane foam dressings or PHMB coated gauze dressing after 48 hours.
Evaluation of a foam dressing for acute and chronic wound exudate management.
Bullough, Lindsay; Johnson, Sue; Forder, Rebecca
2015-09-01
This article discusses the use of a foam dressing for exudate management in both chronic and acute wounds, such as surgical wounds, pressure ulcers, diabetic ulcers, trauma wounds, and leg ulcers. The primary objective of the study was to observe patients' wound progression in terms of wound size and the condition of the wound bed, when using this foam dressing as either a primary or secondary dressing. The outcome of the evaluation demonstrated that ActivHeal Foam Contact dressing effectively managed exudate. It was also observed that the dressing can assist in autolysis and support improvements in peri-wound status. Choosing an appropriate dressing to manage a wound is essential. Clinicians working in the NHS are under pressure to deliver good-quality clinical outcomes, and the ActivHeal Foam Contact dressing supports this outcome.
Payne, Wyatt G; Posnett, John; Alvarez, Oscar; Brown-Etris, Marie; Jameson, Gayle; Wolcott, Randall; Dharma, Hussein; Hartwell, Samantha; Ochs, Diane
2009-02-01
Modern dressings such as hydrocolloids, gels, and foams are typically more expensive than traditional dressings such as gauze. However, if modern dressings require fewer changes, the overall cost of treatment may be lower despite the higher initial purchase price. If healing rates are comparable or better, modern dressings also may be cost-effective. A 4-week, prospective, randomized clinical trial to assess differences in treatment costs and cost-effectiveness between a modern foam dressing and saline-soaked gauze was conducted among 36 patients (22 men, 14 women, mean age 72.8 years) with a Stage II pressure ulcer (mean duration 35 weeks) at five centers in the United States. Participants were randomized to treatment with a self-adhesive polyurethane foam (n = 20) or saline-soaked gauze dressing (n = 16). No difference in time to wound closure was observed (P = 0.817). Patients in the foam group had less frequent dressing changes (P <0.001). Total cost over the study period was lower by $466 per patient (P = 0.055) and spending on dressings was lower by $92 per patient in the foam group (P = 0.025). Cost per ulcer healed was lower by $1,517 and cost per ulcer-free day was lower by $80 for patients in the foam group. On the evidence of this study, the foam dressing is a more cost-effective treatment than saline-soaked gauze for the treatment of Stage II pressure ulcers.
Jung, Jae-A; Yoo, Ki-Hyun; Han, Seung-Kyu; Dhong, Eun-Sang; Kim, Woo-Kyung
2016-12-01
To demonstrate the efficacy of a highly hydrophilic polyurethane foam dressing in the treatment of diabetic ulcers. Diabetic foot ulcers often pose a difficult treatment problem. Polyurethane foam dressings have been used worldwide to accelerate wound healing, but only a few clinical studies demonstrate the effect of foam dressing on the healing of diabetic ulcers. Medical records of 1342 patients with diabetic ulcers who were admitted and treated at the authors' institution were reviewed. A total of 208 patients met the study's inclusion criteria. Of these 208 patients, 137 were treated with a highly hydrophilic polyurethane foam dressing, and 71 were treated with saline gauze (control group). Except for the application of polyurethane foam dressing, the treatment method was identical for patients in both groups. The wound healing outcomes of the 2 groups were compared. Complete wound healing occurred in 87 patients (63.5%) in the polyurethane foam dressing group and in 28 patients (39.4%) in the control group within 12 weeks (P < .05, X test). The mean percentage of wound area reduction in both groups was statistically significant (P < .05, Mann-Whitney U test). The mean time required for complete closure in patients who achieved complete healing within 12 weeks was 6.2 (SD, 3.4) weeks and 7.3 (SD, 2.6) weeks in the polyurethane foam dressing and control groups, respectively (P < .05, Mann-Whitney U test). These results indicate that the highly hydrophilic polyurethane foam dressing may provide an effective treatment strategy for diabetic foot ulcers.
Günal, Özgür; Tuncel, Umut; Turan, Aydin; Barut, Sener; Kostakoglu, Naci
2015-10-01
The aim of this retrospective study was to evaluate the efficacy of vacuum-assisted closure (VAC) and GranuFoam Silver® dressing (KCI, San Antonio, TX) compared with conventional GranuFoam® dressing in the management of diabetic foot ulcers. Twenty-one consecutive patients treated with conventional or silver-coated foam dressing were reviewed retrospectively. The wound duration was 6 mo. Group 1 (n=10) received conventional foam dressing (GranuFoam) and group 2 (n=11) received silver-coated foam dressing (GranuFoam Silver). The wound surface area, duration of treatment, bacteriology, and recurrence were compared between the groups. The mean age of the patients was 61.70±10.52 y in group 1 and 67.27±11.28 y in group 2. In group 1, the average surface area of the wounds was 45.30±46.96 cm2 and 18.40±23.48 cm2 in the pre-treatment and post-treatment periods, respectively. There was a statistically significant difference between two measurements (p=0.005). Average duration of the treatment was 25.50±27.13 d in this group. In group 2, average surface area of the wounds in the pre-treatment and post-treatment periods were 41.55±36.03 cm2 and 7.64±3.91 cm2, respectively. There was a statistically significant difference between two measurements (p=0.003). Average duration of the treatment was 10.09±3.51 d in this group. The patients treated with silver-impregnated polyurethane foam dressing had reduced recurrence (2 vs. 7 wounds, p=0.030) and increased number of the culture-negative cases at the end of the treatment. With the results of the study, it was concluded that VAC GranuFoam silver dressing can be superior to conventional GranuFoam dressing in reducing the recurrence rate of infected diabetic foot ulcers.
Foam dressings for treating pressure ulcers.
Walker, Rachel M; Gillespie, Brigid M; Thalib, Lukman; Higgins, Niall S; Whitty, Jennifer A
2017-10-12
Pressure ulcers, also known as pressure injuries and bed sores, are localised areas of injury to the skin or underlying tissues, or both. Dressings made from a variety of materials, including foam, are used to treat pressure ulcers. An evidence-based overview of dressings for pressure ulcers is needed to enable informed decision-making on dressing use. This review is part of a suite of Cochrane Reviews investigating the use of dressings in the treatment of pressure ulcers. Each review will focus on a particular dressing type. To assess the clinical and cost effectiveness of foam wound dressings for healing pressure ulcers in people with an existing pressure ulcer in any care setting. In February 2017 we searched: the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE (including In-Process & Other Non-Indexed Citations); Ovid Embase; EBSCO CINAHL Plus and the NHS Economic Evaluation Database (NHS EED). We also searched clinical trials registries for ongoing and unpublished studies, and scanned reference lists of relevant included studies as well as reviews, meta-analyses and health technology reports to identify additional studies. There were no restrictions with respect to language, date of publication or study setting. Published or unpublished randomised controlled trials (RCTs) and cluster-RCTs, that compared the clinical and cost effectiveness of foam wound dressings for healing pressure ulcers (Category/Stage II or above). Two review authors independently performed study selection, risk of bias and data extraction. A third reviewer resolved discrepancies between the review authors. We included nine trials with a total of 483 participants, all of whom were adults (59 years or older) with an existing pressure ulcer Category/Stage II or above. All trials had two arms, which compared foam dressings with other dressings for treating pressure ulcers.The certainty of evidence ranged from low to very low due to various combinations of selection, performance, attrition, detection and reporting bias, and imprecision due to small sample sizes and wide confidence intervals. We had very little confidence in the estimate of effect of included studies. Where a foam dressing was compared with another foam dressing, we established that the true effect was likely to be substantially less than the study's estimated effect.We present data for four comparisons.One trial compared a silicone foam dressing with another (hydropolymer) foam dressing (38 participants), with an eight-week (short-term) follow-up. It was uncertain whether alternate types of foam dressing affected the incidence of healed pressure ulcers (RR 0.89, 95% CI 0.45 to 1.75) or adverse events (RR 0.37, 95% CI 0.04 to 3.25), as the certainty of evidence was very low, downgraded for serious limitations in study design and very serious imprecision.Four trials with a median sample size of 20 participants (230 participants), compared foam dressings with hydrocolloid dressings for eight weeks or less (short-term). It was uncertain whether foam dressings affected the probability of healing in comparison to hydrocolloid dressings over a short follow-up period in three trials (RR 0.85, 95% CI 0.54 to 1.34), very low-certainty evidence, downgraded for very serious study limitations and serious imprecision. It was uncertain if there was a difference in risk of adverse events between groups (RR 0.88, 95% CI 0.37 to 2.11), very low-certainty evidence, downgraded for serious study limitations and very serious imprecision. Reduction in ulcer size, patient satisfaction/acceptability, pain and cost effectiveness data were also reported but we assessed the evidence as being of very low certainty.One trial (34 participants), compared foam and hydrogel dressings over an eight-week (short-term) follow-up. It was uncertain if the foam dressing affected the probability of healing (RR 1.00, 95% CI 0.78 to 1.28), time to complete healing (MD 5.67 days 95% CI -4.03 to 15.37), adverse events (RR 0.33, 95% CI 0.01 to 7.65) or reduction in ulcer size (MD 0.30 cm 2 per day, 95% CI -0.15 to 0.75), as the certainty of the evidence was very low, downgraded for serious study limitations and very serious imprecision.The remaining three trials (181 participants) compared foam with basic wound contact dressings. Follow-up times ranged from short-term (8 weeks or less) to medium-term (8 to 24 weeks). It was uncertain whether foam dressings affected the probability of healing compared with basic wound contact dressings, in the short term (RR 1.33, 95% CI 0.62 to 2.88) or medium term (RR 1.17, 95% CI 0.79 to 1.72), or affected time to complete healing in the medium term (MD -35.80 days, 95% CI -56.77 to -14.83), or adverse events in the medium term (RR 0.58, 95% CI 0.33 to 1.05). This was due to the very low-certainty evidence, downgraded for serious to very serious study limitations and imprecision. Reduction in ulcer size, patient satisfaction/acceptability, pain and cost effectiveness data were also reported but again, we assessed the evidence as being of very low certainty.None of the included trials reported quality of life or pressure ulcer recurrence. It is uncertain whether foam dressings are more clinically effective, more acceptable to users, or more cost effective compared to alternative dressings in treating pressure ulcers. It was difficult to make accurate comparisons between foam dressings and other dressings due to the lack of data on reduction of wound size, complete wound healing, treatment costs, or insufficient time-frames. Quality of life and patient (or carer) acceptability/satisfaction associated with foam dressings were not systematically measured in any of the included studies. We assessed the certainty of the evidence in the included trials as low to very low. Clinicians need to carefully consider the lack of robust evidence in relation to the clinical and cost-effectiveness of foam dressings for treating pressure ulcers when making treatment decisions, particularly when considering the wound management properties that may be offered by each dressing type and the care context.
Ondieki, J G; Khainga, S O; Owilla, F; Nangole, F W
2012-07-01
Wounds have provided a challenge to the clinicians for centuries and this scenario persists to the 21st century. Negative pressure wound therapy (NPWT) is one of the latest additions in wound management. It has been widely adopted in developed countries with foam as the default wound dressing although it has some limitations. To determine the difference in outcomes between the use of gauze versus foam as wound dressing in NPWT for the management of acute traumatic wounds with soft tissue loss. Prospective randomised comparative interventional study. Kenyatta National Hospital Orthopaedic and Surgical wards. All patients aged above 12 years with Class III and Class IV acute traumatic wounds. The main outcome measure is the time taken to achieve 100% wound granulation. Comparisons were also made on the mean pain scores during dressing change and the percentage change in wound surface area. Wounds took an average of 8.4 days in the gauze group and 8.1 days in the foam group (p = 0.698) to achieve full granulation. The percentage change in wound surface area was 5.3 versus 5.5 (P = 0.769) in the gauze and foam groups respectively. The infection rates were comparable between the two groups (28% for gauze and 23.1% for foam, p = 0.697) and there was no significant difference in the median pain scores (gauze = 4.5, foam = 4.8 with p = 0.174). However, outcomes with gauze dressing were influenced significantly by the time to application of NPWT, initial wound surface area and wound infection while with foam dressing outcomes tended to be affected less so by the above factors. In the use of NPWT for the management of acute traumatic wounds, there is no difference in terms of time to full wound granulation, change in wound surface area, wound infection and pain during dressing change whether gauze or foam is used as the wound dressing material.
Analysis of the Pressure Distribution Qualities of a Silicone Border Foam Dressing.
Miller, Stephannie K; Sharma, Neal; Aberegg, Lauren C; Blasiole, Kimberly N; Fulton, Judith A
2015-01-01
To determine whether application of a silicone foam dressing is associated with decreased interface pressures when applied to the heel. Prospective, within-subjects design. The study was conducted in a community-based hospital using a convenience sample of 50 healthy volunteers with a mean age of 39.6 years and mean body mass index of 26.6; 70% were female. Application of the silicone border foam dressing was randomized between the left and right heels. Participants were asked to lie down in the supine position on a viscoelastic foam mattress. Interface pressure measurements were captured using a pressure mapping system; measurements were taken once with the dressing applied to the heel (intervention map) and once without (control map). Data were captured after a 4-minute time period allowing stabilization. Analysis was based on mean interface pressure; data points were collected for both heels in each of the 2 frames, yielding 4 observations per subject. Application of the dressing was associated with a significant decrease in average pressure measurements as compared to the heel with no dressing applied (P < .001). Application of the dressing did not impact pressure readings for the heel to which no dressing was applied (P = .53), and application of the dressing to either the left or right heel did not impact pressure readings (ie, the random effect was insignificant; P = .9). Application of a silicone border foam dressing is associated with significant reduction in interface pressure and may be considered as part of a pressure ulcer prevention program.
Matsumura, Hajime; Imai, Ryutaro; Ahmatjan, Niyaz; Ida, Yukiko; Gondo, Masahide; Shibata, Dai; Wanatabe, Katsueki
2014-02-01
In recent years, adhesive wound dressings have been increasingly applied postoperatively because of their ease of use as they can be kept in place without having to cut and apply surgical tapes and they can cover a wound securely. However, if a wound dressing strongly adheres to the wound, a large amount of stratum corneum is removed from the newly formed epithelium or healthy periwound skin. Various types of adhesives are used on adhesive wound dressings and the extent of skin damage depends on how much an adhesive sticks to the wound or skin surface. We quantitatively determined and compared the amount of stratum corneum removed by eight different wound dressings including polyurethane foam using acrylic adhesive, silicone-based adhesive dressing, composite hydrocolloid and self-adhesive polyurethane foam in healthy volunteers. The results showed that wound dressings with silicone adhesive and self-adhesive polyurethane foam removed less stratum corneum, whereas composite hydrocolloid and polyurethane foam using acrylic adhesive removed more stratum corneum. © 2012 The Authors. International Wound Journal © 2012 Medicalhelplines.com Inc and John Wiley & Sons Ltd.
Wiegand, Cornelia; Springer, Steffen; Abel, Martin; Wesarg, Falko; Ruth, Peter; Hipler, Uta-Christina
2013-01-01
Negative-pressure wound therapy (NPWT) is an advantageous treatment option in wound management to promote healing and reduce the risk of complications. NPWT is mainly carried out using open-cell polyurethane (PU) foams that stimulate granulation tissue formation. However, growth of wound bed tissue into foam material, leading to disruption of newly formed tissue upon dressing removal, has been observed. Consequently, it would be of clinical interest to preserve the positive effects of open-cell PU foams while avoiding cellular ingrowth. The study presented analyzed effects of NPWT using large-pored PU foam, fine-pored PU foam, and the combination of large-pored foam with drainage film on human dermal fibroblasts grown in a collagen matrix. The results showed no difference between the dressings in stimulating cellular migration during NPWT. However, when NPWT was applied using a large-pored PU foam, the fibroblasts continued to migrate into the dressing. This led to significant breaches in the cell layers upon removal of the samples after vacuum treatment. In contrast, cell migration stopped at the collagen matrix edge when fine-pored PU foam was used, as well as with the combination of PU foam and drainage film. In conclusion, placing a drainage film between collagen matrix and the large-pored PU foam dressing reduced the ingrowth of cells into the foam significantly. Moreover, positive effects on cellular migration were not affected, and the effect of the foam on tissue surface roughness in vitro was also reduced. © 2013 by the Wound Healing Society.
Padula, William V
The purpose of this study was to examine the effectiveness and value of prophylactic 5-layer foam sacral dressings to prevent hospital-acquired pressure injury rates in acute care settings. Retrospective observational cohort. We reviewed records of adult patients 18 years or older who were hospitalized at least 5 days across 38 acute care hospitals of the University Health System Consortium (UHC) and had a pressure injury as identified by Patient Safety Indicator #3 (PSI-03). All facilities are located in the United States. We collected longitudinal data pertaining to prophylactic 5-layer foam sacral dressings purchased by hospital-quarter for 38 academic medical centers between 2010 and 2015. Longitudinal data on acute care, hospital-level patient outcomes (eg, admissions and PSI-03 and pressure injury rate) were queried through the UHC clinical database/resource manager from the Johns Hopkins Medicine portal. Data on volumes of dressings purchased per UHC hospital were merged with UHC data. Mixed-effects negative binomial regression was used to test the longitudinal association of prophylactic foam sacral dressings on pressure injury rates, adjusted for hospital case-mix and Medicare payments rules. Significant pressure injury rate reductions in US acute care hospitals between 2010 and 2015 were associated with the adoption of prophylactic 5-layer foam sacral dressings within a prevention protocol (-1.0 cases/quarter; P = .002) and changes to Medicare payment rules in 2014 (-1.13 cases/quarter; P = .035). Prophylactic 5-layer foam sacral dressings are an effective component of a pressure injury prevention protocol. Hospitals adopting these technologies should expect good value for use of these products.
2017-01-01
PURPOSE: The purpose of this study was to examine the effectiveness and value of prophylactic 5-layer foam sacral dressings to prevent hospital-acquired pressure injury rates in acute care settings. DESIGN: Retrospective observational cohort. SAMPLE AND SETTING: We reviewed records of adult patients 18 years or older who were hospitalized at least 5 days across 38 acute care hospitals of the University Health System Consortium (UHC) and had a pressure injury as identified by Patient Safety Indicator #3 (PSI-03). All facilities are located in the United States. METHODS: We collected longitudinal data pertaining to prophylactic 5-layer foam sacral dressings purchased by hospital-quarter for 38 academic medical centers between 2010 and 2015. Longitudinal data on acute care, hospital-level patient outcomes (eg, admissions and PSI-03 and pressure injury rate) were queried through the UHC clinical database/resource manager from the Johns Hopkins Medicine portal. Data on volumes of dressings purchased per UHC hospital were merged with UHC data. Mixed-effects negative binomial regression was used to test the longitudinal association of prophylactic foam sacral dressings on pressure injury rates, adjusted for hospital case-mix and Medicare payments rules. RESULTS: Significant pressure injury rate reductions in US acute care hospitals between 2010 and 2015 were associated with the adoption of prophylactic 5-layer foam sacral dressings within a prevention protocol (−1.0 cases/quarter; P = .002) and changes to Medicare payment rules in 2014 (−1.13 cases/quarter; P = .035). CONCLUSIONS: Prophylactic 5-layer foam sacral dressings are an effective component of a pressure injury prevention protocol. Hospitals adopting these technologies should expect good value for use of these products. PMID:28816929
Santamaria, N; Gerdtz, M; Liu, W; Rakis, S; Sage, S; Ng, A W; Tudor, H; McCann, J; Vassiliou, T; Morrow, F; Smith, K; Knott, J; Liew, D
2015-08-01
Critically ill patients are at high risk of developing pressure ulcers (PU), with the sacrum and heels being highly susceptible to pressure injuries. The objective of our study was to evaluate the clinical effectiveness of a new multi-layer, self-adhesive soft silicone foam heel dressing to prevent PU development in trauma and critically ill patients in the intensive care unit (ICU). A cohort of critically ill patients were enrolled at the Royal Melbourne Hospital. Each patient had the multi-layer soft silicone foam dressing applied to each heel on admission to the emergency department. The dressings were retained with a tubular bandage for the duration of the patients' stay in the ICU. The skin under the dressings was examined daily and the dressings were replaced every three days. The comparator for our cohort study was the control group from the recently completed Border Trial. Of the 191 patients in the initial cohort, excluding deaths, loss to follow-up and transfers to another ward, 150 patients were included in the final analysis. There was no difference in key demographic or physiological variables between the cohorts, apart from a longer ICU length of stay for our current cohort. No PUs developed in any of our intervention cohort patients compared with 14 patients in the control cohort (n=152; p<0.001) who developed a total of 19 heel PUs. We conclude, based on our results, that the multi-layer soft silicone foam dressing under investigation was clinically effective in reducing ICU-acquired heel PUs. The findings also support previous research on the clinical effectiveness of multi-layer soft silicone foam dressings for PU prevention in the ICU.
Do Prophylactic Foam Dressings Reduce Heel Pressure Injuries?
Ramundo, Janet; Pike, Catlin; Pittman, Joyce
The purpose of this evidence-based report card is to examine the evidence and provide recommendations related to the effectiveness of prophylactic foam dressings in reducing heel pressure injuries. Do prophylactic foam dressings applied to the heel reduce heel pressure injuries for patients in the acute care setting? A search of the literature was performed by a trained university librarian that resulted in 56 articles that examined pressure injury, prevention, and prophylactic dressings. A systematic approach was used to review titles, abstracts, and text, yielding 13 studies that met inclusion criteria. Strength of the evidence was rated based on the methodology from Essential Evidence Plus: Levels of Evidence and Oxford Center for Evidence-Based Medicine. Thirteen studies were identified that met inclusion criteria; 1 was a randomized controlled trial, 2 were systematic reviews, 3 quasi-experimental cohort studies, 1 quality improvement study, 1 case series, 1 scoping review, 1 consensus panel, and 3 bench studies. All of the studies identified suggest that the use of prophylactic foam dressings reduces the development of pressure injuries on the heel when used in conjunction with a pressure injury prevention program. The strength of the evidence for the identified studies was level 1 (4 level A, 4 level B, and 5 level C). The use of prophylactic multilayer foam dressings applied to the heels, in conjunction with an evidence-based pressure injury prevention program, is recommended for prevention of pressure injuries on the heel (SORT level 1).
Davies, Phil
2016-01-01
Despite the implementation of prevention strategies, pressure ulcers (PUs) continue to be a challenging health problem for patients (and their carers), clinicians and health-care providers. One area of growing interest is the use of prophylactic dressings (which were originally designed for the treatment of PUs and other wound types) as a component of standard prevention measures. Over the past few years, a large amount of scientific and clinical data relating to this subject has been published in peer-reviewed journals and presented at international meetings and conferences. A substantial proportion of these data relate to one group of dressings: multi-layer foam dressings with Safetac, which are manufactured by Mölnlycke Health Care (Gothenburg, Sweden). This evidence pool has influenced the experts involved in updating the Clinical Practice Guideline, produced by the National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel and Pan Pacific Pressure Injury Alliance, on the prevention and treatment of PUs. The updated Guideline, published in 2014, recommends that, as part of their PU prevention regimens, clinicians should consider applying prophylactic dressings to bony prominences in anatomical areas that are frequently subjected to friction and shear. A literature review was undertaken to identify clinical data from the entire evidence hierarchy, as well as scientific data from laboratory studies, on the use of multi-layer foam dressings with Safetac in the prevention of pressure ulceration. The MEDLINE (National Library of Medicine, Bethesda, US) and EMBASE (Elsevier B, Amsterdam, Netherlands) bibliographic databases were searched. In addition, abstract books and proceedings documents relating to national and international conferences were scanned in order to identify presentations (i.e. oral, e-posters and posters) of relevance to the review. Clinical and health economic experts have undertaken numerous studies, including randomised controlled trials, to assess the efficacy and cost-effectiveness of using multi-layer foam dressings with Safetac as a component of standard PU prevention strategies. The results of these studies indicate that the application of multi-layer foam dressings containing Safetac can reduce the occurrence of PUs on anatomical locations such as the sacrum and the heel, and underneath medical devices. Scientists have also developed and used laboratory methods to gain a better understanding of how prophylactic dressings work. The results of these studies indicate that the composition of foam dressings containing Safetac (i.e. their multi-layer structure) sets them apart from other dressings due to their ability to mediate the effects of physical forces (i.e. pressure, friction and shear) and control microclimate, all of which contribute to pressure ulceration. The evidence pool clearly indicates that the prophylactic use of multi-layer foam dressings with Safetac as a component of standard prevention measures is beneficial to the clinician, the health-care provider and the patient. It should be noted that the findings outlined in this review may not be transferable to other products as their makeup and components are likely to differ significantly from those of multi-layer foam dressings with Safetac. As the importance of evidence-based practice and the need for cost-effective care continues to grow, clinicians and provider should carefully consider this point when selecting prophylactic dressings for PU prevention.
Lavery, Lawrence A; La Fontaine, Javier; Thakral, Gaurav; Kim, Paul J; Bhavan, Kavita; Davis, Kathryn E
2014-03-01
This study was designed to compare two approaches to negative-pressure wound therapy: 125-mmHg pressure with a polyurethane foam dressing and 75-mmHg pressure with a silicone-coated dressing. Forty patients with diabetic foot wounds, after incision and drainage or amputation for infection, were assigned randomly to negative-pressure wound therapy with 75-mmHg continuous pressure with a silicone-covered dressing (75-mmHg group) or 125-mmHg with a polyurethane foam dressing (125-mmHg group) for up to 4 weeks or until surgical closure. There was no difference in the proportion of wounds that were closed surgically (75-mmHg group, 50 percent; 125-mmHg group, 60 percent), wounds that demonstrated 50 percent wound area reduction (75-mmHg group, 65 percent; 125-mmHg group, 80 percent), or wounds that demonstrated 50 percent wound volume reduction after 4 weeks of therapy (75-mmHg group, 95 percent; 125-mmHg group, 90 percent). The authors' results suggest that there was no difference in outcomes in wounds treated with low pressure (75 mmHg) with a silicone-coated interface and high pressure (125 mmHg) with a polyurethane foam interface. Therapeutic, II.
Managing burn wounds with SMARTPORE Technology polyurethane foam: two case reports.
Imran, Farrah-Hani; Karim, Rahamah; Maat, Noor Hidayah
2016-05-12
Successful wound healing depends on various factors, including exudate control, prevention of microbial contaminants, and moisture balance. We report two cases of managing burn wounds with SMARTPORE Technology polyurethane foam dressing. In Case 1, a 2-year-old Asian girl presented with a delayed (11 days) wound on her right leg. She sustained a thermal injury from a hot iron that was left idle on the floor. Clinical inspection revealed an infected wound with overlying eschar that traversed her knee joint. As her parents refused surgical debridement under general anesthesia, hydrotherapy and wound dressing using SMARTPORE Technology Polyurethane foam were used. Despite the delay in presentation of this linear thermal pediatric burn injury that crossed the knee joint, the patient's response to treatment and its outcome were highly encouraging. She was cooperative and tolerated each dressing change without the need of supplemental analgesia. Her wound was healed by 24 days post-admission. In Case 2, a 25-year-old Asian man presented with a mixed thickness thermal flame burn on his left leg. On examination, the injury was a mix of deep and superficial partial thickness burn, comprising approximately 3% of his total body surface area. SMARTPORE Technology polyurethane foam was used on his wound; his response to the treatment was very encouraging as the dressing facilitated physiotherapy and mobility. The patient rated the pain during dressing change as 2 on a scale of 10 and his pain score remained the same in every subsequent change. His wound showed evidence of epithelialization by day 7 post-burn. There were no adverse events reported. Managing burn wounds with SMARTPORE Technology polyurethane foam resulted in reduced pain during dressing changes and the successful healing of partial and mixed thickness wounds. The use of SMARTPORE Technology polyurethane foam dressings showed encouraging results and requires further research as a desirable management option in burn wounds.
Silver-containing foam dressings with Safetac: a review of the scientific and clinical data.
Davies, Phil; McCarty, Sara; Hamberg, Kristina
2017-06-01
Background Topical antimicrobials, such as silver dressings, are progressively being used alongside systemic antibiotics to provide adjunctive, antimicrobial therapy to wounds that are clinically infected or at risk of infection. To help improve wound management, dressings that use Safetac soft silicone technology in combination with a silver-impregnated foam dressing material were developed by Mölnlycke Health Care (Gothenburg, Sweden). The range comprises Mepilex Ag, Mepilex Border Ag and Mepilex Transfer Ag. Aims A literature review was undertaken to identify and summarise clinical data from the entire evidence hierarchy, as well as data from in vitro tests, which support the use of silver-containing foam dressings with Safetac. Method The MEDLINE (National Library of Medicine, Bethesda, US) and EMBASE (Elsevier BV, Amsterdam, Netherlands) bibliographic databases were searched. In addition, abstract books and proceedings documents relating to national and international conferences were scanned in order to identify presentations (oral, e-poster and poster) of relevance to the review. Results In vitro test results showed that the silver-containing foam dressings with Safetac have both rapid and sustained activity against a range of wound pathogens, reducing planktonic and established biofilm cultures, and preventing biofilm formation. In numerous clinical studies, silvercontaining foam dressings with Safetac were used to manage wound bioburden effectively and resolve signs of localised infection in both acute wounds (such as surgical, traumatic and burn injuries) and chronic wounds (such as leg ulcers, pressure ulcers (PUs), diabetic foot ulcers (DFUs), and cancerous wounds). Studies reported that silver-containing foam dressings with Safetac are easy to use, provide an optimal environment for wound healing, and are associated with atraumatic and virtually painfree removal. As well as being clinically effective, they are reported to be cost-effective when used on wounds that require topical antimicrobial therapy. Conclusion The findings of both scientific and clinical studies clearly indicate that clinical, patient-related and economic benefits are associated with the use of Mepilex Ag, Mepilex Border Ag and Mepilex Transfer Ag with Safetac in the treatment of wounds where antimicrobial activity is needed to help manage bioburden.
Tran, Phat L; Hamood, Abdul N; de Souza, Anselm; Schultz, Gregory; Liesenfeld, Bernd; Mehta, Dilip; Reid, Ted W
2015-01-01
Bacterial infection of acute and chronic wounds impedes wound healing significantly. Part of this impediment is the ability of bacterial pathogens to grow in wound dressings. In this study, we examined the effectiveness of a polyurethane (PU) foam wound dressings coated with poly diallyl-dimethylammonium chloride (pDADMAC-PU) to inhibit the growth and biofilm development by three main wound pathogens, Staphylococcus aureus, Pseudomonas aeruginosa, and Acinetobacter baumannii, within the wound dressing. pDADMAC-PU inhibited the growth of all three pathogens. Time-kill curves were conducted both with and without serum to determine the killing kinetic of pDADMAC-PU. pDADMAC-PU killed S. aureus, A. baumannii, and P. aeruginosa. The effect of pDADMAC-PU on biofilm development was analyzed quantitatively and qualitatively. Quantitative analysis, colony-forming unit assay, revealed that pDADMAC-PU dressing produced more than eight log reduction in biofilm formation by each pathogen. Visualization of the biofilms by either confocal laser scanning microscopy or scanning electron microscopy confirmed these findings. In addition, it was found that the pDADMAC-PU-treated foam totally inhibited migration of bacteria through the foam for all three bacterial strains. These results suggest that pDADMAC-PU is an effective wound dressing that inhibits the growth of wound pathogens both within the wound and in the wound dressing. © 2014 by the Wound Healing Society.
Yu, Ki-Pi; Yoo, Seol Bong; Yang, Seok Jeong; Yoon, Yong-Soon
2015-11-01
To evaluate the effect of electrical stimulation (ES) combined with foam dressing on wound healing in rats with spinal cord injury. Complete spinal cord injury was induced in 49 male Sprague-Dawley rats at the T11-L1 level, after which a pressure ulcer was induced on the left thigh. The newly invented surface electrode, which was fitted with foam inside, was applied to the ulcers. Rats were divided into 2 groups as follows: the ES group, which received foam dressings and ES (2 Hz and 200-microsecond duration, 15 mA) for 4 times a day, 30 minutes each, for 3 weeks; and the control group, which received the foam dressings without ES. The ulcer area was measured by taking a photograph daily from day 0 to day 21. Histopathologic and immune-histochemical evaluations were performed on day 1 and days 7, 14, and 21. The area of the ulcers of the ES group was smaller than that of the control group after day 14 (P < .05). In the ES group, the vascularity was significantly greater on day 14 and more decreased on day 21 compared with day 7 than that in the control group (P < .05). In the ES group, the area of positive reaction to anti-α-SMA antibody was increased compared with the control group on days 7 and 14 and decreased on day 21 (P > .05). Electrical stimulation combined with foam dressing by means of newly invented surface electrodes facilitates and accelerates the wound-healing process.
Zehrer, Cindy L; Holm, David; Solfest, Staci E; Walters, Shelley-Ann
2014-12-01
This study compared moisture vapour transmission rate (MVTR) and wear time or fluid-handling capacities of six adhesive foam dressings to a reformulated control dressing. Standardised in vitro MVTR methodology and a previously published in vivo artificial wound model (AWM) were used. Mean inverted MVTR for the reformulated dressing was 12 750 g/m(2) /24 hours and was significantly higher than four of the six comparator dressings (P < 0·0001), which ranged from 830 to 11 360 g/m(2) /24 hours. Mean upright MVTR for the reformulated dressing was 980 g/m(2) /24 hours and was significantly different than all of the comparator dressings (P < 0·0001), which ranged from 80 to 1620 g/m(2) /24 hours (three higher/three lower). The reformulated dressing median wear time ranged from 6·1 to >7·0 days, compared with 1·0 to 3·5 days for the comparator dressings (P = 0·0012 to P < 0·0001). The median fluid volume handled ranged from 78·0 to >87 ml compared with 13·0 to 44·5 ml for the comparator dressings (P = 0·0007 to P < 0·001). Interestingly, inverted MVTR did not correspond well to the AWM. These results suggest that marked differences exist between the dressings in terms of both MVTR and wear time or fluid-handling capacity. Furthermore, high inverted MVTR does not necessarily predict longer wear time or fluid-handling capacities of absorbent dressings. © 2013 The Authors. International Wound Journal © 2013 Medicalhelplines.com Inc and John Wiley & Sons Ltd.
Treatment of pressure sores in spina bifida patients with calcium alginate and foam dressings.
Ausili, E; Paolucci, V; Triarico, S; Maestrini, C; Murolo, D; Focarelli, B; Rendeli, C
2013-06-01
Prospective study on local treatment of pressure sores using calcium alginate and foam dressings in spina bifida patients. Investigate if this sequential approach is valid and safe for selected patients with neurological impairments. Using European Pressure Ulcer Grading System, after clinical evaluation of local sore, selected patients of Spina Bifida Center of Rome were treated with sequential calcium alginate and foam dressings for 12 weeks. Pressure ulcere surfaces were measured monthly by ulcer tracing. The endpoints were the mean absolute areas surface reduction during every month and number of patients achieving a 50% or more during study. 14 patients (7 males aged 12-24 years) with spina bifida and pressure sores were treated. Mean and standard deviation of mean surface area reduction were 12.5 ± 7.5 cm 2 at start of the study versus 3.7 ± 5.2 cm 2 after 12 weeks, p < 0.001. 75% of the patients reached mean surface area reduction of 50% during trial. Dressing tolerance was good in every patient. Calcium alginate and foam dressings are valid and safe approach in the treatment of pressure sores in selected patients with spina bifida. In fact, they protect the wound and create an environment favorable to healing.
[Cost-effectiveness of a TLC-NOSF polyurethane foam dressing].
Arroyo Ana, Abejón; Alvarez Vázquez, Juan Carlos; Blasco García, Carmen; Bermejo Martínez, Mariano; López Casanova, Pablo; Cuesta Cuesta, Juan José; De Haro Fernández, Francisco; Mateo Marín, Emilia; Segovia Gómez, Teresa; Villar Rojas, Antonio Erasto
2012-11-01
Chronic wounds represent a drain on the Spanish health system, nowdays is necessary an optimization of the resources used and that is for this that is necessary justify the use of the products over others through cost-effective studies for to show the economic benefit to professionals and the life quality of patient. This article compares the use of a new technology for format polyurethane foam, TLC-NOSF, with the most commonly used products for treating wounds. This comparison is made using a cost-effectiveness model (Markov Model). The results demonstrate that treatment with polyurethane foam dressing with TLC-NOSF are cost-effective versus treatments with polyurethane foams most commonly used in Spain.
A multilayered polyurethane foam technique for skin graft immobilization.
Nakamura, Motoki; Ito, Erika; Kato, Hiroshi; Watanabe, Shoichi; Morita, Akimichi
2012-02-01
Several techniques are applicable for skin graft immobilization. Although the sponge dressing is a popular technique, pressure failure near the center of the graft is a weakness of the technique that can result in engraftment failure. To evaluate the efficacy of a new skin graft immobilization technique using multilayered polyurethane foam in vivo and in vitro. Twenty-six patients underwent a full-thickness skin graft. Multiple layers of a hydrocellular polyurethane foam dressing were used for skin graft immobilization. In addition, we created an in vitro skin graft model that allowed us to estimate immobilization pressure at the center and edges of skin grafts of various sizes. Overall mean graft survival was 88.9%. In the head and neck region (19 patients), mean graft survival was 93.6%. Based on the in vitro outcomes, this technique supplies effective pressure (<30 mmHg) to the center region of the skin graft. This multilayered polyurethane foam dressing is simple, safe, and effective for skin graft immobilization. © 2011 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.
Santamaria, Nick; Liu, Wei; Gerdtz, Marie; Sage, Sarah; McCann, Jane; Freeman, Amy; Vassiliou, Theresa; DeVincentis, Stephanie; Ng, Ai W; Manias, Elizabeth; Knott, Jonathan; Liew, Danny
2015-06-01
Little is known about the cost-benefit of soft silicone foam dressings in pressure ulcer (PU) prevention among critically ill patients in the emergency department (ED) and intensive care unit (ICU). A randomised controlled trial to assess the efficacy of soft silicone foam dressings in preventing sacral and heel PUs was undertaken among 440 critically ill patients in an acute care hospital. Participants were randomly allocated either to an intervention group with prophylactic dressings applied to the sacrum and heels in the ED and changed every 3 days in the ICU or to a control group with standard PU prevention care provided during their ED and ICU stay. The results showed a significant reduction of PU incidence rates in the intervention group (P = 0·001). The intervention cost was estimated to be AU$36·61 per person based on an intention-to-treat analysis, but this was offset by lower downstream costs associated with PU treatment (AU$1103·52). Therefore, the average net cost of the intervention was lower than that of the control (AU$70·82 versus AU$144·56). We conclude that the use of soft silicone multilayered foam dressings to prevent sacral and heel PUs among critically ill patients results in cost savings in the acute care hospital. © 2013 The Authors. International Wound Journal © 2013 Medicalhelplines.com Inc and John Wiley & Sons Ltd.
Tuncel, Umut; Turan, Aydin; Markoc, Fatma; Erkorkmaz, Unal; Elmas, Cigdem; Kostakoglu, Naci
2014-03-01
Since the introduction of negative pressure wound therapy (NPWT), the physiological effects of various interface dressing materials have been studied. The purpose of this experimental study was to compare the use of loofah sponge to standard polyurethane foam or a cotton gauze sponge. Three wounds, each measuring 3 cm x 3 cm, were created by full-thickness skin excision on the dorsal sides of 24 New Zealand adult white rabbits. The rabbits were randomly divided into four groups of six rabbits each. In group 1 (control), conventional saline-moistened gauze dressing was provided and changed at daily intervals. The remaining groups were provided NPWT dressings at -125 mm Hg continuous pressure. This dressing was changed every 3 days for 9 days; group 2 was provided polyurethane foam, group 3 had conventional saline-soaked antimicrobial gauze, and group 4 had loofah sponge. Wound area measurements and histological findings (inflammation, granulation tissue, neovascularization, and reepithelialization) were analyzed on days 3, 6, and 9. Wound area measurements at these intervals were significantly different between the control group and study groups (P<0.05). Granulation and neovascularization scores were also significantly different between the control and treatment groups at day 3 (P=0.002). No differences in any of the healing variables studied were observed between the other three dressing materials. According to scanning electron microscopy analysis of the three interface materials, the mean pore size diameter of foam and gauze interface materials was 415.80±217.58 μm and 912.33±116.88 μm, respectively. The pore architecture of foam was much more regular than that of gauze. The average pore size diameter of loofah sponge was 736.83±23.01 μm; pores were hierarchically located--ie, the smaller ones were usually peripheral and larger ones werecentral. For this study, the central part of loofah sponge was discarded to achieve a more homogenous structure of interface material. Loofah sponge study results were similar to those using gauze or foam, but the purchase price of loofah sponge is lower than that of currently available interface dressings. More experimental, randomized controlled studies are needed to confirm these results.
Satake, Toshihiko; Muto, Mayu; Nagashima, Yu; Haga, Shoko; Homma, Yuki; Nakasone, Reiko; Kadokura, Marina; Kou, Seiko; Fujimoto, Hiroshi; Maegawa, Jiro
2018-04-01
We describe a new wound management technique using a soft dressing material to stabilize the areola skin graft and protect the nipple after nipple-areola reconstruction at the final stage of breast reconstruction. We introduced a center-fenestrated multilayered hydrocellular polyurethane foam dressing material that provides adequate pressure and retains a moist environment for a smooth skin graft "take." Moreover, the reconstructed nipple can be monitored at any time through the fenestrated window for adequate blood circulation. Altogether, this simple and inexpensive wound dressing technique improves the clinical outcome. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Real-time monitoring of moisture levels in wound dressings in vitro: an experimental study.
McColl, David; Cartlidge, Brian; Connolly, Patricia
2007-10-01
Retaining an appropriate level of moisture at the interface between a healing wound and an applied dressing is considered to be critical for effective wound healing. Failure to control exudate at this interface can result in maceration or drying out of the wound surface. The ability to control moisture balance at the wound interface is therefore a key aspect of wound dressing performance. To date it has not been possible to monitor in any effective manner the distribution of moisture within dressings or how this varies with time. A new measurement system is presented based on sensors placed at the wound/dressing interface which are capable of monitoring moisture levels in real time. The system comprises a model wound bed and sensor array complete with fluid injection path to mimic exudate flow. Eight monitoring points, situated beneath the test dressing, allow the moisture profile across the complete dressing to be measured both during and after fluid injection. The system has been used to evaluate the performance of four foam dressings, a composite hydrofibre dressing and a film dressing. Stark contrasts in the performance of the wound contact layer were found between the different wound dressing types. The composite hydrofibre dressing retained moisture at the wound interface throughout the experiments while areas of the foam dressing quickly became dry, even during constant injection of fluid. The abundance of sensors allowed a moisture map of the surface of the wound dressing to be constructed, illustrating that the moisture profile was not uniform across several of the dressings tested during absorption and evaporation of liquid. These results raise questions as to how the dressings behave on a wound in vivo and indicate the need for a similar clinical monitoring system for tracking wound moisture levels.
Borgquist, Ola; Gustafsson, Lotta; Ingemansson, Richard; Malmsjö, Malin
2010-06-01
Negative pressure wound therapy (NPWT) results in 2 types of tissue deformation, macrodeformation (ie, wound contraction) and microdeformation (ie, the interaction of tissue and dressing on a microscopic level). These effects have been delineated for one type of wound filler, foam, but not for gauze. The mechanical deformation initiates a signaling cascade which ultimately leads to wound healing. The aim of the present study was to examine the effect of gauze and foam on macro- and microdeformation during treatment with negative pressure. An in vivo porcine peripheral wound model was used. NPWT was applied for 72 hours at 0, -75, and -125 mm Hg, using either foam or gauze as wound filler. The mechanical effects of NPWT were examined by measuring the wound surface area reduction and by histologic analysis of the wound bed tissue. Similar degrees of wound contraction (macrodeformation) were seen during NPWT regardless if foam or gauze was used. After negative pressure had been discontinued, the wound stayed contracted. There was no difference in wound contraction between -75 and -125 mm Hg. Biopsies of the wound bed revealed a repeating pattern of wound surface undulations and small tissue blebs ("tissue mushrooms") were pulled into the pores of the foam dressing and the spaces between the threads in the gauze dressing (microdeformation). This pattern was obvious in wounds treated both with foam and gauze, at atmospheric pressure (0 mm Hg) as well as at subatmospheric pressures (-75 and -125 mm Hg). The degrees of micro- and macrodeformation of the wound bed are similar after NPWT regardless if foam or gauze is used as wound filler.
Hemostatic kaolin-polyurethane foam composites for multifunctional wound dressing applications.
Lundin, Jeffrey G; McGann, Christopher L; Daniels, Grant C; Streifel, Benjamin C; Wynne, James H
2017-10-01
There are numerous challenges associated with the acute care of traumatic limb injuries in forward military settings. A lack of immediate medical facilities necessitates that the wound dressing perform multiple tasks including exudate control, infection prevention, and physical protection of the wound for extended periods of time. Here, kaolin was incorporated into recently developed robust polyurethane (PU) hydrogel foams at 1-10wt% in an effort to impart hemostatic character. ATR-IR and gel fraction analysis demonstrated that the facile, one-pot synthesis of the PU hydrogel was unaffected by kaolin loading, as well as the use of a non-toxic catalyst, which significantly improved cytocompatibility of the materials. Kaolin was generally well dispersed throughout the PU matrix, though higher loadings exhibited minor evidence of aggregation. Kaolin-PU composites exhibited burst release of ciprofloxacin over 2h, the initial release rates of which increased with kaolin loading. Kaolin loading imparted excellent hemostatic character to the PU foams at relatively low loading levels (5wt%). This work demonstrates the simple and inexpensive synthesis of robust, hemostatic, and absorptive kaolin-PU foams that have promising potential as multifunctional wound dressing materials. Published by Elsevier B.V.
Howell-Taylor, Melania; Hall, Macy G; Brownlee Iii, William J; Taylor, Mary
2008-09-01
Acute infection of surgical incision sites often requires specialized wound care in preparation for surgical closure. Optimal therapy for preparing such wounds for a secondary closure procedure remains uncertain. The authors report wound outcomes after administering acoustic pressure wound therapy in conjunction with negative pressure wound therapy with reticulated open-cell foam dressing changes to assist with bacteria removal from open, infected surgical-incision sites in preparation for secondary surgical closure in three patients. Before incorporating acoustic pressure wound therapy at the authors' facility, the average negative pressure wound therapy with reticulated open-cell foam dressing course prior to secondary surgical closure was 30 days; with its addition, two of three patients underwent successful surgical closure with no postoperative complications after 21 and 14 days, respectively; one patient succumbed to nonwound-related complications before wound closure. Larger, prospective studies are needed to evaluate combining negative pressure wound therapy with reticulated open-cell foam dressing and acoustic pressure wound therapy for infected, acute post surgery wounds.
Antibacterial potency of V.A.C. GranuFoam Silver(®) Dressing.
Sachsenmaier, Saskia; Peschel, Andreas; Ipach, Ingmar; Kluba, Torsten
2013-10-01
V.A.C.(®) GranuFoam™ therapy is regularly used in the surgical therapy of infected wounds and soft tissue injuries. Silver nanoparticles can destroy bacterial cell walls and inhibit enzymes for cell replication. Silver dressings are therefore successfully used for many indications in wound therapy. In this study, we investigated the antimicrobial potency of ionic silver released from the silver-coated V.A.C.(®) GranuFoam™ during vacuum therapy. Silver dressing was exposed to agar plates populated with bacteria to measure silver release. A total of 15 agar plates colonised with either Staphylococcus aureus populations or with Staphylococcus epidermidis, were loaded with V.A.C. GranuFoam Silver(®) Dressing polyurethane foam (KCI, San Antonio, Texas). Each of 13 pieces of silver-coated foam was applied to an agar plate. Two plates were loaded with conventional black foam without any coating. After connecting to a vacuum pump, the vacuum therapy of the 15 plates lasted 5 days. The zone of inhibition of bacterial growth around the foam was measured daily. Silver release was also determined as a function of time. At each time point, there was evidence of silver in the agar independent of bacterial colonisation. The S. aureus agar showed a consecutive increase in silver concentration from baseline upon 48 h after exposure to the negative pressure of V.A.C. therapy. An increasing mean silver level after 48, 72 and 96 h was measured under V.A.C. therapy with a peak value after 120 h. In contrast, the results from the S. epidermidis plates did not follow a linear pattern. At the beginning of vacuum therapy, we documented a rise in silver concentration. After 48-96h, the silver levels fluctuated. A maximum zone of inhibition in both bacterial colonised plates (S. aureus and S. epidermidis) was found 39 h after the start of the V.A.C. GranuFoam Silver(®) therapy. From our results, we confirmed the antimicrobial effect of the silver ions against S. aureus and S. epidermidis under continuous V.A.C. GranuFoam(®) Silver therapy with a negative pressure of 25 mmHg. Furthermore we could quantify the amounts of silver, which were released from the foam under negative pressure as a function of time. Copyright © 2013 Elsevier Ltd. All rights reserved.
Nherera, Leo; Trueman, Paul; Roberts, Christopher; Berg, Leena
2018-02-23
Burn injury is a common type of traumatic injury that causes considerable morbidity and mortality, resulting in about 30,000 admissions annually in specialist burn centers and costing around $1 billion per year in the United States. One percent silver sulfadiazine has been utilized widely in the management of burns and newer silver dressings are on the market, including nanocrystalline silver dressings, silver-impregnated hydrofiber dressings, and silver-impregnated foam dressings. This study sought to determine the cost effectiveness of the newer silver dressings using clinical data from an indirect treatment comparison using silver sulfadiazine as the baseline. A decision analytic model was developed from a US payer's perspective for burn patients with a total body surface area of < 20%. Outcomes were length of stay, infections and incidence of surgical procedures, quality adjusted life years (QALYs), and cost. The meta-analysis reported a statistically significant reduction in length of hospital stay and clinically important reductions in infections and incidence of surgical procedures in favor of the silver barrier dressing compared with other silver dressings. The estimated QALYs were 0.970 versus 0.969 versus 0.969 and mean cost per patient was $15,892, $23,799, and $24,269 for the nanocrystalline silver dressing, silver-impregnated hydrofiber dressing, and silver-impregnated foam dressing, respectively. The analysis showed the nanocrystalline silver dressing to be a dominant strategy (less costly with better outcomes). These findings were robust to a range of sensitivity analyses. According to data from an indirect treatment comparison, this analysis suggests that nanocrystalline silver dressing is the most cost-effective silver delivery system. Prospective head-to-head research on the costs and outcomes of these silver delivery systems in this patient population is necessary to validate the results of this economic evaluation.
Kelleher, Maureen E; Kilcoyne, Isabelle; Dechant, Julie E; Hummer, Emma; Kass, Philip H; Snyder, Jack R
2015-04-01
To determine if application of silver sodium zirconium phosphate polyurethane semi-occlusive foam (SPF) dressing would improve measures of wound healing and decrease bacterial contamination compared with a non-adherent, absorbent dressing applied to wounds created on the distal aspect of the equine limb. Controlled randomized experimental study. Adult Quarter Horse and Thoroughbred horses (n = 5). One 6.25 cm(2) wound was created on the dorsomedial aspect of the proximal metacarpus on each forelimb. A SPF dressing was applied to 1 randomly assigned limb as a treatment and a non-adherent, absorbent dressing was applied to the opposite limb as control. Bandages were changed every 3 days for 60 days. Granulation tissue was scored every 3 days, wound area measured every 6 days, and wound bed was cultured every 12 days. SPF-treatment wounds had significantly decreased wound area and decreased granulation tissue scores when evaluated <30 days and over the 60 day study, although complete wound healing times were not significantly different. Bacteria were cultured from all wounds at varying times throughout the study. The SPF wound dressing improved some measures of wound healing compared with the control dressing, most significantly during the first 30 days. This suggests that the SPF wound dressing may be useful in the early management of wounds on the equine lower limb. Further studies using the SPF dressing are needed to characterize the temporal and cellular effects on wound healing and evaluate this dressing in a clinical environment. © Copyright 2014 by The American College of Veterinary Surgeons.
Milleret, Vincent; Bittermann, Anne Greet; Mayer, Dieter; Hall, Heike
2009-01-01
Many wounds heal slowly and are difficult to manage. Therefore Negative Pressure Wound Therapy (NPWT) was developed where polymer foams are applied and a defined negative pressure removes wound fluid, reduces bacterial burden and increases the formation of granulation tissue. Although NPWT is used successfully, its mechanisms are not well understood. In particular, different NPWT dressings were never compared. Here a poly-ester urethane Degrapol® (DP)-foam was produced and compared with commercially available dressings (polyurethane-based and polyvinyl-alcohol-based) in terms of apparent pore sizes, swelling and effective interconnectivity of foam pores. DP-foams contain relatively small interconnected pores; PU-foams showed large pore size and interconnectivity; whereas PVA-foams displayed heterogeneous and poorly interconnected pores. PVA-foams swelled by 40 %, whereas DP- and PU-foams remained almost without swelling. Effective interconnectivity was investigated by submitting fluorescent beads of 3, 20 and 45 μm diameter through the foams. DP- and PU-foams removed 70-90 % of all beads within 4 h, independent of the bead diameter or bead pre-adsorption with serum albumin. For PVA-foams albumin pre-adsorbed beads circulated longer, where 20 % of 3 μm and 10 % of 20 μm diameter beads circulated after 96 h. The studies indicate that efficient bead perfusion does not only depend on pore size and swelling capacity, but effective interconnectivity might also depend on chemical composition of the foam itself. In addition due to the efficient sieve-effect of the foams uptake of wound components in vivo might occur only for short time suggesting other mechanisms being decisive for success of NPWT.
Antimicrobial Efficacy of a Silver Impregnated Hydrophilic PU Foam.
Percival, Steven L
2018-06-01
A novel hydrophilic polyurethane (PU) foam dressing which is impregnated with silver chloride, Optifoam® Gentle (OG) Ag+ (Medline Industries Inc., Chicago, Illinois), was evaluated in this study. The aims of this study were to determine the rate of elution of silver from the foam dressing over a period of 168 hours into simulated wound fluid and an evaluation of antimicrobial efficacy using zone of inhibition (ZOI), direct kill, and time-kill viability. Thirty-two microorganisms associated with wounds including Pseudomonas aeruginosa, Methicillin sensitive Staphylococcus aureus (MSSA), Acinetobacter baumannii, Candida albicans, and antibiotic-resistant strains (Methicillin-resistant S. aureus [MRSA] and Vancomycin-resistant Enterococci [VRE]) were evaluated. Silver release from the wound dressing showed an exponential curve with a stable sustained release of 25ppm achieved after 24 hours, which was maintained for the full duration of the study. OG Ag+ caused inhibition zones ranging from 4-16mm after a 24-hour contact time. In the direct kill assay, OG Ag+ reduced the microbial numbers below the limit of detection and reduced viability by a log of four within 24 hours. For the time-kill viability studies, the results support the use of this hydrophilic polyurethane foam as a wound dressing for use in wounds at risk of infection or infected by achieving a four log kill within six hours and a six log kill in 16 hours. In conclusion, OG Ag+ was shown to be an effective wound dressing in the killing of a range of important opportunistic pathogens of relevance to wound healing and infections. Achieving a six log kill against S. aureus and E.coli, within 16 hours in the time kill assay, (ASTM E2315-03) demonstrates that OG Ag+ should be an important addition to the armoury available for the management of acute and chronic wounds at risk of infection or clinically infected.
Guillén-Solà, Mireia; Soler Mieras, Aina; Tomàs-Vidal, Antònia M
2013-12-21
Pressure ulcers (PrUs) are ischemic wounds in the skin and underlying tissues caused by long-standing pressure force over an external bone or cartilaginous surface. PrUs are an important challenge for the overall health system because can prolong patient hospitalization and reduce quality of life. Moreover, 95% of PrUs are avoidable, suggesting they are caused by poor quality care assistance. PrUs are also costly, increasing national costs. For example, they represent about 5% of overall annual health expenses in Spain. Stages I and II PrUs have a combined prevalence of 65%. According main clinical guidelines, stage II PrUs (PrU-IIs) are usually treated by applying special dressings (polyurethane or hydrocolloid). However, little scientific evidence regarding their efficacy has been identified in scientific literature. Our aim is to assess the comparative efficacy of adhesive polyurethane foam and hydrocolloid dressings in the treatment of PrU-IIs in terms of healed ulcer after 8 weeks of follow-up. This paper describes the development and evaluation protocol of a randomized clinical trial of two parallel treatment arms. A total of 820 patients with at least 1 PrU-II will be recruited from primary health care and home care centers. All patients will receive standardized healing procedures and preventive measures (e.g. positional changes and pressure-relieving support surfaces), following standardized procedures. The main outcome will be the percentage of wounds healed after 8 weeks. Secondary outcomes will include cost-effectiveness, as evaluated by cost per healed ulcer and cost per treated patient and safety evaluated by adverse events. This trial will address the hypothesis that hydrocolloid dressings will heal at least 10% more stage II PrUs and be more cost-effective than polyurethane foam dressings after 8 weeks. This trial has been registered with controlled-trials number ISCRCTN57842461 and EudraCT 2012-003945-14.
Rapid hemostatic and mild polyurethane-urea foam wound dressing for promoting wound healing.
Liu, Xiangyu; Niu, Yuqing; Chen, Kevin C; Chen, Shiguo
2017-02-01
A novel rapid hemostatic and mild polyurethane-urea foam (PUUF) wound dressing was prepared by the particle leaching method and vacuum freeze-drying method using 4, 4-Methylenebis(cyclohexyl isocyanate), 4,4-diaminodicyclohexylmethane and poly (ethylene glycol) as raw materials. And X-ray diffraction (XRD), tensile test, differential scanning calorimetry (DSC) and thermogravimetry (TG) were used to its crystallinity, stress and strain behavior, and thermal properties, respectively. Platelet adhesion, fibrinogen adhesion and blood clotting were performed to evaluate its hemostatic effect. And H&E staining and Masson Trichrome staining were used to its wound healing efficacy. The results revealed the pore size of PUUF is 50-130μm, and its porosity is 71.01%. Porous PUUF exhibited good water uptake that was benefit to adsorb abundant wound exudates to build a regional moist environment beneficial for wound healing. The PUUF wound dressing exhibit better blood coagulation effect than commercial polyurethane dressing (CaduMedi). Though both PUUF and CaduMedi facilitated wound healing generating full re-epithelialization within 13days, PUUF was milder and lead to more slight inflammatory response than CaduMedi. In addition, PUUF wound dressing exhibited lower cytotoxicity than CaduMedi against NIH3T3 cells. Overall, porous PUUF represents a novel mild wound dressing with excellent water uptake, hemostatic effect and low toxicity, and it can promote wound healing and enhance re-epithelialization. Copyright © 2016 Elsevier B.V. All rights reserved.
150 patient experiences with a soft silicone foam dressing.
Bateman, Sharon Dawn
Pain, malodour and exudate from acute and chronic wounds can be catastrophic to the patient. Excessive exudate results in significant tissue damage to the wound bed and surrounding skin, reduces quality of life, and often requires costly specialist service input. Effective wound assessment and management including appropriate dressing choice is, therefore, paramount to ensure wound healing can take place in a timely manner. This observational evaluation explores 150 ward-based patients who presented with acute and chronic exuding wounds; it examines and evaluates the proposed benefits of the Cutimed(®) Siltec foam dressing range over a 4-month period in an acute hospital setting. The outcomes of the evaluation were exudate management, maceration reduction, atraumatic application and removal, non-adherence and patient experience. The evaluation highlights not only an overall positive improvement in exudate management and maceration reduction, non-adherence, atraumatic application and removal but also emphasises the importance of a positive patient experience in the wound-care journey.
Preventing Facial Pressure Ulcers in Acute Respiratory Distress Syndrome (ARDS).
Kim, Ruth S; Mullins, Kimberly
2016-01-01
In patients with acute lung injury and/or severe acute respiratory distress syndrome (ARDS), prone positioning is a therapeutic intervention to improve oxygenation. Positioning a patient in a prone position increases the risk of medical device-related pressure ulcers in the facial area. This article summarizes experience with 4 patients with ARDS. Two did not receive pressure ulcer preventive measures and subsequently developed multiple necrotic facial pressure ulcers related to prone positioning for treatment of ARDS. The other 2 patients were managed on a thin silicone foam dressing; neither of these patients developed facial pressure ulcers during pronation therapy. The use of thin soft silicone foam dressings may prevent the development of facial deep tissue injuries in patients receiving prolonged pronation therapy.
Yunoki, Shunji; Kohta, Masushi; Ohyabu, Yoshimi; Iwasaki, Tetsuji
2015-01-01
This study evaluated the in vitro antibacterial activity and cytotoxicity of various commercially available silver-containing dressings (Ag dressing). Biohesive Ag (hydrocolloid, silver sulfadiazine), Aquacel® Ag (nonwoven fabric, ionic silver [Ag]), Algisite™ Ag (nonwoven fabric, Ag), Mepilex® Ag (foam, silver sulfate), and PolyMem® Ag (foam, nanocrystalline silver) were tested for characteristics of Ag release, antibacterial activity, and cytotoxicity. The release of Ag was investigated in cell culture medium at immersion periods of 6, 24, and 48 hours. The antibacterial activity against Staphylococcus aureus and Pseudomonas aeruginosa were accessed by a disc diffusion test. The cytotoxicity was evaluated using V79 cells, by an extraction method. The cytotoxicity was not a monotonic function of the antibacterial activity among the Ag dressings and could not be simply explained by Ag-release properties. Biohesive Ag was regarded as a slow-release Ag dressing, showing the lowest cytotoxicity, while the antibacterial activity was classified as "strong" or "significant" against the two species of bacteria. Aquacel Ag and Algisite Ag showed higher antibacterial activity and cytotoxic effects, which were supported by the higher Ag release. Mepilex Ag showed the highest release of Ag, and the cytotoxicity was the highest among the Ag dressings. However, the antibacterial activity was classified as "significant" or "no activity" for P. aeruginosa and S. aureus, respectively. PolyMem Ag showed the lowest Ag release, and the antibacterial activity classified as "significant" or "no activity" for S. aureus and P. aeruginosa, respectively, whereas the cytotoxicity was similar to those of Aquacel Ag and Algisite Ag. The efficacy and adverse effects of the Ag dressings revealed differences that should be considered by clinicians during wound management.
2013-01-01
Background Pressure ulcers (PrUs) are ischemic wounds in the skin and underlying tissues caused by long-standing pressure force over an external bone or cartilaginous surface. PrUs are an important challenge for the overall health system because can prolong patient hospitalization and reduce quality of life. Moreover, 95% of PrUs are avoidable, suggesting they are caused by poor quality care assistance. PrUs are also costly, increasing national costs. For example, they represent about 5% of overall annual health expenses in Spain. Stages I and II PrUs have a combined prevalence of 65%. According main clinical guidelines, stage II PrUs (PrU-IIs) are usually treated by applying special dressings (polyurethane or hydrocolloid). However, little scientific evidence regarding their efficacy has been identified in scientific literature. Our aim is to assess the comparative efficacy of adhesive polyurethane foam and hydrocolloid dressings in the treatment of PrU-IIs in terms of healed ulcer after 8 weeks of follow-up. Methods/design This paper describes the development and evaluation protocol of a randomized clinical trial of two parallel treatment arms. A total of 820 patients with at least 1 PrU-II will be recruited from primary health care and home care centers. All patients will receive standardized healing procedures and preventive measures (e.g. positional changes and pressure-relieving support surfaces), following standardized procedures. The main outcome will be the percentage of wounds healed after 8 weeks. Secondary outcomes will include cost-effectiveness, as evaluated by cost per healed ulcer and cost per treated patient and safety evaluated by adverse events. Discussion This trial will address the hypothesis that hydrocolloid dressings will heal at least 10% more stage II PrUs and be more cost-effective than polyurethane foam dressings after 8 weeks. Trial registration This trial has been registered with controlled-trials number ISCRCTN57842461 and EudraCT 2012-003945-14. PMID:24359122
A study to evaluate primary dressings for the application of cultured keratinocytes.
Price, R D; Das-Gupta, V; Frame, J D; Navsaria, H A
2001-12-01
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. Copyright 2001 The British Association of Plastic Surgeons.
Kloeters, Oliver; Unglaub, Frank; de Laat, Erik; van Abeelen, Marjolijn; Ulrich, Dietmar
2016-12-01
In chronic wounds, excess levels and activity of proteases such as elastase and plasmin have been detected. Oxidised regenerated cellulose/collagen matrix (ORC/collagen matrix) has been reported to ameliorate the wound microenvironment by binding and inactivating excess proteases in wound exudates. In this study, the levels and activity of elastase and plasmin in wound exudates of pressure sore ulcers were measured to determine the beneficial effect of ORC/collagen matrix treatment compared with control treatment with a foam dressing. A total of 33 patients with pressure sores were enrolled in the study and were followed up for 12 weeks after treatment. Ten control patients were treated with a foam hydropolymer dressing (TIELLE ® , Systagenix), and the remaining 23 patients were treated with ORC/collagen matrix plus the foam dressing (TIELLE ® , Systagenix) on top. Wound assessments were carried out over 12 weeks on a weekly basis, with dressing changes twice a week. Ulcers were photographed and wound exudates were collected on admission and at days 5, 14 and then every 14 days to provide a visual record of any changes in appearance of the ulcer and healing rate and for biochemical analysis of the wound. The levels and activity of elastase and plasmin were measured in wound exudates. Statistical analysis was performed using ANOVA and Bonferroni's post hoc test with P-values <0·05 considered to be significant. Compared with controls, ORC/collagen matrix-treated pressure sore wounds showed a significant faster healing rate, which positively correlated with a decreased activity of elastase and plasmin in wound exudates. No signs of infection or intolerance to the ORC/collagen matrix were observed. © 2015 Medicalhelplines.com Inc and John Wiley & Sons Ltd.
Santamaria, Nick; Gerdtz, Marie; Sage, Sarah; McCann, Jane; Freeman, Amy; Vassiliou, Theresa; De Vincentis, Stephanie; Ng, Ai Wei; Manias, Elizabeth; Liu, Wei; Knott, Jonathan
2015-06-01
The prevention of hospital acquired pressure ulcers in critically ill patients remains a significant clinical challenge. The aim of this trial was to investigate the effectiveness of multi-layered soft silicone foam dressings in preventing intensive care unit (ICU) pressure ulcers when applied in the emergency department to 440 trauma and critically ill patients. Intervention group patients (n = 219) had Mepilex(®) Border Sacrum and Mepilex(®) Heel dressings applied in the emergency department and maintained throughout their ICU stay. Results revealed that there were significantly fewer patients with pressure ulcers in the intervention group compared to the control group (5 versus 20, P = 0·001). This represented a 10% difference in incidence between the groups (3·1% versus 13·1%) and a number needed to treat of ten patients to prevent one pressure ulcer. Overall there were fewer sacral (2 versus 8, P = 0·05) and heel pressure ulcers (5 versus 19, P = 0·002) and pressure injuries overall (7 versus 27, P = 0·002) in interventions than in controls. The time to injury survival analysis indicated that intervention group patients had a hazard ratio of 0·19 (P = 0·002) compared to control group patients. We conclude that multi-layered soft silicone foam dressings are effective in preventing pressure ulcers in critically ill patients when applied in the emergency department prior to ICU transfer. © 2013 The Authors. International Wound Journal © 2013 Medicalhelplines.com Inc and John Wiley & Sons Ltd.
The Effect of Offloading Heels on Sacral Pressure.
Al-Majid, Sadeeka; Vuncanon, Barbara; Carlson, Nika; Rakovski, Cyril
2017-09-01
Offloading a patient's heels during supine surgical procedures is a common practice to prevent heel pressure injuries. This practice may increase sacral pressure and jeopardize sacral skin integrity, but prophylactic dressings may help protect sacral skin. The purpose of this study was to examine the effects of offloading the heels and of multilayered silicone foam dressings on sacral pressure. We measured the sacral pressure of 50 healthy volunteers using a pressure-mapping system under four conditions: heels not offloaded and sacral dressing applied, heels offloaded and dressing applied, heels not offloaded and no dressing, and heels offloaded and no dressing. We used linear mixed-effects modeling to compare the effects of these conditions on sacral pressure. Offloading the heels significantly increased sacral pressure (P < .001), whereas the dressing had no effect on sacral pressure (P = .49). Offloading a patient's heels may increase the risk of sacral pressure injuries. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.
Lullove, Eric J
2017-04-01
Dressings that provide broad spectrum metalloprotease reduction along with inherent aspects of an extracellular matrix may contribute to improved wound healing outcomes and shorter treatment times. The author performed a retrospective case series analysis to determine the clinical outcomes of regular debridement with the use of ovine-based collagen extracellular matrix dressings and gentian violet/methylene blue polyurethane antibacterial foam dressings in treating 53 patients with 53 chronic lower extremity wounds (diabetic foot ulcers [DFUs], venous leg ulcers, and heel pressure ulcers). Patients were treated twice weekly in an outpatient clinic for the first 4 weeks and weekly thereafter until closure. Average body mass index (BMI) for the study population was 28.3, and the average patient age was 75.9 years. Mean percent wound surface area reduction at 4, 8, and 12 weeks was 38.5%, 73.3%, and 91.3%, respectively. Average time to closure for all wounds was 10.6 weeks (range, 5-24 weeks). All wounds were 100% reepithelialized by week 20 except 1 DFU that reepithelialized at week 24. The average cost of care for a single wound episode (from presentation to closure) was $2749.49. Results of this analysis showed that the healing of chronic wounds in this series could be achieved at a reasonable cost with regular debridement and a collagen matrix dressing regimen, even in patients of advanced age and above average BMI as well as in wounds that did not achieve > 40% wound surface area reduction at 4 weeks.
Foam-rubber stents for skin grafts.
Larson, P O
1990-09-01
A variety of stents are used to immobilize skin grafts and to hold them firmly to the recipient site. Tie-down stents, the most common type, are constructed from bulky, sterile dressing and are overtied with suture material. These stents are often cumbersome to apply. As an alternative, stents made from foam-rubber pads (Reston, 3M Company, St. Paul, MN) were stapled over skin grafts. These stents could be applied quickly, and they maintain continuous, uniform pressure on the immobilized grafts.
Antimicrobial Activity of a Novel Vascular Access Film Dressing Containing Chlorhexidine Gluconate.
Wibaux, Anne; Thota, Priyaleela; Mastej, Jozef; Prince, Daniel L; Carty, Neal; Johnson, Peter
2015-01-01
Covering insertion sites with chlorhexidine impregnated dressings has been proven to be clinically effective in reducing catheter related blood stream infections (CR-BSI). Two chlorhexidine gluconate (CHG)-impregnated dressings are commercially available, a polyurethane foam disk and a film dressing containing a chlorhexidine gluconate-impregnated gel pad. While both have demonstrated efficacy in clinical settings, the major drawback of high cost and impaired IV insertion site visibility limits their usage. A new, simple film dressing containing CHG within its adhesive layer is now available. The objective of this study was to test the in vitro antimicrobial efficacy of the new dressing in comparison to the CHG-impregnated gel dressing. Quantitative aliquots of suspensions (concentration of 1.0x106 to 5.0x106 cfu/sample) of clinically relevant challenge organisms (Staphylococcus species, gram-negative bacilli, Candida albicans) were incubated in contact with the new CHG-containing film dressing, a placebo version of the same (negative control) and the commercially available CHG-impregnated gel dressing (positive control). Serial dilutions of the surviving organisms were quantified using the pour plate after 1, 3, 5, and 7 days of incubation in order to calculate an antimicrobial log10 reduction for each organism/dressing combination at each point in time. The new CHG-containing film dressing delivered greater than 5.0 log10 reduction throughout the 7 days on all aerobic gram-negative bacilli and Staphylococcus species tested. As of day 1 the CHG-containing film dressing provided greater than 5.0 log10 reduction on Candida albicans. There were no statistically significant differences in the log10 reduction between the two dressings tested. The new CHG-containing film dressing was found to be as effective as the chlorhexidine gluconate-impregnated gel dressing on clinically relevant microbes.
Loeffelbein, Denys J; Rohleder, Nils H; Eddicks, Matthias; Baumann, Claudia M; Stoeckelhuber, Mechthild; Wolff, Klaus-D; Drecoll, Enken; Steinstraesser, Lars; Hennerbichler, Simone; Kesting, Marco R
2014-01-01
Human amniotic membrane (HAM) has been used as a biomaterial in various surgical procedures and exceeds some qualities of common materials. We evaluated HAM as wound dressing for split-thickness skin-graft (STSG) donor sites in a swine model (Part A) and a clinical trial (Part B). Part A: STSG donor sites in 4 piglets were treated with HAM or a clinically used conventional polyurethane (PU) foil (n = 8 each). Biopsies were taken on days 5, 7, 10, 20, 40, and 60 and investigated immunohistochemically for alpha-smooth muscle actin (αSMA: wound contraction marker), von Willebrand factor (vWF: angiogenesis), Ki-67 (cell proliferation), and laminin (basement membrane integrity). Part B: STSG donor sites in 45 adult patients (16 female/29 male) were treated with HAM covered by PU foam, solely by PU foam, or PU foil/paraffin gauze (n = 15 each). Part A revealed no difference in the rate of wound closure between groups. HAM showed improved esthetic results and inhibitory effects on cicatrization. Angioneogenesis was reduced, and basement membrane formation was accelerated in HAM group. Part B: no difference in re-epithelialization/infection rate was found. HAM caused less ichor exudation and less pruritus. HAM has no relevant advantage over conventional dressings but might be a cost-effective alternative.
Wagstaff, Marcus James Dermot; Driver, Sara; Coghlan, Patrick; Greenwood, John Edward
2014-01-01
The objectives of the study were (1) to look for any local, clinically apparent response, within and around a debrided wound, to a novel biocompatible polyurethane foam during repeated, short-term implantation, and (2) to assess the material's efficacy as a negative pressure wound therapy (NPWT) interface compared with a widely used, commercially available foam. Twenty pressure ulcers in 18 patients underwent surgical debridement, then randomization to receive novel treatment or control foam as the wound interface for NPWT. Dressing changes every 2-3 days allowed qualitative wound assessment and quantitative measurement to compare outcomes. No adverse reaction was observed in any patient receiving the new foam. The new "novel foam" performed as a NPWT interface as effectively as the control "standard foam." In deep wounds, the new foam was easier to remove, fragmented less, and showed less retention than the control foam. No marginal in-growth occurred, making removal less traumatic and reducing bleeding from cavity wall granulations. The results support previous large animal studies, and independent ISO10993 testing, that the new foam is safe and biocompatible. Its efficacy as an NPWT interface, nontraumatic removal with low fragmentation and retention rate, favors the new material, especially in deep cavity wounds. © 2014 by the Wound Healing Society.
Closed dressings after laser skin resurfacing.
Newman, J P; Koch, R J; Goode, R L
1998-07-01
To evaluate the safety, efficacy, and patient acceptance of closed dressings after full facial resurfacing with the carbon dioxide laser. Prospective cohort of men and women undergoing full facial carbon dioxide laser resurfacing. Ambulatory surgical center at a university hospital. Forty consecutive patients randomized to 1 of 4 dressing groups. All patients underwent full facial resurfacing with a carbon dioxide laser system. One of 5 closed dressings (single- or 3-layer composite foam, plastic mesh, hydrogel, or polymer film) was placed immediately after the procedure. Closed dressings were changed on postoperative day 2 and removed on postoperative day 4. Objective postoperative criteria of erythema, scarring, reepithelialization, and surface irregularities were recorded and photodocumented. Comparisons were made among the closed dressing groups as well as with a group of historical control subjects treated with open dressings. The ease of application, office time for preparation and application, and cost of the individual dressings were collected. Patient characteristics of overall acceptance, comfort, and ease of maintenance were recorded with a visual analog scale. There were no complications of scarring, surface irregularities, or contact dermatitis from the application or maintenance of the closed dressings. There were no significant differences in the number of days of postoperative erythema or in the rate of facial reepithelialization among the groups. Most patients preferred not to continue with the closed dressings past 2 days. Positive features from the use of closed dressings included reduction in crust formation, decreased pruritus, decreased erythema, and decreased postoperative pain, compared with historical controls. Negative features included time in preparation and application of the dressings. Costs ranged from $9.79 to $50 per dressing change. Closed dressings are safe and offer benefits noted during the first 4 postoperative days. Patients can be expected to maintain a closed dressing for at least 24 hours but no longer than 4 days. The positive features of closed dressings and patient acceptance outweigh the cost and office time involved with their application and maintenance.
Negative pressure wound therapy and external fixation device: a simple way to seal the dressing.
Bulla, Antonio; Farace, Francesco; Uzel, André-Pierre; Casoli, Vincent
2014-07-01
Negative pressure therapy is widely applied to treat lower limb trauma. However, sealing a negative pressure dressing in the presence of an external fixation device may be difficult and time consuming. Therefore, screws, pins, wires, etc, may preclude the vacuum, preventing the plastic drape to perfectly adhere to the foam. To maintain the vacuum, we tried to prevent air leaking around the screws putting bone wax at the junction between the pins and the plastic drape. This solution, in our hands, avoids air leakage and helps maintain vacuum in a fast and inexpensive way.
Antimicrobial Activity of a Novel Vascular Access Film Dressing Containing Chlorhexidine Gluconate
Wibaux, Anne; Thota, Priyaleela; Mastej, Jozef; Prince, Daniel L.; Carty, Neal; Johnson, Peter
2015-01-01
Background Covering insertion sites with chlorhexidine impregnated dressings has been proven to be clinically effective in reducing catheter related blood stream infections (CR-BSI). Two chlorhexidine gluconate (CHG)-impregnated dressings are commercially available, a polyurethane foam disk and a film dressing containing a chlorhexidine gluconate-impregnated gel pad. While both have demonstrated efficacy in clinical settings, the major drawback of high cost and impaired IV insertion site visibility limits their usage. A new, simple film dressing containing CHG within its adhesive layer is now available. The objective of this study was to test the in vitro antimicrobial efficacy of the new dressing in comparison to the CHG-impregnated gel dressing. Methods Quantitative aliquots of suspensions (concentration of 1.0x106 to 5.0x106 cfu/sample) of clinically relevant challenge organisms (Staphylococcus species, gram-negative bacilli, Candida albicans) were incubated in contact with the new CHG-containing film dressing, a placebo version of the same (negative control) and the commercially available CHG-impregnated gel dressing (positive control). Serial dilutions of the surviving organisms were quantified using the pour plate after 1, 3, 5, and 7 days of incubation in order to calculate an antimicrobial log10 reduction for each organism/dressing combination at each point in time. Results The new CHG-containing film dressing delivered greater than 5.0 log10 reduction throughout the 7 days on all aerobic gram-negative bacilli and Staphylococcus species tested. As of day 1 the CHG-containing film dressing provided greater than 5.0 log10 reduction on Candida albicans. There were no statistically significant differences in the log10 reduction between the two dressings tested. Conclusion The new CHG-containing film dressing was found to be as effective as the chlorhexidine gluconate-impregnated gel dressing on clinically relevant microbes. PMID:26599087
Nolff, Mirja C; Albert, Rebecca; Reese, Sven; Meyer-Lindenberg, Andrea
2018-06-11
To evaluate negative pressure wound therapy (NPWT) for treatment of complicated wounds in dogs. Prospective randomized clinical study MATERIALS AND METHODS: Dogs ( n = 26) undergoing open-wound treatment were randomly assigned to one of two groups: Group A ( n = 13) NPWT; Group B ( n = 13) silver-coated foam dressing. Pairs of patients were matched based on wound conformation, localization, and underlying cause and compared in terms of duration of previous treatment, development of wound size (wound planimetry), time to closure, bacterial bio-burden and complications. Wound dressing changes were performed every 3 days during the first 9 days of therapy for both groups. Statistical analysis was performed. Pre-treatment signalment and bacterial status were comparable between groups. Total time to closure was significantly ( p = 0.018) shorter in Group A (14.2 days) compared with Group B (28.6 days), and wound planimetry on days 3, 6 and 9 showed significant greater reduction in total wound area for Group A at all-time points ( p < 0.05). Furthermore, wounds in Group A showed less progression of local infection than did wounds in Group B ( p = 0.01). NPWT-treated wounds showed faster closure, improved macro-deformation and less local signs of infection. Schattauer GmbH Stuttgart.
Lee, Jun Won; Park, Seong Hoon; Suh, In Suck; Jeong, Hii Sun
2018-01-02
Retrograde infections often occur with excessive or incomplete drainage of exudate, or as a result of adherence of dressings to wounds. Dialkylcarbamoyl chloride (DACC) irreversibly binds to bacterial surfaces and physically removes bacteria when dressings are changed. Chlorhexidine acetate-soaked paraffin gauze provides a moist wound-healing environment. We hypothesise that when DACC is combined with chlorhexidine acetate-soaked paraffin gauze, wound healing times decrease. From January 2013 to June 2015, medical records were retrospectively evaluated in 60 patients who underwent split-thickness skin grafts (STSG). Patients were divided into two groups: a 'thick skin group' and a 'thin skin group'. These two groups were further subdivided into a control group, where conventional foam dressings were applied to wounds, and an experimental group, where chlorhexidine acetate-soaked paraffin gauze with DACC was applied (DACC group). We compared the wound healing time between these subgroups. Differences in infected wound healing times were also compared. The Mann-Whitney test was applied to compare wound healing times between groups. Epithelialisation duration was significantly shorter in the DACC group. The control group had longer wound healing times, regardless of wound size. In the thick skin group, the median healing duration was 12 days in the control subgroup, compared with 9.5 days in the DACC subgroup (p=0.049). In the thin skin subgroup, the median healing duration in the control group was 18 days, compared with 10 days in the DACC subgroup (p=0.013). Application of DACC and chlorhexidine acetate-soaked paraffin gauze to skin graft donor sites can shorten healing times and is effective in treating infected wounds.
Mepilex Ag: an antimicrobial, absorbent foam dressing with Safetac technology.
Barrett, Simon
This article examines the role of a unique dressing-Mepilex Ag--that incorporates the rapid and sustained antimicrobial action of ionic silver with the benefits of Safetac soft silicone adhesive technology. The combined attributes of each component of this dressing allow both the control of pain and infection to be achieved simultaneously. This dual approach to the management of wounds is of significance since the evidence suggests that wound infection and the release of pro-inflammatory modulators result in both local pain and delayed healing. In this respect the control and treatment of pain is as important as the treatment of infection itself. A review of the clinical evidence relating to Safetac technology clearly demonstrates that it can be used to prevent dressing-related trauma, minimize pain at dressing change, and control exudate when used on a wide range of wound types and skin injuries. In combination with silver, this technology has been shown in in-vitro studies to have an almost instant and sustainable antimicrobial effect on a broad range of pathogens associated with delayed healing. Finally, in small clinical and case studies, Mepilex Ag has been shown to control wound bioburden and improve healing rates.
Spinal cord injury pressure ulcer treatment: an experience-based approach.
Sunn, Gabriel
2014-08-01
Pressure ulcers continue to impact the lives of spinal cord injury patients severely. Pressure ulcers must be accurately staged according to National Pressure Ulcer Advisory recommendations before treatment design. The first priority in treatment of pressure ulcers is offloading. Intact skin ulcers may be treated with noncontact nonthermal low-frequency ultrasound. Superficial pressure ulcers may be treated with a combination of collagenase and foam dressings. Deeper pressure ulcers warrant negative-pressure wound therapy dressings along with biologic adjuncts to fill in wound depth. Discovery and treatment of osteomyelitis is a high priority when initially evaluating pressure ulcers. Surgical intervention must always be considered. Published by Elsevier Inc.
Or, Matan; Van Goethem, Bart; Kitshoff, Adriaan; Koenraadt, Annika; Schwarzkopf, Ilona; Bosmans, Tim; de Rooster, Hilde
2017-04-01
To report the use of negative pressure wound therapy (NPWT) with polyvinyl alcohol (PVA) foam to bolster full-thickness mesh skin grafts in dogs. Retrospective case series. Client-owned dogs (n = 8). Full-thickness mesh skin graft was directly covered with PVA foam. NPWT was maintained for 5 days (in 1 or 2 cycles). Grafts were evaluated on days 2, 5, 10, 15, and 30 for graft appearance and graft take, granulation tissue formation, and complications. Firm attachment of the graft to the recipient bed was accomplished in 7 dogs with granulation tissue quickly filling the mesh holes, and graft take considered excellent. One dog had bandage complications after cessation of the NPWT, causing partial graft loss. The PVA foam did not adhere to the graft or damage the surrounding skin. The application of NPWT with a PVA foam after full-thickness mesh skin grafting in dogs provides an effective method for securing skin grafts, with good graft acceptance. PVA foam can be used as a primary dressing for skin grafts, obviating the need for other interposing materials to protect the graft and the surrounding skin. © 2017 The American College of Veterinary Surgeons.
Park, Eun Jung; Yoon, Young Tak; Hong, Chong Kun; Ha, Young Rock; Ahn, Jung Hwan
2017-07-01
This study evaluated the efficacy of a teaching method using simulated B-lines of hand ultrasound with a wet foam dressing material. This prospective, randomized, noninferiority study was conducted on emergency medical technician students without any relevant training in ultrasound. Following a lecture including simulated (SG) or real video clips (RG) of B-lines, a posttest was conducted and a retention test was performed after 2 months. The test consisted of questions about B-lines in 40 randomly mixed video clips (20 simulated and 20 real videos) with 4 answer scores (R-1 [the correct answer score for the real video clips] vs S-1 [the correct answer score for the simulated video clips] in the posttest, R-2 [the correct answer score for the real video clips] vs S-2 [the correct answer score for the simulated video clips] in the retention test). A total of 77 and 73 volunteers participated in the posttest (RG, 38; SG, 39) and retention test (RG, 36; SG, 37), respectively. There was no significant (P > .05) difference in scores of R-1, S-1, R-2, or S-2 between RG and SG. The mean score differences between RG and SG were -0.6 (95% confidence interval [CI]: -1.49 to 0.11) in R-1, -0.1 (95% CI: -1.04 to 0.86) in S-1, 0 (95% CI: -1.57 to 1.50) in R-2, and -0.2 (95% CI: -1.52 to 0.25) in S-2. The mean differences and 95% CIs for all parameters fell within the noninferiority margin of 2 points (10%). Simulated B-lines of hand ultrasound with a wet foam dressing material were not inferior to real B-lines. They were effective for teaching and simulations. The study was registered with the Clinical Trial Registry of Korea: https://cris.nih.go.kr/cris/index.jsp (KCT0002144).
Masiero, Franciéle Souza; Thyssen, Patricia Jacqueline
2016-06-01
Larval therapy consists on the application of sterilized carrion flies larvae, reared in laboratory, on acute, chronic, and/or infected wounds in order to promote healing. Conventional methods for treating injuries include mechanical debridement or silver-based dressings; however, they are not always effective for wound healing. Larval therapy is a feasible and safe treatment for therapeutic application and, in many cases, the only and the most recommended alternative for difficult healing injuries. Thus, this study aimed to evaluate the competence of Cochliomyia macellaria F. (Diptera: Calliphoridae) as a suitable species for therapeutic application and evaluate time and effectiveness of the types of treatments most commonly used to treat integumental injuries. C. macellaria eggs were obtained from colonies established in laboratory and sterilized prior to application. Twenty-five larvae were applied for each centimeter squared of lesion. Lesions were induced in 24 Wistar rats; type 1 diabetes mellitus was induced in 12 of them. Animals were divided in four groups with three individuals each, being denominated: larval therapy, larval therapy associated with foam dressing with silver release, mechanical debridement with foam dressing silver and control group, without treatment. All treatments were applied once and held for 24 h. Medical application of larvae was found to be safe, as only dead tissue was removed, and efficient to accelerate healing process when compared to other treatments.
Forni, Cristiana; D'Alessandro, Fabio; Gallerani, Pina; Genco, Rossana; Bolzon, Andrea; Bombino, Caterina; Mini, Sandra; Rocchegiani, Laura; Notarnicola, Teresa; Vitulli, Arianna; Amodeo, Alfredo; Celli, Guglielmo; Taddia, Patrizia
2018-06-01
Hip fractures in the elderly are a serious problem for the health service due to the high rate of complications. One of these complications is pressure ulcers that, according to the literature, occur in 8.8% to 55% of patients and mainly arise in the sacral area. The present randomised controlled trial tests whether applying a new innovative multi-layer polyurethane foam dressing (ALLEVYN LIFE™), reduces the onset of pressure ulcers in the sacral area. From March to December 2016, 359 fragility hip fracture patients were randomly divided into 2 groups: 182 in the control group and 177 in the experimental group. Pressure ulcers occurred overall in 36 patients (10%): 8 patients (4.5%) in the experimental group compared to 28 (15.4%) in the control group: P = 0.001, relative risk 0.29 (95% CI 0.14-0.61) with NNT of 9 (95% CI 6-21). In the experimental group the onset of pressure ulcers occurred on average on the 6th day compared to the 4th day in the control group (HR 4.4). Using polyurethane foam is effective at reducing the rate of pressure ulcers in the sacrum in elderly patients with hip fracture. The adhesiveness of this device also enables costs to be kept down. © 2018 The Authors. International Wound Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.
Skin graft fixation in severe burns: use of topical negative pressure.
Kamolz, L P; Lumenta, D B; Parvizi, D; Wiedner, M; Justich, I; Keck, M; Pfurtscheller, K; Schintler, M
2014-09-30
Over the last 50 years, the evolution of burn care has led to a significant decrease in mortality. The biggest impact on survival has been the change in the approach to burn surgery. Early excision and grafting has become a standard of care for the majority of patients with deep burns; the survival of a given patient suffering from major burns is invariably linked to the take rate and survival of skin grafts. The application of topical negative pressure (TNP) therapy devices has demonstrated improved graft take in comparison to conventional dressing methods alone. The aim of this study was to analyze the impact of TNP therapy on skin graft fixation in large burns. In all patients, we applied TNP dressings covering a %TBSA of >25. The following parameters were recorded and documented using BurnCase 3D: age, gender, %TBSA, burn depth, hospital length-of-stay, Baux score, survival, as well as duration and incidence of TNP dressings. After a burn depth adapted wound debridement, coverage was simultaneously performed using split-thickness skin grafts, which were fixed with staples and covered with fatty gauzes and TNP foam. The TNP foam was again fixed with staples to prevent displacement and finally covered with the supplied transparent adhesive film. A continuous subatmospheric pressure between 75-120 mm Hg was applied (VAC®, KCI, Vienna, Austria). The first dressing change was performed on day 4. Thirty-six out of 37 patients, suffering from full thickness burns, were discharged with complete wound closure; only one patient succumbed to their injuries. The overall skin graft take rate was over 95%. In conclusion, we consider that split thickness skin graft fixation by TNP is an efficient method in major burns, notably in areas with irregular wound surfaces or subject to movement (e.g. joint proximity), and is worth considering for the treatment of aged patients.
Evaluation of Six Split-thickness Skin Graft Donor-site Dressing Materials in a Swine Model
Masella, Pamela C.; Balent, Eric M.; Carlson, Terri L.; Lee, Karen W.
2013-01-01
Background: Numerous dressings for split-thickness skin graft donor sites are commercially available with no conclusive evidence-based consensus regarding the optimal dressing choice. This study was conducted to identify which of 5 commonly used materials promotes wound healing most effectively for use on split-thickness donor sites in comparison with our standard dressing, Xeroform (petrolatum gauze). Methods: Twenty-four partial-thickness wounds were created on the backs of 4 pigs using a dermatome. Wounds (n = 4 per dressing type per pig) were treated with Xeroform, Opsite (polyurethane film), Kaltostat ( calcium sodium alginate), DuoDERM (hydrocolloid), Aquacel (hydrofiber), and Mepilex (silicone foam). Full-thickness skin samples were excised at 3 or 5 days and evaluated histologically for reepithelialization and inflammation. Comparisons also included incidence of infection, ease of use, and cost analyses. Results: DuoDERM elicited the greatest percent reepithelialization (81%) and Mepilex the lowest (33%) after 3 days (P = 0.004). All dressings demonstrated complete reepithelialization except Mepilex (85%) at 5 days. There were no infections and inflammation was mild among all treatments. Mepilex was easiest to use, whereas Aquacel, Kaltostat, and Opsite were most difficult (P = 0.03). Xeroform was most cost-effective and Aquacel most expensive. Combined scoring revealed DuoDERM = Xeroform > Opsite = Mepilex > Kaltostat > Aquacel. Conclusions: DuoDERM and Xeroform were most effective overall. DuoDERM tended to outperform all dressings in reepithelialization at 3 days, while Xeroform was least expensive, easy to use, and demonstrated rapid reepithelialization. These findings suggest that Xeroform may be preferred for use on large donor-site areas. DuoDERM may be more appropriate for small donor sites when healing time is a priority. PMID:25289278
Lee, Ye-Na; Lee, Jong Seok; Han, Seung-Kyu; Jung, Hye-Kyung
Our group has reported that negative-pressure wound therapy (NPWT) decreases tissue oxygenation by 84% in the foot of diabetic patients because the pad of the connecting drainage tube and foam sponge of the NPWT system compress the wound bed. The purpose of this study was to determine whether an NPWT modified dressing application reduces tissue oxygenation in the feet of persons with diabetes mellitus. A prospective, clinical, observational study. We enrolled 30 patients with diabetic mellitus; their mean age was 63.9 ± 11.2 years (mean ± standard deviation). All were cared for at the diabetic wound center at an academic tertiary medical center in South Korea between 2014 and January 2015. Transcutaneous partial oxygen pressures (TcpO2) were measured to determine tissue oxygenation levels beneath modified NPWT dressings. A TcpO2 sensor was fixed at the tarsometatarsal area of the contralateral unwounded foot. A negative pressure of -125 mm Hg was applied until TcpO2 reached a plateau state; values were measured before, during, and after the modified NPWT. The Wilcoxon' and Mann-Whitney U tests were used to compare differences between these measurements. TcpO2 levels decreased by 26% during the modified NPWT. Mean TcpO2 values before, during, and after turning off the therapy were 54.3 ± 15.3 mm Hg, 41.6 ± 16.3 mm Hg, and 53.3 ± 15.6 mm Hg (P < .05), respectively. Applying NPWT without the pad of the connecting drainage tube significantly reduces the amount of tissue oxygenation loss beneath foam dressings on the skin of the foot dorsum in diabetic patients.
Pyun, Do Gi; Choi, Hyun Jun; Yoon, Hyoung Soon; Thambi, Thavasyappan; Lee, Doo Sung
2015-11-01
Diabetic wounds are a major health issue associated with diabetes mellitus. To surmount this issue, we developed polyurethane foams (PUFs) incorporating varying amounts of recombinant human epidermal growth factor (rhEGF) (rhEGF-PUFs) as a wound dressing for diabetic wounds. From electron microscopy images, it was found that the pore size of the rhEGF-PUFs surface (the wound contact layer) was less than 100μm, regardless of rhEGF content. The release of rhEGF from the PUFs was evaluated using an enzyme-linked immunosorbent assay. The result showed that the release of rhEGF was time and concentration dependent, i.e., the amount of released rhEGF significantly increased as the immersion time and the rhEGF content of the PUFs increased. In vitro cytotoxicity testing showed that rhEGF-PUFs increased the viability of HaCaT human keratinocytes and CCD986-sk human fibroblasts, which indicated that the incorporated rhEGF maintained its biological activity. In an in vitro scratch wound healing assay, the wound closure rate was faster in CCD986-sk human fibroblasts than in HaCaT human keratinocytes. Finally, the rhEGF-PUFs were evaluated as an in vivo treatment in a full-thickness wound model in diabetized Sprague-Dawley rats. The result indicated that compared with PUFs, rhEGF-PUFs accelerated wound healing by promoting wound contraction, re-epithelialization, collagen deposition and the formation of a skin appendage. These findings demonstrate that rhEGF-PUFs are a promising dressing for diabetic wounds. Copyright © 2015. Published by Elsevier B.V.
Prophylactic dressing application to reduce pressure ulcer formation in cardiac surgery patients.
Brindle, C Tod; Wegelin, Jacob A
2012-01-01
The study was designed to determine if application of a self-adherent silicone border foam dressing would reduce pressure ulcer incidence when compared to standard preventive interventions among patients managed in a cardiac surgery intensive care unit (CSICU). One hundred consecutive patients in the CSICU at Virginia Commonwealth University Medical Center in Richmond participated in the study. Fifteen were subsequently excluded due to incomplete data or failure to remain in the CSICU for at least 48 hours. Of the 100 subjects consecutively enrolled, 56 subjects were assigned to the intervention group with attrition of 6 subjects (6/56), and 39 were assigned to the standard care comparison group with attrition of 4 subjects (4/39). Five study forms were lost and the group assignment of those subjects is unknown. Patients admitted to the CSICU were assigned to either standard treatment or an intervention group consisting of standard preventive care plus application of the silicone border foam dressing. The assignment of subjects to these groups was done in a nonrandom manner, via prestudy room designation (7 intervention rooms/7 standard practice rooms) and room availability on call from the operating room. The charge nurse and bed management staff were unaware of room designation, and staff did not know which group the subjects were assigned to until they admitted the patient and opened the bedside chart that indicated group assignment. Twenty-one covariates were compared between the 2 groups. A Cox proportional hazards model was computed to compare the hazard (risk per unit time) of developing a pressure ulcer between these groups. Propensity score covariate adjustment was performed to adjust for any imbalance between the groups. Nine pressure ulcers developed during the course of the study. Eight pressure ulcers developed in 4 out of 35 patients who received standard preventive care; 5 were classified as suspected deep tissue injuries and 3 were classified as stage II pressure ulcers. One pressure ulcer developed in 1 out of 50 patients in the intervention group; it was classified as suspected deep tissue injury. No statistically significant difference in any covariate was found between the groups (all P > .058). The group that received standard care had a hazard ratio of 3.6 in relation to the intervention group, but this difference was not statistically significant (P = .3). Pressure ulcer incidence was lower than anticipated over the study period for both groups. No statistically significant difference in pressure ulcer incidence between the intervention and control groups was found. A randomized controlled trial based on a power analysis is needed to more precisely determine the efficacy of a silicone border foam dressing for prevention of pressure ulcers in the intensive care unit.
The Application of Skin Adhesive to Maintain Seal in Negative Pressure Wound Therapy.
Karadsheh, Murad J; Nelson, Josh; Wilcox, Richard
2015-09-01
Optimal wound healing in negative pressure wound therapy (NPWT) depends on a properly sealed vacuum system. Anatomically difficult wounds disrupt the adhesive dressing, resulting in air leaks that impair the integrity of this system. Several techniques have been used in previous reports to prevent air leaks, including the addition of skin adhesives (eg, Skin-Prep [Smith and Nephew, St. Petersburg, FL] or compound tincture of benzoin), hydrocolloid dressings, silicone, and stoma paste. The purpose of this case report is to demonstrate the effectiveness of using a cyanoacrylate tissue adhesive, dermaFLEX (FLEXCon, Spencer, MA), in maintaining an airtight, durable seal in NPWT. The authors present a patient with a difficult to manage anogenital wound where efforts to maintain an airtight seal in NPWT proved difficult. It was decided during the course of treatment to use the cyanoacrylate tissue adhesive to create an airtight, durable seal. The tissue adhesive was applied circumferentially to the skin surrounding the wound edge. After placement of vacuum-assisted closure foam over the wound, the adhesive dressing was applied with its edges overlapping the skin area where the tissue adhesive was applied. The size of the wound was visibly reduced at each dressing change. An airtight seal was consistently maintained for 3 days at a time, surviving the difficult environment of the wound and maximizing the life of each adhesive dressing. For wounds in anatomically challenging locations, the use of the tissue adhesive appears to be a safe and viable option in creating a durable seal in NPWT.
Negative pressure wound therapy in orthopaedic surgery.
Robert, N
2017-02-01
Negative pressure wound therapy (NPWT) consists in applying subatmospheric pressure to a wound that is sealed off by a specially designed dressing and connected by a tube to a suction pump and drainage collection system. Skin defects are extremely common in orthopaedic and trauma surgery. NPWT is valuable across a range of indications. Proven effects include an increase in blood flow, stimulation of angiogenesis, and a decrease in wound surface area. NPWT can be used to treat post-traumatic and surgical wounds, burns, and chronic wounds such as pressure sores and ulcers. The lower frequency of dressing changes with NPWT lightens the staff workload. The French high authority for health (HAS) has issued good practice guidelines for the use of NPWT in specific and limited indications. NPWT has benefited from the introduction of several technological improvements such as silicone interfaces, foam dressings with various densities and pore sizes, and irrigation systems. The result is greater adaptability to each specific situation. Nevertheless, NPWT is not appropriate in every case and cannot replace a necessary surgical procedure. The goal of this work is to review the principles, practical modalities, and indications of NPWT. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
Vaseenon, Tanawat; Thitiboonsuwan, Songwut; Cheewawattanachai, Chaiyarit; Pimchoo, Punngam; Phanphaisarn, Areerak
2014-12-01
The total contact cast is considered to be an effective method of off-loading a diabetic non-infected pressure ulcer. However complications have been reported in 1 to 15% of cases, e.g. prolonged healing of the ulcer. Debridement with modern dressings has been reported to be effective in promoting wound healing; however there have been few reported studies of the combination of modern dressings with the cast. To evaluate the effectiveness of a combination of treatments on healing rates in diabetic non-infected plantar ulcer of the foot. This retrospective study with prospective data collection was conducted between September 2010 and August 2012. Twenty diabetic patients with plantar neuropathic ulcer were treated using a combination of a contact cast plus hydrogel andfoam dressings. The size and location of the ulcer, ulcer healing, foot deformities and complications were evaluated. Of 21 ulcers, 20 (95.2%) healed completely in a mean time of 30.1 days (range 14 to 70 days). Healing times for forefoot and midfoot ulcers were 22.6 and 26.8 days, respectively, which is significantly shorter than the 51.7 days for heel ulcers. One patient who had an unhealed ulcer developed a severe infection two months after treatment, which necessitated below the knee amputation. There were three cases of recurrence of the ulcers after casting. Off-loading casting combined with modern dressings had a high rate of healing in short-term treatment of diabetic non-infected pressure ulcers. Recurrence of ulcers and new site abrasions were common complications; those complications may have been caused by association with bone deformity or improper footwear.
Sopata, M; Kucharzewski, M; Tomaszewska, E
2016-08-01
To assess the impact of a two-period treatment on the clinical condition, bacteriological changes and results of treatment of venous leg ulcers (VLU) using octenidine dihydrochloride. Patients with a VLU were recruited and treated with octenidine dihydrochloride for one month, after which they were randomised and treated with hydrocolloids or foam dressings. The wounds were clinically assessed for the amount of necrotic tissue, granulation tissue, epithelialisation, amount of exudate and pain level. During the first period, bacterial colonisation and antimicrobial efficacy of octenidine dihydrochloride were also evaluated. In the second period the efficacy of treatment, time of treatment and healing rate were investigated. In the group of 50 VLU patients, all wounds (100%) improved after the first treatment period. No clinical signs of infection were observed. Statistically significant changes were observed in all the clinical parameters studied in the treated groups of VLU patients, including reduction of necrotic tissue, the amount of exudate and of pain, as well as increased granulation and epithelialisation. In the second period including treatment with the two dressings, no differences were observed in treatment efficacy, time of treatment or healing rate. As used in this study, octenidine dihydrochloride proved to be effective and useful, changing the clinical condition of VLU, preparing the wound for future treatment with modern dressings. High microbicidal activity of octenidine was observed, both against Gram-negative and Gram-positive bacteria isolated from the ulcers. Octenidine dihydrochloride caused an eradication of multiresistant strains (88%) as well as of bacteria qualified as alert-pathogens (100%) in the treated wounds after four weeks. However, no differences in the effects, time or rate of healing of VLU with two dressings were found in the second period. No side effects or significant local intolerance reactions used for treatment were observed.
Moura, Liane I F; Dias, Ana M A; Leal, Ermelindo C; Carvalho, Lina; de Sousa, Hermínio C; Carvalho, Eugénia
2014-02-01
One important complication of diabetes mellitus is chronic, non-healing diabetic foot ulcers (DFUs). This study aims to develop and use dressings based on chitosan derivatives for the sustained delivery of neurotensin (NT), a neuropeptide that acts as an inflammatory modulator in wound healing. Three different derivatives, namely N-carboxymethyl chitosan, 5-methyl pyrrolidinone chitosan (MPC) and N-succinyl chitosan, are presented as potential biomaterials for wound healing applications. Our results show that MPC has the best fluid handling capacity and delivery profile, also being non-toxic to Raw 264.7 and HaCaT cells. NT-loaded and non-loaded MPC dressings were applied to control/diabetic wounds to evaluate their in vitro/in vivo performance. The results show that the former induced more rapid healing (50% wound area reduction) in the early phases of wound healing in diabetic mice. A NT-loaded MPC foam also reduced expression of the inflammatory cytokine TNF-α (P<0.001) and decreased the amount of inflammatory infiltrate on day 3. On day 10 MMP-9 was reduced in diabetic skin (P<0.001), significantly increasing fibroblast migration and collagen (COL1A1, COL1A2 and COL3A1) expression and deposition. These results suggest that MPC-based dressings may work as an effective support for sustained NT release to reduce DFUs. Copyright © 2013 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.
Impact of non-adherent Ibuprofen foam dressing in the lives of patients with venous ulcers.
Salomé, Geraldo Magela; Ferreira, Lydia Masako
2017-01-01
to evaluate pain in patients with lower limb venous ulcer who used non-adherent Ibuprofen foam dressing (IFD). we conducted a prospective study of patients with lower limb venous ulcers treated from April 2013 to August 2014. We used the Numerical Scale and McGill Pain Questionnaire, performing the assessments at the moment of inclusion of the patient in the study and every eight days thereafter, totaling five consultations. We divided the patients into two groups: 40 in the Study Group (SG), who were treated with IFD, and 40 in the Control Group (CG), treated with primary dressing, according to tissue type and exudate. at the first consultation, patients from both groups reported intense pain. On the fifth day, SG patients reported no pain and the majority of CG reported moderate pain. Regarding the McGill Pain Questionnaire, most patients of both groups reported sensations related to sensory, affective, evaluative and miscellaneous descriptors at the beginning of data collection; after the second assessment, there was slight improvement among the patients in the SG. After the third consultation, they no longer reported the mentioned descriptors. CG patients displayed all the sensations of these descriptors until the fifth visit. non-adherent Ibuprofen foam dressing is effective in reducing the pain of patients with venous ulcers. avaliar a dor em pacientes portadores de úlcera venosa de membros inferiores que utilizaram curativo de espuma não aderente com Ibuprofeno (CEI). estudo prospectivo de pacientes portadores de úlceras venosas de membros inferiores tratados no período de abril de 2013 a agosto de 2014. Foram utilizados os questionários Escala Numérica e Questionário de Dor de McGille, as avaliações eram feitas no momento da inclusão do paciente no estudo e a cada oito dias, totalizando cinco consultas. Os pacientes foram divididos em dois grupos: 40 no Grupo Estudo (GE), que foram tratados com CEI, e 40 no Grupo Controle (GC), tratados com curativo primário, conforme o tipo de tecido e exsudato. na primeira consulta os pacientes de ambos os grupos relataram dor intensa. No quinto dia os pacientes do GE relataram ausência de dor e a maioria do GC relatou dor moderada. Com relação ao Questionário de Dor de McGill, a maioria dos pacientes de ambos os grupos, no início da coleta de dados, relataram sensações relacionadas aos descritores sensorial, afetivo, avaliativo e miscelânea, sendo que entre os pacientes do GE houve discreta melhora após a segunda consulta. Após a terceira consulta já não referiram os descritores citados. Os pacientes do GC manifestaram todas as sensações desses descritores até quinta a consulta. o curativo de espuma não aderente com Ibuprofeno é eficaz na redução da dor de pacientes portadores de úlceras venosas.
Raurell-Torredà, M; Romero-Collado, A; Rodríguez-Palma, M; Farrés-Tarafa, M; Martí, J D; Hurtado-Pardos, B; Peñarrubia-San Florencio, L; Saez-Paredes, P; Esquinas, A M
In the last two decades, non-invasive mechanical ventilation (NIV) has been consolidated as an initial strategy for the management of respiratory failure in critical adult and paediatric patients. To identify risk factors and preventive strategies to reduce the incidence of skin lesions associated with clinical devices (LESADIC) related to NIV, as well as the most effective treatment for injuries that cannot be avoided. Review in the MEDLINE, CINAHL and Cochrane databases of studies published in the last 10years to reach consensus through an expert panel. Knowledge about how to measure correct mask size and protection of the skin with foam or hydrocolloids dressings are factors related to the incidence of LESADIC, as it conditions the degree of pressure-friction and shear that the interface exerts on the skin. The interface that causes fewer LESADIC and is better tolerated is the face mask. When there are injuries, the first thing is to remove the interface that causes pressure on damaged skin, recommending a Helmet ® hood as an alternative, treating the infection, managing the exudate and stimulating perilesional skin. The mask of choice is the facial, always using foam or hydrocolloid dressings on the nasal bridge. Evaluate the condition of the skin under the interface and harness every 4hours (recommended) and 11hours (maximum). Evaluate the rotation strategy of the interface at 24hours if the NIV is still needed on an ongoing basis. Copyright © 2017 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Publicado por Elsevier España, S.L.U. All rights reserved.
Advanced textile materials and biopolymers in wound management.
Petrulyte, Salvinija
2008-02-01
New generation medical textiles are an important growing field with great expansion in wound management products. Virtually new products are coming but also well known materials with significantly improved properties using advanced technologies and new methods are in the centre of research which are highly technical, technological, functional, and effective oriented. The key qualities of fibres and dressings as wound care products include that they are bacteriostatic, anti-viral, fungistatic, non-toxic, high absorbent, non-allergic, breathable, haemostatic, biocompatible, and manipulatable to incorporate medications, also provide reasonable mechanical properties. Many advantages over traditional materials have products modified or blended with also based on alginate, chitin/chitosan, collagen, branan ferulate, carbon fibres. Textile structures used for modern wound dressings are of large variety: sliver, yarn, woven, non-woven, knitted, crochet, braided, embroidered, composite materials. Wound care also applies to materials like hydrogels, matrix (tissue engineering), films, hydrocolloids, foams. Specialized additives with special functions can be introduced in advanced wound dressings with the aim to absorb odours, provide strong antibacterial properties, smooth pain and relieve irritation. Because of unique properties as high surface area to volume ratio, film thinness, nano scale fibre diameter, porosity, light weight, nanofibres are used in wound care. The aim of this study is to outline and review the latest developments and advance in medical textiles and biopolymers for wound management providing the overview with generalized scope about novelties in products and properties.
Landsman, T L; Touchet, T; Hasan, S M; Smith, C; Russell, B; Rivera, J; Maitland, D J; Cosgriff-Hernandez, E
2017-01-01
Uncontrolled hemorrhage accounts for more than 30% of trauma deaths worldwide. Current hemostatic devices focus primarily on time to hemostasis, but prevention of bacterial infection is also critical for improving survival rates. In this study, we sought to improve on current devices used for hemorrhage control by combining the large volume-filling capabilities and rapid clotting of shape memory polymer (SMP) foams with the swelling capacity of hydrogels. In addition, a hydrogel composition was selected that readily complexes with elemental iodine to impart bactericidal properties to the device. The focus of this work was to verify that the advantages of each respective material (SMP foam and hydrogel) are retained when combined in a composite device. The iodine-doped hydrogel demonstrated an 80% reduction in bacteria viability when cultured with a high bioburden of Staphylococcus aureus. Hydrogel coating of the SMP foam increased fluid uptake by 19× over the uncoated SMP foam. The composite device retained the shape memory behavior of the foam with more than 15× volume expansion after being submerged in 37°C water for 15 min. Finally, the expansion force of the composite was tested to assess potential tissue damage within the wound during device expansion. Expansion forces did not exceed 0.6N, making tissue damage during device expansion unlikely, even when the expanded device diameter is substantially larger than the target wound site. Overall, the enhanced fluid uptake and bactericidal properties of the shape memory foam composite indicate its strong potential as a hemostatic agent to treat non-compressible wounds. No hemostatic device currently used in civilian and combat trauma situations satisfies all the desired criteria for an optimal hemostatic wound dressing. The research presented here sought to improve on current devices by combining the large volume-filling capabilities and rapid clotting of shape memory polymer (SMP) foams with the swelling capacity of hydrogels. In addition, a hydrogel composition was selected that readily complexes with elemental iodine to impart bactericidal properties to the device. The focus of this work was to verify that the advantages of each respective material are retained when combined into a composite device. This research opens the door to generating novel composites with a focus on both hemostasis, as well as wound healing and microbial prevention. Copyright © 2016 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.
Dressings and topical agents for treating pressure ulcers.
Westby, Maggie J; Dumville, Jo C; Soares, Marta O; Stubbs, Nikki; Norman, Gill
2017-06-22
Pressure ulcers, also known as bedsores, decubitus ulcers and pressure injuries, are localised areas of injury to the skin or the underlying tissue, or both. Dressings are widely used to treat pressure ulcers and promote healing, and there are many options to choose from including alginate, hydrocolloid and protease-modulating dressings. Topical agents have also been used as alternatives to dressings in order to promote healing.A clear and current overview of all the evidence is required to facilitate decision-making regarding the use of dressings or topical agents for the treatment of pressure ulcers. Such a review would ideally help people with pressure ulcers and health professionals assess the best treatment options. This review is a network meta-analysis (NMA) which assesses the probability of complete ulcer healing associated with alternative dressings and topical agents. To assess the effects of dressings and topical agents for healing pressure ulcers in any care setting. We aimed to examine this evidence base as a whole, determining probabilities that each treatment is the best, with full assessment of uncertainty and evidence quality. In July 2016 we searched the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid Embase and EBSCO CINAHL Plus. We also searched clinical trials registries for ongoing and unpublished studies, and scanned reference lists of relevant included studies as well as reviews, meta-analyses, guidelines and health technology reports to identify additional studies. There were no restrictions with respect to language, date of publication or study setting. Published or unpublished randomised controlled trials (RCTs) comparing the effects of at least one of the following interventions with any other intervention in the treatment of pressure ulcers (Stage 2 or above): any dressing, or any topical agent applied directly to an open pressure ulcer and left in situ. We excluded from this review dressings attached to external devices such as negative pressure wound therapies, skin grafts, growth factor treatments, platelet gels and larval therapy. Two review authors independently performed study selection, risk of bias assessment and data extraction. We conducted network meta-analysis using frequentist mega-regression methods for the efficacy outcome, probability of complete healing. We modelled the relative effectiveness of any two treatments as a function of each treatment relative to the reference treatment (saline gauze). We assumed that treatment effects were similar within dressings classes (e.g. hydrocolloid, foam). We present estimates of effect with their 95% confidence intervals for individual treatments compared with every other, and we report ranking probabilities for each intervention (probability of being the best, second best, etc treatment). We assessed the certainty (quality) of the body of evidence using GRADE for each network comparison and for the network as whole. We included 51 studies (2947 participants) in this review and carried out NMA in a network of linked interventions for the sole outcome of probability of complete healing. The network included 21 different interventions (13 dressings, 6 topical agents and 2 supplementary linking interventions) and was informed by 39 studies in 2127 participants, of whom 783 had completely healed wounds.We judged the network to be sparse: overall, there were relatively few participants, with few events, both for the number of interventions and the number of mixed treatment contrasts; most studies were small or very small. The consequence of this sparseness is high imprecision in the evidence, and this, coupled with the (mainly) high risk of bias in the studies informing the network, means that we judged the vast majority of the evidence to be of low or very low certainty. We have no confidence in the findings regarding the rank order of interventions in this review (very low-certainty evidence), but we report here a summary of results for some comparisons of interventions compared with saline gauze. We present here only the findings from evidence which we did not consider to be very low certainty, but these reported results should still be interpreted in the context of the very low certainty of the network as a whole.It is not clear whether regimens involving protease-modulating dressings increase the probability of pressure ulcer healing compared with saline gauze (risk ratio (RR) 1.65, 95% confidence interval (CI) 0.92 to 2.94) (moderate-certainty evidence: low risk of bias, downgraded for imprecision). This risk ratio of 1.65 corresponds to an absolute difference of 102 more people healed with protease modulating dressings per 1000 people treated than with saline gauze alone (95% CI 13 fewer to 302 more). It is unclear whether the following interventions increase the probability of healing compared with saline gauze (low-certainty evidence): collagenase ointment (RR 2.12, 95% CI 1.06 to 4.22); foam dressings (RR 1.52, 95% CI 1.03 to 2.26); basic wound contact dressings (RR 1.30, 95% CI 0.65 to 2.58) and polyvinylpyrrolidone plus zinc oxide (RR 1.31, 95% CI 0.37 to 4.62); the latter two interventions both had confidence intervals consistent with both a clinically important benefit and a clinically important harm, and the former two interventions each had high risk of bias as well as imprecision. A network meta-analysis (NMA) of data from 39 studies (evaluating 21 dressings and topical agents for pressure ulcers) is sparse and the evidence is of low or very low certainty (due mainly to risk of bias and imprecision). Consequently we are unable to determine which dressings or topical agents are the most likely to heal pressure ulcers, and it is generally unclear whether the treatments examined are more effective than saline gauze.More research is needed to determine whether particular dressings or topical agents improve the probability of healing of pressure ulcers. The NMA is uninformative regarding which interventions might best be included in a large trial, and it may be that research is directed towards prevention, leaving clinicians to decide which treatment to use on the basis of wound symptoms, clinical experience, patient preference and cost.
Gabriel, Allen; Gialich, Shelby; Kirk, Julie; Edwards, Sheriden; Beck, Brooke; Sorocéanu, Alexandra; Nelson, Scott; Gabriel, Cassie; Gupta, Subhas
2011-10-01
Many months after the devastating earthquake in January 2010, wounds remain a major disease burden in Haiti. Since January 2010, through the efforts of corporations, nonprofit charitable organizations, and medical professionals, advanced wound care techniques, including negative-pressure wound therapy (NPWT), have been introduced into the wound care regimens of various hospitals in Haiti. In June 2010, the authors completed their second volunteer trip at a Haitian hospital specializing in orthopedic wounds. The medical team was composed of a plastic surgeon, orthopedic surgeon, anesthesiologist, medical assistant, scrub technician, and registered nurse (specializing in plastic surgery and orthopedics). The authors' team supplied NPWT devices, reticulated open-cell foam dressings, and canisters donated by Kinetic Concepts, Inc, San Antonio, Texas, for use at the hospital. This report describes the medical challenges in postearthquake Haiti (including limb salvage and infection), benefits of adjunctive use of NPWT/reticulated open-cell foam, and current wound care status in a Haitian orthopedic hospital. The future role of NPWT in Haiti and during mass catastrophe in a least-developed country is also discussed.
Otero, D Peña; Domínguez, D Vazquez; Fernández, L Hernanz; Magariño, A Santano; González, V Jimenez; Klepzing, J V García; Montesinos, J V Beneit
2017-03-02
To comparatively assess the efficacy of four different therapeutic strategies to prevent the development of facial pressure ulcers (FPUs) related to the use of non-invasive mechanical ventilation (NIV) with oro-nasal masks in critically ill hospitalised patients. This randomised control trial was performed at the high dependency unit in the University General Hospital Gregorio Marañón in Madrid, Spain. Overall, 152 patients with acute respiratory failure were recruited. All patients were hospitalised and received NIV through oro-nasal masks. The Norton tool was used to evaluate the general risk of developing pressure ulcers (PUs). Subjects were divided into four groups, each of them receiving a different treatment. Tissue assessment and preventive care were performed by a member of the research team. The incidence of FPUs was significantly lower in the group receiving a solution of hyperoxygenated fatty acids (HOFA) when compared with each of the other therapeutic strategies: direct mask (p=0.055), adhesive thin dressing (p=0.03) and adhesive foam dressing (p<0.001). The application of HOFA on the facial skin in contact with the oro-nasal masks showed the highest efficacy in the prevention of NIV-related FPUs.
Tayyib, Nahla; Coyer, Fiona
2016-12-01
Pressure ulcers are associated with substantial health burden, but could be preventable. Hospital-acquired pressure ulcers (HAPUs) prevention has become a priority for all healthcare settings, as it is considered a sign of quality of care providing. Intensive care unit (ICU) patients are at higher risk for HAPUs development. Despite the availability of published prevention strategies, there is a little evidence about which strategies can be safely integrated into routine standard care and have an impact on HAPUs prevention. The aim was to synthesize the best available evidence regarding the effectiveness of single strategies designed to reduce the incidence and prevalence of HAPUs development in ICUs. The search strategy was designed to retrieve studies published in English across CINAHL, Medline, Cochrane Central Register of Controlled Trials, Embase, Scopus, and Mednar between 2000 and 2015. All adult ICU participants were aged 18 years or over. This review included randomized controlled trials, quasi-experimental and comparative studies. The studies that were selected for retrieval were assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardized critical-appraisal instruments. The review included 25 studies, and the meta-analysis revealed a statistically significant effect of a silicon foam dressing strategy in reducing HAPUs incidence (effect size = 4.62; 95% CI: 0.05-0.29; p < .00001, effect size = 4.50; 95% CI: 0.05-0.31; p = .00001, respectively) in critically ill patients. Evidence of the effectiveness of nutrition, skin-care regimen, positioning and repositioning schedule, support surfaces, and the role of education in prevention of HAPUs development in the ICU was limited, which precludes strong conclusions. The review provides an evidence-based guide to future priorities for clinical practice. In particular, a silicone foam dressing has positive impact in reducing sacrum and heel HAPUs incidence in the ICU. © 2016 Sigma Theta Tau International.
Properties of low-fat, low-cholesterol egg yolk prepared by supercritical CO2 extraction.
Bringe, N A
1997-01-01
A dry egg yolk ingredient called Eggcellent has 74% less fat and 90% less cholesterol than liquid egg yolks, when reconstituted on an equal protein basis. The phospholipids and proteins are retained, enabling the ingredient to have the taste and texturizing properties of fresh egg yolk. Using the new yolk, it is possible to significantly improve the acceptability of low-fat, low-cholesterol bakery products, scrambled eggs and mayonnaise dressings without losing nutritional claims. The structures and functional properties of egg yolk components and the conditions required to optimize their benefits in foods are reviewed. The lipoproteins of low-fat, low-cholesterol yolk have valuable properties as flavorants, texturizers, foaming agents, emulsifiers, antioxidants, colorants, and nutraceuticals.
Retrospective clinical evaluation of gauze-based negative pressure wound therapy.
Campbell, Penny E; Smith, Gary S; Smith, Jennifer M
2008-06-01
Negative pressure wound therapy (NPWT) is an established modality in the treatment of challenging wounds. However, most existing clinical evidence is derived from the use of open-cell polyurethane foam at -125 mmHg. Alternative negative pressure systems are becoming available, which use gauze at a pressure of -80 mmHg. This study describes clinical results from a retrospective non comparative analysis of 30 patients treated with Chariker-Jeter gauze-based negative pressure systems (V1STA, Versatile-1 and EZ-Care; Smith & Nephew, Inc.) in a long-term care setting. The mean age of the patients was 72 years. The wounds consisted of chronic (n = 11), surgical dehiscence (n = 11) and surgical incision (n = 8). Wound volume and area were recorded at commencement and at the cessation of therapy. Discontinuation of therapy was instigated upon closure through secondary intention or when size and exudate were sufficiently reduced that the wounds could be managed by conventional wound dressing (median 41 days). An overall median reduction in wound volume of 88.0% (P < 0.001) and a 68.0% reduction in area (P < 0.001) compared with baseline were observed over the course of NPWT. The overall rate of volume reduction (15.1% per week) compares favourably with published data from foam-based systems.
Atypical cause of forearm skin ulceration in a leukaemic child: mucormycosis. A case report.
Zirak, C; Brutus, J P; De Mey, A
2005-01-01
Primary cutaneous mucormycosis is an uncommon, deep and aggressive fungal infection occurring mainly in immunosuppressed or diabetic patients. Rapid diagnosis and therapy are necessary to prevent a fatal outcome. An eight-year-old leukaemic child presented with a dark necrotic ulcer on the volar-ulnar aspect of the left forehand. The lesion had developed over seven days, beginning as a vasculo-haemorrhagic erythematous plaque. There was no known history of trauma to the area, but skin necrosis from external compression caused by an intravenous line could not be completely ruled out. The lesion rapidly progressed to a 5 x 8 cm painful necrotic ulcer with an erythematous border. Treatment with ichthyol dressing and intra-venous antibiotherapy failed to improve the condition. Wide debridement was performed and specimens were sent for microbiology and pathology examinations. Microscopic examination demonstrated broad, irregularly walled, non-septate fungal hyphae that were consistent with Mucor. Amphotericin B was administrated intravenously (1 mg/kg/day) and hydrogel and hydrophile adhesive polyurethane foam dressings were applied. After 12 days, the soft tissue defect was covered with a split-thickness skin graft, harvested from the lateral aspect of the thigh. Diagnosis of this infection is based on complete histopathological and microbiological studies. Awareness, and a high index of suspicion are required because of the potential fulminant and fatal course.
Baharestani, Mona Mylene
2007-06-01
The clinical effectiveness of negative pressure wound therapy for the management of acute and chronic wounds is well documented in the adult population but information regarding its use in the pediatric population is limited. A retrospective, descriptive study was conducted to examine the clinical outcomes of using negative pressure wound therapy in the treatment of pediatric wounds. The medical records of 24 consecutive pediatric patients receiving negative pressure wound therapy were reviewed. Demographic data, wound etiology, time to closure, closure method, duration of negative pressure wound therapy, complications, dressing change frequency, dressing type used, and pressure settings were analyzed. All categorical variables in the dataset were summarized using frequency (count and percentages) and all continuous variables were summarized using median (minimum, maximum). The 24 pediatric patients (mean age 8.5 years [range 14 days to 18 years old]) had 24 wounds - 12 (50%) were infected at baseline. Sixteen patients had hypoalbuminemia and six had exposed hardware and bone in their wounds. Twenty-two wounds reached full closure in a median time of 10 days (range 2 to 45) following negative pressure wound therapy and flap closure (11), split-thickness skin graft (three), secondary (four), and primary (four) closure. Pressures used in this population ranged from 50 to 125 mm Hg and most wounds were covered with reticulated polyurethane foam. One patient developed a fistula during the course of negative pressure wound therapy. When coupled with appropriate systemic antibiotics, surgical debridement, and medical and nutritional optimization, in this population negative pressure wound therapy resulted in rapid granulation tissue and 92% successful wound closure. Future neonatal and pediatric negative pressure wound therapy usage registries and prospective studies are needed to provide a strong evidence base from which treatment decisions can be made in the management of these challenging cases, especially pertaining to the safety and efficacy of pressure settings, dressings, and interposing contact layer selection.
Costa, Matthew L; Achten, Juul; Bruce, Julie; Tutton, Elizabeth; Petrou, Stavros; Lamb, Sarah E; Parsons, Nick R
2018-06-12
Open fractures of the lower limb occur when a broken bone penetrates the skin. There can be major complications from these fractures, which can be life-changing. To assess the disability, rate of deep infection, and quality of life in patients with severe open fracture of the lower limb treated with negative pressure wound therapy (NPWT) vs standard wound management after the first surgical debridement of the wound. Multicenter randomized trial performed in the UK Major Trauma Network, recruiting 460 patients aged 16 years or older with a severe open fracture of the lower limb from July 2012 through December 2015. Final outcome data were collected through November 2016. Exclusions were presentation more than 72 hours after injury and inability to complete questionnaires. NPWT (n = 226) in which an open-cell solid foam or gauze was placed over the surface of the wound and connected to a suction pump, creating a partial vacuum over the dressing, vs standard dressings not involving application of negative pressure (n = 234). Disability Rating Index score (range, 0 [no disability] to 100 [completely disabled]) at 12 months was the primary outcome measure, with a minimal clinically important difference of 8 points. Secondary outcomes were complications including deep infection and quality of life (score ranged from 1 [best possible] to -0.59 [worst possible]; minimal clinically important difference, 0.08) collected at 3, 6, 9, and 12 months. Among 460 patients who were randomized (mean age, 45.3 years; 74% men), 88% (374/427) of available study participants completed the trial. There were no statistically significant differences in the patients' Disability Rating Index score at 12 months (mean score, 45.5 in the NPWT group vs 42.4 in the standard dressing group; mean difference, -3.9 [95% CI, -8.9 to 1.2]; P = .13), in the number of deep surgical site infections (16 [7.1%] in the NPWT group vs 19 [8.1%] in the standard dressing group; difference, 1.0% [95% CI, -4.2% to 6.3%]; P = .64), or in quality of life between groups (difference in EuroQol 5-dimensions questionnaire, 0.02 [95% CI, -0.05 to 0.08]; Short Form-12 Physical Component Score, 0.5 [95% CI, -3.1 to 4.1] and Mental Health Component Score, -0.4 [95% CI, -2.2 to 1.4]). Among patients with severe open fracture of the lower limb, use of NPWT compared with standard wound dressing did not improve self-rated disability at 12 months. The findings do not support this treatment for severe open fractures. isrctn.org Identifier: ISRCTN33756652.
Prevention of Tracheostomy-Related Hospital-Acquired Pressure Ulcers.
O'Toole, Thomas R; Jacobs, Natalie; Hondorp, Brian; Crawford, Laura; Boudreau, Lisa R; Jeffe, Jill; Stein, Brian; LoSavio, Phillip
2017-04-01
Objective To determine if standardization of perioperative tracheostomy care procedures decreased the incidence of hospital-acquired tracheostomy-related pressure ulcers. Methods All patients at least 18 years old who underwent placement of a tracheostomy tube in the operating room from July 1, 2014, through June 30, 2015, were cared for postoperatively through an institutionally adopted quality improvement protocol. This included 4 elements: (1) placement of a hydrocolloid dressing underneath the tracheostomy flange in the postoperative period, (2) removal of plate sutures within 7 days of the tracheostomy procedure, (3) placement of a polyurethane foam dressing after suture removal, and (4) neutral positioning of the head. One year after the bundle was initiated, a retrospective analysis was performed to compare the percentage of tracheostomy patients who developed pressure ulcers versus the preintervention period. Results The incidence of tracheostomy-related pressure ulcers decreased from 20 of 183 tracheostomies (10.93%) prior to use of the standardized protocol to 2 of 155 tracheostomies (1.29%). Chi-square analysis showed a significant difference between the groups, with a P value of .0003. Discussion Adoption of this care bundle at our institution resulted in a significant reduction in the incidence of hospital-acquired tracheostomy-related pressure ulcers. The impact of any single intervention within our protocol was not assessed and could be an area of further investigation. Implications for Practice Adoption of a standardized posttracheostomy care bundle at the institution level may result in the improved care of patients with tracheostomies and specifically may reduce the incidence of pressure ulcers.
Sun, Xiaofang; Wu, Shaohan; Xie, Ting; Zhang, Jianping
2017-12-01
An open abdomen complicated with small-bowel fistulae becomes a complex wound for local infection, systemic sepsis and persistent soiling irritation by intestinal content. While controlling the fistulae drainage, protecting surrounding skin, healing the wound maybe a challenge. In this paper we described a 68-year-old female was admitted to emergency surgery in general surgery department with severe abdomen pain. Resection part of the injured small bowel, drainage of the intra-abdominal abscess, and fashioning of a colostomy were performed. She failed to improve and ultimately there was tenderness and lot of pus under the skin around the fistulae. The wound started as a 3-cm lesion and progressed to a 6 ×13 (78 cm) around the stoma. In our case we present a novel device for managing colostomy wound combination with negative pressure wound therapy. This tube allows for an effective drainage of small-bowel secretion and a safe build-up of granulation tissue. Also it could be a barrier between the bowel suction point and foam. Management of open abdomen wound involves initial dressing changes, antibiotic use and cutaneous closure. When compared with traditional dressing changes, the NPWT offers several advantages including increased granulation tissue formation, reduction in bacterial colonization, decreased of bowel edema and wound size, and enhanced neovascularization. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.
Wang, Shu-Ling; Chuang, Pao-Yu; Su, Wan-Chuan
2018-06-01
Pressure injuries increase the cost of medical care and prolong hospitalization. The incidence of pressure injury at the target coronary care unit (CCU) from January to August 2016 was 1.1%, which was significantly higher than the 0.4% defined in the 2015 Taiwan Clinical Performance Indicators (TCPI) system. Medical device related pressure injury (MDRPI) accounted for 73.1% of the pressure injuries (incidence: 0.8%). The main causes of the high incidence of MDRPI were: (1) inadequate decompression dressing and restraint equipment, (2) incomplete implementation of prevention interventions in the CCU, (3) inadequate knowledge of MDRPI prevention among nurses, (4) deficient standards for preventing MDRPI, (5) ineffective MDRPI-related education, and (6) insufficient auditing frequencies. To reduce the incidence of MDRPI in the target CCU to 0.4% or less. Promote a seed-teacher system and a care bundle that "increased skin tolerance, decompression, medical dressing, change, and removal" using education, the adoption of PE-foam binding gloves, and regular audits. The incidence of MDRPI was reduced from 0.8% to 0.3% between October 2016 and April 2017 and further reduced to 0.1% during the maintenance phase between May and July 2017. The results indicate that the improvement program effectively reduced the incidence of MDRPI and thus increased the quality of nursing care. Therefore, the use of a care bundles should be promoted in intensive care units.
Li, Linjing; Liu, Xiangyu; Niu, Yuqing; Ye, Jianfu; Huang, Shuiwen; Liu, Chao; Xu, Kaitian
2017-07-01
Alternating block polyurethanes (abbreviated as PULA-alt-PEG) and random block polyurethanes (abbreviated as PULA-ran-PEG) based on biodegradable poly(lactic acid) (PLA) and poly(ethylene glycol) (PEG) were prepared. Results showed that alternating block polyurethane gives higher crystal degree, higher mechanical properties, more patterned and rougher surface than the random counterpart, due to the regular and controlled structure. Water absorptions of the polyurethanes were in the range of 620 to 780%. Cytocompatibility of the amphiphilic block polyurethanes (PU) (water static angle 41.4°-61.8°) was assessed by CCK-8 assay using human embryonic kidney (HEK293) cells. Wound healing evaluation of the PU foam scaffolds was carried out by full-thickness SD rat model experiment, with medical gauze as control. It was found that the skin of rat in PU groups was fully covered with new epithelium without any significant adverse reactions and PU dressings give much rapid and better healing than medical gauze. Histological examination revealed that PU dressings suppress the infiltration of inflammatory cells and accelerate fibroblast proliferation. It was also demonstrated that PULA-alt-PEG exhibits obvious better healing effect than PULA-ran-PEG does. This study has demonstrated that without further modification, plain alternating block polyurethane scaffold would help wound recovery efficiently. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 1200-1209, 2017. © 2016 Wiley Periodicals, Inc.
In vitro investigations of a novel wound dressing concept based on biodegradable polyurethane
NASA Astrophysics Data System (ADS)
Rottmar, Markus; Richter, Michael; Mäder, Xenia; Grieder, Kathrin; Nuss, Katja; Karol, Agnieszka; von Rechenberg, Brigitte; Zimmermann, Erika; Buser, Stephan; Dobmann, Andreas; Blume, Jessica; Bruinink, Arie
2015-06-01
Non-healing and partially healing wounds are an important problem not only for the patient but also for the public health care system. Current treatment solutions are far from optimal regarding the chosen material properties as well as price and source. Biodegradable polyurethane (PUR) scaffolds have shown great promise for in vivo tissue engineering approaches, but accomplishment of the goal of scaffold degradation and new tissue formation developing in parallel has not been observed so far in skin wound repair. In this study, the mechanical properties and degradation behavior as well as the biocompatibility of a low-cost synthetic, pathogen-free, biocompatible and biodegradable extracellular matrix mimicking a PUR scaffold was evaluated in vitro. The novel PUR scaffolds were found to meet all the requirements for optimal scaffolds and wound dressings. These three-dimensional scaffolds are soft, highly porous, and form-stable and can be easily cut into any shape desired. All the material formulations investigated were found to be nontoxic. One formulation was able to be defined that supported both good fibroblast cell attachment and cell proliferation to colonize the scaffold. Tunable biodegradation velocity of the materials could be observed, and the results additionally indicated that calcium plays a crucial role in PUR degradation. Our results suggest that the PUR materials evaluated in this study are promising candidates for next-generation wound treatment systems and support the concept of using foam scaffolds for improved in vivo tissue engineering and regeneration.
Hickerson, W L; Kealey, G P; Smith, D J; Thomson, P D
1994-01-01
Three institutions enrolled 38 patients who required bilateral skin graft donor sites into a safety and efficacy study of a new synthetic donor site dressing. Bilateral donor sites were randomized to receive either a new, synthetic donor site dressing or an impregnated gauze dressing. Wounds were assessed by time to healing, pain, and patient preference. Synthetic dressing wounds were treated 7.9 days compared with 10.2 days for gauze dressing wounds (p < 0.001), and synthetic dressing wounds were more completely epithelialized. Visual analogue pain analysis revealed significantly less donor site pain with synthetic dressing (2.94) versus gauze dressing (4.64) (p < 0.001). Synthetic dressing had fewer treatment-related adverse experiences than gauze dressing (2 vs 7) and was judged by recipients to be superior to gauze dressing in comfort, pain relief, cosmetic appeal, ease of ambulation, and overall acceptance.
21 CFR 878.4022 - Hydrogel wound dressing and burn dressing.
Code of Federal Regulations, 2010 CFR
2010-04-01
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hydrogel wound dressing and burn dressing. 878... Hydrogel wound dressing and burn dressing. (a) Identification. A hydrogel wound dressing is a sterile or non-sterile device intended to cover a wound, to absorb wound exudate, to control bleeding or fluid...
21 CFR 878.4022 - Hydrogel wound dressing and burn dressing.
Code of Federal Regulations, 2011 CFR
2011-04-01
... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Hydrogel wound dressing and burn dressing. 878... Hydrogel wound dressing and burn dressing. (a) Identification. A hydrogel wound dressing is a sterile or non-sterile device intended to cover a wound, to absorb wound exudate, to control bleeding or fluid...
Choosing a Wound Dressing Based on Common Wound Characteristics
Dabiri, Ganary; Damstetter, Elizabeth; Phillips, Tania
2016-01-01
Significance: Chronic wounds are a major healthcare burden.The practitioner should have an appropriate understanding of both the etiology of the wound as well as the optimal type of dressings to use. Fundamental wound characteristics may be used to guide the practitioner's choice of dressings. The identification of optimal dressings to use for a particular wound type is an important element in facilitating wound healing. Recent Advances: Researchers have sought to design wound dressings that aim to optimize each stage in the healing process. In addition, dressings have been designed to target and kill infection-causing bacteria, with the incorporation of antimicrobial agents. Critical Issues: Chronic wounds are frequently dynamic in presentation, and the numerous wound dressings available make dressing selection challenging for the practitioner. Choosing the correct dressing decreases time to healing, provides cost-effective care, and improves patient quality of life. Future Directions: Research into the mechanisms of wound healing has enhanced our ability to heal chronic wounds at a faster rate through the use of moisture-retentive dressings. Newer dressings are incorporating the use of nanotechnology by incorporating miniature electrical sensors into the dressing. These dressings are engineered to detect changes in a wound environment and alert the patient or practitioner by altering the color of the dressing or sending a message to a smartphone. Additional investigations are underway that incorporate biologic material such as stem cells into dressings. PMID:26858913
Gabriel, Allen; Shores, Jaimie; Bernstein, Brent; de Leon, Jean; Kamepalli, Ravi; Wolvos, Tom; Baharestani, Mona M; Gupta, Subhas
2009-10-01
Over the last decade Vacuum Assisted Closure((R)) (KCI Licensing, Inc., San Antonio, TX) has been established as an effective wound care modality for managing complex acute and chronic wounds. The therapy has been widely adopted by many institutions to treat a variety of wound types. Increasingly, the therapy is being used to manage infected and critically colonized, difficult-to-treat wounds. This growing interest coupled with practitioner uncertainty in using the therapy in the presence of infection prompted the convening of an interprofessional expert advisory panel to determine appropriate use of the different modalities of negative pressure wound therapy (NPWT) as delivered by V.A.C.((R)) Therapy and V.A.C. Instill((R)) with either GranuFoam() or GranuFoam Silver() Dressings. The panel reviewed infected wound treatment methods within the context of evidence-based medicine coupled with experiential insight using V.A.C.((R)) Therapy Systems to manage a variety of infected wounds. The primary objectives of the panel were 1) to exchange state-of-practice evidence, 2) to review and evaluate the strength of existing data, and 3) to develop practice recommendations based on published evidence and clinical experience regarding use of the V.A.C.((R)) Therapy Systems in infected wounds. These recommendations are meant to identify which infected wounds will benefit from the most appropriate V.A.C.((R)) Therapy System modality and provide an infected wound treatment algorithm that may lead to a better understanding of optimal treatment strategies.
Amino Acid-Based Material for the Complementary Therapy of Decubitus Ulcers.
Nogueira, Frederico; Gouveia, Isabel C
2017-04-28
Chronic wounds, pressure sores, lesions, and infections of microbial origin in bedridden, paralyzed, or malnutrition patients remain the object of study of many researchers. A variety of factors behind the development of these disorders are related to the patient's immune system, making it unable to respond effectively to the treatment of the wound. These factors can be properly controlled, giving particular importance to the ethiology and stage of the wound, as well as the time periods corresponding to the replacement of the dressings. The present research reports a novel foam/soft material, L -Cys-g-PCL, with an application for decubitus/pressure ulcers, especially for wounds with a difficult healing process due to infections and constant oxidation of the soft tissues. During this work, the interactions between S. aureus and L -Cys-g-PCL foam were studied under conditions that simulate decubitus ulcers; namely, pH and exudate. The effects of duration of grafting (1 or 8 h) and pH (7.0 and 8.9) on wettability, surface energy, swelling, and porosity were also evaluated. Results showed an effective microbicidal activity exhibiting an inhibition ratio of 99.73% against S. aureu s. This new L -Cys-g-PCL soft material showed saftey to contact skin, ability to be shaped to fill in sunken holes (craters) - pressure ulcers stage III - and to act as a smart material responsive to pH, which can be tailored to develop better swelling properties at alkaline pH where exudates are normally higher, so as to address exudate self-cleaning and prevention of desiccation..
Evaluation of a non-adherent, povidone-iodine dressing in a case series of chronic wounds.
Campbell, N; Campbell, D
2013-08-01
Here we report a product evaluation for a non-adherent, povidone-iodine (PVP-I) dressing, determining the clinical need for the product, performing a literature review, clinical evaluation and cost-analysis, and developing a recommendation. This evaluation included 20 patients who experienced dressing pain with the previous antimicrobial dressing. Two patients discontinued the evaluation and four ulcers were non-healing; the remaining wounds closed with the PVP-I dressing. Patients indicated a preference for the PVP-I dressing, primarily due to lack of dressing pain. The PVP-I dressing was also the most cost-efficient.
Burke, Neil G; Green, Connor; McHugh, Gavin; McGolderick, Niall; Kilcoyne, Carol; Kenny, Patrick
2012-08-01
It is important to reduce potential wound complications in total hip and total knee arthroplasty procedures. The purpose of this study was to compare the jubilee dressing method to a standard adhesive dressing. 124 patients (62 total hip replacements and 62 total knee replacements) were randomly selected to have either a standard adhesive dressing or jubilee method dressing. The number of dressing changes, incidence of blistering, leakage, appearance of inflammation, infection rate and the average stay in hospital was recorded for each patient. The jubilee dressing significantly reduced the rate of blistering, leakage and number of dressing changes when compare to a traditional adhesive dressing (p < 0.05). The rate of inflammation and average length of stay in hospital was not significantly different between the two groups. The authors recommend the use of this dressing for total hip and total knee arthroplasty procedures due to the associated lower complication rate. Copyright © 2012 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.
Hormbrey, E; Pandya, A; Giele, H
2003-07-01
Painful split-skin-graft donor sites remain a common problem for patients. We undertook a prospective randomised trial to examine the comparative comfort and ease of care of two different donor-site dressings. One dressing is the alginate Kaltostat, the standard plastic-surgical dressing in the UK and abroad, and the other is the adhesive retention tape Mefix, a novel use of a readily available dressing. We randomised 50 patients requiring split-skin grafts to receive either alginate (Kaltostat) or retention (Mefix) donor-site dressings. Dressings were assessed by interview and questionnaire at 24, 72 h and 2 weeks, and by wound review at 2 weeks. Retention dressings were found to be more comfortable, required less nursing intervention and allowed patients easier mobility with a greater range of daily activities, especially washing, without compromising wound healing. We recommend adhesive retention dressings as cost-effective comfortable dressings, which readily conform to any donor site.
ERIC Educational Resources Information Center
Birel, Firat Kiyas
2016-01-01
Problem Statement: Dressing for school has been intensely disputed and has led to periodic changes in dress codes since the foundation of the Turkish republic. Practitioners have tried to put some new practices related to school dress codes into practice for redressing former dress code issues involving mandatory dress standards for both students…
Australasian survey of split skin graft donor site dressings.
Lyall, P W; Sinclair, S W
2000-02-01
There is an ever increasing array of products available for wound dressings. The aim of the present study was to establish which dressings should be used as standard controls for future studies; what factors are regarded as most important in assessing a dressing; what the level of satisfaction is with the available products; what the strengths and weaknesses of the commonly used dressings are; and what dressings would be preferred if cost were no issue. A postal survey was sent to every plastic and reconstructive surgeon registered in Australasia (n = 217). A total of 53% responded. The most commonly used dressing type overall is the calcium alginates, despite the fact that they were not the highest performing dressings. This is also the most commonly used in Australia. In contrast scarlet red is still used most commonly in New Zealand. The level of satisfaction with the most commonly used dressing varied very little. The factor regarded most important was patient comfort level. A profile of the commonly used dressing was constructed. Calcium alginates and or scarlet red should be used as the control for new product comparisons. Most of the respondents were satisfied with their preferred dressing and were not interested in trying alternative dressings.
Edwards, Melannie; Rickard, Claire M; Rapchuk, Ivan; Corley, Amanda; Marsh, Nicole; Spooner, Amy J; Mihala, Gabor; Fraser, John F
2014-09-01
To improve arterial catheter (AC) securement and reduce AC failure; to assess feasibility of a large randomised controlled trial. A four-arm, parallel, randomised, controlled, non-blinded pilot trial with 195 intensive care patients taking part, in a tertiary referral hospital in Brisbane, Australia from May to November 2012. Standard polyurethane (SPU) dressing (controls); bordered polyurethane (BPU) + SPU dressing; tissue adhesive (TA) + SPU dressing; and sutureless securement device (SSD) + SPU dressing (no sutures used). AC failure, ie, complete dislodgement, occlusion (monitor failure, inability to infuse or fluid leaking), pain or infection (local or blood). Median AC dwell time was 26.2 hours and was comparable between groups. AC failure occurred in 26/195 patients (13%). AC failure was significantly worse with SPU dressings (10/47 [21%]) than with BPU + SPU dressings (2/ 43 [5%]; P = 0.03), but not significantly different to TA + SPU (6/56 [11%]; P = 0.18) or SSD + SPU (8/49 [16%]; P = 0.61). The dressing applied at AC insertion lasted until AC removal in 68% of controls; 56% of BPU + SPU dressings; 73% of TA + SPU dressings; and 80% of SSD + SPU dressings (all P > 0.05). There were no infections or serious adverse events. Patient and staff satisfaction with all products was high. Median costs (labour and materials) for securement per patient were significantly higher in all groups compared with the control group (SPU, $3.48 [IQR, $3.48-$9.79]; BPU + SPU, $5.07 [IQR, $5.07-$12.99]; SSD + SPU, $10.90 [IQR, $10.90-$10.90]; TA + SPU, $17.70 [IQR, $17.70-$38.36]; all P < 0.01). AC failure occurred significantly less often with BPU + SPU dressings than with SPU dressings. TA + SPU and SSD + SPU dressings should be further investigated and compared with BPU + SPU dressings as controls. The novel approach of TA + SPU dressings appeared safe and feasible.
Negative pressure wound therapy in pediatric surgery: How and when to use.
de Jesus, Lisieux Eyer; Martins, Alana Bandeira; Oliveira, Pablo Baptista; Gomes, Fernanda; Leve, Thais; Dekermacher, Samuel
2018-04-01
Negative pressure wound therapy (NPWT) has been widely adopted to treat laparostomy, abdominal compartment syndrome (ACS) and complicated wounds associated with tissue loss. The method presents specific aspects, advantages and indications in Pediatrics. Our aim is to review the evidence available about NPWT in children. Active search for papers about NPWT in Pediatric patients. Papers referring to orthopedic problems, wound complications after Cardiac Surgery or burns were excluded. The method shows good results to treat ACS, complicated wounds and abdominal wall malformations in neonates, including prematures. Periwound skin protection, monitoring of fluid losses and fine tuning of negative pressure levels according to age are necessary. Less pain, quicker recovery, less frequent dressing changes, possible recovery of exposed surgical hardware, granulation and shrinkage of the wound are advantages of the method over other kinds of dressing. NPWT is contraindicated over blood vessels and exposed nerves. Debridement is needed before usage over necrotic areas. Enteric fistulae are not contraindications. Complications are rare, mainly foam retention and dermatitis/skin maceration. The possibility of fistulae being caused by NPWT remains debatable. NPWT is widely used in Pediatrics, including neonates and premature, but the evidence available about the method is scarce and low quality. Complications are uncommon and mostly manageable. A possible causal relationship between NPWY and enteric fistula remains unclear. Adult devices and parameters have been adapted to children's use. Extra care is needed to protect the delicate tissues of Pediatric patients. Comparative research to define differential costs, indications and advantages of the method, specific indications and limits of NWTP in Pediatrics is needed. Review. IV. Copyright © 2017 Elsevier Inc. All rights reserved.
Dressing remedies: a concept for improving access to and use of dressings in nursing homes.
Clarkson, A
2007-01-01
Delays in accessing dressings prescribed by general practitioners can result in the inappropriate use of dressings on more than one resident in nursing homes. The dressing remedies concept was developed to overcomes this problem.
Exit-Site Dressing and Infection in Peritoneal Dialysis: A Randomized Controlled Pilot Trial.
Mushahar, Lily; Mei, Lim Wei; Yusuf, Wan Shaariah; Sivathasan, Sudhaharan; Kamaruddin, Norilah; Idzham, Nor Juliana Mohd
2016-01-01
♦ Peritoneal dialysis (PD)-related infection is a common cause of catheter loss and the main reason for PD drop-out. Exit-site infection (ESI) is a pathway to developing tunnel infection and peritonitis, hence rigorous exit-site care has always been emphasized in PD therapy. The aim of this study was to evaluate the effect of exit-site dressing vs non-dressing on the rate of PD-related infection. ♦ A prospective randomized controlled study was conducted in prevalent PD patients at the Hospital Tuanku Jaafar Seremban, Negeri Sembilan, Malaysia, from April 2011 until April 2013. All patients were required to perform daily washing of the exit site with antibacterial soap during a shower. In the dressing group (n = 54), patients were required to clean their exit site using povidone-iodine after drying, followed by topical mupirocin antibiotic application to the exit site. The exit site was then covered with a sterile gauze dressing and the catheter immobilized with tape. In the non-dressing group (n = 54), patients were not required to do any further dressing after drying. They were only required to apply mupirocin cream to the exit site and then left the exit site uncovered. The catheter was immobilized with tape. The primary outcome was ESI. The secondary outcomes were evidence of tunnel infection or peritonitis. ♦ A total of 97 patients completed the study. There were a total of 12 ESI episodes: 4 episodes in 4 patients in the dressing group vs 8 episodes in 4 patients in the non-dressing group. This corresponds to 1 episode per 241.3 patient-months vs 1 episode per 111.1 patient-months in the dressing and non-dressing groups respectively. Median time to first ESI episode was shorter in the non-dressing than in the dressing group, but not significant (p = 0.25). The incidence of gram-positive ESI in both groups was similar. There were no gram-negative ESI in the non-dressing group compared with 2 in the dressing group. The peritonitis rate was 1 per 37.1 patient-month in the dressing group and 1 per 44.4 patient-months in the non-dressing group. Median time to first peritonitis episode was significantly shorter in the dressing group compared to non-dressing (p = 0.03). There was no impact of dressing disruptions in the occurrence of major PD catheter-related infection. ♦ Use of a non-dressing technique with only prophylactic topical mupirocin cream application is effective in preventing PD-related infection. The non-dressing technique is more cost-effective and convenient for PD patients, with fewer disposables. Copyright © 2016 International Society for Peritoneal Dialysis.
McDonald, Kyla P.; Ma, Lili
2015-01-01
This research explored whether children judge the knowledge state of others and selectively learn novel information from them based on how they dress. The results indicated that 4- and 6-year-olds identified a formally dressed individual as more knowledgeable about new things in general than a casually dressed one (Study 1). Moreover, children displayed an overall preference to seek help from a formally dressed individual rather than a casually dressed one when learning about novel objects and animals (Study 2). These findings are discussed in relation to the halo effect, and may have important implications for child educators regarding how instructor dress might influence young students’ knowledge attribution and learning preferences. PMID:26636980
Are biopolymers potential deodourising agents in wound management?
Lee, G; Anand, S C; Rajendran, S
2009-07-01
To investigate the odour-adsorbing properties of biopolymers, with a view to using the findings to develop a novel dressing with odour-adsorbing properties. The odour-adsorbing properties of a selection of biopolymers (aloe vera, tea tree oil, neem oil and manuka honey) and three commercially available dressings containing activated charcoal cloth (ACC) were quantitatively assessed using laboratory test equipment. An aloe vera-containing composite dressing, designed and developed by the authors, was also compared with the ACC dressings. Aloe vera was the most adsorbent of the biopolymers and a 40% dilution had comparable values to those of the ACC dressings. Furthermore, values for the novel composite dressing were similar to those of the ACC dressings. The novel composite dressing may be a potential alternative to ACC dressings, and has the added advantages of having antimicrobial properties as well as the ability to promote a moist wound environment. However, more research is needed.
Dressing disrupted: negotiating care through the materiality of dress in the context of dementia.
Buse, Christina; Twigg, Julia
2018-02-01
This paper explores how the materiality of dress mediates and shapes practices of care in the context of dementia. Earlier research called for an approach to conceptualising care that recognised the role played by everyday artefacts. We extend this to a consideration of dress and dressing the body in relation to people with dementia that involves the direct manipulation of material objects, as well as the materiality of bodies. The paper draws on an ESRC funded study Dementia and Dress, which examined experiences of dress for people with dementia, families and care-workers using ethnographic and qualitative methods. Our analysis explores the process of dressing the body, the physicality of guiding and manipulating bodies into clothing, dealing with fabrics and bodies which 'act back' and are resistant to the process of dressing. We consider how the materiality of clothing can constrain or enable practices of care, exploring tensions between garments that support ease of dressing and those that sustain identity. Examining negotiations around dress also reveals tensions between competing 'logics' of care (Mol ). © 2018 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL.
Effect of periodontal dressings on human gingiva fibroblasts in vitro
DOE Office of Scientific and Technical Information (OSTI.GOV)
Eber, R.M.; Shuler, C.F.; Buchanan, W.
1989-08-01
In vitro cytotoxicity studies of periodontal dressings have not generally produced a result consistent with in vivo observations. These prior in vitro studies have not used human intraoral cell lines. We tested the effects of two eugenol containing and two non-eugenol periodontal dressings on cultured human gingival fibroblasts (HGF) (ATCC No. 1292). Replicate HGF cultures grown in microtiter plates were exposed to stock, 1:4 and 1:16 dilutions of extracts made from each of the four periodontal dressings. The HGF cultures were pulse labelled with tritiated thymidine (3HTdR) after 24, 48, and 72 hours. Incorporations of the labelled thymidine were measuredmore » using liquid scintillation counting and expressed as counts per minute. The results showed that undiluted extracts from all four periodontal dressings totally inhibited 3HTdR uptake (P less than 0.05). The 1:4 dilution of eugenol dressings inhibited 3HTdR uptake significantly more than non-eugenol dressings (P less than 0.05). Interestingly, at 72 hours the 1:16 dilution of the non-eugenol dressings caused significantly increased 3HTdR uptake which was not observed with the eugenol dressings. The present results suggest that the use of a human fibroblastic cell line for testing the effects of periodontal dressings may provide information about the relative biological effects of these dressings. Using this cell line, we have found that eugenol dressings inhibit fibroblast proliferation to a greater extent than non-eugenol dressings.« less
Mahoney, Diane Feeney; Burleson, Winslow; Lozano, Cecil; Ravishankar, Vijay; Mahoney, Edward Leo
2015-01-01
Background Prior research has critiqued the lack of attention to the stressors associated with dementia related dressing issues, stigmatizing patient clothing, and wearable technology challenges. This paper describes the conceptual development and feasibility testing of an innovative ‘smart dresser’ context aware affective system (DRESS) to enable dressing by people with moderate memory loss through individualized audio and visual task prompting in real time. Methods Mixed method feasibility study involving qualitative focus groups with 25 Alzheimer’s family caregivers experiencing dressing difficulties to iteratively inform system design and a quantitative usability trial with 10 healthy subjects in a controlled laboratory setting to assess validity of technical operations. Results Caregivers voiced the need for tangible dressing assistance to reduce their frustration from time spent in repetitive cueing and power struggles over dressing. They contributed 6 changes that influenced the prototype development, most notably adding a dresser top iPad to mimic a familiar ‘TV screen’ for the audio and visual cueing. DRESS demonstrated promising overall functionality, however the validity of identification of dressing status ranged from 0% for the correct pants dressing to 100% for all shirts dressing scenarios. Adjustments were made to the detection components of the system raising the accuracy of detection of all acted dressing scenarios for pants from 50% to 82%. Conclusions Findings demonstrate family caregiver acceptability of the proposed system, the successful interoperability of the built system’s components, and the system’s ability to interpret correct and incorrect dressing actions in controlled laboratory simulations. Future research will advance the system to the alpha stage and subsequent testing with end users in real world settings. PMID:26321895
21 CFR 169.115 - French dressing.
Code of Federal Regulations, 2010 CFR
2010-04-01
... 21 Food and Drugs 2 2010-04-01 2010-04-01 false French dressing. 169.115 Section 169.115 Food and... § 169.115 French dressing. (a) Description. French dressing is the separable liquid food or the..., lecithin, or polyglycerol esters of fatty acids. (d) Nomenclature. The name of the food is “French dressing...
NASA Astrophysics Data System (ADS)
Aleksandrova, Irina
2016-01-01
The existing studies, concerning the dressing process, focus on the major influence of the dressing conditions on the grinding response variables. However, the choice of the dressing conditions is often made, based on the experience of the qualified staff or using data from reference books. The optimal dressing parameters, which are only valid for the particular methods and dressing and grinding conditions, are also used. The paper presents a methodology for optimization of the dressing parameters in cylindrical grinding. The generalized utility function has been chosen as an optimization parameter. It is a complex indicator determining the economic, dynamic and manufacturing characteristics of the grinding process. The developed methodology is implemented for the dressing of aluminium oxide grinding wheels by using experimental diamond roller dressers with different grit sizes made of medium- and high-strength synthetic diamonds type ??32 and ??80. To solve the optimization problem, a model of the generalized utility function is created which reflects the complex impact of dressing parameters. The model is built based on the results from the conducted complex study and modeling of the grinding wheel lifetime, cutting ability, production rate and cutting forces during grinding. They are closely related to the dressing conditions (dressing speed ratio, radial in-feed of the diamond roller dresser and dress-out time), the diamond roller dresser grit size/grinding wheel grit size ratio, the type of synthetic diamonds and the direction of dressing. Some dressing parameters are determined for which the generalized utility function has a maximum and which guarantee an optimum combination of the following: the lifetime and cutting ability of the abrasive wheels, the tangential cutting force magnitude and the production rate of the grinding process. The results obtained prove the possibility of control and optimization of grinding by selecting particular dressing parameters.
Forni, Cristiana; D'Alessandro, Fabio; Gambino, Orazio; Amodeo, Alfredo; Pignotti, Elettra; Zanotti, Enrichetta; Tremosini, Morena; Trofa, Carmela; Sabattini, Tania; Matino, Federica; Genco, Rossana; Schiavone, Miguel; Bombino, Caterina; Mini, Sandra; Rocchegiani, Laura; Notarnicola, Teresa; Capezzali, Daniela; Boschi, Rita; Loro, Loretta
2012-01-01
Effectiveness of the transparent sterile dressing vs standard to fix the peripheral venous catheter (PVC), on the incidence of phlebitis. A randomized controlled trial. The type of dressing could contribute to the incidence of phlebitis, infiltration and accidental removals but the results of the studies are contrasting and samples are limited. To compare the effectiveness of a transparent polyurethane sterile dressing on the rate of phlebitis associated to peripheral venous catheter (PVC) vs a non sterile sticking plaster in use in current practice (standard dressing). Randomized controlled trial. Participants. 1061 PVCs (703 patients, adults and children) at a research orthopedic hospital in the north of Italy; 540 PVCs allocated to receive the sterile and 521 the standard dressing. 96 PVCs were excluded for phlebitis, 48 (9.6%) in the sterile and 48 (10.1%) in the standard dressing group, RR 0.96 (95%CI 0.697 - 1.335). Accidental removal of the PVCs was more frequent with the sterile dressing (9.6% vs 6.3%) but the number of catheters removed without complications was larger in the standard dressing group (48.9% vs 54.9% P=0.0503). Eighty-five PVCs were replaced for detachment of the dressing (50, 9.2% sterile and 35, 6.7% standard dressing). The cheapest transparent sterile dressing costs 32 cents while the standard 9 cents. A sticking non sterile plasters is not influential on the rate of phlebitis and ensures an good fix of the PVC compared the transparent sterile dressing to of polyurethane film.
Nanofibrillar cellulose wound dressing in skin graft donor site treatment.
Hakkarainen, T; Koivuniemi, R; Kosonen, M; Escobedo-Lucea, C; Sanz-Garcia, A; Vuola, J; Valtonen, J; Tammela, P; Mäkitie, A; Luukko, K; Yliperttula, M; Kavola, H
2016-12-28
Although new therapeutic approaches for burn treatment have made progress, there is still need for better methods to enhance wound healing and recovery especially in severely burned patients. Nanofibrillar cellulose (NFC) has gained attention due to its renewable nature, good biocompatibility and excellent physical properties that are of importance for a range of applications in pharmaceutical and biomedical fields. In the present study, we investigated the potential of a wood based NFC wound dressing in a clinical trial on burn patients. Previously, we have investigated NFC as a topical functionalized wound dressing that contributes to improve wound healing in mice. Wood based NFC wound dressing was tested in split-thickness skin graft donor site treatment for nine burn patients in clinical trials at Helsinki Burn Centre. NFC dressing was applied to split thickness skin graft donor sites. The dressing gradually dehydrated and attached to donor site during the first days. During the clinical trials, physical and mechanical properties of NFC wound dressing were optimized by changing its composition. From patient 5 forward, NFC dressing was compared to commercial lactocapromer dressing, Suprathel® (PMI Polymedics, Germany). Epithelialization of the NFC dressing-covered donor site was faster in comparison to Suprathel®. Healthy epithelialized skin was revealed under the detached NFC dressing. NFC dressing self-detached after 11-21days for patients 1-9, while Suprathel® self-detached after 16-28days for patients 5-9. In comparison studies with patients 5-9, NFC dressing self-detached on average 4days earlier compared with Suprathel®. Lower NFC content in the material was evaluated to influence the enhanced pliability of the dressing and attachment to the wound bed. No allergic reaction or inflammatory response to NFC was observed. NFC dressing did not cause more pain for patients than the traditional methods to treat the skin graft donor sites. Based on the preliminary clinical data, NFC dressing seems to be promising for skin graft donor site treatment since it is biocompatible, attaches easily to wound bed, and remains in place until donor site has renewed. It also detaches from the epithelialized skin by itself. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.
Timsit, Jean-François; Mimoz, Olivier; Mourvillier, Bruno; Souweine, Bertrand; Garrouste-Orgeas, Maïté; Alfandari, Serge; Plantefeve, Gaétan; Bronchard, Régis; Troche, Gilles; Gauzit, Remy; Antona, Marion; Canet, Emmanuel; Bohe, Julien; Lepape, Alain; Vesin, Aurélien; Arrault, Xavier; Schwebel, Carole; Adrie, Christophe; Zahar, Jean-Ralph; Ruckly, Stéphane; Tournegros, Caroline; Lucet, Jean-Christophe
2012-12-15
Most vascular catheter-related infections (CRIs) occur extraluminally in patients in the intensive care unit (ICU). Chlorhexidine-impregnated and strongly adherent dressings may decrease catheter colonization and CRI rates. To determine if chlorhexidine-impregnated and strongly adherent dressings decrease catheter colonization and CRI rates. In a 2:1:1 assessor-masked randomized trial in patients with vascular catheters inserted for an expected duration of 48 hours or more in 12 French ICUs, we compared chlorhexidine dressings, highly adhesive dressings, and standard dressings from May 2010 to July 2011. Coprimary endpoints were major CRI with or without catheter-related bloodstream infection (CR-BSI) with chlorhexidine versus nonchlorhexidine dressings and catheter colonization rate with highly adhesive nonchlorhexidine versus standard nonchlorhexidine dressings. Catheter-colonization, CR-BSIs, and skin reactions were secondary endpoints. A total of 1,879 patients (4,163 catheters and 34,339 catheter-days) were evaluated. With chlorhexidine dressings, the major-CRI rate was 67% lower (0.7 per 1,000 vs. 2.1 per 1,000 catheter-days; hazard ratio [HR], 0.328; 95% confidence interval [CI], 0.174-0.619; P = 0.0006) and the CR-BSI rate 60% lower (0.5 per 1,000 vs. 1.3 per 1,000 catheter-days; HR, 0.402; 95% CI, 0.186-0.868; P = 0.02) than with nonchlorhexidine dressings; decreases were noted in catheter colonization and skin colonization rates at catheter removal. The contact dermatitis rate was 1.1% with and 0.29% without chlorhexidine. Highly adhesive dressings decreased the detachment rate to 64.3% versus 71.9% (P < 0.0001) and the number of dressings per catheter to two (one to four) versus three (one to five) (P < 0.0001) but increased skin colonization (P < 0.0001) and catheter colonization (HR, 1.650; 95% CI, 1.21-2.26; P = 0.0016) without influencing CRI or CR-BSI rates. A large randomized trial demonstrated that chlorhexidine-gel-impregnated dressings decreased the CRI rate in patients in the ICU with intravascular catheters. Highly adhesive dressings decreased dressing detachment but increased skin and catheter colonization. Clinical trial registered with www.clinicaltrials.gov (NCT 01189682).
NASA Astrophysics Data System (ADS)
Kampeerapappun, Piyaporn
In general, a dressing is used to protect and help heal wounds. There are several types of dressings on the market such as hydrocolloid, hydrogel, and medicated dressings. One technique for making a dressing is electrospinning, which is a very simple procedure used to produce fibers. Due to much smaller fiber-diameters than produced with the conventional technique, the fibers from electrospinning have unique properties: high porosity and high surface areas, which are advantageous for wound healing. In this research, the fibers were electrospun using polyurethane, TecophilicRTM or TecoflexRTM, with various additives. First, multilayer transdermal electrospun dressings, four and five-layers, were developed that allowed for the controlled release of nitric oxide (NO) from a NO2 -/ascorbic acid system encapsulated in polymer nanofibers. The amount of NO released from each wound dressing was investigated. Both the four and five-layer dressings were tested for morphology of fibers, water absorption, nitrite distribution, NO release profile after sterilization by gamma radiation, and stability. In the case of the four-layer transdermal dressing, the dressing was tested in diabetic, periodontal, and cutaneous leishmaniasis patients. Furthermore, the color change of dressing was investigated. TecophilicRTM was also spun with an antimicrobial agent, which was added to the TecophilicRTM solution to electrospin an antimicrobial dressing. The morphology of fibers was tested using an optical microscope and the water absorption, uniformity, and percent extraction of dressing were also determined. In addition, the efficiency of the antimicrobial agent in the dressing was determined according to SN 195920-1994 and ASTM 2149-01. Another NO-releasing dressing was developed employing the NO donor molecules, sodium salt of linear polyethylenimine NONOates (LPEINO-Na) and calcium salt of linear polyethylenimine NONOates (LPEINO-Ca), which were electrospun with TecophilicRTM. The NO release profiles for the LPEINO fibers were generated using a nitric oxide analyzer (NOA) and distribution of the particles in the dressing was examined. Moreover, the amount of NO released after patch storage for 1 and 2 months was determined.
... as much gauze or packing gauze. Removing the Old Dressing Follow these steps to remove your dressing: ... sterile gloves. Carefully remove the tape. Remove the old dressing. If it is sticking to your skin, ...
A prospective randomized clinical trial to evaluate methods of postoperative care of hypospadias.
McLorie, G; Joyner, B; Herz, D; McCallum, J; Bagli, D; Merguerian, P; Khoury, A
2001-05-01
Hypospadias repair is a common operation performed by pediatric urologists. Perhaps the greatest variable and source of controversy of postoperative care is the surgical dressing. We hypothesized that using no dressing would achieve surgically comparable results to those traditionally achieved by a postoperative dressing and it would also simplify postoperative parent delivered home care. Accordingly we designed a prospective randomized clinical trial to compare surgical outcome and postoperative care after hypospadias repair in boys with no dressing and those who received 1 of the 2 most common types of dressing. In a 12-month period 120 boys with an average age of 2.2 years underwent primary 1-stage hypospadias repair at a single center with 4 participating surgeons. Repair was performed in 60 boys with proximal and 60 with distal hypospadias on an outpatient basis. Ethics and Internal Review Board approval, and informed consent were obtained. Boys were then prospectively randomized to receive no dressing, an adhesive biomembrane dressing or a compressive wrap dressing. Comprehensive instructions on postoperative care were distributed to all families and a questionnaire was distributed to the parents at the initial followup. Surgical outcome was evaluated and questionnaire responses were analyzed. Fisher's exact test was done to test the significance of differences in surgical outcomes and questionnaire responses. A total of 117 boys completed the prospective randomized trial. Surgical staff withdrew 3 cases from randomized selection to place a dressing for postoperative hemostasis. We obtained 101 questionnaires for response analysis. The type or absence of the dressing did not correlate with the need for repeat procedures, urethrocutaneous fistula, or meatal stenosis or regression. Analysis revealed less narcotic use in the no dressing group and fewer telephone calls to the urology nurse, or on-call resident and/or fellow. These findings were statistically significant. In addition, there were more unscheduled visits to the urology clinic, emergency room or primary physician office by boys with than without a dressing. Furthermore, 29% of the parents were not psychologically prepared to remove the dressing and 12% were so reluctant that the dressing was removed at the urology outpatient clinic. The surgical outcome and rate of adverse events or complications were not compromised without a postoperative dressing. An absent dressing simplified postoperative ambulatory parent delivered home care. We recommend that dressings should be omitted from routine use after hypospadias repair.
Burleson, Winslow; Lozano, Cecil; Ravishankar, Vijay; Lee, Jisoo; Mahoney, Diane
2018-05-01
Individuals living with advancing stages of dementia (persons with dementia, PWDs) or other cognitive disorders do not have the luxury of remembering how to perform basic day-to-day activities, which in turn makes them increasingly dependent on the assistance of caregivers. Dressing is one of the most common and stressful activities provided by caregivers because of its complexity and privacy challenges posed during the process. In preparation for in-home trials with PWDs, the aim of this study was to develop and evaluate a prototype intelligent system, the DRESS prototype, to assess its ability to provide automated assistance with dressing that can afford independence and privacy to individual PWDs and potentially provide additional freedom to their caregivers (family members and professionals). This laboratory study evaluated the DRESS prototype's capacity to detect dressing events. These events were engaged in by 11 healthy participants simulating common correct and incorrect dressing scenarios. The events ranged from donning a shirt and pants inside out or backwards to partial dressing-typical issues that challenge a PWD and their caregivers. A set of expected detections for correct dressing was prepared via video analysis of all participants' dressing behaviors. In the initial phases of donning either shirts or pants, the DRESS prototype missed only 4 out of 388 expected detections. The prototype's ability to recognize other missing detections varied across conditions. There were also some unexpected detections such as detection of the inside of a shirt as it was being put on. Throughout the study, detection of dressing events was adversely affected by the relatively smaller effective size of the markers at greater distances. Although the DRESS prototype incorrectly identified 10 of 22 cases for shirts, the prototype preformed significantly better for pants, incorrectly identifying only 5 of 22 cases. Further analyses identified opportunities to improve the DRESS prototype's reliability, including increasing the size of markers, minimizing garment folding or occlusions, and optimal positioning of participants with respect to the DRESS prototype. This study demonstrates the ability to detect clothing orientation and position and infer current state of dressing using a combination of sensors, intelligent software, and barcode tracking. With improvements identified by this study, the DRESS prototype has the potential to provide a viable option to provide automated dressing support to assist PWDs in maintaining their independence and privacy, while potentially providing their caregivers with the much-needed respite. ©Winslow Burleson, Cecil Lozano, Vijay Ravishankar, Jisoo Lee, Diane Mahoney. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 01.05.2018.
Evaluation of dressings used with local anaesthetic cream and for peripheral venous cannulation.
Needham, Rowan; Strehle, Eugen-Matthias
2008-10-01
To compare four polyurethane dressings manufactured by two different companies for use in children. Seventy-eight dressings were applied to secure either local anaesthetic creams (n = 62) or intravenous cannulae (n = 16). Each dressing was evaluated for ease of application, security and ease of removal, using a simple scoring system. 84 per cent of Opsite flexigrid and 90 per cent of Tegaderm local anaesthetic cream dressings were rated as easy or very easy to apply. Opsite flexigrid was felt to be more secure, whereas Tegaderm was easier to remove. The Tegaderm cannula dressing was easier to apply than the iv3000 dressing. There was little difference between the two brands, including costs.
ERIC Educational Resources Information Center
Griffiths, Noola K.
2010-01-01
This study investigates the effects of concert dress and physical appearance on perceptions of female classical soloists' musical abilities over a range of genres. Four female violinists were recorded playing three pieces, in four styles of dress of varying formality. Each combination of performer, piece and dress was recorded twice, once as the…
Use of wound dressings with soft silicone adhesive technology.
Morris, Clare; Emsley, Paulene; Marland, Elizabeth; Meuleneire, Frans; White, Richard
2009-04-01
To evaluate how pain, during and in-between dressing changes, is affected by the introduction of Mepilex Border Lite, a wound dressing manufactured by Mölnlycke Health Care using Safetac soft silicone adhesive technology, to the treatment of different types of paediatric wounds/skin injuries. Wounds/skin injuries that met the criteria for inclusion in the study were dressed with Mepilex Border Lite. Patients were followed for six weeks or until their wounds/skin injuries had healed, whichever occurred earlier. At each dressing change, pain severity before and during dressing removal was rated by the patient and the investigator on a scale from zero (no pain at all) to ten (worst pain ever). Other variables measured included: signs of trauma to wound/skin injury and surrounding skin, the proportion of viable/non-viable tissue, the quantity and appearance of exudate, odour, and clinical signs of infection. At the final dressing change, patients and investigators completed questionnaires to rate the dressing performance. Mean pain severity scores were significantly lower (p < or = 0.003) at the first dressing change than at baseline. Over 99.5 per cent of the Mepilex Border Lite dressing changes were reported to be atraumatic and more than half of the wounds healed within the study period. Conformability, ease of use, ease of removal, patient comfort, and overall experience with the dressing were rated as 'good' to 'very good' at the vast majority of final visit evaluations. This study provides further evidence of the ability of dressings with Safetac soft silicone adhesive technology to minimise trauma and pain and demonstrates the ability of Mepilex Border Lite to overcome the clinical challenges associated with the use of dressings on the wounds/skin injuries of paediatric patients.
Napavichayanun, Supamas; Yamdech, Rungnapha; Aramwit, Pornanong
2016-03-01
In our previous work, we have attempted to develop a novel bacterial nanocellulose wound dressing which composed of both polyhexamethylene biguanide (PHMB) as an antimicrobial agent and sericin as an accelerative wound healing component. The loading sequence and concentration of PHMB and sericin were optimized to provide the wound dressing with the most effective antimicrobial activity and enhanced collagen production. In this study, further in vitro, in vivo, and clinical studies of this novel wound dressing were performed to evaluate its safety, efficacy, and applicability. For the in vitro cytotoxic test with L929 mouse fibroblast cells, our novel dressing was not toxic to the cells and also promoted cell migration as good as the commercially available dressing, possibly due to the component of sericin released. When implanted subcutaneously in rats, the lower inflammation response was observed for the novel dressing implanted, comparing to the commercially available dressing. This might be that the antimicrobial PHMB component of the novel dressing played a role to reduce infection and inflammation reaction. The clinical trial patch test was performed on the normal skin of healthy volunteers to evaluate the irritation effect of the dressing. Our novel dressing did not irritate the skin of any volunteers, as characterized by the normal levels of erythema and melanin and the absence of edema, papule, vesicle, and bullae. Then, the novel dressing was applied for the treatment of full-thickness wounds in rats. The wounds treated with our novel dressing showed significantly lower percentage of wound size and higher extent of collagen formation mainly due to the activity of sericin. We concluded that our novel bacterial nanocellulose incorporating PHMB and sericin was a safe and efficient wound dressing material for further investigation in the wound healing efficacy in clinic.
Dressing the post-Newtonian two-body problem and classical effective field theory
NASA Astrophysics Data System (ADS)
Kol, Barak; Smolkin, Michael
2009-12-01
We apply a dressed perturbation theory to better organize and economize the computation of high orders of the 2-body effective action of an inspiralling post-Newtonian (PN) gravitating binary. We use the effective field theory approach with the nonrelativistic field decomposition (NRG fields). For that purpose we develop quite generally the dressing theory of a nonlinear classical field theory coupled to pointlike sources. We introduce dressed charges and propagators, but unlike the quantum theory there are no dressed bulk vertices. The dressed quantities are found to obey recursive integral equations which succinctly encode parts of the diagrammatic expansion, and are the classical version of the Schwinger-Dyson equations. Actually, the classical equations are somewhat stronger since they involve only finitely many quantities, unlike the quantum theory. Classical diagrams are shown to factorize exactly when they contain nonlinear worldline vertices, and we classify all the possible topologies of irreducible diagrams for low loop numbers. We apply the dressing program to our post-Newtonian case of interest. The dressed charges consist of the dressed energy-momentum tensor after a nonrelativistic decomposition, and we compute all dressed charges (in the harmonic gauge) appearing up to 2PN in the 2-body effective action (and more). We determine the irreducible skeleton diagrams up to 3PN and we employ the dressed charges to compute several terms beyond 2PN.
Cost of dressings for prevention of sacral pressure ulcers.
Inoue, Kelly Cristina; Matsuda, Laura Misue
2016-01-01
to identify costs of dressings to prevent sacral pressure ulcers in an adult intensive care unit in Paraná, Brazil. secondary analysis study with 25 patients admitted between October 2013 and March 2014, using transparent polyurethane film (n=15) or hydrocolloid dressing (n=10) on the sacral region. The cost of each intervention was based on the unit amount used in each type of dressing, and its purchase price (transparent film = R$15.80, hydrocolloid dressing = R$68.00). the mean cost/patient was R$23.17 for use of transparent film and R$190.40 for use of hydrocolloid dressing. The main reason for changing the dressing was detachment. the transparent film was the most economically advantageous alternative to prevent sacral pressure ulcers in critical care patients. However, additional studies should be carried out including assessment of the effectiveness of both dressings.
Trends for Electron Beam Accelerator Applications in Industry
NASA Astrophysics Data System (ADS)
Machi, Sueo
2011-02-01
Electron beam (EB) accelerators are major pieces of industrial equipment used for many commercial radiation processing applications. The industrial use of EB accelerators has a history of more than 50 years and is still growing in terms of both its economic scale and new applications. Major applications involve the modification of polymeric materials to create value-added products, such as heat-resistant wires, heat-shrinkable sheets, automobile tires, foamed plastics, battery separators and hydrogel wound dressing. The surface curing of coatings and printing inks is a growing application for low energy electron accelerators, resulting in an environmentally friendly and an energy-saving process. Recently there has been the acceptance of the use of EB accelerators in lieu of the radioactive isotope cobalt-60 as a source for sterilizing disposable medical products. Environmental protection by the use of EB accelerators is a new and important field of application. A commercial plant for the cleaning flue gases from a coal-burning power plant is in operation in Poland, employing high power EB accelerators. In Korea, a commercial plant uses EB to clean waste water from a dye factory.
Genuino, Glenn Angelo S; Baluyut-Angeles, Kathrina Victoria; Espiritu, Andre Paolo T; Lapitan, Marie Carmela M; Buckley, Brian S
2014-11-01
Non-extensive superficial partial thickness burns constitute a major proportion of burns. Conventional treatment involves regular changing of absorptive dressings including the application of a topical antimicrobial, commonly silver sulfadiazine. A systematic review has found insufficient evidence to support or refute such antimicrobial prophylaxis. Another review compared silver sulfadiazine dressings with other occlusive and non-antimicrobial dressings and found insufficient evidence to guide practice. Other research has suggested that dressings with petrolatum gel are as effective as silver sulfadiazine. Single-center, randomized, controlled parallel group trial comparing conventional silver sulfadiazine dressings with treatment with petrolatum gel alone. Consenting adults 18-45 years old with superficial partial thickness burns≤10% total body surface area seen within 24h of the injury were randomized to daily dressing either with petrolatum gel without top dressings or conventional silver sulfadiazine treatment with gauze dressings. Primary outcomes were blinded assessment of time to complete re-epithelialization, wound infection or allergic contact dermatitis. Secondary outcomes included assessment of ease, time and pain of dressing changes. 26 patients were randomized to petrolatum and 24 to silver sulfadiazine dressings. Follow up data available for 19 in each group. Mean time to re-epithelialization was 6.2 days (SD 2.8) in the petrolatum group and 7.8 days (SD 2.1) in the silver sulfadiazine group (p=0.050). No wound infection or dermatitis was observed in either group. Scores for adherence to wound, ease of dressing removal and time required to change dressings were significantly better in the petrolatum treatment arm (p<0.01). Petrolatum gel without top dressings may be at least as effective as silver sulfadiazine gauze dressings with regard to time to re-epithelialization, and incidence of infection and allergic contact dermatitis. Petrolatum gel appears to be an effective, affordable and widely available alternative in the treatment of minor superficial partial thickness burns in adults. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.
Kent, Dea J
2010-01-01
I compared the effects of a just-in-time educational intervention (educational materials for dressing application attached to the manufacturer's dressing package) to traditional wound care education on reported confidence and dressing application in a simulated model. Nurses from a variety of backgrounds were recruited for this study. The nurses possessed all levels of education ranging from licensed practical nurse to master of science in nursing. Both novice and seasoned nurses were included, with no stipulations regarding years of nursing experience. Exclusion criteria included nurses who spent less than 50% of their time in direct patient care and nurses with advanced wound care training and/or certification (CWOCN, CWON). Study settings included community-based acute care facilities, critical access hospitals, long-term care facilities, long-term acute care facilities, and home care agencies. No level 1 trauma centers were included in the study for geographical reasons. Participants were randomly allocated to control or intervention groups. Each participant completed the Kent Dressing Confidence Assessment tool. Subjects were then asked to apply the dressing to a wound model under the observation of either the principal investigator or a trained observer, who scored the accuracy of dressing application according to established criteria. None of the 139 nurses who received traditional dressing packaging were able to apply the dressing to a wound model correctly. In contrast, 88% of the nurses who received the package with the educational guide attached to it were able to apply the dressing to a wound model correctly (χ2 = 107.22, df = 1, P = .0001). Nurses who received the dressing package with the attached educational guide agreed that this feature gave them confidence to correctly apply the dressing (88%), while no nurse agreed that the traditional package gave him or her the confidence to apply the dressing correctly (χ2 = 147.47, df = 4, P < .0001). A just-in-time education intervention improved nurses' confidence when applying an unfamiliar dressing and accuracy of application when applying the dressing to a simulated model compared to traditional wound care education.
Oxidized Regenerated Cellulose/Collagen Dressings: Review of Evidence and Recommendations.
Wu, Stephanie; Applewhite, Andrew J; Niezgoda, Jeffrey; Snyder, Robert; Shah, Jayesh; Cullen, Breda; Schultz, Gregory; Harrison, Janis; Hill, Rosemary; Howell, Melania; Speyrer, Marcus; Utra, Howard; de Leon, Jean; Lee, Wayne; Treadwell, Terry
2017-11-01
Healthcare systems are being challenged to manage increasing numbers of nonhealing wounds. Wound dressings are one of the first lines of defense in wound management, and numerous options exist. The oxidized regenerated cellulose (ORC)/collagen dressing may offer healthcare providers a robust and cost-effective tool for use in a variety of wounds. A multidisciplinary panel meeting was convened to discuss the use of ORC/collagen dressings in wound care and provide practice recommendations. A literature search was conducted to provide a brief review of the peer-reviewed studies published between January 2000 and March 2016 to inform the meeting. A 2-day panel meeting convened in February 2017. Healthcare providers with experience using ORC/collagen dressings. This multidisciplinary panel of 15 experts in wound healing included podiatrists, wound care specialists (doctors, certified wound care nurses, and research scientists), and an orthopedist. The literature search identified 58 articles, a majority of which were low levels of evidence (69.3% were level 3 or lower). Panel members identified wound types, such as abrasions, burns, stalled wounds, diabetic foot ulcers, and pressure injuries, where ORC/collagen dressing use could be beneficial. Panel members then provided recommendations and technical pearls for the use of ORC/collagen dressings in practice. Barriers to ORC/collagen dressing use were discussed, and potential resolutions were offered. An ORC/collagen dressing can be a critical tool for clinicians to help manage a variety of wounds. Clinical and economic studies comparing standard-of-care dressings and plain collagen dressings to ORC/collagen dressings are needed.
Oxidized Regenerated Cellulose/Collagen Dressings: Review of Evidence and Recommendations
Wu, Stephanie; Applewhite, Andrew J.; Niezgoda, Jeffrey; Snyder, Robert; Shah, Jayesh; Cullen, Breda; Schultz, Gregory; Harrison, Janis; Hill, Rosemary; Howell, Melania; Speyrer, Marcus; Utra, Howard; de Leon, Jean; Lee, Wayne; Treadwell, Terry
2017-01-01
ABSTRACT OBJECTIVE: Healthcare systems are being challenged to manage increasing numbers of nonhealing wounds. Wound dressings are one of the first lines of defense in wound management, and numerous options exist. The oxidized regenerated cellulose (ORC)/collagen dressing may offer healthcare providers a robust and cost-effective tool for use in a variety of wounds. DESIGN: A multidisciplinary panel meeting was convened to discuss the use of ORC/collagen dressings in wound care and provide practice recommendations. A literature search was conducted to provide a brief review of the peer-reviewed studies published between January 2000 and March 2016 to inform the meeting. SETTING: A 2-day panel meeting convened in February 2017. PARTICIPANTS: Healthcare providers with experience using ORC/collagen dressings. This multidisciplinary panel of 15 experts in wound healing included podiatrists, wound care specialists (doctors, certified wound care nurses, and research scientists), and an orthopedist. RESULTS: The literature search identified 58 articles, a majority of which were low levels of evidence (69.3% were level 3 or lower). Panel members identified wound types, such as abrasions, burns, stalled wounds, diabetic foot ulcers, and pressure injuries, where ORC/collagen dressing use could be beneficial. Panel members then provided recommendations and technical pearls for the use of ORC/collagen dressings in practice. Barriers to ORC/collagen dressing use were discussed, and potential resolutions were offered. CONCLUSIONS: An ORC/collagen dressing can be a critical tool for clinicians to help manage a variety of wounds. Clinical and economic studies comparing standard-of-care dressings and plain collagen dressings to ORC/collagen dressings are needed. PMID:29049055
Economics of pressure-ulcer care: review of the literature on modern versus traditional dressings.
San Miguel, L; Torra i Bou, J E; Verdú Soriano, J
2007-01-01
Published evidence suggests that some of the benefits of modern dressings--longer wear times and less frequent dressing changes--make them more cost-effective than traditional gauze dressings in pressure ulcer management.
Watson, Denis; Bergquist, Stephen; Nicholson, Julie; Norrie, David H
2017-06-28
While Manuka honey in vitro is strongly antimicrobial, there have been, to the best of the authors' knowledge, no studies showing that dressings impregnated with Manuka honey can kill organisms in the dressing itself. The investigators used the American Association of Textile Chemists and Colorists' 100 test methodology to compare honey-impregnated dressings with control dressings (without honey) on the ability to kill common wound pathogens. Organisms were chosen after a review of the causal organisms found in actual wound infections over a 12-month period in a busy outpatient wound clinic. Even when the dressings were challenged daily with further inoculated organisms, > 5-log reductions were routinely noted across a range of pathogens, including multiple drug-resistant species using dressings containing Manuka honey relative to the control. The results presented herein show that when well-characterized medical-grade Manuka honey is used in dressings (ie, a minimum of 400 mg methylglyoxal/kg) these dressings can comprehensively kill common wound pathogens associated with infected wounds.
Lozano, Cecil; Ravishankar, Vijay; Lee, Jisoo; Mahoney, Diane
2018-01-01
Background Individuals living with advancing stages of dementia (persons with dementia, PWDs) or other cognitive disorders do not have the luxury of remembering how to perform basic day-to-day activities, which in turn makes them increasingly dependent on the assistance of caregivers. Dressing is one of the most common and stressful activities provided by caregivers because of its complexity and privacy challenges posed during the process. Objective In preparation for in-home trials with PWDs, the aim of this study was to develop and evaluate a prototype intelligent system, the DRESS prototype, to assess its ability to provide automated assistance with dressing that can afford independence and privacy to individual PWDs and potentially provide additional freedom to their caregivers (family members and professionals). Methods This laboratory study evaluated the DRESS prototype’s capacity to detect dressing events. These events were engaged in by 11 healthy participants simulating common correct and incorrect dressing scenarios. The events ranged from donning a shirt and pants inside out or backwards to partial dressing—typical issues that challenge a PWD and their caregivers. Results A set of expected detections for correct dressing was prepared via video analysis of all participants’ dressing behaviors. In the initial phases of donning either shirts or pants, the DRESS prototype missed only 4 out of 388 expected detections. The prototype’s ability to recognize other missing detections varied across conditions. There were also some unexpected detections such as detection of the inside of a shirt as it was being put on. Throughout the study, detection of dressing events was adversely affected by the relatively smaller effective size of the markers at greater distances. Although the DRESS prototype incorrectly identified 10 of 22 cases for shirts, the prototype preformed significantly better for pants, incorrectly identifying only 5 of 22 cases. Further analyses identified opportunities to improve the DRESS prototype’s reliability, including increasing the size of markers, minimizing garment folding or occlusions, and optimal positioning of participants with respect to the DRESS prototype. Conclusions This study demonstrates the ability to detect clothing orientation and position and infer current state of dressing using a combination of sensors, intelligent software, and barcode tracking. With improvements identified by this study, the DRESS prototype has the potential to provide a viable option to provide automated dressing support to assist PWDs in maintaining their independence and privacy, while potentially providing their caregivers with the much-needed respite. PMID:29716885
Effects of adhesive dressings on stratum corneum conductance.
Cavallini, Maurizio; Gazzola, Riccardo; Vaienti, Luca
2012-05-01
Stratum corneum is a fundamental layer of epidermis. It acts as a barrier, with antimicrobial features, regulating skin permeability and integrity as well. Adhesive dressings and their removal could alter this layer, affecting cutaneous water balance and lipid composition of stratum corneum. These changes could be monitored by measurement of cutaneous hydration. Ninety-two patients affected by wounds dressed with adhesive tapes or plasters have been studied. Measurement of skin conductance under tape/plaster and in the surrounding healthy skin, immediately after removal of dressing has been performed. Dressing age, wound localization, and characteristics were also considered. Adhesive dressings alter significantly stratum corneum conductance. Although healthy skin hydration has significant variations throughout the body, cutaneous conductance under adhesive dressing in different areas displays no significative changes. Moreover, the increase in hydration due to adhesive tapes/plasters showed no association with wound dehiscence. Adhesive dressings cause a significative increase in stratum corneum conductance, acting as a barrier to apocrine secretions. Although different hydration levels have been observed in healthy skin throughout the body, no difference exists under adhesive dressing among different regions, suggesting no contraindications in their employment throughout the body. Increase in cutaneous hydration showed no correlations with wound dehiscence, thus confirming safety and practicality of these dressings. © 2011 John Wiley & Sons A/S.
Percy, Dean B; Haddock, Candace; Ma, Vivian; Nowak, Amie; Panczuk, Julia; Butterworth, Sonia
2018-05-01
The purpose of this study was to describe outcomes and resource utilization in patients treated with twice-weekly silver impregnated (SI) nanocrystalline dressings for initial non-operative management of giant omphalocele (GO). A retrospective review of patients with GO treated with SI dressings was undertaken. Clinical parameters, cost, and complications were recorded. Five patients with GO were treated with SI dressings between 2014 and 2016. Clinical characteristic (mean ± SD) included gestational age 36 ± 4 weeks, birth weight 2.6 ± 0.63 kg, GO size 10.2 ± 4.7 cm, ventilator days 7.5 ± 8.7 d, days in NICU 41 ± 20 d, days to full feeds, 30 ± 15 d, and LOS 62 ± 41 d. The average in-hospital cost of SI dressings was $110 CAD/week. This is comparable to daily silver sulfadiazine dressings ($109CAD/week) which were used historically. All patients were discharged with once- or twice-weekly dressing changes. No ruptures occurred. There was one mortality secondary to pulmonary sepsis. For initial non-operative management of GO, twice weekly SI nanocrystalline dressings is safe and effective. Use of SI dressings results in decreased handling of infants, reduced physician and nursing resource utilization, and favourable outcomes. IV (Retrospective Case Series). Copyright © 2018. Published by Elsevier Inc.
Hua, Yun; Qiu, Rong; Yao, Wen-Yan; Zhang, Qin; Chen, Xiao-Li
2015-10-01
It has been demonstrated that patients with chronic wounds experience the most pain during dressing changes. Currently, researchers focus mostly on analgesics and appropriate dressing materials to relieve pain during dressing changes of chronic wounds. However, the effect of nonpharmacologic interventions, such as virtual reality distraction, on pain management during dressing changes of pediatric chronic wounds remains poorly understood. To investigate the effect of virtual reality distraction on alleviating pain during dressing changes in children with chronic wounds on their lower limbs. A prospective randomized study. A pediatric center in a tertiary hospital. Sixty-five children, aged from 4 to 16 years, with chronic wounds on their lower limbs. Pain and anxiety scores during dressing changes were recorded by using the Wong-Baker Faces picture scale, visual analogue scale, and pain behavior scale, as well as physiological measurements including pulse rate and oxygen saturation. Time length of dressing change was recorded. Virtual reality distraction significantly relieved pain and anxiety scores during dressing changes and reduced the time length for dressing changes as compared to standard distraction methods. The use of virtual reality as a distraction tool in a pediatric ward offered superior pain reduction to children as compared to standard distractions. This device can potentially improve clinical efficiency by reducing length time for dressing changes. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.
An Inexpensive Bismuth-Petrolatum Dressing for Treatment of Burns
Chattopadhyay, Arhana; Chang, Kathleen; Nguyen, Khoa; Galvez, Michael G.; Legrand, Anais; Davis, Christopher; McGoldrick, Rory; Long, Chao; Pham, Hung
2016-01-01
Background: Xeroform remains the current standard for treating superficial partial-thickness burns but can be prohibitively expensive in developing countries with prevalent burn injuries. This study (1) describes the production of an alternative low-cost dressing and (2) compares the alternative dressing and Xeroform using the metrics of cost-effectiveness, antimicrobial activity, and biocompatibility in vitro, and wound healing in vivo. Methods: To produce the alternative dressing, 3% bismuth tribromophenate powder was combined with petroleum jelly by hand and applied to Kerlix gauze. To assess cost-effectiveness, the unit costs of Xeroform and components of the alternative dressing were compared. To assess antimicrobial properties, the dressings were placed on agar plated with Escherichia coli and the Kirby-Bauer assay performed. To assess biocompatibility, the dressings were incubated with human dermal fibroblasts and cells stained with methylene blue. To assess in vivo wound healing, dressings were applied to excisional wounds on rats and the rate of re-epithelialization calculated. Results: The alternative dressing costs 34% of the least expensive brand of Xeroform. Antimicrobial assays showed that both dressings had similar bacteriostatic effects. Biocompatibility assays showed that there was no statistical difference (P < 0.05) in the cytotoxicity of Xeroform, alternative dressing, and Kerlix gauze. Finally, the in vivo healing model showed no statistical difference (P < 0.05) in mean re-epithelialization time between Xeroform (13.0 ± 1.6 days) and alternative dressing (13.5 ± 1.0 days). Conclusions: Xeroform is biocompatible, reduces infection, and enhances healing of burn wounds by preventing desiccation and mechanical trauma. Handmade petrolatum gauze may be a low-cost replacement for Xeroform. Future studies will focus on clinical trials in burn units. PMID:27482485
Gee Kee, Emma; Kimble, Roy M; Cuttle, Leila; Stockton, Kellie
2013-11-25
In the paediatric population, pain and distress associated with burn injuries during wound care procedures remain a constant challenge. Although silver dressings are the gold standard for burn care in Australasia, very few high-level trials have been conducted that compare silver dressings to determine which will provide the best level of care clinically. Therefore, for paediatric patients in particular, identifying silver dressings that are associated with lower levels of pain and rapid wound re-epithelialisation is imperative. This study will determine whether there is a difference in time to re-epithelialisation and pain and distress experienced during wound care procedures among Acticoat™, Acticoat™ combined with Mepitel™ and Mepilex Ag™ dressings for acute, paediatric partial thickness burns. Children aged 0 to 15 years with an acute partial thickness (superficial partial to deep partial thickness inclusive) burn injury and a burn total body surface area of ≤ 10% will be eligible for the trial. Patients will be randomised to one of the three dressing groups: (1) Acticoat™ or (2) Acticoat™ combined with Mepitel™ or (3) Mepilex Ag™. A minimum of 28 participants will be recruited for each treatment group. Primary measures of pain, distress and healing will be repeated at each dressing change until complete wound re-epithelialisation occurs or skin grafting is required. Additional data collected will include infection status at each dressing change, physical function, scar outcome and scar management requirements, cost effectiveness of each dressing and staff perspectives of the dressings. The results of this study will determine the effects of three commonly used silver and silicone burn dressing combinations on the rate of wound re-epithelialisation and pain experienced during dressing procedures in acute, paediatric partial thickness burn injuries. Australian New Zealand Clinical Trials Registry ACTRN12613000105741.
Prospective randomized controlled trial: fibrin sealant reduces split skin graft donor-site pain.
Healy, Ciaran; Greig, Aina V H; Murphy, Adrian D; Powell, Christopher; Pinder, Richard J; Saour, Samer; Abela, Christopher; Knight, William; Geh, Jenny L C
2013-07-01
Pain at split skin graft donor sites is common. Fibrin sealant has been demonstrated to reduce time to hemostasis at wound sites, and patients receiving this treatment were incidentally noted to report less pain. This study aimed to evaluate pain and incapacity in split skin graft donor sites treated with and without fibrin sealant. Fifty patients requiring thigh donor-site split skin grafts were prospectively randomized to receive either a self-adhesive fabric dressing alone or fibrin sealant plus the self-adhesive fabric dressing as primary donor-site dressings. External secondary dressings were the same. Patients were blinded with regard to treatment group. Using visual analogue scales (scored 0 to 5), patients rated their donor-site pain and incapacity for 14 days postoperatively. Secondary endpoints were length of hospital stay and duration of requirement for dressings. Forty patients were included in the study analysis and completed self-reported pain and incapacity scores. Twenty received the fibrin sealant plus self-adhesive fabric dressing and 20 received the fabric dressing only (controls). Patients using the fibrin sealant plus the dressing reported significantly less pain (mean score, 0.42 versus 1.60, p < 0.001) and significantly less incapacity (mean score, 0.48 versus 1.71, p < 0.001). Patients allocated to the fibrin sealant group recorded shorter lengths of stay and faster time to discontinuation of dressing, though statistical significance was not achieved. Patients whose split skin graft donor sites were dressed with fibrin sealant plus self-adhesive fabric dressing experienced significantly less pain and incapacity than patients with self-adhesive fabric dressings alone, allowing a more rapid return to normal activity. Therapeutic, II.
Klode, J; Schöttler, L; Stoffels, I; Körber, A; Schadendorf, D; Dissemond, J
2011-08-01
In the process of chronic wound care, adhesive wound dressings may cause pain and injury in the wound environment during dressing changes. At present, no standardized test procedures are available for the investigation of adhesion of wound dressings. Therefore, our study aimed to test the adhesion of different wound dressings on steel as well as on healthy skin. Within an open, comparative study, the adhesive areas of 56 wound dressings were investigated. The adhesives were categorized into acrylate (n = 23), silicone (n = 9), hydrocolloid (n = 17) and polyurethane groups (n = 7). Using an especially modified testing machine, the adhesion of the wound dressings was measured on steel as well as on the skin of healthy study participants, in compliance with the European EN 1939:2003 standard. The energy required to remove the wound dressings from human skin, was measured in Newton (N) and the following median values were obtained: hydrocolloid (2.25 N) > acrylate (1.14 N) > polyurethane (0.9 N) > silicone (0.7 N). The subjective pain intensity during the removal of the wound dressings was recorded using the visual analogue scale (VAS) with values ranging from 0 to 10. For hydrocolloid, it was 6.8, for acrylate 4.9, for polyurethane 3.1 and for silicone 2.5 points VAS. In comparison with human skin, the adhesion of wound dressings was significantly higher on steel (P < 0.0001), but was different for the different groups of wound dressings. Moreover, there was a statistically significant correlation between the adhesion and pain intensity (correlation coefficient 0.806; P = 0.01). The knowledge about the widely differing adhesion properties of different wound dressings on the skin of patients should nowadays be considered during the individual selection of the applied products. Based on these data, different types of wound dressings could be developed, guaranteeing a good adhesion and a low traumatic risk when removed. © 2010 The Authors. Journal of the European Academy of Dermatology and Venereology © 2010 European Academy of Dermatology and Venereology.
Renda, Francesca; Landoni, Giovanni; Bertini Malgarini, Renato; Assisi, Alessandro; Azzolini, Maria Luisa; Mucchetti, Marta; Pimpinella, Giuseppe; Pani, Luca
2015-12-01
Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare, severe and potentially fatal cutaneous adverse drug reaction (the mortality rate is up to 10 %) associated with numerous and apparently heterogeneous drugs. The aetiology is unknown. To report Italian cases of DRESS over a 10-year period. We searched the National Pharmacovigilance Network (NPN) for the term 'drug reaction with eosinophilia and systemic symptoms' from 1 January 2004 to 1 January 2014, to identify all reports of DRESS. Each case was checked to avoid duplication. In the NPN, we identified 91 serious cases of DRESS: 68 were spontaneous, still-unpublished reports, while 23 additional cases were derived from screening of the scientific literature, performed by marketing authorization holders. Notably, the single common element linking all cases of DRESS was intake of a drug containing an aromatic ring. Thanks to the largest national DRESS case series ever reported, we were able to hypothesize, for the first time, that there is an association between use of drugs containing an aromatic ring in their chemical structure and DRESS. This might aid understanding of the aetiology of DRESS and facilitate diagnosis.
NASA Astrophysics Data System (ADS)
Wei, Qilin; Xu, Feiyang; Xu, Xingjian; Geng, Xue; Ye, Lin; Zhang, Aiying; Feng, Zengguo
2016-06-01
The non-woven wound dressing with core-shell structured fibers was prepared by coaxial electrospinning. The polycaprolactone (PCL) was electrospun as the fiber's core to provide mechanical strength whereas collagen was fabricated into the shell in order to utilize its good biocompatibility. Simultaneously, the silver nanoparticles (Ag-NPs) as anti-bacterial agent were loaded in the shell whereas the vitamin A palmitate (VA) as healing-promoting drug was encapsulated in the core. Resulting from the fiber's core-shell structure, the VA released from the core and Ag-NPs present in the shell can endow the dressing both heal-promoting and anti-bacteria ability simultaneously, which can greatly enhance the dressing's clinical therapeutic effect. The dressing can maintain high swelling ratio of 190% for 3 d indicating its potential application as wet dressing. Furthermore, the dressing's anti-bacteria ability against Staphylococcus aureus was proved by in vitro anti-bacteria test. The in vitro drug release test showed the sustainable release of VA within 72 h, while the cell attachment showed L929 cells can well attach on the dressing indicating its good biocompatibility. In conclusion, the fabricated nanofibrous dressing possesses multiple functions to benefit wound healing and shows promising potential for clinical application.
Imran, Muhammad; Hussain, Muhammad Barkaat; Baig, Mukhtiar
2015-10-01
To investigate the effect of Beri-honey-impregnated dressing on diabetic foot ulcer and compare it with normal saline dressing. A randomized, controlled trial. Sughra Shafi Medical Complex, Narowal, Pakistan and Bhatti International Trust (BIT) Hospital, Affiliated with Central Park Medical College, Lahore, from February 2006 to February 2010. Patients with Wagner's grade 1 and 2 ulcers were enrolled. Those patients were divided in two groups; group A (n=179) treated with honey dressing and group B (n=169) treated with normal saline dressing. Outcome measures were calculated in terms of proportion of wounds completely healed (primary outcome), wound healing time, and deterioration of wounds. Patients were followed-up for a maximum of 120 days. One hundred and thirty six wounds (75.97%) out of 179 were completely healed with honey dressing and 97 (57.39%) out of 169 wtih saline dressing (p=0.001). The median wound healing time was 18.00 (6 - 120) days (Median with IQR) in group A and 29.00 (7 - 120) days (Median with IQR) in group B (p < 0.001). The present results showed that honey is an effective dressing agent instead of conventional dressings, in treating patients of diabetic foot ulcer.
21 CFR 169.150 - Salad dressing.
Code of Federal Regulations, 2010 CFR
2010-04-01
... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Salad dressing. 169.150 Section 169.150 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION FOOD DRESSINGS AND FLAVORINGS Requirements for Specific Standardized Food Dressings and Flavorings...
21 CFR 878.4020 - Occlusive wound dressing.
Code of Federal Regulations, 2011 CFR
2011-04-01
... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Occlusive wound dressing. 878.4020 Section 878...) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4020 Occlusive wound dressing. (a) Identification. An occlusive wound dressing is a nonresorbable, sterile or non-sterile device...
21 CFR 878.4020 - Occlusive wound dressing.
Code of Federal Regulations, 2010 CFR
2010-04-01
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Occlusive wound dressing. 878.4020 Section 878...) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4020 Occlusive wound dressing. (a) Identification. An occlusive wound dressing is a nonresorbable, sterile or non-sterile device...
21 CFR 169.115 - French dressing.
Code of Federal Regulations, 2011 CFR
2011-04-01
... 21 Food and Drugs 2 2011-04-01 2011-04-01 false French dressing. 169.115 Section 169.115 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION FOOD DRESSINGS AND FLAVORINGS Requirements for Specific Standardized Food Dressings and Flavorings...
21 CFR 169.150 - Salad dressing.
Code of Federal Regulations, 2011 CFR
2011-04-01
... 21 Food and Drugs 2 2011-04-01 2011-04-01 false Salad dressing. 169.150 Section 169.150 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION FOOD DRESSINGS AND FLAVORINGS Requirements for Specific Standardized Food Dressings and Flavorings...
ERIC Educational Resources Information Center
Dulin, Charles Dewitt
2016-01-01
The purpose of this research is to evaluate the impact of uniform dress codes on a school's climate for student behavior and learning in four middle schools in North Carolina. The research will compare the perceptions of parents, teachers, and administrators in schools with uniform dress codes against schools without uniform dress codes. This…
Verbelen, Jozef; Hoeksema, Henk; Heyneman, Alexander; Pirayesh, Ali; Monstrey, Stan
2014-05-01
Studies comparing contemporary silver dressings in burns are scarce. In a prospective, randomized, controlled study, counting 50 patients/research group, we compared two frequently used silver dressings, Acticoat™ and Aquacel(®) Ag, in the management of partial thickness burns with a predicted healing time between 7 and 21 days as assessed by laser Doppler imaging between 48 and 72h after burn. Variables investigated were related to baseline research group characteristics, wound healing, bacteriology, economics, nurse, and patient experience. Both research groups were comparably composed taking into account gender, age and burn characteristics. Similar results were obtained as to healing time and bacterial control with both silver dressings. A statistically significant difference in favor of the Aquacel(®) Ag dressing was found for average ease of use (p<0.001), average ease of application (p=0.001), patient pain (p<0.001), patient comfort with the dressing (p=0.017), silver staining (p<0.001), and cost effectiveness (p<0.001). Both silver dressings resulted in comparable healing times and bacterial control but the Aquacel(®) Ag dressing significantly increased comfort for patients as well as nurses and was significantly more cost-effective than the Acticoat™ dressing for the given indication. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.
Davis, Stephen C; Li, Jie; Gil, Joel; Valdes, Jose; Solis, Michael; Higa, Alex; Bowler, Philip
2018-06-11
Topical antimicrobials are widely used to control wound bioburden and facilitate wound healing; however, the fine balance between antimicrobial efficacy and non-toxicity must be achieved. This study evaluated whether an anti-biofilm silver-containing wound dressing interfered with the normal healing process in non-contaminated deep partial thickness wounds. In an in-vivo porcine wound model using 2 pigs, 96 wounds were randomly assigned to 1 of 3 dressing groups: anti-biofilm silver Hydrofiber dressing (test), silver Hydrofiber dressing (control), or polyurethane film dressing (control). Wounds were investigated for 8 days, and wound biopsies (n = 4) were taken from each dressing group, per animal, on days 2, 4, 6, and 8 after wounding and evaluated using light microscopy. No statistically significant differences were observed in the rate of reepithelialisation, white blood cell infiltration, angiogenesis, or granulation tissue formation following application of the anti-biofilm silver Hydrofiber dressing versus the 2 control dressings. Overall, epithelial thickness was similar between groups. Some differences in infiltration of specific cell types were observed between groups. There were no signs of tissue necrosis, fibrosis, or fatty infiltration in any group. An anti-biofilm silver Hydrofiber wound dressing did not cause any notable interference with normal healing processes. © 2018 Medicalhelplines.com Inc and John Wiley & Sons Ltd.
21 CFR 878.4018 - Hydrophilic wound dressing.
Code of Federal Regulations, 2011 CFR
2011-04-01
... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Hydrophilic wound dressing. 878.4018 Section 878...) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4018 Hydrophilic wound dressing. (a) Identification. A hydrophilic wound dressing is a sterile or non-sterile device intended to cover...
21 CFR 878.4018 - Hydrophilic wound dressing.
Code of Federal Regulations, 2010 CFR
2010-04-01
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hydrophilic wound dressing. 878.4018 Section 878...) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4018 Hydrophilic wound dressing. (a) Identification. A hydrophilic wound dressing is a sterile or non-sterile device intended to cover...
Rationale for Student Dress Codes: A Review of School Handbooks
ERIC Educational Resources Information Center
Freeburg, Elizabeth W.; Workman, Jane E.; Lentz-Hees, Elizabeth S.
2004-01-01
Through dress codes, schools establish rules governing student appearance. This study examined stated rationales for dress and appearance codes in secondary school handbooks; 182 handbooks were received. Of 150 handbooks containing a rationale, 117 related dress and appearance regulations to students' right to a non-disruptive educational…
21 CFR 878.4022 - Hydrogel wound dressing and burn dressing.
Code of Federal Regulations, 2014 CFR
2014-04-01
... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Hydrogel wound dressing and burn dressing. 878.4022 Section 878.4022 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4022...
21 CFR 878.4022 - Hydrogel wound dressing and burn dressing.
Code of Federal Regulations, 2013 CFR
2013-04-01
... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Hydrogel wound dressing and burn dressing. 878.4022 Section 878.4022 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4022...
21 CFR 878.4022 - Hydrogel wound dressing and burn dressing.
Code of Federal Regulations, 2012 CFR
2012-04-01
... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Hydrogel wound dressing and burn dressing. 878.4022 Section 878.4022 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4022...
Colloidal silver-based nanogel as nonocclusive dressing for multiple superficial pellet wounds.
Dharmshaktu, Ganesh Singh; Singhal, Aanshu; Pangtey, Tanuja
2016-01-01
A good dressing is mandatory to an uncomplicated wound healing, especially when foreign particles contaminate the wound. Various forms of dressing preparations are available for use and differ in chemical composition and efficacy. Silver has been a known agent with good antimicrobial and healing properties and recent times has seen an upsurge in various silver-based dressing supplements. We describe our report of use and efficacy of a silver nanoparticle- based gel dressing in the healing of multiple superficial firearm pellet wounds.
Self adhesive dressing pouch for the protection of catheters.
de la Cruz Martínez, Maria Teresa; Hernández, María José
2002-01-01
This paper is about a new model of dressing, used for the protection of all types of temporary and permanent catheters. Those who developed this dressing realised the practical difficulties during the placement and removal of traditional dressings, used in haemodialysis units. They also realised that it this was unpleasant for the patients, and there was a risk to the catheters when removing the dressings because of the use of scissors and other cutting instruments. This new dressing solves these previously mentioned problems and at the same time contributes to the comfort of the patients. The model has been registered as a standard using model, and therefore it is protected by law and its copyright (Intellectual Property).
Tunable electromagnetically induced transparency and absorption with dressed superconducting qubits
NASA Astrophysics Data System (ADS)
Ian, Hou; Liu, Yu-Xi; Nori, Franco
2010-06-01
Electromagnetically induced transparency and absorption (EIT and EIA) are usually demonstrated using three-level atomic systems. In contrast to the usual case, we theoretically study the EIT and EIA in an equivalent three-level system: a superconducting two-level system (qubit) dressed by a single-mode cavity field. In this equivalent system, we find that both the EIT and the EIA can be tuned by controlling the level-spacing of the superconducting qubit and hence controlling the dressed system. This tunability is due to the dressed relaxation and dephasing rates which vary parametrically with the level-spacing of the original qubit and thus affect the transition properties of the dressed qubit and the susceptibility. These dressed relaxation and dephasing rates characterize the reaction of the dressed qubit to an incident probe field. Using recent experimental data on superconducting qubits (charge, phase, and flux qubits) to demonstrate our approach, we show the possibility of experimentally realizing this proposal.
Childress, Beverly B; Berceli, Scott A; Nelson, Peter R; Lee, W Anthony; Ozaki, C Keith
2007-09-01
Surgical wounds for lower extremity revascularization are prone to infection and dehiscence. Acticoat Absorbent, an antimicrobial dressing, offers sustained release of ionic silver. We hypothesized that immediate application of Acticoat as a postoperative dressing would reduce wound complications in patients undergoing leg revascularization. All infrainguinal revascularization cases involving leg incisions at a single Veterans Administration Medical Center were identified from July 1, 2002, to September 30, 2005. The control group received conventional dressings, while the treatment group received an Acticoat dressing. Wound complication rates were captured via National Surgical Quality Improvement Program data. Patient characteristics and procedure distributions were similar between groups. The wound complication rate fell 64% with utilization of the Acticoat-based dressing (control 14% [17/118], treatment 5% [7/130]; P = 0.016). An Acticoat-based dressing system offers a potentially useful, cost-effective adjunct to reduce open surgical leg revascularization wound complications.
School Dress Codes v. The First Amendment: Ganging up on Student Attire.
ERIC Educational Resources Information Center
Jahn, Karon L.
Do school dress codes written with the specific purpose of limiting individual dress preferences, including dress associated with gangs, infringe on speech freedoms granted by the First Amendment of the U.S. Constitution? Although the Supreme Court has extended its protection of political speech to nonverbal acts of communication, it has…
Dressing of Cognitively Impaired Nursing Home Residents: Description and Analysis
ERIC Educational Resources Information Center
Cohen-Mansfield, Jiska; Creedon, Michael A.; Malone, Thomas; Parpura-Gill, Aleksandra; Dakheel-Ali, Maha; Heasly, Christopher
2006-01-01
Purpose: Getting dressed is an activity that is of particular difficulty for many persons with dementia, given the need for hand-eye coordination, fine motor skills, and overall planning skills. Despite several studies concerning interventions to improve dressing behavior, very little is known about the dressing process as it is currently…
Insights on Flow Behavior of Foam in Unsaturated Porous Media during Soil Flushing.
Zhao, Yong S; Su, Yan; Lian, Jing R; Wang, He F; Li, Lu L; Qin, Chuan Y
2016-11-01
One-dimensional column and two-dimensional tank experiments were carried out to determine (1) the physics of foam flow and propagation of foaming gas, foaming liquid, and foam; (2) the pressure distribution along foam flow and the effect of media permeability, foam flow rate and foam quality on foam injection pressure; and (3) the migration and distribution property of foam flow in homogeneous and heterogeneous sediments. The results demonstrated that: (1) gas and liquid front were formed ahead of the foam flow front, the transport speed order is foaming gas > foaming liquid > foam flowing; (2) injection pressure mainly comes from the resistance to bubble migration. Effect of media permeability on foam injection pressure mainly depends on the physics and behavior of foam flow; (3) foam has a stronger capacity of lateral spreading, besides, foam flow was uniformly distributed across the foam-occupied region, regardless of the heterogeneity of porous media.
Women in relationships with cross-dressing men: a descriptive study from a nonclinical setting.
Brown, G R
1994-10-01
Over a 6-year period, 106 women involved with men who cross-dress (mostly heterosexual transvestites) completed a questionnaire regarding themselves, their male partners, and their relationships. Interview data supplemented these questionnaires for 75% of the respondents. All respondents were recruited from nonclinical settings. The "modal" female partner was a 40-year-old Protestant, Caucasian woman, who was a firstborn child, in her first marriage. She was more likely than other women her age to be childless, and to have earned at least a 2-year college degree. She was no more likely to have had lesbian experiences or substance use problems than comparably aged American women. She had been married to her cross-dressing mate for 13 years and had known of his activities for 9 years. A quarter of women reported at least occasional sexual arousal to their mate's cross-dressing. The two variables associated with low acceptance of cross-dressing were discovery of their partner's cross-dressing after marriage and lack of sexual arousal to cross-dressing stimuli. Low acceptance was unrelated to firstborn status, amount of exposure to cross-dressing activities, or having had children. This group may be more representative of women in relationships with cross-dressing men than previous reports limited to cross-dressers and spouses who are in treatment.
Umbilical Negative Pressure Dressing for Transumbilical Appendectomy in Childern.
Seifarth, Federico G; Kundu, Neilendu; Guerron, Alfredo D; Garland, Mary M; Gaffley, Michaela W G; Worley, Sarah; Knight, Colin G
2016-01-01
Transumbilical laparoscopic-assisted appendectomy (TULAA) carries a high risk for surgical site infection. We investigated the effect of a bio-occlusive umbilical vacuum dressing on wound infection rates after TULAA for patients with acute appendicitis and compared to it with a conventional 3-port appendectomy with a nonvacuum dressing. This study was a retrospective chart review of 1377 patients (2-20 years) undergoing laparoscopic appendectomy for acute appendicitis in 2 tertiary care referral centers from January 2007 through December 2012. Twenty-two different operative technique/dressing variations were documented. The 6 technique/dressing groups with >50 patients were assessed, including a total of 1283 patients. The surgical site infection rate of the 220 patients treated with TULAA and application of an umbilical vacuum dressing with dry gauze is 1.8% (95% CI, 0.0-10.3%). This compares to an infection rate of 4.1% (95% CI, 1.3-10.5%) in 97 patients with dry dressing without vacuum. In the 395 patients who received an umbilical vacuum dressing with gauze and bacitracin, the surgical site infection rate was found to be 4.3% (95% CI, 2.7-6.8%). Application of an umbilical negative-pressure dressing with dry gauze lowers the rate of umbilical site infections in patients undergoing transumbilical laparoscopic-assisted appendectomy for acute appendicitis.
Human neutrophil elastase and collagenase sequestration with phosphorylated cotton wound dressings.
Edwards, J Vincent; Howley, Phyllis S
2007-11-01
The design and preparation of wound dressings that redress the protease imbalance in chronic wounds is an important goal of wound healing and medical materials science. Chronic wounds contain high levels of tissue and cytokine-destroying proteases including matrix metalloprotease and neutrophil elastase. Thus, the lowering of excessive protease levels in the wound environment by wound dressing sequestration prevents the breakdown of extracellular matrix proteins and growth factors necessary for wound healing. Phosphorylated cotton wound dressings were prepared to target sequestration of proteases from chronic wound exudate through a cationic uptake binding mechanism involving salt bridge formation of the positively charged amino acid side chains of proteases with the phosphate counterions of the wound dressing fiber. Dressings were prepared by applying sodium hexametaphosphate and diammonium phosphate in separate formulations to cotton gauze by pad/dry/cure methods. Phosphorylated cotton dressings were assessed for their ability to lower elastase and collagenase activity. The phosphorylated cotton dressings lowered elastase and collagenase activity 40-80% more effectively than the untreated cotton wound dressings under conditions that mimic chronic wound exudate. Efficacy of the phosphorylated cotton was found to be related to the level of phosphorylation and a lower pH due to protonated phosphate at the surface of the dressing. The capacity of the modified gauze to sequester continued elastase secretions similar to that found in a chronic wound over a 24-h period was retained within a 80% retention of elastase sequestration and was dose-dependent. Copyright (c) 2007 Wiley Periodicals, Inc.
Enhanced wound contraction in fresh wounds dressed with honey in Wistar rats (Rattus Novergicus).
Osuagwu, F C; Oladejo, O W; Imosemi, I O; Aiku, A; Ekpos, O E; Salami, A A; Oyedele, O O; Akang, E U
2004-01-01
Due to reports that honey accelerates wound healing, an investigation on its role in wound contraction in fresh wounds inflicted on wistar rats was carried out. Twenty adult male wistar rats had 2cm by 2cm square wound inflicted on their right dorsolateral trunk. They were divided into two groups. The experimental group had their wounds dressed with honey while the control group had normal saline dressing. Wound dressing was done every five days and measurements taken at each dressing. Wound morphology was also assessed. Dressing with honey significantly enhanced percentage wound contraction on day 10 with value of 79.20+/-2.94 compared to control value of 53.50+/-4.32. p=0.0. The mean wound measurement on day 10 reduced significantly in honey group, 1.15+/-0.18 compared to control group 2.38+/-0.28. p=0.002. However, there was no significant difference in fibroblast count per high power field in honey group 68.0+/-2.59 compared to control 90.2+/-17.40, p=0.242. Honey dressing increased mean blood vessel count per high power field, 18.8+/-3.77 albeit non significantly when compared to control value of 13.4+/-2.44, p=0.264. Also honey dressing caused increased granulation tissue formation in wounds dressed with honey compared to control group. Our study suggests that honey dressing enhances wound contraction in fresh wounds which is one of the key features of wound healing.
Processing parameter optimization for the laser dressing of bronze-bonded diamond wheels
NASA Astrophysics Data System (ADS)
Deng, H.; Chen, G. Y.; Zhou, C.; Li, S. C.; Zhang, M. J.
2014-01-01
In this paper, a pulsed fiber-laser dressing method for bronze-bonded diamond wheels was studied systematically and comprehensively. The mechanisms for the laser dressing of bronze-bonded diamond wheels were theoretically analyzed, and the key processing parameters that determine the results of laser dressing, including the laser power density, pulse overlap ratio, ablation track line overlap ratio, and number of scanning cycles, were proposed for the first time. Further, the effects of these four key parameters on the oxidation-damaged layer of the material surface, the material removal efficiency, the material surface roughness, and the average protrusion height of the diamond grains were explored and summarized through pulsed laser ablation experiments. Under the current experimental conditions, the ideal values of the laser power density, pulse overlap ratio, ablation track line overlap ratio, and number of scanning cycles were determined to be 4.2 × 107 W/cm2, 30%, 30%, and 16, respectively. Pulsed laser dressing experiments were conducted on bronze-bonded diamond wheels using the optimized processing parameters; next, both the normal and tangential grinding forces produced by the dressed grinding wheel were measured while grinding alumina ceramic materials. The results revealed that the normal and tangential grinding forces produced by the laser-dressed grinding wheel during grinding were smaller than those of grinding wheels dressed using the conventional mechanical method, indicating that the pulsed laser dressing technology provides irreplaceable advantages relative to the conventional mechanical dressing method.
Siritientong, Tippawan; Angspatt, Apichai; Ratanavaraporn, Juthamas; Aramwit, Pornanong
2014-01-01
An ethyl alcohol-precipitated silk sericin/PVA scaffold that controlled the release of silk sericin was previously developed and applied for the treatment of full-thickness wounds in rats and demonstrated efficient healing. In this study, we aimed to further evaluate the clinical potential of this scaffold, hereafter called "silk sericin-releasing wound dressing", for the treatment of split-thickness skin graft donor sites by comparison with the clinically available wound dressing known as "Bactigras®". In vitro characterization and in vivo evaluation for safety of the wound dressings were performed. A clinical trial of the wound dressings was conducted according to standard protocols. The sericin released from the wound dressing was not toxic to HaCat human keratinocytes. A peel test indicated that the silk sericin-releasing wound dressing was less adhesive than Bactigras®, potentially reducing trauma and the risk of repeated injury upon removal. There was no evidence of skin irritation upon treatment with either wound dressing. When tested in patients with split-thickness skin graft donor sites, the wounds treated with the silk sericin-releasing wound dressing exhibited complete healing at 12 ± 5.0 days, whereas those treated with Bactigras® were completely healed at 14 ± 5.2 days (p = 1.99 × 10(-4)). In addition, treatment with the silk sericin-releasing wound dressing significantly reduced pain compared with Bactigras® particularly during the first 4 postoperative days (p = 2.70 × 10(-5) on day 1). We introduce this novel silk sericin-releasing wound dressing as an alternative treatment for split-thickness skin graft donor sites.
A model for quantitative evaluation of skin damage at adhesive wound dressing removal.
Matsumura, Hajime; Ahmatjan, Niyaz; Ida, Yukiko; Imai, Ryutaro; Wanatabe, Katsueki
2013-06-01
The removal of adhesive wound dressings from the wound surface involves a risk of damaging the intact stratum corneum and regenerating epithelium. Pain associated with the removal of wound dressings is a major issue for patients and medical personnel. Recently, wound dressings coated with a silicone adhesive have been developed to reduce such skin damage and pain on removal and they have received good evaluation in various clinical settings. However, there is neither a standard method to quantify whether or not the integrity of the stratum corneum and regenerating epithelium is retained or if both structures are damaged by the removal of wound dressings, nor are there standardised values with which to assess skin damage. We applied six different types of adhesive wound dressing on plain copy paper printed with black ink by a laser printer, removed the dressings, examined the adhesive-coated surface of the wound dressings using a high-power videoscope, and examined the stripped areas. Wound dressings coated with a silicone adhesive showed significantly less detachment of the stratum corneum and regenerating epithelium, followed by those coated with polyurethane, hydrocolloid, and acrylic adhesives. The assessment method utilised in this study revealed distinct differences between wound dressing types, but less variation in the evaluation outcome of each type. This assessment method may be useful for the evaluation of adhesive wound dressings, particularly during product development. However, further studies will be needed to examine the effectiveness of this assessment method in the clinical setting because the adherent properties of polyurethane and hydrocolloid adhesives may be altered by the absorption of water from the skin. © 2012 The Authors. International Wound Journal © 2012 John Wiley & Sons Ltd and Medicalhelplines.com Inc.
Role of natural polysaccharides in radiation formation of PVA hydrogel wound dressing
NASA Astrophysics Data System (ADS)
Varshney, Lalit
2007-02-01
Radiation processed PVA-polysaccharides hydrogels have been observed to be suitable for producing transparent, flexible, mechanically strong, biocompatible, effective and economical hydrogel dressings. The dressings were formed in single stage irradiation process achieving gel formation and sterilization at 25-30 kGy gamma radiation dose. No synthetic plasticizers and additives were used. Different formulations containing poly-vinylalcohol (PVA) and polysaccharides selected from combinations of agar and carrageenan were used to make the dressings. The selected polysaccharides themselves form thermo-reversible gels and degrade on irradiation. Using concentration of polysaccharides as low as 0.5-2% resulted in increase of tensile strength from 45 g/cm 2 to 411 g/cm 2, elongation from 30% to 410% and water uptake from 25% to 157% with respect to PVA gel without polysaccharides. Besides improving mechanical strength, agar contributes more to elongation and carrageenan to mechanical strength of the gel dressing. PVA formulations containing the polysaccharides show significantly different pre-gel viscosities behaviour. Increasing the concentration of agar in the formulation to about 2% converts the sheet gel to paste gel useful for filling wound cavities. The results indicate that pre irradiation network structure of the formulation plays an important role in determining mechanical properties of the irradiated gel dressing. Formulations containing 7-9% PVA, 0.5-1.5% carrageenan and 0.5-1% agar gave highly effective usable hydrogel dressings. Scanning electron micrographs show highly porous structure of the gel. Clinical trials of wound dressing on human patients established safety and efficacy of the dressing. The dressing has been observed to be useful in treating burns, non-healing ulcers of diabetes, leprosy and other external wounds. The dressings are now being marketed in India under different brand names.
Kleidon, Tricia M; Ullman, Amanda J; Gibson, Victoria; Chaseling, Brett; Schoutrop, Jason; Mihala, Gabor; Rickard, Claire M
2017-11-01
To evaluate feasibility of an efficacy trial comparing peripherally inserted central catheter (PICC) dressing and securement techniques to prevent complications and failure. This pilot, 3-armed, randomized controlled trial was undertaken at Royal Children's Hospital and Lady Cilento Children's Hospital, Brisbane, Australia, between April 2014 and September 2015. Pediatric participants (N = 101; age range, 0-18 y) were assigned to standard care (bordered polyurethane [BPU] dressing, sutureless securement device), tissue adhesive (TA) (plus BPU dressing), or integrated securement dressings (ISDs). Average PICC dwell time was 8.1 days (range, 0.2-27.7 d). Primary outcome was trial feasibility including PICC failure. Secondary outcomes were PICC complications, dressing performance, and parent and staff satisfaction. Protocol feasibility was established. PICC failure was 6% (2/32) with standard care, 6% (2/31) with ISD, and 3% (1/32) with TA. PICC complications were 16% across all groups. TA provided immediate postoperative hemostasis, prolonging the first dressing change until 5.5 days compared with 3.5 days and 2.5 days with standard care and ISD respectively. Bleeding was the most common reason for first dressing change: standard care (n = 18; 75%), ISD (n = 11; 69%), TA (n = 4; 27%). Parental satisfaction (median 9.7/10; P = .006) and staff feedback (9.2/10; P = .002) were most positive for ISD. This research suggests safety and acceptability of different securement dressings compared with standard care; securement dressings may also reduce dressing changes after insertion. Further research is required to confirm clinically cost-effective methods to prevent PICC failure. Copyright © 2017 SIR. Published by Elsevier Inc. All rights reserved.
2013-01-01
Background In the paediatric population, pain and distress associated with burn injuries during wound care procedures remain a constant challenge. Although silver dressings are the gold standard for burn care in Australasia, very few high-level trials have been conducted that compare silver dressings to determine which will provide the best level of care clinically. Therefore, for paediatric patients in particular, identifying silver dressings that are associated with lower levels of pain and rapid wound re-epithelialisation is imperative. This study will determine whether there is a difference in time to re-epithelialisation and pain and distress experienced during wound care procedures among Acticoat™, Acticoat™ combined with Mepitel™ and Mepilex Ag™ dressings for acute, paediatric partial thickness burns. Methods/Design Children aged 0 to 15 years with an acute partial thickness (superficial partial to deep partial thickness inclusive) burn injury and a burn total body surface area of ≤10% will be eligible for the trial. Patients will be randomised to one of the three dressing groups: (1) Acticoat™ or (2) Acticoat™ combined with Mepitel™ or (3) Mepilex Ag™. A minimum of 28 participants will be recruited for each treatment group. Primary measures of pain, distress and healing will be repeated at each dressing change until complete wound re-epithelialisation occurs or skin grafting is required. Additional data collected will include infection status at each dressing change, physical function, scar outcome and scar management requirements, cost effectiveness of each dressing and staff perspectives of the dressings. Discussion The results of this study will determine the effects of three commonly used silver and silicone burn dressing combinations on the rate of wound re-epithelialisation and pain experienced during dressing procedures in acute, paediatric partial thickness burn injuries. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12613000105741 PMID:24274190
Choi, Young Suk; Gwak, Heui-Chul; Park, Jae Keun; Lim, Ji Yun; Yeo, Eui Dong; Park, Eunseok; Kim, Junyong; Lee, Young Koo
2018-04-13
Silver nanoparticle (AgNP)-containing dressings are used worldwide for the treatment of wounds; however, many studies have indicated that AgNPs are toxic to humans and cause cell death, primarily via apoptosis. In this study, the investigators compare the apoptotic effects of various AgNP dressing materials, with the hypothesis that nanosilver would be less toxic than ionic silver. For the in vivo experiments, Sprague-Dawley (SD) and streptozotocin (STZ)-induced diabetic rats were treated with 5 dressing materials: Aquacel Ag (product A, silver ion; ConvaTec, Berkshire, UK), Acticoat (product B, AgNP; Smith & Nephew, Fort Worth, TX), Medifoam Silver (product C, silver ion; Genewel Science Co Ltd, Seongnam, South Korea), PolyMem Silver (product D, AgNP; Ferris Mfg Corp, Fort Worth, TX), and Vaseline-impregnated dressing gauze (control; Unilever, London, UK). All treatments were applied 3 times per week. After 14 days of treatment, the SD and STZ rats were euthanized, and wound samples were examined for apoptosis. The analysis included immunohistochemistry, terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining, Western blotting, and reverse transcription polymerase chain reaction for a semiquantitative evaluation of apoptosis. The AgNP-containing dressing materials were more cytotoxic than the silver dressings. Compared with the AgNP dressing materials, no significant levels of apoptotic factors were observed in the silver dressing-treated wounds. The TUNEL staining showed that product C-dressed wounds contained the most apoptotic cells, while some apoptotic cells were observed in product B-dressed wounds. Moreover, apoptotic gene expression was altered, including a decline in B-cell lymphoma-2 and activation of caspase-3. This was most evident in wounds treated with product C. Interestingly, apoptotic gene expression was not induced in product A-treated wounds. Finally, product D had a relatively lower silver concentration and was less toxic than products A-C. Dressing materials containing AgNP have an antimicrobial effect. However, the authors observed that some AgNP dressings induced DNA damage and apoptosis. Although AgNP dressings did not cause significant acute apoptotic effects, they should be examined for cytotoxic effects in chronic wounds and should be used with caution when treating chronic wounds and those with low bacteria counts.
USDA-ARS?s Scientific Manuscript database
Understanding how wound dressings may be designed to address critical unsolved issues in wound repair and treatment influences the development of dressings and new concepts of promoting healing. The vast majority of commercial dressing materials focus on the physical aspects of wounds, e.g., acting ...
School Dress Codes and Uniform Policies.
ERIC Educational Resources Information Center
Anderson, Wendell
2002-01-01
Opinions abound on what students should wear to class. Some see student dress as a safety issue; others see it as a student-rights issue. The issue of dress codes and uniform policies has been tackled in the classroom, the boardroom, and the courtroom. This Policy Report examines the whole fabric of the debate on dress codes and uniform policies…
NASA Astrophysics Data System (ADS)
Li, Xinghua; Zhang, Dan; Sun, Ming; Li, Kangkang; Wang, Zhiguo; Zhang, Yanpeng
2018-04-01
We study different dressing effects in parametrically amplified four-wave mixing (PA-FWM) processes. By seeding a weak probe laser into the Stokes or anti-Stokes channel of the FWM, the gain process is generated in the so-called bright twin beams which are the probe and conjugate beams. The dressing types dramatically affect the gain factors in both the probe and conjugate channels. The gain factor of the FWM signal decreases under the cascade-type dressing and the signal's shape splits into two dips under this dressing type. However, the intensity of the FWM signal changes from suppression to enhancement under the parallel-type dressing. We will apply this switching process to all-optical switching.
Overview of Silk Fibroin Use in Wound Dressings.
Farokhi, Mehdi; Mottaghitalab, Fatemeh; Fatahi, Yousef; Khademhosseini, Ali; Kaplan, David L
2018-05-12
Recently, biomimetic wound dressings were introduced as potential replacements for treating skin injuries. Although there are some clinically available skin replacements, the range of wound types and locations necessitates a broader range of options for the clinic. Natural polymeric-based dressings are of central interest in this area due to their outstanding biocompatibility, biodegradability, low toxicity, and non-allergenic nature. Among them, silk fibroin (SF) has exceptional characteristics as a wound dressing. SF-based dressings can also be used as carriers for delivering drugs, growth factors, and bioactive agents to the wound area, while providing appropriate support for complete healing. In this review, we describe recent advances in the development of SF-based wound dressings for skin regeneration. Copyright © 2018 Elsevier Ltd. All rights reserved.
A retrospective review of burn dressings on a porcine burn model.
Wang, Xue-Qing; Kravchuk, Olena; Kimble, Roy M
2010-08-01
This is a study to compare wound healing among three types of dressings on a porcine model with deep-dermal-partial-thickness burns. The burns in this study were from eight animal trials conducted in the past for other purposes and only burns with a uniform pale appearance that had served as controls in original experiments were selected. In total, there were 57 burns in 33 pigs, using one of following three dressings: Acticoat (Silver) (3 trials), Jelonet (Gauze) (3 trials), and Solosite Gel/Jelonet (Gel/Gauze) (2 trials). The wound healing assessments included wound re-epithelialisation during a 6-week period, clinical and histological scar assessments at week 6 after burn. Of all wound healing/scar assessments, only re-epithelialisation showed statistical difference between dressings. Earlier re-epithelialisation was observed in Gel/Gauze dressings compared to Silver and/or Gauze dressings. However, this study revealed huge variation in wound healing outcome between 3 trials within both Silver and/or Gauze dressings, supported by significant differences on re-epithelialisation, clinical and histological scar measurements. In addition, it was found that larger animals healed better than smaller ones, based on weights from 21 pigs. Of all dressings, Silver delivers the best protection for wound colonization/infection. Wound colonization/infection was found to confine wound healing and lead to thinner RND in scars. From this study, we cannot find enough evidence to suggest the beneficial effect of one dressing(s) over others on burn wound healing outcome on a porcine model with small deep-dermal-partial-thickness burns with a relative small sample size.
Guo, Chunlan; Deng, Hongyan; Yang, Jian
2015-01-01
To assess the effect of virtual reality distraction on pain among patients with a hand injury undergoing a dressing change. Virtual reality distraction can effectively alleviate pain among patients undergoing a dressing change. Clinical research has not addressed pain control during a dressing change. A randomised controlled trial was performed. In the first dressing change sequence, 98 patients were randomly divided into an experimental group and a control group, with 49 cases in each group. Pain levels were compared between the two groups before and after the dressing change using a visual analog scale. The sense of involvement in virtual environments was measured using the Pearson correlation coefficient analysis, which determined the relationship between the sense of involvement and pain level. The difference in visual analog scale scores between the two groups before the dressing change was not statistically significant (t = 0·196, p > 0·05), but the scores became statistically significant after the dressing change (t = -30·792, p < 0·01). The correlation between the sense of involvement in a virtual environment and pain level during the dressing was statistically significant (R(2) = 0·5538, p < 0·05). Virtual reality distraction can effectively alleviate pain among patients with a hand injury undergoing a dressing change. Better results can be obtained by increasing the sense of involvement in a virtual environment. Virtual reality distraction can effectively relieve pain without side effects and is not reliant on a doctor's prescription. This tool is convenient for nurses to use, especially when analgesics are unavailable. © 2014 John Wiley & Sons Ltd.
Elsner, J J; Berdicevsky, I; Zilberman, M
2011-01-01
About 70% of all people with severe burns die from related infections, despite advances in treatment regimens and the best efforts of nurses and doctors. Although silver-eluting wound dressings are available for addressing this problem, there is growing evidence of the deleterious effects of such dressings in delaying the healing process owing to cellular toxicity. A new concept of antibiotic-eluting composite wound dressings is described here. These dressings are based on a polyglyconate mesh coated with a porous poly-(dl-lactic-co-glycolic acid) matrix loaded with antibiotic drugs. The effect of antibiotic release on bacterial inhibition was studied, and cell cytotoxicity was examined. The dressings resulted in a 99.99% decrease in the viable counts of Pseudomonas aeruginosa and Staphylococcus albus at very high initial inoculations of 10⁷-10⁸ CFU ml⁻¹ after only 1 day, while such a decrease in Staphylococcus aureus was obtained within 3 days. Bacterial inhibition zones around the dressing material were found to persist for 2 weeks, indicating a long-lasting antimicrobial effect. Despite severe toxicity to bacteria, the dressing material was found to have no toxic effect on cultured fibroblasts, indicating that the new antibiotic-eluting wound dressings represent an effective option for selective treatment of bacterial infections. Copyright © 2010 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.
A new postoperative otoplasty dressing technique using cyanoacrylate tissue adhesives.
Vetter, Miriam; Foehn, Matthias; Wedler, Volker
2010-04-01
There are many techniques for cosmetic surgery of the ears and also many different procedures for postoperative treatment. The postoperative dressing is described as important for a successful outcome. We present our method of postoperative dressing in the form of liquid bonding. Cyanoacrylate tissue adhesives as liquid bonding agents are used for fixation of the pinna at the mastoid area. After 10-14 days the bonding can be easily removed. No huge dressings, tapes, or plasters are necessary. The patients are satisfied with the light dressing; they do not feel ashamed to appear in public. We have found this dressing technique to be simple and economical, especially because of the use of the bonding for skin closure before. It can be used after otoplasty with an anterior or a posterior approach.
Current applications of foams formed from mixed surfactant-polymer solutions.
Bureiko, Andrei; Trybala, Anna; Kovalchuk, Nina; Starov, Victor
2015-08-01
Foams cannot be generated without the use of special foaming agents, as pure liquids do not foam. The most common foaming agents are surfactants, however often for foam stability one active agent is not enough, it is necessary to add other component to increase foam lifetime. Foams on everyday use are mostly made from mixture of different components. Properly chosen combinations of two active ingredients lead to a faster foam formation and increased foam stability. During the last decade polymers (mainly polyelectrolytes and proteins) have become frequently used additives to foaming solutions. Mixtures of surfactants and polymers often demonstrate different foaming properties in comparison to surfactant only or polymer only solutions. The nature of surfactant-polymer interactions is complicated and prediction of resulting foaming properties of such formulations is not straightforward. Properties and foaming of surfactant-polymer mixtures are discussed as well as current applications of foams and foaming agents as foams are widely used in cosmetics, pharmaceutics, medicine and the food industry. Copyright © 2014 Elsevier B.V. All rights reserved.
Wang, Jin-song; Cao, Pin-lu; Yin, Kun
2015-07-01
Environmental, economical and efficient antifoaming technology is the basis for achievement of foam drilling fluid recycling. The present study designed a novel two-stage laval mechanical foam breaker that primarily uses vacuum generated by Coanda effect and Laval principle to break foam. Numerical simulation results showed that the value and distribution of negative pressure of two-stage laval foam breaker were larger than that of the normal foam breaker. Experimental results showed that foam-breaking efficiency of two-stage laval foam breaker was higher than that of normal foam breaker, when gas-to-liquid ratio and liquid flow rate changed. The foam-breaking efficiency of normal foam breaker decreased rapidly with increasing foam stability, whereas the two-stage laval foam breaker remained unchanged. Foam base fluid would be recycled using two-stage laval foam breaker, which would reduce the foam drilling cost sharply and waste disposals that adverse by affect the environment.
Dressed Wilson loops as dual condensates in response to magnetic and electric fields
DOE Office of Scientific and Technical Information (OSTI.GOV)
Bruckmann, Falk; Endroedi, Gergely
2011-10-01
We introduce dressed Wilson loops as a novel confinement observable. It consists of closed planar loops of arbitrary geometry but fixed area, and its expectation values decay with the latter. The construction of dressed Wilson loops is based on chiral condensates in response to magnetic and electric fields, thus linking different physical concepts. We present results for generalized condensates and dressed Wilson loops on dynamical lattice configurations and confirm the agreement with conventional Wilson loops in the limit of large probe mass. We comment on the renormalization of dressed Wilson loops.
The role of dressings in the prevention of pressure ulcers.
Brown, Julie
2016-08-11
Pressure ulceration is a significant global healthcare problem and represents a considerable burden on healthcare resources. Within the literature an increasing number of studies have examined the role prophylactic dressings play in redistributing pressure and helping to protect the skin from the effects of friction and shear. The use of dressings to prevent pressure ulcers may be considered a controversial issue, as previous opinion has been that dressings do not reduce the effects of pressure. This article will critically evaluate the literature to examine the role dressings play in the prevention of pressure ulceration.
Face Masks for Noninvasive Ventilation: Fit, Excess Skin Hydration, and Pressure Ulcers.
Visscher, Marty O; White, Cynthia C; Jones, Jennifer M; Cahill, Thomas; Jones, Donna C; Pan, Brian S
2015-11-01
Pressure ulcers (stages III and IV) are serious safety events (ie, never events). Healthcare institutions are no longer reimbursed for costs to care for affected patients. Medical devices are the leading cause of pediatric pressure ulcers. Face masks for noninvasive ventilation were associated with a high percentage of pressure ulcers at our institution. A prospective cohort study investigated factors contributing to pressure ulcer development in 50 subjects using face masks for noninvasive ventilation. Color imaging, 3-dimensional surface imaging, and skin hydration measurements were used to identify early skin compromise and evaluate 3 interventions to reduce trauma: (1) a silicone foam dressing, (2) a water/polyethylene oxide hydrogel dressing, and (3) a flexible cloth mask. A novel mask fit technique was used to examine the impact of fit on the potential for skin compromise. Fifty subjects age 10.4 ± 9.1 y participated with color images for 22, hydration for 34, and mask fit analysis for 16. Of these, 69% had diagnoses associated with craniofacial anomalies. Stage I pressure ulcers were the most common injury. Skin hydration difference was 317 ± 29 for sites with erythema versus 75 ± 28 for sites without erythema (P < .05) and smallest for the cloth mask (P < .05). Fit distance metrics differed for the nasal, oronasal, and face shield interfaces, with threshold distances being higher for the oronasal mask than the others (P < .05). Areas of high contact were associated with skin erythema and pressure ulcers. This fit method is currently being utilized to select best-fit masks from available options, to identify the potential areas of increased tissue pressure, and to prevent skin injuries and their complications. Improvement of mask fit is an important priority for improving respiratory outcomes. Strategies to maintain normal skin hydration are important for protecting tissue integrity. Copyright © 2015 by Daedalus Enterprises.
A conservative approach to perineal Fournier's gangrene.
Milanese, Giulio; Quaresima, Luigi; Dellabella, Marco; Scalise, Alessandro; Di Benedetto, Giovanni Maria; Muzzonigro, Giovanni; Minardi, Daniele
2015-03-31
Fournier's gangrene (FG) is a disease involving necrosis of perineum and external genitalia; in 95% of cases it is possible to diagnose the Fournier's gangrene just by physical examination. The clinical presentation of FG varies from an initial localized infection to large areas with necrotizing infection. The disease typically affect elderly men (6°-7° decade) with important systemic comorbidities; women are less frequently affected. Despite improvements in diagnosis and management, the mortality rate nowadays is between 20% and 43%. The severity and mortality of the disease is dependent upon the general condition of the patient at presentation and upon the rate of spread of the infection. Treatment involves a multidisciplinary approach: intensive systematic management, broad-spectrum antibiotic therapy, early surgical debridement (wide abscission of necrotic tissues and surgical drainage of peritoneum, scrotum, penis, and inguinal areas), hyperbaric oxygen therapy; surgery can eventually be repeated if necessary; reconstructive surgery has an important role in the final treatment of the disease. The technical difficulties frequently encountered and the inability to make a complete removal of the necrotizing tissues at the time of surgery in some cases has led to the application of combined techniques, in view of the enhancement effect of specific advanced medications, targeted antibiotic therapy and hyperbaric medicine. We have considered 6 patients affected by Fournier's gangrene treated at our institution; all the patients received treatment with the help of plastic surgeons of the same institution. After debridement, all the patients were treated with advanced specific dressings consisting of plates and strips made of calcium alginate, hydrogels and polyurethane and twodimensional cavity foams. Reconstructive surgery was necessary in one case. Hyperbaric oxygen therapy (HBO) has been performed in all cases. The multidisciplinary approach, the combined use of HBO therapy and the adoption of advanced specific dressings, have made possible the complete healing of the lesions in a shorter period, avoiding further surgery in 5 out of 6 patients.
Ullman, Amanda J; Kleidon, Tricia; Gibson, Victoria; McBride, Craig A; Mihala, Gabor; Cooke, Marie; Rickard, Claire M
2017-08-30
Central venous access device (CVAD) associated complications are a preventable source of patient harm, frequently resulting in morbidity and delays to vital treatment. Dressing and securement products are used to prevent infectious and mechanical complications, however current complication rates suggest customary practices are inadequate. The aim of this study was to evaluate the feasibility of launching a full-scale randomized controlled efficacy trial of innovative dressing and securement products for pediatric tunneled CVAD to prevent complication and failure. An external, pilot, four-group randomized controlled trial of standard care (bordered polyurethane dressing and suture), in comparison to integrated securement-dressing, suture-less securement device, and tissue adhesive was undertaken across two large, tertiary referral pediatric hospitals in Australia. Forty-eight pediatric participants with newly inserted tunneled CVADs were consecutively recruited. The primary outcome of study feasibility was established by elements of eligibility, recruitment, attrition, protocol adherence, missing data, parent and healthcare staff satisfaction and acceptability, and effect size estimates for CVAD failure (cessation of function prior to completion of treatment) and complication (associated bloodstream infection, thrombosis, breakage, dislodgement or occlusion). Dressing integrity, product costs and site complications were also examined. Protocol feasibility was established. CVAD failure was: 17% (2/12) integrated securement-dressing; 8% (1/13) suture-less securement device; 0% tissue adhesive (0/12); and, 0% standard care (0/11). CVAD complications were: 15% (2/13) suture-less securement device (CVAD associated bloodstream infection, and occlusion and partial dislodgement); 8% (1/12) integrated securement-dressing (partial dislodgement); 0% tissue adhesive (0/12); and, 0% standard care (0/11). One CVAD-associated bloodstream infection occurred, within the suture-less securement device group. Overall satisfaction was highest in the integrated securement-dressing (mean 8.5/10; standard deviation 1.2). Improved dressing integrity was evident in the intervention arms, with the integrated securement-dressing associated with prolonged time to first dressing change (mean days 3.5). Improving the security and dressing integrity of tunneled CVADs is likely to improve outcomes for pediatric patients. Further research is necessary to identify novel, effective CVAD securement to reduce complications, and provide reliable vascular access for children. ACTRN12614000280606 ; prospectively registered on 17/03/2014.
Percutaneous urinary procedures - discharge
... a shower if you wrap the dressing with plastic wrap and replace the dressing if it gets ... include: Telfa (the dressing material), Tegaderm (the clear plastic tape that holds the plastic ring in place), ...
Fries, C A; Ayalew, Y; Penn-Barwell, J G; Porter, K; Jeffery, S L A; Midwinter, M J
2014-07-01
Recent conflicts have been characterised by the use of improvised explosive devices causing devastating injuries, including heavily contaminated wounds requiring meticulous surgical debridement. After being rendered surgical clean, these wounds are dressed and the patient transferred back to the UK for on-going treatment. A dressing that would prevent wounds from becoming colonised during transit would be desirable. The aim of this study was to establish whether using nanocrystalline silver dressings, as an adjunct to the initial debridement, would positively affect wound microbiology and wound healing compared to standard plain gauze dressings. Patients were prospectively randomised to receive either silver dressings, in a nanocrystalline preparation (Acticoat™), or standard of care dressings (plain gauze) following their initial debridement in the field hospital. On repatriation to the UK microbiological swabs were taken from the dressing and the wound, and an odour score recorded. Wounds were followed prospectively and time to wound healing was recorded. Additionally, patient demographic data were recorded, as well as the mechanism of injury and Injury Severity Score. 76 patients were recruited to the trial between February 2010 and February 2012. 39 received current dressings and 37 received the trial dressings. Eleven patients were not swabbed. There was no difference (p=0.1384, Fishers) in the primary outcome measure of wound colonisation between the treatment arm (14/33) and the control arm (20/32). Similarly time to wound healing was not statistically different (p=0.5009, Mann-Whitney). Wounds in the control group were scored as being significantly more malodorous (p=0.002, Mann-Whitney) than those in the treatment arm. This is the first randomised controlled trial to report results from an active theatre of war. Performing research under these conditions poses additional challenges to military clinicians. Meticulous debridement of wounds remains the critical determinant in wound healing and infection and this study did not demonstrate a benefit of nanocrystaline silver dressing in respect to preventing wound colonisation or promoting healing, these dressings do however seem to significantly reduce the unpleasant odour commonly associated with battlefield wounds. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.
Bernatchez, Stéphanie F.; Ruckly, Stéphane; Timsit, Jean-François
2015-01-01
Objective To model the cost-effectiveness impact of routine use of an antimicrobial chlorhexidine gluconate-containing securement dressing compared to non-antimicrobial transparent dressings for the protection of central vascular lines in intensive care unit patients. Design This study uses a novel health economic model to estimate the cost-effectiveness of using the chlorhexidine gluconate dressing versus transparent dressings in a French intensive care unit scenario. The 30-day time non-homogeneous markovian model comprises eight health states. The probabilities of events derive from a multicentre (12 French intensive care units) randomized controlled trial. 1,000 Monte Carlo simulations of 1,000 patients per dressing strategy are used for probabilistic sensitivity analysis and 95% confidence intervals calculations. The outcome is the number of catheter-related bloodstream infections avoided. Costs of intensive care unit stay are based on a recent French multicentre study and the cost-effectiveness criterion is the cost per catheter-related bloodstream infections avoided. The incremental net monetary benefit per patient is also estimated. Patients 1000 patients per group simulated based on the source randomized controlled trial involving 1,879 adults expected to require intravascular catheterization for 48 hours. Intervention Chlorhexidine Gluconate-containing securement dressing compared to non-antimicrobial transparent dressings. Results The chlorhexidine gluconate dressing prevents 11.8 infections /1,000 patients (95% confidence interval: [3.85; 19.64]) with a number needed to treat of 85 patients. The mean cost difference per patient of €141 is not statistically significant (95% confidence interval: [€-975; €1,258]). The incremental cost-effectiveness ratio is of €12,046 per catheter-related bloodstream infection prevented, and the incremental net monetary benefit per patient is of €344.88. Conclusions According to the base case scenario, the chlorhexidine gluconate dressing is more cost-effective than the reference dressing. Trial Registration This model is based on the data from the RCT registered with www.clinicaltrials.gov (NCT01189682). PMID:26086783
Desroche, N; Dropet, C; Janod, P; Guzzo, J
2016-10-02
This study was designed to evaluate the antibacterial activity of a wound dressing which combines polyacrylate fibres and a silver lipido-colloid matrix (UrgoClean Ag, silver polyabsorbent dressing), against biofilm of methicillin-resistant Staphylococcus aureus (MRSA). Samples of silver polyabsorbent dressing and the neutral form of this dressing (UrgoClean) were applied to biofilms of MRSA formed on a collagen I-coated surface, cultured for 24 hours. Different exposure times were tested (1, 2, 4 and 7 days) without dressing change. The biofilm reduction was quantified by using culture methods and by confocal laser scanning microscopy experiments. The application of the silver polyabsorbent dressing resulted in a significant decrease of the biofilm population by a log reduction of 4.6, after 24 hours of exposure. Moreover, the antibiofilm activity was maintained for 7 days with reduction values up to 4 log (reduction of biofilm superior to 99.99%). The application of the neutral dressing also induced a significant reduction of the concentration of sessile cells after 1 day (about 0.90 log). The results obtained with this neutral form of the dressing showed that the polyacrylate fibres were able to exert a mechanical disruption of the biofilm architecture. These in vitro experiments demonstrated that silver polyabsorbent dressing was able to strongly reduce the biofilm of MRSA. The antibiofilm mechanism of this dressing can be explained by a dual action of the polyabsorbent fibres (based on ammonium polyacrylate polymer around an acrylic core) which induced a mechanical disruption of the biofilm matrix and/or a sequestration of sessile cells, and the diffusion of silver ions which produced bactericidal activity. This study was supported by Laboratoires Urgo (Dijon). P. Janod is an employee of Laboratoires Urgo. The company had no influence on the experimental design and the interpretation of the results.
2010-01-01
Background The use of honey as a natural product of Apis spp. for burn treatment has been widely applied for centuries. Tualang honey has been reported to have antibacterial properties against various microorganisms, including those from burn-related diagnoses, and is cheaper and easier to be absorbed by Aquacel dressing. The aim of this study is to evaluate the potential antibacterial properties of tualang honey dressing and to determine its effectiveness as a partial thickness burn wound dressing. Methods In order to quantitate the bioburden of the swabs, pour plates were performed to obtain the colony count (CFU/ml). Swabs obtained from burn wounds were streaked on blood agar and MacConkey agar for bacterial isolation and identification. Later, antibacterial activity of Aquacel-tualang honey, Aquacel-Manuka honey, Aquacel-Ag and Aquacel- plain dressings against bacteria isolated from patients were tested (in-vitro) to see the effectiveness of those dressings by zone of inhibition assays. Results Seven organisms were isolated. Four types of Gram-negative bacteria, namely Enterobacter cloacae, Klebsiella pneumoniae, Pseudomonas spp. and Acinetobacter spp., and three Gram-positive bacteria, namely Staphylococcus aureus, coagulase-negative Staphylococcus aureus (CONS) and Streptococcus spp., were isolated. Total bacterial count decreased on day 6 and onwards. In the in-vitro antibacterial study, Aquacel-Ag and Aquacel-Manuka honey dressings gave better zone of inhibition for Gram positive bacteria compared to Aquacel-Tualang honey dressing. However, comparable results were obtained against Gram negative bacteria tested with Aquacel-Manuka honey and Aquacel-Tualang honey dressing. Conclusions Tualang honey has a bactericidal as well as bacteriostatic effect. It is useful as a dressing, as it is easier to apply and is less sticky compared to Manuka honey. However, for Gram positive bacteria, tualang honey is not as effective as usual care products such as silver-based dressing or medical grade honey dressing. PMID:20576085
Nasir, Nur-Azida Mohd; Halim, Ahmad Sukari; Singh, Kirnpal-Kaur Banga; Dorai, Ananda Aravazhi; Haneef, Mehru-Nisha Muhammad
2010-06-24
The use of honey as a natural product of Apis spp. for burn treatment has been widely applied for centuries. Tualang honey has been reported to have antibacterial properties against various microorganisms, including those from burn-related diagnoses, and is cheaper and easier to be absorbed by Aquacel dressing. The aim of this study is to evaluate the potential antibacterial properties of tualang honey dressing and to determine its effectiveness as a partial thickness burn wound dressing. In order to quantitate the bioburden of the swabs, pour plates were performed to obtain the colony count (CFU/ml). Swabs obtained from burn wounds were streaked on blood agar and MacConkey agar for bacterial isolation and identification. Later, antibacterial activity of Aquacel-tualang honey, Aquacel-Manuka honey, Aquacel-Ag and Aquacel- plain dressings against bacteria isolated from patients were tested (in-vitro) to see the effectiveness of those dressings by zone of inhibition assays. Seven organisms were isolated. Four types of Gram-negative bacteria, namely Enterobacter cloacae, Klebsiella pneumoniae, Pseudomonas spp. and Acinetobacter spp., and three Gram-positive bacteria, namely Staphylococcus aureus, coagulase-negative Staphylococcus aureus (CONS) and Streptococcus spp., were isolated. Total bacterial count decreased on day 6 and onwards. In the in-vitro antibacterial study, Aquacel-Ag and Aquacel-Manuka honey dressings gave better zone of inhibition for Gram positive bacteria compared to Aquacel-Tualang honey dressing. However, comparable results were obtained against Gram negative bacteria tested with Aquacel-Manuka honey and Aquacel-Tualang honey dressing. Tualang honey has a bactericidal as well as bacteriostatic effect. It is useful as a dressing, as it is easier to apply and is less sticky compared to Manuka honey. However, for Gram positive bacteria, tualang honey is not as effective as usual care products such as silver-based dressing or medical grade honey dressing.
Konstantatos, A H; Angliss, M; Costello, V; Cleland, H; Stafrace, S
2009-06-01
Pain arising in burns sufferers is often severe and protracted. The prospect of a dressing change can heighten existing pain by impacting both physically and psychologically. In this trial we examined whether pre-procedural virtual reality guided relaxation added to patient controlled analgesia with morphine reduced pain severity during awake dressings changes in burns patients. We conducted a prospective randomized clinical trial in all patients with burns necessitating admission to a tertiary burns referral centre. Eligible patients requiring awake dressings changes were randomly allocated to single use virtual reality relaxation plus intravenous morphine patient controlled analgesia (PCA) infusion or to intravenous morphine patient controlled analgesia infusion alone. Patients rated their worst pain intensity during the dressing change using a visual analogue scale. The primary outcome measure was presence of 30% or greater difference in pain intensity ratings between the groups in estimation of worst pain during the dressing change. Of 88 eligible and consenting patients having awake dressings changes, 43 were assigned to virtual reality relaxation plus intravenous morphine PCA infusion and 43 to morphine PCA infusion alone. The group receiving virtual reality relaxation plus morphine PCA infusion reported significantly higher pain intensities during the dressing change (mean=7.3) compared with patients receiving morphine PCA alone (mean=5.3) (p=0.003) (95% CI 0.6-2.8). The addition of virtual reality guided relaxation to morphine PCA infusion in burns patients resulted in a significant increase in pain experienced during awake dressings changes. In the absence of a validated predictor for responsiveness to virtual reality relaxation such a therapy cannot be recommended for general use in burns patients having awake dressings changes.
Dhillon, M; Carter, C P; Morrison, J; Hislop, W S; Currie, W J R
2015-06-01
The success of skin grafting is dependent on the interplay between many factors including nutrient uptake and vascular in-growth. To allow this, it is important that the graft is immobile and traditionally a 'pressure dressing' has been placed over the graft to improve outcome and graft 'take'. We present the findings of our comparative study of full-thickness skin grafts performed in the head, neck and face region over a period of 24 months. We felt that there was an unacceptably high infection rate and graft failure using pressure dressings. Data was collected retrospectively from the case notes on 70 patients who had undergone full-thickness skin grafting to the head, neck and face over a 2 year period. Thirty-five patients underwent grafting with pressure dressing and 35 without. The group with the pressure dressing had the same 'bolster' specification-type dressing and those without had their graft 'quilted' in and chloramphenicol ointment applied topically. Success was determined by the percentage 'take' of the grafts and absence of infection i.e. purulence. Infection in those with a pressure dressing stood at 26 % in contrast to those without, at 9 %. Without a pressure dressing we observed no total graft failures, compared to 6 % in those with a pressure dressing. The results confirmed the perception that there was a higher infection and graft failure rate where a pressure dressing was applied; however, this was not a statistically significant difference and a randomised control trial with a larger sample size would be required to validate the results.
Leaper, David; Nazir, Jameel; Roberts, Chris; Searle, Richard
2010-01-01
In patients at risk of surgical site infection (SSI), there is evidence that an antimicrobial barrier dressing (Acticoat* ) applied immediately post-procedure is effective in reducing the incidence of infection. The objective of this study was to assess when it is appropriate to use an antimicrobial barrier dressing rather than a post-operative film dressing, by evaluating the net cost and budget impact of the two strategies. An economic model was developed, which estimates expected expenditure on dressings and the expected costs of surgical site infection during the initial inpatient episode, based on published literature on the pre-discharge costs of surgical infection and the efficacy of an antimicrobial barrier dressing in preventing SSI. At an SSI risk of 10%, an antimicrobial barrier dressing strategy is cost neutral if the incidence of infection is reduced by at least 9% compared with a post-operative film dressing. At 35% efficacy, expenditure on dressings would be higher by £30,760 per 1000 patients, and the cost of treating infection would be lower by £111,650, resulting in a net cost saving of £80,890. The break-even infection risk for cost neutrality is 2.6%. Although this cost analysis is based on published data, there are limitations in methodology: the model is dependent on and subject to the limitations of the data used to populate it. Further studies would be useful to increase the robustness of the conclusions, particularly in a broader range of surgical specialties. A strategy involving the use of an antimicrobial barrier dressing in patients at moderate (5-10%) or high (>10%) risk of infection appears reasonable and cost saving in light of the available clinical evidence.
Zaller, Johann G; König, Nina; Tiefenbacher, Alexandra; Muraoka, Yoko; Querner, Pascal; Ratzenböck, Andreas; Bonkowski, Michael; Koller, Robert
2016-08-17
Seed dressing with pesticides is widely used to protect crop seeds from pest insects and fungal diseases. While there is mounting evidence that especially neonicotinoid seed dressings detrimentally affect insect pollinators, surprisingly little is known on potential side effects on soil biota. We hypothesized that soil organisms would be particularly susceptible to pesticide seed dressings as they get in direct contact with these chemicals. Using microcosms with field soil we investigated, whether seeds treated either with neonicotinoid insecticides or fungicides influence the activity and interaction of earthworms, collembola, protozoa and microorganisms. The full-factorial design consisted of the factor Seed dressing (control vs. insecticide vs. fungicide), Earthworm (no earthworms vs. addition Lumbricus terrestris L.) and collembola (no collembola vs. addition Sinella curviseta Brook). We used commercially available wheat seed material (Triticum aesticum L. cf. Lukullus) at a recommended seeding density of 367 m(-2). Seed dressings (particularly fungicides) increased collembola surface activity, increased the number of protozoa and reduced plant decomposition rate but did not affect earthworm activity. Seed dressings had no influence on wheat growth. Earthworms interactively affected the influence of seed dressings on collembola activity, whereas collembola increased earthworm surface activity but reduced soil basal respiration. Earthworms also decreased wheat growth, reduced soil basal respiration and microbial biomass but increased soil water content and electrical conductivity. The reported non-target effects of seed dressings and their interactions with soil organisms are remarkable because they were observed after a one-time application of only 18 pesticide treated seeds per experimental pot. Because of the increasing use of seed dressing in agriculture and the fundamental role of soil organisms in agroecosystems these ecological interactions should receive more attention.
Toon, Clare D; Lusuku, Charnelle; Ramamoorthy, Rajarajan; Davidson, Brian R; Gurusamy, Kurinchi Selvan
2015-09-03
Most surgical procedures involve a cut in the skin that allows the surgeon to gain access to the deeper tissues or organs. Most surgical wounds are closed fully at the end of the procedure (primary closure). The surgeon covers the closed surgical wound with either a dressing or adhesive tape. The dressing can act as a physical barrier to protect the wound until the continuity of the skin is restored (within about 48 hours) and to absorb exudate from the wound, keeping it dry and clean, and preventing bacterial contamination from the external environment. Some studies have found that the moist environment created by some dressings accelerates wound healing, although others believe that the moist environment can be a disadvantage, as excessive exudate can cause maceration (softening and deterioration) of the wound and the surrounding healthy tissue. The utility of dressing surgical wounds beyond 48 hours of surgery is, therefore, controversial. To evaluate the benefits and risks of removing a dressing covering a closed surgical incision site within 48 hours permanently (early dressing removal) or beyond 48 hours of surgery permanently with interim dressing changes allowed (delayed dressing removal), on surgical site infection. In March 2015 we searched the following electronic databases: The Cochrane Wounds Group Specialised Register; The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); Database of Abstracts of Reviews of Effects (DARE) (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE; and EBSCO CINAHL. We also searched the references of included trials to identify further potentially-relevant trials. Two review authors independently identified studies for inclusion. We included all randomised clinical trials (RCTs) conducted with people of any age and sex, undergoing a surgical procedure, who had their wound closed and a dressing applied. We included only trials that compared early versus delayed dressing removal. We excluded trials that included people with contaminated or dirty wounds. We also excluded quasi-randomised studies, and other study designs. Two review authors independently extracted data on the characteristics of the trial participants, risk of bias in the trials and outcomes for each trial. We calculated risk ratios (RR) with 95% confidence intervals (CI) for binary outcomes and mean difference (MD) with 95% CI for continuous outcomes. We used RevMan 5 software to perform these calculations. Four trials were identified for inclusion in this review. All the trials were at high risk of bias. Three trials provided information for this review. Overall, this review included 280 people undergoing planned surgery. Participants were randomised to early dressing removal (removal of the wound dressing within the 48 hours following surgery) (n = 140) or delayed dressing removal (continued dressing of the wound beyond 48 hours) (n = 140) in the three trials. There were no statistically significant differences between the early dressing removal group and delayed dressing removal group in the proportion of people who developed superficial surgical site infection within 30 days (RR 0.64; 95% CI 0.32 to 1.28), superficial wound dehiscence within 30 days (RR 2.00; 95% CI 0.19 to 21.16) or serious adverse events within 30 days (RR 0.83; 95% CI 0.28 to 2.51). No deep wound infection or deep wound dehiscence occurred in any of the participants in the trials that reported this outcome. None of the trials reported quality of life. The hospital stay was significantly shorter (MD -2.00 days; 95% CI -2.82 to -1.18) and the total cost of treatment significantly less (MD EUR -36.00; 95% CI -59.81 to -12.19) in the early dressing removal group than in the delayed dressing removal group in the only trial that reported these outcomes. The early removal of dressings from clean or clean contaminated surgical wounds appears to have no detrimental effect on outcomes. However, it should be noted that the point estimate supporting this statement is based on very low quality evidence from three small randomised controlled trials, and the confidence intervals around this estimate were wide. Early dressing removal may result in a significantly shorter hospital stay, and significantly reduced costs, than covering the surgical wound with wound dressings beyond the first 48 hours after surgery, according to very low quality evidence from one small randomised controlled trial. Further randomised controlled trials of low risk of bias are necessary to investigate whether dressings are necessary after 48 hours in different types of surgery and levels of contamination and investigate whether antibiotic therapy influences the outcome.
Toon, Clare D; Ramamoorthy, Rajarajan; Davidson, Brian R; Gurusamy, Kurinchi Selvan
2013-09-05
Most surgical procedures involve a cut in the skin that allows the surgeon to gain access to the deeper tissues or organs. Most surgical wounds are closed fully at the end of the procedure (primary closure). The surgeon covers the closed surgical wound with either a dressing or adhesive tape. The dressing can act as a physical barrier to protect the wound until the continuity of the skin is restored (within about 48 hours) and to absorb exudate from the wound, keeping it dry and clean, and preventing bacterial contamination from the external environment. Some studies have found that the moist environment created by some dressings accelerates wound healing, although others believe that the moist environment can be a disadvantage, as excessive exudate can cause maceration (softening and deterioration) of the wound and the surrounding healthy tissue. The utility of dressing surgical wounds beyond 48 hours of surgery is, therefore, controversial. To evaluate the benefits and risks of removing a dressing covering a closed surgical incision site within 48 hours permanently (early dressing removal) or beyond 48 hours of surgery permanently with interim dressing changes allowed (delayed dressing removal), on surgical site infection. In July 2013 we searched the following electronic databases: The Cochrane Wounds Group Specialised Register; The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); Database of Abstracts of Reviews of Effects (DARE) (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE; and EBSCO CINAHL. We also searched the references of included trials to identify further potentially-relevant trials. Two review authors independently identified studies for inclusion. We included all randomised clinical trials (RCTs) conducted with people of any age and sex, undergoing a surgical procedure, who had their wound closed and a dressing applied. We included only trials that compared early versus delayed dressing removal. We excluded trials that included people with contaminated or dirty wounds. We also excluded quasi-randomised studies, and other study designs. Two review authors independently extracted data on the characteristics of the trial participants, risk of bias in the trials and outcomes for each trial. We calculated risk ratios (RR) with 95% confidence intervals (CI) for binary outcomes and mean difference (MD) with 95% CI for continuous outcomes. We used RevMan 5 software to perform these calculations. Four trials were identified for inclusion in this review. All the trials were at high risk of bias. Three trials provided information for this review. Overall, this review included 280 people undergoing planned surgery. Participants were randomised to early dressing removal (removal of the wound dressing within the 48 hours following surgery) (n = 140) or delayed dressing removal (continued dressing of the wound beyond 48 hours) (n = 140) in the three trials. There were no statistically significant differences between the early dressing removal group and delayed dressing removal group in the proportion of people who developed superficial surgical site infection within 30 days (RR 0.64; 95% CI 0.32 to 1.28), superficial wound dehiscence within 30 days (RR 2.00; 95% CI 0.19 to 21.16) or serious adverse events within 30 days (RR 0.83; 95% CI 0.28 to 2.51). No deep wound infection or deep wound dehiscence occurred in any of the participants in the trials that reported this outcome. None of the trials reported quality of life. The hospital stay was significantly shorter (MD -2.00 days; 95% CI -2.82 to -1.18) and the total cost of treatment significantly less (MD EUR -36.00; 95% CI -59.81 to -12.19) in the early dressing removal group than in the delayed dressing removal group in the only trial that reported these outcomes. The early removal of dressings from clean or clean contaminated surgical wounds appears to have no detrimental effect on outcomes. However, it should be noted that the point estimate supporting this statement is based on very low quality evidence from three small randomised controlled trials, and the confidence intervals around this estimate were wide. Early dressing removal may result in a significantly shorter hospital stay, and significantly reduced costs, than covering the surgical wound with wound dressings beyond the first 48 hours after surgery, according to very low quality evidence from one small randomised controlled trial. Further randomised controlled trials of low risk of bias are necessary to investigate whether dressings are necessary after 48 hours in different types of surgery and levels of contamination and investigate whether antibiotic therapy influences the outcome.
Pediatric Digital Necrosis Secondary to Dressing Application: A Case Series.
Bjorklund, Kim A; Rice, Dahlia M; Amalfi, Ashley N
2018-04-01
Pediatric digital necrosis resulting in revision amputation is a devastating outcome following digital dressing application. We report a series of 4 pediatric patients (age: 21 months-11 years) who presented for surgical consultation related to digital ischemia and irreversible necrosis following the application of Coban digital dressings. A review of the literature demonstrated that such injuries had not previously been described. In our case series, Coban dressing was utilized as a deterrent for thumb sucking, fingertip tuft fractures with nail bed lacerations, and a phalanx fracture secondary to crush injury. All 4 children suffered digital necrosis secondary to Coban dressings and ultimately required revision amputation. We discuss risks factors, application practices, and strategies to minimize complications with digital dressings in the pediatric population with the intent of creating awareness among hand surgeons to help promote safe practices and improve patient outcomes.
Enhancing pressure ulcer prevention using wound dressings: what are the modes of action?
Call, Evan; Pedersen, Justin; Bill, Brian; Black, Joyce; Alves, Paulo; Brindle, C Tod; Dealey, Carol; Santamaria, Nick; Clark, Michael
2015-08-01
Recent clinical research has generated interest in the use of sacral wound dressings as preventive devices for patients at risk of ulceration. This study was conducted to identify the modes of action through which dressings can add to pressure ulcer prevention, for example, shear and friction force redistribution and pressure distribution. Bench testing was performed using nine commercially available dressings. The use of dressings can reduce the amplitude of shear stress and friction reaching the skin of patients at risk. They can also effectively redirect these forces to wider areas which minimises the mechanical loads upon skeletal prominences. Dressings can redistribute pressure based upon their effective Poisson ratio and larger deflection areas, providing greater load redistribution. © 2013 The Authors. International Wound Journal © 2013 Medicalhelplines.com Inc and John Wiley & Sons Ltd.
Heffernan, A; Martin, A J
1994-01-01
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. PMID:7894807
Elsner, Jonathan J; Egozi, Dana; Ullmann, Yehuda; Berdicevsky, Israela; Shefy-Peleg, Adaya; Zilberman, Meital
2011-08-01
Approximately 70% of all people with severe burns die from related infections despite advances in treatment regimens and the best efforts of nurses and doctors. Silver ion-eluting wound dressings are available for overcoming this problem. However, there are reports of deleterious effects of such dressings due to cellular toxicity that delays the healing process, and the dressing changes needed 1-2 times a day are uncomfortable for the patient and time consuming for the stuff. An alternative concept in wound dressing design that combines the advantages of occlusive dressings with biodegradability and intrinsic topical antibiotic treatment is described herewith. The new composite structure presented in this article is based on a polyglyconate mesh and a porous poly-(dl-lactic-co-glycolic acid) matrix loaded with gentamicin developed to provide controlled release of antibiotics for three weeks. In vivo evaluation of the dressing material in contaminated deep second degree burn wounds in guinea pigs (n=20) demonstrated its ability to accelerate epithelialization by 40% compared to an unloaded format of the material and a conventional dressing material. Wound contraction was reduced significantly, and a better quality scar tissue was formed. The current dressing material exhibits promising results, does not require frequent bandage changes, and offers a potentially valuable and economic approach to treating the life-threatening complication of burn-related infections. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.
Release of antibiotics from collagen dressing.
Grzybowski, J; Antos-Bielska, M; Ołdak, E; Trafny, E A
1997-01-01
Our new collagen dressing has been developed recently. Three types (A, B, and C) of the dressing were prepared in this study. Each type contained bacitracin, neomycin or colistin. The antibiotic was input into: i. collagen sponge (CS)--type A, ii. layer of limited hydrophobicity (LLH)--type B, and iii. into both CS and LLH layers--type C. The final concentration of the antibiotic that resulted from the loading level was 2 mg/cm2 for the dressings of type A and B and 4 mg/cm2 for the dressing of type C. The antibiotics were then extracted from the pieces of dressings for two days through dialysis membrane. Susceptibility of 54 bacterial strains (S. aureus, P. aeruginosa, and Acinetobacter) isolated from burn wounds were tested to the three antibiotics used for preparation of the dressings. The results of the study evidenced that efficiency of released of antibiotics into the extracts depended on the kind of antibiotic and on the type of dressing. The concentration of the antibiotics proved to be much higher than MIC90 values of the bacterial isolates tested in respect to their susceptibility. The dressing containing mixture of the three antibiotics in two layers--CS and LLH is now considered as potentially effective for care of infected wounds. It may be useful for the treatment of infected wounds or for profilaxis of contaminated wounds, ensuring: i. sufficient antimicrobial activity in wound, and ii. optimal wound environment for the presence of collagenic biomaterial on the damaged tissue.
Combe, Alexander L; Ang, Justin K; Bamforth, Charles W
2013-07-01
The foam stability of beer is dependent on the presence of foam-stabilizing polypeptides derived from the cereals from which it is made. It has long been argued that there is a tendency to boost the foam-stabilizing capabilities of these polypeptides at the heating stages involved in the production of the grist materials. The present study started with the intent to confirm whether these changes occurred and to assess the extent to which different cereal products differed in their foam-stabilizing tendencies. Cereal products differ enormously in their foam-stabilizing capabilities. Heavily roasted grains, notably black malt and roast barley, do have superior foaming properties. However, certain specialty malts, notably crystal malts, display inferior foam performance. The observed foaming pattern is a balance between their content of foam-positive and foam-negative components. Products such as pale malt do contain foam-negative materials but have a net balance in favour of foam-stabilizing entities. By contrast, wheat malt and especially black malt have a heavy preponderance of foam-positive components. Crystal malt displays the converse behaviour: it contains low-molecular-weight foam-negative species. Several of the cereal products appear to contain higher-molecular-weight foam inhibitors, but it appears that they are merely species that are of inherently inferior foam-stabilizing capability to the foaming polypeptides from egg white that were employed to probe the system. The foam-damaging species derived from crystal malt carried through to beers brewed from them. Intense heating in the production of cereal products does lead to enhanced foam performance in extracts of those products. However, not all speciality malts display superior foam performance, through their development of foam-negative species of lower molecular weight. © 2013 Society of Chemical Industry.
Bi-Layer Wound Dressing System for Combat Casualty Care
2004-09-01
C. Bonacorsi, M.S.G. Raddi, and I.Z. Carlos. 2004. Cytotoxicity of chlorhexidine digluconate to murine macrophages and its effect on hydrogen...chlorexhidine digluconate or 1 % chloramphenicol, as described previously. Each experimental dressing was then covered with a piece of sterile parafilm...chloramphenicol-loaded dressings were 2-log lower for the first 24 h than when applying the chlorhexidine -loaded dressings (Figure 2). However, there was no
Mendes, D A; Veiga, D F; Veiga-Filho, J; Loyola, A B A T; Paiva, L F; Novo, N F; Sabino-Neto, M; Ferreira, L M
2018-06-01
Concepts regarding the best way to treat a surgical wound vary, in literature, ranging from no dressing use to dressing maintenance for 24 to 48 hours or until suture removal. This study aimed to evaluate the influence of the length of dressing maintenance after breast augmentation with implants on cutaneous colonization and surgical site infection. This is a two-arm, parallel group, randomized clinical trial. Eighty patients who were candidates for augmentation mammoplasty with silicone implants were randomly allocated to two groups, in which the dressing was removed on postoperative day 1 (group A, n = 40) or postoperative day 6 (group B, n = 40). Cutaneous colonization was examined by culturing samples collected before and after dressing removal. The criteria defined by the Centers for Disease Control and Prevention were used to assess surgical site infection. No significant difference regarding cutaneous colonization was observed between groups before dressing application. On postoperative day 6, significantly more bacterial growth was observed in group A (p = 0.01). No surgical site infection occurred. We concluded that maintaining the dressing for 6 days led to a lower cutaneous colonization but did not influence surgical site infection rates. Copyright © 2018 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
The clinical and cost effectiveness of bee honey dressing in the treatment of diabetic foot ulcers.
Moghazy, A M; Shams, M E; Adly, O A; Abbas, A H; El-Badawy, M A; Elsakka, D M; Hassan, S A; Abdelmohsen, W S; Ali, O S; Mohamed, B A
2010-09-01
Honey is known, since antiquity, as an effective wound dressing. Emergence of resistant strains and the financial burden of modern dressings, have revived honey as cost-effective dressing particularly in developing countries. Its suitability for all stages of wound healing suggests its clinical effectiveness in diabetic foot wound infections. Thirty infected diabetic foot wounds were randomly selected from patients presenting to Surgery Department, Suez Canal University Hospital, Ismailia, Egypt. Honey dressing was applied to wounds for 3 months till healing, grafting or failure of treatment. Changes in grade and stage of wounds, using University of Texas Diabetic Wound Classification, as well as surface area were recorded weekly. Bacterial load was determined before and after honey dressing. Complete healing was significantly achieved in 43.3% of ulcers. Decrease in size and healthy granulation was significantly observed in another 43.3% of patients. Bacterial load of all ulcers was significantly reduced after the first week of honey dressing. Failure of treatment was observed in 6.7% of ulcers. This study proves that commercial clover honey is a clinical and cost-effective dressing for diabetic wound in developing countries. It is omnipresence and concordance with cultural beliefs makes it a typical environmentally based method for treating these conditions. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.
Milne, Stephen D; Seoudi, Ihab; Al Hamad, Hanadi; Talal, Talal K; Anoop, Anzila A; Allahverdi, Niloofar; Zakaria, Zain; Menzies, Robert; Connolly, Patricia
2016-12-01
Wound moisture is known to be a key parameter to ensure optimum healing conditions in wound care. This study tests the moisture content of wounds in normal practice in order to observe the moisture condition of the wound at the point of dressing change. This study is also the first large-scale observational study that investigates wound moisture status at dressing change. The WoundSense sensor is a commercially available moisture sensor which sits directly on the wound in order to find the moisture status of the wound without disturbing or removing the dressing. The results show that of the 588 dressing changes recorded, 44·9% were made when the moisture reading was in the optimum moisture zone. Of the 30 patients recruited for this study, 11 patients had an optimum moisture reading for at least 50% of the measurements before dressing change. These results suggest that a large number of unnecessary dressing changes are being made. This is a significant finding of the study as it suggests that the protocols currently followed can be modified to allow fewer dressing changes and less disturbance of the healing wound bed. © 2015 The Authors. International Wound Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.
Seeing "the Dress" in the Right Light: Perceived Colors and Inferred Light Sources.
Chetverikov, Andrey; Ivanchei, Ivan
2016-08-01
In the well-known "dress" photograph, people either see the dress as blue with black stripes or as white with golden stripes. We suggest that the perception of colors is guided by the scene interpretation and the inferred positions of light sources. We tested this hypothesis in two online studies using color matching to estimate the colors observers see, while controlling for individual differences in gray point bias and color discrimination. Study 1 demonstrates that the interpretation of the dress corresponds to differences in perceived colors. Moreover, people who perceive the dress as blue-and-black are two times more likely to consider the light source as frontal, than those who see the white-and-gold dress. The inferred light sources, in turn, depend on the circadian changes in ambient light. The interpretation of the scene background as a wall or a mirror is consistent with the perceived colors as well. Study 2 shows that matching provides reliable results on differing devices and replicates the findings on scene interpretation and light sources. Additionally, we show that participants' environmental lighting conditions are an important cue for perceiving the dress colors. The exact mechanisms of how environmental lighting and circadian changes influence the perceived colors of the dress deserve further investigation.
Technics study on high accuracy crush dressing and sharpening of diamond grinding wheel
NASA Astrophysics Data System (ADS)
Jia, Yunhai; Lu, Xuejun; Li, Jiangang; Zhu, Lixin; Song, Yingjie
2011-05-01
Mechanical grinding of artificial diamond grinding wheel was traditional wheel dressing process. The rotate speed and infeed depth of tool wheel were main technics parameters. The suitable technics parameters of metals-bonded diamond grinding wheel and resin-bonded diamond grinding wheel high accuracy crush dressing were obtained by a mount of experiment in super-hard material wheel dressing grind machine and by analysis of grinding force. In the same time, the effect of machine sharpening and sprinkle granule sharpening was contrasted. These analyses and lots of experiments had extent instruction significance to artificial diamond grinding wheel accuracy crush dressing.
Tiny patients, tiny dressings: a guide to the neonatal PICC dressing change.
Sharpe, Elizabeth L
2008-06-01
Advances in neonatology now support the survival of the tiniest of infants. The peripherally inserted central catheter (PICC) has now become an integral part of routine practice in neonatal intensive care units around the world. Keen attention to safe maintenance of these devices is essential. A properly applied and maintained PICC dressing is the first line of defense to minimize the risk of complications such as dislodgement, migration, and infection. This article describes a neonatal PICC dressing change and discusses the frequently encountered quandaries surrounding this important procedure, including dressing materials, frequency, site preparation, barrier precautions, and other relevant concerns.
Constructing medical social authority on dress in Victorian Canada.
O'Connor, Eileen
2008-01-01
During the late-Victorian period, campaigns to "reform" middle-class women's dress were grounded in discourses on health, eugenics, declining birth rates, comfort, and aesthetics. In Britain, the United States and Germany, organized "dress reform" movements emerged in the latter half of the 19th century, while in Canada the campaign was led primarily by physicians through public health education. This article explores the discussion on women's dress in public health literature in Canadian circulation between 1860-1900 and interprets findings within a feminist poststructuralist framework that posits the understanding of women's bodies and gender regulation to be central to knowledge construction on women's dress.
NASA Astrophysics Data System (ADS)
Sahu, Sritam Swapnadarshi; Gandhi, Indu Siva Ranjani; Khwairakpam, Selija
2018-06-01
Foam concrete finds application in many areas, generally as a function of its relatively lightweight and its beneficial properties in terms of reduction in dead load on structure, excellent thermal insulation and contribution to energy conservation. For production of foam concrete with desired properties, stable and good quality foam is the key requirement. It is to be noted that the selection of surfactant and foam production parameters play a vital role in the properties of foam which in turn affects the properties of foam concrete. However, the literature available on the influence of characteristics of foaming agent and foam on the properties of foam concrete are rather limited. Hence, a more systematic research is needed in this direction. The focus of this work is to provide a review on characteristics of surfactant (foaming agent) and foam for use in foam concrete production.
NASA Astrophysics Data System (ADS)
Sahu, Sritam Swapnadarshi; Gandhi, Indu Siva Ranjani; Khwairakpam, Selija
2018-02-01
Foam concrete finds application in many areas, generally as a function of its relatively lightweight and its beneficial properties in terms of reduction in dead load on structure, excellent thermal insulation and contribution to energy conservation. For production of foam concrete with desired properties, stable and good quality foam is the key requirement. It is to be noted that the selection of surfactant and foam production parameters play a vital role in the properties of foam which in turn affects the properties of foam concrete. However, the literature available on the influence of characteristics of foaming agent and foam on the properties of foam concrete are rather limited. Hence, a more systematic research is needed in this direction. The focus of this work is to provide a review on characteristics of surfactant (foaming agent) and foam for use in foam concrete production.
Bonferoni, Maria Cristina; Sandri, Giuseppina; Rossi, Silvia; Dellera, Eleonora; Invernizzi, Alessandro; Boselli, Cinzia; Cornaglia, Antonia Icaro; Del Fante, Claudia; Perotti, Cesare; Vigani, Barbara; Riva, Federica; Caramella, Carla; Ferrari, Franca
2018-02-09
Chitosan oleate was previously proposed to encapsulate in nanocarriers some poorly soluble molecules aimed to wound therapy, such as the anti-infective silver sulfadiazine, and the antioxidant α tocopherol. Because nanocarriers need a suitable formulation to be administered to wounds, in the present paper, these previously developed nanocarriers were loaded into freeze dried dressings based on chitosan glutamate. These were proposed as bioactive dressings aimed to support the application to wounds of platelet lysate, a hemoderivative rich in growth factors. The dressings were characterized for hydration capacity, morphological aspect, and rheological and mechanical behavior. Although chitosan oleate nanocarriers clearly decreased the mechanical properties of dressings, these remained compatible with handling and application to wounds. Preliminary studies in vitro on fibroblast cell cultures demonstrated good compatibility of platelet lysate with nanocarriers and bioactive dressings. An in vivo study on a murine wound model showed an accelerating wound healing effect for the bioactive dressing and its suitability as support of the platelet lysate application to wounds.
Bonferoni, Maria Cristina; Dellera, Eleonora; Invernizzi, Alessandro; Cornaglia, Antonia Icaro; Perotti, Cesare; Vigani, Barbara; Caramella, Carla; Ferrari, Franca
2018-01-01
Chitosan oleate was previously proposed to encapsulate in nanocarriers some poorly soluble molecules aimed to wound therapy, such as the anti-infective silver sulfadiazine, and the antioxidant α tocopherol. Because nanocarriers need a suitable formulation to be administered to wounds, in the present paper, these previously developed nanocarriers were loaded into freeze dried dressings based on chitosan glutamate. These were proposed as bioactive dressings aimed to support the application to wounds of platelet lysate, a hemoderivative rich in growth factors. The dressings were characterized for hydration capacity, morphological aspect, and rheological and mechanical behavior. Although chitosan oleate nanocarriers clearly decreased the mechanical properties of dressings, these remained compatible with handling and application to wounds. Preliminary studies in vitro on fibroblast cell cultures demonstrated good compatibility of platelet lysate with nanocarriers and bioactive dressings. An in vivo study on a murine wound model showed an accelerating wound healing effect for the bioactive dressing and its suitability as support of the platelet lysate application to wounds. PMID:29425164
Boonbaichaiyapruck, S; Hutayanon, P; Chanthanamatta, P; Dumrongwatana, T; Intarayotha, N; Krisdee, V; Yamvong, S
2001-12-01
Post cardiac catheterization puncture site care is usually done with a tight pressure dressing by an elastic adhesive bandage (Tensoplast) due to the belief that it should prevent bleeding. The practice is uncomfortable to the patients. The authors compared a new way of dressing using light transparent tape (Tegaderm) to the conventional tight pressure one. 126 post coronary angiography patients were randomized to have their groins dressed either with Tensoplast or with Tegaderm. Patients ambulated 8 hours after the procedures. The groin was evaluated for pain, discomfort and bleeding complications. 49 per cent in the Tensoplast vs 26.9 per cent in the Tegaderm group experienced pain (p value of 0.01). 55.5 per cent in the Tensoplast group vs 11.1 per cent in the Tegaderm group reported discomfort. 4.7 per cent in the Tensoplast vs 1.6 per cent in the Tegaderm group developed bleeding or hematoma. Dressing of the puncture site after cardiac catheterization with Tegaderm was more comfortable than the conventional Tensoplast without any difference in bleeding complications.
Effects of honey and sugar dressings on wound healing.
Mphande, A N G; Killowe, C; Phalira, S; Jones, H Wynn; Harrison, W J
2007-07-01
To investigate whether there is a difference between the efficacy of honey and sugar as wound dressings. Patients with open or infected wounds were randomised to receive either honey or sugar dressings. Bacterial colonisation, wound size, wound ASEPSIS score and pain were assessed at the start of treatment and at weekly intervals until full healing occurred. Forty patients were enrolled; 18 received sugar dressings and 22 honey dressings. In the honey group, 55% of patients had positive wound cultures at the start of treatment and 23% at one week, compared with 52% and 39% respectively in the sugar group.The median rate of healing in the first two weeks of treatment was 3.8cm2/week for the honey group and 2.2cm2/week for the sugar group. After three weeks of treatment 86% of patients treated with honey had no pain during dressing changes, compared with 72% treated with sugar. Honey appears to be more effective than sugar in reducing bacterial contamination and promoting wound healing, and slightly less painful than sugar during dressing changes and motion.
Using leptospermum honey to manage wounds impaired by radiotherapy: a case series.
Robson, Val; Cooper, Rose
2009-01-01
Radiation-induced tissue injury and wounds with radiation-impaired healing are traumatic for patients and challenging for their caregivers. Standardized management approaches do not exist. The effect of Leptospermum honey as a primary dressing for managing these wounds was assessed in four patients (age range 63 to 93 years) who had previously undergone radiotherapy that left them with fragile friable areas of damaged skin that did not respond to conventional treatment. Compromised areas involved the neck, cheek, groin/perineum, and chest. In patients 1 and 2, after topical application of honey via hydrofiber rope and nonadhesive foam, respectively, improvements in the size and condition of wound/periwound area and a reduction in pain were noted before death or loss to follow-up. After including honey in the treatment regimen of patients 3 and 4, complete healing was noted in 2.5 weeks (with honey and paraffin) and 6 weeks (with honey-soaked hydrofiber rope), respectively. No adverse events were reported. Honey as an adjunct to conventional wound/skin care post radiation therapy shows promise for less painful healing in these chronic wounds. Prospective, randomized, controlled clinical studies are needed to confirm these observations.
Experimental Study of Hysteresis behavior of Foam Generation in Porous Media.
Kahrobaei, S; Vincent-Bonnieu, S; Farajzadeh, R
2017-08-21
Foam can be used for gas mobility control in different subsurface applications. The success of foam-injection process depends on foam-generation and propagation rate inside the porous medium. In some cases, foam properties depend on the history of the flow or concentration of the surfactant, i.e., the hysteresis effect. Foam may show hysteresis behavior by exhibiting multiple states at the same injection conditions, where coarse-textured foam is converted into strong foam with fine texture at a critical injection velocity or pressure gradient. This study aims to investigate the effects of injection velocity and surfactant concentration on foam generation and hysteresis behavior as a function of foam quality. We find that the transition from coarse-foam to strong-foam (i.e., the minimum pressure gradient for foam generation) is almost independent of flowrate, surfactant concentration, and foam quality. Moreover, the hysteresis behavior in foam generation occurs only at high-quality regimes and when the pressure gradient is below a certain value regardless of the total flow rate and surfactant concentration. We also observe that the rheological behavior of foam is strongly dependent on liquid velocity.
NASA Astrophysics Data System (ADS)
Izadi, M.; Kam, S.
2017-12-01
Scope: Numerous laboratory and field tests revealed that foam can effectively control gas mobility and improve sweep efficiency in enhanced-oil-recovery and subsurface-remediation processes, if correctly designed. The objective of this study is to answer (i) how mechanistic foam model parameters can be determined by fitting lab experiments in a step-by-step manner; (ii) how different levels of mobilization pressure gradient for foam generation affects the fundamentals of foam propagation; and (iii) how foam propagation distance can be estimated in the subsurface. This study for the first time shows why, and by how much, supercritical CO2 foams are advantaged over other types of foams such as N2 foam. Methods: First of all, by borrowing experimental data existing in the literature, this study shows how to capture mechanistic foam model parameters. The model, then, is applied to a wide range of mobilization pressure gradient to represent different types of foams that have been applied in the field (Note that supercritical CO2 foams exhibit much lower mobilization pressure compared to other types of foams (N2, steam, air, etc.). Finally, the model and parameters are used to evaluate different types of foam injection scenarios in order to predict how far foams can propagate with what properties in the field condition. Results and Conclusions: The results show that (i) the presence of three different foam states (strong, weak, intermediate) as well as two different strong-foam flow regimes (high-quality and low-quality regimes) plays a key role in model fit and field-scale propagation prediction and (ii) the importance of complex non-Newtonian foam rheology should not be underestimated. More specifically, this study finds that (i) supercritical CO2 foams can propagate a few hundreds of feet easily, which is a few orders of magnitude higher than other foams such as N2 foams; (ii) for dry foams (or, strong foams in the high-quality regime), the higher gas fractions the less foams travel, while for wet foams (or, strong foams in the low-quality regime) the distance is not sensitive to gas fraction; and (iii) the higher injection rates (or pressures), the farther foams propagate (this effect is much more pronounced for dry foams).
The brain's dress code: How The Dress allows to decode the neuronal pathway of an optical illusion.
Schlaffke, Lara; Golisch, Anne; Haag, Lauren M; Lenz, Melanie; Heba, Stefanie; Lissek, Silke; Schmidt-Wilcke, Tobias; Eysel, Ulf T; Tegenthoff, Martin
2015-12-01
Optical illusions have broadened our understanding of the brain's role in visual perception. A modern day optical illusion emerged from a posted photo of a striped dress, which some perceived as white and gold and others as blue and black. Here we show, using functional magnetic resonance imaging (fMRI), that those who perceive The Dress as white/gold have higher activation in response to the image of The Dress in brain regions critically involved in higher cognition (frontal and parietal brain areas). These results are consistent with theories of top-down modulation and present a neural signature associated with the differences in perceiving The Dress as white/gold or blue/black. Furthermore the results support recent psychophysiological data on this phenomenon and provide a fundamental building block to study interindividual differences in visual processing. Copyright © 2015 Elsevier Ltd. All rights reserved.
NASA Astrophysics Data System (ADS)
Felgueiras, H. P.; Amorim, M. T. P.
2017-10-01
Modern wound dressings combine medical textiles with active compounds that stimulate wound healing while protecting against infection. Electrospun wound dressings have been extensively studied and the electrospinning technique recognized as an efficient approach for the production of nanoscale fibrous mats. The unique diverse function and architecture of antimicrobial peptides (AMPs) has attracted considerable attention as a tool for the design of new anti-infective drugs. Functionalizing electrospun wound dressings with these AMPs is nowadays being researched. In the present work, we explore these new systems by highlighting the most important characteristics of electropsun wound dressings, revealing the importance of AMPs to wound healing, and the methods available to functionalize the electrospun mats with these molecules. The combined therapeutic potential of collagen type I and these AMP functionalized dressings will be highlighted as well; the significance of these new strategies for the future of wound healing will be clarified.
The Evaluation of Foam Performance and Flooding Efficiency
NASA Astrophysics Data System (ADS)
Keliang, Wang; Yuhao, Chen; Gang, Wang; Gen, Li
2017-12-01
ROSS-Miles and spinning drop interfacial tensionmeter are used to select suitable foam system through foam composite index (FCI) and interfacial tension (IT). The selected foam system are taken to conduct further test. The further tests are evaluating the foam system resistance to adsorption with multi-round core flooding dynamic adsorption test and evaluating the performance of foam system with four kinds of different transport distance, quantitatively analyzing the foam system effective distance after dynamic adsorption. The result shows that the foaming ability and the mobilizing ability of the foam system decrease with the increase of the round of dynamic adsorption. As the transport distance increases, the foaming ability and the mobilizing ability of the foam system decrease. This result further reveals the flooding characteristics of nitrogen foam flooding, which provides a reference for the implementation of nitrogen foam flooding technology.
[Split-thickness skin graft donor site: which dressing use?].
Caliot, J; Bodin, F; Chiriac, S; Correia, N; Poli-Mérol, M-L; François-Fiquet, C
2015-04-01
The management of split-thickness skin graft donor sites is targeted towards promoting the healing process, reducing pain. This has been an inconclusive topic. The aim of this study was to list and to discuss the French practices in term of split-thickness skin graft (STSG) donor site dressing. Multicentric national study by questionnaire (Google Drive(®)) for the attention of the plastic and/or pediatric surgeons. The type of dressing used on skin and sclap and the rhythm of dressing changes were analyzed. The study included 26 surgical centers on 40 contacted. The alginate is mainly used (Algostéril(®)) (17/26). It is left in position until healing (13/17). Five other types of dressings have been reported: paraffin gauze (3/26), lipidocolloides (1/26), Mepitel(®) (1/26), Mepilex(®) (1/26), indifferent use of gauze or alginate dressings (4/26). Twenty-two out of 26 centers make no difference in dressing choice between skin and scalp. Medical practices did not differ between adult or pediatric departments. Cost-effectiveness has become an important issue in wound management, requiring judicious use. The lack of consensus regarding split-thickness skin graft donor site dressing and our clinical practices force us to reconsider the best therapeutic option. This study coupled with the analysis of the literature highlights the difficulties of the practitioner in choosing the best dressing. The alginate seems to get the preference of our practices by its ease of use, its absence of change (reduces pain by limiting manipulations) and its moderate cost. Copyright © 2014 Elsevier Masson SAS. All rights reserved.
A comparison of an antibacterial sandwich dressing vs dressing containing silver.
Krasowski, Grzegorz; Jawień, Arkadiusz; Tukiendorf, Andrzej; Rybak, Zbigniew; Junka, Adam; Olejniczak-Nowakowska, Małgorzata; Bartoszewicz, Marzenna; Smutnicka, Danuta
2015-01-01
The purpose of this study was to compare the efficacy of dressings containing octenidine vs. dressings containing silver in the wound healing in the course of a chronic venous disease. There were two groups of 40 patients who met the inclusion criteria and who did not meet the exclusion criteria. The patients were randomly assigned into the groups (envelope method). The first, "O group" was treated with octenidine-based dressings. The second, "S group" was treated with silver dressings. The study lasted for 56 days. All patients in the research were treated with medical compression stockings with cotton understockings. Microbiological eradication was observed on the 28th day of the study among 33% of patients in the treatment group vs. 6% in control group. On the 56th day of the treatment, these percentages equalled 72% and 35%. The rate of healing was faster in the 0 group than in the S group. In the wounds <10 cm(2) it was faster by 1.35 cm(2)/week and in wounds >10 cm(2) it equalled 3.44 cm(2). The reduction of pain level was 37.5% higher in the O group, in contrast with the S group. One change of a dressing in the O group led to a 0.06 cm(2) greater wound size reduction and in the case of wounds >10 cm(2) to 0.29 cm(2) reduction compared with the S group. The presented results indicate that the efficacy of dressings containing octenidine is higher compared to silver dressings. © 2015 by the Wound Healing Society.
Organic pollutant loading and biodegradability of firefighting foam
NASA Astrophysics Data System (ADS)
Zhang, Xian-Zhong; Bao, Zhi-ming; Hu, Cheng; Li-Shuai, Jing; Chen, Yang
2017-11-01
Firefighting foam has been widely used as the high-performance extinguishing agent in extinguishing the liquid poor fire. It was concerned for its environmental impacts due to its massive usage. In this study, the organic loading level and the biodegradability of 18 firefighting foams commonly used in China were evaluated and compared. The COD and TOC of firefighting foam concentrates are extremely high. Furthermore, those of foam solutions are also much higher than regular wastewater. The COD/TOC ratio of synthetic foams are higher than protein foams. The 28-day biodegradation rates of 18 firefighting foams are all over 60%, indicating that they are all ready biodegradable. Protein foams (P, FP and FFFP) have the higher organic loading and lower 28-day biodegradation rates compared to the synthetic foams (Class A foam, AFFF and S). The short and long-term impact of protein foams on the environment are larger than synthetic foams.
NASA Astrophysics Data System (ADS)
Anghel, Ion; Holban, Alina Maria; Grumezescu, Alexandru Mihai; Andronescu, Ecaterina; Ficai, Anton; Anghel, Alina Georgiana; Maganu, Maria; Lazǎr, Veronica; Chifiriuc, Mariana Carmen
2012-12-01
This paper reports a newly fabricated nanophyto-modified wound dressing with microbicidal and anti-adherence properties. Nanofluid-based magnetite doped with eugenol or limonene was used to fabricate modified wound dressings. Nanostructure coated materials were characterized by TEM, XRD, and FT-IR. For the quantitative measurement of biofilm-embedded microbial cells, a culture-based method for viable cell count was used. The optimized textile dressing samples proved to be more resistant to staphylococcal and pseudomonal colonization and biofilm formation compared to the uncoated controls. The functionalized surfaces for wound dressing seems to be a very useful tool for the prevention of wound microbial contamination on viable tissues.
2012-01-01
This paper reports a newly fabricated nanophyto-modified wound dressing with microbicidal and anti-adherence properties. Nanofluid-based magnetite doped with eugenol or limonene was used to fabricate modified wound dressings. Nanostructure coated materials were characterized by TEM, XRD, and FT-IR. For the quantitative measurement of biofilm-embedded microbial cells, a culture-based method for viable cell count was used. The optimized textile dressing samples proved to be more resistant to staphylococcal and pseudomonal colonization and biofilm formation compared to the uncoated controls. The functionalized surfaces for wound dressing seems to be a very useful tool for the prevention of wound microbial contamination on viable tissues. PMID:23272823
Anghel, Ion; Holban, Alina Maria; Grumezescu, Alexandru Mihai; Andronescu, Ecaterina; Ficai, Anton; Anghel, Alina Georgiana; Maganu, Maria; Laz R, Veronica; Chifiriuc, Mariana Carmen
2012-12-31
This paper reports a newly fabricated nanophyto-modified wound dressing with microbicidal and anti-adherence properties. Nanofluid-based magnetite doped with eugenol or limonene was used to fabricate modified wound dressings. Nanostructure coated materials were characterized by TEM, XRD, and FT-IR. For the quantitative measurement of biofilm-embedded microbial cells, a culture-based method for viable cell count was used. The optimized textile dressing samples proved to be more resistant to staphylococcal and pseudomonal colonization and biofilm formation compared to the uncoated controls. The functionalized surfaces for wound dressing seems to be a very useful tool for the prevention of wound microbial contamination on viable tissues.
Exploratory Development of an Ultrafast-Curing Wound Dressing
1991-05-31
mils thick: Formulation 2 and 5 .. 36 17. Elution Rates for the 30% Chlorhexidine Gluconate ADD’s at t=0 and Stored at the Temperature Extremes (400C...determined from the in vivo trials conducted earlier (9). The 6 mil thick dressing (Formulation 2) demonstrated effectiveness when tested on guinea pigs...This dressing released approximately 3000 micrograms/sq. cm. in 72 hours or about 64% of the 12 mil dressing tested for shelf stability (Figure 16
Woo, Kevin Y
2015-07-01
The purpose of this study was to examine the mediating effect of anxiety in the relationship between anticipation and pain in people with chronic wounds. Pain is common in people with chronic wounds. Anticipation or negative expectation of discomfort has been shown to have an augmenting effect on pain; also known as nocebo hyperalgesia. This was a cross-sectional study with repeated measures. Prior to dressing change, anticipatory pain level was evaluated by a 11-point numerical rating scale and anxiety by the Six-items State-Trait Anxiety Inventory (STAI-6). During wound dressing changes, pain was measured before dressing removal, at dressing removal, at cleansing and dressing application using the numerical scale. Analysis was completed based on the data from a convenience sample of 96 patients. Participants reported more pain at cleansing and dressing removal than baseline. High levels of anticipation, anxiety and pain at dressing change for wounds were related to heavy exudate and wound that were covered with necrotic tissue. Finally, the relationship between anticipation and pain perception was mediated by anxiety. Anticipation of pain triggers anxiety that can lead to increased pain. There is a need to incorporate evaluation of anxiety and personal expectations as part of comprehensive pain assessment. Clinicians should be aware of the impact of emotions and anticipation on overall pain experience. © 2015 John Wiley & Sons Ltd.
Ng, Shiow-Fern; Lew, Pit-Chin; Sin, Yong-Boey
2014-11-01
Topical emollients are known to provide symptomatic relief for atopic dermatitis. In hospitals, wet-wrap therapy has been shown to benefit children with moderate-to-severe atopic dermatitis (AD), but the application of wet-wraps is tedious and time-consuming. Topical emollients have low residence time and often dry out easily. The aim of this work was to develop a hydrogel-gauze dressing that is not only easy to apply but also rehydrates and traps moisture to provide longer relief for AD patients. In this study, a prototype hydrogel-gauze dressing was developed with varying ratios of sodium carboxymethylcellulose (NaCMC) and propylene glycol. The hydrogel-gauze dressings were assessed based on the moisture vapor transmission rate, moisture absorption, mechanical properties and storage stability over three months. Then, the efficacy of the hydrogel-gauze dressing was compared to topical emollients using transgenic NC/Nga mice with AD-like lesions. The NaCMC hydrogel-gauze dressings significantly lowered transepidermal water loss, and the animals displayed a faster recovery, which indicates that hydrogel-gauze dressings can trap moisture more effectively and accelerate AD healing. Hence, we propose that hydrogel-gauze dressings can potentially become an alternative to wet-wrap therapy due to the ease of application and the higher efficacy compared to topical products.
Van Hoesel, Willem; Tiefenbacher, Alexandra; König, Nina; Dorn, Verena M; Hagenguth, Julia F; Prah, Urša; Widhalm, Theresia; Wiklicky, Viktoria; Koller, Robert; Bonkowski, Michael; Lagerlöf, Jan; Ratzenböck, Andreas; Zaller, Johann G
2017-01-01
Seed dressing, i.e., the treatment of crop seeds with insecticides and/or fungicides, aiming to protect seeds from pests and diseases, is widely used in conventional agriculture. During the growing season, those crop fields often receive additional broadband herbicide applications. However, despite this broad utilization, very little is known on potential side effects or interactions between these different pesticide classes on soil organisms. In a greenhouse pot experiment, we studied single and interactive effects of seed dressing of winter wheat ( Triticum aestivum L. var. Capo ) with neonicotinoid insecticides and/or strobilurin and triazolinthione fungicides and an additional one-time application of a glyphosate-based herbicide on the activity of earthworms, soil microorganisms, litter decomposition, and crop growth. To further address food-web interactions, earthworms were introduced to half of the experimental units as an additional experimental factor. Seed dressings significantly reduced the surface activity of earthworms with no difference whether insecticides or fungicides were used. Moreover, seed dressing effects on earthworm activity were intensified by herbicides (significant herbicide × seed dressing interaction). Neither seed dressings nor herbicide application affected litter decomposition, soil basal respiration, microbial biomass, or specific respiration. Seed dressing did also not affect wheat growth. We conclude that interactive effects on soil biota and processes of different pesticide classes should receive more attention in ecotoxicological research.
Gerçeker, Gülçin Özalp; Yardımcı, Figen; Aydınok, Yeşim
2017-06-01
To compare the effects of the care bundles including chlorhexidine dressing and advanced dressings on the catheter-related bloodstream infection (CRBSI) rates in pediatric hematology-oncology patients with central venous catheters (CVCs). Twenty-seven PHO patients were recruited to participate in a prospective, randomized study in Turkey. The researcher used care bundles with chlorhexidine dressing in the experimental group (n = 14), and care bundles with advanced dressings in the control group (n = 13). According to the study results, 28.6% of the patients in the experimental group had CRBSI, while this rate was 38.5% in the control group patients. The CRBSI rate in the experimental group was 3.9, and the control group had 4.4 per 1000 inpatient catheter days. There was no exit-site infection in the experimental group. However, the control group had 1.7 per 1000 inpatient catheter days. Even though there was no difference between the two groups in which the researcher implemented care bundles with chlorhexidine dressing and advanced dressings in terms of CRBSI development, there was reduction in the CRBSI rates thanks to the care bundle approach. It is possible to control the CRBSI rates using care bundles in pediatric hematology-oncology patients. Copyright © 2017 Elsevier Ltd. All rights reserved.
Witkowski, Wojciech; Surowiecka-Pastewka, Agnieszka; Biesaga, Magdalena; Gierczak, Tomasz
2015-08-12
The aim of this study was to determine effectiveness of first aid dressings in extinguishing burning white phosphorous (WP), eliminating WP pieces from the surface, inhibiting re-ignition on the model (fresh bacon covered with military uniform), and preventing from late re-ignition caused by persistent WP pieces. Burning WP was extinguished with several dressings: tactical Military Dressing (WJ10), wet gauze, 2 hydrocolloids, and 3 prototypes of hydrocolloids developed by the authors. All examined dressings were effective in extinguishing WP provided that the entire area of the burning substance was completely covered. Moist gauze was especially effective in extinguishing WP, and also removed and absorbed the majority of the WP mass, preventing deeper penetration of WP particles. The immediate re-ignition was observed when all the remaining examined dressings were removed from the bacon. A stream of water was dangerous, as it splashed and transferred pieces of WP around. Moist gauze placed on burning WP for approximately 3 min was most effective in extinguishing WP and removing most of the WP pieces. We recommend moist gauze, used once or twice, as the best primary means for WP elimination and preventing tissue penetration. As a dressing used for medical evacuation (MEDEVAC), or as a second step after complete removal of visible WP, innovative hydrocolloid or hydrogel dressings should be used.
Witkowski, Wojciech; Surowiecka-Pastewka, Agnieszka; Biesaga, Magdalena; Gierczak, Tomasz
2015-01-01
Background The aim of this study was to determine effectiveness of first aid dressings in extinguishing burning white phosphorous (WP), eliminating WP pieces from the surface, inhibiting re-ignition on the model (fresh bacon covered with military uniform), and preventing from late re-ignition caused by persistent WP pieces. Material/Methods Burning WP was extinguished with several dressings: tactical Military Dressing (WJ10), wet gauze, 2 hydrocolloids, and 3 prototypes of hydrocolloids developed by the authors. Results All examined dressings were effective in extinguishing WP provided that the entire area of the burning substance was completely covered. Moist gauze was especially effective in extinguishing WP, and also removed and absorbed the majority of the WP mass, preventing deeper penetration of WP particles. The immediate re-ignition was observed when all the remaining examined dressings were removed from the bacon. A stream of water was dangerous, as it splashed and transferred pieces of WP around. Conclusions Moist gauze placed on burning WP for approximately 3 min was most effective in extinguishing WP and removing most of the WP pieces. We recommend moist gauze, used once or twice, as the best primary means for WP elimination and preventing tissue penetration. As a dressing used for medical evacuation (MEDEVAC), or as a second step after complete removal of visible WP, innovative hydrocolloid or hydrogel dressings should be used. PMID:26264209
Suzuki, Makoto; Yamada, Sumio; Omori, Mikayo; Hatakeyama, Mayumi; Sugimura, Yuko; Matsushita, Kazuhiko; Tagawa, Yoshikatsu
2008-09-01
A patient with poststroke hemiparesis learns to use the nonparetic arm to compensate for the weakness of the paretic arm to achieve independence in dressing. This is the learning process of new component actions on dressing. The purpose of this study was to develop the Upper-Body Dressing Scale (UBDS) for buttoned shirt dressing, which evaluates the component actions of upper-body dressing, and to provide preliminary data on internal consistency of the UBDS, as well as its reproducibility, validity, and sensitivity to clinical change. Correlational study of concurrent validity and reliability in which 63 consecutive stroke patients were enrolled in the study and were assessed repeatedly by the UBDS and the dressing item of Functional Independent Measure (FIM). Fifty-one patients completed the 3-wk study. The Cronbach's coefficient alpha of UBDS was 0.88. The principal component analysis extracted two components, which explained 62.3% of total variance. All items of the scale had high loading on the first component (0.65-0.83). Actions on the paralytic side were the positive loadings and actions on the healthy side were the negative loadings on the second component. Intraclass correlation coefficient was 0.87. The level of correlation between UBDS score and FIM dressing item scores was -0.72. Logistic regression analysis showed that only the score of UBDS on the first day of evaluation was a significant independent predictor of dressing ability (odds ratio, 0.82; 95% confidence interval, 0.71-0.95). The UBDS scores for paralytic hand passed into the sleeve, sleeve pulled up beyond the elbow joint, and sleeve pulled up beyond the shoulder joint were worse than the score for the other components of the task. These component actions had positive loading on the second component, which was identified by the principal component analysis. The UBDS has good internal consistency, reproducibility, validity, and sensitivity to clinical changes of patients with poststroke hemiparesis. This detailed UBDS assessment enables us to document the most difficult stages in dressing and to assess motor and process skills for independence of dressing.
8. SIDE VIEW OF NORTHEASTERN ROCKFACED DRESSED AND MORTARED STONE ...
8. SIDE VIEW OF NORTHEASTERN ROCKFACED DRESSED AND MORTARED STONE BRIDGE ABUTMENT (LEFT) AND DRESSED, DRY-LAID RETAINING WALL (RIGHT). FACING WEST. - Coverts Crossing Bridge, Spanning Mahoning River along Township Route 372 (Covert Road), New Castle, Lawrence County, PA
10. SIDE VIEW OF SOUTHEASTERN ROCKFACED DRESSED AND MORTARED STONE ...
10. SIDE VIEW OF SOUTHEASTERN ROCKFACED DRESSED AND MORTARED STONE BRIDGE ABUTMENT (RIGHT) AND DRESSED, DRY-LAID RETAINING WALL (LEFT). FACING NORTHWEST. - Coverts Crossing Bridge, Spanning Mahoning River along Township Route 372 (Covert Road), New Castle, Lawrence County, PA
Junka, Adam F; Żywicka, Anna; Szymczyk, Patrycja; Dziadas, Mariusz; Bartoszewicz, Marzena; Fijałkowski, Karol
2017-12-01
In the present article, we propose a simple Antibiofilm Dressing's Activity Measurement (A.D.A.M.) test that allows to check in vitro a dressing's suitability against biofilm-related wound infections. To perform the test, three agar discs are covered with biofilm formed by the tested pathogen after which they are assembled one over another in the form of an agar plug and placed in the well of a 24-well plate. The top disc is covered with the analyzed dressing and the entire set is incubated for 24h. During this time, the investigated antimicrobial substance is released from the dressing and penetrates to subsequent biofilm-covered agar discs. Biofilm reduction is measured using 2,3,5-triphenyl-2H-tetrazolium chloride (TTC) spectrometric assay and the results are compared to untreated control samples (agar plug covered with biofilm and without the dressing/or with a passive dressing placed on the top disc). Furthermore, in order to standardize the differences in penetrability of the drugs released from active dressings the results can be expressed as a dimensionless value referred to as the Penetrability Index. In summary, A.D.A.M. test is simple, cheap, can be performed practically in every clinical laboratory and takes no more time than routine microbiological diagnostics. Apart from measuring the released drug's activity, the A.D.A.M. test allows to assess drug penetrability (across three agar discs), reflecting real wound conditions, where microbes are frequently hidden under the necrotic tissue or cloth. In conclusion, the A.D.A.M. test produces a high volume of data that, when analyzed, can provide a researcher with a valuable hint concerning the applicability of active dressings against specific biofilm pathogens in a particular setting. Copyright © 2017 Elsevier B.V. All rights reserved.
Lo, Shu-Fen; Chang, Chee-Jen; Hu, Wen-Yu; Hayter, Mark; Chang, Yu-Ting
2009-03-01
The purpose of this study was to examine the efficacy of silver-releasing dressings in the management of non-healing chronic wounds. Non-healing chronic wounds often have a negative physical impact on patients and place a financial burden on healthcare systems. Silver dressings are wound products designed to control infection and provide a wound environment conducive to healing. However, validation of the clinical efficacy of these dressings is lacking. Systematic review and meta-analysis. A systematic search of the major electronic databases PubMed, CINAHL, Cochrane, MEDLINE, British Nursing Index, EBSCO, OCLC and Proquest between 1950-June 2007 was conducted. Hand searches of selected periodicals, textbooks and checking reference lists and contacting experts was also performed. Eight studies were selected from a potentially relevant 1957 references screened. Analysis incorporated data from 1399 participants in the eight randomised control trials. We found that silver dressings significantly improved wound healing (CI(95): 0.16-0.39, p < 0.001), reduced odour (CI(95): 0.24-0.52, p < 0.001) and pain-related symptoms (CI(95): 0.18-0.47, p < 0.001), decreased wound exudates (CI(95): 0.17-0.44, p < 0.001) and had a prolonged dressing wear time (CI(95): 0.19-0.48, p = 0.028) when compared with alternative wound management approaches. An analysis of sensitivity in these studies by subgroup analysis generally supported these associations. Furthermore, studies indicated an improvement in quality of life (CI(95): 0.04-0.33, p = 0.013) using silver dressings in wound management with no associated severe adverse events. This meta-analysis confirms the effectiveness of silver dressings in wound healing and improving patients' quality of life. However, it also highlights the need for additional well-designed randomised controlled trials to evaluate the effectiveness of silver-related dressings further. The results of this study provide objective data on the effectiveness of silver-related dressing when applied to non-healing chronic wounds.
NASA Astrophysics Data System (ADS)
Chen, Mingjun; Li, Ziang; Yu, Bo; Peng, Hui; Fang, Zhen
2013-09-01
In the grinding of high quality fused silica parts with complex surface or structure using ball-headed metal bonded diamond wheel with small diameter, the existing dressing methods are not suitable to dress the ball-headed diamond wheel precisely due to that they are either on-line in process dressing which may causes collision problem or without consideration for the effects of the tool setting error and electrode wear. An on-machine precision preparation and dressing method is proposed for ball-headed diamond wheel based on electrical discharge machining. By using this method the cylindrical diamond wheel with small diameter is manufactured to hemispherical-headed form. The obtained ball-headed diamond wheel is dressed after several grinding passes to recover geometrical accuracy and sharpness which is lost due to the wheel wear. A tool setting method based on high precision optical system is presented to reduce the wheel center setting error and dimension error. The effect of electrode tool wear is investigated by electrical dressing experiments, and the electrode tool wear compensation model is established based on the experimental results which show that the value of wear ratio coefficient K' tends to be constant with the increasing of the feed length of electrode and the mean value of K' is 0.156. Grinding experiments of fused silica are carried out on a test bench to evaluate the performance of the preparation and dressing method. The experimental results show that the surface roughness of the finished workpiece is 0.03 μm. The effect of the grinding parameter and dressing frequency on the surface roughness is investigated based on the measurement results of the surface roughness. This research provides an on-machine preparation and dressing method for ball-headed metal bonded diamond wheel used in the grinding of fused silica, which provides a solution to the tool setting method and the effect of electrode tool wear.
Zhou, Xin; Wang, He; Zhang, Jimin; Li, Xuemei; Wu, Yifan; Wei, Yongzhen; Ji, Shenglu; Kong, Deling; Zhao, Qiang
2017-05-01
Wound healing dressings are increasingly needed clinically due to the large number of skin damage annually. Nitric oxide (NO) plays a key role in promoting wound healing, thus biomaterials with NO-releasing property receive increasing attention as ideal wound dressing. In present study, we prepared a novel functional wound dressing by combining electrospun poly(ε-caprolactone) (PCL) nonwoven mat with chitosan-based NO-releasing biomaterials (CS-NO). As-prepared PCL/CS-NO dressing released NO sustainably under the physiological conditions, which was controlled by the catalysis of β-galactosidase. In vivo wound healing characteristics were further evaluated on full-thickness cutaneous wounds in mice. Results showed that PCL/CS-NO wound dressings remarkably accelerated wound healing process through enhancing re-epithelialization and granulation formation and effectively improved the organization of regenerated tissues including epidermal-dermal junction, which could be ascribed to the pro-angiogenesis, immunomodulation, and enhanced collagen synthesis provided by the sustained release of NO. Therefore, PCL/CS-NO may be a promising candidate for wound dressings, especially for the chronic wound caused by the ischemia. Serious skin damage caused by trauma, surgery, burn or chronic disease has become one of the most serious clinical problems. Therefore, there is an increasing demand for ideal wound dressing that can improve wound healing. Due to the vital role of nitric oxide (NO), we developed a novel functional wound dressing by combining electrospun polycaprolactone (PCL) mat with NO-releasing biomaterial (CS-NO). The sustained release of NO from PCL/CS-NO demonstrated positive effects on wound healing, including pro-angiogenesis, immunomodulation, and enhanced collagen synthesis. Hence, wound healing process was remarkably accelerated and the organization of regenerated tissues was effectively improved as well. Taken together, PCL/CS-NO dressing may be a promising candidate for wound treatment, especially for the chronic wound caused by the ischemia. Copyright © 2017 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.
Biophysical effects of repetitive removal of adhesive dressings on peri-ulcer skin.
Zillmer, R; Agren, M S; Gottrup, F; Karlsmark, T
2006-05-01
To study the effect of repeated removal of four different adhesive dressings on peri-ulcer skin using quantitative non-invasive techniques. Forty-five patients with open (n = 29) or healed (n = 16) venous leg ulcers were included. Peri-ulcer skin was treated for 14 days with patches of two different hydrocolloid-based adhesive dressings, one polyurethane adhesive and one soft silicone adhesive dressing. Normal skin of the patients' ventral forearm was also treated identically. Adhesive patches of the dressings were replaced every second day. The skin barrier function was assessed by measuring transepidermal water loss and stratum corneum hydration by measuring electrical conductance. Thirty-nine patients completed the study. The hydrocolloid adhesives increased transepidermal water loss and conductance while the polyurethane and soft silicone adhesives did not influence these parameters significantly compared with adjacent non-treated peri-ulcer skin. For normal forearm skin, similar relative effects among the four adhesives were found. Repetitive treatment with hydrocolloid-based adhesive dressings induced major functional alterations of the stratum corneum. In contrast, a polyurethane adhesive and a soft silicone adhesive dressing did not alter transepidermal water loss or conductance of peri-ulcer skin.
Peroxide-based oxygen generating topical wound dressing for enhancing healing of dermal wounds.
Chandra, Prafulla K; Ross, Christina L; Smith, Leona C; Jeong, Seon S; Kim, Jaehyun; Yoo, James J; Harrison, Benjamin S
2015-01-01
Oxygen generating biomaterials represent a new trend in regenerative medicine that aims to generate and supply oxygen at the site of requirement, to support tissue healing and regeneration. To enhance the healing of dermal wounds, we have developed a highly portable, in situ oxygen generating wound dressings that uses sodium percarbonate (SPO) and calcium peroxide (CPO) as chemical oxygen sources. The dressing continuously generated oxygen for more than 3 days, after which it was replaced. In the in vivo testing on porcine full-thickness porcine wound model, the SPO/CPO dressing showed enhanced wound healing during the 8 week study period. Quantitative measurements of wound healing related parameters, such as wound closure, reepithelialization, epidermal thickness and collagen content of dermis showed that supplying oxygen topically using the SPO/CPO dressing significantly accelerated the wound healing. An increase in neovascularization, as determined using Von Willebrand factor (vWF) and CD31 staining, was also observed in the presence of SPO/CPO dressing. This novel design for a wound dressing that contains oxygen generating biomaterials (SPO/CPO) for supplying topical oxygen, may find utility in treating various types of acute to chronic wounds. © 2015 by the Wound Healing Society.
Misgav, Mudi; Kenet, Gili; Martinowitz, Uriel
2014-03-01
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. 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. 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. Hemostatic dressings, such as the chitosan, should be encouraged for the treatment of external/accessible bleeds, especially among the pediatric patients with bleeding tendency.
Plasma treatments of dressings for wound healing: a review.
Eswaramoorthy, Nithya; McKenzie, David R
2017-12-01
This review covers the use of plasma technology relevant to the preparation of dressings for wound healing. The current state of knowledge of plasma treatments that have potential to provide enhanced functional surfaces for rapid and effective healing is summarized. Dressings that are specialized to the needs of individual cases of chronic wounds such as diabetic ulcers are a special focus. A summary of the biology of wound healing and a discussion of the various types of plasmas that are suitable for the customizing of wound dressings are given. Plasma treatment allows the surface energy and air permeability of the dressing to be controlled, to ensure optimum interaction with the wound. Plasmas also provide control over the surface chemistry and in cases where the plasma creates energetic ion bombardment, activation with long-lived radicals that can bind therapeutic molecules covalently to the surface of the dressing. Therapeutic innovations enabled by plasma treatment include the attachment of microRNA or antimicrobial peptides. Bioactive molecules that promote subsequent cell adhesion and proliferation can also be bound, leading to the recruitment of cells to the dressing that may be stem cells or patient-derived cells. The presence of a communicating cell population expressing factors promotes healing.
Topical Application of Honey on Surgical Wounds: A Randomized Clinical Trial.
Goharshenasan, Peiman; Amini, Shahideh; Atria, Ali; Abtahi, Hamidreza; Khorasani, Ghasemali
2016-01-01
The antimicrobial and anti-inflammatory activity of honey and its ability to accelerate wound healing make it an attractive option in surgical wound care. We performed a randomized clinical trial to compare the efficacy of honey dressing with conventional dressing regarding the aesthetic outcome. Bilateral symmetric incisions in randomly selected plastic surgical patients were randomly covered postoperatively with conventional dressing and honey dressing for five days. The aesthetic outcome of the two sides was rated on a Visual Analog Scale by the surgeon and the patient and compared at month three and six after surgery. Seventy two symmetrical incisions in 52 patients were evaluated during the study. The mean width of the scar after the third and the sixth month was 3.64 +/- 0.83 mm and 3.49 +/- 0.87 mm on the side that received honey dressing and 5.43 +/- 0.05 mm and 5.30+/- 1.35 mm in the control group. Wilcoxon signed-rank test showed significant difference between honey and conventional dressing outcomes at third and sixth month (p < 0.001). The healing process of the surgical wound and its final aesthetic result could be improved by using honey dressing. © 2016 S. Karger GmbH, Freiburg.
Aduba, Donald C.; Yang, Hu
2017-01-01
Wound dressings are critical for wound care because they provide a physical barrier between the injury site and outside environment, preventing further damage or infection. Wound dressings also manage and even encourage the wound healing process for proper recovery. Polysaccharide biopolymers are slowly becoming popular as modern wound dressings materials because they are naturally derived, highly abundant, inexpensive, absorbent, non-toxic and non-immunogenic. Polysaccharide biopolymers have also been processed into biomimetic platforms that offer a bioactive component in wound dressings that aid the healing process. This review primarily focuses on the fabrication and biocompatibility assessment of polysaccharide materials. Specifically, fabrication platforms such as electrospun fibers and hydrogels, their fabrication considerations and popular polysaccharides such as chitosan, alginate, and hyaluronic acid among emerging options such as arabinoxylan are discussed. A survey of biocompatibility and bioactive molecule release studies, leveraging polysaccharide’s naturally derived properties, is highlighted in the text, while challenges and future directions for wound dressing development using emerging fabrication techniques such as 3D bioprinting are outlined in the conclusion. This paper aims to encourage further investigation and open up new, disruptive avenues for polysaccharides in wound dressing material development. PMID:28952482
A review of aqueous foam in microscale.
Anazadehsayed, Abdolhamid; Rezaee, Nastaran; Naser, Jamal; Nguyen, Anh V
2018-06-01
In recent years, significant progress has been achieved in the study of aqueous foams. Having said this, a better understanding of foam physics requires a deeper and profound study of foam elements. This paper reviews the studies in the microscale of aqueous foams. The elements of aqueous foams are interior Plateau borders, exterior Plateau borders, nodes, and films. Furthermore, these elements' contribution to the drainage of foam and hydraulic resistance are studied. The Marangoni phenomena that can happen in aqueous foams are listed as Marangoni recirculation in the transition region, Marangoni-driven flow from Plateau border towards the film in the foam fractionation process, and Marangoni flow caused by exposure of foam containing photosurfactants under UV. Then, the flow analysis of combined elements of foam such as PB-film along with Marangoni flow and PB-node are studied. Next, we contrast the behavior of foams in different conditions. These various conditions can be perturbation in the foam structure caused by injected water droplets or waves or using a non-Newtonian fluid to make the foam. Further review is about the effect of oil droplets and particles on the characteristics of foam such as drainage, stability and interfacial mobility. Copyright © 2018 Elsevier B.V. All rights reserved.
Innovative test method for the estimation of the foaming tendency of substrates for biogas plants
DOE Office of Scientific and Technical Information (OSTI.GOV)
Moeller, Lucie, E-mail: lucie.moeller@ufz.de; Eismann, Frank, E-mail: info@antoc.de; Wißmann, Daniel, E-mail: d.s.wissmann@gmx.de
2015-07-15
Graphical abstract: Display Omitted - Highlights: • Foaming in biogas plants depends on the interactions between substrate and digestate. • Foaming tests enable the evaluation of substrate foaming tendency in biogas plants. • Leipzig foam tester enables foaming tests of substrates prior to use. - Abstract: Excessive foaming in anaerobic digestion occurs at many biogas plants and can cause problems including plugged gas pipes. Unfortunately, the majority of biogas plant operators are unable to identify the causes of foaming in their biogas reactor. The occurrence of foaming is often related to the chemical composition of substrates fed to the reactor.more » The consistency of the digestate itself is also a crucial part of the foam formation process. Thus, no specific recommendations concerning substrates can be given in order to prevent foam formation in biogas plants. The safest way to avoid foaming is to test the foaming tendency of substrates on-site. A possible solution is offered by an innovative foaming test. With the help of this tool, biogas plant operators can evaluate the foaming disposition of new substrates prior to use in order to adjust the composition of substrate mixes.« less
Development of Defoamers for Confinenment Foam
DOE Office of Scientific and Technical Information (OSTI.GOV)
Hoffman, D M; Mitchell, A R
Aqueous foam concentrate (AFC) 380 foam was developed by Sandia National Laboratory as a blast mitigation foam for unexploded ordnance (UXO) and its ''engineered foam structure'' is reported to be able to ''envelop chemical or biological aerosols'' [1]. It is similar to commercial fire-fighting foams, consisting mostly of water with small amounts of two alcohols, an ether and surfactant. It also contains xanthan gum, probably, to strengthen the foam film and delay drainage. The concentrate is normally diluted in a 6:94 ratio with water for foaming applications. The diluted solution is normally foamed with air to an expansion factor ofmore » about 100 (density 0.01 g/cc), which is called ''dry'' foam. Higher density foam (0.18 > {rho} > 0.03 g/cc) was discovered which had quite different characteristics from ''dry'' foam and was called ''wet'' foam. Some characterization of these foams has also been carried out, but the major effort described in this document is the evaluation, at the small and medium scale, of chemical, mechanical and thermal approaches to defoaming AFC 380 foam. Several chemical approaches to defoaming were evaluated including oxidation and precipitation of the xanthan, use of commercial oil-emulsion or suspension defoamers, pH modification, and cation exchange with the surfactant. Of these the commercial defoamers were most effective. Two mechanical approaches to defoaming were evaluated: pressure and foam rupture with very fine particles. Pressure and vacuum techniques were considered too difficult for field applications but high surface area silica particles worked very well on dry foam. Finally simple thermal techniques were evaluated. An order-disorder transition occurs in xanthan solutions at about 60 C, which may be responsible for the effectiveness of hot air as a defoamer. During defoaming of 55 gallons of foam with hot air, after about 70% of the AFC 380 foam had been defoamed, the effectiveness of hot air was dramatically reduced. Approximately 15 gal of residual foam containing mostly small bubbles was resistant to further defoaming by methods that had been effective on the original, dry foam. In this paper the residual foam is referred to as ''wet'' and the original foam is referred to as ''dry''. Methods for generating ''wet'' foam in small to moderate quantities for defoaming experiments have been developed. Methods for defoaming wet foam are currently under study.« less
40 CFR 63.8830 - What definitions apply to this subpart?
Code of Federal Regulations, 2012 CFR
2012-07-01
... (CONTINUED) National Emission Standards for Hazardous Air Pollutants: Flexible Polyurethane Foam Fabrication... chemical substance that is applied for the purpose of bonding foam to foam, foam to fabric, or foam to any... means the process of bonding flexible foam to one or more layers of material by heating the foam surface...
40 CFR 63.8830 - What definitions apply to this subpart?
Code of Federal Regulations, 2010 CFR
2010-07-01
... (CONTINUED) National Emission Standards for Hazardous Air Pollutants: Flexible Polyurethane Foam Fabrication... chemical substance that is applied for the purpose of bonding foam to foam, foam to fabric, or foam to any... means the process of bonding flexible foam to one or more layers of material by heating the foam surface...
40 CFR 63.8830 - What definitions apply to this subpart?
Code of Federal Regulations, 2013 CFR
2013-07-01
... (CONTINUED) National Emission Standards for Hazardous Air Pollutants: Flexible Polyurethane Foam Fabrication... chemical substance that is applied for the purpose of bonding foam to foam, foam to fabric, or foam to any... means the process of bonding flexible foam to one or more layers of material by heating the foam surface...
40 CFR 63.8830 - What definitions apply to this subpart?
Code of Federal Regulations, 2011 CFR
2011-07-01
... (CONTINUED) National Emission Standards for Hazardous Air Pollutants: Flexible Polyurethane Foam Fabrication... chemical substance that is applied for the purpose of bonding foam to foam, foam to fabric, or foam to any... means the process of bonding flexible foam to one or more layers of material by heating the foam surface...
40 CFR 63.8830 - What definitions apply to this subpart?
Code of Federal Regulations, 2014 CFR
2014-07-01
... (CONTINUED) National Emission Standards for Hazardous Air Pollutants: Flexible Polyurethane Foam Fabrication... chemical substance that is applied for the purpose of bonding foam to foam, foam to fabric, or foam to any... means the process of bonding flexible foam to one or more layers of material by heating the foam surface...
Maruta, Michito; Matsuya, Shigeki; Nakamura, Seiji; Ishikawa, Kunio
2011-01-01
Carbonate apatite (CO(3)Ap) foam may be an ideal bone substitute as it is sidelined to cancellous bone with respect to its chemical composition and structure. However, CO(3)Ap foam fabricated using α-tricalcium phosphate foam showed limited mechanical strength. In the present study, feasibility of the fabrication of calcite which could be a precursor of CO(3)Ap was studied. Calcite foam was successfully fabricated by the so-called "ceramic foam" method using calcium hydroxide coated polyurethane foam under CO(2)+O(2) atmosphere. Then the calcite foam was immersed in Na(2)HPO(4) aqueous solution for phase transformation based on dissolution-precipitation reaction. When CaO-free calcite foam was immersed in Na(2)HPO(4) solution, low-crystalline CO(3)Ap foam with 93-96% porosity and fully interconnected porous structure was fabricated. The compressive strength of the foam was 25.6 ± 6 kPa. In light of these results, we concluded that the properties of the precursor foam were key factors for the fabrication of CO(3)Ap foams.
Efficient continuous dryer for flexible polyurethane foam and cleaning apparatus
Jody, Bassam; Daniels, Edward; Libera, Joseph A.
1999-01-01
A method of cleaning polyurethane foams where the material is transported through a wash station while alternately soaking the polyurethane foam in an organic solvent and squeezing solvent from the polyurethane foam a number of times. Then the polyurethane foam is sent through a rinse or solvent transfer station for reducing the concentration of solvent in the foam. The rinsed polyurethane foam is sent to a drying station wherein the foam is repeatedly squeezed while being exposed to hot air to remove wet air from the foam.
Efficient continuous dryer for flexible polyurethane foam and cleaning apparatus
Jody, B.; Daniels, E.; Libera, J.A.
1999-03-16
A method of cleaning polyurethane foams where the material is transported through a wash station while alternately soaking the polyurethane foam in an organic solvent and squeezing solvent from the polyurethane foam a number of times. Then the polyurethane foam is sent through a rinse or solvent transfer station for reducing the concentration of solvent in the foam. The rinsed polyurethane foam is sent to a drying station wherein the foam is repeatedly squeezed while being exposed to hot air to remove wet air from the foam. 4 figs.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Evans, M.L.; Carroll, H.A.
1986-07-01
The handbook describes basic types of foams that may be used to control vapor hazards from spilled volatile chemicals. It provides a table to be used by spill-response personnel to choose an appropriate foam based on the type of chemical spill. Six general types of foams, surfactant (syndet) foams, aqueous film forming foams (AFFF), alcohol type or polar solvent type foams (ATF), and special foams such as Hazmat NF no. 1 which was developed especially for alkaline spills. The handbook provides the basis for spill responders to evaluate and select a foam for vapor control by using the test methodsmore » presented or by considering manufacturers specifications for foam-expansion ratios and quarter drainage times. The responder is encouraged to maximize the effectiveness of a foam by trying different nozzles, distances of applications, and thicknesses of the foam layers.« less
Aramwit, Pornanong; Yamdech, Rungnapha; Ampawong, Sumate
2016-05-01
One approach in wound dressing development is to incorporate active molecules or drugs in the dressing. In order to reduce the frequency of dressing changes as well as to prolong wound healing efficacy, wound dressings that can sustain the release of the active molecules should be developed. In our previous work, we developed chitosan/sericin (CH/SS) microspheres that released sericin in a controlled rate. However, the difficulty of applying the microspheres that easily diffuse and quickly degrade onto the wound was its limitations. In this study, we aimed to develop wound dressing materials which are easier to apply and to provide extended release of sericin. Different amounts of CH/SS microspheres were embedded into various compositions of polyvinyl alcohol/gelatin (PVA/G) scaffolds and fabricated using freeze-drying and glutaraldehyde crosslinking techniques. The obtained CH/SS microspheres-embedded scaffolds with appropriate design and formulation were introduced as a wound dressing material. Sericin was released from the microspheres and the scaffolds in a sustained manner. Furthermore, an optimized formation of the microspheres-embedded scaffolds (2PVA2G+2CHSS) was shown to possess an effective antimicrobial activity against both gram-positive and gram-negative bacteria. These microspheres-embedded scaffolds were not toxic to L929 mouse fibroblast cells, and they did not irritate the tissue when applied to the wound. Finally, probably by the sustained release of sericin, these microspheres-embedded scaffolds could promote wound healing as well as or slightly better than a clinically used wound dressing (Allevyn®) in a mouse model. The antimicrobial CH/SS microspheres-embedded PVA/G scaffolds with sustained release of sericin would appear to be a promising candidate for wound dressing application.
Assadian, Ojan; Arnoldo, Brett; Purdue, Gary; Burris, Agnes; Skrinjar, Edda; Duschek, Nikolaus; Leaper, David J
2015-06-01
This prospective, randomised study compares a new transforming methacrylate dressing (TMD) with a silver-containing carboxymethylcellulose dressing (CMC-Ag) after application to split-thickness skin graft (STSG) donor sites. This was an unblinded, non-inferiority, between-patient, comparison study that involved patients admitted to a single-centre burn unit who required two skin graft donor sites. Each patient's donor sites were covered immediately after surgery: one donor site with TMD and the other with CMC-Ag. The donor sites were evaluated until healing or until 24 days post-application, whichever came first. Study endpoints were time to healing, daily pain scores, number of dressing changes, patient comfort and physicians' and patients' willingness to use the dressings in the future. Nineteen patients had both the dressings applied. No statistically significant difference was noted in time to healing between the two dressings (14·2 days using TMD compared with 13·2 days using CMC-Ag). When pain scores were compared, TMD resulted in statistically significantly less pain at three different time periods (2-5 days, 6-10 days and 11-15 days; P < 0·001 at all time periods). Patients also reported greater comfort with TMD (P < 0·001). Users rated TMD as being less easy to use because of the time and technique required for application. Reductions in pain and increased patient comfort with the use of the TMD dressing, compared with CMC-Ag, were seen as clinical benefits as these are the major issues in donor site management. © 2013 The Authors. International Wound Journal © 2013 Medicalhelplines.com Inc and John Wiley & Sons Ltd.
Wang, Li; Li, Lin-Feng
2017-03-01
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe drug-induced hypersensitivity reaction characterized by skin rash, fever, blood abnormalities, and multiple organ involvement. The diagnosis of DRESS syndrome is often delayed because of its variable presentation. Prompt withdrawal of the culprit drug is the definitive treatment. DRESS syndrome induced by antituberculosis drugs has rarely been reported. A 50-year-old man admitted to our hospital with recurrent episodes of progressive rash, fever, eosinophilia, lymphadenopathy, hepatic, and pulmonary involvement were experienced after repeat trials of the same antituberculosis drugs. We diagnosed it as DRESS caused by antituberculosis drugs. The case responded well to treatment with systemic corticosteroids and intravenous immunoglobulins. However, repeated bouts of infection with methicillin-resistant Staphylococcus aureus occurred during treatment (clavicular osteomyelitis and knee septic arthritis). He was cured after treatment with linezolid. The patient was discharged on day 112. At 8-month follow-up, there was no relapse of drug eruption and joint swelling. Early diagnosis and prompt withdrawal of all suspected drugs is a key tenet of the treatment of DRESS. Our case report highlights the risks inherent in delayed diagnosis of DRESS and the challenges in the clinical management of this condition. Pulmonary manifestations with radiological changes on chest X-ray and CT can be seen in DRESS. These changes need to be differentiated from those caused by pulmonary infections. Clavicular osteomyelitis infected with MRSA may be caused by iatrogenic injury during subclavian vein catheterization. This type of MRSA infections should be treated for 4 to 6 weeks. Blood eosinophilia could be a useful marker of disease progression and treatment response in patients with DRESS. However, more experience and clinical evidence is needed to confirm this.
Nakagami, Gojiro; Sanada, Hiromi; Konya, Chizuko; Kitagawa, Atsuko; Tadaka, Etsuko; Matsuyama, Yutaka
2007-09-01
This paper is a report of an evaluation of the effectiveness of a newly developed dressing for preventing persistent erythema and pressure ulcer development and improving the water-holding capacity without increasing the skin pH in bedridden older patients. Shear forces and skin dryness play important roles in persistent erythema and pressure ulcer development. To eliminate these risks, we developed a dressing to reduce shear forces and improve the water-holding capacity. However, the effects of this dressing in clinical settings remain unknown. An experimental bilateral comparison study was conducted at a hospital in Japan in 2004 with 37 bedridden older patients at risk of pressure ulcer development. The dressing was randomly applied to the right or left greater trochanter for 3 weeks. No dressing was applied to the opposite side as a control. The skin was monitored weekly during the 3-week application for persistent erythema and pressure ulcer development. Skin hydration and pH were also assessed during the intervention and for 1 week after dressing removal. The incidence of persistent erythema was significantly lower in the intervention area than the control area [P = 0.007, RR 0.18 (95% CI: 0.05-0.73) and NNT 4.11 (2.50-11.63) ]. No pressure ulcers occurred in either the intervention or control area. Skin hydration increased significantly during dressing application and remained high after removal (P < 0.001) relative to the control area. Skin pH decreased significantly during the application (P < 0.001) but returned to control levels after removal (P = 0.38). This safe and effective dressing can be used for patients with highly prominent bones and dry skin to prevent pressure ulcers.
Patients' attitudes toward the attire of male physicians: a single-center study in Saudi Arabia.
Batais, Mohammad Ali
2014-01-01
The doctor-patient relationship has been influenced by the appearance of physicians, and there is an association between a physician's physical appearance and the patients' initial perceptions of physician competence. This study aims to explore patients' preferences toward the attire of a male physician, and to examine if a physician's choice of uniform influences the degree of trust, confidence, and follow-up care among respondents. A cross-sectional survey conducted among patients of the Alwazarat family medicine center in Riyadh, Saudi Arabia. A self-administered questionnaire was completed by 300 patients (50% were male and 83.6% had received a secondary education; the mean age was 33.4 [10.1] years) in the Alwazarat family medicine center in Riyadh. The questionnaire was also customized for the local setting with the inclusion of photos of a male doctor in Saudi Arabian national costume, and 3 other dress styles (Western dress with white coat, scrubs with white coat, and scrubs only). Overall, across all questions regarding physician dress style preferences, participants significantly preferred Western dress (39.9%, P < .001), followed by Saudi national dress (26.3%), a scrub suit with a white coat (22.3%), and scrubs only (11.5%). Respondents reported that they were more likely to follow medical advice and would return for follow-up care if a physician wore Western dress. They were significantly more willing to share their social, sexual, and psychological problems with a physician wearing Saudi national dress (P < .001). The importance of a physician's appearance was ranked significantly higher by older patients (P=.002). Respondents were more likely to favor a physician wearing Western attire with a white coat. However, Saudi national dress, followed by Western dress, is the preferred attire when physicians are dealing with social, sexual, and psychological problems.
Chin, Chai-Yee; Jalil, Juriyati; Ng, Pei Yuen; Ng, Shiow-Fern
2018-02-15
M.oleifera is a medicinal plant traditionally used for skin sores, sore throat and eye infections. Recently, the wound healing property of the leaves of M. oleifera was has been well demonstrated experimentally in both in vivo and in vitro models. However, there is a lack of research which focuses on formulating M.oleifera into a functional wound dressing. In this study, the M.oleifera leaf standardized aqueous extract with highest potency in vitro migration was formulated into a film for wound healing application. Firstly, M. oleifera leaf were extracted in various solvents (aqueous, 50%, 70% and 100% ethanolic extracts) and standardized by reference standards using UHPLC technique. The extracts were then tested for cell migration and proliferation using HDF and HEK cell lines. M. oleifera leaf aqueous extract was then incorporated into alginate-pectin (SA-PC) based film dressing. The film dressings were characterized for the physicochemical properties and the bioactives release from the M. oleifera leaf extract loaded film dressing was also investigated using Franz diffusion cells. All extracts were found to contain vicenin-2, chlorogenic acid, gallic acid, quercetin, kaempferol, rosmarinic acid and rutin. Among all M. oleifera extracts, aqueous standardized leaf extracts showed the highest human dermal fibroblast and human keratinocytes cells proliferation and migration properties. Among the film formulations, SA-PC (3% w/v) composite film dressing containing M. oleifera aqueous leaf extract was found to possess optimal physicochemical properties as wound dressing. A potentially applicable wound dressing formulated as an alginate-pectin film containing aqueous extracts of M. oleifera has been developed. The dressing would be suitable for wounds with moderate exudates. Copyright © 2017 Elsevier B.V. All rights reserved.
Biffi, Roberto; Fattori, Luca; Bertani, Emilio; Radice, Davide; Rotmensz, Nicole; Misitano, Pasquale; Cenciarelli, Sabine; Chiappa, Antonio; Tadini, Liliana; Mancini, Marina; Pesenti, Giovanni; Andreoni, Bruno; Nespoli, Angelo
2012-05-23
An antimicrobial dressing containing ionic silver was found effective in reducing surgical-site infection in a preliminary study of colorectal cancer elective surgery. We decided to test this finding in a randomized, double-blind trial. Adults undergoing elective colorectal cancer surgery at two university-affiliated hospitals were randomly assigned to have the surgical incision dressed with Aquacel Ag Hydrofiber dressing or a common dressing. To blind the patient and the nursing and medical staff to the nature of the dressing used, scrub nurses covered Aquacel Ag Hydrofiber with a common wound dressing in the experimental arm, whereas a double common dressing was applied to patients of control group. The primary end-point of the study was the occurrence of any surgical-site infection within 30 days of surgery. A total of 112 patients (58 in the experimental arm and 54 in the control group) qualified for primary end-point analysis. The characteristics of the patient population and their surgical procedures were similar. The overall rate of surgical-site infection was lower in the experimental group (11.1% center 1, 17.5% center 2; overall 15.5%) than in controls (14.3% center 1, 24.2% center 2, overall 20.4%), but the observed difference was not statistically significant (P = 0.451), even with respect to surgical-site infection grade 1 (superficial) versus grades 2 and 3, or grade 1 and 2 versus grade 3. This randomized trial did not confirm a statistically significant superiority of Aquacel Ag Hydrofiber dressing in reducing surgical-site infection after elective colorectal cancer surgery. Clinicaltrials.gov: NCT00981110.
Payne, Caroline; Edwards, Daren
2014-01-01
Objectives: Traumatic wounds and surgery inherently have their complications. Localized infections, wound dehiscence, and excessive wound leakage can be devastating to the patient with a prolonged recovery, but it is also costly to the hospital with an increased length of stay, extra workload, and dressing changes. The single use PICO (Smith and Nephew Healthcare, Hull, United Kingdom) negative pressure wound therapy (NPWT) dressing has revolutionized our management of various acute, chronic, and high output wounds. It requires fewer dressing changes than conventional practice, is used in the outpatient setting, and is a necessary adjuvant therapy to hasten wound healing. Aims: To observe the efficacy of the PICO vacuum-assisted healing within a cost improvement programme. Settings: Plastic surgery department, Royal London Hospital. Materials and Methods: Twenty-one patients with a diversity of postoperative or posttraumatic wounds were considered suitable for PICO application and treated totally on an outpatient basis once the PICO dressing was applied. All wounds were then subjected to continued PICO dressings until healed. Results: All patients tolerated the PICO well with no dressing failure or failure to comply. The number of dressings per patient ranged from 1 to 7. The cost per patient of treatment ranged from £120 to £1578. Estimated cost of all PICO dressing for 21 patients including plastic surgery dressing clinic appointments = £13,345. Median length of treatment to healing (days) = 16; standard deviation = 9.5. Eight patients would have had an inpatient bed stay with conventional therapy, total 24 bed days saved at Bartshealth @£325 per day. Conclusions: The outpatient application of a disposable NPWT can benefit a wide range of clinical wounds that optimizes patient care, promotes rapid wound healing, and importantly helps manage costs. PMID:24917894
Devices and dressings to secure peripheral venous catheters to prevent complications.
Marsh, Nicole; Webster, Joan; Mihala, Gabor; Rickard, Claire M
2015-06-12
A peripheral venous catheter (PVC) is typically used for short-term delivery of intravascular fluids and medications. It is an essential element of modern medicine and the most frequent invasive procedure performed in hospitals. However, PVCs often fail before intravenous treatment is completed: this can occur because the device is not adequately attached to the skin, allowing the PVC to fall out, leading to complications such as phlebitis (irritation or inflammation to the vein wall), infiltration (fluid leaking into surrounding tissues) or occlusion (blockage). An inadequately secured PVC also increases the risk of catheter-related bloodstream infection (CRBSI), as the pistoning action (moving back and forth in the vein) of the catheter can allow migration of organisms along the catheter and into the bloodstream. Despite the many dressings and securement devices available, the impact of different securement techniques for increasing PVC dwell time is still unclear; there is a need to provide guidance for clinicians by reviewing current studies systematically. To assess the effects of PVC dressings and securement devices on the incidence of PVC failure. We searched the following electronic databases to identify reports of relevant randomised controlled trials (RCTs): the Cochrane Wounds Group Register (searched 08 April 2015): The Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 3), Ovid MEDLINE (1946 to March 7 2015); Ovid MEDLINE (In-Process & Other Non-Indexed Citations, March 7 2015); Ovid EMBASE (1974 to March 7 2015); and EBSCO CINAHL (1982 to March 8 2015). RCTs or cluster RCTs comparing different dressings or securement devices for the stabilisation of PVCs. Cross-over trials were ineligible for inclusion, unless data for the first treatment period could be obtained. Two review authors independently selected studies, assessed trial quality and extracted data. We contacted study authors for missing information. We used standard methodological procedures expected by Cochrane. We included six RCTs (1539 participants) in this review. Trial sizes ranged from 50 to 703 participants. These six trials made four comparisons, namely: transparent dressings versus gauze; bordered transparent dressings versus a securement device; bordered transparent dressings versus tape; and transparent dressing versus sticking plaster. There is very low quality evidence of fewer catheter dislodgements or accidental removals with transparent dressings compared with gauze (two studies, 278 participants, RR 0.40; 95% CI 0.17 to 0.92, P = 0.03%). The relative effects of transparent dressings and gauze on phlebitis (RR 0.89; 95% CI 0.47 to 1.68) and infiltration (RR 0.80; 95% CI 0.48 to 1.33) are unclear. The relative effects on PVC failure of a bordered transparent dressing and a securement device have been assessed in only one small study and these were unclear. There was very low quality evidence from the same single study of less frequent dislodgement or accidental catheter removal with bordered transparent dressings than securement devices (RR 0.14, 95% CI 0.03 to 0.63) but more phlebitis with bordered dressings (RR 8.11, 95% CI 1.03 to 64.02) (very low quality evidence). A small single study compared bordered transparent dressings with tape and found very low quality evidence of more PVC failure with the bordered dressing (RR 1.84, 95% CI 1.08 to 3.11) but the relative effects on dislodgement were not clear (very low quality evidence). The relative effects of transparent dressings and a sticking plaster have only been compared in one small study and are unclear. More high quality RCTs are required to determine the relative effects of alternative PVC dressings and securement devices. It is not clear if any one dressing or securement device is better than any other in securing peripheral venous catheters. There is a need for further, independent high quality trials to evaluate the many traditional as well as the newer, high use products. Given the large cost differences between some different dressings and securement devices, future trials should include a robust cost-effectiveness analysis.
Forming foam structures with carbon foam substrates
Landingham, Richard L.; Satcher, Jr., Joe H.; Coronado, Paul R.; Baumann, Theodore F.
2012-11-06
The invention provides foams of desired cell sizes formed from metal or ceramic materials that coat the surfaces of carbon foams which are subsequently removed. For example, metal is located over a sol-gel foam monolith. The metal is melted to produce a metal/sol-gel composition. The sol-gel foam monolith is removed, leaving a metal foam.
González, Arturo
2016-01-01
This case study describes treatment for a 52-year-old man with a recurrent venous leg ulcer using a collagen dressing with extracellular matrix. The patient was admitted to the wound care service for a 3-week-old recurrent venous ulcer. Treatment included application of a collagen dressing with extracellular matrix twice weekly or as needed by the patient; application of a secondary dressing (4 × 4 gauze); and coverage with an expandable netting or gauze using a conforming stretch gauze bandage and latex-free dressing retention tape. The initial venous leg ulcer in this patient required 10 weeks to achieve closure. Ninety-eight percent resolution of the recurrent ulcer had occurred within 4 weeks of treatment, with complete closure at 7 weeks. The average healing time for recurrent venous ulcers is reported in the literature to be longer than initial venous ulcers. In the case provided, collagen ECM dressings promoted complete wound healing in 49 days.
Application of VitaVallis dressing for infected wounds
DOE Office of Scientific and Technical Information (OSTI.GOV)
Kirilova, N. V., E-mail: n.kirilova@vitavallis.com; Fomenko, A. N., E-mail: alserova@ispms.tsc.ru; Korovin, M. S., E-mail: msk@ispms.tsc.ru
Today there is a growing demand for safe and efficient antimicrobial dressings for infected wound treatment. The antimicrobial sorption material for VitaVallis dressings was produced by one-stage oxidation of aluminum nanopowder in water in the presence of fibrous acetylcellulose matrix. Scanning electron microscopy revealed that the material is made up of fibers of diameter 1.5–3.0 µm with adhered agglomerated alumina nanosheets. An antimicrobial study revealed a high inhibitory effect of VitaVallis against the growth of gram-negative (E.coli, P. aeruginosa) and gram-positive (S. aureus) strains. The antimicrobial activity of the dressing against microbial pathogens on the wound surface was demonstrated in inmore » vivo experiments on male rats. The dressing was also tested on volunteer patients. The testing showed reduction of the wound healing period, accelerated cleaning of the infected wound and enhanced tissue regeneration in the wound. The results demonstrate that the VitaVallis dressing can be used for the treatment of deep infected wounds.« less
Waring, Mike; Bielfeldt, Stephan; Mätzold, Katja; Wilhelm, Klaus-Peter
2013-02-01
Chronic wounds require frequent dressing changes. Adhesive dressings used for this indication can be damaging to the stratum corneum, particularly in the elderly where the skin tends to be thinner. Understanding the level of damage caused by dressing removal can aid dressing selection. This study used a novel methodology that applied a stain to the skin and measured the intensity of that stain after repeated application and removal of a series of different adhesive types. Additionally, a traditional method of measuring skin barrier damage (transepidermal water loss) was also undertaken and compared with the staining methodology. The staining methodology and measurement of transepidermal water loss differentiated the adhesive dressings, showing that silicone adhesives caused least trauma to the skin. The staining methodology was shown to be as effective as transepidermal water loss in detecting damage to the stratum corneum and was shown to detect disruption of the barrier earlier than the traditional technique. © 2012 John Wiley & Sons A/S.
Controlled trial of Iodosorb in chronic venous ulcers.
Ormiston, M C; Seymour, M T; Venn, G E; Cohen, R I; Fox, J A
1985-01-01
Cadexomer iodine (Iodosorb) is a hydrophilic starch powder containing iodine, which is a suitable dressing for granulating wounds such as venous ulcers. A total of 61 outpatients with chronic venous ulcers participated in a randomised optional crossover trial using cadexomer iodine or a standard dressing for their ulcers. The trial lasted for 24 weeks or until the ulcer had healed. Two patients withdrew during the course of the trial. Both treatments were highly effective, but the epithelium of ulcers dressed with cadexomer iodine grew again significantly faster (p less than 0.001). At the midpoint of the trial (12th week) 13 of 30 patients receiving standard treatment were changed to cadexomer iodine, while only three of 29 receiving cadexomer iodine changed to the standard dressing (p less than 0.02). In most cases ulcers were dressed and rebandaged daily by the patients themselves after instruction and supervision. This may be better than having dressings and bandages applied by professionals less regularly. PMID:3926169
Gelam (Melaleuca spp.) Honey-Based Hydrogel as Burn Wound Dressing
Mohd Zohdi, Rozaini; Abu Bakar Zakaria, Zuki; Yusof, Norimah; Mohamed Mustapha, Noordin; Abdullah, Muhammad Nazrul Hakim
2012-01-01
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-1α, IL-1β, and IL-6). The present study substantiates the potential efficacy of honey hydrogel dressings in accelerating burn wound healing. PMID:21941590
EL Omairi, Nissrine; Abourazzak, Sanae; Chaouki, Sanae; Atmani, Samir; Hida, Moustapha
2014-01-01
Drug-induced hypersensitivity or Drug Reaction with Eosinophilia and Systemic Symptom (DRESS) is a severe adverse drug-induced reaction. Diagnosing DRESS is challenging due to the diversity of cutaneous eruption and organs involved. Most of the aromatic anticonvulsants, such as phenytoin, phenobarbital, and carbamazepine, can induce DRESS. Culprit drug withdrawal and corticosteroids constituted the mainstay of DRESS treatment. We describe a 6 year-old boy who presented fever and rash 4 weeks after starting carbamazepine. Investigation revealed leukocytosis, atypical lymphocytosis, and elevated serum transaminases. The diagnosis of DREES syndrome was made, Carbamazepine was stopped and replaced initially by Clobazam and by Valproic acid after discharge, no systemic corticotherapy was prescribed. Symptoms began to resolve within two weeks, and by one month later her laboratory values had returned to normal. The aim of this work is to raise awareness general practitioner and pediatricians to suspect Dress syndrome in patients who present with unusual complaints and skin findings after starting any antiepileptic drug. PMID:25360193
Evaluation of a honey-impregnated tulle dressing in primary care.
Stephen-Haynes, Jackie
2004-06-01
Honey has been used for its healing properties for centuries and has been used to dress wounds with favourable results. The emergence of antibiotic resistance and growing interest in "natural" or "complementary" therapies has led to an interest in honey dressings. Much of the research to date has been related to honey's antibacterial properties. However, the healing properties claimed for honey also include stimulating new tissue growth, moist wound healing, fluid handling and promoting epithelialization. Until recently, honey had not been developed as a wound management product and was not a certified pharmaceutical device. Activon Tulle is a sterile, non-adherent dressing impregnated with Leptospermum scoparium hone. The claimed properties of honey dressings would make this a valuable addition to the dressing currently available in the primary care setting. An evaluation was undertaken involving 20 patients with a variety of wounds. A conclusion is drawn that while further research is needed, medical grade honey does appear to be a valuable addition to the wound management formulary.
Effects of wound dressings on cultured primary keratinocytes.
Esteban-Vives, Roger; Young, Matthew T; Ziembicki, Jenny; Corcos, Alain; Gerlach, Jörg C
2016-02-01
Autologous cell-spray grafting of non-cultured epidermal cells is an innovative approach for the treatment of severe second-degree burns. After treatment, wounds are covered with dressings that are widely used in wound care management; however, little is known about the effects of wound dressings on individually isolated cells. The sprayed cells have to actively attach, spread, proliferate, and migrate in the wound for successful re-epithelialization, during the healing process. It is expected that exposure to wound dressing material might interfere with cell survival, attachment, and expansion. Two experiments were performed to determine whether some dressing materials have a negative impact during the early phases of wound healing. In one experiment, freshly isolated cells were seeded and cultured for one week in combination with eight different wound dressings used during burn care. Cells, which were seeded and cultured with samples of Adaptic(®), Xeroform(®), EZ Derm(®), and Mepilex(®) did not attach, nor did they survive during the first week. Mepitel(®), N-Terface(®), Polyskin(®), and Biobrane(®) dressing samples had no negative effect on cell attachment and cell growth when compared to the controls. In a second experiment, the same dressings were exposed to pre-cultured cells in order to exclude the effects of attachment and spreading. The results confirm the above findings. This study could be of interest for establishing skin cell grafting therapies in burn medicine and also for wound care in general. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.
Efficacy of a surfactant-based wound dressing on biofilm control.
Percival, Steven L; Mayer, Dieter; Salisbury, Anne-Marie
2017-09-01
The aim of this study was to evaluate the efficacy of both a nonantimicrobial and antimicrobial (1% silver sulfadiazine-SSD) surfactant-based wound dressing in the control of Pseudomonas aeruginosa, Enterococcus sp, Staphylococcus epidermidis, Staphylococcus aureus, and methicillin-resistant S. aureus (MRSA) biofilms. Anti-biofilm efficacy was evaluated in numerous adapted American Standards for Testing and Materials (ASTM) standard biofilm models and other bespoke biofilm models. The ASTM standard models employed included the Minimum biofilm eradication concentration (MBEC) biofilm model (ASTM E2799) and the Centers for Disease Control (CDC) biofilm reactor model (ASTM 2871). Such bespoke biofilm models included the filter biofilm model and the chamberslide biofilm model. Results showed complete kill of microorganisms within a biofilm using the antimicrobial surfactant-based wound dressing. Interestingly, the nonantimicrobial surfactant-based dressing could disrupt existing biofilms by causing biofilm detachment. Prior to biofilm detachment, we demonstrated, using confocal laser scanning microscopy (CLSM), the dispersive effect of the nonantimicrobial surfactant-based wound dressing on the biofilm within 10 minutes of treatment. Furthermore, the non-antimicrobial surfactant-based wound dressing caused an increase in microbial flocculation/aggregation, important for microbial concentration. In conclusion, this nonantimicrobial surfactant-based wound dressing leads to the effective detachment and dispersion of in vitro biofilms. The use of surfactant-based wound dressings in a clinical setting may help to disrupt existing biofilm from wound tissue and may increase the action of antimicrobial treatment. © 2017 by the Wound Healing Society.
N-Halamine Biocidal Materials with Superior Antimicrobial Efficacies for Wound Dressings.
Demir, Buket; Broughton, Roy M; Qiao, Mingyu; Huang, Tung-Shi; Worley, S D
2017-09-21
This work demonstrated the successful application of N-halamine technology for wound dressings rendered antimicrobial by facile and inexpensive processes. Four N-halamine compounds, which possess different functional groups and chemistry, were synthesized. The N-halamine compounds, which contained oxidative chlorine, the source of antimicrobial activity, were impregnated into or coated onto standard non-antimicrobial wound dressings. N-halamine-employed wound dressings inactivated about 6 to 7 logs of Staphylococcus aureus and Pseudomonas aeruginosa bacteria in brief periods of contact time. Moreover, the N-halamine-modified wound dressings showed superior antimicrobial efficacies when compared to commercially available silver wound dressings. Zone of inhibition tests revealed that there was no significant leaching of the oxidative chlorine from the materials, and inactivation of bacteria occurred by direct contact. Shelf life stability tests showed that the dressings were stable to loss of oxidative chlorine when they were stored for 6 months in dark environmental conditions. They also remained stable under florescent lighting for up to 2 months of storage. They could be stored in opaque packaging to improve their shelf life stabilities. In vitro skin irritation testing was performed using a three-dimensional human reconstructed tissue model (EpiDerm™). No potential skin irritation was observed. In vitro cytocompatibility was also evaluated. These results indicate that N-halamine wound dressings potentially can be employed to prevent infections, while at the same time improving the healing process by eliminating undesired bacterial growth.
Dressing wear time after breast reconstruction: study protocol for a randomized controlled trial
2013-01-01
Background One of the major risk variables for surgical site infection is wound management. Understanding infection risk factors for breast operations is essential in order to develop infection-prevention strategies and improve surgical outcomes. The aim of this trial is to assess the influence of dressing wear time on surgical site infection rates and skin colonization. Patients’ perception at self-assessment will also be analyzed. Methods/Design This is a two-arm randomized controlled trial. Two hundred breast cancer patients undergoing immediate or delayed breast reconstruction will be prospectively enrolled. Patients will be randomly allocated to group I (dressing removed on postoperative day one) or group II (dressing removed on postoperative day six). Surgical site infections will be defined by standard criteria from the Centers for Disease Control and Prevention (CDC). Skin colonization will be assessed by culture of samples collected at predefined time points. Patients will score dressing wear time with regard to safety, comfort and convenience. Discussion The evidence to support dressing standards for breast surgery wounds is empiric and scarce. CDC recommends protecting, with a sterile dressing for 24 to 48 hours postoperatively, a primarily closed incision, but there is no recommendation to cover this kind of incision beyond 48 hours, or on the appropriate time to shower or bathe with an uncovered incision. The results of the ongoing trial may support standard recommendations regarding dressing wear time after breast reconstruction. Trial registration ClinicalTrials.gov identifier: http://NCT01148823. PMID:23432779
Jin, Sung Giu; Yousaf, Abid Mehmood; Kim, Kyeong Soo; Kim, Dong Wuk; Kim, Dong Shik; Kim, Jin Ki; Yong, Chul Soon; Youn, Yu Seok; Kim, Jong Oh; Choi, Han-Gon
2016-03-30
The purpose of this study was to investigate the influence of different hydrophilic polymers on the swelling, bioadhesion and mechanical strength of hydrocolloid wound dressings (HCDs) in order to provide an appropriate composition for a hydrocolloid wound dressing system. In this study, the HCDs were prepared with styrene-isoprene-styrene copolymer (SIS) and polyisobutylene (PIB) as the base using a hot melting method. Additionally, numerous SIS/PIB-based HCDs were prepared with six hydrophilic polymers, and their wound dressing properties were assessed. Finally, the wound healing efficacy of the selected formulations was compared to a commercial wound dressing. The swelling ratio, bioadhesive force and mechanical strengths of HCDs were increased in the order of sodium alginate>sodium CMC=poloxamer=HPMC>PVA=PVP, sodium alginate>sodium CMC=poloxamer>PVA>HPMC=PVP and sodium alginate≥PVA>PVP=HPMC=sodium CMC>poloxamer, respectively. Among the hydrophilic polymers tested, sodium alginate most enhanced the swelling capacity, bioadhesive force and mechanical strengths. Thus, the hydrophilic polymers played great role in the swelling, bioadhesion and mechanical strength of SIS/PIB-based HCDs. The HCD formulation composed of PIB, SIS, liquid paraffin and sodium alginate at the weight ratio of 20/25/12/43 gave better wound dressing properties and more excellent wound healing efficacy than the commercial wound dressing. Therefore, the novel HCD formulation could be a promising hydrocolloid system for wound dressings. Copyright © 2016 Elsevier B.V. All rights reserved.
A Wireless Electroceutical Dressing Lowers Cost of Negative Pressure Wound Therapy
Ghatak, Piya Das; Schlanger, Richard; Ganesh, Kasturi; Lambert, Lynn; Gordillo, Gayle M.; Martinsek, Patsy; Roy, Sashwati
2015-01-01
Objective: To test whether the use of a wireless electroceutical dressing (WED) (Procellera®) in conjunction with a 5-day negative pressure wound therapy (NPWT) may reduce the number of dressing changes required per week with this therapy. Approach: At the Ohio State University Comprehensive Wound Center, chronic wound patients (n=30) undergoing NPWT were randomized into two arms following consent as approved by the institutional review board. The control arm received standard of care NPWT, where the dressing change was performed thrice a week. The test arm received the same care except that the WED was added as an interface layer and dressing change was limited to twice a week. Results: A reduced cost of care was achieved using the WED in conjunction with NPWT. Despite fewer dressing changes in wounds dressed with the WED, closure outcomes were comparable with no overt signs of any wound complication, including infection. The cost of NPWT care during the week was significantly lower (from $2918 to $2346) in the WED-treated group compared with patients in the control arm. Innovation: This work introduces a novel technology platform involving a WED, which may be used in conjunction with NPWT. If used as such, NPWT is effective in decreasing the frequency of dressing change and lowering the cost of care. Conclusion: This work points toward the benefit of using the WED combined with NPWT. A larger clinical trial investigating the cost-effectiveness of WED in wound care is warranted. PMID:26005596
Technological parameters influence on the non-autoclaved foam concrete characteristics
NASA Astrophysics Data System (ADS)
Bartenjeva, Ekaterina; Mashkin, Nikolay
2017-01-01
Foam concretes are used as effective heat-insulating materials. The porous structure of foam concrete provides good insulating and strength properties that make them possible to be used as heat-insulating structural materials. Optimal structure of non-autoclaved foam concrete depends on both technological factors and properties of technical foam. In this connection, the possibility to manufacture heat-insulation structural foam concrete on a high-speed cavity plant with the usage of protein and synthetic foamers was estimated. This experiment was carried out using mathematical planning method, and in this case mathematical models were developed that demonstrated the dependence of operating performance of foam concrete on foaming and rotation speed of laboratory plant. The following material properties were selected for the investigation: average density, compressive strength, bending strength and thermal conductivity. The influence of laboratory equipment technological parameters on technical foam strength and foam stability coefficient in the cement paste was investigated, physical and mechanical properties of non-autoclaved foam concrete were defined based on investigated foam. As a result of investigation, foam concrete samples were developed with performance parameters ensuring their use in production. The mathematical data gathered demonstrated the dependence of foam concrete performance on the technological regime.
Role of foam drainage in producing protein aggregates in foam fractionation.
Li, Rui; Zhang, Yuran; Chang, Yunkang; Wu, Zhaoliang; Wang, Yanji; Chen, Xiang'e; Wang, Tao
2017-10-01
It is essential to obtain a clear understanding of the foam-induced protein aggregation to reduce the loss of protein functionality in foam fractionation. The major effort of this work is to explore the roles of foam drainage in protein aggregation in the entire process of foam fractionation with bovine serum albumin (BSA) as a model protein. The results show that enhancing foam drainage increased the desorption of BSA molecules from the gas-liquid interface and the local concentration of desorbed molecules in foam. Therefore, it intensified the aggregation of BSA in foam fractionation. Simultaneously, it also accelerated the flow of BSA aggregates from rising foam into the residual solution along with the drained liquid. Because enhancing foam drainage increased the relative content of BSA molecules adsorbed at the gas-liquid interface, it also intensified the aggregation of BSA during both the defoaming process and the storage of the foamate. Furthermore, enhancing foam drainage more readily resulted in the formation of insoluble BSA aggregates. The results are highly important for a better understanding of foam-induced protein aggregation in foam fractionation. Copyright © 2017 Elsevier B.V. All rights reserved.
Enhanced rhamnolipids production via efficient foam-control using stop valve as a foam breaker.
Long, Xuwei; Shen, Chong; He, Ni; Zhang, Guoliang; Meng, Qin
2017-01-01
In this study, a stop valve was used as a foam breaker for dealing with the massive overflowing foam in rhamnolipid fermentation. As found, a stop valve at its tiny opening could break over 90% of the extremely stable rhamnolipid foam into enriched liquid when foam flows through the sharp gap in valve. The efficient foam-control by the stop valve considerably improved the rhamnolipid fermentation and significantly enhanced the rhamnolipid productivity by 83% compared to the regular fermentation. This efficient foam breaking was mainly achieved by a high shear rate in combination with fast separation of air from the collapsed foam. Altogether, the stop valve possessed a great activity in breaking rhamnolipid foam, and the involving mechanism holds the potential for developing efficient foam breakers for industrial rhamnolipid fermentation. Copyright © 2016. Published by Elsevier Ltd.
ZrP nanoplates based fire-fighting foams stabilizer
NASA Astrophysics Data System (ADS)
Zhang, Lecheng; Cheng, Zhengdong; Li, Hai
2015-03-01
Firefighting foam, as a significant innovation in fire protection, greatly facilitates extinguishments for liquid pool fire. Recently, with developments in LNG industry, high-expansion firefighting foams are also used for extinguishing LNG fire or mitigating LNG leakage. Foam stabilizer, an ingredient in fire-fighting foam, stabilizes foam bubbles and maintains desired foam volume. Conventional foam stabilizers are organic molecules. In this work, we developed a inorganic based ZrP (Zr(HPO4)2 .H2O, Zirconium phosphate) plates functionalized as firefighting foam stabilizer, improving firefighting foam performance under harsh conditions. Several tests were conducted to illustrate performance. The mechanism for the foam stabilization is also proposed. Artie McFerrin Department of Chemical Engineering, Texas A&M University, College Station, TX 77843, USA. Mary Kay O'Connor Process Safety Center, Texas A&M University, College Station, TX, 77843-3122
Foam, Foam-resin composite and method of making a foam-resin composite
NASA Technical Reports Server (NTRS)
MacArthur, Doug E. (Inventor); Cranston, John A. (Inventor)
1995-01-01
This invention relates to a foam, a foam-resin composite and a method of making foam-resin composites. The foam set forth in this invention comprises a urethane modified polyisocyanurate derived from an aromatic amino polyol and a polyether polyol. In addition to the polyisocyanurate foam, the composite of this invention further contains a resin layer, wherein the resin may be epoxy, bismaleimide, or phenolic resin. Such resins generally require cure or post-cure temperatures of at least 350.degree. F.
DEVELOPMENT OF A NEXT-GENERATION ANTIMICROBIAL WOUND DRESSING.
Metcalf, Daniel; Parsons, David; Bowler, I Philip
2016-03-01
Delayed wound healing due to infection is a burden on healthcare systems, and the patient and caregiver alike. An emerging factor in infection and delayed healing is the presence development of biofilm in wounds. Biofilm is communities of microorganisms, protected by an extracellular matrix of slime in the wound, which can tolerate host defences and applied antimicrobials such as antibiotics or antimicrobial dressings. A growing evidence base exists suggesting that biofilm exists in a majority of chronic wounds, and can be a precursor to infection while causing delayed healing itself. In vivo models have demonstrated that the inflammatory, granulation and epithelialization processes of normal wound healing are impaired by biofilm presence. The challenge in the development of a new antimicrobial wound dressing was to make standard antimicrobial agents more effective against biofilm, and this was answered following extensive biofilm research and testing. A combination of metal chelator, surfactant and pH control displayed highly synergistic anti-biofilm action with 1.2% ionic silver in a carboxymethylcellulose dressing. Its effectiveness was challenged and proven in complex in vitro and in vivo wound biofilm models, followed by clinical safety and performance demonstrations in a 42-patient study and 113 clinical evaluations. Post-market surveillance was conducted on the commercially available dressing, and in a 112-case evaluation, the dressing was shown to effectively manage exudate and suspected biofilm while shifting difficult-to-heal wounds onto healing trajectories, after an average of 4 weeks of new dressing use in otherwise standard wound care protocols. This was accompanied by a low frequency of dressing related adverse events. In a second evaluation, clinical signs of infection and wound dimension data, before and after the evaluations, were also available. Following an average of 5.4 weeks of dressing use, all signs of clinical infection were reduced, from an average frequency of 36% to 21%. An average of 62% wound size reduction was achieved, with 90% of wounds reducing in size and 10 wounds healing completely. The new clinical evidence for this next-generation antimicrobial wound dressing suggests it is safe and effective at managing exudate, infection and biofilm, while it can shift established, stubborn wounds onto healing trajectories. The scientific rationale for this new dressing technology is supported by in vitro and in vivo evidence, so now further comparative, randomized and outcome-based clinical studies are required to fully understand the clinical and economic benefits this new dressing technology can bring.
Use of a copolymer dressing on superficial and partial-thickness burns in a paediatric population.
Everett, M; Massand, S; Davis, W; Burkey, B; Glat, P M
2015-07-01
Despite extensive research into the treatment of partial-thickness burns, to date there has not been the emergence of a preeminent modality. This pilot study, the first such study to be performed in a burn unit in the US, was designed to evaluate the efficacy and outcomes of the application of copolymer dressing (Suprathel; PolyMedics Innovations Corporation, Stuttgart, Germany) for both superficial and deeper partial-thickness burns. The copolymer dressing was used as a primary wound dressing to treat superficial and deep partial-thickness burns (average 5% total body surface area) in paediatric patients. Burns were debrided within 24 hours, at bedside, in the burn unit or in the operating room. The copolymer dressing was then applied directly to the wound and covered with a non-adherent second layer and an absorptive outer dressing. After discharge, patients were seen every 5-7 days until healed. Parameters evaluated included average hospital length of stay, average number of intravenous doses of narcotics administered, pain score at first follow-up visit, average time to complete re epithelialisation, incidence of burn wound infection, and patient/parent satisfaction on a 4-point scale. We also evaluated our experience with the dressing. Data were evaluated retrospectively under an Investigational Review Board approved protocol. Of the 17 patients assessed the average hospital length of stay was 1.4 days during which the average number of intravenous narcotic doses administered before copolymer dressing application was 1.5 and after was 0.1 doses. At the first follow-up visit, average pain score was 1.2 on a 10-point scale and the average time to re epithelialisation was 9.5 days. There was no incidence of burn wound infection. Patient/parent satisfaction was average of 3.66 on a 4-point scale. The staff had found that the self-adherence and elasticity of the dressing made it easy to apply and stay adherent, especially in areas of difficult contour. There were no readmissions for further debridement or skin grafting. Our experience shows that patients may be discharged shortly after the application of the copolymer dressing, with manageable pain scores and ease of use as determined by the caretakers high satisfaction. This new, fully synthetic copolymer dressing is easy to apply, does not require any additional antimicrobial coverage and may be used to successfully manage deeper partial-thickness burns, donor sites or burns in areas of contour, where many other dressings might not be considered or be appropriate. None declared.
Naruse, Koji; Uchino, Masataka; Hirakawa, Noriko; Toyama, Masahiro; Miyajima, Genyo; Mukai, Manabu; Urabe, Ken; Uchida, Kentaro; Itoman, Moritoshi
2016-08-01
We have conducted a basic study on the influences on ultrasonic properties when LIPUS is applied through wound dressing. According to the results of ex vivo experiments conducted to date, LIPUS showed ultrasonic properties such as transmittance, coefficient of transmission, and a non-uniformity ratio through film wound dressing better than other wound dressing, and it was considered that LIPUS's effect for fracture healing was not influenced by film wound dressing. Then, we discussed the influence on the effect of LIPUS through film wound dressing. Thirty male 8-week-old Sprague-Dawley rats were used for the trial. After creating close transverse femoral fractures on the right legs of these 30 rats, they were divided into 3 groups of 10; LIPUS through wound dressing (Group A), LIPUS without wound dressing (Group B), and No LIPUS treatment (Group C). OPSITE Wound, which was thought to have the least influence on ultrasound properties, was used for this trial. Group A and B received LIPUS for 20 minutes a day from the first day after the fractures. LIPUS was generated from Teijin Pharma's device for a basic experiment. When treating Group A, the wound dressing was pasted on the ultrasound terminal in order to apply LIPUS through the dressing. We assessed the time-oriented morphological change of each group in anesthetized condition using simple radiographs on the 8th, 16th, and 24th day after the fractures. Six rats in Group A, 2 in Group B, and 1 in Group C died in anesthesia, and we discussed the remaining 4 rats in Group A, 8 in Group B, and 9 in Group C. We defined more than one teleost callus bridging as bone-union. We also counted a bone remodeling when we recognized the absorption of existing cortical bone and the transformation of new bone to cortical bone in simple radiographs. As a result, compared with Group C, we recognized that both bone union and remodeling accelerated remarkably in Group B, but not in Group A. It suggested that LIPUS through wound dressing had negative influences on both period shorting of fracture healing and bone remodeling. When LIPUS was conducted through film wound dressing, transmittance and coefficient of transmission were unchanged; however, the non-uniformity ratio changed slightly. The non-uniformity ratio of the ultrasound transducer had a significant influence on the effect of LIPUS on fracture healing.
Exploratory development of foams from liquid crystal polymers
NASA Technical Reports Server (NTRS)
Chung, T. S.
1985-01-01
Two types of liquid crystal polymer (LCP) compositions were studied and evaluated as structural foam materials. One is a copolymer of 6-hydroxy-2-naphthoic acid, terephthalic acid, and p-acetoxyacetanilide (designed HNA/TA/AAA), and the other is a copolymer of p-hydroxybenzoic acid and 6-hydroxy-2-naphthoic acid (designated HBA/HNA). Experimental results showed that the extruded HNA/TA/AA foams have better mechanical quality and appearance than HBA/HNA foams. Heat treatment improved foam tensile strength and break elongation, but reduced their modulus. The injection molding results indicated that nitrogen foaming agents with a low-pressure process gave better void distribution in the injection molded LCP foams than those made by the conventional injection-molding machine and chemical blowing agents. However, in comparing LCP foams with other conventional plastic foams, HBA/HNA foams have better mechanical properties than foamed ABS and PS, but are comparable to PBT and inferior to polycarbonate foams, especially in heat-deflection temperature and impact resistance energy. These deficiencies are due to LCP molecules not having been fully oriented during the Union-Carbide low-pressure foaming process.
Espresso coffee foam delays cooling of the liquid phase.
Arii, Yasuhiro; Nishizawa, Kaho
2017-04-01
Espresso coffee foam, called crema, is known to be a marker of the quality of espresso coffee extraction. However, the role of foam in coffee temperature has not been quantitatively clarified. In this study, we used an automatic machine for espresso coffee extraction. We evaluated whether the foam prepared using the machine was suitable for foam analysis. After extraction, the percentage and consistency of the foam were measured using various techniques, and changes in the foam volume were tracked over time. Our extraction method, therefore, allowed consistent preparation of high-quality foam. We also quantitatively determined that the foam phase slowed cooling of the liquid phase after extraction. High-quality foam plays an important role in delaying the cooling of espresso coffee.
Generation of sclerosant foams by mechanical methods increases the foam temperature.
Tan, Lulu; Wong, Kaichung; Connor, David; Fakhim, Babak; Behnia, Masud; Parsi, Kurosh
2017-08-01
Objective To investigate the effect of agitation on foam temperature. Methods Sodium tetradecyl sulphate and polidocanol were used. Prior to foam generation, the sclerosant and all constituent equipment were cooled to 4-25℃ and compared with cooling the sclerosant only. Foam was generated using a modified Tessari method. During foam agitation, the temperature change was measured using a thermocouple for 120 s. Results Pre-cooling all the constituent equipment resulted in a cooler foam in comparison with only cooling the sclerosant. A starting temperature of 4℃ produced average foam temperatures of 12.5 and 13.2℃ for sodium tetradecyl sulphate and polidocanol, respectively. It was also found that only cooling the liquid sclerosant provided minimal cooling to the final foam temperature, with the temperature 20 and 20.5℃ for sodium tetradecyl sulphate and polidocanol, respectively. Conclusion The foam generation process has a noticeable impact on final foam temperature and needs to be taken into consideration when creating foam.
Infiltrated carbon foam composites
NASA Technical Reports Server (NTRS)
Lucas, Rick D. (Inventor); Danford, Harry E. (Inventor); Plucinski, Janusz W. (Inventor); Merriman, Douglas J. (Inventor); Blacker, Jesse M. (Inventor)
2012-01-01
An infiltrated carbon foam composite and method for making the composite is described. The infiltrated carbon foam composite may include a carbonized carbon aerogel in cells of a carbon foam body and a resin is infiltrated into the carbon foam body filling the cells of the carbon foam body and spaces around the carbonized carbon aerogel. The infiltrated carbon foam composites may be useful for mid-density ablative thermal protection systems.
Foam property tests to evaluate the potential for longwall shield dust control.
Reed, W R; Beck, T W; Zheng, Y; Klima, S; Driscoll, J
2018-01-01
Tests were conducted to determine properties of four foam agents for their potential use in longwall mining dust control. Foam has been tried in underground mining in the past for dust control and is currently being reconsidered for use in underground coal longwall operations in order to help those operations comply with the Mine Safety and Health Administration's lower coal mine respirable dust standard of 1.5 mg/m 3 . Foams were generated using two different methods. One method used compressed air and water pressure to generate foam, while the other method used low-pressure air generated by a blower and water pressure using a foam generator developed by the U.S. National Institute for Occupational Safety and Health. Foam property tests, consisting of a foam expansion ratio test and a water drainage test, were conducted to classify foams. Compressed-air-generated foams tended to have low expansion ratios, from 10 to 19, with high water drainage. Blower-air-generated foams had higher foam expansion ratios, from 30 to 60, with lower water drainage. Foams produced within these ranges of expansion ratios are stable and potentially suitable for dust control. The test results eliminated two foam agents for future testing because they had poor expansion ratios. The remaining two foam agents seem to have properties adequate for dust control. These material property tests can be used to classify foams for their potential use in longwall mining dust control.
Foam property tests to evaluate the potential for longwall shield dust control
Reed, W.R.; Beck, T.W.; Zheng, Y.; Klima, S.; Driscoll, J.
2018-01-01
Tests were conducted to determine properties of four foam agents for their potential use in longwall mining dust control. Foam has been tried in underground mining in the past for dust control and is currently being reconsidered for use in underground coal longwall operations in order to help those operations comply with the Mine Safety and Health Administration’s lower coal mine respirable dust standard of 1.5 mg/m3. Foams were generated using two different methods. One method used compressed air and water pressure to generate foam, while the other method used low-pressure air generated by a blower and water pressure using a foam generator developed by the U.S. National Institute for Occupational Safety and Health. Foam property tests, consisting of a foam expansion ratio test and a water drainage test, were conducted to classify foams. Compressed-air-generated foams tended to have low expansion ratios, from 10 to 19, with high water drainage. Blower-air-generated foams had higher foam expansion ratios, from 30 to 60, with lower water drainage. Foams produced within these ranges of expansion ratios are stable and potentially suitable for dust control. The test results eliminated two foam agents for future testing because they had poor expansion ratios. The remaining two foam agents seem to have properties adequate for dust control. These material property tests can be used to classify foams for their potential use in longwall mining dust control. PMID:29416179
Multiscale Analysis of Open-Cell Aluminum Foam for Impact Energy Absorption
NASA Astrophysics Data System (ADS)
Kim, Ji Hoon; Kim, Daeyong; Lee, Myoung-Gyu; Lee, Jong Kook
2016-09-01
The energy-absorbing characteristics of crash members in automotive collision play an important role in controlling the amount of damage to the passenger compartment. Aluminum foams have high strength-to-weight ratio and high deformability, thus good crashworthiness is expected while maintaining or even saving weights when foams are implemented in crash members. In order to investigate the effect of the open-cell aluminum foam fillers on impact performance and weight saving, a multiscale framework for evaluating the crashworthiness of aluminum foam-filled members is used. To circumvent the difficulties of mechanical tests on foams, a micromechanical model of the aluminum foam is constructed using the x-ray micro tomography and virtual tests are conducted for the micromechanical model to characterize the behavior of the foam. In the macroscale, the aluminum foam is represented by the crushable foam constitutive model, which is then incorporated into the impact test simulation of the foam-filled crash member. The multiscale foam-filled crash member model was validated for the high-speed impact test, which confirms that the material model characterized by the micromechanical approach represents the behavior of the open-cell foam under impact loading well. Finally, the crash member design for maximizing the energy absorption is discussed by investigating various designs from the foam-only structure to the hollow tube structure. It was found that the foam structure absorbs more energy than the hollow tube or foam-filled structure with the same weight.
Professional Characteristics Communicated by Formal versus Casual Workplace Attire
ERIC Educational Resources Information Center
Cardon, Peter W.; Okoro, Ephraim A.
2009-01-01
Employees are frequently advised to dress for success to build their careers. From the corporate perspective, employees who are well dressed are believed to form better impressions with colleagues, clients, and customers. Many companies create dress codes in order to gain the benefits of a professionally appearing workforce. Developing effective…
Identification of Workplace Dress by Low-Income Job Seekers
ERIC Educational Resources Information Center
Saiki, Diana
2013-01-01
The author examined how low-income job seekers participating in a workplace dress program identified traditional business and business casual dress. Seventy low-income job seekers identified clothing items as traditional business (e.g., suits, ties), similar to identifications made by professionals and image consultants in previous literature.…
ERIC Educational Resources Information Center
Lumsden, Linda; Miller, Gabriel
2002-01-01
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…
Counterconformity: An Attribution Model of Adolescents' Uniqueness-Seeking Behaviors in Dressing
ERIC Educational Resources Information Center
Ling, I-Ling
2008-01-01
This article explores how an attribution model will illustrate uniqueness-seeking behavior in dressing in the Taiwanese adolescent subculture. The study employed 443 senior high school students. Results show that the tendency of uniqueness-seeking behavior in dressing is moderate. However, using cluster analysis to segment the counterconformity…
21 CFR 878.4018 - Hydrophilic wound dressing.
Code of Federal Regulations, 2012 CFR
2012-04-01
... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Hydrophilic wound dressing. 878.4018 Section 878.4018 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4018 Hydrophilic wound dressing...
21 CFR 878.4018 - Hydrophilic wound dressing.
Code of Federal Regulations, 2014 CFR
2014-04-01
... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Hydrophilic wound dressing. 878.4018 Section 878.4018 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4018 Hydrophilic wound dressing...
21 CFR 878.4020 - Occlusive wound dressing.
Code of Federal Regulations, 2012 CFR
2012-04-01
... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Occlusive wound dressing. 878.4020 Section 878.4020 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4020 Occlusive wound dressing...
21 CFR 878.4020 - Occlusive wound dressing.
Code of Federal Regulations, 2014 CFR
2014-04-01
... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Occlusive wound dressing. 878.4020 Section 878.4020 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4020 Occlusive wound dressing...
21 CFR 878.4018 - Hydrophilic wound dressing.
Code of Federal Regulations, 2013 CFR
2013-04-01
... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Hydrophilic wound dressing. 878.4018 Section 878.4018 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4018 Hydrophilic wound dressing...
21 CFR 878.4020 - Occlusive wound dressing.
Code of Federal Regulations, 2013 CFR
2013-04-01
... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Occlusive wound dressing. 878.4020 Section 878.4020 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4020 Occlusive wound dressing...
9 CFR 108.9 - Dressing rooms and other facilities.
Code of Federal Regulations, 2010 CFR
2010-01-01
... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Dressing rooms and other facilities. 108.9 Section 108.9 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT... REQUIREMENTS FOR LICENSED ESTABLISHMENTS § 108.9 Dressing rooms and other facilities. Each licensed...
2003-09-01
Pharmaceuticals, Inc. (Westlake, OH), submitted the Hemarrest dressing. This dressing was a thin, sheet-like pad with a mixture of epsilon aminocaproic acid ...chloric acid salt purified bovine corium collagen. It was prepared in a compacted nonwoven web form (7.0 7.0 cm). Ethicon, Inc. (Somerville, NJ...may be related to enhanced platelet procoagulant activity and annexin V binding.46 Another derivative of gallic acid , bis- muth subgallate, appears to
An evaluation of a silicone adhesive shaped heel dressing.
Hampton, Sylvie
Tissue breakdown is complex and involves many factors. Pressure ulcer development in the heels is subject to extrinsic factors such as pressure, shear, friction and moisture. The heels are the most common sites for friction and shear damage, which can lead to blistering, skin erosion and tissue breakdown (Grey et al, 2006). To address the issues of wounds that are painful on dressing removal and friable skin, Smith & Nephew has introduced a soft silicone adhesive dressing to its Allevyn dressing range. Silicone does not adhere to wounded areas and can be removed gently without trauma to the periwound area. This paper discusses the findings of a 20-patient multi-site evaluation examining the performance and acceptability of Allevyn Gentle Border Heel dressing in the management of heel wounds.
The use of prophylactic dressings in the prevention of pressure ulcers: a literature review.
Cornish, Lynn
2017-06-02
Pressure ulcers pose a significant burden to both patients and health care resources. There are an increasing number of studies that have examined the use of prophylactic dressings, and their ability to redistribute pressure and protect the skin from shear and friction damage. This literature review examines six studies conducted on this controversial subject. Brindle and Wegelin ( 2012 ; Chaiken, 2012 ; Cubit et al, 2012 ; Santamaria et al, 2012) all examined the role of dressings to prevent pressure ulcers, and Call et al (2013a ; 2013b ), conducted in vitro research into the mode of dressings. Current research suggests that while further research is required, the use of prophylactic dressings have a place alongside standard measures, in helping to prevent pressure, shear and friction damage.
Wound dressings from naturally-occurring polymers: A review on homopolysaccharide-based composites.
Naseri-Nosar, Mahdi; Ziora, Zyta Maria
2018-06-01
Wound dressings are designed to support the wound bed and protect it from the factors that may delay or impede its healing such as contaminations and moisture-loss, thereby facilitating and accelerating the healing process. The materials used to prepare wound dressings include natural and synthetic polymers, as well as their combinations, in the forms of films, sponges and hydrogels. Polysaccharides are naturally-occurring polymers that have been extensively used as wound dressing materials. Homopolysaccharides are a class of polysaccharides consist of only one type of monosaccharide. The current review intends to overview the studies in which wound dressings from naturally-occurring polymers, based on homopolysaccharides, were prepared and evaluated. Homopolysaccharides such as cellulose, chitosan, chitin, pullulan, starch and β-glucan were considered. Copyright © 2018 Elsevier Ltd. All rights reserved.
She Wears the Pants: The Reform Dress as Technology in Nineteenth-Century America.
Mas, Catherine
This article examines the American dress-reform movement, detailing the ways in which reformers conceptualized clothing as a social and bodily technology. In the mid-nineteenth century, women began making and wearing the "reform dress"-a costume consisting of pants and shortened, lightweight skirts-as an alternative to burdensome feminine fashions. When ridiculed in public for wearing overtly masculine garments, dress reformers insisted their clothing was healthful, functional, and natural. This article discusses women's use of medical science and technical knowledge in their rejection of fashion, promotion of sexual equality, and efforts to change mainstream clothing practices. When approached from a technological perspective, the reform dress reveals broader tensions in an industrializing American society, such as changing gender relations and new understandings of the relationship between humans and technology.
Dabiri, Ganary; Hammerman, Scott; Falanga, Vincent
2014-01-01
Venous leg ulcers affect millions of patients worldwide and are a tremendous financial burden on our healthcare system. The hallmark of venous disease of the lower extremities is venous hypertension, and compression is the current mainstay of treatment. However, many patients are noncompliant, in part because of the complexity of the dressings and the difficulties with application and removal. The aim of our study was to determine an effective compression dressing regimen for patients with venous leg ulcers who require changing the ulcer primary dressing twice daily. We used two layers of a latex free tubular elastic bandage for compression. The primary endpoint of our study was increased wound healing rate and our secondary endpoint was complete wound closure. All active study subjects had positive healing rates at week 4 and week 8. Two subjects achieved complete wound closure by week 8. We conclude that compression with a latex-free tubular elastic bandage can be safely used in patients with venous leg ulcers requiring frequent dressing changes. This type of compression allows for daily inspection of wounds, dressing changes at home, flexibility in the context of clinical trials, and is a compromise for patients that are intolerant to compression dressings. PMID:24267477
Effect of music intervention on burn patients' pain and anxiety during dressing changes.
Hsu, Kuo-Cheng; Chen, Li Fen; Hsiep, Pi Hsia
2016-12-01
For burn patients, the daily dressing process causes pain and anxiety. Although drugs can relieve them, the degree of pain during dressing changes is often moderate to severe. Therefore, relevant supporting interventions, like music as an ideal intervention, could alleviate the patient's pain. This study investigated the impact of music intervention at dressing change time on burn patients' pain and anxiety. This was a prospective, randomized clinical trial; patients were randomly assigned into control (standard intervention) and experimental groups (crystal music intervention) for five consecutive days (35 patients in each group). Patients' pain and anxiety measurements were collected before, during, and after dressing changes and morphine usage was recorded. The study period was October 2014 to September 2015. There was no difference in morphine dosage for both groups. By the fourth day of music intervention, burn patients' pain before, during, and after dressing changes had significantly decreased; anxiety on the fourth day during and after dressing changes had also significantly decreased. Nurses may use ordered prescription analgesics, but if non-pharmacological interventions are increased, such as providing timely music intervention and creating a friendly, comfortable hospital environment, patients' pain and anxiety will reduce. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.
Cattelan, Marília Gonçalves; Nishiyama, Yara Paula de Oliveira; Gonçalves, Tânia Maria Vinturim; Coelho, Alexandre Rodrigo
2018-08-01
There is a broad research interest in the search for alternatives to chemical additives for use as natural food preservatives. Although many natural compounds have biological in vitro properties evidenced, in situ studies are still scarce. This study evaluated the effect of oregano essential oil (OEO) and salt (NaCl) concentrations against Escherichia coli (ATCC 8739), in salad dressing, using the response surface methodology. The experiment included a 2 2 central composite rotatable design (CCRD) in a total of 11 formulations of salad dressings. Oregano essential oil was characterized by gas chromatography and salad dressings by ash, lipids, proteins and moisture. OEO was composed mainly by carvacrol (65.1%) and p-cymene (12.0%). Salad dressings showed similar chemical profiles. A mathematical model for the prediction of the antibacterial activity in salad dressing was obtained. The results revealed that the interaction between OEO and salt showed effect on the bacterial count. However, the effect of salt was negative suggesting that the highest NaCl concentrations decreases the bacterial count. Therefore, within the parameters studied, the use of OEO to control E. coli in salad dressing can be considered promising and allows reduction in the levels of salt to be incorporated in food. Copyright © 2018 Elsevier Ltd. All rights reserved.
Sahraro, Maryam; Yeganeh, Hamid; Sorayya, Marziyeh
2016-02-01
Preparation and assessments of novel absorptive wound dressing materials with efficient antimicrobial activity as well as very good cytocompatibility were described in this work. An amine terminated poly(hexamethylene guanidine hydrochloride) was prepared and used as curing agent of different epoxy-terminated polyurethane prepolymers. The structures of prepared materials were elucidated by evaluation of their (1)H NMR and FTIR spectra. The recorded tensile strength of membranes confirmed the excellent dimensional stability of the film type dressings even at fully hydrated conditions. Therefore, these dressings could protect the wound bed from external forces during the healing period. The structurally optimized dressing membranes could preserve the desired moist environment over the wounded area, as a result of their balanced equilibrium, water absorption and water vapor transmission rate. Therefore, a very good condition for stimulation of self-healing of wound bed was attained. Also, owing to the presence of guanidine hydrochloride moieties embedded into the structure of dressings, efficient antimicrobial activity against Staphylococcus aureus, Pseudomonas aeruginosa and Candida albicans were detected. In vitro cytotoxicity assay of the prepared dressings revealed cytocompatibility of these materials against fibroblast cells. Therefore, they could support cell growth and proliferation at the wounded area. Copyright © 2015 Elsevier B.V. All rights reserved.
In vivo performance of novel soybean/gelatin-based bioactive and injectable hydroxyapatite foams
Kovtun, Anna; Goeckelmann, Melanie J.; Niclas, Antje A.; Montufar, Edgar B.; Ginebra, Maria-Pau; Planell, Josep A.; Santin, Matteo; Ignatius, Anita
2015-01-01
Major limitations of calcium phosphate cements (CPCs) are their relatively slow degradation rate and the lack of macropores allowing the ingrowth of bone tissue. The development of self-setting cement foams has been proposed as a suitable strategy to overcome these limitations. In previous work we developed a gelatine-based hydroxyapatite foam (G-foam), which exhibited good injectability and cohesion, interconnected porosity and good biocompatibility in vitro. In the present study we evaluated the in vivo performance of the G-foam. Furthermore, we investigated whether enrichment of the foam with soybean extract (SG-foam) increased its bioactivity. G-foam, SG-foam and non-foamed CPC were implanted in a critical-size bone defect in the distal femoral condyle of New Zealand white rabbits. Bone formation and degradation of the materials were investigated after 4, 12 and 20 weeks using histological and biomechanical methods. The foams maintained their macroporosity after injection and setting in vivo. Compared to non-foamed CPC, cellular degradation of the foams was considerably increased and accompanied by new bone formation. The additional functionalization with soybean extract in the SG-foam slightly reduced the degradation rate and positively influenced bone formation in the defect. Furthermore, both foams exhibited excellent biocompatibility, implying that these novel materials may be promising for clinical application in non-loaded bone defects. PMID:25448348
In vivo performance of novel soybean/gelatin-based bioactive and injectable hydroxyapatite foams.
Kovtun, Anna; Goeckelmann, Melanie J; Niclas, Antje A; Montufar, Edgar B; Ginebra, Maria-Pau; Planell, Josep A; Santin, Matteo; Ignatius, Anita
2015-01-01
Major limitations of calcium phosphate cements (CPCs) are their relatively slow degradation rate and the lack of macropores allowing the ingrowth of bone tissue. The development of self-setting cement foams has been proposed as a suitable strategy to overcome these limitations. In previous work we developed a gelatine-based hydroxyapatite foam (G-foam), which exhibited good injectability and cohesion, interconnected porosity and good biocompatibility in vitro. In the present study we evaluated the in vivo performance of the G-foam. Furthermore, we investigated whether enrichment of the foam with soybean extract (SG-foam) increased its bioactivity. G-foam, SG-foam and non-foamed CPC were implanted in a critical-size bone defect in the distal femoral condyle of New Zealand white rabbits. Bone formation and degradation of the materials were investigated after 4, 12 and 20weeks using histological and biomechanical methods. The foams maintained their macroporosity after injection and setting in vivo. Compared to non-foamed CPC, cellular degradation of the foams was considerably increased and accompanied by new bone formation. The additional functionalization with soybean extract in the SG-foam slightly reduced the degradation rate and positively influenced bone formation in the defect. Furthermore, both foams exhibited excellent biocompatibility, implying that these novel materials may be promising for clinical application in non-loaded bone defects. Copyright © 2014 Acta Materialia Inc. All rights reserved.
Polymer-Reinforced, Non-Brittle, Lightweight Cryogenic Insulation
NASA Technical Reports Server (NTRS)
Hess, David M.
2013-01-01
The primary application for cryogenic insulating foams will be fuel tank applications for fueling systems. It is crucial for this insulation to be incorporated into systems that survive vacuum and terrestrial environments. It is hypothesized that by forming an open-cell silica-reinforced polymer structure, the foam structures will exhibit the necessary strength to maintain shape. This will, in turn, maintain the insulating capabilities of the foam insulation. Besides mechanical stability in the form of crush resistance, it is important for these insulating materials to exhibit water penetration resistance. Hydrocarbon-terminated foam surfaces were implemented to impart hydrophobic functionality that apparently limits moisture penetration through the foam. During the freezing process, water accumulates on the surfaces of the foams. However, when hydrocarbon-terminated surfaces are present, water apparently beads and forms crystals, leading to less apparent accumulation. The object of this work is to develop inexpensive structural cryogenic insulation foam that has increased impact resistance for launch and ground-based cryogenic systems. Two parallel approaches will be pursued: a silica-polymer co-foaming technique and a post foam coating technique. Insulation characteristics, flexibility, and water uptake can be fine-tuned through the manipulation of the polyurethane foam scaffold. Silicate coatings for polyurethane foams and aerogel-impregnated polyurethane foams have been developed and tested. A highly porous aerogel-like material may be fabricated using a co-foam and coated foam techniques, and can insulate at liquid temperatures using the composite foam
Fan, Donglei; Li, Minggang; Qiu, Jian; Xing, Haiping; Jiang, Zhiwei; Tang, Tao
2018-05-31
Auxetic materials are a class of materials possessing negative Poisson's ratio. Here we establish a novel method for preparing auxetic foam from closed-cell polymer foam based on steam penetration and condensation (SPC) process. Using polyethylene (PE) closed-cell foam as an example, the resultant foams treated by SPC process present negative Poisson's ratio during stretching and compression testing. The effect of steam-treated temperature and time on the conversion efficiency of negative Poisson's ratio foam is investigated, and the mechanism of SPC method for forming re-entrant structure is discussed. The results indicate that the presence of enough steam within the cells is a critical factor for the negative Poisson's ratio conversion in the SPC process. The pressure difference caused by steam condensation is the driving force for the conversion from conventional closed-cell foam to the negative Poisson's ratio foam. Furthermore, the applicability of SPC process for fabricating auxetic foam is studied by replacing PE foam by polyvinyl chloride (PVC) foam with closed-cell structure or replacing water steam by ethanol steam. The results verify the universality of SPC process for fabricating auxetic foams from conventional foams with closed-cell structure. In addition, we explored potential application of the obtained auxetic foams by SPC process in the fabrication of shape memory polymer materials.
mdFoam+: Advanced molecular dynamics in OpenFOAM
NASA Astrophysics Data System (ADS)
Longshaw, S. M.; Borg, M. K.; Ramisetti, S. B.; Zhang, J.; Lockerby, D. A.; Emerson, D. R.; Reese, J. M.
2018-03-01
This paper introduces mdFoam+, which is an MPI parallelised molecular dynamics (MD) solver implemented entirely within the OpenFOAM software framework. It is open-source and released under the same GNU General Public License (GPL) as OpenFOAM. The source code is released as a publicly open software repository that includes detailed documentation and tutorial cases. Since mdFoam+ is designed entirely within the OpenFOAM C++ object-oriented framework, it inherits a number of key features. The code is designed for extensibility and flexibility, so it is aimed first and foremost as an MD research tool, in which new models and test cases can be developed and tested rapidly. Implementing mdFoam+ in OpenFOAM also enables easier development of hybrid methods that couple MD with continuum-based solvers. Setting up MD cases follows the standard OpenFOAM format, as mdFoam+ also relies upon the OpenFOAM dictionary-based directory structure. This ensures that useful pre- and post-processing capabilities provided by OpenFOAM remain available even though the fully Lagrangian nature of an MD simulation is not typical of most OpenFOAM applications. Results show that mdFoam+ compares well to another well-known MD code (e.g. LAMMPS) in terms of benchmark problems, although it also has additional functionality that does not exist in other open-source MD codes.
46 CFR 108.473 - Foam system components.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 46 Shipping 4 2011-10-01 2011-10-01 false Foam system components. 108.473 Section 108.473 Shipping... EQUIPMENT Fire Extinguishing Systems Foam Extinguishing Systems § 108.473 Foam system components. (a) Each foam agent, each tank for a foam agent, each discharge outlet, each control, and each valve for the...
46 CFR 108.473 - Foam system components.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 46 Shipping 4 2010-10-01 2010-10-01 false Foam system components. 108.473 Section 108.473 Shipping... EQUIPMENT Fire Extinguishing Systems Foam Extinguishing Systems § 108.473 Foam system components. (a) Each foam agent, each tank for a foam agent, each discharge outlet, each control, and each valve for the...
Initial Evaluation of Burn Characteristics of Phenolic Foam Runway Brake Arrestor Material
1993-12-01
foam immersed in a jet fuel fire when extinguished using 3-percent Aqueous Film Forming Foam ( AFFF ). Three pool...extinguishment time of phenolic foam immersed in a jet fuel fire, using 3-percent Aqueous Film Forming Foam ( AFFF ) extinguishing agent. The wind was negligible...percent Aqueous Film Forming Foam ( AFFF ) agent. This project is an initial assessment of the fire safety of phenolic foam
Electrostatic Safety with Explosion Suppressant Foams.
1983-03-01
the foam, and (2) sorption of alkylphenol type substances, present as oxidation inhibitors in the fuel, by the foam. It had been previously reported... alkylphenol type substances. The use of antistatic ingredients in the reticulated polyurethane foam was suggested as a means of minimizing static...foam with JP-4 are: o Removal of diethylhexyl phthalate from the foam. o Sorption of alkylphenol type compounds by the foam. Tne latter of these two
Impact of foamed matrix components on foamed concrete properties
NASA Astrophysics Data System (ADS)
Tarasenko, V. N.
2018-03-01
The improvement of the matrix foam structure by means of foam stabilizing additives is aimed at solving the technology-oriented problems as well as at the further improvement of physical and mechanical properties of cellular-concrete composites. The dry foam mineralization is the mainstream of this research. Adding the concrete densifiers, foam stabilizers and mineral powders reduces the drying shrinkage, which makes the foam concrete products technologically effective.
Foam-mat drying technology: A review.
Hardy, Z; Jideani, V A
2017-08-13
This article reviews various aspects of foam-mat drying such as foam-mat drying processing technique, main additives used for foam-mat drying, foam-mat drying of liquid and solid foods, quality characteristics of foam-mat dried foods, and economic and technical benefits for employing foam-mat drying. Foam-mat drying process is an alternative method that allows the removal of water from liquid materials and pureed materials. In this drying process, a liquid material is converted into foam that is stable by being whipped after adding an edible foaming agent. The stable foam is then spread out in sheet or mat and dried by using hot air (40-90°C) at atmospheric pressure. Methyl cellulose (0.25-2%), egg white (3-20%), maltodextrin (0.5-05%), and gum Arabic (2-9%) are the commonly utilized additives for the foam-mat drying process at the given range, either combined together for their effectiveness or individual effect. The foam-mat drying process is suitable for heat sensitive, viscous, and sticky products that cannot be dried using other forms of drying methods such as spray drying because of the state of product. More interest has developed for foam-mat drying because of the simplicity, cost effectiveness, high speed drying, and improved product quality it provides.
Application of an Elongated Kelvin Model to Space Shuttle Foams
NASA Technical Reports Server (NTRS)
Sullivan, Roy M.; Ghosn, Louis J.; Lerch, Bradley A.
2009-01-01
The space shuttle foams are rigid closed-cell polyurethane foams. The two foams used most-extensively oil space shuttle external tank are BX-265 and NCFL4-124. Because of the foaming and rising process, the foam microstructures are elongated in the rise direction. As a result, these two foams exhibit a nonisotropic mechanical behavior. A detailed microstructural characterization of the two foams is presented. Key features of the foam cells are described and the average cell dimensions in the two foams are summarized. Experimental studies are also conducted to measure the room temperature mechanical response of the two foams in the two principal material directions (parallel to the rise and perpendicular to the rise). The measured elastic modulus, proportional limit stress, ultimate tensile strength, and Poisson's ratios are reported. The generalized elongated Kelvin foam model previously developed by the authors is reviewed and the equations which result from this model are summarized. Using the measured microstructural dimensions and the measured stiffness ratio, the foam tensile strength ratio and Poisson's ratios are predicted for both foams and are compared with the experimental data. The predicted tensile strength ratio is in close agreement with the measured strength ratio for both BX-265 and NCFI24-124. The comparison between the predicted Poisson's ratios and the measured values is not as favorable.
Foam Transport in Porous Media - A Review
DOE Office of Scientific and Technical Information (OSTI.GOV)
Zhang, Z. F.; Freedman, Vicky L.; Zhong, Lirong
2009-11-11
Amendment solutions with or without surfactants have been used to remove contaminants from soil. However, it has drawbacks such that the amendment solution often mobilizes the plume, and its movement is controlled by gravity and preferential flow paths. Foam is an emulsion-like, two-phase system in which gas cells are dispersed in a liquid and separated by thin liquid films called lamellae. Potential advantages of using foams in sub-surface remediation include providing better control on the volume of fluids injected, uniformity of contact, and the ability to contain the migration of contaminant laden liquids. It is expected that foam can servemore » as a carrier of amendments for vadose zone remediation, e.g., at the Hanford Site. As part of the U.S. Department of Energy’s EM-20 program, a numerical simulation capability will be added to the Subsurface Transport Over Multiple Phases (STOMP) flow simulator. The primary purpose of this document is to review the modeling approaches of foam transport in porous media. However, as an aid to understanding the simulation approaches, some experiments under unsaturated conditions and the processes of foam transport are also reviewed. Foam may be formed when the surfactant concentration is above the critical micelle concentration. There are two main types of foams – the ball foam (microfoam) and the polyhedral foam. The characteristics of bulk foam are described by the properties such as foam quality, texture, stability, density, surface tension, disjoining pressure, etc. Foam has been used to flush contaminants such as metals, organics, and nonaqueous phase liquids from unsaturated soil. Ball foam, or colloidal gas aphrons, reportedly have been used for soil flushing in contaminated site remediation and was found to be more efficient than surfactant solutions on the basis of weight of contaminant removed per gram of surfactant. Experiments also indicate that the polyhedral foam can be used to enhance soil remediation. The transport of foam in porous media is complicated in that the number of lamellae present governs flow characteristics such as viscosity, relative permeability, fluid distribution, and interactions between fluids. Hence, foam is a non-Newtonian fluid. During transport, foam destruction and formation occur. The net result of the two processes determines the foam texture (i.e., bubble density). Some of the foam may be trapped during transport. According to the impacts of the aqueous and gas flow rates, foam flow generally has two regimes – weak and strong foam. There is also a minimum pressure gradient to initiate foam flow and a critical capillary for foam to be sustained. Similar to other fluids, the transport of foam is described by Darcy’s law with the exception that the foam viscosity is variable. Three major approaches to modeling foam transport in porous media are the empirical, semi-empirical, and mechanistic methods. Mechanistic approaches can be complete in principal but may be difficult to obtain reliable parameters, whereas empirical and semi-empirical approaches can be limited by the detail used to describe foam rheology and mobility. Mechanistic approaches include the bubble population-balance model, the network/percolation theory, the catastrophe theory, and the filtration theory. Among these methods, all were developed for modeling polyhedral foam with the exception that the method based on the filtration theory was for the ball foam (microfoam).« less
Advanced nondestructive techniques applied for the detection of discontinuities in aluminum foams
NASA Astrophysics Data System (ADS)
Katchadjian, Pablo; García, Alejandro; Brizuela, Jose; Camacho, Jorge; Chiné, Bruno; Mussi, Valerio; Britto, Ivan
2018-04-01
Metal foams are finding an increasing range of applications by their lightweight structure and physical, chemical and mechanical properties. Foams can be used to fill closed moulds for manufacturing structural foam parts of complex shape [1]; foam filled structures are expected to provide good mechanical properties and energy absorption capabilities. The complexity of the foaming process and the number of parameters to simultaneously control, demand a preliminary and hugely wide experimental activity to manufacture foamed components with a good quality. That is why there are many efforts to improve the structure of foams, in order to obtain a product with good properties. The problem is that even for seemingly identical foaming conditions, the effective foaming can vary significantly from one foaming trial to another. The variation of the foams often is related by structural imperfections, joining region (foam-foam or foam-wall mold) or difficulties in achieving a complete filling of the mould. That is, in a closed mold, the result of the mold filling and its structure or defects are not known a priori and can eventually vary significantly. These defects can cause a drastic deterioration of the mechanical properties [2] and lead to a low performance in its application. This work proposes the use of advanced nondestructive techniques for evaluating the foam distribution after filling the mold to improve the manufacturing process. To achieved this purpose ultrasonic technique (UT) and cone beam computed tomography (CT) were applied on plate and structures of different thicknesses filled with foam of different porosity. UT was carried out on transmission mode with low frequency air-coupled transducers [3], in focused and unfocused configurations.
Analysis of Influence of Foaming Mixture Components on Structure and Properties of Foam Glass
NASA Astrophysics Data System (ADS)
Karandashova, N. S.; Goltsman, B. M.; Yatsenko, E. A.
2017-11-01
It is recommended to use high-quality thermal insulation materials to increase the energy efficiency of buildings. One of the best thermal insulation materials is foam glass - durable, porous material that is resistant to almost any effect of substance. Glass foaming is a complex process depending on the foaming mode and the initial mixture composition. This paper discusses the influence of all components of the mixture - glass powder, foaming agent, enveloping material and water - on the foam glass structure. It was determined that glass powder is the basis of the future material. A foaming agent forms a gas phase in the process of thermal decomposition. This aforementioned gas foams the viscous glass mass. The unreacted residue thus changes a colour of the material. The enveloping agent slows the foaming agent decomposition preventing its premature burning out and, in addition, helps to accelerate the sintering of glass particles. The introduction of water reduces the viscosity of the foaming mixture making it evenly distributed and also promotes the formation of water gas that additionally foams the glass mass. The optimal composition for producing the foam glass with the density of 150 kg/m3 is defined according to the results of the research.
Foams for barriers and nonlethal weapons
NASA Astrophysics Data System (ADS)
Rand, Peter B.
1997-01-01
Our times demand better solutions to conflict resolution than simply shooting someone. Because of this, police and military interest in non-lethal concepts is high. Already in use are pepper sprays, bean-bag guns, flash-bang grenades, and rubber bullets. At Sandia we got a head start on non- lethal weapon concepts. Protection of nuclear materials required systems that went way beyond the traditional back vault. Dispensable deterrents were used to allow a graduated response to a threat. Sticky foams and stabilized aqueous foams were developed to provide access delay. Foams won out for security systems simply because you could get a large volume from a small container. For polymeric foams the expansion ratio is thirty to fifty to one. In aqueous foams expansion ratios of one thousand to ne are easily obtained. Recent development work on sticky foams has included a changeover to environmentally friendly solvents, foams with very low toxicity, and the development of non-flammable silicone resin based foams. High expansion aqueous foams are useful visual and aural obscurants. Our recent aqueous foam development has concentrated on using very low toxicity foaming agents combined with oleoresin capsicum irritant to provide a safe but highly irritating foam.
Fontaine, Mathieu; Latarjet, Jacques; Payre, Jacqueline; Poupelin, Jean-Charles; Ravat, François
2017-03-01
The severe pain related to repeated burn dressing changes at bedside is often difficult to manage. However these dressings can be performed at bedside on spontaneously breathing non-intubated patients using powerful intravenous opioids with a quick onset and a short duration of action such as alfentanil. The purpose of this study is to demonstrate the efficacy and safety of the protocol which is used in our burn unit for pain control during burn dressing changes. Cohort study began after favorable opinion from local ethic committee has been collected. Patient's informed consent was collected. No fasting was required. Vital signs for patients were continuously monitored (non-invasive blood pressure, ECG monitoring, cutaneous oxygen saturation, respiratory rate) all over the process. Boluses of 500 (±250) mcg IV alfentanil were administered. A continuous infusion was added in case of insufficient analgesia. Adverse reactions were collected and pain intensity was measured throughout the dressing using a ten step verbal rating scale (VRS) ranging from 0 (no pain) to 10 (worst pain conceivable). 100 dressings (35 patients) were analyzed. Median age was 45 years and median burned area 10%. We observed 3 blood pressure drops, 5 oxygen desaturations (treated with stimulation without the necessity of ventilatory support) and one episode of nausea. Most of the patients (87%) were totally conscious during the dressing and 13% were awakened by verbal stimulation. Median total dose of alfentanil used was 2000μg for a median duration of 35min. Pain scores during the procedure were low or moderate (VRS mean=2.0 and maximal VRS=5). Median satisfaction collected 2h after the dressing was 10 on a ten step scale. Pain control with intravenous alfentanil alone is efficient and appears safe for most burn bedside repeated dressings in hospitalized patients. It achieves satisfactory analgesia during and after the procedure. It is now our standard analgesic method to provide repeated bedside dressings changes for burned patients. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.
Benefits of polidocanol endovenous microfoam (Varithena®) compared with physician-compounded foams
Carugo, Dario; Ankrett, Dyan N; Zhao, Xuefeng; Zhang, Xunli; Hill, Martyn; O’Byrne, Vincent; Hoad, James; Arif, Mehreen; Wright, David DI
2015-01-01
Objective To compare foam bubble size and bubble size distribution, stability, and degradation rate of commercially available polidocanol endovenous microfoam (Varithena®) and physician-compounded foams using a number of laboratory tests. Methods Foam properties of polidocanol endovenous microfoam and physician-compounded foams were measured and compared using a glass-plate method and a Sympatec QICPIC image analysis method to measure bubble size and bubble size distribution, Turbiscan™ LAB for foam half time and drainage and a novel biomimetic vein model to measure foam stability. Physician-compounded foams composed of polidocanol and room air, CO2, or mixtures of oxygen and carbon dioxide (O2:CO2) were generated by different methods. Results Polidocanol endovenous microfoam was found to have a narrow bubble size distribution with no large (>500 µm) bubbles. Physician-compounded foams made with the Tessari method had broader bubble size distribution and large bubbles, which have an impact on foam stability. Polidocanol endovenous microfoam had a lower degradation rate than any physician-compounded foams, including foams made using room air (p < 0.035). The same result was obtained at different liquid to gas ratios (1:4 and 1:7) for physician-compounded foams. In all tests performed, CO2 foams were the least stable and different O2:CO2 mixtures had intermediate performance. In the biomimetic vein model, polidocanol endovenous microfoam had the slowest degradation rate and longest calculated dwell time, which represents the length of time the foam is in contact with the vein, almost twice that of physician-compounded foams using room air and eight times better than physician-compounded foams prepared using equivalent gas mixes. Conclusion Bubble size, bubble size distribution and stability of various sclerosing foam formulations show that polidocanol endovenous microfoam results in better overall performance compared with physician-compounded foams. Polidocanol endovenous microfoam offers better stability and cohesive properties in a biomimetic vein model compared to physician-compounded foams. Polidocanol endovenous microfoam, which is indicated in the United States for treatment of great saphenous vein system incompetence, provides clinicians with a consistent product with enhanced handling properties. PMID:26036246
Benefits of polidocanol endovenous microfoam (Varithena®) compared with physician-compounded foams.
Carugo, Dario; Ankrett, Dyan N; Zhao, Xuefeng; Zhang, Xunli; Hill, Martyn; O'Byrne, Vincent; Hoad, James; Arif, Mehreen; Wright, David D I; Lewis, Andrew L
2016-05-01
To compare foam bubble size and bubble size distribution, stability, and degradation rate of commercially available polidocanol endovenous microfoam (Varithena®) and physician-compounded foams using a number of laboratory tests. Foam properties of polidocanol endovenous microfoam and physician-compounded foams were measured and compared using a glass-plate method and a Sympatec QICPIC image analysis method to measure bubble size and bubble size distribution, Turbiscan™ LAB for foam half time and drainage and a novel biomimetic vein model to measure foam stability. Physician-compounded foams composed of polidocanol and room air, CO2, or mixtures of oxygen and carbon dioxide (O2:CO2) were generated by different methods. Polidocanol endovenous microfoam was found to have a narrow bubble size distribution with no large (>500 µm) bubbles. Physician-compounded foams made with the Tessari method had broader bubble size distribution and large bubbles, which have an impact on foam stability. Polidocanol endovenous microfoam had a lower degradation rate than any physician-compounded foams, including foams made using room air (p < 0.035). The same result was obtained at different liquid to gas ratios (1:4 and 1:7) for physician-compounded foams. In all tests performed, CO2 foams were the least stable and different O2:CO2 mixtures had intermediate performance. In the biomimetic vein model, polidocanol endovenous microfoam had the slowest degradation rate and longest calculated dwell time, which represents the length of time the foam is in contact with the vein, almost twice that of physician-compounded foams using room air and eight times better than physician-compounded foams prepared using equivalent gas mixes. Bubble size, bubble size distribution and stability of various sclerosing foam formulations show that polidocanol endovenous microfoam results in better overall performance compared with physician-compounded foams. Polidocanol endovenous microfoam offers better stability and cohesive properties in a biomimetic vein model compared to physician-compounded foams. Polidocanol endovenous microfoam, which is indicated in the United States for treatment of great saphenous vein system incompetence, provides clinicians with a consistent product with enhanced handling properties. © The Author(s) 2015.
Ampawong, Sumate; Aramwit, Pornanong
2017-09-01
In this study, three kinds of antiseptics which were 0.05% chlorhexidine, 0.2% polyhexamethylene biguanide (PHMB), or 200 ppm silver nanoparticle was introduced to incorporate in the sericin-based scaffold to produce the antimicrobial dressing for the treatment of infected chronic wound. The effects of antiseptic incorporation on the stability, release of sericin, and short-term and long-term (6 months) antimicrobial activity of the sericin dressing against gram-negative and gram-positive bacteria were investigated. We showed that the incorporation of each antiseptic did not have significant effect on the internal morphology (pore size ~ 73-105 μm), elasticity (Young's modulus ~ 200-500 kPa), and the sericin release behavior of the sericin-based dressing. The release of sericin from the dressing was prolonged over 120 h and thereafter. Comparing among three antiseptics, 0.05% chlorhexidine incorporated in the sericin dressing showed the highest immediate and long-term (6 months) antimicrobial effect (largest inhibition zone) against most bacteria either gram-positive or gram-negative bacteria. The in vivo safety test following ISO10993 standard (Biological evaluation of medical devices - Part 6: Tests for local effects after implantation) confirmed that the sericin dressing incorporating 0.05% chlorhexidine did not irritate to tissue, comparing with the commercial material used generally in clinic (Allevyn®, Smith & Nephew). We suggested the sericin dressing incorporating 0.05% chlorhexidine for the treatment of infected chronic wound. Chlorhexidine would reduce the risk of infection while the sericin may promote wound healing.
Bikmoradi, Ali; Harorani, Mehdi; Roshanaei, Ghodratollah; Moradkhani, Shirin; Falahinia, Golam Hossein
2016-01-01
Pain is one of the common problems encountered by patients with burns, which increases after each dressing. This study aimed to investigate the effect of inhalation aromatherapy with damask rose essence on the pain of patients with burns that is caused after dressing. A randomized clinical trial was conducted on 50 patients with second- and third-degree burn wounds. The baseline pain of the patients was assessed 30 min before they entered into the dressing room on the first and second days of intervention. The patients in the experimental group inhaled five drops of damask rose essence 40% in distilled water, while those in the control group inhaled five drops of distilled water as placebo. The pain intensity was assessed using Visual Analogue Scale at 15 and 30 min after the patients exited from the dressing room. Data were analyzed by SPSS (version 18) using descriptive and inferential statistics. There was significant difference between the mean of pain intensity before and after intervention at 15 and 30 min after dressing (P < 0.001). Moreover, there was significant difference in reduction of pain intensity before and after aromatherapy in the experimental group (P < 0.05). Also, there was a significant reduction in severity of pain after dressing in the experimental group compared with the control group (P < 0.05). Inhalation aromatherapy with damask rose could be effective for relieving the pain caused after dressing in patients with burns. Therefore, it could be suggested as a complementary therapy in burn patients for pain relief.
Prophylactic Sacral Dressing for Pressure Ulcer Prevention in High-Risk Patients.
Byrne, Jaime; Nichols, Patricia; Sroczynski, Marzena; Stelmaski, Laurie; Stetzer, Molly; Line, Cynthia; Carlin, Kristen
2016-05-01
Patients in intensive care units are likely to have limited mobility owing to hemodynamic instability and activity orders for bed rest. Bed rest is indicated because of the severity of the disease process, which often involves intubation, sedation, paralysis, surgical procedures, poor nutrition, low flow states, and poor circulation. These patients are predisposed to the development and/or the progression of pressure ulcers not only because of their underlying diseases, but also because of limited mobility and deconditioned states of health. To assess whether treating high-risk patients with a prophylactic sacral dressing decreases the incidence of unit-acquired sacral pressure ulcers. An evidence-based tool for identifying patients at high risk for pressure ulcers was used in 3 intensive care units at an urban tertiary care hospital and academic medical center. Those patients deemed at high risk had a prophylactic sacral dressing applied. Incidence rates were collected and compared for the 7 months preceding use of the dressings and for 7 months during the trial period when the dressing was used. After the sacral dressing began being used, the number of unit-acquired sacral pressure ulcers decreased by 3.4 to 7.6 per 1000 patient days depending on the unit. A prophylactic sacral dressing may help prevent unit-acquired sacral pressure ulcers. Implementation of an involved care team with heightened awareness and increased education along with a prophylactic sacral dressing in patients deemed high risk for skin breakdown are all essential for success. ©2016 American Association of Critical-Care Nurses.
NASA Astrophysics Data System (ADS)
Patil, Sanjay S.; Bhalerao, Yogesh J.
2017-02-01
Grinding is metal cutting process used for mainly finishing the automobile components. The grinding wheel performance becomes dull by using it most of times. So it should be reshaping for consistent performance. It is necessary to remove dull grains of grinding wheel which is known as dressing process. The surface finish produced on the work piece is dependent on the dressing parameters in sub-sequent grinding operation. Multi-point diamond dresser has four important parameters such as the dressing cross feed rate, dressing depth of cut, width of the diamond dresser and drag angle of the dresser. The range of cross feed rate level is from 80-100 mm/min, depth of cut varies from 10 - 30 micron, width of diamond dresser is from 0.8 - 1.10mm and drag angle is from 40o - 500, The relative closeness to ideal levels of dressing parameters are found for surface finish produced on the En-31 work piece during sub-sequent grinding operation by using Technique of Order Preference by Similarity to Ideal Solution (TOPSIS).In the present work, closeness to ideal solution i.e. levels of dressing parameters are found for Computer Numerical Control (CNC) cylindrical angular grinding machine. After the TOPSIS technique, it is found that the value of Level I is 0.9738 which gives better surface finish on the En-31 work piece in sub-sequent grinding operation which helps the user to select the correct levels (combinations) of dressing parameters.
Medical workers' cognition of using 50% nitrous oxide in children with burns: a qualitative study.
Wang, Hai-Xia; Li, Yu-Xiang; Zhou, Ru-Zhen; Zhao, Ji-Jun
2015-09-01
Pain caused by dressing among children with burns is an issue worth discussing. Medical workers' understanding of pain during dressing in children with burns is correlated with the quality of pain management. Effective pain management is significant to improve anxiety and reduce pain and psychological distress during dressing for children with burns. We aimed to investigate medical workers' understanding of current pain management during dressing among children with burns and their attitudes toward the application of 50% nitrous oxide in pain management. Interviews were conducted with seven doctors and nurses from a burn center in East China. Data were collected by in-depth interviews and qualitative description after full transcription of each interview. Three themes were identified: (1) Medical workers felt sympathy for children with burns and believed that a gap existed between the current and expected situation in pain management. In addition, the prescription of analgesics during dressing for children with burns was not favored. (2) Given the fact that 50% nitrous oxide is effective in pain management for adult patients with burns, medical workers tended to apply it to children with burns during dressing after being provided the literature on the use of 50% nitrous oxide in children. (3) Guidelines for the application of 50% nitrous oxide during dressing for children with burns require further modification. Medical workers deemed the pain management for children with burns unsatisfactory, and they supported the application of 50% nitrous oxide during dressing for children with burns. Meanwhile, they hoped that administrators would also support it. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.
Fontenot, Krystal R; Edwards, J Vincent; Haldane, David; Pircher, Nicole; Liebner, Falk; Condon, Brian D; Qureshi, Huzaifah; Yager, Dorne
2017-11-01
Interfacing nanocellulosic-based biosensors with chronic wound dressings for protease point of care diagnostics combines functional material properties of high specific surface area, appropriate surface charge, and hydrophilicity with biocompatibility to the wound environment. Combining a protease sensor with a dressing is consistent with the concept of an intelligent dressing, which has been a goal of wound-dressing design for more than a quarter century. We present here biosensors with a nanocellulosic transducer surface (nanocrystals, nanocellulose composites, and nanocellulosic aerogels) immobilized with a fluorescent elastase tripeptide or tetrapeptide biomolecule, which has selectivity and affinity for human neutrophil elastase present in chronic wound fluid. The specific surface area of the materials correlates with a greater loading of the elastase peptide substrate. Nitrogen adsorption and mercury intrusion studies revealed gas permeable systems with different porosities (28-98%) and pore sizes (2-50 nm, 210 µm) respectively, which influence water vapor transmission rates. A correlation between zeta potential values and the degree of protease sequestration imply that the greater the negative surface charge of the nanomaterials, the greater the sequestration of positively charged neutrophil proteases. The biosensors gave detection sensitivities of 0.015-0.13 units/ml, which are at detectable human neutrophil elastase levels present in chronic wound fluid. Thus, the physical and interactive biochemical properties of the nano-based biosensors are suitable for interfacing with protease sequestrant prototype wound dressings. A discussion of the relevance of protease sensors and cellulose nanomaterials to current chronic wound dressing design and technology is included.
Tan, Xueli; Yowler, Charles J; Super, Dennis M; Fratianne, Richard B
2010-01-01
The purpose of this study was to explore the efficacy of two music therapy protocols on pain, anxiety, and muscle tension levels during dressing changes in burn patients. Twenty-nine inpatients participated in this prospective, crossover randomized controlled trial. On two consecutive days, patients were randomized to receive music therapy services either on the first or second day of the study. On control days, they received no music. On music days, patients practiced music-based imagery (MBI), a form of music-assisted relaxation with patient-specific mental imagery before and after dressing changes. Also, on music days during dressing changes, the patients engaged in music alternate engagement (MAE), which consisted of active participation in music making. The dependent variables were the patients' subjective ratings of their pain and anxiety levels and the research nurse's objective ratings of their muscle tension levels. Two sets of data were collected before, three sets during, and another two sets after dressing changes. The results showed significant decrease in pain levels before (P < .025), during (P < .05), and after (P < .025) dressing changes on days the patients received music therapy in contrast to control days. Music therapy was also associated with a decrease in anxiety and muscle tension levels during the dressing changes (P < .05) followed by a reduction in muscle tension levels after dressing changes (P < .025). Music therapy significantly decreases the acute procedural pain, anxiety, and muscle tension levels associated with daily burn care.
#TheDress: Categorical perception of an ambiguous color image.
Lafer-Sousa, Rosa; Conway, Bevil R
2017-10-01
We present a full analysis of data from our preliminary report (Lafer-Sousa, Hermann, & Conway, 2015) and test whether #TheDress image is multistable. A multistable image must give rise to more than one mutually exclusive percept, typically within single individuals. Clustering algorithms of color-matching data showed that the dress was seen categorically, as white/gold (W/G) or blue/black (B/K), with a blue/brown transition state. Multinomial regression predicted categorical labels. Consistent with our prior hypothesis, W/G observers inferred a cool illuminant, whereas B/K observers inferred a warm illuminant; moreover, subjects could use skin color alone to infer the illuminant. The data provide some, albeit weak, support for our hypothesis that day larks see the dress as W/G and night owls see it as B/K. About half of observers who were previously familiar with the image reported switching categories at least once. Switching probability increased with professional art experience. Priming with an image that disambiguated the dress as B/K biased reports toward B/K (priming with W/G had negligible impact); furthermore, knowledge of the dress's true colors and any prior exposure to the image shifted the population toward B/K. These results show that some people have switched their perception of the dress. Finally, consistent with a role of attention and local image statistics in determining how multistable images are seen, we found that observers tended to discount as achromatic the dress component that they did not attend to: B/K reporters focused on a blue region, whereas W/G reporters focused on a golden region.
What #theDress reveals about the role of illumination priors in color perception and color constancy
Aston, Stacey; Hurlbert, Anya
2018-01-01
The disagreement between people who named #theDress (the Internet phenomenon of 2015) “blue and black” versus “white and gold” is thought to be caused by individual differences in color constancy. It is hypothesized that observers infer different incident illuminations, relying on illumination “priors” to overcome the ambiguity of the image. Different experiences may drive the formation of different illumination priors, and these may be indicated by differences in chronotype. We assess this hypothesis, asking whether matches to perceived illumination in the image and/or perceived dress colors relate to scores on the morningness-eveningness questionnaire (a measure of chronotype). We find moderate correlations between chronotype and illumination matches (morning types giving bluer illumination matches than evening types) and chronotype and dress body matches, but these are significant only at the 10% level. Further, although inferred illumination chromaticity in the image explains variation in the color matches to the dress (confirming the color constancy hypothesis), color constancy thresholds obtained using an established illumination discrimination task are not related to dress color perception. We also find achromatic settings depend on luminance, suggesting that subjective white point differences may explain the variation in dress color perception only if settings are made at individually tailored luminance levels. The results of such achromatic settings are inconsistent with their assumed correspondence to perceived illumination. Finally, our results suggest that perception and naming are disconnected, with observers reporting different color names for the dress photograph and their isolated color matches, the latter best capturing the variation in the matches. PMID:28793353
#TheDress: Categorical perception of an ambiguous color image
Lafer-Sousa, Rosa; Conway, Bevil R.
2017-01-01
We present a full analysis of data from our preliminary report (Lafer-Sousa, Hermann, & Conway, 2015) and test whether #TheDress image is multistable. A multistable image must give rise to more than one mutually exclusive percept, typically within single individuals. Clustering algorithms of color-matching data showed that the dress was seen categorically, as white/gold (W/G) or blue/black (B/K), with a blue/brown transition state. Multinomial regression predicted categorical labels. Consistent with our prior hypothesis, W/G observers inferred a cool illuminant, whereas B/K observers inferred a warm illuminant; moreover, subjects could use skin color alone to infer the illuminant. The data provide some, albeit weak, support for our hypothesis that day larks see the dress as W/G and night owls see it as B/K. About half of observers who were previously familiar with the image reported switching categories at least once. Switching probability increased with professional art experience. Priming with an image that disambiguated the dress as B/K biased reports toward B/K (priming with W/G had negligible impact); furthermore, knowledge of the dress's true colors and any prior exposure to the image shifted the population toward B/K. These results show that some people have switched their perception of the dress. Finally, consistent with a role of attention and local image statistics in determining how multistable images are seen, we found that observers tended to discount as achromatic the dress component that they did not attend to: B/K reporters focused on a blue region, whereas W/G reporters focused on a golden region. PMID:29090319
Black, Jonathan S; Drake, David B
2015-01-01
The lipid base of silver sulfadiazine (SSD) makes removal of the product painful for the patient and difficult for the physician to accurately assess particularly in partial-thickness burn injuries. As an alternative, a water-soluble antimicrobial gel is used at the University of Virginia. We present a prospective, randomized comparison of these two therapies using pain with dressing changes and time to perform dressing changes as our primary endpoints. Adult inpatients with partial-thickness burn wounds were randomized to begin therapy with either SSD cream or the water-soluble burn wound gel (BWG), and then therapies were alternated daily. Pain assessments, time to complete dressing care, total narcotic medication administered, and the number of personnel required for dressing changes were recorded. Eight patients were enrolled resulting in 13 pairs (26 points) of data comparison between the two therapies. Four of the eight enrolled patients (50%) refused to continue receiving SSD because of pain associated with dressing changes and voluntarily withdrew from the study. The amount of time to perform dressing changes was an average of 79 nurse-minutes longer for SSD. A 6.08 greater morphine equivalent was delivered to those having BWG removed.A water-soluble polyantimicrobial gel was superior to SSD in the parameters measured as exhibited by our patient dropout rate and differential time to perform dressing care. Limiting the time to perform dressing care will reduce the cumulative pain experience, improve patient satisfaction, and reduce the resources to deliver care.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Not Available
1982-06-01
The objective of this study is to assess the effectiveness of air sprays and foam systems for dust control on longwall double-drum shearer faces. Laboratory testing has been conducted using foam systems and promising results have been obtained. Upon Bureau approval, underground testing will be scheduled to assess the effectiveness of foam systems under actual operating conditions. Laboratory testing of air sprays is being conducted at present. This report presents the results of the laboratory testing of foam systems. Specifically, the results obtained on the evaluation of selected foaming agents are presented, the feasibility investigation of flushing foam through themore » shearer-drum are demonstrated, and conceptual layout of the foam system on the shearer is discussed. The laboratory investigation of the selected foaming agents reveal that the Onyx Microfoam, Onyx Maprosyl and DeTer Microfoam foaming agents have higher expansion ratios compared to the others tested. Flushing foam through the shearer drum is entirely feasible and could be a viable technique for dust suppression on longwall faces.« less
Ocean foam generation and modeling
NASA Technical Reports Server (NTRS)
Porter, R. A.; Bechis, K. P.
1976-01-01
A laboratory investigation was conducted to determine the physical and microwave properties of ocean foam. Special foam generators were designed and fabricated, using porous glass sheets, known as glass frits, as the principal element. The glass frit was sealed into a water-tight vertical box, a few centimeters from the bottom. Compressed air, applied to the lower chamber, created ocean foam from sea water lying on the frit. Foam heights of 30 cm were readily achieved, with relatively low air pressures. Special photographic techniques and analytical procedures were employed to determine foam bubble size distributions. In addition, the percentage water content of ocean foam was determined with the aid of a particulate sampling procedure. A glass frit foam generator, with pore diameters in the range 70 - 100 micrometers, produced foam with bubble distributions very similar to those found on the surface of natural ocean foam patches.
NASA Astrophysics Data System (ADS)
Haryanto, B.; Chang, C. H.; Kuo, A. T.; Siswarni, M. Z.; Sinaga, T. M. A.
2018-02-01
In this study, the effect of the coffee colloidal particle and Cd ion contaminant on the foam capacity and stability of sodium dodecyl sulfate (SDS) solution was investigated. The foam was generated by using a foam generator. The foam capacity of SDS was first evaluated at different concentrations. After the foam capacity reaching a constant value, the foam stability was then measured by flowing to a column. The results showed that the presence the coffee colloidal particles or Cd ions in the solution would decrease the foam capacity and stability of SDS. In addition, the decreased foam capacity and stability was more pronounced in the presence of coffee colloidal particles than Cd ions. The colloidal particles may have stronger interaction with SDS and thus reduce the formation of the foam.
Fashion as Argument: Nineteenth-Century Dress Reform.
ERIC Educational Resources Information Center
Torrens, Kathleen M.
1999-01-01
Examines the place of the body in the dress-reform movement, a social movement that focused on fashion as a vehicle for achieving social and political equality. Discusses how fashion became one arena in which definitions of gender were contested. Suggests the dress-reform movement's failure in redefining femininity indicates the depth of…
ERIC Educational Resources Information Center
Chatelain, Amber M.
2015-01-01
This study sought to discover student perceptions of academics' dress and gender and their impact on perceived instructor approachability and likeability. Three categories of dress were examined: casual, business casual and professional. The results of this study suggest students at career-arts institutions perceive female teachers as less…
ERIC Educational Resources Information Center
Freeburg, Beth Winfrey; Workman, Jane E.
2010-01-01
The purpose of this study was to explore teacher dress in United States schools as presented in the newspaper. Twenty-nine articles were examined to answer three questions. Results revealed: (a) the newspaper provided four contexts for processing information about teacher dress--roles, control, impression management, and educational learning…
Dress-Related Responses to the Columbine Shootings: Other-Imposed and Self-Designed.
ERIC Educational Resources Information Center
Ogle, Jennifer Paff; Eckman, Molly
2002-01-01
An inductive content analysis approach was used to examine 155 dress-related newspaper articles following the Columbine High School shootings in 1999. Analysis revealed two dress-related responses: (1) other-imposed regulation to protect students and deter them from expressing hatred and (2) self-designed acts of resistance for grieving. (Contains…
ERIC Educational Resources Information Center
Morris, Tracy L.; And Others
1996-01-01
Finds that more formal dress (business suits, dress shoes) was associated with increased ratings of teaching assistants' competence, particularly for female students rating female instructors. Shows, however, that contrary to common assumptions, the most positive influences of instructor dress were found in the highly casual condition (faded…
Effect of Andrographis paniculata leaf extract on wound healing in rats.
Al-Bayaty, Fouad Hussain; Abdulla, Mahmood Ameen; Abu Hassan, Mohamed Ibrahim; Ali, Hapipah Mohd
2012-01-01
This work was carried out to study the effect of topical application of Andrographis paniculata on the rate of wound enclosure and its histological features. A wound was created in four groups of rat in posterior neck region. Blank placebo was applied topically to the wounds of Group 1. Groups 2 and 3 were dressed with placebo containing 5% and 10% extracts of A. paniculata, respectively. Intrasite gel was applied topically to the wounds of Group 4. Macroscopical examination revealed that the rate of wound healing was significantly accelerated in the wound dressed with A. paniculata extract compared to the blank placebo. The wounds dressed with 10% extract or Intrasite gel healed earlier compared to the wounds dressed with placebo containing 5% A. paniculata extract. Histologically, wounds dressed with A. paniculata extracts showed markedly less scar width and contained large amounts of fibroblast proliferation. More collagen and less angiogenesis with absence of inflammatory cells were seen for wounds dressed with 10% A. paniculata compared to the blank placebo. Conclusion, A. paniculata extracts significantly enhanced rate of wound healing in rats.
An in vitro test of the efficacy of an anti-biofilm wound dressing.
Said, Jawal; Walker, Michael; Parsons, David; Stapleton, Paul; Beezer, Anthony E; Gaisford, Simon
2014-10-20
Broad-spectrum antimicrobial agents, such as silver, are increasingly being formulated into medicated wound dressings in order to control colonization of wounds by opportunistic pathogens. Medicated wound dressings have been shown in-vitro to be effective against planktonic cultures, but in-vivo bacteria are likely to be present in biofilms, which makes their control and eradication more challenging. Recently, a functional wound dressing (AQUACEL(®) Ag+ Extra™ (AAg + E)) has been developed that in addition to silver contains two agents (ethylenediaminetetraacetic acid (EDTA) and benzethonium chloride (BC)) designed to disrupt biofilms. Here, the efficacy of AAg + E is demonstrated using a biofilm model developed in an isothermal microcalorimeter. The biofilm was seen to remain viable in the presence of unmedicated dressing, silver-containing dressing or silver nitrate solution. In the presence of AAg + E, however, the biofilm was eradicated. Control experiments showed that neither EDTA nor BC alone had a bactericidal effect, which means it is the synergistic action of EDTA and BC disrupting the biofilm with silver being bactericidal that leads to the product's efficacy. Copyright © 2014 Elsevier B.V. All rights reserved.
Mitchell, Michael S; Koen, Clifford M; Moore, Thomas W
2013-01-01
As more and more individuals choose to express themselves and their religious beliefs with headwear, jewelry, dress, tattoos, and body piercings and push the envelope on what is deemed appropriate in the workplace, employers have an increased need for creation and enforcement of reasonable dress codes and appearance policies. As with any employment policy or practice, an appearance policy must be implemented and enforced without regard to an individual's race, color, sex, national origin, religion, disability, age, or any other protected status. A policy governing dress and appearance based on the business needs of an employer that is applied fairly and consistently and does not have a disproportionate effect on any protected class will generally be upheld if challenged in court. By examining some of the more common legal challenges to dress codes and how courts have resolved the disputes, health care managers can avoid many potential problems. This article addresses the issue of religious discrimination focusing on dress and appearance and some of the court cases that provide guidance for employers.
Dispersive detection of radio-frequency-dressed states
NASA Astrophysics Data System (ADS)
Jammi, Sindhu; Pyragius, Tadas; Bason, Mark G.; Florez, Hans Marin; Fernholz, Thomas
2018-04-01
We introduce a method to dispersively detect alkali-metal atoms in radio-frequency-dressed states. In particular, we use dressed detection to measure populations and population differences of atoms prepared in their clock states. Linear birefringence of the atomic medium enables atom number detection via polarization homodyning, a form of common path interferometry. In order to achieve low technical noise levels, we perform optical sideband detection after adiabatic transformation of bare states into dressed states. The balanced homodyne signal then oscillates independently of field fluctuations at twice the dressing frequency, thus allowing for robust, phase-locked detection that circumvents low-frequency noise. Using probe pulses of two optical frequencies, we can detect both clock states simultaneously and obtain population difference as well as the total atom number. The scheme also allows for difference measurements by direct subtraction of the homodyne signals at the balanced detector, which should technically enable quantum noise limited measurements with prospects for the preparation of spin squeezed states. The method extends to other Zeeman sublevels and can be employed in a range of atomic clock schemes, atom interferometers, and other experiments using dressed atoms.
The effect of semirigid dressings on below-knee amputations.
MacLean, N; Fick, G H
1994-07-01
The effect of using semirigid dressings (SRDs) on the residual limb of individuals who have had below-knee amputations as a consequence of peripheral vascular disease was investigated, with the primary question being: Does the time to readiness for prosthetic fitting for patients treated with the SRDs differ from that of patients treated with soft dressings? Forty patients entered the study and were alternately assigned to one of two groups. Nineteen patients were assigned to the SRD group, and 21 patients were assigned to the soft dressing group. The time from surgery to readiness for prosthetic fitting was recorded for each patient. Kaplan-Meier survival curves were generated for each group, and the results were analyzed with the log-rank test. There was a difference between the two curves, and an examination of the curves suggests that the expected time to readiness for prosthetic fitting for patients treated with the SRDs would be less than half that of patients treated with soft dressings. The results suggest that a patient may be ready for prosthetic fitting sooner if treated with SRDs instead of soft dressings.
Tyring, Stephen; Bukhalo, Michael; Alonso-Llamazares, Javier; Olesen, Martin; Lowson, David; Yamauchi, Paul
2016-01-01
Objective: To evaluate the efficacy of fixed combination aerosol foam calcipotriene 0.005% (Cal) plus betamethasone dipropionate 0.064% (BD). Design: Patients were randomized (100:101:101) to receive Cal/BD foam, Cal foam, or BD foam once daily for four weeks. Setting: Twenty-eight United States centers. Participants: 302 patients (≥18 years) with Psoriasis vulgaris (plaque Psoriasis; ≥mild disease severity by physicians global assessment). Measurements: Treatment success of the body (“clear”/”almost clear” from baseline moderate/severe disease; “clear” from baseline mild disease). Involved scalp treatment success was an additional endpoint. Results: Most patients (76%) had moderate Psoriasis of the body (66% for scalp). At Week 4, 45 percent of Cal/BD foam patients achieved treatment success, significantly more than Cal foam (14.9%; OR 4.34 [95%CI 2.16,8.72] P<0.001) or BD foam (30.7%; 1.81 [1.00,3.26] P=0.047). Fifty-three percent of Cal/BD foam patients achieved treatment success of the scalp, significantly greater than Cal foam (35.6%; 1.91 [1.09,3.35] P=0.021), but not BD foam (47.5%; 1.24 [0.71,2.16] P=0.45). Mean modified Psoriasis area and severity index (population baseline 7.6) improved in all groups, with statistically significant differences in Week 4 Cal/BD foam score (2.37) versus Cal foam (4.39; mean difference -2.03 [-2.63][-1.43] P<0.001) and BD foam (3.37; -1.19 [-1.80][-0.59] P<0.001). Four (Cal/BD), 10 (Cal), and 8 (BD) adverse drug reactions were reported. Conclusion: Cal/BD foam was significantly more effective than Cal foam and BD foam in providing treatment success at Week 4 and effective on involved scalp. Trial registration: NCT01536938. PMID:27313822
NASA Astrophysics Data System (ADS)
Langevin, Dominique; Saint-Jalmes, Arnaud; Marze, Sébastien; Cox, Simon; Hutzler, Stefan; Drenckhan, Wiebke; Weaire, Denis; Caps, Hervé; Vandewalle, Nicolas; Adler, Micheàle; Pitois, Olivier; Rouyer, Florence; Cohen-Addad, Sylvie; Höhler, Reinhard; Ritacco, Hernan
2005-10-01
Foams and foaming pose important questions and problems to the chemical industry. As a material, foam is unusual in being a desired product while also being an unwanted byproduct within industry. Liquid foams are an essential part of gas/liquid contacting processes such as distillation and absorption, but over-production of foam in these processes can lead to downtime and loss of efficiency. Solid polymeric foams, such as polystyrene and polyurethane, find applications as insulation panels in the construction industry. Their combination of low weight and unique elastic/plastic properties make them ideal as packing and cushioning materials. Foams made with proteins are extensively used in the food industry. Despite the fact that foam science is a rapidly maturing field, critical aspects of foam physics and chemistry remain unclear. Several gaps in knowledge were identified to be tackled as the core of this MAP project. In addition, microgravity affords conditions for extending our understanding far beyond the possibilities offered by ground-based investigation. This MAP project addresses the challenges posed by the physics of foams under microgravity.
Foam relaxation in fractures and narrow channels
NASA Astrophysics Data System (ADS)
Lai, Ching-Yao; Rallabandi, Bhargav; Perazzo, Antonio; Stone, Howard A.
2017-11-01
Various applications, from foam manufacturing to hydraulic fracturing with foams, involve pressure-driven flow of foams in narrow channels. We report a combined experimental and theoretical study of this problem accounting for the compressible nature of the foam. In particular, in our experiments the foam is initially compressed in one channel and then upon flow into a second channel the compressed foam relaxes as it moves. A plug flow is observed in the tube and the pressure at the entrance of the tube is higher than the exit. We measure the volume collected at the exit of the tube, V, as a function of injection flow rate, tube length and diameter. Two scaling behaviors for V as a function of time are observed depending on whether foam compression is important or not. Our work may relate to foam fracturing, which saves water usage in hydraulic fracturing, more efficient enhanced oil recovery via foam injection, and various materials manufacturing processes involving pressure-driven flow foams.
Role of Temperature and SiCP Parameters in Stability and Quality of Al-Si-Mg/SiC Foams
NASA Astrophysics Data System (ADS)
Ravi Kumar, N. V.; Gokhale, Amol A.
2018-06-01
Composites of Al-Si-Mg (A356) alloy with silicon carbide particles were synthesized in-house and foamed by melt processing using titanium hydride as foaming agent. The effects of the SiCP size and content, and foaming temperature on the stability and quality of the foam were explored. It was observed that the foam stability depended on the foaming temperature alone but not on the particle size or volume percent within the studied ranges. Specifically, foam stability was poor at 670°C. Among the stable foams obtained at 640°C, cell soundness (absence of/low defects, and collapse) was seen to vary depending on the particle size and content; For example, for finer size, lower particle contents were sufficient to obtain sound cell structure. It is possible to determine a foaming process window based on material and process parameters for good expansion, foam stability, and cell structure.
NASA Astrophysics Data System (ADS)
Hangai, Yoshihiko; Matsushita, Hayato; Koyama, Shinji; Suzuki, Ryosuke; Matsubara, Masaaki
2017-07-01
A preliminary study of the reproducibility of aluminum foam was performed. Aluminum foam was fabricated by a sintering and dissolution process. It was found that aluminum foam containing a blowing agent can be fabricated without the decomposition of the blowing agent, namely, the densified aluminum foam can be used as a foamable precursor for refoaming. By heat treatment of the densified aluminum foam containing the blowing agent, pores were reproduced in the aluminum.
Synergistic effect of casein glycomacropeptide on sodium caseinate foaming properties.
Morales, R; Martinez, M J; Pilosof, A M R
2017-11-01
Several strategies to improve the interfacial properties and foaming properties of proteins may be developed; among them, the use of mixtures of biopolymers that exhibit synergistic interactions. The aim of the present work was to evaluate the effect of casein glycomacropeptide (CMP) on foaming and surface properties of sodium caseinate (NaCas) and to establish the role of protein interactions in the aqueous phase. To this end particles size, interfacial and foaming properties of CMP, NaCas and NaCas-CMP mixtures at pH 5.5 and 7 were determined. At both pH, the interaction between CMP and NaCas induced a decrease in the aggregation state of NaCas. Single CMP foams showed the highest and NaCas the lowest foam overrun (FO) and the mixture exhibited intermediate values. CMP foam quickly drained. The drainage profile of mixed foams was closer to NaCas foams; at pH 5.5, mixed foams drained even slower than NaCas foam, exhibiting a synergistic performance. Additionally, a strong synergism was observed on the collapse of mixed foams at pH 5.5. Finally, a model to explain the synergistic effect observed on foaming properties in CMP-NaCas mixtures has been proposed; the reduced aggregation state of NaCas in the presence of CMP, made it more efficient for foam stabilization. Copyright © 2017 Elsevier B.V. All rights reserved.
Heyneman, A; Hoeksema, H; Vandekerckhove, D; Pirayesh, A; Monstrey, S
2016-11-01
For more than 40 years, silver sulphadiazine 1% (SSD) is considered as standard therapy for the conservative treatment of burn wounds. However, in the last 10 years, substantial disadvantages of SSD have been reported in the literature and probably as a result of this, several new dressings for burn wounds have been developed and put on the market. The objective of this systematic review is to evaluate the available evidence on SSD in the conservative treatment of burns, specifically in comparison with the newer burn dressings that are increasingly being used nowadays. A search filter was composed to select randomized controlled trials (RCTs) from the MEDLINE database. Only RCTs studying the effect of conservative treatment on burns were selected. At least one of the two comparative groups was treated with SSD. Each included article was analysed and relevant data (baseline parameters, interventions, outcomes and methodological parameters) were registered using Microsoft Office Excel 2007. Many dressings showed superior healing properties compared to SSD, but no dressing was able to show a clear benefit over SSD regarding infection. The number of dressing changes, pain and patient's satisfaction are more favourable in the newer dressings, especially with solid and biological dressings. The results of this systematic review clearly demonstrate that a faster wound healing is obtained with the newly developed burn dressings. Additionally, these new dressings tend to be more comfortable for the patients and easier to use for care givers. The minor differences in antibacterial activity between SSD and the new products did not seem to have any influence on the rate of wound healing. Since rapid wound closure is essential to obtain an optimal functional and aesthetic outcome, it can be concluded from the results of this systemic review that the standard use of SSD in the conservative treatment of burn wounds can no longer be supported. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.
Crack Initiation and Growth in Rigid Polymeric Closed-Cell Foam Cryogenic Applications
NASA Technical Reports Server (NTRS)
Sayyah, Tarek; Steeve, Brian; Wells, Doug
2006-01-01
Cryogenic vessels, such as the Space Shuttle External Tank, are often insulated with closed-cell foam because of its low thermal conductivity. The coefficient of thermal expansion mismatch between the foam and metallic substrate places the foam under a biaxial tension gradient through the foam thickness. The total foam thickness affects the slope of the stress gradient and is considered a significant contributor to the initiation of subsurface cracks. Rigid polymeric foams are brittle in nature and any subsurface cracks tend to propagate a finite distance toward the surface. This presentation investigates the relationship between foam thickness and crack initiation and subsequent crack growth, using linear elastic fracture mechanics, in a rigid polymeric closed-cell foam through analysis and comparison with experimental results.
Advances of Researches on Improving the Stability of Foams by Nanoparticles
NASA Astrophysics Data System (ADS)
Wang, G.; Wang, K. L.; Lu, C. J.
2017-09-01
Recently, nano-tech made a change of traditional oil-gas exploration. Considering that foam fluid had a poor stability, investigators proposed to add nanoparticles to stabilize the foam fluid system. This paper described the mechanism of particles to improve the stability of the foam fluid in detail; and emphasized the synergistic effect between nanoparticles and surfactants and its effect on the foaming and foam stability of dispersions; and reviewed the latest applications of foam fluid that was stabilized by nanoparticle in enhancing oil-gas recovery, in which there are analysis that showed that the nanoparticles not only greatly increase the stability of the foam fluid, but also improve the efficiency of foam fluid; and lastly, forecasted the development of nanotechnology in petroleum areas.
Porous Media Approach for Modeling Closed Cell Foam
NASA Technical Reports Server (NTRS)
Ghosn, Louis J.; Sullivan, Roy M.
2006-01-01
In order to minimize boil off of the liquid oxygen and liquid hydrogen and to prevent the formation of ice on its exterior surface, the Space Shuttle External Tank (ET) is insulated using various low-density, closed-cell polymeric foams. Improved analysis methods for these foam materials are needed to predict the foam structural response and to help identify the foam fracture behavior in order to help minimize foam shedding occurrences. This presentation describes a continuum based approach to modeling the foam thermo-mechanical behavior that accounts for the cellular nature of the material and explicitly addresses the effect of the internal cell gas pressure. A porous media approach is implemented in a finite element frame work to model the mechanical behavior of the closed cell foam. The ABAQUS general purpose finite element program is used to simulate the continuum behavior of the foam. The soil mechanics element is implemented to account for the cell internal pressure and its effect on the stress and strain fields. The pressure variation inside the closed cells is calculated using the ideal gas laws. The soil mechanics element is compatible with an orthotropic materials model to capture the different behavior between the rise and in-plane directions of the foam. The porous media approach is applied to model the foam thermal strain and calculate the foam effective coefficient of thermal expansion. The calculated foam coefficients of thermal expansion were able to simulate the measured thermal strain during heat up from cryogenic temperature to room temperature in vacuum. The porous media approach was applied to an insulated substrate with one inch foam and compared to a simple elastic solution without pore pressure. The porous media approach is also applied to model the foam mechanical behavior during subscale laboratory experiments. In this test, a foam layer sprayed on a metal substrate is subjected to a temperature variation while the metal substrate is stretched to simulate the structural response of the tank during operation. The thermal expansion mismatch between the foam and the metal substrate and the thermal gradient in the foam layer causes high tensile stresses near the metal/foam interface that can lead to delamination.
Dynamical Casimir-Polder force on a partially dressed atom near a conducting wall
DOE Office of Scientific and Technical Information (OSTI.GOV)
Messina, Riccardo; Vasile, Ruggero; Passante, Roberto
2010-12-15
We study the time evolution of the Casimir-Polder force acting on a neutral atom in front of a perfectly conducting plate, when the system starts its unitary evolution from a partially dressed state. We solve the Heisenberg equations for both atomic and field quantum operators, exploiting a series expansion with respect to the electric charge and an iterative technique. After discussing the behavior of the time-dependent force on an initially partially dressed atom, we analyze a possible experimental scheme to prepare the partially dressed state and the observability of this new dynamical effect.
Berry, Tristan K; Yang, Xin; Foegeding, E Allen
2009-06-01
The effects of sucrose on the physical properties and thermal stability of foams prepared from 10% (w/v) protein solutions of whey protein isolate (WPI), egg white protein (EWP), and their combinations (WPI/EWP) were investigated in wet foams and angel food cakes. Incorporation of 12.8 (w/v) sucrose increased EWP foam stability (drainage 1/2 life) but had little effect on the stability of WPI and WPI/EWP foams. Increased stability was not due to viscosity alone. Sucrose increased interfacial elasticity (E ') of EWP and decreased E' of WPI and WPI/EWP combinations, suggesting that altered interfacial properties increased stability in EWP foams. Although 25% WPI/75% EWP cakes had similar volumes as EWP cakes, cakes containing WPI had larger air cells. Changes during heating showed that EWP foams had network formation starting at 45 degrees C, which was not observed in WPI and WPI/EWP foams. Moreover, in batters, which are foams with additional sugar and flour, a stable foam network was observed from 25 to 85 degrees C for batters made from EWP foams. Batters containing WPI or WPI/EWP mixtures showed signs of destabilization starting at 25 degrees C. These results show that sucrose greatly improved the stability of wet EWP foams and that EWP foams form network structures that remain stable during heating. In contrast, sucrose had minimal effects on stability of WPI and WPI/EWP wet foams, and batters containing these foams showed destabilization prior to heating. Therefore, destabilization processes occurring in the wet foams and during baking account for differences in angel food cake quality.
Hangai, Yoshihiko; Saito, Masaki; Utsunomiya, Takao; Kitahara, Soichiro; Kuwazuru, Osamu; Yoshikawa, Nobuhiro
2014-09-19
Aluminum foam has received considerable attention in various fields and is expected to be used as an engineering material owing to its high energy absorption properties and light weight. To improve the mechanical properties of aluminum foam, combining it with dense tubes, such as aluminum foam-filled tubes, was considered necessary. In this study, an aluminum foam-filled steel tube, which consisted of ADC12 aluminum foam and a thin-wall steel tube, was successfully fabricated by friction welding. It was shown that a diffusion bonding layer with a thickness of approximately 10 μm was formed, indicating that strong bonding between the aluminum foam and the steel tube was realized. By the X-ray computed tomography observation of pore structures, the fabrication of an aluminum foam-filled tube with almost uniform pore structures over the entire specimen was confirmed. In addition, it was confirmed that the aluminum foam-filled steel tube exhibited mechanical properties superior to those of the ADC12 aluminum foam and steel tube. This is considered to be attributed to the combination of the aluminum foam and steel tube, which particularly prevents the brittle fracture and collapse of the ADC12 foam by the steel tube, along with the strong metal bonding between the aluminum foam and the steel tube.
Effects of yolk contamination, shearing, and heating on foaming properties of fresh egg white.
Wang, G; Wang, T
2009-03-01
A series of experiments were conducted to evaluate effects of yolk contamination, shearing, and thermal treatment on foaming properties of liquid egg white. Samples obtained from industrial processing were also evaluated. Whipping and purging methods were both used to assess their effectiveness and sensitivity in evaluating foaming. A concentration as low as 0.022% (as-is basis) of yolk contamination caused significant reductions in foaming capacity and foaming speed. The neutral lipid fraction of egg yolk caused the major detrimental effect on foaming, and phospholipids fraction did not give significant foaming reduction at a concentration as high as 0.1%. High-speed and short-time shearing caused no apparent damage but longer shearing time significantly impaired foaming. Heat-induced foaming change is a function of temperature and holding time. Foaming was significantly reduced at a temperature of 55 degrees C for 10 min, whereas it did not change up to 3 min at a heating temperature of 62 to 64 degrees C. Industrial processing steps (pumping, pipe transfer, and storage) did not produce negative effects on foaming of the final products and the controlled pasteurization was actually beneficial for good foaming performance. Therefore, yolk contamination of the egg white was the major factor in reducing foaming properties of the white protein.
NASA Astrophysics Data System (ADS)
Chuaponpat, N.; Areerat, S.
2017-11-01
This research studies the effects of foaming conditions by using liquid carbon dioxide (CO2) as a physical blowing agent on plasticized polyvinyl chloride (PVC) foam morphology. Foaming conditions were soaking time of 6, 10, and 12 h, foaming temperature of 70, 80, 90 °C for 5 s, at constant soaking temperature of -20 °C and pressure of 50 bar. Instantaneously increasing temperature was employed in this process for making foam structure. PVC foam samples were calculated percentage of shrinkage (Sh) by using density at before and after aging process at 30 °C for 12 h. When PVC samples were activated to form foam by using liquid CO2 as a physical blowing agent, it reveal bimodal foam structure with a thick bubble wall (10-20 μm). Bubble diameter of PVC foam at longer soaking time is in the range of 40-60 μm and its at shorter soaking time reveal a large bubble that is in the range of 80-120 μm. Foaming condition slightly affected to bubble density that was in the narrow range of 106-108 bubbles/cm3. PVC foam reveal reduction of density up to 65% when compare with PVC and Sh is less than 10%.
Guo, Feng; Wang, Zhi-Ping; Yu, Ke; Zhang, T.
2015-01-01
Foaming of activated sludge (AS) causes adverse impacts on wastewater treatment operation and hygiene. In this study, we investigated the microbial communities of foam, foaming AS and non-foaming AS in a sewage treatment plant via deep-sequencing of the taxonomic marker genes 16S rRNA and mycobacterial rpoB and a metagenomic approach. In addition to Actinobacteria, many genera (e.g., Clostridium XI, Arcobacter, Flavobacterium) were more abundant in the foam than in the AS. On the other hand, deep-sequencing of rpoB did not detect any obligate pathogenic mycobacteria in the foam. We found that unknown factors other than the abundance of Gordonia sp. could determine the foaming process, because abundance of the same species was stable before and after a foaming event over six months. More interestingly, although the dominant Gordonia foam former was the closest with G. amarae, it was identified as an undescribed Gordonia species by referring to the 16S rRNA gene, gyrB and, most convincingly, the reconstructed draft genome from metagenomic reads. Our results, based on metagenomics and deep sequencing, reveal that foams are derived from diverse taxa, which expands previous understanding and provides new insight into the underlying complications of the foaming phenomenon in AS. PMID:25560234
dsmcFoam+: An OpenFOAM based direct simulation Monte Carlo solver
NASA Astrophysics Data System (ADS)
White, C.; Borg, M. K.; Scanlon, T. J.; Longshaw, S. M.; John, B.; Emerson, D. R.; Reese, J. M.
2018-03-01
dsmcFoam+ is a direct simulation Monte Carlo (DSMC) solver for rarefied gas dynamics, implemented within the OpenFOAM software framework, and parallelised with MPI. It is open-source and released under the GNU General Public License in a publicly available software repository that includes detailed documentation and tutorial DSMC gas flow cases. This release of the code includes many features not found in standard dsmcFoam, such as molecular vibrational and electronic energy modes, chemical reactions, and subsonic pressure boundary conditions. Since dsmcFoam+ is designed entirely within OpenFOAM's C++ object-oriented framework, it benefits from a number of key features: the code emphasises extensibility and flexibility so it is aimed first and foremost as a research tool for DSMC, allowing new models and test cases to be developed and tested rapidly. All DSMC cases are as straightforward as setting up any standard OpenFOAM case, as dsmcFoam+ relies upon the standard OpenFOAM dictionary based directory structure. This ensures that useful pre- and post-processing capabilities provided by OpenFOAM remain available even though the fully Lagrangian nature of a DSMC simulation is not typical of most OpenFOAM applications. We show that dsmcFoam+ compares well to other well-known DSMC codes and to analytical solutions in terms of benchmark results.
Pitch based foam with particulate
Klett, James W.
2001-01-01
A thermally conductive, pitch based foam composite having a particulate content. The particulate alters the mechanical characteristics of the foam without severely degrading the foam thermal conductivity. The composite is formed by mixing the particulate with pitch prior to foaming.
Strain compatibility tests for sprayed foam cryogenic insulation
NASA Technical Reports Server (NTRS)
Hill, W. L.; Kimberlin, D. O.
1970-01-01
Mechanical stress applied to foam-coated aluminum alloy specimens maintained at cryogenic temperature simulates actual use conditions of the foam insulation. The testing reveals defects in the polyurethane foam or in the foam to metal bond.
Rigid closed-cell polyimide foams for aircraft applications and foam-in-place technology
NASA Technical Reports Server (NTRS)
Gagliani, J.; Straub, P.; Gagliani, J., Jr.
1983-01-01
Significant accomplishments generated are summarized. Testing of closed cell foams, which has resulted in the characterization of compositions which produce rigid foams for use in galley structure applications is reported. It is shown that the density, compressive strength and shear strength of the foams are directly related to the concentrations of the microballoons. The same properties are also directly related to the resin loading. Prototype samples of rigid closed cell foams meeting the requirements of the program were submitted. Investigation of the apparatus to produce polyimide foams using foam in place techniques, resulted in the selection of a spray gun apparatus, capable to deliver a mixture of microballoons and resin binder on substrates which cures to yield a closed cell foam. It is found that the adhesion of the foam on aluminum, titanium and steel substrates is satisfactory. It is concluded that the material meets the mechanical and thermal requirements of the program.
Fabrication of Aluminum Foams with Small Pore Size by Melt Foaming Method
NASA Astrophysics Data System (ADS)
Cheng, Ying; Li, Yanxiang; Chen, Xiang; Shi, Tong; Liu, Zhiyong; Wang, Ningzhen
2017-04-01
This article introduces an improvement to the fabrication of aluminum foams with small pore size by melt foaming method. Before added to the melt, the foaming agent (titanium hydride) was pretreated in two steps. It firstly went through the traditional pre-oxidation treatment, which delayed the decomposition of titanium hydride and made sure the dispersion stage was controllable. Then such pre-oxidized titanium hydride powder was mixed with copper powder in a planetary ball mill. This treatment can not only increase the number of foaming agent particles and make them easier to disperse in the melt, which helps to increase the number of pores, but also reduce the amount of hydrogen released in the foaming stage. Therefore, the pore size could be decreased. Using such a ball-milled foaming agent in melt foaming method, aluminum foams with small pore size (average size of 1.6 mm) were successfully fabricated.
Sun, Yange; Qi, Xiaoqing; Sun, Haoyang; Zhao, Hui; Li, Ying
2016-08-02
In this paper, the detailed behaviors of all the molecules, especially the interfacial array behaviors of surfactants and diffusion behaviors of gas molecules, in foam systems with different gases (N2, O2, and CO2) being used as foaming agents were investigated by combining molecular dynamics simulation and experimental approaches for the purpose of interpreting how the molecular behaviors effect the properties of the foam and find out the key factors which fundamentally determine the foam stability. Sodium dodecyl sulfate SDS was used as the foam stabilizer. The foam decay and the drainage process were determined by Foamscan. A texture analyzer (TA) was utilized to measure the stiffness and viscoelasticity of the foam films. The experimental results agreed very well with the simulation results by which how the different gas components affect the interfacial behaviors of surfactant molecules and thereby bring influence on foam properties was described.
Innovative test method for the estimation of the foaming tendency of substrates for biogas plants.
Moeller, Lucie; Eismann, Frank; Wißmann, Daniel; Nägele, Hans-Joachim; Zielonka, Simon; Müller, Roland A; Zehnsdorf, Andreas
2015-07-01
Excessive foaming in anaerobic digestion occurs at many biogas plants and can cause problems including plugged gas pipes. Unfortunately, the majority of biogas plant operators are unable to identify the causes of foaming in their biogas reactor. The occurrence of foaming is often related to the chemical composition of substrates fed to the reactor. The consistency of the digestate itself is also a crucial part of the foam formation process. Thus, no specific recommendations concerning substrates can be given in order to prevent foam formation in biogas plants. The safest way to avoid foaming is to test the foaming tendency of substrates on-site. A possible solution is offered by an innovative foaming test. With the help of this tool, biogas plant operators can evaluate the foaming disposition of new substrates prior to use in order to adjust the composition of substrate mixes. Copyright © 2015 Elsevier Ltd. All rights reserved.
Foam-oil interaction in porous media: implications for foam assisted enhanced oil recovery.
Farajzadeh, R; Andrianov, A; Krastev, R; Hirasaki, G J; Rossen, W R
2012-11-15
The efficiency of a foam displacement process in enhanced oil recovery (EOR) depends largely on the stability of foam films in the presence of oil. Experimental studies have demonstrated the detrimental impact of oil on foam stability. This paper reviews the mechanisms and theories (disjoining pressure, coalescence and drainage, entering and spreading of oil, oil emulsification, pinch-off, etc.) suggested in the literature to explain the impact of oil on foam stability in the bulk and porous media. Moreover, we describe the existing approaches to foam modeling in porous media and the ways these models describe the oil effect on foam propagation in porous media. Further, we present various ideas on an improvement of foam stability and longevity in the presence of oil. The outstanding questions regarding foam-oil interactions and modeling of these interactions are pointed out. Copyright © 2012 Elsevier B.V. All rights reserved.
NASA Technical Reports Server (NTRS)
1979-01-01
A decade ago, NASA's Ames Research Center developed a new foam material for protective padding of airplane seats. Now known as Temper Foam, the material has become one of the most widely-used spinoffs. Latest application is a line of Temper Foam cushioning produced by Edmont-Wilson, Coshocton, Ohio for office and medical furniture. The example pictured is the Classic Dental Stool, manufactured by Dentsply International, Inc., York, Pennsylvania, one of four models which use Edmont-Wilson Temper Foam. Temper Foam is an open-cell, flameresistant foam with unique qualities.
Foaming volume and foam stability
NASA Technical Reports Server (NTRS)
Ross, Sydney
1947-01-01
A method of measuring foaming volume is described and investigated to establish the critical factors in its operation. Data on foaming volumes and foam stabilities are given for a series of hydrocarbons and for a range of concentrations of aqueous ethylene-glycol solutions. It is shown that the amount of foam formed depends on the machinery of its production as well as on properties of the liquid, whereas the stability of the foam produced, within specified mechanical limitations, is primarily a function of the liquid.
Development of drilling foams for geothermal applications
DOE Office of Scientific and Technical Information (OSTI.GOV)
McDonald, W.J.; Remont, L.J.; Rehm, W.A.
The use of foam drilling fluids in geothermal applications is addressed. A description of foams - what they are, how they are used, their properties, equipment required to use them, the advantages and disadvantages of foams, etc. - is presented. Geothermal applications are discussed. Results of industry interviews presented indicate significant potential for foams, but also indicate significant technical problems to be solved to achieve this potential. Testing procedures and results of tests on representative foams provide a basis for work to develop high-temperature foams.
Hasatsri, Sukhontha; Angspatt, Apichai
2015-01-01
We developed the novel silk fibroin-based bilayered wound dressing for the treatment of partial thickness wounds. And it showed relevant characteristics and accelerated the healing of full-thickness wounds in a rat model. This study is the clinical evaluation of the bilayered wound dressing to confirm its safety and efficacy for the treatment of split-thickness skin donor sites. The safety test was performed using a patch model and no evidence of marked and severe cutaneous reactions was found. The efficacy test of the bilayered wound dressing was conducted on 23 patients with 30 split-thickness skin graft donor sites to evaluate healing time, pain score, skin barrier function, and systemic reaction in comparison to Bactigras. We found that the healing time of donor site wounds treated with the bilayered wound dressing (11 ± 6 days) was significantly faster than those treated with Bactigras (14 ± 6 days) (p = 10−6). The wound sites treated with the bilayered wound dressing showed significantly less pain and more rapid skin functional barrier recovery than those treated with Bactigras (p = 10−5). Therefore, these results confirmed the clinical safety and efficacy of the bilayered wound dressing for the treatment of split-thickness skin graft donor sites. PMID:26221170
Economic impact of Tegaderm chlorhexidine gluconate (CHG) dressing in critically ill patients.
Thokala, Praveen; Arrowsmith, Martin; Poku, Edith; Martyn-St James, Marissa; Anderson, Jeff; Foster, Steve; Elliott, Tom; Whitehouse, Tony
2016-09-01
To estimate the economic impact of a Tegaderm TM chlorhexidine gluconate (CHG) gel dressing compared with a standard intravenous (i.v.) dressing (defined as non-antimicrobial transparent film dressing), used for insertion site care of short-term central venous and arterial catheters (intravascular catheters) in adult critical care patients using a cost-consequence model populated with data from published sources. A decision analytical cost-consequence model was developed which assigned each patient with an indwelling intravascular catheter and a standard dressing, a baseline risk of associated dermatitis, local infection at the catheter insertion site and catheter-related bloodstream infections (CRBSI), estimated from published secondary sources. The risks of these events for patients with a Tegaderm CHG were estimated by applying the effectiveness parameters from the clinical review to the baseline risks. Costs were accrued through costs of intervention (i.e. Tegaderm CHG or standard intravenous dressing) and hospital treatment costs depended on whether the patients had local dermatitis, local infection or CRBSI. Total costs were estimated as mean values of 10,000 probabilistic sensitivity analysis (PSA) runs. Tegaderm CHG resulted in an average cost-saving of £77 per patient in an intensive care unit. Tegaderm CHG also has a 98.5% probability of being cost-saving compared to standard i.v. dressings. The analyses suggest that Tegaderm CHG is a cost-saving strategy to reduce CRBSI and the results were robust to sensitivity analyses.
Silver deposition and tissue staining associated with wound dressings containing silver.
Walker, Michael; Cochrane, Christine A; Bowler, Philip G; Parsons, David; Bradshaw, Peter
2006-01-01
Argyria is the general term used to denote a clinical condition in which excessive administration and deposition of silver causes a permanent irreversible gray-blue discoloration of the skin or mucous membranes. The amount of discoloration usually depends on the route of silver delivery (ie, oral or topical administration) along with the body's ability to absorb and excrete the administered silver compound. Argyria is accepted as a rare dermatosis but once silver particles are deposited, they remain immobile and may accumulate during the aging process. Topical application of silver salts (eg, silver nitrate solution) may lead to transient skin staining. To investigate their potential to cause skin staining, two silver-containing dressings (Hydrofiber and nanocrystalline) were applied to human skin samples taken from electively amputated lower limbs. The potential for skin discoloration was assayed using atomic absorption spectroscopy. When the dressings were hydrated with water, a significantly higher amount of silver was released from the nanocrystalline dressing compared to the Hydrofiber dressing (P <0.005), which resulted in approximately 30 times more silver deposition. In contrast, when saline was used as the hydration medium, the release rates were low for both dressings and not significantly different (silver deposition was minimal). Controlling the amount of silver released from silver-containing dressings should help reduce excessive deposition of silver into wound tissue and minimize skin staining.
Hämmerle, Gilbert; Strohal, Robert
2016-04-01
The aim of this study was to determine the efficacy, safety and cost-effectiveness of an octenidine-based wound gel in the treatment of chronic venous leg ulcers. For this purpose, 49 wounds were treated with either modern wound-phase-adapted dressings alone (treatment arm 1; n = 17), octenidine wound gel plus modern wound-phase-adapted dressings (treatment arm 2; n = 17) or octenidine wound gel alone (treatment arm 3; n = 15). During the study period of 42 days with dressing changes every 3-5 days, wound healing characteristics and treatment costs of different dressings were analysed. Wound size reduction was significantly better (P = 0·028) in both octenidine wound gel treatment arms compared to modern dressings alone with total reductions of 14·6%, 64·1% and 96·2% in treatment arms 1-3. Early wound healing was merely observed under octenidine wound gel treatment (n = 9), whereby lowest treatment costs were generated by octenidine wound gel alone (€20·34/dressing change). As a result, the octenidine wound gel is cost-effective and well suitable for the treatment of chronic venous leg ulcers, considering both safety and promotion of wound healing. © 2014 The Authors. International Wound Journal © 2014 Medicalhelplines.com Inc and John Wiley & Sons Ltd.
Anjum, Sadiya; Gupta, Amlan; Sharma, Deepika; Gautam, Deepti; Bhan, Surya; Sharma, Anupama; Kapil, Arti; Gupta, Bhuvanesh
2016-07-01
This study is aimed at the development of a composite material for wound dressing containing nanosilver nanohydrogels (nSnH) along with Aloe vera and curcumin that promote antimicrobial nature, wound healing and infection control. Nanosliver nanohydrogels were synthesized by nanoemulsion polymerization of methacrylic acid (MAA) followed by subsequent crosslinking and silver reduction under irradiation. Both the polymerization and irradiation time had significant influence on the nanoparticle shape, size and its formation. Polyvinyl alcohol/polyethylene oxide/carboxymethyl cellulose matrix was used as gel system to blend with nSnH, A. vera, curcumin and coat it on the hydrolysed PET fabric to develop antimicrobial dressings. The cumulative release of silver from the dressing was found to be ~42% of the total loading after 48h. The antimicrobial activity of the dressings was studied against both Staphylococcus aureus and Escherichia coli. In vivo wound healing studies were carried out over a period of 16d on full-thickness skin wounds created on Swiss albino mice. Fast healing was observed in Gel/nSnH/Aloe treated wounds with minimum scarring, as compared to other groups. The histological studies showed A. vera based dressings to be the most optimum one. These results suggest that nSnH along with A. vera based dressing material could be promising candidates for wound dressings. Copyright © 2016 Elsevier B.V. All rights reserved.
Spatial filtering, color constancy, and the color-changing dress.
Dixon, Erica L; Shapiro, Arthur G
2017-03-01
The color-changing dress is a 2015 Internet phenomenon in which the colors in a picture of a dress are reported as blue-black by some observers and white-gold by others. The standard explanation is that observers make different inferences about the lighting (is the dress in shadow or bright yellow light?); based on these inferences, observers make a best guess about the reflectance of the dress. The assumption underlying this explanation is that reflectance is the key to color constancy because reflectance alone remains invariant under changes in lighting conditions. Here, we demonstrate an alternative type of invariance across illumination conditions: An object that appears to vary in color under blue, white, or yellow illumination does not change color in the high spatial frequency region. A first approximation to color constancy can therefore be accomplished by a high-pass filter that retains enough low spatial frequency content so as to not to completely desaturate the object. We demonstrate the implications of this idea on the Rubik's cube illusion; on a shirt placed under white, yellow, and blue illuminants; and on spatially filtered images of the dress. We hypothesize that observer perceptions of the dress's color vary because of individual differences in how the visual system extracts high and low spatial frequency color content from the environment, and we demonstrate cross-group differences in average sensitivity to low spatial frequency patterns.
Gharibi, Reza; Yeganeh, Hamid; Rezapour-Lactoee, Alireza; Hassan, Zuhair M
2015-11-04
A series of novel polyurethane/siloxane-based wound dressing membranes was prepared through sol-gel reaction of methoxysilane end-functionalized urethane prepolymers composed of castor oil and ricinoleic methyl ester as well as methoxysilane functional aniline tetramer (AT) moieties. The samples were fully characterized and their physicochemical, mechanical, electrical, and biological properties were assayed. The biological activity of these dressings against fibroblast cells and couple of microbes was also studied. It was revealed that samples that displayed electroactivity by introduction of AT moieties showed a broad range of antimicrobial activity toward different microorganisms, promising antioxidant (radical scavenging) efficiency and significant activity for stimulation of fibroblast cell growth and proliferation. Meanwhile, these samples showed appropriate tensile strength and ability for maintaining a moist environment over a wound by controlled equilibrium water absorption and water vapor transmission rate. The selected electroactive dressing was subjected to an in vivo assay using a rat animal model and the wound healing process was monitored and compared with analogous dressing without AT moieties. The recorded results showed that the electroactive dressings induced an increase in the rate of wound contraction, promoted collagen deposition, and encouraged vascularization in the wounded area. On the basis of the results of in vitro and in vivo assays, the positive influence of designed dressings for accelerated healing of a wound model was confirmed.
Investigation of Shock Wave Attenuation in Porous Materials
2009-12-01
Foam ...... 38 Table 4. Summary of Material Characteristics of Polyurethane Foams ............ 40 Table 5. Summary of Experiment Results...polyurethane foam , he performed a simple symmetric impact simulation to investigate the material properties and wave propagation characteristics of the...describes the characteristics of the two foam materials studied in this research, namely the aluminum metal foam and rigid polyurethane foam , which
Indentability of conventional and negative Poisson's ratio foams
NASA Technical Reports Server (NTRS)
Lakes, R. S.; Elms, K.
1992-01-01
The indentation resistance of foams, both of conventional structure and of reentrant structure giving rise to negative Poisson's ratio, is studied using holographic interferometry. In holographic indentation tests, reentrant foams had higher yield strength and lower stiffness than conventional foams of the same original relative density. Calculated energy absorption for dynamic impact is considerably higher for reentrant foam than conventional foam.
Pyrophoric metal-carbon foam composites and methods of making the same
Gash, Alexander E [Brentwood, CA; Satcher, Jr., Joe H.; Simpson, Randall L [Livermore, CA; Baumann, Theodore F [Discovery Bay, CA; Worsley, Marcus A [Belmont, CA
2012-05-08
A method for creating a pyrophoric material according to one embodiment includes thermally activating a carbon foam for creating micropores therein; contacting the activated carbon foam with a liquid solution comprising a metal salt for depositing metal ions in the carbon foam; and reducing the metal ions in the foam to metal particles. A pyrophoric material in yet another embodiment includes a pyrophoric metal-carbon foam composite comprising a carbon foam having micropores and mesopores and a surface area of greater than or equal to about 2000 m.sup.2/g, and metal particles in the pores of the carbon foam. Additional methods and materials are also disclosed.
Space Shuttle Stiffener Ring Foam Failure Analysis, a Non-Conventional Approach
NASA Technical Reports Server (NTRS)
Howard, Philip M.
2015-01-01
The Space Shuttle Program made use of the excellent properties of rigid polyurethane foam for cryogenic tank insulation and as structural protection on the solid rocket boosters. When foam applications de-bond, classical methods of failure analysis did not provide root cause of the failure of the foam. Realizing that foam is the ideal media to document and preserve its own mode of failure, thin sectioning was seen as a logical approach for foam failure analysis to observe the three dimensional morphology of the foam cells. The cell foam morphology provided a much greater understanding of the failure modes than previously achieved.
Bio-based Polymer Foam from Soyoil
NASA Astrophysics Data System (ADS)
Bonnaillie, Laetitia M.; Wool, Richard P.
2006-03-01
The growing bio-based polymeric foam industry is presently lead by plant oil-based polyols for polyurethanes and starch foams. We developed a new resilient, thermosetting foam system with a bio-based content higher than 80%. The acrylated epoxidized soybean oil and its fatty acid monomers is foamed with pressurized carbon dioxide and cured with free-radical initiators. The foam structure and pore dynamics are highly dependent on the temperature, viscosity and extent of reaction. Low-temperature cure hinds the destructive pore coalescence and the application of a controlled vacuum results in foams with lower densities ˜ 0.1 g/cc, but larger cells. We analyze the physics of foam formation and stability, as well as the structure and mechanical properties of the cured foam using rigidity percolation theory. The parameters studied include temperature, vacuum applied, and cross-link density. Additives bring additional improvements: nucleating agents and surfactants help produce foams with a high concentration of small cells and low bulk density. Hard and soft thermosetting foams with a bio content superior to 80% are successfully produced and tested. Potential applications include foam-core composites for hurricane-resistant housing, structural reinforcement for windmill blades, and tissue scaffolds.
Liu, Bo; Leng, Yangming; Zhou, Renhong; Liu, Jingjing; Liu, Dongdong; Liu, Jia; Zhang, Su-Lin; Kong, Wei-Jia
2018-04-01
The present study investigated the effect of foam thickness on postural stability in patients with unilateral vestibular hypofunction (UVH) during foam posturography. Static and foam posturography were performed in 33 patients (UVH group) and 30 healthy subjects (control group) with eyes open (EO) and closed (EC) on firm surface and on 1-5 foam pad(s). Sway velocity (SV) of center of pressure, standing time before falling (STBF) and falls reaction were recorded and analyzed. (1) SVs had an increasing tendency in both groups as the foam pads were added under EO and EC conditions. (2) STBFs, only in UVH group with EC, decreased with foam thickness increasing. (3) Significant differences in SV were found between the control and UVH group with EO (except for standing on firm surface, on 1 and 2 foam pad(s)) and with EC (all surface conditions). (4) Receiver operating characteristic curve analysis showed that the SV could better reflect the difference in postural stability between the two groups while standing on the 4 foam pads with EC. Our study showed that diagnostic value of foam posturography in detecting postural instability might be enhanced by using foam pad of right thickness.
Civil Behavior, Safe-School Planning, and Dress Codes
ERIC Educational Resources Information Center
Studak, Cathryn M.; Workman, Jane E.
2007-01-01
This research examined news reports in order to identify incidents that precipitated dress code revisions. News reports were examined within the framework of rules for civil behavior. Using key words "school dress codes" and "violence," LEXIS/NEXIS was used to access 104 articles from 44 U.S. newspapers from December 3, 2004 to December 2, 2005.…
Cross Dressing and Gender Dysphoria in People with Learning Disabilities: A Descriptive Study
ERIC Educational Resources Information Center
Parkes, Georgina; Hall, Ian; Wilson, Daniel
2009-01-01
We aimed to determine the characteristics of people with learning disability who cross-dress or who have gender dysphoria. Using a retrospective review of anonymised data from clinical records about people referred to a specialist service. All 13 participants cross-dressed and 12 were biological males. Only one person was in a core transsexual…
Rural School District Dress Code Implementation: Perceptions of Stakeholders after First Year
ERIC Educational Resources Information Center
Wright, Krystal M.
2012-01-01
Schools are continuously searching for solutions to solve truancy, academic, behavioral, safety, and climate issues. One of the latest trends in education is requiring students to adhere to dress codes as a solution to these issues. Dress codes can range from slightly restrictive clothing to the requiring of a uniform. Many school district…
21 CFR 878.4015 - Wound dressing with poly (diallyl dimethyl ammonium chloride) (pDADMAC) additive.
Code of Federal Regulations, 2010 CFR
2010-04-01
... ammonium chloride) (pDADMAC) additive. 878.4015 Section 878.4015 Food and Drugs FOOD AND DRUG...) additive. (a) Identification. A wound dressing with pDADMAC additive is intended for use as a primary... Dressing With Poly (Diallyl Dimethyl Ammonium Chloride) (pDADMAC) Additive.” See § 878.1(e) for...
21 CFR 878.4015 - Wound dressing with poly (diallyl dimethyl ammonium chloride) (pDADMAC) additive.
Code of Federal Regulations, 2014 CFR
2014-04-01
... ammonium chloride) (pDADMAC) additive. 878.4015 Section 878.4015 Food and Drugs FOOD AND DRUG...) additive. (a) Identification. A wound dressing with pDADMAC additive is intended for use as a primary... Dressing With Poly (Diallyl Dimethyl Ammonium Chloride) (pDADMAC) Additive.” See § 878.1(e) for...
21 CFR 878.4015 - Wound dressing with poly (diallyl dimethyl ammonium chloride) (pDADMAC) additive.
Code of Federal Regulations, 2012 CFR
2012-04-01
... ammonium chloride) (pDADMAC) additive. 878.4015 Section 878.4015 Food and Drugs FOOD AND DRUG...) additive. (a) Identification. A wound dressing with pDADMAC additive is intended for use as a primary... Dressing With Poly (Diallyl Dimethyl Ammonium Chloride) (pDADMAC) Additive.” See § 878.1(e) for...
21 CFR 878.4015 - Wound dressing with poly (diallyl dimethyl ammonium chloride) (pDADMAC) additive.
Code of Federal Regulations, 2011 CFR
2011-04-01
... ammonium chloride) (pDADMAC) additive. 878.4015 Section 878.4015 Food and Drugs FOOD AND DRUG...) additive. (a) Identification. A wound dressing with pDADMAC additive is intended for use as a primary... Dressing With Poly (Diallyl Dimethyl Ammonium Chloride) (pDADMAC) Additive.” See § 878.1(e) for...
21 CFR 878.4015 - Wound dressing with poly (diallyl dimethyl ammonium chloride) (pDADMAC) additive.
Code of Federal Regulations, 2013 CFR
2013-04-01
... ammonium chloride) (pDADMAC) additive. 878.4015 Section 878.4015 Food and Drugs FOOD AND DRUG...) additive. (a) Identification. A wound dressing with pDADMAC additive is intended for use as a primary... Dressing With Poly (Diallyl Dimethyl Ammonium Chloride) (pDADMAC) Additive.” See § 878.1(e) for...
Effect of Most-to-Least Prompting Procedure on Dressing Skill of Students with Autism
ERIC Educational Resources Information Center
Çetrez-Iscan, Galibiye; Nurçin, Elçin; Fazlioglu, Yesim
2016-01-01
Dressing skill is one of the necessary self-care skills that is taught to individuals with autism in order for them to be able to live independently. Typically, developing individuals can acquire dressing skill on their own; however, children with autism have difficulties in learning such skill without systematic teaching. Thus, teaching dressing…
Application of an Elongated Kelvin Model to Space Shuttle Foams
NASA Technical Reports Server (NTRS)
Sullivan, Roy M.; Ghosn, Louis J.; Lerch, Bradley A.
2008-01-01
Spray-on foam insulation is applied to the exterior of the Space Shuttle s External Tank to limit propellant boil-off and to prevent ice formation. The Space Shuttle foams are rigid closed-cell polyurethane foams. The two foams used most extensively on the Space Shuttle External Tank are BX-265 and NCFI24-124. Since the catastrophic loss of the Space Shuttle Columbia, numerous studies have been conducted to mitigate the likelihood and the severity of foam shedding during the Shuttle s ascent to space. Due to the foaming and rising process, the foam microstructures are elongated in the rise direction. As a result, these two foams exhibit a non-isotropic mechanical behavior. In this paper, a detailed microstructural characterization of the two foams is presented. The key features of the foam cells are summarized and the average cell dimensions in the two foams are compared. Experimental studies to measure the room temperature mechanical response of the two foams in the two principal material directions (parallel to the rise and perpendicular to the rise) are also reported. The measured elastic modulus, proportional limit stress, ultimate tensile stress and the Poisson s ratios for the two foams are compared. The generalized elongated Kelvin foam model previously developed by the authors is reviewed and the equations which result from this model are presented. The resulting equations show that the ratio of the elastic modulus in the rise direction to that in the perpendicular-to-rise direction as well as the ratio of the strengths in the two material directions is only a function of the microstructural dimensions. Using the measured microstructural dimensions and the measured stiffness ratio, the foam tensile strength ratio and Poisson s ratios are predicted for both foams. The predicted tensile strength ratio is in close agreement with the measured strength ratios for both BX-265 and NCFI24-124. The comparison between the predicted Poisson s ratios and the measured values is not as favorable.
Compressive Deformation Behavior of Closed-Cell Micro-Pore Magnesium Composite Foam.
Wang, Jing; Wang, Nannan; Liu, Xin; Ding, Jian; Xia, Xingchuan; Chen, Xueguang; Zhao, Weimin
2018-05-04
The closed-cell micro-pore magnesium composite foam with hollow ceramic microspheres (CMs) was fabricated by a modified melt foaming method. The effect of CMs on the compressive deformation behavior of CM-containing magnesium composite foam was investigated. Optical microscopy and scanning electron microscopy were used for observation of the microstructure. Finite element modeling of the magnesium composite foam was established to predict localized stress, fracture of CMs, and the compressive deformation behavior of the foam. The results showed that CMs and pores directly affected the compressive deformation behavior of the magnesium composite foam by sharing a part of load applied on the foam. Meanwhile, the presence of Mg₂Si phase influenced the mechanical properties of the foam by acting as the crack source during the compression process.
Compressive Deformation Behavior of Closed-Cell Micro-Pore Magnesium Composite Foam
Wang, Jing; Wang, Nannan; Liu, Xin; Ding, Jian; Xia, Xingchuan; Chen, Xueguang; Zhao, Weimin
2018-01-01
The closed-cell micro-pore magnesium composite foam with hollow ceramic microspheres (CMs) was fabricated by a modified melt foaming method. The effect of CMs on the compressive deformation behavior of CM-containing magnesium composite foam was investigated. Optical microscopy and scanning electron microscopy were used for observation of the microstructure. Finite element modeling of the magnesium composite foam was established to predict localized stress, fracture of CMs, and the compressive deformation behavior of the foam. The results showed that CMs and pores directly affected the compressive deformation behavior of the magnesium composite foam by sharing a part of load applied on the foam. Meanwhile, the presence of Mg2Si phase influenced the mechanical properties of the foam by acting as the crack source during the compression process. PMID:29734700
Evaluation of a steady-state test of foam stability
NASA Astrophysics Data System (ADS)
Hutzler, Stefan; Lösch, Dörte; Carey, Enda; Weaire, Denis; Hloucha, Matthias; Stubenrauch, Cosima
2011-02-01
We have evaluated a steady-state test of foam stability, based on the steady-state height of a foam produced by a constant velocity of gas flow. This test is mentioned in the book by Bikerman [Foams, Springer, Berlin, 1973] and an elementary theory was developed for it by Verbist et al. [J. Phys. Condens. Matter 8 (1996) p. 3715]. For the study, we used an aqueous solution of the cationic surfactant dodecyl trimethylammonium bromide, C12TAB, at a concentration of two times the critical micelle concentration (2 cmc). During foam generation, bubbles collapse at the top of the column which, in turn, eventually counterbalances the rate of bubble production at the bottom. The resulting balance can be described mathematically by an appropriate solution of the foam drainage equation under specified boundary conditions. Our experimental findings are in agreement with the theoretical predictions of a diverging foam height at a critical gas velocity and a finite foam height in the limit of zero velocity. We identify a critical liquid fraction below which a foam is unstable as an important parameter for characterizing foam stability. Furthermore, we deduce an effective viscosity of the liquid which flows through the foam. Currently unexplained are two experimental observations, namely sudden changes of the steady-state foam height in experiments that run over several hours and a reduction in foam height once an overflow of the foam from the containing vessel has occurred.
Foaming Volume and Foam Stability
1947-02-01
for a series of hydrocarbons and for a range of concentrations of aqueous ethylene-glycol solutions. It is shown that the amount of foam formed depends...methodofmeasuringfoamingvolumeisdescribedandinvestigated to establishthecriticalfactorsin itsoperation.Dataon foaming ...zethatfoamstabll. # itymeasurementsshouldbe takenipcon@.n@ionwithmeasurementsof foam density.It iseasilyrecognizedthatinitialfoamdensities,asmeasured by
The analytic structure of non-global logarithms: Convergence of the dressed gluon expansion
DOE Office of Scientific and Technical Information (OSTI.GOV)
Larkoski, Andrew J.; Moult, Ian; Neill, Duff Austin
Non-global logarithms (NGLs) are the leading manifestation of correlations between distinct phase space regions in QCD and gauge theories and have proven a challenge to understand using traditional resummation techniques. Recently, the dressed gluon ex-pansion was introduced that enables an expansion of the NGL series in terms of a “dressed gluon” building block, defined by an all-orders factorization theorem. Here, we clarify the nature of the dressed gluon expansion, and prove that it has an infinite radius of convergence as a solution to the leading logarithmic and large-N c master equation for NGLs, the Banfi-Marchesini-Smye (BMS) equation. The dressed gluonmore » expansion therefore provides an expansion of the NGL series that can be truncated at any order, with reliable uncertainty estimates. In contrast, manifest in the results of the fixed-order expansion of the BMS equation up to 12-loops is a breakdown of convergence at a finite value of α slog. We explain this finite radius of convergence using the dressed gluon expansion, showing how the dynamics of the buffer region, a region of phase space near the boundary of the jet that was identified in early studies of NGLs, leads to large contributions to the fixed order expansion. We also use the dressed gluon expansion to discuss the convergence of the next-to-leading NGL series, and the role of collinear logarithms that appear at this order. Finally, we show how an understanding of the analytic behavior obtained from the dressed gluon expansion allows us to improve the fixed order NGL series using conformal transformations to extend the domain of analyticity. Furthermore, this allows us to calculate the NGL distribution for all values of α slog from the coefficients of the fixed order expansion.« less
Fischer, Sebastian; Wall, Jennifer; Pomahac, Bohdan; Riviello, Robert; Halvorson, Eric G
2016-03-01
The use of negative-pressure-wound-therapy (NPWT) is associated with improved outcomes in smaller burns. We report our experience using extra-large (XL) NPWT dressings to treat ≥15% total body surface area (TBSA) burned and describe our technique and early outcomes. We also provide NPWT exudate volume for predictive fluid resuscitation in these critically ill patients. We retrospectively reviewed patients treated with XL-NPWT from 2012 to 2014. Following excision/grafting, graft and donor sites were sealed with a layered NPWT dressing. We documented wound size, dressing size, NPWT outputs, graft take, wound infections, and length of stay (LOS). Mean NPWT exudate volume per %TBSA per day was calculated. Twelve burn patients (mean TBSA burned 30%, range 15-60%) were treated with XL-NPWT (dressing TBSA burned and skin graft donor sites range 17-44%). Average graft take was 97%. No wound infections occurred. Two patients had burns ≥50% TBSA and their LOS was reduced compared to ABA averages. XL-NPWT outputs peaked at day 1 after grafting followed by a steady decline until dressings were removed. Average XL-NPWT dressing output during the first 5 days was 101±66mL/%BSA covered per day. 2 patients developed acute kidney injury. The use of XL-NPWT to treat extensive burns is feasible with attention to application technique. NPWT dressings appear to improve graft take, and to decrease risk of infection, LOS, and pain and anxiety associated with wound care. Measured fluid losses can improve patient care in future applications of NPWT to large burn wounds. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.
Mahoney, Diane Feeney; Coon, David W; Lozano, Cecil
2016-11-01
To gain an understanding of Latino/Hispanic caregivers' dementia-related dressing issues, their impressions of using a "smart" context-aware dresser to coach dressing, and recommendations to improve its acceptability. The same Latina moderator conducted all the caregiver focus groups. She followed a semi-structured interview guide that was previously used with White and African American family caregivers who experienced Alzheimer's disease related dressing challenges. From that study, the Preservation of Self model emerged. Using a deductive qualitative analytic approach, we applied the thematic domains from the Preservation of Self model to ascertain relevance to Latino/Hispanic caregivers. Twenty Latino/Hispanic experienced caregivers were recruited, enrolled, and participated in one of three focus groups. The majority were female (75%) and either the spouse (25%) or adult child (35%). Striking similarities occurred with the dressing challenges and alignment with the Preservation of Self model. Ethnic differences arose in concerns over assimilation weakening the Latino culture of family caregiving. Regional clothing preferences were noted. Technology improvement recommendations for our system, called DRESS, included developing bilingual prompting dialogs and video modules using the local vernacular to improve cultural sensitivity. Caregivers identified the potential for the technology to enable user privacy, empowerment, and exercise as well as offering respite time for themselves. Findings suggest dementia-related dressing issues were shared in common by different racial/ethnic groups but the response to them was influenced by cultural dynamics. For the first time Latino/Hispanic voices are heard to reflect their positive technology impressions, concerns, and recommendations in order to begin to address the cultural digital disparities divide.
Mahoney, Diane Feeney; Coon, David W; Lozano, Cecil
2016-01-01
Objective To gain an understanding of Latino/Hispanic caregivers’ dementia-related dressing issues, their impressions of using a “smart” context-aware dresser to coach dressing, and recommendations to improve its acceptability. Method The same Latina moderator conducted all the caregiver focus groups. She followed a semi-structured interview guide that was previously used with White and African American family caregivers who experienced Alzheimer’s disease related dressing challenges. From that study, the Preservation of Self model emerged. Using a deductive qualitative analytic approach, we applied the thematic domains from the Preservation of Self model to ascertain relevance to Latino/Hispanic caregivers. Results Twenty Latino/Hispanic experienced caregivers were recruited, enrolled, and participated in one of three focus groups. The majority were female (75%) and either the spouse (25%) or adult child (35%). Striking similarities occurred with the dressing challenges and alignment with the Preservation of Self model. Ethnic differences arose in concerns over assimilation weakening the Latino culture of family caregiving. Regional clothing preferences were noted. Technology improvement recommendations for our system, called DRESS, included developing bilingual prompting dialogs and video modules using the local vernacular to improve cultural sensitivity. Caregivers identified the potential for the technology to enable user privacy, empowerment, and exercise as well as offering respite time for themselves. Conclusion Findings suggest dementia-related dressing issues were shared in common by different racial/ethnic groups but the response to them was influenced by cultural dynamics. For the first time Latino/Hispanic voices are heard to reflect their positive technology impressions, concerns, and recommendations in order to begin to address the cultural digital disparities divide.
Walker, Michael; Bowler, Philip G; Cochrane, Christine A
2007-09-01
Excess or "uncontrolled" proteinase activity in the wound bed has been implicated as one factor that may delay or compromise wound healing. One proteinase group--matrix metalloproteinases--includes collagenases, elastase, and gelatinases and can be endogenous (cell) or exogenous (bacterial) in origin. A study was conducted to assess the ability of five silver-containing wound care products to reduce a known matrix metalloproteinase supernatant concentration in vitro. Four silver-containing wound dressings (a carboxy-methyl cellulose, a nanocrystalline, a hydro-alginate, and a collagen/oxidized regenerated cellulose composite dressing), along with a 0.5% aqueous silver nitrate [w/v] solution and controls for matrix metalloproteinase-2 and matrix metalloproteinase-9 sourced from ex vivo dermal tissue and blood monocytes, respectively, were used. Extracts were separated and purified using gelatine-Sepharose column chromatography and dialysis and polyacrylamide gel electrophoretic zymography was used to analyze specific matrix metalloproteinase activity. All dressings and the solution were shown to sequester both matrix metalloproteinases. The silver-containing carboxy-methyl cellulose dressing showed significantly greater sequestration for matrix metalloproteinase-2 at 6 and 24 hours (P< 0.001) compared to the other treatments. For matrix metalloproteinase-9, both the carboxy-methyl cellulose dressing and the oxidized regenerated cellulose dressing achieved significant sequestration when compared to the other treatments at 24 hours (P <0.001), which was maintained to 48 hours (P < 0.001). Results from this study show that silver-containing dressings are effective in sequestering matrix metalloproteinase-2 and -9 and that this can be achieved without a sacrificial protein (eg, collagen). Although the varying ability of wound dressings to sequester matrix metalloproteinases has been shown in vitro, further in vivo evidence is required to confirm these findings.
Management of Psychotropic Drug-Induced DRESS Syndrome: A Systematic Review.
Bommersbach, Tanner J; Lapid, Maria I; Leung, Jonathan G; Cunningham, Julie L; Rummans, Teresa A; Kung, Simon
2016-06-01
Drug rash with eosinophilia and systemic symptoms (DRESS) is a severe cutaneous eruption that has been linked to several common drugs and drug categories, including antiepileptics, allopurinol, sulfonamides, and various antibiotics; however, because of a number of recent case reports linking psychotropic medications to this condition, DRESS is increasingly recognized among psychiatrists. We systematically reviewed all psychotropic drugs linked to DRESS syndrome, and this article summarizes the clinical management relevant to psychiatric professionals. A comprehensive search was performed using Ovid MEDLINE, Ovid EMBASE, Ovid Cochrane Database of Systematic Reviews, Web of Science, Scopus, and Litt's Drug Eruption and Reaction Database for articles published in English during the past 20 years (1996-2015) using the search terms (1) psychotropic drugs OR serotonin uptake inhibitors AND DRESS or (2) psychotropic drugs AND drug reaction (or rash) eosinophilia systemic syndrome, and all article abstracts were screened for inclusion and exclusion criteria by 3 reviewers. Two independent reviewers examined the full text of 163 articles, of which 96 (25 original articles, 12 review articles, 55 case reports, and 4 letters to the editor) were included in the systematic review. We identified 1072 cases of psychotropic drug-induced DRESS, with carbamazepine, lamotrigine, phenytoin, valproate, and phenobarbital being the most implicated drugs. Based on our review of the literature, we outline management principles that include prompt withdrawal of the causative drug, hospitalization, corticosteroid therapy, and novel treatments, including intravenous immunoglobulin, cyclophosphamide, and cyclosporine, for corticosteroid-resistant DRESS. Finally, we outline strategies for treating comorbid psychiatric illness after a DRESS reaction to the psychotropic medication. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
Karlsson, Bodil S A; Allwood, Carl Martin
2016-01-01
The Dress photograph, first displayed on the internet in 2015, revealed stunning individual differences in color perception. The aim of this study was to investigate if lay-persons believed that the question about The Dress colors was answerable. Past research has found that optimism is related to judgments of how answerable knowledge questions with controversial answers are (Karlsson et al., 2016). Furthermore, familiarity with a question can create a feeling of knowing the answer (Reder and Ritter, 1992). Building on these findings, 186 participants saw the photo of The Dress and were asked about the correct answer to the question about The Dress' colors (" blue and black," "white and gold," "other, namely…," or "there is no correct answer" ). Choice of the alternative "there is no correct answer" was interpreted as believing the question was not answerable. This answer was chosen more often by optimists and by people who reported they had not seen The Dress before. We also found that among participants who had seen The Dress photo before, 19%, perceived The Dress as "white and gold" but believed that the correct answer was "blue and black ." This, in analogy to previous findings about non-believed memories (Scoboria and Pascal, 2016), shows that people sometimes do not believe the colors they have perceived are correct. Our results suggest that individual differences related to optimism and previous experience may contribute to if the judgment of the individual perception of a photograph is enough to serve as a decision basis for valid conclusions about colors. Further research about color judgments under ambiguous circumstances could benefit from separating individual perceptual experience from beliefs about the correct answer to the color question. Including the option "there is no correct answer " may also be beneficial.
The analytic structure of non-global logarithms: Convergence of the dressed gluon expansion
Larkoski, Andrew J.; Moult, Ian; Neill, Duff Austin
2016-11-15
Non-global logarithms (NGLs) are the leading manifestation of correlations between distinct phase space regions in QCD and gauge theories and have proven a challenge to understand using traditional resummation techniques. Recently, the dressed gluon ex-pansion was introduced that enables an expansion of the NGL series in terms of a “dressed gluon” building block, defined by an all-orders factorization theorem. Here, we clarify the nature of the dressed gluon expansion, and prove that it has an infinite radius of convergence as a solution to the leading logarithmic and large-N c master equation for NGLs, the Banfi-Marchesini-Smye (BMS) equation. The dressed gluonmore » expansion therefore provides an expansion of the NGL series that can be truncated at any order, with reliable uncertainty estimates. In contrast, manifest in the results of the fixed-order expansion of the BMS equation up to 12-loops is a breakdown of convergence at a finite value of α slog. We explain this finite radius of convergence using the dressed gluon expansion, showing how the dynamics of the buffer region, a region of phase space near the boundary of the jet that was identified in early studies of NGLs, leads to large contributions to the fixed order expansion. We also use the dressed gluon expansion to discuss the convergence of the next-to-leading NGL series, and the role of collinear logarithms that appear at this order. Finally, we show how an understanding of the analytic behavior obtained from the dressed gluon expansion allows us to improve the fixed order NGL series using conformal transformations to extend the domain of analyticity. Furthermore, this allows us to calculate the NGL distribution for all values of α slog from the coefficients of the fixed order expansion.« less
Hierarchy of Dysfunction Related to Dressing Performance in Stroke Patients: A Path Analysis Study.
Fujita, Takaaki; Nagayama, Hirofumi; Sato, Atsushi; Yamamoto, Yuichi; Yamane, Kazuhiro; Otsuki, Koji; Tsuchiya, Kenji; Tozato, Fusae
2016-01-01
Previous reports indicated that various dysfunctions caused by stroke affect the level of independence in dressing. These dysfunctions can be hierarchical, and these effects on dressing performance can be complicated in stroke patients. However, there are no published reports focusing on the hierarchical structure of the relationships between the activities of daily living and balance function, motor and sensory functions of the affected lower limb, strength of the abdominal muscles and knee extension on the unaffected side, and visuospatial deficits. The purpose of this study was to elucidate the hierarchical and causal relationships between dressing performance and these dysfunctions in stroke patients. This retrospective study included 104 first-time stroke patients. The causal relationship between the dressing performance and age, time post stroke, balance function, motor and sensory functions of the affected lower limb, strength of the abdominal muscles and knee extension on the unaffected side, and visuospatial deficits were examined using path analysis. A hypothetical path model was created based on previous studies, and the goodness of fit between the data and model were verified. A modified path model was created that achieved an almost perfect fit to the data. Balance function and abdominal muscle strength have direct effects on dressing performance, with standardized direct effect estimates of 0.78 and 0.15, respectively. Age, motor and sensory functions of the affected lower limb, and strength of abdominal muscle and knee extension on the unaffected side have indirect effects on dressing by influencing balance function. Our results suggest that dressing performance depends strongly on balance function, and it is mainly influenced by the motor function of the affected lower limb.
Bikmoradi, Ali; Harorani, Mehdi; Roshanaei, Ghodratollah; Moradkhani, Shirin; Falahinia, Golam Hossein
2016-01-01
Background: Pain is one of the common problems encountered by patients with burns, which increases after each dressing. This study aimed to investigate the effect of inhalation aromatherapy with damask rose essence on the pain of patients with burns that is caused after dressing. Materials and Methods: A randomized clinical trial was conducted on 50 patients with second- and third-degree burn wounds. The baseline pain of the patients was assessed 30 min before they entered into the dressing room on the first and second days of intervention. The patients in the experimental group inhaled five drops of damask rose essence 40% in distilled water, while those in the control group inhaled five drops of distilled water as placebo. The pain intensity was assessed using Visual Analogue Scale at 15 and 30 min after the patients exited from the dressing room. Data were analyzed by SPSS (version 18) using descriptive and inferential statistics. Results: There was significant difference between the mean of pain intensity before and after intervention at 15 and 30 min after dressing (P < 0.001). Moreover, there was significant difference in reduction of pain intensity before and after aromatherapy in the experimental group (P < 0.05). Also, there was a significant reduction in severity of pain after dressing in the experimental group compared with the control group (P < 0.05). Conclusions: Inhalation aromatherapy with damask rose could be effective for relieving the pain caused after dressing in patients with burns. Therefore, it could be suggested as a complementary therapy in burn patients for pain relief. PMID:27186201
Kougias, P G; Boe, K; Einarsdottir, E S; Angelidaki, I
2015-08-01
Foaming is one of the major operational problems in biogas plants, and dealing with foaming incidents is still based on empirical practices. Various types of antifoams are used arbitrarily to combat foaming in biogas plants, but without any scientific support this action can lead to serious deterioration of the methanogenic process. Many commercial antifoams are derivatives of fatty acids or oils. However, it is well known that lipids can induce foaming in manure based biogas plants. This study aimed to elucidate the effect of rapeseed oil and oleic acid on foam reduction and process performance in biogas reactors fed with protein or lipid rich substrates. The results showed that both antifoams efficiently suppressed foaming. Moreover rapeseed oil resulted in stimulation of the biogas production. Finally, it was reckoned that the chemical structure of lipids, and more specifically their carboxylic ends, is responsible for their foam promoting or foam counteracting behaviour. Thus, it was concluded that the fatty acids and oils could suppress foaming, while salt of fatty acids could generate foam. Copyright © 2015 Elsevier Ltd. All rights reserved.
Influence of Syringe Volume on Foam Stability in Sclerotherapy for Varicose Vein Treatment.
Bai, Taoping; Jiang, Wentao; Fan, Yubo
2018-05-01
Despite the popularity of sclerotherapy for treating varicose veins, it still exhibits various problems, such as pulmonary embolism, deep-vein thrombosis, phlebitis, and visual disorders. To investigate syringe volume influence on foam stability, obtain the foam decay rule, and provide a reference for clinics. Five types of syringes are used to prepare foam at room temperature with various liquid-gas ratios. Foam decay process experiments were performed 5 times and recorded by video. The stability indices used include drainage time, half-life, bubble diameter, bubble surface density, and drainage rate. The 30 and 2-mL syringes, respectively, recorded the highest and lowest drainage speeds. Foam drainage time and half-life, differences varied between 15 and 70 seconds, and 20 and 100 seconds, respectively. Foam bubble diameters were distributed over 0.1 to 2.0 mm with roughly 200 to 700 bubbles per square centimeter. Increased syringe volume causes the bubble diameter to increase. Thus, foam dispersion increases and foam half-life decreases; hence, foam becomes unstable. It is, thus, better to use a small syringe several times to prepare foam in clinics using segmented injections.
Close relationship between a dry-wet transition and a bubble rearrangement in two-dimensional foam
Furuta, Yujiro; Oikawa, Noriko; Kurita, Rei
2016-01-01
Liquid foams are classified into a dry foam and a wet foam, empirically judging from the liquid fraction or the shape of the gas bubbles. It is known that physical properties such as elasticity and diffusion are different between the dry foam and the wet foam. Nevertheless, definitions of those states have been vague and the dry-wet transition of foams has not been clarified yet. Here we show that the dry-wet transition is closely related to rearrangement of the gas bubbles, by simultaneously analysing the shape change of the bubbles and that of the entire foam in two dimensional foam. In addition, we also find a new state in quite low liquid fraction, which is named “superdry foam”. Whereas the shape change of the bubbles strongly depends on the change of the liquid fraction in the superdry foam, the shape of the bubbles does not change with changing the liquid fraction in the dry foam. Our results elucidate the relationship between the transitions and the macroscopic mechanical properties. PMID:27874060
Nanoparticle-stabilized CO₂ foam for CO₂ EOR application
DOE Office of Scientific and Technical Information (OSTI.GOV)
Liu, Ning; Lee, Robert; Yu, Jianjia
The purpose of this project was to develop nanoparticle-stabilized CO₂ foam for CO₂ -EOR application, in which nanoparticles instead of surfactants are used for stabilizing CO₂ foam to improve the CO₂ sweep efficiency and increase oil recovery. The studies included: (1) investigation of CO₂ foam generation nanoparticles, such as silica nanoparticles, and the effects of particle concentration and surface properties, CO₂/brine ratio, brine salinity, pressure, and temperature on foam generation and foam stability; (2) coreflooding tests to understand the nanoparticle-stabilized CO₂ foam for waterflooded residual oil recovery, which include: oil-free coreflooding experiments with nanoparticle-stabilized CO₂ foam to understand the transportationmore » of nanoparticles through the core; measurements of foam stability and CO₂ sweep efficiency under reservoir conditions to investigate temperature and pressure effects on the foam performance and oil recovery as well as the sweep efficiency in different core samples with different rock properties; and (3) long-term coreflooding experiments with the nanoparticle- stabilized CO₂ foam for residual oil recovery. Finally, the technical and economical feasibility of this technology was evaluated.« less
A dressed spin qubit in silicon
Laucht, Arne; Kalra, Rachpon; Simmons, Stephanie; ...
2016-10-17
Coherent dressing of a quantum two-level system provides access to a new quantum system with improved properties—a different and easily tunable level splitting, faster control and longer coherence times. In our work we investigate the properties of the dressed, donor-bound electron spin in silicon, and assess its potential as a quantum bit in scalable architectures. The two dressed spin-polariton levels constitute a quantum bit that can be coherently driven with an oscillating magnetic field, an oscillating electric field, frequency modulation of the driving field or a simple detuning pulse. We measure coherence times of T* 2p = 2.4 ms andmore » T Hahn 2p = 9 ms, one order of magnitude longer than those of the undressed spin. Moreover, the use of the dressed states enables coherent coupling of the solid-state spins to electric fields and mechanical oscillations.« less
Control of traumatic wound bleeding by compression with a compact elastic adhesive dressing.
Naimer, Sody Abby; Tanami, Menachem; Malichi, Avishai; Moryosef, David
2006-07-01
Compression dressing has been assumed effective, but never formally examined in the field. A prospective interventional trial examined efficacy and feasibility of an elastic adhesive dressing compression device in the arena of the traumatic incident. The primary variable examined was the bleeding rate from wounds compared before and after dressing. Sixty-two consecutive bleeding wounds resulting from penetrating trauma were treated. Bleeding intensity was profuse in 58%, moderate 23%, and mild in 19%. Full control of bleeding was achieved in 87%, a significantly diminished rate in 11%, and, in 1 case, the technique had no influence on the bleeding rate. The Wilcoxon test for variables comparing bleeding rates before and after the procedure obtained significant difference (Z = -6.9, p < 0.01). No significant complications were observed. Caregivers were highly satisfied in 90% of cases. Elastic adhesive dressing was observed as an effective and reliable technique, demonstrating a high rate of success without complications.
Dressings as an adjunct to pressure ulcer prevention: consensus panel recommendations.
Black, Joyce; Clark, Michael; Dealey, Carol; Brindle, Christopher T; Alves, Paulo; Santamaria, Nick; Call, Evan
2015-08-01
The formulation of recommendations on the use of wound dressings in pressure ulcer prevention was undertaken by a group of experts in pressure ulcer prevention and treatment from Australia, Portugal, UK and USA. After review of literature, they concluded that there is adequate evidence to recommend the use of five-layer silicone bordered dressings (Mepilex Border Sacrum(®) and 3 layer Mepilex Heel(®) dressings by Mölnlycke Health Care, Gothenburg, Sweden) for pressure ulcer prevention in the sacrum, buttocks and heels in high-risk patients, those in Emergency Department (ED), intensive care unit (ICU) and operating room (OR). Literature on which this recommendation is based includes one prospective randomised control trial, three cohort studies and two case series. Recommendations for dressing use in patients at high risk for pressure injury and shear injury were also provided. © 2014 The Authors. International Wound Journal © 2014 Medicalhelplines.com Inc and John Wiley & Sons Ltd.
Wiegand, C; Abel, M; Ruth, P; Hipler, U C
2011-11-01
A comprehensive in vitro approach was used to assess the effects of superabsorbent polymer (SAP) containing wound dressings in treatment of non-healing wounds. A slight negative effect on HaCaT cells was noted in vitro which is most likely due to the Ca(2+) deprivation of the medium by binding to the SAP. It could be shown that SAP wound dressings are able to bind considerable amounts of elastase reducing enzyme activity significantly. Furthermore, SAP's inhibit the formation of free radicals. The SAP-containing wound dressings tested also exhibited a significant to strong antimicrobial activity effectively impeding the growth of gram-negative and gram-positive bacteria as well as yeasts. In conclusion, in vitro data confirm the positive effect of SAP wound dressings observed in vivo and suggest that they should be specifically useful for wound cleansing.
Method of casting pitch based foam
Klett, James W.
2002-01-01
A process for producing molded pitch based foam is disclosed which minimizes cracking. The process includes forming a viscous pitch foam in a container, and then transferring the viscous pitch foam from the container into a mold. The viscous pitch foam in the mold is hardened to provide a carbon foam having a relatively uniform distribution of pore sizes and a highly aligned graphic structure in the struts.
2011-04-01
NavyFOAM has been developed using an open-source CFD software tool-kit ( OpenFOAM ) that draws heavily upon object-oriented programming. The...numerical methods and the physical models in the original version of OpenFOAM have been upgraded in an effort to improve accuracy and robustness of...computational fluid dynamics OpenFOAM , Object Oriented Programming (OOP) (CFD), NavyFOAM, 16. SECURITY CLASSIFICATION OF: a. REPORT UNCLASSIFIED b
Preparation and characterization of starch-based loose-fill packaging foams
NASA Astrophysics Data System (ADS)
Fang, Qi
Regular and waxy corn starches were blended in various ratios with biodegradable polymers including polylactic acid (PLA), Eastar Bio Copolyester 14766 (EBC) and Mater-Bi ZF03U (MBI) and extruded with a C. W. Brabender laboratory twin screw extruder using a 3-mm die nozzle at 150°C and 150 rev/min. Physical characteristics including radial expansion, unit density and bulk density and water solubility index, water absorption characteristics, mechanical properties including compressibility, Young's modulus, spring index, bulk compressibility and bulk spring index and abrasion resistance were investigated as affected by the ingredient formulations, i.e. type of polymers, type of starches, polymer to starch ratio and starch moisture content. A completely randomized factorial blocking experimental design was used. Fifty-four treatments resulted. Each treatment was replicated three times. SAS statistical software package was used to analyze the data. Foams made of waxy starch had better radial expansion, lower unit density and bulk density than did foams made of regular starch. Regular starch foams had significantly lower water solubility index than did the waxy starch foams. PLA-starch foams had the lowest compressibility and Young's modulus. MBI-starch foams were the most rigid. All foams had excellent spring indices and bulk spring indices which were comparable to the spring index of commercial expanded polystyrene foam. Correlations were established between the foam mechanical properties and the physical characteristics. Foam compressibility and Young's modulus decreased as increases in radial expansion and decreases in unit and bulk densities. Their relationships were modeled with power law equations. No correlation was observed between spring index and bulk spring index and foam physical characteristics. MBI-starch foams had the highest equilibrium moisture content. EBC-starch and PLA-starch foams had similar water absorption characteristics. No significant difference existed in water absorption characteristics between foams made of regular and waxy starches. Empirical models were developed to correlate foam water absorption characteristics with relative humidity and polymer content. The developed models fit the data well with relatively small standard errors and uniformly scattered residual plots. Foams with higher polymer content had better abrasion resistance than did foams with lower polymer content.
Synthesis and analysis of foam drainage agent for gas well in Jilin Oilfield
NASA Astrophysics Data System (ADS)
Qiao, Sanyuan; Liu, Qingwang; Fan, Zhenzhong; Wang, Jigang; Xu, Jianjun
2017-05-01
The gas well in Jilin oil field has the characteristics of large temperature variation range and high condensate oil content. So the foam drainage agent of the gas well in Jilin oil field needs to have the performance of oil resistance and less effected by temperature. In this paper, a main foaming agent named lauramidopropyl betaine (LAB) and two kinds of auxiliary foaming agent named sodium alcohol ether sulphate (AES) and lauramidopropylamine oxide (LAO). Through the evaluation of the static foaming capacity and dynamic liquid carrying capacity, the AES is more suitable for LAB. The foaming agent with 70% LAB and 30% AES has 138mm foam height with ROSS-Miles equipment; stirring foam volume can reach 480mL, the half-life of foam is 520s. When the ventilation volume is 8L/min the liquid carrying capacity of 10% of the condensate oil content reached 82g. When the foaming agent concentration is 2%, the liquid carrying capacity of 10% of the condensate oil content reached 75g. When the aeration rate reaches 8-10L/min, the liquid carrying capacity of foam drainage agent can reach the best. The foam drainage agent can retain the performance after 120°C aging for 12h, these performances above can satisfy the requirements for gas well foam drainage in Jilin Oil Field.
Hangai, Yoshihiko; Saito, Masaki; Utsunomiya, Takao; Kitahara, Soichiro; Kuwazuru, Osamu; Yoshikawa, Nobuhiro
2014-01-01
Aluminum foam has received considerable attention in various fields and is expected to be used as an engineering material owing to its high energy absorption properties and light weight. To improve the mechanical properties of aluminum foam, combining it with dense tubes, such as aluminum foam-filled tubes, was considered necessary. In this study, an aluminum foam-filled steel tube, which consisted of ADC12 aluminum foam and a thin-wall steel tube, was successfully fabricated by friction welding. It was shown that a diffusion bonding layer with a thickness of approximately 10 μm was formed, indicating that strong bonding between the aluminum foam and the steel tube was realized. By the X-ray computed tomography observation of pore structures, the fabrication of an aluminum foam-filled tube with almost uniform pore structures over the entire specimen was confirmed. In addition, it was confirmed that the aluminum foam-filled steel tube exhibited mechanical properties superior to those of the ADC12 aluminum foam and steel tube. This is considered to be attributed to the combination of the aluminum foam and steel tube, which particularly prevents the brittle fracture and collapse of the ADC12 foam by the steel tube, along with the strong metal bonding between the aluminum foam and the steel tube. PMID:28788213
Coordinate Stimulation of Macrophages by Microparticles and TLR Ligands Induces Foam Cell Formation1
Keyel, Peter A; Tkacheva, Olga A.; Larregina, Adriana T.; Salter, Russell D
2012-01-01
Aberrant activation of macrophages in arterial walls by oxidized lipoproteins can lead to atherosclerosis. Oxidized lipoproteins convert macrophages to foam cells through lipid uptake and TLR signaling. To investigate the relative contributions of lipid uptake and TLR signaling in foam cell formation, we established an in vitro assay utilizing liposomes of defined lipid compositions. We found that TLRs signaling through Trif promoted foam cell formation by inducing both NF-KB signaling and Type I IFN production, whereas TLRs that do not induce IFN, like TLR2, did not enhance foam cell formation. Addition of IFNα to TLR2 activator promoted robust foam cell formation. TLR signaling further required PPARα, as inhibition of PPARα blocked foam cell formation. We then investigated the ability of endogenous microparticles (MP) to contribute to foam cell formation. We found that lipid containing MP promoted foam cell formation, which was enhanced by TLR stimulation or IFNα. These MP also stimulated foam cell formation in a human skin model. However, these MP suppressed TNFα production and T cell activation, showing that foam cell formation can occur by immunosuppressive microparticles. Taken together, the data reveal novel signaling requirements for foam cell formation and suggest that uptake of distinct types of MP in the context of activation of multiple distinct TLR can induce foam cell formation. PMID:23018455
Code of Federal Regulations, 2013 CFR
2013-07-01
... water. Flexible polyurethane foams are open-celled, permit the passage of air through the foam, and... Standards for Hazardous Air Pollutants for Flexible Polyurethane Foam Production § 63.1292 Definitions. All... for the purposes of this subpart. Cured foam means flexible polyurethane foam with fully developed...
Code of Federal Regulations, 2011 CFR
2011-07-01
... water. Flexible polyurethane foams are open-celled, permit the passage of air through the foam, and... Hazardous Air Pollutants for Flexible Polyurethane Foam Production § 63.1292 Definitions. All terms used in... purposes of this subpart. Cured foam means flexible polyurethane foam with fully developed physical...
Code of Federal Regulations, 2014 CFR
2014-07-01
... water. Flexible polyurethane foams are open-celled, permit the passage of air through the foam, and... Standards for Hazardous Air Pollutants for Flexible Polyurethane Foam Production § 63.1292 Definitions. All... for the purposes of this subpart. Cured foam means flexible polyurethane foam with fully developed...
Code of Federal Regulations, 2012 CFR
2012-07-01
... water. Flexible polyurethane foams are open-celled, permit the passage of air through the foam, and... Hazardous Air Pollutants for Flexible Polyurethane Foam Production § 63.1292 Definitions. All terms used in... purposes of this subpart. Cured foam means flexible polyurethane foam with fully developed physical...
DOE Office of Scientific and Technical Information (OSTI.GOV)
Lu, Wei-Yang
Foam materials are used to protect sensitive components from impact loading. In order to predict and simulate the foam performance under various loading conditions, a validated foam model is needed and the mechanical properties of foams need to be characterized. Uniaxial compression and tension tests were conducted for different densities of foams under various temperatures and loading rates. Crush stress, tensile strength, and elastic modulus were obtained. A newly developed confined compression experiment provided data for investigating the foam flow direction. A biaxial tension experiment was also developed to explore the damage surface of a rigid polyurethane foam.
NASA Astrophysics Data System (ADS)
Sharudin, Rahida Wati; Ajib, Norshawalina Muhamad; Yusoff, Marina; Ahmad, Mohd Aizad
2017-12-01
Thermoplastic elastomer SEBS foams were prepared by using carbon dioxide (CO2) as a blowing agent and the process is classified as physical foaming method. During the foaming process, the diffusivity of CO2 need to be controlled since it is one of the parameter that will affect the final cellular structure of the foam. Conventionally, the rate of CO2 diffusion was measured experimentally by using a highly sensitive device called magnetic suspension balance (MSB). Besides, this expensive MSB machine is not easily available and measurement of CO2 diffusivity is quite complicated as well as time consuming process. Thus, to overcome these limitations, a computational method was introduced. Particle Swarm Optimization (PSO) is a part of Swarm Intelligence system which acts as a beneficial optimization tool where it can solve most of nonlinear complications. PSO model was developed for predicting the optimum foaming temperature and CO2 diffusion rate in SEBS foam. Results obtained by PSO model are compared with experimental results for CO2 diffusivity at various foaming temperature. It is shown that predicted optimum foaming temperature at 154.6 °C was not represented the best temperature for foaming as the cellular structure of SEBS foamed at corresponding temperature consisted pores with unstable dimension and the structure was not visibly perceived due to foam shrinkage. The predictions were not agreed well with experimental result when single parameter of CO2 diffusivity is considered in PSO model because it is not the only factor that affected the controllability of foam shrinkage. The modification on the PSO model by considering CO2 solubility and rigidity of SEBS as additional parameters needs to be done for obtaining the optimum temperature for SEBS foaming. Hence stable SEBS foam could be prepared.
Foaming in simulated radioactive waste.
Bindal, S K; Nikolov, A D; Wasan, D T; Lambert, D P; Koopman, D C
2001-10-01
Radioactive waste treatment process usually involves concentration of radionuclides before waste can be immobilized by storing it in stable solid form. Foaming is observed at various stages of waste processing like SRAT (sludge receipt and adjustment tank) and melter operations. This kind of foaming greatly limits the process efficiency. The foam encountered can be characterized as a three-phase foam that incorporates finely divided solids (colloidal particles). The solid particles stabilize foaminess in two ways: by adsorption of biphilic particles at the surfaces of foam lamella and by layering of particles trapped inside the foam lamella. During bubble generation and rise, solid particles organize themselves into a layered structure due to confinement inside the foam lamella, and this structure provides a barrier against the coalescence of the bubbles, thereby causing foaming. Our novel capillary force balance apparatus was used to examine the particle-particle interactions, which affect particle layer formation in the foam lamella. Moreover, foaminess shows a maximum with increasing solid particle concentration. To explain the maximum in foaminess, a study was carried out on the simulated sludge, a non-radioactive simulant of the radioactive waste sludge at SRS, to identify the parameters that affect the foaming in a system characterized by the absence of surface-active agents. This three-phase foam does not show any foam stability unlike surfactant-stabilized foam. The parameters investigated were solid particle concentration, heating flux, and electrolyte concentration. The maximum in foaminess was found to be a net result of two countereffects that arise due to particle-particle interactions: structural stabilization and depletion destabilization. It was found that higher electrolyte concentration causes a reduction in foaminess and leads to a smaller bubble size. Higher heating fluxes lead to greater foaminess due to an increased rate of foam lamella generation in the sludge system.
Transient foam flow in porous media with CAT Scanner
DOE Office of Scientific and Technical Information (OSTI.GOV)
Liu, Dianbin; Brigham, W.E.
1992-03-01
Transient behavior is likely to dominate over most of the duration of a foam injection field project. Due to the lack of date, little is presently known about transient foam flow behavior. Foam flow does not follow established models such as the Buckley-Leverett theory, and no general predictive model has been derived. Therefore, both experimental data and a foam flow theory are needed. In this work, foam was injected at a constant mass rate into one-dimensional sandpacks of 1-in diameter and 24-in or 48-in length that had initially been saturate with distilled water. The system was placed in a catmore » Scanner. Data, obtained at room temperature and low pressure at various times, include both the pressure and saturation distributions. Pressure profiles showed that the pressure gradient is much greater behind the foam front than ahead of it. Moreover, the pressure gradients keep changing as the foam advances in the sandpack. This behavior differs from Buckley-Leverett theory. The CT scan results demonstrated gas channeling near the front, but eventually the foam block all these channels and sweeps the entire cross section after many pore volumes of injection. Three series of experiments were run: (1) surfactant adsorption measurements; (2) gas displacements of surfactant-laden solutions and (3) foam displacements. The first two series of experiments were made to provide the necessary parameters required to match the foam displacements. To this end, it was necessary to smooth the saturation history data, using a Langmuir-type formula. A theory was proposed based on the principles of the fractional flow curve construction method. This foam theory treats the foam as composed of infinitesimal slugs of gas of varying viscosities. The foam front has the lowest viscosity and foam at the injection end has the highest.« less
Star, Phoebe; Connor, David E; Parsi, Kurosh
2018-04-01
Scope Varithena® is a recently approved commercially available drug/delivery unit that produces foam using 1% polidocanol for the management of varicose veins. The purpose of this review is to examine the benefits of foam sclerotherapy, features of the ideal foam sclerosant and the strengths and limitations of Varithena® in the context of current foam sclerotherapy practices. Method Electronic databases including PubMed, Medline (Ovid) SP as well as trial registries and product information sheets were searched using the keywords, 'Varithena', 'Varisolve', 'polidocanol endovenous microfoam', 'polidocanol' and/or 'foam sclerotherapy/sclerosant'. Articles published prior to 20 September 2016 were identified. Results Foam sclerosants have effectively replaced liquid agents due to their physiochemical properties resulting in better clinical outcomes. Medical practitioners commonly prepare sclerosant foam at the bedside by agitating liquid sclerosant with a gas such as room air, using techniques as described by Tessari or the double syringe method. Such physician-compounded foams are highly operator dependent producing inconsistent foams of different gas/liquid compositions, bubble size, foam behaviour and varied safety profiles. Varithena® overcomes the variability and inconsistencies of physician-compounded foam. However, Varithena® has limited applications due to its fixed sclerosant type and concentration, cost and lack of worldwide availability. Clinical trials of Varithena® have demonstrated efficacy and safety outcomes equivalent or better than physician-compounded foam but only in comparison to placebo alone. Conclusion Varithena® is a promising step towards the creation of an ideal sclerosant foam. Further assessment in independent randomised controlled clinical trials is required to establish the advantages of Varithena® over and above the current best practice physician-compounded foam.
NASA Technical Reports Server (NTRS)
1975-01-01
The retention of granular catalyst in a metal foam matrix was demonstrated to greatly increase the life capability of hydrazine monopropellant reactors. Since nickel foam used in previous tests was found to become degraded after long-term exposure the cause of degradation was examined and metal foams of improved durability were developed. The most durable foam developed was a rhodium-coated nickel foam. An all-platinum foam was found to be incompatible in a hot ammonia (hydrazine) environment. It is recommended to scale up the manufacturing process for the improved foam to produce samples sufficiently large for space shuttle APU gas generator testing.
Space Shuttle Stiffener Ring Foam Failure, a Non-Conventional Approach
NASA Technical Reports Server (NTRS)
Howard, Philip M.
2007-01-01
The Space Shuttle makes use of the excellent properties of rigid polyurethane foam for cryogenic tank insulation and as structural protection on the solid rocket boosters. When foam applications debond, classical methods of analysis do not always provide root cause of the failure of the foam. Realizing that foam is the ideal media to document and preserve its own mode of failure, thin sectioning was seen as a logical approach for foam failure analysis. Thin sectioning in two directions, both horizontal and vertical to the application, was chosen to observe the three dimensional morphology of the foam cells. The cell foam morphology provided a much greater understanding of the failure modes than previously achieved.
NASA Astrophysics Data System (ADS)
Hossein Elahi, S.; Arabi Jeshvaghani, R.; Shahverdi, H. R.
2015-05-01
In this paper, the influence of calcium addition and melt stirring on the structure and foaming behavior of molten zinc was investigated. In this regard, zinc foam was produced by Alporas method (in which foam alloy melts and titanium hydride is used as a blowing agent). Optical microscopy and scanning electron microscopy were used to investigate the phase distribution and structure in the foams. Results showed that addition of calcium increased foamability and foam efficiency of the molten zinc. In contrast, stirring had no significant effect on the foaming behavior of the melt. Microstructural examinations indicated that improving the foaming behavior of molten zinc was attributed to the formation of CaZn13 intermetallic phase and ZnO particles in the foam structure, which increased viscosity and reduced drainage rate.
Electrical conductivity of quasi-two-dimensional foams.
Yazhgur, Pavel; Honorez, Clément; Drenckhan, Wiebke; Langevin, Dominique; Salonen, Anniina
2015-04-01
Quasi-two-dimensional (quasi-2D) foams consist of monolayers of bubbles squeezed between two narrowly spaced plates. These simplified foams have served successfully in the past to shed light on numerous issues in foam physics. Here we consider the electrical conductivity of such model foams. We compare experiments to a model which we propose, and which successfully relates the structural and the conductive properties of the foam over the full range of the investigated liquid content. We show in particular that in the case of quasi-2D foams the liquid in the nodes needs to be taken into account even at low liquid content. We think that these results may provide different approaches for the characterization of foam properties and for the in situ characterization of the liquid content of foams in confining geometries, such as microfluidics.
Fabrication and Physical Evaluation of Gelatin-Coated Carbonate Apatite Foam.
Hara, Kanae; Fujisawa, Kenji; Nagai, Hirokazu; Takamaru, Natsumi; Ohe, Go; Tsuru, Kanji; Ishikawa, Kunio; Miyamoto, Youji
2016-08-23
Carbonate apatite (CO₃Ap) foam has gained much attention in recent years because of its ability to rapidly replace bone. However, its mechanical strength is extremely low for clinical use. In this study, to understand the potential of gelatin-reinforced CO₃Ap foam for bone replacement, CO₃Ap foam was reinforced with gelatin and the resulting physical characteristics were evaluated. The mechanical strength increased significantly with the gelatin reinforcement. The compressive strength of gelatin-free CO₃Ap foam was 74 kPa whereas that of the gelatin-reinforced CO₃Ap foam, fabricated using 30 mass % gelatin solution, was approximately 3 MPa. Heat treatment for crosslinking gelatin had little effect on the mechanical strength of the foam. The gelatin-reinforced foam did not maintain its shape when immersed in a saline solution as this promoted swelling of the gelatin; however, in the same conditions, the heat-treated gelatin-reinforced foam proved to be stable. It is concluded, therefore, that heat treatment is the key to the fabrication of stable gelatin-reinforced CO₃Ap foam.
Improving the mechanical performance of wood fiber reinforced bio-based polyurethane foam
NASA Astrophysics Data System (ADS)
Chang, Li-Chi
Because of the environmental impact of fossil fuel consumption, soybean-based polyurethane (PU) foam has been developed as an alternative to be used as the core in structural insulated panels (SIPs). Wood fibers can be added to enhance the resistance of foam against bending and buckling in compression. The goal of this work is to study the effect of three modifications: fiber surface treatment, catalyst choice, and mixing method on the compression performance of wood fiber-reinforced PU foam. Foams were made with a free-rising process. The compression performance of the foams was measured and the foams were characterized using Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), and X-ray computed tomography (CT). The foam reinforced with alkali-treated fibers had improved compression performance. The foams made with various catalysts shared similar performance. The foam made using a mechanical stirrer contained well-dispersed fibers but the reinforcing capability of the fibers was reduced.
Numerical simulation of heat transfer in metal foams
NASA Astrophysics Data System (ADS)
Gangapatnam, Priyatham; Kurian, Renju; Venkateshan, S. P.
2018-02-01
This paper reports a numerical study of forced convection heat transfer in high porosity aluminum foams. Numerical modeling is done considering both local thermal equilibrium and non local thermal equilibrium conditions in ANSYS-Fluent. The results of the numerical model were validated with experimental results, where air was forced through aluminum foams in a vertical duct at different heat fluxes and velocities. It is observed that while the LTE model highly under predicts the heat transfer in these foams, LTNE model predicts the Nusselt number accurately. The novelty of this study is that once hydrodynamic experiments are conducted the permeability and porosity values obtained experimentally can be used to numerically simulate heat transfer in metal foams. The simulation of heat transfer in foams is further extended to find the effect of foam thickness on heat transfer in metal foams. The numerical results indicate that though larger foam thicknesses resulted in higher heat transfer coefficient, this effect weakens with thickness and is negligible in thick foams.
NASA Astrophysics Data System (ADS)
Hangai, Yoshihiko; Nakano, Yukiko; Utsunomiya, Takao; Kuwazuru, Osamu; Yoshikawa, Nobuhiro
2017-02-01
In this study, Al-Si-Cu alloy ADC12 foam-filled thin-walled stainless steel pipes, which exhibit metal bonding between the ADC12 foam and steel pipe, were fabricated by friction stir back extrusion. Drop weight impact tests were conducted to investigate the deformation behavior and mechanical properties of the foam-filled pipes during dynamic compression tests, which were compared with the results of static compression tests. From x-ray computed tomography observation, it was confirmed that the fabricated foam-filled pipes had almost uniform porosity and pore size distributions. It was found that no scattering of the fragments of collapsed ADC12 foam occurred for the foam-filled pipes owing to the existence of the pipe surrounding the ADC12 foam. Preventing the scattering of the ADC12 foam decreases the drop in stress during dynamic compression tests and therefore improves the energy absorption properties of the foam.
Effect of thermal hydrolysis and ultrasounds pretreatments on foaming in anaerobic digesters.
Alfaro, N; Cano, R; Fdz-Polanco, F
2014-10-01
Foam appears regularly in anaerobic digesters producing operational and safety problems. In this research, based on the operational observation at semi-industrial pilot scale where sludge pretreatment mitigated foaming in anaerobic digesters, this study aimed at evaluating any potential relationship between foaming tools applied to activated sludge at lab-scale (foam potential, foam stability and Microthrix parvicella abundance) and the experimental behavior observed in pilot scale and full-scale anaerobic digesters. The potential of thermal hydrolysis and ultrasounds for reducing foaming capacity was also evaluated. Filamentous bacteria abundance was directly linked to foaming capacity in anaerobic processes. A maximum reduction of M.parvicella abundance (from 5 to 2) was reached using thermal hydrolysis with steam explosion at 170°C and ultrasounds at 66.7kWh/m(3), showing both good anti-foaming properties. On the other hand, foam potential and stability determinations showed a lack of consistency with the bacteria abundance results and experimental evidences. Copyright © 2014 Elsevier Ltd. All rights reserved.
Dress Fashion in Feminist and Child Rights Campaigns in Ghanaian Public Sculptures of the 1990s
ERIC Educational Resources Information Center
Essel, Osuanyi Quaicoo; Opoku-Mensah, Isaac
2017-01-01
This article examines how dress fashion in outdoor sculptures of the 1990s in the Accra cityscape accentuated feminist activism, sensitised child right campaigns, and encouraged girl-child education in support of governmental efforts and activism of civil society organisations in Ghana. It gives attention to how dress fashion of the time was used…
USDA-ARS?s Scientific Manuscript database
An intelligent dressing is a self-adjusting material with multifunctional properties and/or a biosensor-interface designed to treat specific pathological issues of wounds at a molecular or cellular level. The ability to detect and treat excessive protease levels in wounds, one indicator of chronic w...
ERIC Educational Resources Information Center
Sebastian, Richard J.; Bristow, Dennis
2008-01-01
In this article, the authors examine the effects of style of dress, forms of address, and gender of the stimulus person on business students' perceptions of professors' attributes. Student participants (125 women, 132 men) rated the stimulus person on indexes of attractiveness, trustworthiness, credibility, and likeability. Style of dress and form…
Politicas de uniformes y codigos de vestuario (Uniforms and Dress-Code Policies). ERIC Digest.
ERIC Educational Resources Information Center
Lumsden, Linda
This digest in Spanish examines schools' dress-code policies and discusses the legal considerations and research findings about the effects of such changes. Most revisions to dress codes involve the use of uniforms, typically as a way to curb school violence and create a positive learning environment. A recent survey of secondary school principals…
Indentability of conventional and negative Poisson's ratio foams
NASA Technical Reports Server (NTRS)
Lakes, R. S.; Elms, K.
1992-01-01
The indentation resistance of foams, both of conventional structure and of re-entrant structure giving rise to negative Poisson's ratio, is studied using holographic interferometry. In holographic indentation tests, re-entrant foams had higher yield strengths sigma(sub y) and lower stiffness E than conventional foams of the same original relative density. Calculated energy absorption for dynamic impact is considerably higher for re-entrant foam than conventional foam.
Dressing control of biphoton waveform transitions
NASA Astrophysics Data System (ADS)
Li, Xinghua; Zhang, Dan; Zhang, Da; Hao, Ling; Chen, Haixia; Wang, Zhiguo; Zhang, Yanpeng
2018-05-01
We experimentally realize and theoretically analyze narrow-band biphotons generated in a hot rubidium vapor cell by four-wave-mixing processing. A dressing laser beam is used to alternate both linear and nonlinear susceptibilities of the vapor, thereby modifying the biphoton's temporal correlation function. Most notably, the correlation time is increased from 6 to 165 ns. The biphoton shape is also shown to change as a result of the coupled-states dressing. We observed Rabi oscillations and optical precursors in hot atomic vapor cells. We also theoretically simulated biphoton correlation times as influenced by dressing-laser detuning and power, the results of which are consistent with our experiments.
Evidence review: the clinical benefits of Safetac technology in wound care.
Davies, Phil; Rippon, Mark
2008-11-01
Common causes of trauma and wound pain include: the removal of dressings that become stuck to the wound bed; skin stripping of peri-wound skin, as a result of the repeated application and removal of adhesive dressings; and tissue excoriation and maceration of the peri-wound skin, due to inadequate management of wound exudate. This supplement outlines how dressings with Safetac adhesive technology can help clinicians to avoid these problems. A review of the clinical and scientific evidence relating to dressings with Safetac clearly demonstrates that they can be used to prevent trauma and minimise pain on a wide range of wound types and skin injuries.
The Concept of Fashion Design on the Basis of Color Coordination Using White LED Lighting
NASA Astrophysics Data System (ADS)
Mizutani, Yumiko; Taguchi, Tsunemasa
This thesis focuses on the development of fashion design, especially a dress coordinated with White LED Lighting (=LED). As for the design concept a fusion of the advanced science and local culture was aimed for. For such a reason this development is a very experimental one. Here in particular I handled an Imperial Court dinner dress for the last Japanese First Lady, Mrs. Akie Abe who wore it at the Imperial Court dinner for the Indonesian First Couple held on November 2006 to. This dress made by Prof. T. Taguchi and I open up a new field in the dress design.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Ou, Xiaoxia
Open-cell SiC foams clearly are promising materials for continuous-flow chemical applications such as heterogeneous catalysis and distillation. X-ray micro computed tomography characterization of cellular β-SiC foams at a spatial voxel size of 13.6{sup 3} μm{sup 3} and the interpretation of morphological properties of SiC open-cell foams with implications to their transport properties are presented. Static liquid hold-up in SiC foams was investigated through in-situ draining experiments for the first time using the μ-CT technique providing thorough 3D information about the amount and distribution of liquid hold-up inside the foam. This will enable better modeling and design of structured reactors basedmore » on SiC foams in the future. In order to see more practical uses, μ-CT data of cellular foams must be exploited to optimize the design of the morphology of foams for a specific application. - Highlights: •Characterization of SiC foams using novel X-ray micro computed tomography. •Interpretation of structural properties of SiC foams regarding to their transport properties. •Static liquid hold-up analysis of SiC foams through in-situ draining experiments.« less
Pore Size Control in Aluminium Foam by Standardizing Bubble Rise Velocity and Melt Viscosity
NASA Astrophysics Data System (ADS)
Avinash, G.; Harika, V.; Sandeepika, Ch; Gupta, N.
2018-03-01
In recent years, aluminium foams have found use in a wide range of applications. The properties of these foams, as good structural strength with light weight have made them as a promising structural material for aerospace industry. Foaming techniques (direct and indirect) are used to produce these foams. Direct foaming involves blowing of gas to create gas bubbles in the melt whereas indirect foaming technique uses blowing agents as metallic hydrides, which create hydrogen bubbles. Porosity and its distribution in foams directly affect its properties. This demands for more theoretical studies, to control such cellular structure and hence properties. In present work, we have studied the effect of gas bubble rise velocity and melt viscosity, on pore size and its distribution in aluminium foam. A 15 PPI aluminium foam, prepared using indirect foaming technique having porosity ~86 % was used for study. In order to obtain metal foam, the bubble must not escape from the melt and should get entrapped during solidification. Our calculations suggest that bubble rise velocity and melt viscosity are responsible for vertical displacement of bubble in the melt. It is observed that melt viscosity opposes bubble rise velocity and help the bubbles to stay in the melt, resulting in porous structure.
Dutra, R A A; Salomé, G M; Leal, L M F; Alves, M G; Moura, J P; Silva, A T; Pereira, V O S; de Brito, M J A; Ferreira, L M
2016-11-02
To evaluate and compare the costs of using a transparent polyurethane film (PF) and hydrocolloid dressing (HD) in the prevention of pressure ulcers (PUs). This descriptive, observational, longitudinal, comparative study was conducted in the intensive care units, coronary care unit and medical clinic of a charity hospital in Brazil. Data were collected during a 30-day study period, consisting of physical examination, assessment of risk factors for PU development and application of the Braden scale, which were performed at inclusion in the study and once daily during hospitalisation. Either PF or HD was applied bilaterally in the sacral and trochanteric regions for prevention of PUs in patients at a moderate to high risk of PUs according to the Braden scale, and costs of using PU preventive dressings were estimated. The mean total costs per dressing change per patient when using the HD and PF to prevent PUs were 413.60 BRL and 74.04 BRL, respectively. There were significant between-group differences in mean costs for all variables, except for saline solution and nurse-technician services. Results showed that the mean cost per dressing change per patient was lower when using the transparent PF than when using the HD.
The Dress: Transforming a web viral event into a scientific survey.
Moccia, Marcello; Lavorgna, Luigi; Lanzillo, Roberta; Brescia Morra, Vincenzo; Tedeschi, Gioacchino; Bonavita, Simona
2016-05-01
The Dress picture recently has become a hot topic on the Internet, prompting a debate whether it was black and blue, or white and gold. To investigate The Dress color perception in both multiple sclerosis (MS) patients, characterized by frequent visual system impairment with ensuing color vision effects, and general population. We developed a questionnaire to record demographics, clinical features, and The Dress color perception, posted on general and MS-specific social networks. No statistically significant differences were observed in The Dress color perception between MS patients (n=103) and general population (n=441). Furthermore, white and gold color perception was positively associated with aging in the general population (p=0.04), whereas negatively associated with progressive course (p=0.03) and longer disease duration (p<0.001) in MS patients, independently from patients' age. The Dress black and blue or white and gold perception might be due to aging in the general population, whereas black and blue perception, despite of aging, might suggest a specific effect of the MS burden (i.e. disease duration and progression) on the visual structures specifically involved in the white and gold perception. Copyright © 2016 Elsevier B.V. All rights reserved.
Endo, Arisa; Suzuki, Makoto; Akagi, Atsumi; Chiba, Naoyuki; Ishizaka, Ikuyo; Matsunaga, Atsuhiko; Fukuda, Michinari
2015-03-01
The purpose of this study was to examine the reliability and validity of the Upper-body Dressing Scale (UBDS) for buttoned shirt dressing, which evaluates the learning process of new component actions of upper-body dressing in patients diagnosed with dementia and hemiparesis. This was a preliminary correlational study of concurrent validity and reliability in which 10 vascular dementia patients with hemiparesis were enrolled and assessed repeatedly by six occupational therapists by means of the UBDS and the dressing item of the Functional Independence Measure (FIM). Intraclass correlation coefficient was 0.97 for intra-rater reliability and 0.99 for inter-rater reliability. The level of correlation between UBDS score and FIM dressing item scores was -0.93. UBDS scores for paralytic hand passed into the sleeve and sleeve pulled up beyond the shoulder joint were worse than the scores for the other components of the task. The UBDS has good reliability and validity for vascular dementia patients with hemiparesis. Further research is needed to investigate the relation between UBDS score and the effect of intervention and to clarify sensitivity or responsiveness of the scale to clinical change. Copyright © 2014 John Wiley & Sons, Ltd.
Elewski, Boni E; Vlahovic, Tracey C
2014-07-01
Econazole nitrate is a broad-spectrum topical antifungal with activity against a variety of dermatophytes and yeasts. A new topical dosage form, econazole nitrate topical foam 1%, utilizing patented Proderm Technology® has been developed for treatment of interdigital tinea pedis. To evaluate econazole nitrate foam 1% versus foam vehicle for treatment of interdigital tinea pedis. Two randomized, double-blind, parallel-group, vehicle-controlled, multicenter studies enrolled males and females ≥12 years old with a clinical diagnosis of interdigital tinea pedis and baseline fungal culture positive for a dermatophyte. Subjects applied econazole nitrate foam 1% (n=246) or foam vehicle (n=249) once daily for 4 weeks. The primary endpoint was proportion of subjects achieving a complete cure (negative KOH, negative fungal culture, complete resolution of all signs and symptoms) at 2 weeks post-treatment (Day 43). Secondary endpoints included mycologic cure (negative KOH and negative culture) and effective treatment (mycologic cure + no or mild erythema and/or scaling and all other signs and symptoms absent). The complete cure rate at Day 43 was 24.3% for econazole nitrate foam 1% vs 3.6% for foam vehicle. In addition, higher rates of mycologic cure (67.6% vs 16.9%) and effective treatment (48.6% vs 10.8%) were observed with econazole nitrate foam 1% versus the foam vehicle. There were few adverse events and only nasopharyngitis and headache were experienced by >1% of subjects. No serious adverse events were reported for econazole nitrate foam 1%. Econazole nitrate foam 1% exhibited superiority over foam vehicle for the primary and secondary endpoints with a high mycologic cure rate for all pathogens evaluated. Econazole nitrate foam 1% was safe and well tolerated with a safety profile comparable with the foam vehicle. Econazole nitrate foam 1% presents a novel alternative for the management of tinea pedis.
Experimental study on foam coverage on simulated longwall roof.
Reed, W R; Zheng, Y; Klima, S; Shahan, M R; Beck, T W
2017-01-01
Testing was conducted to determine the ability of foam to maintain roof coverage in a simulated longwall mining environment. Approximately 27 percent of respirable coal mine dust can be attributed to longwall shield movement, and developing controls for this dust source has been difficult. The application of foam is a possible dust control method for this source. Laboratory testing of two foam agents was conducted to determine the ability of the foam to adhere to a simulated longwall face roof surface. Two different foam generation methods were used: compressed air and blower air. Using a new imaging technology, image processing and analysis utilizing ImageJ software produced quantifiable results of foam roof coverage. For compressed air foam in 3.3 m/s (650 fpm) ventilation, 98 percent of agent A was intact while 95 percent of agent B was intact on the roof at three minutes after application. At 30 minutes after application, 94 percent of agent A was intact while only 20 percent of agent B remained. For blower air in 3.3 m/s (650 fpm) ventilation, the results were dependent upon nozzle type. Three different nozzles were tested. At 30 min after application, 74 to 92 percent of foam agent A remained, while 3 to 50 percent of foam agent B remained. Compressed air foam seems to remain intact for longer durations and is easier to apply than blower air foam. However, more water drained from the foam when using compressed air foam, which demonstrates that blower air foam retains more water at the roof surface. Agent A seemed to be the better performer as far as roof application is concerned. This testing demonstrates that roof application of foam is feasible and is able to withstand a typical face ventilation velocity, establishing this technique's potential for longwall shield dust control.
Experimental study on foam coverage on simulated longwall roof
Reed, W.R.; Zheng, Y.; Klima, S.; Shahan, M.R.; Beck, T.W.
2018-01-01
Testing was conducted to determine the ability of foam to maintain roof coverage in a simulated longwall mining environment. Approximately 27 percent of respirable coal mine dust can be attributed to longwall shield movement, and developing controls for this dust source has been difficult. The application of foam is a possible dust control method for this source. Laboratory testing of two foam agents was conducted to determine the ability of the foam to adhere to a simulated longwall face roof surface. Two different foam generation methods were used: compressed air and blower air. Using a new imaging technology, image processing and analysis utilizing ImageJ software produced quantifiable results of foam roof coverage. For compressed air foam in 3.3 m/s (650 fpm) ventilation, 98 percent of agent A was intact while 95 percent of agent B was intact on the roof at three minutes after application. At 30 minutes after application, 94 percent of agent A was intact while only 20 percent of agent B remained. For blower air in 3.3 m/s (650 fpm) ventilation, the results were dependent upon nozzle type. Three different nozzles were tested. At 30 min after application, 74 to 92 percent of foam agent A remained, while 3 to 50 percent of foam agent B remained. Compressed air foam seems to remain intact for longer durations and is easier to apply than blower air foam. However, more water drained from the foam when using compressed air foam, which demonstrates that blower air foam retains more water at the roof surface. Agent A seemed to be the better performer as far as roof application is concerned. This testing demonstrates that roof application of foam is feasible and is able to withstand a typical face ventilation velocity, establishing this technique’s potential for longwall shield dust control. PMID:29563765
Assessments of low emission asphalt mixtures produced using combinations of foaming agents
NASA Astrophysics Data System (ADS)
Mohd Hasan, Mohd Rosli
The asphalt foaming techniques have been used over the last couple of decades as an alternative to the traditional method of preparing asphalt mixtures. Based on positive feedback from the industry, this study was initiated to explore and evaluate the performance of the Warm Mix Asphalt (WMA) mixture produced through a foaming process using physical and chemical foaming agents, which are ethanol and sodium bicarbonate (NaHCO3), respectively. The success of this project may lead to new theories and provide an environmentally friendly technique to produce asphalt mixtures. This may advance the understanding of the foaming process and improve the performance of WMA to support sustainable development. Theoretically, ethanol can function in the same manner as water but requires less energy to foam due to its lower boiling point, 78°C. During the asphalt foaming process, numerous bubbles were generated by the vaporized ethanol, which significantly increased the volume of the asphalt binder, hence the coating potential of aggregates improves. The sodium bicarbonate was incorporated to enhance the quantity of bubbles and its stability. Therefore, understanding foaming agents, their solubility, chemical reactions, chemical function groups and rheological properties of the foamed binder are essential to help control the foam structure and final properties of the foamed WMA mixture. In order to understand the overall performance of newly developed foaming WMA, this material was evaluated for moisture susceptibility, rutting potential, and resistance to fracture and thermal cracking. The coatability, workability and compactability of foamed asphalt mixtures during production were also evaluated. Based on the results, it was found that the newly proposed foaming WMA has high potential to promote sustainable development by lowering the energy consumption and impacts on the environment. The ethanol is efficient in lowering the viscosity of asphalt binders, enhancing the workability, and having a higher expulsion rate from the foamed binder compared to water as a foaming agent. The addition of foaming agents to the asphalt binder has also lowered the activation energy of the asphalt binder, which has high potential in lowering the energy demand during production processes. The foamed WMA mixture prepared at 100°C was found to have behavior comparable with the control Hot Mix Asphalt (HMA) prepared at 155°C in terms of coatability, workability and compactability. Based on the mixture performance tests, the foamed WMA has a comparable or better performance than the HMA in terms of resistance to moisture damage, permanent deformation, fracture cracking and thermal cracking. The application of nano-hydrated lime is efficient in enhancing the aggregate coatability and improving the bearing capacity of asphalt pavement to lower the rutting potential and moisture susceptibility of foamed WMA mixtures. Limitations for each of the related parameters are also reported in this dissertation for the lab production of foamed WMA mixtures using ethanol and NaHCO 3 as foaming agents. The specified values were made based on the binder test, service characteristics and performance of foamed WMA mixtures in order to yield a comparable or better performance than the control HMA. Field validations should be carried out to understand the overall performance and durability of the proposed foaming WMA.
Mori, Michela; Rossi, Silvia; Ferrari, Franca; Bonferoni, Maria C; Sandri, Giuseppina; Riva, Federica; Tenci, Marika; Del Fante, Claudia; Nicoletti, Giovanni; Caramella, Carla
2016-03-01
Platelet lysate (PL) was loaded into dressings based on chitosan glutamate (CSG) low and high molecular weight, sericin (Ser), and glycine (Gly). A synergic effect of Ser and PL on fibroblast proliferation was proved in vitro. Two different PL loading approaches were considered: the first provided to prepare dressings by freeze-drying a mixture of PL and CSG/Gly/Ser solution, the second approach consisted in the extemporarily loading of PL in the CSG/Gly/Ser freeze-dried dressings. As for the first approach, PL loading did not produce any variation in dressing mechanical properties. Such dressings absorbed a high amount (about 8-fold of dry weight) of phosphate-buffered saline (fluid mimicking wound exudate), forming a gel with pseudoplastic and elastic properties. Platelet-derived growth factor AB assay indicated that neither freeze-drying nor the excipients alter PL growth factor content. As for the second approach, mechanical and rheological properties of the gel formed upon PL absorption enabled to choose a PL loading of about 90 μL/cm(2). Upon contact with fibroblasts, all PL loaded formulations increased the number not only of viable cells but also of those in the proliferative phase. Histological studies effected on human skin strips pointed out the positive effect of PL loaded dressings on dermal matrix reconstruction. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.
Ferreira, Lydia M; Blanes, Leila; Gragnani, Alfredo; Veiga, Daniela F; Veiga, Frederico; Nery, Gilka B; Rocha, Gustavo H; Gomes, Heitor C; Rocha, Mario G; Okamoto, Regina
2009-06-01
Objective. The aim of this study was to compare the health-related quality of life (HRQoL) and self-esteem of patients who underwent split-thickness skin grafting, when either cellulose dressings or rayon dressings were applied to the donor sites. A total of 25 patients, who were enrolled at five participant hospitals and required split-thickness skin grafting for various clinical reasons, were randomized into two treatment groups, the rayon dressing group (n = 13), or the cellulose dressing group (n = 12). All patients were assessed preoperatively and 60 days postoperatively. The HRQoL was assessed with the Short Form-36 (SF-36) health survey questionnaire, and self-esteem was evaluated using the Rosenberg Self-Esteem Scale (RSE)/UNIFESP-EPM (Brazilian versions). There were no surgery-related complications during the study period. In both treatment groups, SF-36 scores for emotional role, mental health, vitality, and general health decreased from baseline. RSE scores increased from baseline in both treatment groups, showing a reduction in self-esteem after treatment. There was a statistical difference (P = 0.024) in the SF-36 bodily pain domain for the rayon group. There were no significant differences in HRQoL and self-esteem between treatment groups. In the rayon-dressing group, there was a significant decrease in bodily pain from baseline .
A review of negative-pressure wound therapy in the management of burn wounds.
Kantak, Neelesh A; Mistry, Riyam; Halvorson, Eric G
2016-12-01
Negative pressure has been employed in various aspects of burn care and the aim of this study was to evaluate the evidence for each of those uses. The PubMed and Cochrane CENTRAL databases were queried for articles in the following areas: negative pressure as a dressing for acute burns, intermediate treatment prior to skin grafting, bolster for skin autografts, dressing for integration of dermal substitutes, dressing for skin graft donor sites, and integrated dressing in large burns. Fifteen studies met our inclusion criteria. One study showed negative pressure wound therapy improved perfusion in acute partial-thickness burns, 8 out of 9 studies showed benefits when used as a skin graft bolster dressing, 1 out of 2 studies showed improved rate of revascularization when used over dermal substitutes, and 1 study showed increased rate of re-epithelialization when used over skin graft donor sites. Negative pressure can improve autograft take when used as a bolster dressing. There is limited data to suggest that it may also improve the rate of revascularization of dermal substitutes and promote re-epithelialization of skin graft donor sites. Other uses suggested by studies that did not meet our inclusion criteria include improving vascularity in acute partial-thickness burns and as an integrated dressing for the management of large burns. Further studies are warranted for most clinical applications to establish negative pressure as an effective adjunct in burn wound care. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.
From Foam Rubber to Volcanoes: The Physical Chemistry of Foam Formation
NASA Astrophysics Data System (ADS)
Hansen, Lee D.; McCarlie, V. Wallace
2004-11-01
Principles of physical chemistry and physical properties are used to describe foam formation. Foams are common in nature and in consumer products. The process of foam formation can be used to understand a wide variety of phenomena from exploding volcanoes to popping popcorn and making shoe soles.
40 CFR 428.110 - Applicability; description of the latex foam subcategory.
Code of Federal Regulations, 2010 CFR
2010-07-01
... latex foam subcategory. 428.110 Section 428.110 Protection of Environment ENVIRONMENTAL PROTECTION... Foam Subcategory § 428.110 Applicability; description of the latex foam subcategory. The provisions of... foam except for those discharges from textile plants subject to the provisions of part 410 of this...
Code of Federal Regulations, 2011 CFR
2011-04-01
... certification program for polystyrene foam insulation board. 200.947 Section 200.947 Housing and Urban... program for polystyrene foam insulation board. (a) Applicable standards. (1) All polystyrene foam... visit the manufacturer's facility to select a sample of each certified polystyrene foam insulation board...
40 CFR 428.110 - Applicability; description of the latex foam subcategory.
Code of Federal Regulations, 2011 CFR
2011-07-01
... latex foam subcategory. 428.110 Section 428.110 Protection of Environment ENVIRONMENTAL PROTECTION... Foam Subcategory § 428.110 Applicability; description of the latex foam subcategory. The provisions of... foam except for those discharges from textile plants subject to the provisions of part 410 of this...
46 CFR 108.474 - Aqueous film forming foam systems.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 46 Shipping 4 2011-10-01 2011-10-01 false Aqueous film forming foam systems. 108.474 Section 108... DESIGN AND EQUIPMENT Fire Extinguishing Systems Foam Extinguishing Systems § 108.474 Aqueous film forming foam systems. Aqueous film forming foam systems may be installed if approved by the Commandant. ...
Electrically conductive rigid polyurethane foam
Neet, T.E.; Spieker, D.A.
1983-12-08
A rigid, moldable polyurethane foam comprises about 2 to 10 weight percent, based on the total foam weight, of a carbon black which is CONDUCTEX CC-40-220 or CONDUCTEX SC, whereby the rigid polyurethane foam is electrically conductive and has essentially the same mechanical properties as the same foam without carbon black added.
Starch/fiber/poly(lactic acid) foam and compressed foam composites
USDA-ARS?s Scientific Manuscript database
Composites of starch, fiber, and poly(lactic acid) (PLA) were made using a foam substrate formed by dehydrating starch or starch/fiber gels. PLA was infiltrated into the dry foam to provide better moisture resistance. Foam composites were compressed into plastics using force ranging from 4-76MPa. Te...
46 CFR 108.474 - Aqueous film forming foam systems.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 46 Shipping 4 2010-10-01 2010-10-01 false Aqueous film forming foam systems. 108.474 Section 108... DESIGN AND EQUIPMENT Fire Extinguishing Systems Foam Extinguishing Systems § 108.474 Aqueous film forming foam systems. Aqueous film forming foam systems may be installed if approved by the Commandant. ...
Electrically conductive rigid polyurethane foam
Neet, Thomas E.; Spieker, David A.
1985-03-19
A rigid, polyurethane foam comprises about 2-10 weight percent, based on the total foam weight, of a carbon black which is CONDUCTEX CC-40-220 or CONDUCTEX SC, whereby the rigid polyurethane foam is electrically conductive and has essentially the same mechanical properties as the same foam without carbon black added.
46 CFR 108.474 - Aqueous film forming foam systems.
Code of Federal Regulations, 2012 CFR
2012-10-01
... 46 Shipping 4 2012-10-01 2012-10-01 false Aqueous film forming foam systems. 108.474 Section 108... DESIGN AND EQUIPMENT Fire Extinguishing Systems Foam Extinguishing Systems § 108.474 Aqueous film forming foam systems. Aqueous film forming foam systems may be installed if approved by the Commandant. ...
46 CFR 108.474 - Aqueous film forming foam systems.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 46 Shipping 4 2013-10-01 2013-10-01 false Aqueous film forming foam systems. 108.474 Section 108... DESIGN AND EQUIPMENT Fire Extinguishing Systems Foam Extinguishing Systems § 108.474 Aqueous film forming foam systems. Aqueous film forming foam systems may be installed if approved by the Commandant. ...
46 CFR 108.474 - Aqueous film forming foam systems.
Code of Federal Regulations, 2014 CFR
2014-10-01
... 46 Shipping 4 2014-10-01 2014-10-01 false Aqueous film forming foam systems. 108.474 Section 108... DESIGN AND EQUIPMENT Fire Extinguishing Systems Foam Extinguishing Systems § 108.474 Aqueous film forming foam systems. Aqueous film forming foam systems may be installed if approved by the Commandant. ...
40 CFR 63.8784 - What parts of my plant does this subpart cover?
Code of Federal Regulations, 2013 CFR
2013-07-01
... CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air Pollutants: Flexible Polyurethane Foam... flexible polyurethane foam fabrication. (b) The affected sources are defined in this section in paragraphs... to bond foam to foam at a flexible polyurethane foam fabrication plant site. (2) The flame lamination...
40 CFR 63.1300 - Standards for molded flexible polyurethane foam production.
Code of Federal Regulations, 2013 CFR
2013-07-01
... polyurethane foam production. 63.1300 Section 63.1300 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Foam Production § 63.1300 Standards for molded flexible polyurethane foam production. Each owner or... polyurethane foam process, with the following exception. Diisocyanates may be used to flush the mixhead and...
40 CFR 63.1301 - Standards for rebond foam production.
Code of Federal Regulations, 2011 CFR
2011-07-01
... National Emission Standards for Hazardous Air Pollutants for Flexible Polyurethane Foam Production § 63.1301 Standards for rebond foam production. Each owner or operator of a new or existing rebond foam... 40 Protection of Environment 11 2011-07-01 2011-07-01 false Standards for rebond foam production...