Comparison of bacteria-retaining ability of absorbent wound dressings

Fibrous materials in some modern absorbent wound dressings have the ability to sequester and retain bacteria; however, this ability varies according to the nature of the fibres. We studied the bacterial retention capacity of alginate and carboxymethylcellulose dressings, using an infected skin ulcer model on the backs of rats. Wound surfaces were inoculated with either Staphylococcus aureus or Pseudomonas aeruginosa at a concentration of 1.5 x 10(6) colony-forming units per wound. AQUACEL; Hydrofiber;, Kaltostat; or Sorbsan; were applied to the contaminated wounds for 12 h. Each dressing was then divided into two pieces. Total viable bacterial count within the dressing was calculated using one piece, and bacterial count released from the dressing into physiological saline was determined using the other piece, enabling bacterial retention rate to be calculated. Bacterial counts in tissue were also determined. Each dressing was tested on each of 10 wounds contaminated with each bacterium. Statistical analyses were performed using one-way analysis of variance (ANOVA) for replicated measures combined with Duncan's multiple comparison test. AQUACEL; Hydrofiber; dressing was most effective in its ability to retain both Staphylococcus aureus and Pseudomonas aeruginosa (p < 0.05). Bacterial counts in tissue showed no significant change with respect to pathogen or the type of dressing used. It can be concluded that the bacterial retaining ability of AQUACEL; Hydrofiber; dressing was found to be significantly higher than that of alginate dressings in an infected animal wound model.     

Experimental study of reparative regeneration processes in the wound treated with bioactive dressings

Quantitative and structural functional analysis of granulation tissue cells during treatment with protein-polysaccharide dressing Collahit F was carried out. The preparation effectively cleansed the wound from detritus, prevented secondary infection due to stimulation of the functional activity of macrophages and due to the effect of its antiseptic component (furagin), and stimulated proliferative activity of fibroblasts and granulation tissue microvessels on day 5 of treatment, thus promoting repair processes in the wound.     

From simplicity to complexity: developing a model of practical skill performance in nursing

The purpose of this article is to present and discuss a new model of practical skill performance in nursing. The model is conceptualized as having five components: substance and sequence; accuracy; fluency; integration; and caring conduct. The model challenges the truism of 'simple' nursing procedures. It is argued that performance of practical skills in nursing is characterized by complexity on many levels. Complexity lies within and between the components of the performance model and in the interaction between the nurse and the clinical context where practical nursing actions are performed. These complexities are described. Examples that illustrate the complex and reciprocal nature of these components are drawn from an empirical study of graduate nurses' development of practical skill in surgical hospital units. Implications of the model for education, practice and research are discussed.     

内镜鼻窦手术后Rhino凝胶填塞效果的观察

目的 前瞻性比较新型鼻腔填塞材料Rhino凝胶与传统填塞物用于内镜鼻窦手术后填塞的效果.方法 对双侧病变基本对称,手术范围基本相同的24例慢性鼻窦炎患者行内镜鼻窦手术,术后右侧鼻腔以Rhino凝胶填塞(观察组),左侧鼻腔以藻酸钙+油纱条填塞(对照组).术后1日抽取对照侧填充物,观察侧凝胶保留至术后1周第1次内镜复查时清理,鼻腔冲洗、鼻喷糖皮质激素等其他局部处理双侧鼻腔相同.采用视觉模拟量表(visual analog scale,VAS)记录两侧鼻腔术后当天(填塞期)、术后第1天(抽取左侧填充物时)、术后第2天(抽取左侧填充物后)患者鼻痛、鼻堵程度,分泌物、渗血、流泪量,以及术后内镜复查术腔恢复情况(干痂、分泌物、反应膜、黏膜水肿、囊泡、窦口阻塞),并对两组上述11项观察项目评分和上皮化时间进行比较.结果 苏醒时因血压过高,凝胶侧鼻腔出血改用纱条填塞1例;外地患者失访2例.余21例完成2～20个月的随访.术后当天、术后第1天鼻痛,术后当天流泪评分,Rhino组<对照组(Z值分别为-3.575、-3.546、-2.736,P值均<0.05);术后第1天渗血评分,Rhino组<对照组(Z=-3.075,P<0.05);术后1周术腔干痂评分,Rhino组<对照组(Z=-2.103,P<0.05);其余各项评分差异无统计学意义;凝胶侧术腔平均上皮化时间为(10.7±2.6)周,对照侧为(10.6±2.9)周,两组差异无统计学意义(t=-0.146,P=0.886).结论 Rhino凝胶可减轻患者鼻腔填塞期的不适,并可避免专门撤除填充物造成的痛苦和出血,较传统方法有明显的优越性.在促进术腔恢复方面与传统方式相当.     

海藻酸药物缓释纤维敷料临床应用研究

目的：研究应用一种新型的速愈型医用敷料。方法：对采用自行研制的海藻酸药物缓释纤维敷料治疗80例患者，进行临床观察研究。结果：80例患者90个创面，甲级愈合68个，乙级愈合16个，丙级愈合6个，平均愈合时间10．6天。结论：海藻酸药物缓释纤维敷料有良好的生物相容性和多项促进伤口愈合的功能，是一种较好的伤口敷料。     

MEBO在脑卒中并发褥疮护理中的应用

目的 探讨湿润烧伤膏（MEBO）治疗脑卒中病人并发褥疮的治疗与护理效果。方法 30例脑卒中病人并发褥疮行MEBO全程湿润暴露疗法治疗。结果 28例治愈，治愈率93．3％。结论 MEBO在脑卒中病人并发褥疮换药，效果好，时间短，减少疤痕的形成，为目前首选药物。     

Effect of calcium hydroxide treatment on periodontal repair and root resorption

Abstract Pulpal application of calcium hydroxide is a common treatment for external root resorption. Several mechanisms of action have been suggested. In the present investigation, the effect of pulpal calcium hydroxide on cells at the root surface and in the periodontal ligament was studied by means of scanning-electron microscopy and light microscopy. Lateral incisors in monkeys were extracted, a groove was made- in the root surface and the teeth were then immediately replanted. The pulps of some teeth were infected by bacteria from the saliva. Application of calcium hydroxide in the root canal caused a limited necrosis of the cells resorbing dentin as well as the cells forming reparative cementum in the experimental groove. In the non-infected teeth, a temporary ankylosis developed. The high pH having a bactericidal and necrotizing effect seemed to be sufficient to explain the therapeutic effect of calcium hydroxide on root resorption.     

The use of FT-IR for the determination of stratum corneum hydration in vitro and in vivo

Measurement of the water content of stratum corneum plays an important role in physiological and therapeutic inquiries in dermatology. There are many techniques available for non-invasive determination of skin hydration such as measurement of electrical, mechanical, thermal and spectroscopic properties of the skin. Most techniques, however, suffer from the fact that they do not employ a direct measurement of water content rather a property caused by skin hydration. Recently, Potts et al., (Arch. Derm. Res. 277, 489–495, 1985) developed an FT-IR method for the determination of water content of the skin both in vitro and in vivo. The method employed attenuated total reflectance infrared (ATR-IR) to measure a weak OH stretch formed by the presence of water at 2100 cm⁻¹. This absorbance is distant from interferences due to skin and most topically applied substances and therefore may be used in the quantitation of skin water content (hydration). This report describes the use of this technique in an investigation into the effect of occlusion on the water content of the skin. Method development and validation employing an in vitro system is also discussed.     

气管切开造口处蝶形透明敷料的临床应用

目的 探讨蝶形透明敷料用于气管切开造口处的效果.方法 随机选取急性呼吸衰竭气管切开患者62例,随机分为观察组32例和对照组30例,观察组采用蝶形透明敷料覆盖,对照组采取白色医用胶布覆盖造口.对比观察2组患者拔管后无创通气、耐受情况,造口处局部皮肤反应及平均愈合时间.结果 观察组患者耐受性明显高于对照组.局部不良反应明显低于对照组,且平均愈合时间缩短.结论 蝶形透明敷料是一种气管切开造口处良好的敷料.