泡沫敷料在术后预防压疮的应用观察

[目的]探讨泡沫敷料在术后预防压疮的应用。[方法]选择2011年3月—2012年3月我院收治的160例术后需俯卧或侧卧位的病人,随机将160例病人平均分为研究组和观察组,观察组采用海绵垫进行常规方式预防压疮,研究组采用泡沫敷料贴敷预防,观察比较两组病人的皮肤受压情况及压疮发生率。[结果]研究组的压疮发生率为6.25%,观察组为33.75%,研究组的压疮发生率明显少于观察组,差异有统计学意义(P<0.05)。[结论]选用泡沫敷料预防术后病人压疮的出现,明显加强了受压部位的抗压性,减少病人压疮的发生率及相关病发症状,安全可靠。     

Umbilical Negative Pressure Dressing for Transumbilical Appendectomy in Childern

Methods:This study was a retrospective chart review of 1377 patients (2–20 years) undergoing laparoscopic appendectomy for acute appendicitis in 2 tertiary care referral centers from January 2007 through December 2012. Twenty-two different operative technique/dressing variations were documented. The 6 technique/dressing groups with >50 patients were assessed, including a total of 1283 patients.Results:The surgical site infection rate of the 220 patients treated with TULAA and application of an umbilical vacuum dressing with dry gauze is 1.8% (95% CI, 0.0–10.3%). This compares to an infection rate of 4.1% (95% CI, 1.3–10.5%) in 97 patients with dry dressing without vacuum. In the 395 patients who received an umbilical vacuum dressing with gauze and bacitracin, the surgical site infection rate was found to be 4.3% (95% CI, 2.7–6.8%).Conclusions:Application of an umbilical negative-pressure dressing with dry gauze lowers the rate of umbilical site infections in patients undergoing transumbilical laparoscopic-assisted appendectomy for acute appendicitis.     

Silver nanoparticle-embedded poly(vinyl pyrrolidone) hydrogel dressing: gamma-ray synthesis and biological evaluation

Silver nanoparticle (nAg)-embedded poly(vinyl pyrrolidone) (PVP) hydrogels, to be used as antibacterial wound dressings, were prepared by γ-irradiation at various doses: 25, 35, and 45?kGy. The formation and characteristics of the silver nanoparticles were investigated with a UV–vis spectrophotometer, transmission electron microscopy, and scanning electron microscopy with energy-dispersive X-ray. The hydrogels were characterized for physical and biological properties. Based on the antibacterial determination, the 1 and 5?mM nAg–embedded PVP hydrogels were effective, with 99.99% bactericidal activity at 12 and 6?h, respectively. The indirect cytotoxicity evaluation based on 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay indicated that both the neat and the nAg-embedded PVP hydrogels were non-toxic to mouse fibroblasts (L929). The 5?mM nAg-embedded PVP hydrogels not only provided a clean, moist environment for wound healing, but also effectively prevented bacterial infection and enhanced wound recovery.     

Global burn care and the ideal burn dressing reloaded — A survey of global experts

PurposeBurn care is a highly relevant medical specialty in every part of the world. Different infrastructure, healthcare systems and access to medical supplies lead to different needs, treatment strategies and outcomes. A fundamental tool in a burn care provider’s armamentarium is the use of different dressings. Several studies have investigated the question of the ideal burn dressing, but none could achieve a proper global perspective. With advanced dressings being on the rise, we conducted this study to get a global understanding of the actual use and idea of the ideal burn dressing.ObjectiveThe objective of this study was to investigate the understanding of an ‘ideal burn dressing’ on a global scale.Materials and methodsA questionnaire about burn care and the ideal burn dressing has been created and translated to five of the most spoken languages world-wide (English, Spanish, French, Chinese, Indonesian). It has been uploaded to an online survey platform and sent out to burn experts worldwide. The voluntary participation was possible for a period of four weeks.ResultsIn total, 196 respondents from 49 countries participated in the study, yielding a response rate of 24.5%. The most important burn dressing characteristics in a cumulative ranking were (1) lack of adhesion (80.54%), (2) pain-free dressing change (79.87%), (3) requirement of fewer dressing changes, while in a linear ranking they were (1) anti-infective (35.14% 1st), pain-reduction (24.14% 2nd), and high absorbency (23.49% 3rd). Silver-based dressings are the most used dressings for superficial (45.21%) and deep (52.78%). 94.81% believe that the choice of burn dressing affects the outcome.ConclusionThis investigation has delivered valuable insights into the global perspective of the ideal burn dressing. Yet, the question of the ideal burn dressing is still inconclusive. Wound dressing research is of fundamental interest for patients, healthcare providers and healthcare systems.     

Chitosan nanoparticle/PCL nanofiber composite for wound dressing and drug delivery

Many investigations of wound dressings equipped with drug delivery systems have recently been conducted. Chitosan is widely used not only as a material for wound dressing by the efficacy of its own, but also as a nanoparticle for drug delivery. In this study, an electrospun polycaprolactone nanofiber composite with chitosan nanoparticles (ChiNP–PCLNF) was fabricated and then evaluated for its drug release and biocompatibility to skin fibroblasts. ChiNP–PCLNF complexes showed no cytotoxicity and nanoparticles adsorbed by van der Waals force were released into aquatic environments and then penetrated into rat primary fibroblasts. Our studies demonstrate the potential for application of ChiNP–PCLNF as a wound dressing system with drug delivery for skin wound healing without side effects.     

Case of Fusarium paronychia successfully treated with occlusive dressing of antifungal cream

We report a case of refractory Fusarium paronychia in a 42‐year‐old man with Behçet's disease receiving oral cyclosporin and corticosteroid. Symptoms resembling candidal paronychia of his little finger could not be cured by topical ketoconazole and oral terbinafine. The pathogen was identified as Fusarium solani species complex by gene analysis, and was multiple drug resistant. The case eventually resolved by occlusive dressing therapy with 0.5% amorolfine cream for 3 months.     

Investigation of adhesion of modern wound dressings: a comparative analysis of 56 different wound dressings

Introduction In the process of chronic wound care, adhesive wound dressings may cause pain and injury in the wound environment during dressing changes. At present, no standardized test procedures are available for the investigation of adhesion of wound dressings. Therefore, our study aimed to test the adhesion of different wound dressings on steel as well as on healthy skin. Methods Within an open, comparative study, the adhesive areas of 56 wound dressings were investigated. The adhesives were categorized into acrylate (n = 23), silicone (n = 9), hydrocolloid (n = 17) and polyurethane groups (n = 7). Using an especially modified testing machine, the adhesion of the wound dressings was measured on steel as well as on the skin of healthy study participants, in compliance with the European EN 1939:2003 standard. Results The energy required to remove the wound dressings from human skin, was measured in Newton (N) and the following median values were obtained: hydrocolloid (2.25 N) > acrylate (1.14 N) > polyurethane (0.9 N) > silicone (0.7 N). The subjective pain intensity during the removal of the wound dressings was recorded using the visual analogue scale (VAS) with values ranging from 0 to 10. For hydrocolloid, it was 6.8, for acrylate 4.9, for polyurethane 3.1 and for silicone 2.5 points VAS. In comparison with human skin, the adhesion of wound dressings was significantly higher on steel (P < 0.0001), but was different for the different groups of wound dressings. Moreover, there was a statistically significant correlation between the adhesion and pain intensity (correlation coefficient 0.806; P = 0.01). Conclusion The knowledge about the widely differing adhesion properties of different wound dressings on the skin of patients should nowadays be considered during the individual selection of the applied products. Based on these data, different types of wound dressings could be developed, guaranteeing a good adhesion and a low traumatic risk when removed.     

新型敷料治疗糖尿病足的临床护理探讨

目的：探讨新型敷料治疗糖尿病足的临床护理效果。方法选取该院2011年7月—2014年12月收治的80例糖尿病足患者作为研究对象,随机分为观察组与对照组各40例。对照组患者护理过程中应用传统敷料换药,观察组患者护理过程中应用新型敷料。结果对两组患者的临床治疗效果进行对比,观察组治疗总有效率为95%,对照组治疗总有效率为70%,治疗效果明显低于观察组（P＜0.05）,差异有统计学意义;对比两组患者的换药次数和愈合时间,观察组换药次数和愈合时间明显少于对照组（P＜0.05）,差异有统计学意义。结论糖尿病足患者的临床护理过程中,应用新型敷料可最大程度减少患者伤口和周围皮肤的损伤,提高治疗效果,减少换药次数,缩短患者伤口愈合时间,具有重要的作用,值得临床推广。     

封闭负压引流（VSD）技术与传统换药技术治疗深度烧伤的临床疗效比较

目的：比较VSD技术与传统换药技术对深度烧伤的治疗效果。方法：选取110例深Ⅱ度、Ⅲ度烧伤患者按照随机平行分组法随机分为治疗组（VSD技术组）58例与对照组（传统换药组）52例,比较两组患者对深度烧伤的治疗效果。结果：治疗组优良率明显高于对照组,治疗组植皮时间、疼痛评分明显少于对照组,且细菌培养阴性率、治疗费用明显高于对照组。结论：封闭负压引流（VSD）技术可缩短植皮时间、减轻疼痛,但治疗费用较高。     

康惠尔水胶体敷料在治疗长期卧床老年患者压疮方面的疗效观察与护理

目的：观察长期卧床的老年患者使用康惠尔水胶体敷料治疗压疮方面的疗效。方法收集我科近1年来共42例压疮,采用对照组与观察组的方法,对照组21例,观察组21例,均为长期卧床的老年患者,两组患者通过使用康惠尔水胶体敷料对压疮治疗的观察与护理,以9d为1个疗程,采用统计学分析。结果康惠尔水胶体敷料在治疗压疮方面有显著的疗效,同时便于患者的护理,值得推广使用。