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1.
Carbohydr Polym ; 226: 115302, 2019 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-31582049

RESUMO

Hydrogels could be promising wound healing dressings that maintain a moist environment in the wound site and accelerate wound healing. However, the lack of antibacterial effect, suitable mechanical property and adhesiveness limits their applications. Here, we designed a quaternized chitosan-Matrigel-polyacrylamide (QCS-M-PAM) hydrogel with multi-functions. The morphology, swelling ratio, mechanical test, antimicrobial property, hemostatic performance and biocompatibility of the hybrid hydrogel were investigated in vitro and vivo. The hybrid hydrogel showed a three-dimensional (3D) microporous structure, high swelling ratio, excellent stretchable and compressive property, similar modulus to human skin, good adhesiveness, and low cytotoxicity. The results of histology and molecular testing in vivo demonstrated that the hybrid hydrogel could significantly enhance wound healing, collagen deposition, and induce skin adnexal regeneration by upregulating anti-inflammatory factors, and downregulating proinflammatory factors. Together, the present antibacterial hydrogels with hemostatic and adhesive properties are considered to have promising potential used as wound dressings for full-thickness skin defect.


Assuntos
Resinas Acrílicas/farmacologia , Curativos Hidrocoloides , Quitosana/farmacologia , Colágeno/farmacologia , Hidrogéis/farmacologia , Laminina/farmacologia , Proteoglicanas/farmacologia , Cicatrização/efeitos dos fármacos , Resinas Acrílicas/química , Adesividade , Animais , Antibacterianos/química , Antibacterianos/farmacologia , Antifúngicos/química , Antifúngicos/farmacologia , Células Cultivadas , Quitosana/química , Colágeno/química , Combinação de Medicamentos , Humanos , Hidrogéis/química , Laminina/química , Camundongos , Proteoglicanas/química , Cicatrização/fisiologia
3.
J Wound Care ; 28(Sup9a): S4-S10, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31536459

RESUMO

Chronic wound exudate is associated with stalled or delayed healing. Excess amounts will break down healthy tissue, increasing the production of slough and necrotic tissue. This will also create an ideal environment for microbial proliferation and place the surrounding skin at risk of maceration. It is vital, therefore, to select an absorbent dressing that can retain excessive exudate. This article describes how to achieve this. It introduces an absorbent dressing, Aquacel Foam, which not only retains exudate, but can also help remove devitalised tissue and promote healing.


Assuntos
Curativos Hidrocoloides , Carboximetilcelulose Sódica/administração & dosagem , Exsudatos e Transudatos , Cicatrização , Humanos
4.
Carbohydr Polym ; 225: 115110, 2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-31521272

RESUMO

Various functional active hydrogels have been widely applied in tissue regeneration, especially in fields of wound repair as they are similar to the natural extracellular matrix (ECM) and can maintain moist at the wound site. However, preparing a hydrogel with multifunctional properties including high mechanical properties, excellent biocompatibility and long-term antibacterial activity is still a challenge. Herein, we developed a series of double network hydrogels based on poly (ethylene glycol) diacrylate (PEGDA) and chitosan (CS) or thiolated chitosan (TCS). The hydrogels presented in situ forming properties, good mechanical strength, adhesiveness, antibacterial activity and biocompatibility. The sample with the optimal formula of 15 wt% of PEGDA and 2 wt% of CS or TCS showed excellent mechanical adhesiveness, sustained release of antibacterial peptide and plasmid DNA, and it significantly accelerated in vivo wound healing process in a full-thickness skin defect model by reducing the inflammation and promoting the angiogenesis, meaning that the prepared hydrogels are excellent candidates for wound dressing.


Assuntos
Curativos Hidrocoloides , Quitosana/farmacologia , Hidrogéis/farmacologia , Polietilenoglicóis/farmacologia , Cicatrização , Adesividade , Animais , Antibacterianos/farmacologia , Materiais Biocompatíveis/farmacologia , Linhagem Celular , Ratos , Ratos Sprague-Dawley , Pele/efeitos dos fármacos
5.
Adv Skin Wound Care ; 32(7): 1-5, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31232840

RESUMO

OBJECTIVE: To evaluate the effect of different dressing methods on the wound healing process after pilonidal sinus surgery. METHODS: In this clinical trial, 60 patients undergoing pilonidal sinus surgery were randomly assigned to one of three groups. In the first group, hydrogel or alginate and hydrocolloid compounds were used as a standard occlusive dressing method. A modified dressing method was used for the second group, in which transparent hydrocolloid films were replaced by Vaseline gauze. The third group was treated using gauze swabs soaked in normal saline. The length and depth of the studied wounds were recorded once a week for a month. During dressing changes, patient pain was recorded using an 11-point numeric rating scale. The collected data were analyzed by descriptive and inferential statistical methods. RESULTS: There was a significant reduction in wound length after 2 weeks in all three groups (P < .05), and the pain experienced by the first and second groups was significantly lower than the third group. However, the modified method used for the second group was associated with a lower cost. CONCLUSIONS: Considering the beneficial results of using modern dressings for wound healing and reducing the severity of associated pain, providers may want to consider using modified wound dressings after pilonidal sinus surgery. Study authors recommend that providers receive training on how to use these products.


Assuntos
Curativos Hidrocoloides/estatística & dados numéricos , Curativos Biológicos/estatística & dados numéricos , Curativos Oclusivos/estatística & dados numéricos , Seio Pilonidal/cirurgia , Infecção da Ferida Cirúrgica/prevenção & controle , Cicatrização/fisiologia , Adulto , Bandagens/economia , Bandagens/estatística & dados numéricos , Curativos Hidrocoloides/economia , Curativos Biológicos/economia , Análise Custo-Benefício , Feminino , Humanos , Irã (Geográfico) , Masculino , Curativos Oclusivos/economia , Seio Pilonidal/diagnóstico , Cuidados Pós-Operatórios/métodos , Medição de Risco , Resultado do Tratamento , Adulto Jovem
6.
Wounds ; 31(8): 193-199, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31184996

RESUMO

INTRODUCTION: Pressure injury is one of the most prevalent skin injuries and a great challenge in the hospital environment. The implementation of preventive measures contributes to reducing its occurrence. OBJECTIVE: This study compares the protective effect of 2 adhesive dressings used in the prevention of pressure injuries in at-risk patients. MATERIALS AND METHODS: This case series was conducted at a university hospital in southeastern Brazil with 80 hospitalized adult patients at risk for pressure injuries, as per the Braden Scale for Predicting Pressure Sore Risk. Patients were randomized to preventive intervention with either hydrocellular foam (n = 40) or hydrocolloid plate (n = 40) dressing, which was applied to the intact skin over the sacrum and trochanters and changed weekly over 8 weeks. RESULTS: Of the patients, 56.5% were women, 64.5% were 60 years of age or older, 58.1% were admitted to an intensive care unit, and 63.9% were at high risk for pressure injuries. None of the patients developed a pressure injury. However, the presence of blanchable erythema, desquamation, pruritus, discomfort during dressing removal, and skin damage caused by the strong adhesiveness of the dressings were observed in both groups. In the hydrocolloid plate group, patients reported significantly more discomfort during dressing removal due to its strong adhesion to the skin (P = .004) than those in the hydrocellular foam group. CONCLUSIONS: Standard preventive measures combined with the use of either hydrocellular foam or hydrocolloid plate contributed to the prevention of pressure injuries in at-risk patients, with hydrocolloid plate being associated with significantly more discomfort during dressing removal.


Assuntos
Bandagens , Lesão por Pressão/prevenção & controle , Cicatrização/fisiologia , Idoso , Curativos Hidrocoloides , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Lesão por Pressão/fisiopatologia , Resultado do Tratamento
7.
J Wound Care ; 28(6): 409-415, 2019 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-31166863

RESUMO

OBJECTIVE: To analyse the treatment of pressure ulcers (PU) in long-term care. METHOD: In this correlational cross-sectional study, data was collected between November 2015 and January 2016 from older people with PUs in private and public long-term care facilities in Finland. Data collection was conducted by trained nurses using the Pressure Ulcer Patient Instrument (PUP-Ins). Outcomes measured were: prevalence and localisation of PU, local PU treatment, frequency (how often/week/day) and duration (minutes/week or day) of PU treatment. RESULTS: In total, 112 patients with 158 PUs were identified (a prevalence rate of 5%). PUs were located most often on the heel (38%), hip (13%), buttocks (10%) and lateral malleolus (9.5%). The most frequently used PU treatment was skin protecting agents and local wound care products. The most typical treatment in category I, II and III PUs were foam dressings. In category III PUs, ribbon gauze dressings were also used. The most typical products for category IV PUs were complex dressings. Category I PUs received more treatment per day or week than other categories of PUs. CONCLUSION: PU treatment is inconsistent and often conducted with varying methods and products. Holistic patient care must be the focus. Nurses in long-term care settings might benefit from in-depth in-service education focusing on the treatment of PUs. More research is needed about nurses' competence in PU treatment.


Assuntos
Casas de Saúde , Padrões de Prática em Enfermagem/estatística & dados numéricos , Lesão por Pressão/terapia , Idoso , Idoso de 80 Anos ou mais , Tornozelo , Bandagens , Curativos Hidrocoloides , Nádegas , Estudos Transversais , Desbridamento , Feminino , Finlândia/epidemiologia , Calcanhar , Quadril , Humanos , Assistência de Longa Duração , Masculino , Pessoa de Meia-Idade , Lesão por Pressão/epidemiologia , Prevalência , Qualidade da Assistência à Saúde , Região Sacrococcígea , Creme para a Pele , Irrigação Terapêutica
8.
Arq. bras. med. vet. zootec. (Online) ; 71(3): 889-898, May-June 2019. tab, ilus
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1011314

RESUMO

This study aimed to macroscopically and microscopically evaluate the healing of skin wounds induced in rats by topical application of cassava polyamide biopolymer hydrogel. In total, 32 rats were used and divided into four groups (n= 8): negative control - saline solution; positive control - use of commercial ointment; experimental group - I - ointment + cassava hydrogel; experimental group - II - cassava hydrogel. A 1cm2 wound induced on the animals dorsum was treated and evaluated. At day 21 post-operation, the animals were sacrificed by anesthetic overdose, and then 1cm2 of cicatricial skin from the wound region was collected. The material was cut to evaluate healing. In the macroscopic evaluation, complete healing was observed at the end of 21 days. Re-epithelialization was observed histologically; the connective tissue in the negative control, positive, and experimental - I groups was characterized by an abundance of collagen fibers, fibroblasts, and blood vessels. In experimental group - II additional healing was observed, as evidenced by the arrangement of collagen fibers and fibroblasts, and the reduction of neoformed vessels. Thus, we concluded that the hydrogel can assist in healing skin wounds, especially in the remodeling phase.(AU)


O objetivo deste estudo foi avaliar macro e microscopicamente a cicatrização de feridas cutâneas induzidas em ratos, a partir da aplicação tópica do hidrogel de biopolímero de poliamido de mandioca. Trinta e dois ratos foram divididos em quatro grupos (n= 8): controle negativo, tratado com solução salina; controle positivo, com pomada comercial; grupo experimental - I, com pomada + hidrogel de mandioca; grupo experimental - II, com hidrogel de mandioca. Feridas induzidas de 1cm 2 no dorso dos animais foram tratadas e avaliadas em intervalos de três a quatro dias. No 21º dia do pós-operatório, os animais foram mortos por aprofundamento anestésico, em seguida foi coletado 1cm 2 de pele da região cicatricial. O material foi cortado, corado pelas técnicas de hematoxilina-eosina e azocarmine-G, para avaliação da cicatrização. Na avaliação macroscópica, foi observada cicatrização completa no final do período de 21 dias. Histologicamente, observou-se reepitelização, o tecido conjuntivo no grupos controle negativo, positivo e experimental - I se caracterizou pela abundância de fibras colágenas, fibroblastos e vasos sanguíneos. No grupo experimental - II, a cicatrização sugere avanço de etapas, evidenciado pelo arranjo das fibras colágenas, pela redução de fibroblastos e dos vasos neoformados. Assim, foi possível concluir que o hidrogel de biopolímero de amido de mandioca pode auxiliar na cicatrização de feridas cutâneas, principalmente na fase de remodelação.(AU)


Assuntos
Animais , Masculino , Ratos , Cicatrização , Ferimentos e Lesões/veterinária , Curativos Hidrocoloides/veterinária , Amidos e Féculas
10.
Dermatol Clin ; 37(3): 349-366, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31084729

RESUMO

Dressings are integrally tied to wound outcomes in dermatologic surgery. Due to the wide range of wound types and dressing options available, dressing selection can be a formidable task. An understanding of dressing materials and their unique properties allows for a tailored approach to postoperative wound care. Conventional layered dressings often are suitable for uncomplicated dermatologic surgery wounds. Occlusive dressings and tissue-engineered skin substitutes may be warranted in more complex cases. This review is intended to equip the reader with the knowledge and confidence to successfully manage surgical wounds in dermatology.


Assuntos
Anti-Infecciosos Locais/uso terapêutico , Bandagens , Procedimentos Cirúrgicos Dermatológicos , Pele Artificial , Ferida Cirúrgica/terapia , Alginatos/uso terapêutico , Curativos Hidrocoloides , Humanos , Curativos Oclusivos
11.
Biosens Bioelectron ; 135: 50-63, 2019 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-30999241

RESUMO

The use of intrinsically conducting polymers (CPs) in wound care and skin tissue engineering presents a novel opportunity for accelerated wound healing, enhanced antibacterial activity and the potential for controlled drug delivery. Through their increased electrical conductivity, CPs can facilitate the application of electrical stimulation directly to the wound area, which has been linked to faster wound healing. The release of drugs or biological agents to the wound site can likewise be modulated through the use of an external electrical stimuli. This review thus summarises the available literature regarding the use of CPs for wound healing and skin tissue engineering applications, in particular the most common CPs, polyaniline (PANI), polypyrrole (PPy), polythiophene (PTh) and their derivates, including poly(3,4-ethylenedioxythiophene) (PEDOT). Results indicated that PANI and PPy, two CPs that have been most extensively studied across a range of applications, including biological, were also most frequently used in wound dressings and hydrogels. PPy was most commonly applied to skin tissue scaffolds. CPs were also frequently combined with biomolecules or biocompatible polymers via doping, the formation of composites, co-polymerisation or blending in order to improve their biocompatibility and physical properties. Overall, CPs offer much potential in terms of promoting enhanced wound healing and in skin tissue engineering.


Assuntos
Materiais Biocompatíveis/uso terapêutico , Polímeros/uso terapêutico , Regeneração , Fenômenos Fisiológicos da Pele , Engenharia Tecidual/métodos , Cicatrização , Compostos de Anilina/química , Compostos de Anilina/uso terapêutico , Animais , Curativos Hidrocoloides , Materiais Biocompatíveis/química , Condutividade Elétrica , Humanos , Polímeros/química , Pirróis/química , Pirróis/uso terapêutico , Pele/citologia , Tiofenos/química , Tiofenos/uso terapêutico , Tecidos Suporte/química
12.
Radiología (Madr., Ed. impr.) ; 61(2): 153-160, mar.-abr. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-185125

RESUMO

Objetivo: La utilización de un tapón de hidrogel reduce el número de neumotórax y la necesidad de tubos de drenaje pleural en las biopsias de pulmón guiadas por tomografía computarizada. Realizamos un estudio de coste-efectividad sobre su uso. Material y métodos: Se analizaron 171 biopsias de pulmón divididas en tres grupos: grupo 1 (n=22): punción aspirativa con aguja fina (PAAF) sin tapón de hidrogel; grupo 2 (n=89): PAAF con tapón, y grupo 3 (n=60): PAAF más biopsia con aguja gruesa (BAG) con tapón. Se calcularon costes totales (directos e indirectos) de los tres grupos. Se analizó el porcentaje de diagnósticos correctos, las ratios medias e incrementales y la opción más coste-efectiva. Resultados: Costes totales: grupo 1 = 1.261,28 + 52,65 = 1.313,93 Euros, grupo 2 = 1.201,36 + 67,25 = 1.268,61 €, grupo 3 = 1.220,22 + 47,20 = 1.267,42 Euros. Porcentaje de diagnósticos correctos: grupo 1 = 77,3%, grupo 2 = 85,4% y grupo 3 = 95% (p = 0,04). Ratio medio de coste-efectividad: grupo 1 = 16,99, grupo 2 = 14,85 y grupo 3=13,34. Conclusiones: El grupo 3 fue la opción dominante, con la menor ratio media, lo cual demuestra que, en las biopsias de pulmón guiadas por TC, la opción más coste-efectiva es la realización de una PAAF y una BAG con la utilización del tapón de hidrogel deshidratado al final del procedimiento


Objective: Using a hydrogel plug decreases the number of cases of pneumothorax and reduces the need for pleural drainage tubes in CT-guided lung biopsies. We aimed to analyze the cost-effectiveness of using hydrogel plugs. Material and methods: We analyzed 171 lung biopsies divided into three groups: Group 1 (n=22): fine-needle aspiration cytology (FNAC) without hydrogel plugs; Group 2 (n=89): FNAC with hydrogel plugs; and Group 3 (n=60): FNAC plus core-needle biopsy (CNB) with hydrogel plugs. We calculated the total costs (direct and indirect) in the three groups. We analyzed the percentage of correct diagnoses, the average and incremental rations, and the most cost-effective option. Results: Total costs: Group 1 = 1,261.28 + 52.65 = € 1,313.93; Group 2 = 1,201.36 + 67.25 = Euros 1,268.61; Group 3 = 1,220.22 + 47.20 = Euros 1,267.42. Percentage of correct diagnoses: Group 1 = 77.3%, Group 2 = 85.4%, and Group 3 = 95% (p = 0.04). Average cost-effectiveness ratio: Group 1 = 16.99; Group 2 = 14.85; and Group 3 = 13.34. Conclusions: Group 3 was the best option, with the lowest average cost-effectiveness ratio; therefore, the most cost-effective approach is to do FNAC and CNB using a dehydrated hydrogel plug at the end of the procedure


Assuntos
Humanos , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Técnicas de Fechamento de Ferimentos , Biópsia Guiada por Imagem/métodos , Curativos Hidrocoloides , Biópsia por Agulha Fina/métodos , Neoplasias Pulmonares/patologia , Avaliação de Custo-Efetividade , Tomografia Computadorizada por Raios X/métodos , Pneumotórax/prevenção & controle , Estudos Retrospectivos , Sensibilidade e Especificidade
13.
Br J Community Nurs ; 24(Sup3): S20-S24, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30817184

RESUMO

Wounds can be found anywhere on the wound healing continuum, which can be used to select appropriate dressings. With the exception of black toes or arterial heels, some simple rules of thumb to use for dressing selection would be as follows: a wet dressing for a dry wound; a dry dressing for a wet wound; an antibacterial dressing for one that is odorous; a superabsorbent dressing for high exudate loss; and a foam dressing to cover as a secondary dressing or as a primary dressing when the wound is healing. This article seeks to outline a method for changing black or yellow wounds on the healing continuum into a red and then pink wound. It also describes a case in which this method was successfully used to treat recalcitrant wounds.


Assuntos
Antibacterianos/uso terapêutico , Curativos Hidrocoloides , Exsudatos e Transudatos/efeitos dos fármacos , Necrose/tratamento farmacológico , Cicatrização/fisiologia , Ferimentos e Lesões/tratamento farmacológico , Idoso de 80 Anos ou mais , Humanos , Masculino , Resultado do Tratamento
14.
J Wound Care ; 28(3): 164-175, 2019 03 03.
Artigo em Inglês | MEDLINE | ID: mdl-30840551

RESUMO

OBJECTIVE: To assess the efficacy, safety and acceptability of a new TLC-NOSF dressing with poly-absorbent fibres in the management of exuding leg ulcers, at the different stages of healing. METHOD: This work presents the results of two prospective, multicentric clinical studies: NEREIDES and CASSIOPEE. Patients with a non-infected, moderate-to-strongly exudating leg ulcer of venous or mixed origin, were treated with the dressing and an appropriate compression system for 12 weeks. The wounds included in NEREIDES had to be in debridement stage, and those in CASSIOPEE at granulation stage. In both studies, the primary outcome was the relative wound area reduction (RWAR) at week 12. Main secondary outcomes included healing rate, time-to-reach wound closure, adverse events and acceptability of the dressing by patients and health professionals. RESULTS: There were 37 patients included in NEREIDES and 51 in CASSIOPEE. The two cohorts presented similar patient and wound characteristics, except from the percentage of sloughy tissue on wound bed at baseline (median: 75% NEREIDES and 30% CASSIOPEE). At week 12, the RWAR (60% NEREIDES and 81% CASSIOPEE), wound closure rates (18% NEREIDES and 20% CASSIOPEE) and mean times-to-reach wound closure (58±27 days NEREIDES and 55±23 days CASSIOPEE) supported the beneficial outcomes of the treatment in both cohorts. In patients with a wound duration ≤6 months, the wound area reduction reached 85% in NEREIDES and 81% in CASSIOPEE, highlighting the importance to initiate adequate treatment as soon as possible. The nature and frequency of the local adverse events were similar in both studies and consistent with the good safety profiles of the poly-absorbent fibres and of the TLC-NOSF dressings. The acceptability of the dressing (easy to apply, conformable and non-adherent to the wound bed at removal, with no pain or bleeding at removal) has been judged 'very good' or 'good' at each stage of the healing process, by both nursing staff and patients. CONCLUSION: These clinical results establish the new TLC-NOSF dressing with poly-absorbent fibres (UrgoStart Plus, Laboratoires Urgo) as an effective, safe and simple treatment for the local management of leg ulcers, at the different stages of healing and until wound closure.


Assuntos
Curativos Hidrocoloides , Úlcera da Perna/terapia , Idoso , Feminino , França , Humanos , Masculino , Estudos Prospectivos , Resultado do Tratamento , Cicatrização
15.
Wound Repair Regen ; 27(4): 360-365, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30920083

RESUMO

The wound environment is a fertile ground for biofilm forming pathogens. Once biofilms form within the wound, they can be very challenging to eradicate. The purpose of this study was to examine the effect of a gelling fiber dressing with silver using a well-established porcine wound biofilm model. Deep partial thickness wounds were inoculated with Pseudomonas aeruginosa ATCC 27312 and covered with a polyurethane film dressing to promote biofilm formation. Wounds were then divided into treatment groups: gelling fiber dressing with silver, gelling fiber dressing without silver, hydrofiber dressing with silver, benzethonium chloride and ethylenediaminetetraacetic acid and compared to untreated control. Microbiological, biofilm, and histological wound assessments were performed on days 3, 5, and 7 postinfection. Treatment with gelling fiber dressing with silver resulted in significant reduction of P. aeruginosa biofilm when compared to all other treatment groups on every assessment time point. In addition, gelling fiber dressing with silver treatment resulted in detachment of biofilm from the wound, while wounds treated with gelling fiber dressing with and without silver showed more granulation tissue formation on day 3. Our data show that a new gelling fiber dressing with silver was effective in reducing biofilm associated P. aeruginosa in vivo. This study may have important clinical implications especially for wounds heavily colonized with gram-negative biofilm-forming bacteria.


Assuntos
Antibacterianos/farmacologia , Curativos Hidrocoloides , Infecções por Pseudomonas/tratamento farmacológico , Prata/farmacologia , Cicatrização/efeitos dos fármacos , Infecção dos Ferimentos/microbiologia , Animais , Fenômenos Fisiológicos Bacterianos , Biofilmes/efeitos dos fármacos , Modelos Animais de Doenças , Feminino , Géis , Suínos , Cicatrização/fisiologia , Infecção dos Ferimentos/tratamento farmacológico
16.
Wound Manag Prev ; 65(2): 30-38, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30730303

RESUMO

Use of a hydrocolloid dressing (HCD) is generally recommended to help prevent pressure ulcers (PUs) in high-risk patients, including ulcers caused by noninvasive ventilation (NIV). PURPOSE: The study was conducted to compare the effect of preventive use of HCD to other methods in the rate of facial PUs caused by NIV. METHODS: PubMed, Web of Science, China National Knowledge Infrastructure, and Wanfang Data were searched from date of index inception to August 2018 without language restrictions to identify randomized controlled trials (RCTs) that compared HCD use to other NIV-related PU prevention measures. Publications were systematically reviewed, data were extracted, and study quality was assessed using the Jadad scale. Odds ratio (OR) with 95% confidence intervals (CIs) for PU incidence in patients using HCD versus patients managed with gauze or standard skin care procedures (control) were calculated using a fixed-effects model. RESULTS: The search yielded 80 publications; 40 met the study criteria for full-text and 22 met the meta-analysis inclusion criteria (total study participants = 2519). Patients who used a HCD (n = 1260) had a significantly decreased incidence of PU (OR = 0.15; 95% CI: 0.11-0.20) compared with control group patients (n = 1259). Subgroup analysis by age showed a lower incidence in children (OR = 0.09; 95% CI: 0.01-0.81) and adults (OR = 0.16; 95% CI: 0.12-0.22) in the HCD group than in the control group. PU incidence using HCD was lower compared to gauze (OR = 0.17; 95% CI: 0.10-0.28) and regular skin care (OR = 0.13; 95% CI: 0.09-0.19). Funnel plot diagrams suggested a risk of bias. Sensitivity analysis using a random-effects model did not change the result of the main meta-analysis. CONCLUSION: Using a HCD significantly decreased the incidence of facial PUs caused by NIV. Additional high-quality, prospective research to confirm the effectiveness of HCD in preventing NIV-related PUs is warranted.


Assuntos
Curativos Hidrocoloides/normas , Desenho de Equipamento/normas , Ventilação não Invasiva/efeitos adversos , Lesão por Pressão/prevenção & controle , China , Desenho de Equipamento/métodos , Humanos , Incidência , Ventilação não Invasiva/métodos , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos , Cicatrização
17.
Complement Ther Clin Pract ; 34: 123-131, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30712715

RESUMO

OBJECTIVE: Honey dressing has been applied in the treatment of diabetic foot ulcers (DFUs). However, there is a lack of research showing ample evidence that honey dressing is more effective in the treatment of DFUs than other dressings. This study aimed to examine the effects of honey dressing on wound-healing process for DFUs. METHOD: We searched for evidence regarding honey dressing used in the treatment of DFUs in various databases. We selected randomized controlled trials (RCTs) and quasi-experimental studies for meta-analysis. RESULTS: The meta-analysis showed that honey dressing effectively shortened the wound debridement time, wound healing time, and bacterial clearance time; it increased the wound healing rate and bacterial clearance rate during the first one to two weeks of use. CONCLUSION: Our findings suggest that honey dressing effectively promotes healing in DFUs. Further research is needed to elucidate these findings so that this form of treatment can be widely applied.


Assuntos
Pé Diabético/terapia , Mel , Cicatrização , Curativos Hidrocoloides , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
18.
J Wound Care ; 28(2): 82-88, 2019 02 02.
Artigo em Inglês | MEDLINE | ID: mdl-30767643

RESUMO

OBJECTIVE: There is a lack of literature on the characteristics and properties of fibre dressings available on the market. This study analysed the structure and absorption properties of different fibrous dressings used in wound treatment. METHOD: This in vitro experiment was performed using scanning electron microscopy (SEM) and absorption test. Dressings were compared before and after the gelling process which was then compared with the results of the absorption test. RESULTS: A total of five samples were analysed. The SEM analysis demonstrated that there are differences in the gelling processes for each. In some cases, a formation of dead spaces was noticed. Despite a similar structure and mode of action, the dressings have different properties. Results were correlated with absorption measurements. There was a considerable difference in absorption capacity of individual dressings, which may further affect the capacity of the dressing to manage exudate. CONCLUSION: Absorption of excess exudate and maintaining moisture balance in the wound environment are among the most important conditions of successful healing. Various fibrous dressings have different properties and clinicians should use this information to select the most appropriate dressing for the type of wound.


Assuntos
Curativos Hidrocoloides , Úlcera Cutânea/terapia , Cicatrização , Desenho de Equipamento , Humanos , Microscopia Eletrônica de Varredura , Propriedades de Superfície
19.
J Wound Care ; 28(2): 89-101, 2019 02 02.
Artigo em Inglês | MEDLINE | ID: mdl-30767647

RESUMO

OBJECTIVE: To evaluate the performance of Jelonet Plus (JP) and UrgoTul (UT), assessing pain at dressing removal when managing acute or chronic wounds at granulation and epithelialisation stages. METHODS: This was a randomised, multicentre, controlled single-blinded study using a cross-over design. Hospitalised and ambulatory patients presenting with non-infected acute or chronic wounds (at least 40% of wound area of ≤100cm2 covered with granulation tissue) were randomly allocated to be treated with either JP or UT dressings applied according to a standardised local care procedure for two days. At the following visit, patients received the other dressing for a second 2-day period. Pain was evaluated after two days of dressing application and immediately after its removal using a 100mm Visual Analog Scale (VAS). A pain level >30mm was considered as clinically relevant. A lower limit of -12% was determined as the threshold necessary to demonstrate the non-inferiority of JP compared to UT. RESULTS: For the 99 patients completing the study, a difference of 7.9% was observed in favour of JP (83.8% JP versus 75.9% UT) for pain immediately after dressing removal (VAS score < 30mm) with a confidence interval (CI) lower limit of -2.6%, demonstrating non-inferiority (pre-defined limit of -12%). Concerning pain at dressing removal, a difference of 19.6% was observed in favour of JP (81.6% versus 62.0%; p=0.029 for superiority analysis), with a CI lower limit ranging from 2.4% to 38.9%. Therefore, superiority could be concluded. A statistically significant period effect was detected (p=0.003) with fewer patients experiencing pain after the second period day 2 (D2) to day 4 (D4) than the first day 0 (D0) to D2. A statistically significant cross-over effect was also detected (p=0.047), with fewer patients experiencing pain when JP was applied first followed by UT. This suggests a carry-over effect thus preventing a full cross-over design analysis. Adherence of the dressing was less frequent with the JP than the UT dressing (2.0% JP versus 6.9% with UT). CONCLUSION: Non-inferiority of pain at dressing removal was demonstrated with JP. Superiority on this criteria was non-significant but we found adherence of the dressing to the wound bed to be more rare.


Assuntos
Acetatos/administração & dosagem , Curativos Hidrocoloides , Dor/prevenção & controle , Vaselina/administração & dosagem , Úlcera Cutânea/terapia , Cicatrização , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Bandagens , Estudos Cross-Over , Feminino , França , Humanos , Masculino , Pessoa de Meia-Idade , Método Simples-Cego , Resultado do Tratamento , Adulto Jovem
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