Robert Jones bandage versus cast in the treatment of distal radius fracture in children: A randomized controlled trial / 中华创伤杂志(英文版)

PURPOSE@#The present study aimed to treat fractures of the distal end of the radius in children with Robert Jones (RJ) bandage. The objective was to compare this treatment modality with the cast regarding the frequency of the complication occurrence, child comfortability, and family satisfaction.@*METHODS@#The study was a randomized controlled non-inferiority clinical trial including children with recent (less than 5 days) fractures at the distal end of the radius OTA/AO 23-A2, which is usually treated conservatively. Those with open fractures, pathological fracture, severely displaced fracture that needs reduction or multiple injuries were excluded. The participants were divided randomly into 2 groups according to the treatment modalities. Group 1 was treated by plaster of Paris cast (the control group), and Group 2 by modified RJ bandage (the trial group). The difference between the 2 groups was found by the Chi-squared test. The difference was considered statistically significant when the p value was less than 0.05.@*RESULTS@#There were 150 children (aged 2 - 12 years, any gender) included in the study, 75 in each group. The complications occured in 5 (3.3%) cases only, pressure sores of 3 cases in Group 1 and fracture displacement of 2 cases in Group 2. There was no statistically significant difference in the rate of complication occurrence between both modalities of treatment (p = 0.649). Children treated by RJ bandages were more comfortable than those treated by the cast (97.3% vs. 73.3%, p < 0.001) with a statistically significant difference between them. Contrary to that, the families were more satisfied with the cast than RJ bandage (88.0% vs. 81.3%), but without a statistically significant difference (p = 0.257).@*CONCLUSION@#RJ bandage is a non-inferior alternative to the cast for the treatment of fractures at the distal end of the radius that can be treated conservatively in children.

Percutaneous minimally invasive osteotomy with 8-shaped bandage and hallux valgus splint fixation for the treatment of moderate hallux valgus / 中国骨伤

OBJECTIVE@#To observe clinical effect of percutaneous minimally invasive osteotomy with 8-shaped bandage and hallux valgus splint fixation in treating moderate hallux valgus.@*METHODS@#Totally 23 patients with moderate hallux valgus were treated with percutaneous minimally invasive osteotomy with 8-shaped bandage and hallux valgus splint fixation from August 2019 to January 2021, and 1 patient was loss to follow-up, and finally 22 patients(30 feet) were included, 4 males (6 feet) and 18 females(24 feet), aged from 27 to 66 years old with an average of(50.59±11.95) years old. Hallux valgus angle (HVA), intermetatarsal angle (IMA), metatarsal span (the distance between the first and the fifth metatarsal bones), changed of soft tissue width, American Orthopaedic Foot and Ankle Society(AOFAS) score, and Visual Analogue Scale (VAS) were collected and compared before operation and 6 months after operation.@*RESULTS@#Twenty-two patients were followed up from 5.7 to 6.4 months with an average of (6.13±0.85) months. The first metatarsal osteotomy of patients were obtained bone union, and deformity of the toes was corrected. Complications such as avascular necrosis of metatarsal head and transfer metatarsalgia were not occurred. Postoperative HVA, IMA, metatarsal span, soft tissue width, VAS, AOFAS score at 6 months were significantly improved compared with pre-operation (P<0.01). According to AOFAS score at 6 months after operation, 10 feet were excellent, 18 good and 2 poor. Two feet with poor were excellent after prolonged 8-shaped bandage and hallux valgus splint fixation time.@*CONCLUSION@#Percutaneous minimally invasive osteotomy with 8-shaped bandage and hallux valgus splint fixation for the treatment of moderate hallux valgus could better correct deformity of hallux valgus, relieve foot symptoms, good recovery of postoperative function, and has a significant clinical efficacy.

Meta-analysis of the effects of xenogeneic acellular dermal matrix dressings in the treatment of wounds in burn patients / 中华烧伤杂志

Objective: To evaluate the efficacy and safety of xenogeneic acellular dermal matrix (ADM) dressings for the treatment of wounds in burn patients. Methods: The meta-analysis method was adopted. Databases including Chinese Journal Full-text Database, Wanfang Database, VIP Database, and Chinese Biomedical Database were retrieved with the search terms in Chinese version of ", , , " and PubMed, Embase, Web of Science, and Cochrane Library were retrieved with the search terms in English version of "xenogeneic acellular dermal matrix, dressing, burn wound, burn" to obtain the publicly published randomized controlled trials on the efficacy of xenogeneic ADM dressings for the treatment of wounds in burn patients from the establishment of each database to December 2021. The outcome indexes included wound healing time, ratio of scar hyperplasia, Vancouver scar scale (VSS) score, ratio of complications, ratio of skin grafting, and ratio of bacteria detection. Rev Man 5.3 and Stata 14.0 statistical softwares were used to conduct a meta-analysis of eligible studies. Results: A total of 1 596 burn patients from 16 studies were included, including 835 patients in experimental group who received xenogeneic ADM dressings therapy and 761 patients in control group who received other methods therapy. The bias risk of all the 16 included studies was uncertain. Compared with those in control group, patients in experimental group had significantly shorter wound healing time, lower VSS scores (with standardized mean differences of -2.50 and -3.10, 95% confidence intervals of -3.02--1.98 and -4.87--1.34, respectively, P values both <0.05), and lower ratios of scar hyperplasia, complications, skin grafting, and bacteria detection (with relative risks of 0.58, 0.23, 0.32, and 0.27, 95% confidence intervals of 0.43-0.80, 0.14-0.37, 0.15-0.67, and 0.11-0.69, respectively, P<0.05). Subgroup analysis showed that the difference of intervention measures in control group might be the source of heterogeneity in wound healing time. There was no publication bias in ratio of scar hyperplasia (P≥0.05), while there was publication bias in wound healing time, VSS score, and ratio of complications (P<0.05). Conclusions: Xenogeneic ADM dressings can shorten the wound healing time of burn patients, reduce the VSS score and the ratios of scar hyperplasia, complications, skin grafting, and bacteria detection.

Research progress on moderate and deep sedation during wound dressing change in pediatric burn patients / 中华烧伤杂志

Moderate and deep sedation can effectively relieve or eliminate the pain and body discomfort during wound dressing change in pediatric burn patients, relieve anxiety, agitation, and even delirium of the children, reduce the metabolic rate of the children, make them in a quiet, comfortable, and cooperative state, which is conducive to the smooth completion of dressing change. This paper summarized the three aspects of moderate and deep sedation in pediatric burn patients, including the overview, main points of implementation, and effects, and further introduced the moderate and deep sedation medication regimens for different routes of administration, as well as the content of evaluation and monitoring. Suggestions on the prevention and management of related complications and the management of moderate and deep sedation implementation procedures were put forward, in order to provide references for the development of moderate and deep sedation for wound dressing change in pediatric burn patients in China.

Vivências de mães no cuidado a crianças e adolescentes com Epidermólise Bolhosa / Experiencias de madres en el cuidado de niños y adolescentes con Epidermólisis Ampollosa / Experiences of mothers in the care of children and adolescents with epidermolysis bullosa

Resumo Objetivo conhecer e analisar as vivências de mães no cuidado a crianças e adolescentes com Epidermólise Bolhosa. Método estudo descritivo de abordagem qualitativa desenvolvido junto a dez mães de crianças e adolescentes com Epidermólise Bolhosa de diferentes regiões do Brasil, a partir de entrevistas semiestruturadas, áudio e vídeo gravadas, por via remota, utilizando-se a plataforma Google Meet®, entre setembro e novembro de 2021. A técnica da análise temática direcionou a apreciação do material empírico. Resultados participaram do estudo mães com idade entre 23 e 53 anos. Duas categorias traduzem a vivência materna: i) O "baque" do diagnóstico e os desafios iniciais e ii) "Deixar de viver para viver para ele": as mudanças no cotidiano das famílias. Considerações finais e implicações para a prática as mães vivenciaram sentimentos de medo e insegurança diante do diagnóstico do filho e a rotina de cuidados, em especial, as trocas diárias de curativos, acarretaram sobrecarga física e emocional. Esses resultados podem subsidiar o acompanhamento dessas famílias de modo a instrumentalizá-las para o cuidado e apoiá-las emocionalmente.

Resumen Objetivo conocer y analizar la vida de las madres en el cuidado de niños y adolescentes con Epidermólisis Bullosa. Método estudio descriptivo de abordaje cualitativo desarrollado junto a diez madres de niños y adolescentes con Epidermólisis Bullosa de diferentes regiones de Brasil, a partir de entrevistas semiestructuradas con grabación de audio y video, por vía remota, utilizando la plataforma Google Meet®, entre septiembre y noviembre de 2021. La técnica de análisis temático dirigió la apreciación del material empírico. Resultados participaron en el estudio mujeres de entre 23 y 53 años. Dos categorías traducen la experiencia materna: i) El "shock" del diagnóstico y los retos iniciales; y ii) "Dejar de vivir para vivir por él": los cambios en la vida cotidiana de las familias. Consideraciones finales e implicaciones para la práctica las madres experimentaron sentimientos de miedo e inseguridad ante el diagnóstico de su hijo y la rutina de cuidados, especialmente los cambios de apósito diarios provocaron una sobrecarga física y emocional. Estos resultados pueden servir de apoyo para el seguimiento de estas familias, con el fin de poder cuidarlas y apoyarlas emocionalmente.

Abstract Objective to know and analyze mothers' experiences in caring for children and adolescents with Epidermolysis Bullosa. Method a descriptive qualitative study was developed with ten mothers of children and adolescents with epidermolysis bullosa from different regions of Brazil using semi-structured interviews recorded remotely using Google Meet® between September and November 2021. The thematic analysis technique guided the appreciation of the empirical material. Results mothers aged between 23 and 53 years participated in the study. Two categories translate the maternal experience: i) the "shock" of the diagnosis and the initial challenges and ii) "Stop living to live for them": the changes in the families' daily life. Final considerations and implications for practice mothers experienced fear and insecurity when their child was diagnosed, and the care routine, especially the daily dressing changes, caused a physical and emotional burden. These results can support the follow-up of these families to provide them with care tools and emotional support.

Eletrofiação aplicada a cicatrização de feridas: revisão de literatura / Electrospinning applied to wound healing: literature review / Electroalambre aplicado a la cicatrización de heridas: revisión de la literatura

feridas correspondem a interrupção da continuidade da pele, com a perda de uma ou mais camadas do tecido cutâneo. Curativos tradicionalmente aplicados em feridas cutâneas buscam principalmente fornecer uma barreira de proteção e permitir o desenvolvimento dos eventos celulares e bioquímicos que compreendem a cicatrização. Objetivou-se com este estudo apresentar sob a forma de revisão de literatura narrativa os principais eventos relacionados ao processo de reparo tecidual da pele, bem como abordar a aplicabilidade da técnica de eletrofiação no desenvolvimento de curativos funcionais biocompatíveis. Foram selecionados artigos voltados à caracterização dos eventos chave ocorridos a nível tecidual durante a cicatrização e, na sequência, buscou-se artigos voltados à produção, caracterização e aplicação de filmes nanoeletrofiados com ênfase na utilização de biopolímeros e substâncias bioativas. Observou-se que a maioria dos trabalhos recentes, voltados a pesquisa de base, descrevem a resposta vascular como o principal evento do processo cicatricial, sendo responsável pelas etapas que se desenrolam a seguir, que compreendem as fases inflamatória, proliferativa e de remodelamento, classicamente já descritas. Os curativos funcionais baseados em polímeros eletrofiados apresentam resultados superiores quanto testados in vitro e in vivo. As características morfoestruturais mimetizam a matriz extracelular e podem atuar em tecidos alvo como dispositivos de entrega de substâncias. Conclui-se que a atualização e reorganização de conceitos relativos à cicatrização podem contribuir no desenvolvimento de inovações, como os curativos produzidos por eletrofiação. Embora promissora, as desvantagens da técnica encontram-se principalmente no processo de obtenção e disponibilidade, que limitam a aplicação clínica em escala comercial.

Wounds correspond to the interruption of skin continuity, with the loss of one or more layers of skin tissue. Dressings traditionally applied to cutaneous wounds mainly seek to provide a protective barrier and allow the development of cellular and biochemical events that comprise healing. The objective of this study was to present, in the form of a narrative literature review, the main events related to the skin tissue repair process, as well as to address the applicability of the electrospinning technique in the development of biocompatible functional dressings. Articles focused on the characterization of the key events that occurred at the tissue level during healing were selected and, subsequently, articles focused on the production, characterization and application of nanoelectrospun films with emphasis on the use of biopolymers and bioactive substances were sought. It was observed that most recent works, focused on basic research, describe the vascular response as the main event of the healing process, being responsible for the steps that follow, which include the inflammatory, proliferative and remodeling phases, classically already described. Functional dressings based on electrospun polymers show superior results when tested in vitro and in vivo. The morphostructural features mimic the extracellular matrix and can act in target tissues as substance delivery devices. It is concluded that the updating and reorganization of concepts related to healing can contribute to the development of innovations, such as dressings produced by electrospinning. Although promising, the technique's disadvantages lie mainly in the process of obtaining and availability, which limit clinical application on a commercial scale.

Las heridas corresponden a la interrupción de la continuidad de la piel, con la pérdida de una o más capas de tejido cutáneo. Los apósitos aplicados tradicionalmente a las heridas cutáneas buscan principalmente proporcionar una barrera protectora y permitir el desarrollo de los eventos celulares y bioquímicos que comprenden la curación. El objetivo de este estudio fue presentar en forma de revisión bibliográfica narrativa los principales acontecimientos relacionados con el proceso de reparación tisular de la piel, así como abordar la aplicabilidad de la técnica de electrodeposición en el desarrollo de apósitos funcionales biocompatibles. Se seleccionaron artículos dirigidos a la caracterización de los eventos chave ocurridos a nivel técnico durante la cicatrización y, a continuación, se buscaron artículos dirigidos a la producción, caracterización y aplicación de películas nanoelectrofíricas con énfasis en el uso de biopolímeros y sustancias bioativas. Se observa que la mayoría de los trabajos recientes, realizados en la investigación de base, describen la respuesta vascular como el principal evento del proceso cicatricial, siendo responsable de las etapas que se desarrollan a continuación, que comprenden las fases inflamatoria, proliferativa y de remodelación, clásicamente descritas. Los apósitos funcionales basados en polímeros electro-tejidos presentan resultados superiores cuando se prueban in vitro e in vivo. Las características morfoestruturales mimetizan la matriz extracelular y pueden actuar en tejidos alvos como dispositivos de entrega de sustancias. Se concluye que la actualización y la reorganización de los conceptos relativos a la cicatrización pueden contribuir al desarrollo de innovaciones, como las curativas producidas por la electrofagia. Aunque es prometedora, las desventajas de la técnica radican principalmente en el proceso de obtención y la disponibilidad, que limitan la aplicación clínica a escala comercial.

The role of transperineal ultrasound in the evaluation of stress urinary incontinence cases

ABSTRACT Purpose: To evaluate the use of transperineal ultrasonography while diagnosing stress urinary incontinence (SUI) by comparing the urethral angle (α), posterior urethrovesical angle (β), and bladder neck descent (BND) during rest and Valsalva maneuver in continent women and women with SUI. Materials and methods: This prospective observational study was conducted with 50 women with SUI and 50 continent women. Transperineal ultrasonography was performed at rest and during Valsalva maneuver. Q-tip test was performed. Results: During the Valsalva maneuver, both α and β angles were significantly higher in women with SUI (p <0.001). The difference between Valsalva and rest measurements of α and β angles (R α, R β) were also significantly higher in women with SUI (p <0.001). The cut-off point determined for the R α in the diagnosis of stress incontinence was 16° (80% sensitivity, 98% specificity). A statistically significant strong correlation was found between Q-tip test angle and R α value (p=0.000; r=0.890). Q-tip VAS pain scores were significantly higher than ultrasonography VAS pain scores (p <0.001). In relation to the bladder neck descent comparison between the two groups showed that BND was significantly higher in SUI group (p <0.001). The cut-off point determined for BND in the diagnosis of SUI was >11mm (90% sensitivity, 98% specificity). Conclusion: Transperineal ultrasonography is a practical, reliable, non-invasive and comfortable method for evaluation of SUI. It has the advantage of dynamic evaluation during the Valsalva maneuver. Rotation angles and BND have high sensitivity and specificity for detection of SUI. The change in α angle with Valsalva (Rα) can be used as an alternative to Q-tip test.

Research advances on the promotive healing effect of hydrogel dressing for diabetic foot wound / 中华烧伤杂志

In recent years, the number of diabetic patients has gradually increased, and the number of patients with diabetic foot has also increased. Diabetic foot has a high rate of disability and death, seriously affects the patients' quality of life, shortens life expectancy, and brings heavy social burden. The current treatment methods for diabetic foot are insufficient. The concepts and methods of tissue engineering provide new thoughts and means for the treatment of diabetic foot. This article introduces the pathogenesis of diabetic foot wounds, the factors leading to non-healing of diabetic foot, the applications of functional hydrogel dressings in the treatment of diabetic foot and their technical methods of functional hydrogel dressings for treating skin wounds in diabetic animals, and the future development direction of functional hydrogel dressing for treating diabetic foot wounds is prospected.

Contribuições do enfermeiro na pesquisa básica: modelo de fixação de curativo em feridas cutâneas excisionais de camundongos / Contributions of nurses in basic research: dressing fixation model for excisional cutaneous wounds of mice / Contribuciones del enfermero en la investigación básica: modelo de fijación de apósito en heridas cutáneas excisionales de ratones

Objetivo:validar método de fixação de curativos em feridas cutâneas excisionais de camundongos. Método: estudo pré-clínico. Amostra composta por animais da linhagem C57BL/6, que tiveram duas feridas excisionais confeccionadas na região dorsal. Foram avaliados diferentes métodos e produtos, amplamente aceitos na prática clínica, para fixação de curativos no modelo animal. Os desfechos avaliados foram tempo de permanência do curativo e ocorrência de eventos adversos. Resultados: atadura de crepom, fita microporosa e bandagem autoaderente apresentaram menor tempo de permanência quando comparadas ao filme de poliuretano. Esse, por sua vez, variou o tempo quando comparadas diferentes marcas (E, F, G e H) e número de voltas ao redor do corpo do animal. Com 1 volta, o tempo variou de < 24 a 36 horas. Com 2 voltas, as marcas E e G permaneceram 48 e 96 horas, respectivamente, e F e H tempo < 24 horas. Filme da marca G, cortado no tamanho 3 cm x 15 cm, dando 2 voltas no corpo do camundongo, manteve o curativo por 96 horas. A pele permaneceu íntegra, sem evento adverso. Conclusão: foi criado modelo de fixação de curativos para feridas em camundongos com produto disponível no Brasil e compatível com a estrutura copórea do animal.

Objective:validate method of fixation of dressings on excisional cutaneous wounds of mice. Method: preclinical study. Sample made up of animals of the C57BL/6 strain, which had two excision wounds made in the dorsal region. Different methods and products, widely accepted in clinical practice, for fixing dressings in the animal model were evaluated. The evaluated outcomes were the length of stay of the dressing and the occurrence of adverse events. Results: crepe bandage, microporous tape and self-adhesive bandage had a shorter residence time when compared to polyurethane film. This, in turn, varied the time when comparing different marks (E, F, G and H) and number of turns around the animal's body. With 1 lap, the time varied from <24 to 36 hours. With 2 laps, the marks E and G remained 48 and 96 hours, respectively, and F and H time <24 hours. G-brand film, cut to size 3 cm x 15 cm, giving the mouse body 2 turns, kept the dressing for 96 hours. The skin remained intact, with no adverse event. Conclusion: a dressing fixation model for wounds in mice was created with a product available in Brazil and compatible with the animal's body structure

Objetivo:validar método de fijación de apósitos en heridas cutáneas excisionales de ratones. Método: estudio preclínico. Muestra compuesta por animales del linaje C57BL/6 que tuvieron dos heridas excisionales confeccionadas en la región dorsal. Se evaluaron distintos métodos y productos, ampliamente aceptados en la práctica clínica, para fijación de apósitos en el modelo animal. Los resultados evaluados fueron tiempo de permanencia del apósito y ocurrencia de eventos adversos. Resultados: La venda de crepé, la cinta microporosa y el vendaje autoadherente presentaron menor tiempo de permanencia cuando comparados con la película de poliuretano. Esta, a su vez, varió en el tiempo cuando comparadas distintas marcas (E, F, G y H) y número de vueltas alrededor del cuerpo del animal. Con una vuelta completa, el tiempo varió de menos de 24 a 36 horas. Con dos vueltas, las marcas E y G permanecieron 48 y 96 horas, respectivamente, y F y H, tiempo igual e inferior a 24 horas. La piel permaneció íntegra, sin evento adverso. Conclusión: se creó un modelo de fijación de apósitos en ratones con un producto disponible en Brasil y compatible con la estructura del cuerpo del animal

Reconstrucción en amputaciones distales de dedos en niños con injerto compuesto y vendaje semioclusivo / Reconstruction of distal finger amputations in children with composite autograft and semi-oclusive dressing

La reconstrucción de una amputación distal de dedo en un niño es un desafío. Los procedimientos propuestos son muchos, y los resultados no han sido buenos. La reconstrucción con reposición del segmento a modo de injerto compuesto, o con técnicas microquirúrgicas, parece ofrecer la mejor de las posibilidades, pues se conservan estructuras irremplazables, como el lecho ungueal y el hiponiquio, lo que permite que los niños mantengan un pulpejo anatómico y con función normal. Presentamos una serie de tres pacientes pediátricos tratados con una nueva técnica, que combina la reposición del segmento, como un injerto compuesto, y el uso de curación semioclusiva (composite autograft and semi-oclussive dressing, CASOD, en inglés). Hemos observado buenos resultados.

The reconstruction of finger tip amputation in children is challenging. There are many procedures described to treat this injury, none of which present optimal results. Repositioning of the amputated segment as an autograft or with microsurgical techniques seems to offer the best outcome. It enables the preservation of otherwise irreplaceable structures, such as the nail bed and the hyponychium, thus enabling children to mantain an anatomically and functionally normal finger pad. We present a series of three pediatric patients treated with tha new technique, which combines composite autograft and semi-oclusive dressing (CASOD). The results observed so far have been promising.

Curativos em queimaduras: Revisão da prática brasileira / Burns dressing: Review of Brazilian practice

OBJETIVO: Identificar quais os curativos e coberturas mais utilizados no tratamento de feridas por queimaduras no Brasil. MÉTODO: Trata-se de uma revisão narrativa, com artigos publicados no período de 2011 a 2020. A busca foi realizada na Biblioteca Virtual em Saúde a partir dos descritores: curativo, cobertura, queimadura e enfermagem, no mês de maio de 2021. RESULTADOS: Foram selecionados oito estudos para análise e, a partir da leitura desses artigos, as coberturas citadas foram: sulfadiazina de prata, ácido hialurônico e película de biocelulose, assim como gaze não aderente, hidrogel e hidrofibra de carboximetilcelulose sódica. CONSIDERAÇÕES FINAIS: Conhecer as coberturas utilizadas no tratamento de queimadura permite melhor e mais rápido resultado para o paciente, diminui os custos da instituição e favorece a equipe assistencial, que não sofre desgaste emocional, pois observa resultados positivos no tratamento das lesões.

OBJECTIVE: To identify which dressings are most used in the treatment of burn wounds in Brazil. METHODS: This is a narrative review, with articles published from 2011 to 2020. The search was carried out in the Virtual Health Library using the descriptors: dressing, coverage, burns, and nursing, in May 2021. RESULTS: Eight studies were selected for analysis, and from the reading of these articles, the coatings cited were: silver sulfadiazine, hyaluronic acid, and biocellulose film, as well as non-adherent gauze, hydrogel, and sodium carboxymethylcellulose hydrofiber. FINAL CONSIDERATIONS: Knowing the dressings used in the treatment of burns allows for better and faster results for the patient, reduces the institution's costs, and favors the care team, which does not suffer emotional distress, as it observes positive results in the treatment of injuries.

Vegetable cellulose nanofiber dressing aids in the healing process of third-degree burns? study on rats / Curativo de nanofibras de celulose vegetal auxilia na cicatrização de queimaduras de terceiro grau? estudo em ratos

ABSTRACT Background: The treatment of 3rd degree burns represents a major medical challenge. Pinus vegetable cellulose is a biomaterial with characteristic similar to bacterial cellulose. Aim: To evaluate the safety of cellulose membrane (Pinus sp) in the treatment of 3rd burns in rats and to compare its effectiveness with the bacterial membrane already on the market. Method: Thirty-three Wistar rats were beaten with a 3rd degree burn on back skin by applying water at 98º C for 30 s. Then, they were divided into three groups (n=11): group 1 - simple dressing with gauze; group 2 - dressing with bacterial cellulose membrane; and group 3 - dressing with vegetable cellulose membrane. The animals were maintained for 15 days to check the general clinical status, macroscopic aspect, contraction of the wounds and microscopic analysis for the degree of healing and collagenization. Results: They were clinically well during the experiment. During the removal of the dressing, there was bleeding in the wound of the control group, unlike the groups treated with cellulose membranes, which protected the bed from injury. The macroscopic evaluation showed a greater contraction of the wounds treated with the membranes in relation to the control. A microscopic analysis revealed that most of the wounds were in advanced healing degree with predominance of mature collagen in all groups. Conclusion: Pinus sp cellulose membrane showed efficacy similar to that of the bacterial membrane in the treatment of 3rd degree burns.

RESUMO Racional: O tratamento das queimaduras de 3˚ grau representa grande desafio na área médica. A celulose vegetal de pinus é biomaterial com características semelhantes às da celulose bacteriana. Objetivo: Avaliar a segurança da membrana de celulose vegetal (Pinus sp) no tratamento de queimaduras de terceiro grau em ratos e comparar sua eficácia com a da membrana bacteriana já comercializada. Método: Trinta e três ratos Wistar foram submetidos à queimadura de 3º grau na pele do dorso mediante aplicação de água a 98º C durante 30 s. Em seguida, foram distribuídos em três grupos (n=11): grupo 1 - curativo simples com gaze; grupo 2 - curativo com membrana de celulose bacteriana; e grupo 3 - curativo com membrana de celulose vegetal . Os animais foram avaliados durante 15 dias para verificar o estado clínico geral, aspecto macroscópico, contração das feridas e análise microscópica pelo grau de cicatrização e colagenizacao. Resultados: Permaneceram clinicamente bem durante o experimento. Durante a retirada do curativo houve sangramento na ferida do grupo controle, diferentemente dos grupos tratados com as membranas de celulose, que protegeram o leito da lesão. A análise microscópica mostrou que a maioria das feridas apresentava-se em grau avançado de cicatrização, com predomínio de colágeno maduro em todos os grupos. Houve maior contração das feridas tratadas com as membranas em relação ao grupo controle. Conclus ão: A membrana de celulose de Pinus sp apresentou eficácia semelhante à da membrana bacteriana no tratamento de queimaduras de 3˚ grau.

Análise das práticas assistenciais para prevenção das infecções primárias da corrente sanguínea / Análisis de las prácticas asistenciales para la prevención de las infecciones primarias de la circulación sanguínea / Analysis of healthcare practices for prevention of primary bloodstream infections

RESUMO Objetivo: analisar as práticas assistenciais no uso do cateter venoso central para a prevenção das Infecções Primárias da Corrente Sanguínea em uma Unidade de Terapia Intensiva. Método: estudo transversal realizado em um Hospital Universitário entre março e junho de 2018 com profissionais de uma Unidade de Terapia Intensiva. Utilizaram-se questionário estruturado e observação não participante dos procedimentos inserção, preparo e administração de medicação e troca de curativos de cateter central. Os dados foram analisados por meio da estatística descritiva com aplicação do Teste Qui-quadrado e exato de Fisher. Resultados: participaram 83 profissionais de enfermagem e 25 médicos. Foram observadas 260 administrações de medicações, 32 inserções de cateter e 29 trocas de curativos. Houve inadequação da prática de higienização das mãos nos procedimentos de manutenção, principalmente entre os técnicos de enfermagem. Os melhores resultados foram preparo da pele (94%), secagem espontânea do antisséptico antes das punções (96,87%) e respeito às trocas dos equipos de infusão contínua e intermitente (93,42%). Conclusão: o seguimento dasmedidas preventivas estava comprometido em oportunidades importantes para evitar Infecções Primárias da Corrente Sanguínea, sendo necessário reforçar a educação permanente e a implementação de protocolos assistenciais.

RESUMEN Objetivo: analizar las prácticas asistenciales en el uso del catéter venoso central para la prevención de las Infecciones Primarias de la Circulación Sanguínea en una Unidad de Cuidados Intensivos. Método: estudio transversal realizado en un Hospital Universitario entre marzo y junio de 2018 con profesionales de una Unidad de Cuidados Intensivos. Se utilizaron cuestionario estructurado y observación no participante de los procedimientos inserción, preparación y administración de medicación y cambio de vendajes de catéter central. Los datos fueron analizados por medio de la estadística descriptiva con aplicación delaPrueba Chi-cuadrado y exacta de Fisher. Resultados: participaron 83 profesionales de enfermería y 25 médicos. Se observaron 260 administraciones de medicamentos, 32 inserciones de catéter y 29 intercambios de vendajes. Hubo inadecuación de la práctica de higienización de las manos en los procedimientos de mantenimiento, principalmente entre los técnicos de enfermería. Los mejores resultados fueron preparación de la piel (94%), secado espontáneo del antiséptico antes de las punciones (96,87%) y respeto a los cambios de los equipos de infusión continua e intermitente (93,42%). Conclusión: el seguimiento de las medidas preventivas estaba comprometido en oportunidades importantes para evitar Infecciones Primarias de la Circulación Sanguínea, siendo necesario reforzar la educación permanente y la implementación de protocolos asistenciales.

ABSTRACT Objective: to analyze healthcare practices in the use of central venous catheters for the prevention of Primary Bloodstream Infections in an Intensive Care Unit. Method: cross-sectional study conducted in a University Hospital between March and June 2018 with professionals working in an Intensive Care Unit. A structured questionnaire and non-participant observation of the procedures related to insertion, preparation and administration of drugs and change of central catheter dressings were used. The data were analyzed using descriptive statistics and applying the Chi-square and Fisher's exact tests. Results: a total of 83 nursing professionals and 25 physicians participated. There were 260 drug administrations, 32 catheter insertions and 29 dressing changes. There was inadequacy of the hand hygiene practice in maintenance procedures, especially among nursing technicians. The best results were: skin preparation (94%), spontaneous drying of the antiseptic before punctures (96.87%) and respect for the changes of continuous and intermittent infusion sets (93.42%). Conclusion: the follow-up of preventive measures was undermined in important opportunities to avoid Primary Bloodstream Infections, being necessary to reinforce continuing education and implementation of healthcare protocols.

Biological and mechanical characterization of commercial and experimental periodontal surgical dressings

Abstract The objective of this study was to evaluate the biocompatibility and mechanical properties of two commercially available and one experimental periodontal dressing materials. The cytotoxicity of Periobond ® , Barricaid ® and one experimental periodontal dressing based on Exothane ® 8 monomer was tested on 3T3/NIH mouse fibroblast. Genotoxicity was assessed by micronuclei formation, and cell alterations were analyzed using light microscopy. Both biological assays were performed using the eluate obtained from specimens after 24, 72, or 168 hours of incubation. Mechanical characterization was assessed through the ultimate tensile strength and the water sorption and solubility tests. The significance level of α = 0.05 was used for all statistical analyses. All the materials promoted a cell viability lower than 60% in all evaluated times. In general, the cell viability was significantly reduced after 72 and 168h of specimens' incubation. Considering the factor material, there were not statistical differences in the cell viability (p = 0.156). The genotoxicity was not statistically significant among the groups in the different periods of time (p > 0.05). Differences in the ultimate tensile strength values were not statistically significant different among the groups (p = 0.125). Periobond ® showed the higher water sorption values (p < 0.001). Regarding solubility, there were no statistical differences between the groups (p = 0.098). All the periodontal dressing materials evaluated in this study exerted a cytotoxic effect against mouse fibroblasts, and their toxicity became more evident over time. Among the materials evaluated, the experimental light-cure type has shown overall similar properties to the commercial references.

National expert consensus on the clinical application of eschar dermabrasion in burn wounds (2021 version) / 中华烧伤杂志

As one of the three major debridement procedures in burn surgery, eschar dermabrasion is optimal to manage fresh deep partial-thickness burn wounds. Despite decades' application in clinic, considerable discrepancies exist in various units on the timing, instruments, procedures, selection of post-operative dressings, and patterns of post-operative dressing change, etc., leading to inconsistent clinical outcomes. After thorough review of relative literature, screening and analysis of high-level evidence articles and multiple in-depth discussions, the expert team of Chinese Burn Association has formed an instructional expert consensus, hoping to provide scientific and standardized guidance for application of eschar dermabrasion in burn wounds.

Determination of β-lactoglobulin in Anti-HPV Biological Protein Dressing by Amino Acid Assay / 中国医疗器械杂志

OBJECTIVE@#To establish an amino acid assay for the determination of β-lactoglobulin in Anti-HPV biological protein dressing.@*METHODS@#Under acidic conditions, β-lactoglobulin is hydrolyzed into free amino acids, separated by cation exchange chromatography, and derivatived after ninhydrin column. The chromatogram at 570 nm is collected. The content of β-lactoglobulin in the sample is indirectly determined by measuring the lysine content obtained by hydrolysis.@*RESULTS@#β-lactoglobulin has a good linear relationship in the concentration range of 77.28~309.12 μg/mL (@*CONCLUSIONS@#The method is simple, specific, accurate and reproducible, which is suitable for the quantitative analysis of β-lactoglobulin in anti-HPV biological protein dressing.

Point on Consideration of Products for Negative Pressure Wound Therapy Design and Evaluation / 中国医疗器械杂志

Negative pressure wound therapy has become an important technology in the global field of wound care, and the development of this technology is inseparable from the development and application of negative pressure wound care products. Based on the characteristics of the negative pressure wound therapy products, this paper discusses the key contents that should be considered in the design and evaluation of the negative pressure wound protection products from the aspects of physical and chemical properties, biocompatibility, intended use and risk warning information, in order to provide reference for the development and technical review of such products.

Gaze vaselinada para prevenção de lesões por pressão em pessoas com dermatoses imunobolhosas / Vaseline gauze for prevention of pressure injuries in people with immunobullous dermatoses / Gasa con vaselina para la prevención de lesiones por presión en personas con dermatosis inmunobulosa

Objetivo: avaliar a mobilidade do cliente com dermatose imunobolhosa antes e após aplicação do curativo com gaze vaselinada. Método: estudo quase experimental, interinstitucional, com clientes com dermatoses imunobolhosas hospitalizados em um hospital estadual e um hospital federal do Estado do Rio de Janeiro e uma instituição do Mato Grosso do Sul. Utilizou-se a lógica fuzzy para classificar a mobilidade dos sujeitos antes, 24 horas após e uma semana após aplicação do curativo. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa. Resultados: Incluídos 14 participantes, sendo nove com pênfigo vulgar, dois com pênfigo foliáceo e três com penfigóide bolhoso, entre 27 e 82 anos, predominando 11 mulheres. Após 24 horas, nenhum participante se considerou com baixa mobilidade, sete passaram a mobilidade média, e sete, alta, o que foi mantido uma semana após aplicação do curativo. Conclusão: constatou-se significativo aumento da mobilidade logo nas primeiras 24 horas após aplicação do curativo.

Objective: to assess the mobility of clients with immunobullous dermatoses, before and after applying vaseline gauze dressings. Method: in this quasi-experimental, interinstitutional study of inpatients with immunobullous dermatoses at a state hospital and a federal hospital in Rio de Janeiro State and an institution in Mato Grosso do Sul (Brazil), patient mobility before, 24 hours after, and one week after applying the dressing was classified using fuzzy logic. The study was approved by the research ethics committee. Results: 14 participants, nine with pemphigus vulgaris, two with pemphigus foliaceus, and three with bullous pemphigoid, aged between 27 and 82 years old, and predominantly (11) women. After 24 hours, none of the participants considered their mobility to be poor, seven began to be moderately mobile, and seven were highly mobile, and continued so one week after applying the dressing. Conclusion: mobility increased significant in the first 24 hours after applying the dressing.

Objetivo: evaluar la movilidad de clientes con dermatosis inmunobullosa, antes y después de la aplicación de apósitos de gasa con vaselina. Método: en este estudio cuasi-experimental, interinstitucional de pacientes hospitalizados con dermatosis inmunobullosa en un hospital estatal y un hospital federal en el estado de Río de Janeiro y una institución en Mato Grosso do Sul (Brazil), la movilidad del paciente antes, 24 horas después y una semana después la aplicación del apósito se clasificó mediante lógica difusa. El estudio fue aprobado por el comité de ética en investigación. Resultados: se incluyeron 14 participantes, nueve con pénfigo vulgar, dos con pénfigo foliáceo y tres con penfigoide ampolloso, con edades comprendidas entre 27 y 82 años, y predominantemente mujeres (n=11). Después de 24 horas, ninguno de los participantes consideró que su movilidad fuera pobre, siete comenzaron a ser moderadamente móviles y siete eran altamente móviles, y así continuaron una semana después de la aplicación del apósito. Conclusión: la movilidad aumentó significativamente en las primeras 24 horas después de la aplicación del apósitoconsideraba con baja movilidad, siete comenzaron a tener movilidad media y siete, alta, que se mantuvo una semana después de aplicar el apósito. Conclusión: hubo un aumento significativo en la movilidad en las primeras 24 horas después de aplicar el apósito.

Terapias aplicadas no tratamento das lesões por queimaduras de terceiro grau e extensão variável: revisão integrativa / Therapies applied in the treatment of injuries by burns of third degreeand variable extension: an integrative review

RESUMO: Lesões por queimaduras se apresentam como simples ou graves de acordo com sua profundidade, extensão e localização. Diversas terapias são lançadas no mercado, devendo prover um ambiente úmido, amplo aspecto antimicrobiano e serem efetivas, mesmo na presença de grande quantidade de exsudato, visando os benefícios que trarão para o processo de cicatrização. Neste sentido, este estudo objetivou revisar a literatura acerca da caracterização clínica e terapias aplicadas no tratamento das queimaduras de terceiro grau e de extensão variável. Para alcançar o objetivo proposto, foi realizada uma revisão integrativa da literatura nas bases de dados LILACS, BDENF e SciELO. Foram selecionados 17 artigos e os resultados apontaram que os curativos a base de prata são os mais utilizados, dentre eles, sulfadiazina de prata, prata nanocristalina e espuma absorvente. Para casos particulares mais complexos, a matriz de regeneração dérmica assume-se como uma alternativa eficaz e segura. A utilização da terapia por pressão negativa no tratamento da contratura cicatricial, muito presente nas lesões de terceiro grau, agrega como vantagem o fato de o paciente não precisar ficar imobilizado e imóvel após as cirurgias. Dentre as terapias inovadoras no tratamento de queimaduras, evidenciou-se o uso de enxerto da pele de tilápia, que foi citado por um estudo como um possível subproduto com alta aplicabilidade clínica. Ao longo do estudo foi possível concluir que os pacientes necessitam de uma assistência adequada desde os cuidados imediatos até o fim da reabilitação. Com o passar dos anos, inovações terapêuticas vêm sendo estudadas para serem implantadas no tratamento ao paciente queimado, entre elas a substituição de pele vem ganhando espaço pelos resultados positivos. (AU)

ABSTRACT: Burn injuries are classified as simple or severe according to their depth, extent, and location. Several therapies are commercially available, which should provide a humid skin, broad antimicrobial aspect and be effective, even if a large amount of exudate is present, aiming at benefiting the healing process. Therefore, this study aimed to review the literature on the clinical characterization and therapies applied in the treatment of third-degree burns and of variable extension. To reach the proposed objective, an integrative literature review was carried out in the LILACS, BDENF, and SciELO databases. Seventeen papers were selected, and the results showed that silver-based dressings are the most used, and among these, stand out: silver sulfadiazine, nanocrystalline silver, and an absorbent foam. For more complex cases, the dermal regeneration matrix is an effective and safe alternative. The use of negative pressure therapy in the treatment of scar contracture, present in third-degree injuries, has some advantage since the patient does not need to be immobilized and still after the surgeries. Among the innovative therapies in the treatment of burns, the use of tilapia skin graft was evidenced, which was mentioned by a study as a possible by-product with high clinical applicability. Throughout the study, it was possible to conclude that patients need adequate assistance, from immediate care, until the end of the rehabilitation. Over the years, therapeutic innovations have been studied to be implemented in the treatment of burned patients, including the replacement of skin, which has been highlighted due to the positive results. (AU)