Clinical evaluation of a thin absorbent skin adhesive dressing for wound management.

OBJECTIVE: This article assesses the use of BeneHold Thin Absorbent Skin Adhesive (TASA) wound dressings in a large UK primary care organisation. These wound dressings are thin (0.12 mm), breathable, transparent, and are able to absorb and retain wound exudate. This non-comparative evaluation was undertaken to explore the clinical advantages this differentiated combination of physical properties offered. METHOD: The dressings are CE-marked medical devices, and were used on patients with acute and chronic wounds that were assessed and classified as light to moderately exuding. Clinical performance was evaluated with respect to the dressing's ease of use (application and removal, conformability, mould-ability, rolling and edge-lift), debridement, protection of the peri-wound, wear time, fluid handling, wound bed residue, visibility of the wound, and clinical acceptability. The evaluating clinicians used an agreed audit tool to collect data from case reports to document the progression of wounds of various aetiologies, including chronic and acute, for a maximum period of four weeks. Qualitative feedback on dressing performance was also collected at the evaluation's end, both from the clinicians' and patients' perspectives Results: Some 15 patients were assessed. The wear time was up to seven days in many cases, and on average was 3.9 days longer than their previous dressings. Clinicians perceived that wounds progressed toward healing in all but two cases, where the wounds remained unchanged. Out of five cases where wounds presented with necrosis, all underwent significant autolytic debridement underneath the new dressings. Transparency was a noted benefit from both the clinicians' and patients' perspectives because it enabled continuous monitoring of the full wound bed and peri-wound skin without the need to disrupt the dressing. CONCLUSION: The dressing was well-received by both clinicians and patients in all fifteen cases. The thin absorbent skin adhesive dressing was found to be a promising new technology that could offer significant advantages to improve the quality, cost, and convenience of wound care. Further work is underway to validate these findings in larger and more homogeneous patient groups.

Skin efficacy and biophysical assessment of glycerol-containing hydrocolloid patches.

Hydrocolloid patches are developed with 10, 20 and 30% (w/w) glycerol as the main active ingredient. By making use of two experimental forearm models, skin efficacy and its dependency on the glycerol concentration applied were compared with a blank reference patch, a commercialized protective patch and a cosmetic barrier cream. Skin hydration and transepidermal water loss measurements were combined with skin erythema assessments. After a single application to healthy skin, a clear concentration-dependent effect of glycerol-containing patches was observed with - for the highest glycerol content - a 31% increase in skin hydration and an improvement in skin barrier properties of 15%. This glycerol-containing patch also accelerated barrier recovery of mechanically irritated skin after stripping with cyanoacrylate tape. After 7 days of repetitive application, a significantly hydrating effect of the 30% glycerol-containing patch was observed, which was of the same order of magnitude as observed for the cosmetic barrier cream, the latter being applied twice daily. The effects seen were maximal after 3 days of patch application.

[Retrospective study of 106 cases of varicella in immunocompetent adults. Parameters associated with varicella pneumonia]. / Etude rétrospective de 106 cas de varicelle chez l'adulte immunocompétent. Paramètres associés à la pneumonie varicelleuse.

INTRODUCTION: Varicella occurring in healthy adults may extend to the lungs. Diagnosing this complication is sometimes difficult because of the discrepancy between imaging and clinical presentation usually reported in this affection. METHOD: The authors report the result of a retrospective study on 106 immunocompetent patients including 48 cases of varicella pneumonia. This condition is defined as the presence of clinical signs of pneumonia and radiological and biological abnormalities consistent with viral pneumonitis. RESULTS: Comparison of the patients with or without varicella pneumonia (VP) showed that smoking was a risk factor for VP. Other parameters seem to be more associated with VP, such as fever greater than 38.3 degrees C, enanthem in the mouth, and biological hepatitis. In this study, 29.2% of the patients had received nonjustified acyclovir treatment because of missing specific criteria for the diagnosis of VP. CONCLUSION: An exact definition of VP and using parameters associated to VP would help to specify indication for hospitalization and acyclovir treatment. Careful monitoring of healthy patients with varicella is essential for an early detection of clinical signs requiring hospitalization.