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1.
Estima (Online) ; 19(1): e1221, jan.-dez. 2021.
Artigo em Português | BDENF - Enfermagem | ID: biblio-1291466

RESUMO

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.


Assuntos
Bandagens , Cicatrização , Pesquisa Básica
2.
Wounds ; 33(10): 245-252, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34735361

RESUMO

INTRODUCTION: For persons with diabetes, surgery is fraught with complications; of primary concern is postoperative infection. A postoperative infection rate of up to 13% has been noted in patients with diabetes undergoing elective surgical procedures compared with less than 3% in nondiabetic populations. OBJECTIVE: The objective of this study was to provide preliminary evaluation of the efficacy of a novel bioresorbable microfilm matrix (20 µm thick) containing very low amounts of silver (0.16 mg/in²) in preventing surgical site infections when placed at the level of subcutaneous tissue and dermis prior to primary closure in the patient with diabetes undergoing elective surgery. MATERIALS AND METHODS: Twenty-two patients with diabetes undergoing nonemergent or elective foot or ankle surgery and who met at least 1 of the following 6 criteria were included in the study: neuropathy, infection, open wound, history of recurrent infection, nonhealing wound, or peripheral vascular disease. Patients underwent amputation, removal of exostosis, midfoot bone removal, Achilles tendon repair, bunionectomy, or an elevating osteotomy with primary closure of the wound. After hemostasis was obtained and subcutaneous closure achieved, if applicable, the bioresorbable microfilm matrix was applied just deep to the incision at the level of subcutaneous tissue and dermis, and the incision primarily closed. A nonadherent cover dressing was applied over the suture line, and routine follow-up was scheduled for 3 to 5 days later. RESULTS: No patient exhibited signs of infection at initial follow-up, and all adherent patients achieved complete healing during the 3-month follow-up period. Eighteen patients healed at a rate typical for the respective procedure. In 2 patients, time to healing was delayed secondary to weight-bearing dehiscence. Two patients were not included in the results secondary to multiple infractions of nonadherence with the postoperative protocol. CONCLUSIONS: The application of microfilm matrix in surgical incisions at the level of subcutaneous tissue and dermis prior to primary closure is safe for and has the potential to prevent postoperative surgical site infections in at-risk patients with diabetes..


Assuntos
Ferida Cirúrgica , Implantes Absorvíveis , Bandagens , Humanos , Prata , Infecção da Ferida Cirúrgica/prevenção & controle
3.
Wounds ; 33(10): 253-259, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34735362

RESUMO

INTRODUCTION: Topical antimicrobial treatment of wounds in pediatric, and especially neonatal, patients can be challenging due to increased systemic absorption, damaging inflammatory cytokines, and oxygen radicals released by bacterial death. A product combining all wound bed preparation principles is desired. Methylene blue and gentian violet (MB/GV) foam dressings can keep wound beds moist, decrease ongoing inflammation, provide antibacterial coverage, and promote healthy wound edges. OBJECTIVE: This article examines the use of MB/GV antibacterial foams in pediatric patients. Cases included infants with giant omphalocele epidermal stripping, dehisced abdominal wounds, peristomal dermatitis, and peripheral intravenous extravasations and adolescents with stage 4 pressure injuries. The treatment goals were to optimize the wound bed through debridement, elimination of bioburden, providing moisture balance, and enhancement of granulation tissue growth. MATERIALS AND METHODS: Eight patients (6 infants and 2 adolescents) received MB/GV foam dressings every 2 to 3 days along with standard of care (SOC) management. RESULTS: Effective debridement, bioburden elimination, moisture balance, and edge enhancement were achieved in all wounds. All wound beds were well-prepared to receive other SOC products as needed. Three cases were considered for negative pressure wound therapy (NPWT), but NPWT was not used because of challenging clinical characteristics and wound locations. Instead, MB/GV polyvinyl alcohol foam provided capillary wicking action that enhanced wound closure without NPWT. No side effects were observed. CONCLUSIONS: Methylene blue and gentian violet foam dressings appear to be a safe clinical option for antibacterial coverage, moisture management, and debridement in neonatal and pediatric patients.


Assuntos
Tratamento de Ferimentos com Pressão Negativa , Ferimentos e Lesões , Adolescente , Bandagens , Criança , Violeta Genciana , Humanos , Azul de Metileno , Resultado do Tratamento , Cicatrização
4.
Wounds ; 33(10): 260-262, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34735363

RESUMO

Surgical site infection (SSI) incidence is affected by 3 types of interacting factors: the infecting organisms (eg, number, type, virulence), the local wound environment (eg, foreign matter, aseptic technique, wound dressings), and systemic host defenses (eg, smoking, obesity, diabetes). Cancer or related chemotherapy and other aspects of cancer care may affect host defenses, as evidenced by increased SSI risk following "clean" surgery to remove breast cancer tissue compared with similar "clean" surgeries in patients who do not have cancer. If patient risk factors for development of an SSI are strictly controlled in individuals undergoing breast cancer surgery, the likelihood of the development of an SSI drops sharply, creating the illusion that preoperative antibiotics are not needed. This Evidence Corner, which includes 2 studies, clarifies evidence supporting the use of recognized preoperative antibiotic administration to support host defenses in patients undergoing breast cancer surgery. In the first study, the controversy about wound dressings following cancer surgery is also explored. Some surgeons question whether routine use of gauze dressings promotes the ideal local wound environment after surgical excision of cancerous tissue. Disintegrating gauze strands can act as foreign bodies in wounds, and gauze dressings have been reported to increase SSI incidence in clean surgical wounds. The second study compared healing and SSI incidence of Mohs surgical excisions dressed with either an antibiotic-free, film-forming silicone wound dressing or a triple antibiotic primary dressing following Mohs micrographic or non-Mohs dermatologic surgery. The surprising results reinforce the importance of the local wound environment as a key factor in minimizing SSI in oncologic surgery.


Assuntos
Neoplasias , Infecção da Ferida Cirúrgica , Antibacterianos/uso terapêutico , Bandagens , Humanos , Mastectomia , Neoplasias/cirurgia , Infecção da Ferida Cirúrgica/epidemiologia , Infecção da Ferida Cirúrgica/etiologia , Cicatrização
5.
Trials ; 22(1): 797, 2021 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-34774091

RESUMO

BACKGROUND: Pressure dressings have been used after open hemorrhoidectomy to protect surgical wounds and manage postoperative bleeding for many years. However, pressure dressings may increase the incidence of postoperative complications, such as urinary retention, medical adhesive-related skin injury, and pain. A previous controlled trial included 67 patients who underwent Milligan-Morgan hemorrhoidectomy. The data indicated that the use of a nonpressure dressing after hemorrhoidectomy reduces the incidence of urinary retention and catheterization. However, the incidence of severe postoperative bleeding and other postoperative complications was not assessed. There is no consensus on whether it is necessary and beneficial to use a nonpressure dressing after hemorrhoidectomy. The results of this randomized clinical study will help answer this question. METHODS: In this study, we plan to include 186 patients who have undergone modified Milligan-Morgan hemorrhoidectomy, which only sutured external hemorrhoids to reduce the risk of bleeding. The purpose is to determine whether the use of nonpressure dressings after open hemorrhoidectomy is inferior to the use of pressure dressings in terms of severe postoperative bleeding and postoperative complications. The primary endpoints of the trial are the incidence of urinary retention within 24 h after surgery and the incidence of severe postoperative bleeding 1 h after dressing removal, which requires revision surgery within 24 h after the surgery. The secondary endpoints of the study are the pain score, anal distension score, postoperative use of analgesics, and incidence of medical adhesive-related skin injury, all of which will be assessed before removing the dressings. The length of hospitalization in days and hospitalization expenses will be recorded. Safety will be assessed with consideration of all adverse and severe adverse events related to the study treatment. DISCUSSION: The study received full ethics committee approval. The first patient was enrolled on 27 November 2020. The results of this trial will finally answer the question of whether a nonpressure dressing after open hemorrhoidectomy is necessary and beneficial. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2000040283 . Registered on 28 November 2020.


Assuntos
Hemorroidectomia , Hemorroidas , Bandagens , Hemorroidectomia/efeitos adversos , Hemorroidas/diagnóstico , Hemorroidas/cirurgia , Humanos , Dor Pós-Operatória/diagnóstico , Dor Pós-Operatória/etiologia , Dor Pós-Operatória/prevenção & controle , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Hemorragia Pós-Operatória , Ensaios Clínicos Controlados Aleatórios como Assunto
6.
Br J Community Nurs ; 26(11): 526-531, 2021 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-34731040

RESUMO

Although dignity has been widely explored in the context of healthcare, it has rarely been the subject of empirical exploration when care is delivered by community district nursing teams. This paper demonstrates how a commonplace community nursing task (changing dressings) can constitute a clinical lens through which to explore the ways in which community nurses can influence patients' dignity. This ethnographic study involved two research methods: interviews with patients and nurses (n=22) and observations of clinical interactions (n=62). Dignity can manifest during routine interactions between community nurses and patients. Patient-participants identified malodour from their ill-bodies as a particular threat to dignity. Nurses can reinforce the dignity of their patients through relational aspects of care and the successful concealment of 'leaky' bodies.


Assuntos
Comunicação , Enfermagem em Saúde Comunitária/métodos , Relações Enfermeiro-Paciente , Enfermeiros de Saúde Comunitária/psicologia , Pacientes/psicologia , Pessoalidade , Respeito , Antropologia Cultural , Atitude do Pessoal de Saúde , Bandagens , Humanos , Entrevistas como Assunto , Pesquisa Qualitativa , População Urbana
7.
Zhonghua Shao Shang Za Zhi ; 37(11): 1090-1098, 2021 Nov 20.
Artigo em Chinês | MEDLINE | ID: mdl-34794262

RESUMO

Diabetes can lead to a variety of complications, such as chronic wound (diabetic foot), which is one of the important causes of death for patients with diabetes. Unfavorable factors such as high blood glucose, high level of oxidative stress and inflammation, and susceptibility to infection lead to difficult healing and even worsening of diabetic chronic wounds. Due to the advantages of high water content, good biocompatibility, and tunable physicochemical properties, the hydrogels have become hot-spot materials in wound dressing research. Compared with the traditional dressings such as gauze, the hydrogel dressings can provide a moist environment that is beneficial for wound healing. By loading of bioactive components and modulation of compositions and structures of hydrogels, the hydrogel dressings can be endowed with excellent tissue adhesion, antibacterial ability, anti-oxidation, and inflammation regulation effect, etc., and thus show great prospects in wound dressing applications. Based on the characteristics of hydrogel materials and microenvironment of diabetic chronic wound, this review summarized the research advances on new multifunctional hydrogel dressings for the treatment of diabetic chronic wounds in recent years, and discussed the drawbacks of current hydrogel dressings with prospects proposed.


Assuntos
Anti-Infecciosos , Diabetes Mellitus , Pé Diabético , Bandagens , Pé Diabético/terapia , Humanos , Hidrogéis , Cicatrização
8.
Zhonghua Shao Shang Za Zhi ; 37(11): 1085-1089, 2021 Nov 20.
Artigo em Chinês | MEDLINE | ID: mdl-34794261

RESUMO

Objective: To investigate the clinical effect of applying hydrogel dressings in deep partial-thickness burn wounds after dermabrasion and tangential excision. Methods: A prospective randomized controlled study was conducted. From November 2015 to August 2019, 168 patients with deep partial-thickness burns hospitalized in Zibo Sixth People's Hospital met the inclusion criteria. According to the random number table, the patients were divided into hydrogel dressing+vaseline gauze group (84 cases, 67 males and 17 females) and vaseline gauze only group (84 cases, 65 males and 19 females) who were aged (31±16) and (35±17) years, respectively, and were given corresponding treatment after dermabrasion and tangential excision. The dressings were changed every 3-5 days. Autologous skin grafting was performed with split-thickness or medium-thickness skin grafts taken from trunk or thigh if the wounds failed to heal over 21 days or the wounds were less than 21 days but located in the joints, which might affect the functional activities at later stage. After operation, the general condition of the wounds was observed continuously and dynamically till the wounds were healed. The degree of dressing adhesion was evaluated during the first 4 dressing changes after operation, and the degree of pain was evaluated using Numerical Rating Scale (NRS). The wound healing rate on post operation day (POD) 3, 6, and 15 was calculated. The positive proportion of bacterial culture of wound exudates/cleanout fluid on admission and at dressing change on POD 3, 6, and 15 was calculated. The number of dressing changes were recorded, the rate of skin grafting operation was calculated, and the time of complete wound healing was recorded. Vancouver Scar Scale (VSS) was used in 6 months of follow-up to evaluate the hyperplasia of scar. Data were statistically analyzed with analysis of variance for repeated measurement, independent sample t test, Mann-Whitney U test, chi-square test or Fisher's exact probability test, and Bonferroni correction. Results: During the observation period after operation, the wound was moist with less exudates and the wound healed much faster in patients of hydrogel dressing+vaseline gauze group, with the inner dressing being easier to remove with mild pain, while the wounds showed more exudates and slower healing in patients of vaseline gauze only group with the obvious adhesions of inner dressing, stronger pain, and bleeding in the wounds. Compared with those in vaseline gauze only group, the degree of dressing adhesion and pain NRS score of patients in hydrogel dressing+vaseline gauze group decreased significantly during the first 4 dressing changes after operation (χ2=52.625, Z=-10.854, P<0.01), the wound healing rate increased significantly at dressing change on POD 3, 6, and 15 (t=10.347, 41.150, 167.627, P<0.01), the positive proportion of wound exudates/cleanout fluid bacterial culture did not change significantly on admission or at dressing change on POD 3 (P>0.05) but decreased significantly at dressing change on POD 6 and 15 (χ2=15.616, 15.226, P<0.01), the dressing change times was significantly reduced (t=-11.986, P<0.01), and the rate of skin grafting operation was significantly decreased (χ2=35.850, P<0.01). The complete wound healing time of patients in hydrogel dressing+vaseline gauze group was (17.6±2.8) d, significantly shorter than (27.1±3.0) d in vaseline gauze only group (t=-21.288, P<0.01). During the follow-up of 6 months, the VSS score of scar hyperplasia of patients in hydrogel dressing+vaseline gauze group was significantly lower than that in vaseline gauze only group (Z=-11.287, P<0.01). Conclusions: Compared with the use of vaseline gauze only, the application of vaseline gauze coated with hydrogel dressing in deep partial-thickness burn wounds after dermabrasion and tangential excision is more effective in moisturizing, significantly reducing the degree of dressing adhesion and patients' pain during dressing change, increasing wound healing rate, decreasing wound infection rate and the rate of skin grafting operation, and reducing the number of dressing changes. It shortens the time for complete wound healing, and effectively relieves scar hyperplasia.


Assuntos
Queimaduras , Hidrogéis , Bandagens , Queimaduras/cirurgia , Dermabrasão , Feminino , Humanos , Masculino , Estudos Prospectivos , Transplante de Pele
9.
Ann Palliat Med ; 10(10): 11156-11165, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34763475

RESUMO

BACKGROUND: High anal fistula (HAF) is a refractory infectious disease. Surgery is the most effective way to treat HAF. Dressing change is an indispensable part of the rehabilitation process after surgery. The purpose of this study is to provide feasibility and evidence of safety for the implementation of a simplified dressing change after loose combined cutting seton (LCCS) surgery and to offer a better method for clinical treatment and postoperative rehabilitation of HAF. METHODS: In this single-blind randomized controlled trial, 76 patients diagnosed with HAF will be randomly divided into two groups: the simplified dressing change group (n=38) or the traditional debridement and dressing change group (n=38). Compared with traditional debridement and dressing change, simplified dressing change was conducted without mechanical debridement and disinfection. All patients were treated surgically with the LCCS and dressing change. Postoperative follow-up will be carried out on the 3rd, 7th, 14th, 21st, and 180th day after the operation. The primary outcomes will be: complete healing rate of wound and fistula, long-term recurrence rate, poor wound healing rate, and complete wound healing time. The following secondary outcomes will be evaluated: postoperative pain using a visual analogue scale (VAS) score, wound secretions, edema, granulation shape, depth of wound, duration of each dressing change, and incidence of adverse events. DISCUSSION: Dressing change after HAF surgery is a necessary stage of recovery after anorectal surgery. Effective dressing change can reduce false healing and increase the cure rate. However, traditional dressing change takes a long time, and the patient endures severe pain. We have found that the dressing change process can be simplified in the clinic for patients treated with LCCS. In particular, simplification of the dressing change process may be related to the unobstructed drainage provided by the combination of LCCS and the separation of the dotted line. We will treat HAF using LCCS and compare the simplified dressing change method after the operation with traditional routine debridement and dressing change to demonstrate whether the simplified dressing change can be used in patients with HAF treated with LCCS. TRIAL REGISTRATION: ChiCTR2100047312.


Assuntos
Recidiva Local de Neoplasia , Fístula Retal , Bandagens , Humanos , Estudos Prospectivos , Fístula Retal/cirurgia , Método Simples-Cego , Resultado do Tratamento
10.
Br J Hosp Med (Lond) ; 82(11): 1-12, 2021 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-34817253

RESUMO

There is a vast number of wound dressings to choose from, which can make selecting the most suitable dressing for a wound a daunting prospect. This article highlights how the wound can guide the doctor's decision. Although all wound dressings are intended to achieve optimal wound healing and protection from contamination, they do so to varying degrees depending on the qualities of the dressing and the wound itself. This article looks at a range of dressings, from traditional to newer dressings, and evaluates their benefits and contraindications to help determine where they are best suited for use in wound management.


Assuntos
Bandagens , Cicatrização , Humanos , Curativos Oclusivos
11.
Zhongguo Yi Liao Qi Xie Za Zhi ; 45(5): 551-554, 2021 Sep 30.
Artigo em Chinês | MEDLINE | ID: mdl-34628771

RESUMO

OBJECTIVE: To establish an amino acid assay for the determination of ß-lactoglobulin in Anti-HPV biological protein dressing. METHODS: Under acidic conditions, ß-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 ß-lactoglobulin in the sample is indirectly determined by measuring the lysine content obtained by hydrolysis. RESULTS: ß-lactoglobulin has a good linear relationship in the concentration range of 77.28~309.12 µg/mL (y=5.060x+4.278, r=0.999 7); The recovery rate (n=9) is 100.06%. CONCLUSIONS: The method is simple, specific, accurate and reproducible, which is suitable for the quantitative analysis of ß-lactoglobulin in anti-HPV biological protein dressing.


Assuntos
Aminoácidos , Lactoglobulinas , Bandagens
12.
Rozhl Chir ; 100(9): 435-439, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34649452

RESUMO

INTRODUCTION: The development of an ideal dressing for wound healing remains an unresolved issue. Thanks to the development of electrospinning technology, polymers in the form of nanofibers have come to the forefront of research interest. A modern and very promising dressing material is a “nonwoven” based on nanofibers of the synthetic polymer polylactide (PLA). The aim of this work was to assess the regenerative abilities of PLA in a standardized wound in a porcine model and compare our results to the literature data. METHODS: We applied PLA-based nanofiber dressings to the standardized wounds created in the porcine model. On the third, tenth, seventeenth and twenty-fourth days after the formation of the defect, we changed the wound dressing while taking a tissue sample for histopathological examination. We continuously monitored serum levels of acute phase proteins. RESULTS: PLA stimulated an inflammatory response. From the third day, the thickness of the fibrin layer with granulocytes increased. It reached its maximum values on the tenth day (mean 340 μm); at the same time the level of serum amyloid A, as a marker of inflammation, culminated. The individual phases of healing intertwined. The highest thickness values of the granulation tissue with cellular connective tissue (diameter 8463 μm) were reached on the seventeenth day. On the twenty-fourth day, the defects were healed macroscopically with a mean reepithelialization layer of 9913 μm. CONCLUSION: PLA-based nanofiber dressing potentiates the inflammatory, proliferative and reepithelialization phases of healing. Its structure perfectly mimics the extracellular matrix and serves as a 3D network for the growth and interaction of cellular elements. In addition to biocompatibility, PLA has a unique ability of two-phase biodegradation. It is a promising material for industrial production of dressing materials. Most of the available studies were performed in vitro. In vivo comparative studies approximating the use of PLA to daily practice are still missing.


Assuntos
Nanofibras , Animais , Bandagens , Poliésteres , Suínos , Cicatrização
13.
Medicine (Baltimore) ; 100(37): e27156, 2021 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-34664841

RESUMO

BACKGROUND: The purpose of this meta-analysis was to assess the effects of Modified Robert Jones Bandage (MRJB) in primary total knee arthroplasty (TKA). METHODS: PubMed, EMBASE, the Cochrane Library, Web of Science, and Google Scholar were systematically searched for randomized controlled trials (RCTs). All RCTs were compared to receive either MRJB (study group) or conventional wound dressing (control group) in TKA. Statistical analysis was assessed using RevMan 5.3 software. RESULTS: A total of 5 RCTs involving 362 patients were included in the meta-analysis. No significant difference between the 2 groups was found in terms of total blood loss (Mean difference [MD], -25.41; 95% confidence interval [CI], -90.52 to 39.70; P = .44), intra-operative blood loss (MD, -13.77; 95% CI, -31.84 to 4.29; P = .14), drain blood loss (MD, 0.83; 95% CI, -30.07 to 31.72; P = .96), and transfusion rate (risk ratio, 0.95; 95% CI, 0.55-1.64; P = .86); There was also no significant difference in terms of range of motion (MD, -0.93; 95% CI, -3.64 to 1.79; P = .50), visual analog scale pain sores (MD, -0.02; 95% CI, -0.34 to 0.30; P = .90), and operative time (MD, -3.12; 95% CI, -13.42 to 7.18; P = .55), without increasing the risk of wound-related complications (risk ratio, 0.75; 95% CI, 0.27-2.08; P = .58) in both groups. No deep venous thrombosis occurred in all studies. CONCLUSIONS: The current meta-analysis of the available evidence indicates patients with MRJB had not required the additional advantage compared to the conventional wound dressing for TKA. However, more high-quality studies are needed to confirm the above conclusions. LEVEL OF EVIDENCE: Level I, therapeutic study.


Assuntos
Artroplastia do Joelho/efeitos adversos , Bandagens/normas , Perda Sanguínea Cirúrgica/prevenção & controle , Hemorragia/classificação , Artroplastia do Joelho/métodos , Perda Sanguínea Cirúrgica/enfermagem , Hemorragia/prevenção & controle , Humanos , Complicações Pós-Operatórias/prevenção & controle , Ensaios Clínicos Controlados Aleatórios como Assunto/estatística & dados numéricos
14.
Medicina (Kaunas) ; 57(10)2021 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-34684166

RESUMO

Background and Objective: Copper, a wide spectrum biocide, also plays a key role in angiogenesis and wound healing. Antibacterial wound dressings impregnated with copper oxide microparticles (COD) have been recently cleared by the U.S. FDA and other regulatory bodies for the treatment of acute and chronic wounds, including diabetic wounds. Our objective was to evaluate the capacity of COD in stimulating the healing of non-infected stagnated wounds in diabetic patients initially treated with standard of care (SOC) dressings. Materials and Methods: The trial was divided into the three following phases: 1-2 weeks of screening, during which the patients were treated with SOC dressings; 4 weeks of treatment, during which the COD was applied twice weekly; and 2 weeks of follow-up, during which the patients were again treated with SOC dressings. The wound conditions and sizes were assessed by clinical evaluation and a wound imaging artificial intelligence system. Results: Following 1 month of COD treatment, there was a clear reduction in the mean wound area (53.2%; p = 0.003), an increase in granulation tissue (43.37; p < 0.001), and a reduction in fibrins (47.8%; p = 0.002). In patients with non-weight-bearing wounds, the reduction in wound size was even more dramatic (66.9%; p < 0.001). Conclusions: The results of this study, showing a statistically significant influence of COD on wound healing of hard-to-heal wounds in diabetic patients, strongly supports the notion that copper oxide-impregnated dressings enhance wound healing directly. Further larger controlled studies should be conducted to substantiate our findings.


Assuntos
Cobre , Diabetes Mellitus , Inteligência Artificial , Bandagens , Cobre/uso terapêutico , Humanos , Óxidos , Cicatrização
15.
Arq Bras Cir Dig ; 34(2): e1586, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34669881

RESUMO

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.


Assuntos
Síndrome de Imunodeficiência Adquirida , Queimaduras , Nanofibras , Animais , Bandagens , Queimaduras/terapia , Celulose , Ratos , Ratos Wistar , Verduras
16.
J Wound Care ; 30(Sup9a): XVi-XVvii, 2021 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-34597165

RESUMO

AIMS: Hypertrophic scars show abnormal responses during healing. These scars, associated with dysregulated growth and excessive collagen formation, can have both functional and cosmetic consequences for patients. The present study evaluated the effects of kiwifruit on hypertrophic scars in a rabbit ear model. METHODS: This study included 13 New Zealand albino rabbits with full thickness wounds down to the cartilage (four wounds per ear; total: 104 scars). Sixteen days after initial wound formation, one ear of each rabbit was treated with daily kiwifruit dressing, while the other ear (control group) was dressed after normal saline irrigation for 10 days. Harvested skin samples were examined for histopathological, morphometric and immunohistochemical results. RESULTS: In comparison with the control group, early kiwifruit dressing significantly reduced the scar elevation index, fibroblast count and dermal collagen organisation. The ratio of collagen type III to total collagen immunoreactivity, inflammation and dermal capillary count increased significantly in the treated group, compared to the untreated controls. CONCLUSION: Based on the findings, early kiwifruit dressing improved the histological features of cutaneous wounds in rabbits. Therefore, this approach may be effective in clinical practice.


Assuntos
Cicatriz Hipertrófica , Lesões dos Tecidos Moles , Animais , Bandagens , Cicatriz Hipertrófica/terapia , Modelos Animais de Doenças , Fibroblastos , Humanos , Coelhos , Cicatrização
17.
J Wound Care ; 30(Sup9a): IVi-IVx, 2021 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-34597167

RESUMO

AIM: Self-healing, swellable and biodegradable polymers are vital materials that may facilitate the different stages of wound healing. The aim of this research was to prepare wound healing films using self-healing polyvinyl alcohol (PVA), swellable hydroxypropyl methylcellulose (HPMC), biodegradable polyglycolic acid (PGA) sutures and ciprofloxacin antibiotic for improved treatment outcome. METHODS: Films were formulated through aqueous-based mixing of varying amounts of polyvinyl alcohol (10-20% weight/weight (w/w)) and hydroxypropyl methylcellulose (0.5, 1% w/w) with fixed quantities of ciprofloxacin. PGA sutures were placed as grids within the wet mixtures of the polymers and ciprofloxacin, and thereafter products were air dried. The formulated films were evaluated for swelling ratio, breaking elongation, folding endurance, moisture uptake and loss, compatibility and in vitro antibiotic release. Furthermore, in vivo wound healing was studied using excision model and histopathological examinations. RESULTS: Swelling ratios were above 1.0 and the films were minimally stretchable, with folding endurance greater than 500. Films were stable while moisture uptake and loss were observed to be less than 30%. Among the optimised hydrogel batches, those containing 10% w/w PVA and 1% w/w HPMC with no PGA showed the highest drug release of 73%, whereas the batches with higher PGA content showed higher percentage wound size reduction with minimal scar. The completeness of wound healing with batches containing PVA, HPMC, ciprofloxacin and PGA, along with the standard, is evident considering the massive cornification, regeneration of the epithelial front and stratum spinosum. CONCLUSION: The findings show that polymer-based multifunctional composite films are suitable for use as dressings for improved wound healing.


Assuntos
Ciprofloxacina , Polímeros , Bandagens , Hidrogéis , Cicatrização
18.
J Wound Care ; 30(Sup9a): XIIIi-XIIIx, 2021 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-34597172

RESUMO

OBJECTIVE: Providing a suitable environment to improve the healing process is the main target of wound dressing that also protects the wound from additional harms. In the present study, fabrication and characterisation of a new kind of electrospun wound dressing composed of polyvinyl alcohol (PVA) and quince seed mucilage (QSM) is reported. METHOD: QSM was extracted from quince seeds, purified, freeze-dried and used to produce aqueous solutions containing different amounts of PVA and QSM. The wound dressings were fabricated via the electrospinning method and their characteristics were investigated with scanning electron microscope (SEM) images, Fourier transform infrared (FTIR) spectra, tensile and swelling test, and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) cytotoxicity assay against fibroblast cells. RESULTS: SEM images confirmed that proper, uniform, non-oriented nanofibres with an average diameter in the range of 60-240nm, depending on the QSM content had been fabricated. The tensile test showed that with increasing QSM content, the tensile strength of fibre increased while elongation at break was decreased, which was consistent with SEM images where the diameter of samples decreased by increasing QSM content. MTT assay showed significant biocompatibility against fibroblast cells; however, it was increased by increased QSM proportion. In addition, SEM images supported the proper adhesion of fibroblast cells on the sample one day after culturing. CONCLUSION: Overall, the findings of the current study support the potential of PVA/QSM nanofibres as a proper candidate for biomedical applications, especially as a wound dressing.


Assuntos
Álcool de Polivinil , Rosaceae , Bandagens , Sementes , Cicatrização
19.
Am Fam Physician ; 104(4): 386-394, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34652105

RESUMO

Diabetes-related foot infections occur in approximately 40% of diabetes-related foot ulcers and cause significant morbidity. Clinicians should consider patient risk factors (e.g., presence of foot ulcers greater than 2 cm, uncontrolled diabetes mellitus, poor vascular perfusion, comorbid illness) when evaluating for a foot infection or osteomyelitis. Indicators of infection include erythema, induration, tenderness, warmth, and drainage. Superficial wound cultures should be avoided because of the high rate of contaminants. Deep cultures obtained through aseptic procedures (e.g., incision and drainage, debridement, bone culture) help guide treatment. Plain radiography is used for initial imaging if osteomyelitis is suspected; however, magnetic resonance imaging or computed tomography may help if radiography is inconclusive, the extent of infection is unknown, or if the infection orientation needs to be determined to help in surgical planning. Staphylococcus aureus and Streptococcus agalactiae are the most commonly isolated pathogens, although polymicrobial infections are common. Antibiotic therapy should cover commonly isolated organisms and reflect local resistance patterns, patient preference, and the severity of the foot infection. Mild and some moderate infections may be treated with oral antibiotics. Severe infections require intravenous antibiotics. Treatment duration is typically one to two weeks and is longer for slowly resolving infections or osteomyelitis. Severe or persistent infections may require surgery and specialized team-based wound care. Although widely recommended, there is little evidence on the effectiveness of primary prevention strategies. Systematic assessment, counseling, and comorbidity management are hallmarks of effective secondary prevention for diabetes-related foot infections.


Assuntos
Antibacterianos/administração & dosagem , Pé Diabético/terapia , Antibacterianos/efeitos adversos , Bandagens , Desbridamento , Pé Diabético/diagnóstico , Pé Diabético/microbiologia , Pé Diabético/prevenção & controle , Humanos , Fatores de Risco , Índice de Gravidade de Doença , Sapatos
20.
Mater Sci Eng C Mater Biol Appl ; 130: 112436, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34702521

RESUMO

Improving wound healing by developing innovative dressing materials has been an important focus over the past few years in the biomedical field. In this regard, the current study focuses on developing new dressings based on acrylate-endcapped urethane-based polymers (AUPs). The materials have been processed into films and electrospun mats. Exudate uptake capacity, mechanical properties and fiber morphology were evaluated herein. The results showed superior uptake capacity of both films and mats when compared to Aquacel®Ag, Exufiber® and Help®. Addition of a high molar mass poly(ethylene glycol) to the AUP polymers benefits both the film and electrospun dressings in terms of flexibility and elongation. An in vivo study was conducted to assess the wound healing properties of these dressings on an acute wound model induced to rats. A macroscopic evaluation indicated that wound contraction and wound fraction percentages were improved significantly in case of the AUP-materials when compared to both the positive (Aquacel®Ag) and negative (Exufiber® and Help®) controls. A histopathological assay, to underline the changes noticed on a macroscopical level, was also performed. The data obtained proved that the developed dressings are beneficial towards tissue regeneration and accelerated wound healing. These findings offer a practical yet adequate strategy for the fabrication of acrylate-endcapped urethane-based materials for wound healing applications.


Assuntos
Hidrogéis , Uretana , Acrilatos , Animais , Bandagens , Hidrogéis/farmacologia , Ratos , Cicatrização
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