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1.
Int J Mol Sci ; 22(21)2021 Oct 23.
Artículo en Inglés | MEDLINE | ID: mdl-34768868

RESUMEN

2-deoxy-D-Ribose (2dDR) was first identified in 1930 in the structure of DNA and discovered as a degradation product of it later when the enzyme thymidine phosphorylase breaks down thymidine into thymine. In 2017, our research group explored the development of wound dressings based on the delivery of this sugar to induce angiogenesis in chronic wounds. In this review, we will survey the small volume of conflicting literature on this and related sugars, some of which are reported to be anti-angiogenic. We review the evidence of 2dDR having the ability to stimulate a range of pro-angiogenic activities in vitro and in a chick pro-angiogenic bioassay and to stimulate new blood vessel formation and wound healing in normal and diabetic rat models. The biological actions of 2dDR were found to be 80 to 100% as effective as VEGF in addition to upregulating the production of VEGF. We then demonstrated the uptake and delivery of the sugar from a range of experimental and commercial dressings. In conclusion, its pro-angiogenic properties combined with its improved stability on storage compared to VEGF, its low cost, and ease of incorporation into a range of established wound dressings make 2dDR an attractive alternative to VEGF for wound dressing development.


Asunto(s)
Desoxirribosa/farmacología , Factores de Crecimiento Endotelial Vascular/metabolismo , Cicatrización de Heridas/efectos de los fármacos , Inductores de la Angiogénesis/química , Animales , Vendajes/tendencias , Fenómenos Fisiológicos Cardiovasculares/efectos de los fármacos , Desoxirribosa/metabolismo , Humanos , Morfogénesis/efectos de los fármacos , Neovascularización Fisiológica/efectos de los fármacos , Neovascularización Fisiológica/fisiología , Ribosa/metabolismo , Ribosa/farmacología , Factores de Crecimiento Endotelial Vascular/efectos de los fármacos
2.
Molecules ; 26(20)2021 Oct 11.
Artículo en Inglés | MEDLINE | ID: mdl-34684703

RESUMEN

Epigallocatechin gallate (EGCG) is associated with various health benefits. In this review, we searched current work about the effects of EGCG and its wound dressings on skin for wound healing. Hydrogels, nanoparticles, micro/nanofiber networks and microneedles are the major types of EGCG-containing wound dressings. The beneficial effects of EGCG and its wound dressings at different stages of skin wound healing (hemostasis, inflammation, proliferation and tissue remodeling) were summarized based on the underlying mechanisms of antioxidant, anti-inflammatory, antimicrobial, angiogenesis and antifibrotic properties. This review expatiates on the rationale of using EGCG to promote skin wound healing and prevent scar formation, which provides a future clinical application direction of EGCG.


Asunto(s)
Catequina/análogos & derivados , Cicatrización de Heridas/efectos de los fármacos , Animales , Antibacterianos/farmacología , Antiinfecciosos/farmacología , Antioxidantes/farmacología , Vendajes/tendencias , Catequina/metabolismo , Catequina/farmacología , Cicatriz/prevención & control , Humanos , Hidrogeles/farmacología , Piel/efectos de los fármacos , Piel/metabolismo , Té/metabolismo , Cicatrización de Heridas/fisiología
3.
J Wound Care ; 30(6): 482-490, 2021 Jun 02.
Artículo en Inglés | MEDLINE | ID: mdl-34121431

RESUMEN

OBJECTIVE: Hard-to-heal wounds, such as pressure ulcers and diabetic ulcers, are a major challenge for wound dressings. The aim of this study was to develop a bioactive dressing based on polymers and natural materials with unique biological and therapeutic properties. METHOD: The dressing was composed of an active layer containing polyvinyl alcohol (PVA), honey, curcumin and keratin, and an upper layer with lower hydrophilicity comprising PVA to induce flexibility. Physicochemical properties of the dressing were characterised by Fourier transform infrared spectroscopy, field emission scanning electron microscopy, swelling behaviour and antibacterial measurements. A wound healing study was performed using an experimental rat model and two different compositions of the bioactive dressing were compared with a commercial wound dressing (Comfeel, Coloplast, Denmark). Histopathological evaluation was conducted for this purpose. RESULTS: Characterisation results showed that a smooth bilayer film with two homogenous but distinct layers was produced. The dressing also provided adequate moisture to the wound environment without infection and adhesion due to dryness occurring. Our results exhibited significant bactericidal activity against Gram-negative (Escherichia coli) and Gram-positive (Staphylococcus aureus) bacteria and improved the wound healing process without any scarring. Histopathological findings demonstrated a significant higher healing rate in vivo together with well-formed epidermis, granulation tissue formation and tissue contraction, when compared with the commercial wound dressing. CONCLUSION: Our results demonstrated acceptable physical and healing effects for the novel bioactive wound dressing; however, more investigations are recommended.


Asunto(s)
Vendajes , Alcohol Polivinílico/uso terapéutico , Cicatrización de Heridas , Animales , Antibacterianos/uso terapéutico , Vendajes/tendencias , Ratas , Staphylococcus aureus
4.
Medicine (Baltimore) ; 100(7): e24876, 2021 Feb 19.
Artículo en Inglés | MEDLINE | ID: mdl-33607864

RESUMEN

BACKGROUND: Diabetic foot (DF) is one of the most common and serious chronic complications of diabetes. At present, there are many dressings used in the treatment of the diabetic foot. Among them, silver dressings are widely used, but the conclusion has not yet been formed. The purpose of this study is to search for relevant studies on the treatment of DF with silver dressings through evidence-based medicine methods and to draw conclusions with higher levels of evidence to provide a basis for the clinical treatment of DF. METHODS: Computer search of databases such as CNKI, SinoMed, VIP, Wanfang, PubMed, Embase, and Cochrane Library. The search time is from the establishment of the database to January 23, 2021. Two researchers will independently select studies, collect data, and assess the methodology quality by the Cochrane risk of bias tool. The meta-analysis will be completed by RevMan 5.3 software. RESULTS: This systematic review will provide an assessment of the current state of DF, aiming to assess the efficacy of silver dressings for patients with DF. CONCLUSION: This systematic review will provide a credible evidence-based for the clinical treatment of DF with silver dressings.


Asunto(s)
Vendajes/tendencias , Pie Diabético/terapia , Compuestos de Plata/uso terapéutico , Manejo de Datos , Medicina Basada en la Evidencia/métodos , Femenino , Humanos , Masculino , Ensayos Clínicos Controlados Aleatorios como Asunto , Resultado del Tratamiento , Cicatrización de Heridas/fisiología , Metaanálisis como Asunto
5.
Burns ; 47(1): 215-221, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-32739224

RESUMEN

BACKGROUND: One of the most important problems in burn patients was pain, especially in dressing changes. This pain can lead to anxiety in the patient. The aim of this study was to determine the effect of foot reflexology on pain and anxiety severity in burn patients. METHODS: This study was a randomized controlled trial, in which 66 patients with burn injuries referred to Vali-e-asr Hospital, Arak, Iran participated. After obtaining written consent, patients were enrolled to study according to inclusion criteria and then, divided into intervention (n = 33) and control (n = 33) groups using simple random allocation. In the intervention group, in addition to standard care, reflexology was performed for one week on Saturday, Monday and Wednesday (three times in a week). The intervention was done one hour before dressing change in a separate room for 30 min. The control group received only standard care during this time (both intervention and control groups were the same in the type of treatment, and reflexology was considered as an extra care in the intervention group). Severity of pain and anxiety in both groups was measured using visual analog scale twice a day (5-10 min before dressing change and 5-10 min after dressing change) for six days. SPSS software ver. 15 was used for statistical analysis. Mean and standard deviation were used for quantitative variables and qualitative variables were reported as frequency and percentage. Data were analyzed using Chi­square, Mann-Whitney, Fisher's exact tests, and paired t-test. The Kolmogorov-Smirnov test was used to check the normality of data. RESULTS: The results showed no significant difference in severity of pain (p = 0.25) and anxiety (p = 0.37) between the two groups on the first day, before the intervention. In the following days, the results showed no significant difference between the two groups in the second and third treatments after intervention . However, the mean pain scores showed a significant difference between the two groups in the forth (p = 0.005), fifth (p = 0.001), and sixth (p = 0.001) days after intervention. Anxiety scores also showed a significant difference between the two groups on the fourth (p = 0.01), fifth (p = 0.001), and sixth (p = 0.001) days. CONCLUSIONS: Our results showed foot reflexology is an appropriate and safe intervention for management of pain and anxiety of burn patients. Therefore, it can be used as a complementary method alongside other methods.


Asunto(s)
Ansiedad/terapia , Vendajes/efectos adversos , Quemaduras/terapia , Manipulaciones Musculoesqueléticas/normas , Manejo del Dolor/normas , Adulto , Ansiedad/psicología , Vendajes/tendencias , Quemaduras/complicaciones , Quemaduras/psicología , Distribución de Chi-Cuadrado , Femenino , Pie , Humanos , Irán , Masculino , Persona de Mediana Edad , Manipulaciones Musculoesqueléticas/métodos , Manipulaciones Musculoesqueléticas/psicología , Manejo del Dolor/métodos , Manejo del Dolor/estadística & datos numéricos , Dimensión del Dolor/métodos , Estadísticas no Paramétricas , Escala Visual Analógica
6.
Gerokomos (Madr., Ed. impr.) ; 31(3): 193-197, sept. 2020. graf, tab
Artículo en Español | IBECS | ID: ibc-197355

RESUMEN

OBJETIVOS: Analizar la efectividad, en términos de disminución de la incidencia de úlceras por presión (UPP), de las medidas y estrategias preventivas de UPP en neonatos hospitalizados. MÉTODO: La recuperación de estudios se realizó a través de tres bases de datos (Medline a través de PubMed, Scopus y Science Direct) y a partir de un experto. Solamente se incluyeron en esta revisión los estudios publicados del 2007 al 2017 en español o inglés, que de forma directa o indirecta valoraran la efectividad de una medida o estrategia preventiva de UPP en neonatos hospitalizados y que en cuanto al diseño fueran o estudios clínicos controlados o cuasiexperimentales. RESULTADOS: De 100 estudios recuperados se realizó el análisis de cinco; los demás fueron excluidos por no cumplir los criterios de elegibilidad. La mayoría de los estudios analizan la efectividad de una medida preventiva de UPP secundaria al tratamiento con ventilación mecánica no invasiva en neonatos prematuros. Todos ellos tienen limitaciones en la metodología que emplean, lo que hace que la evidencia de sus recomendaciones sea baja-moderada. CONCLUSIONES: Es necesaria la realización de estudios controlados aleatorios de mayor potencia para poder recomendar alguna medida o estrategia preventiva


Objetives: The main objective of this review was to examine the effectiveness, in terms of reducing the incidence of pressure ulcers (PU), of measures and preventive strategies of PU in hospitalized infants. METHOD: The recovery of studies was carried out through three databases (Medline through Pubmed, Scopus and Science Direct), and from an expert. Only studies published from 2007-2017 in Spanish or English were included in this review, which directly or indirectly appreciate the effectiveness of a measure or preventive strategy of PU in hospitalized neonates and that in terms of design were controlled or quasi-experimental trials. RESULTS: From 100 retrieved studies was conducted analysis of 5 studies, others were excluded for failing to meet the eligibility criteria. Most studies analyze the effectiveness of a preventive measure of secondary PU to treatment with Noninvasive mechanical ventilation in preterm infants. All of the studies have limitations in the methodology used, which makes the evidence of its recommendations to be low-moderate. CONCLUSIONS: Is necessary the realization of randomized controlled studies of higher power to be able to recommend any measure or preventive strategy


Asunto(s)
Humanos , Masculino , Femenino , Recién Nacido , Úlcera por Presión/prevención & control , Resultado del Tratamiento , Ventilación no Invasiva , Vendajes/tendencias , Sesgo , Evaluación de Resultados de Acciones Preventivas
7.
Burns ; 46(1): 207-212, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31787476

RESUMEN

BACKGROUND: Burn injuries are the third leading cause of preventable death in children worldwide, resulting in over 100 000 annual hospitalisations. In the paediatric population, scalds are the commonest mechanism and burn injuries of greater than 40% total burn surface area (TBSA) are associated with a high mortality and morbidity rate. AIMS: The aim of this study was to review mortality in paediatric burns in a tertiary burns centre over a 60-year period, providing an understanding of local causes of mortality and directing future clinical research. METHODS: We reviewed data collected prospectively from patients treated for burn injuries at the WCH from 1960 to 2017. Data of age, gender, mechanism of injury and TBSA were collected. TBSA of 40% and greater were included in the study. RESULTS: All patients with total burn surface area (TBSA) less than 40% survived. There were a total of 75 patients who sustained burns of or greater than 40% TBSA. Overall mortality was 34% (26 of 75) of which 24 occurred in the 1960s. Of the 21 patients who died of flame burn injuries, 12 of them were described as clothes catching alight from being in close proximity to the source of flame. Average length of stay for patients who did not survive was 7 days (1-26). CONCLUSION: Mortality has since declined and the prognosis for survival good, even in TBSA of greater than 90%. The investigations in fabric flammability led by Dr Thomas Pressley and Mr Murray Clarke prompted the rewriting of Australian standards for production of children's clothing. This, in combination with advances in paediatric resuscitation, surgical techniques as well as wound care has improved survival rates and outcomes in extensive burn injuries. Future studies focus to see not only better survival rates, but also better aesthetic and functional outcomes in burn survivors.


Asunto(s)
Vendajes/tendencias , Quemaduras/mortalidad , Vestuario , Seguridad de Productos para el Consumidor , Cuidados Críticos/tendencias , Trasplante de Piel/tendencias , Superficie Corporal , Quemaduras/epidemiología , Quemaduras/terapia , Niño , Preescolar , Femenino , Incendios , Humanos , Lactante , Recién Nacido , Tiempo de Internación/estadística & datos numéricos , Masculino , Mortalidad/tendencias , Pediatría/tendencias , Piel Artificial/tendencias , Australia del Sur/epidemiología , Textiles
8.
J Wound Ostomy Continence Nurs ; 46(4): 337-342, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31274868

RESUMEN

BACKGROUND: Repair of an enterocutaneous fistula (ECF) is challenging, particularly when complications occur. This case describes the use of negative pressure wound therapy (NPWT) and microadhesive dressings with polyabsorbent fibers and an acrylic core, with and without lipidocolloid and nano-oligosaccharide factors, in the management of a patient with a large abdominal wound and ECF. CASE: An 84-year-old woman underwent abdominoperineal resection with colostomy, hysterectomy, and subsequent chemotherapy and radiotherapy for colorectal cancer. She experienced complications, ultimately resulting in ECF of the jejunum. Initial management with NPWT was used to promote abdominal wound healing, while protecting exposed bowel loops proved challenging because of leakage of stoma effluent that impeded the formation of granulation tissue. In order to promote wound healing and prevent infection, we applied a microadhesive dressing composed of polyabsorbent fibers with an acrylic core and lipidocolloid and nano-oligosaccharide factors that facilitated autolytic debridement and healing. CONCLUSIONS: Use of NPWT with the microadhesive dressing proved successful in the management of this complex and challenging ECF.


Asunto(s)
Pared Abdominal/cirugía , Fístula Intestinal/cirugía , Pared Abdominal/anomalías , Pared Abdominal/fisiopatología , Técnicas de Cierre de Herida Abdominal , Anciano de 80 o más Años , Vendajes/efectos adversos , Vendajes/tendencias , Neoplasias Colorrectales/complicaciones , Neoplasias Colorrectales/cirugía , Femenino , Humanos , Fístula Intestinal/fisiopatología , Terapia de Presión Negativa para Heridas/métodos , Cicatrización de Heridas/efectos de los fármacos , Cicatrización de Heridas/fisiología
9.
J Wound Ostomy Continence Nurs ; 46(4): 343-345, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31276452

RESUMEN

BACKGROUND: Aplasia cutis congenita (ACC) is an uncommon, heterogeneous group of disorders characterized by focal or widespread absence of skin from certain parts of the body. Complications range from 20% to 50%; they are potentially life-threatening. There is no consensus on best treatment of ACC. We report on successful closure of aplasia cutis lesions using topical active Leptospermum honey (ALH). CASES: This article describes a case of a full-term neonate with a large ACC lesion. A conservative approach was taken in the care of this lesion, in accordance with appropriate wound care principles and the care of this medically fragile neonate. This included applying topical ALH twice a day and covering defects with a secure dressing. All lesions progressed to complete closure. Time to closure was either similar or shorter than published data. CONCLUSIONS: Our experience with these cases suggests that topical ALH may be an effective natural treatment option for neonates with ACC. This conservative management led to wound closure without topical or systemic antibiotics or prolonged hospital stay.


Asunto(s)
Vendajes/tendencias , Displasia Ectodérmica/tratamiento farmacológico , Miel , Leptospermum , Tratamiento Conservador/métodos , Displasia Ectodérmica/fisiopatología , Humanos , Recién Nacido , Masculino , Resultado del Tratamiento
10.
BMJ ; 364: k4411, 2019 03 13.
Artículo en Inglés | MEDLINE | ID: mdl-30867157

RESUMEN

The studyEffect of negative pressure wound therapy vs standard wound management on 12-month disability among adults with severe open fracture of the lower limb: the WOLLF randomised clinical trial.Costa ML, Achten J, Bruce J, et al; UK WOLLF CollaborationPublished on 9 October 2018 JAMA 2018;319:2280-8.This project was funded by the National Institute for Health Research Health Technology Assessment Programme (project number 10/57/20).To read the full NIHR Signal, go to: https://discover.dc.nihr.ac.uk/content/signal-000655/negative-pressure-dressings-are-no-better-than-standard-dressings-for-open-fractures.


Asunto(s)
Vendajes/tendencias , Fracturas Abiertas/terapia , Extremidad Inferior/lesiones , Terapia de Presión Negativa para Heridas/métodos , Vendajes/normas , Evaluación de la Discapacidad , Personas con Discapacidad/psicología , Personas con Discapacidad/estadística & datos numéricos , Fracturas Abiertas/complicaciones , Fracturas Abiertas/microbiología , Fracturas Abiertas/cirugía , Humanos , Extremidad Inferior/patología , Terapia de Presión Negativa para Heridas/instrumentación , Terapia de Presión Negativa para Heridas/normas , Calidad de Vida , Evaluación de la Tecnología Biomédica , Heridas y Lesiones/epidemiología , Heridas y Lesiones/patología , Heridas y Lesiones/terapia
12.
Skin Res Technol ; 25(4): 461-468, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-30623998

RESUMEN

BACKGROUND: Nipple pain is the second most common reason for early weaning, exceeded only by the insufficient milk supply. Nipple fissures can bring other problems, acting also as a portal for bacteria and leading to mastitis. This work proposes the breast protector composite development using materials with tissue repair and moisturizing properties, aligned with a low-cost procedure, aiming not only to relieve pain, but also to heal the nipple fissures caused by breastfeeding. MATERIALS AND METHODS: For the dressings, production was used Natural Latex extracted from the rubber tree and glycerol. The Samples were evaluated chemically and physically by the techniques of Scanning Electron Microscopy, Fourier transform infrared spectroscopy, mechanical traction, and contact angle. The samples were also biologically evaluated by the hemolytic and cytotoxic activity assays. RESULTS: From the physical-chemical assays, the matrix with glycerol has high pore density; the natural latex and glycerol do not covalently interact, indicating that the glycerol can be released; the glycerol addition makes the matrix more elastic but fragile, and increase the wettability. From the biological assays, both materials showed no hemolytic effects; and the cytotoxicity results showed that glycerol did not present cytotoxicity in the fibroblasts, but show a dose-dependent influence in the keratinocytes. CONCLUSION: The material developed for application in breast fissures has mechanical properties similar to those found for materials for dermal applications, present high wettability and pore density. Furthermore, the material showed no cytolytic activity and the tests with skin cell cultures demonstrated the biocompatibility.


Asunto(s)
Vendajes/tendencias , Lactancia Materna/efectos adversos , Pezones/patología , Dolor/prevención & control , Vendajes/normas , Materiales Biocompatibles/química , Crioprotectores/administración & dosificación , Crioprotectores/química , Femenino , Glicerol/administración & dosificación , Glicerol/química , Humanos , Látex/química , Ensayo de Materiales/métodos , Microscopía Electrónica de Rastreo , Pezones/efectos de los fármacos , Piel/efectos de los fármacos , Piel/patología , Espectroscopía Infrarroja por Transformada de Fourier , Cicatrización de Heridas/efectos de los fármacos
13.
Int J Biol Macromol ; 124: 138-147, 2019 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-30447365

RESUMEN

High mortality rate in potentially survivable casualties due to severe hemorrhage is a major challenge in today's battlefield because technological advancements have revolutionized the combat tactics and complicated the type and severity associated with wound grades. Quality of pre-hospital care prior to patient evacuation is crucial in determining the survival rate in injured patients. To deal with this challenge, considerable improvements in the hemostatic dressings have been introduced and pre-hospital care has been upgraded in many tactical combat casually care guidelines. Combat Gauze has been widely used bandage which is now been replaced by different chitosan based hemostatic dressings. It not only exhibits anti-bacterial activity but also induces hemostasis via direct interaction with erythrocytes and platelets. Its hemostasis mechanism is not dependent on host coagulation pathway which makes it an ideal dressing to stop bleeding in coagulopathic patients. Different generations of chitosan bandages have been developed to overcome the limitations of previous ones. This review provides performance analysis of chitosan bandage generations and discusses the progress made in its fabrication methods during the recent years.


Asunto(s)
Vendajes/tendencias , Quitosano/química , Hemorragia/prevención & control , Técnicas Hemostáticas/instrumentación , Coagulación Sanguínea/efectos de los fármacos , Quitosano/uso terapéutico , Hemorragia/patología , Hemostasis/efectos de los fármacos , Hemostáticos , Humanos , Medicina Militar/tendencias
15.
Trends Biotechnol ; 36(12): 1259-1274, 2018 12.
Artículo en Inglés | MEDLINE | ID: mdl-30197225

RESUMEN

Chronic non-healing wounds are major healthcare challenges that affect a noticeable number of people; they exert a severe financial burden and are the leading cause of limb amputation. Although chronic wounds are locked in a persisting inflamed state, they are dynamic and proper therapy requires identifying abnormalities, administering proper drugs and growth factors, and modulating the conditions of the environment. In this review article, we discuss technologies that have been developed to actively monitor the wound environment. We also highlight drug delivery tools that have been integrated with bandages to facilitate precise temporal and spatial control over drug release and review automated or semi-automated systems that can respond to the wound environment.


Asunto(s)
Vendajes/tendencias , Sistemas de Liberación de Medicamentos/métodos , Heridas y Lesiones/terapia , Enfermedad Crónica , Humanos , Cicatrización de Heridas
16.
J Trauma Acute Care Surg ; 85(3): 485-490, 2018 09.
Artículo en Inglés | MEDLINE | ID: mdl-29851903

RESUMEN

BACKGROUND: The use of kaolin-coated dressings has become common and have efficacy in normal patients, but their increased use will inevitably include use on bleeding patients taking anticoagulants. We hypothesize that kaolin coating material (KCM) will improve clotting regardless of anticoagulation medication. METHODS: A prospective study was performed on blood from patients who were on a vitamin K antagonist (VKA), unfractionated heparin (UH), an antiplatelet (AP) agent, a Xa inhibitor (Xa), or a direct thrombin inhibitor (DTI). None were on more than one type of anticoagulation medication. Viscoelastic testing was performed with and without KCM. All p values were adjusted for multiple comparisons. RESULTS: The addition of KCM significantly decreased the time for initial clot formation (CT) in all groups. The mean CT for controls was decreased from 692 to 190.8 s (p < 0.0001). KCM decreased the initial clot formation time by about 1.5 times in those on DTI (p = 0.043) and 2.5 times in those taking AP medication (p < 0.001). The most profound effect was seen in those on UH (no KCM 1,602 s vs. KCM 440 s; p < 0.001), VKA (no KCM 1,152 s vs. 232 s; p < 0.01), and Xa (no KCM 1,342 s vs. 287 s; p < 0.001). Analysis of other clot formation parameters revealed that KCM significantly improved the clot formation kinetics (CFT) only in patients taking Xa (p = 0.03). KCM improved maximum clot strength in patients on Xa inhibitors (p = 0.05). Patients on UH had a larger effect size with an increase in clot strength from 24.35 mm to 43.35 mm whereas those on Xa had an increase of 38.7 mm to 49.85 mm. CONCLUSION: In this in vitro analysis, the addition of KCM to the blood of patients taking any of these anticoagulation medications significantly improved the time to initial clot formation, indicating that kaolin-based hemostatic dressings will be effective in initiating clot formation in patients on anticoagulants. LEVEL OF EVIDENCE: Therapeutic, level IV.


Asunto(s)
Coagulación Sanguínea/efectos de los fármacos , Hemostáticos/uso terapéutico , Caolín/farmacología , Vitamina K/antagonistas & inhibidores , Adulto , Anticoagulantes/administración & dosificación , Anticoagulantes/uso terapéutico , Antitrombinas/sangre , Arginina/análogos & derivados , Vendajes/tendencias , Pruebas de Coagulación Sanguínea/métodos , Dabigatrán/administración & dosificación , Dabigatrán/uso terapéutico , Inhibidores del Factor Xa/sangre , Heparina/sangre , Humanos , Caolín/efectos adversos , Ácidos Pipecólicos/administración & dosificación , Ácidos Pipecólicos/uso terapéutico , Inhibidores de Agregación Plaquetaria/sangre , Estudios Prospectivos , Rivaroxabán/administración & dosificación , Rivaroxabán/uso terapéutico , Sulfonamidas , Sustancias Viscoelásticas/química , Vitamina K/sangre
18.
Dtsch Arztebl Int ; 115(13): 213-219, 2018 03 30.
Artículo en Inglés | MEDLINE | ID: mdl-29669676

RESUMEN

BACKGROUND: Lower-limb endoprosthetic operations and spinal operations are among the more common types of orthopedic procedures. Postoperative woundhealing disturbances and infections can lead to longer periods of hospital stay and recovery as well as to higher morbidity and mortality. METHODS: 209 patients who had been judged to have an indication for a primary knee or hip endoprosthesis or for a primary spinal operation were included in this randomized trial (ClinicalTrials.gov: NCT01988818) over the period June 2014- February 2015. After randomization, patients in the intervention group were given a trial dressing (Mepilex-Border Post-Op) and those in the control group were given a conventional adhesive dressing (Cosmopor). The primary endpoint was blister formation. RESULTS: In the overall study population, only a single case of blister formation was seen. The affected patient belonged to the intervention group but was mistakenly given a control dressing and developed blisters on the 6th day after surgery. Dressings were changed less frequently in the intervention group, and this difference was statistically significant (p<0.001). The patients, nurses, and physicians all expressed greater satisfaction with the trial dressings than with the control dressings (p<0.001). CONCLUSION: The intervention group did not differ from the control group with respect to the primary endpoint, postoperative blister formation. The patients, nurses, and physicians all judged the dressing used in the intervention group more favorably than the conventional dressing.


Asunto(s)
Almohadillas Absorbentes/normas , Vendajes/normas , Cicatrización de Heridas/fisiología , Adulto , Anciano , Anciano de 80 o más Años , Artroplastia de Reemplazo de Cadera/efectos adversos , Artroplastia de Reemplazo de Cadera/métodos , Artroplastia de Reemplazo de Rodilla/efectos adversos , Artroplastia de Reemplazo de Rodilla/métodos , Vendajes/tendencias , Vesícula/etiología , Vesícula/prevención & control , Femenino , Humanos , Masculino , Persona de Mediana Edad
19.
Crit Rev Ther Drug Carrier Syst ; 34(5): 387-452, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-29256838

RESUMEN

Chronic wounds which include diabetic foot ulcer (DFU), pressure ulcer, and arterial or venous ulcers compel a significant burden to the patients, healthcare providers, and the healthcare system. Chronic wounds are characterized by an excessive persistent inflammatory phase, prolonged infection, and the failure of defense cells to respond to environmental stimuli. Unlike acute wounds, chronic nonhealing wounds pose a substantial challenge to conventional wound dressings, and the development of novel and advanced wound healing modalities is needed. Toward this end, numerous conventional wound-healing modalities have been evaluated in the management of nonhealing wounds, but a multifaceted approach is lacking. Therefore, this review aims to compile and explore the wide therapeutic algorithm of current and advanced wound healing approaches to the treatment of chronic wounds. The algorithm of chronic wound healing techniques includes conventional wound dressings; approaches based on autografts, allografts, and cultured epithelial autografts; and recent modalities based on natural, modified or synthetic polymers and biomaterials, processed mutually in the form of hydrogels, films, hydrocolloids, and foams. Moreover, this review also explores the promising potential of advanced drug delivery systems for the sustained delivery of growth factors, curcumin, aloe vera, hyaluronic acid, and other bioactive substances as well as stem cell therapy. The current review summarizes the convincing evidence for the clinical dominance of polymer-based chronic wound healing modalities as well as the latest and innovative therapeutic strategies for the treatment of chronic wounds.


Asunto(s)
Pie Diabético/terapia , Sistemas de Liberación de Medicamentos/métodos , Úlcera por Presión/terapia , Úlcera Varicosa/terapia , Cicatrización de Heridas/efectos de los fármacos , Algoritmos , Animales , Vendajes/tendencias , Pie Diabético/tratamiento farmacológico , Sistemas de Liberación de Medicamentos/tendencias , Humanos , Polímeros/administración & dosificación , Úlcera por Presión/tratamiento farmacológico , Úlcera Varicosa/tratamiento farmacológico
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