A randomized prospective comparision of two methods of administering topical treatment in otitis externa

Ten patients with bilateral moderate or severe otitis externa were studied. Following aural toilet each patient was subjected to two different treatments: one ear had alternate day dressings containing a topical antibiotic/steroid mixture, while the external canal of the other was filled with the same topical preparation (sump filling). Improvement in the severity of the otitis externa was assessed after 1 week. 9 out of 10 ear canals improved in each group. An estimate of the relative cost of each treatment was made and sump filling was found to be less expensive. The results suggest that sump filling is a low cost alternative to standard treatment in moderate and severe otitis externa.     

The use of the skin substitute “omiderm” in the Bashkyrian train catastrophe: a useful adjunct for mass burn casualties Report of 15 cases

Summary In June 1989, two trains exploded when passing over the trans-Ural natural gas pipeline. Eight hundred people were badly burned and between 1500–3000 people died. International assistance was requested by the Soviet government, and the Israel Army Medical Corps assistance delegation treated 40 burned patients who were transferred to the Sklifosovsky Trauma Center in Moscow. Fifteen of them suffered second degree burns with a BSA between 15% to 60%, and were treated with the skin substitute omiderm. Ten days after the application of the dressing, the wounds were epithelized and the patients discharged. The advantages of the omiderm as a skin substitute in second degree burns are described and its usefulness in mass burn casualties emphasized.     

The sorptivity and durability of gelling fibre dressings tested in a simulated sacral pressure ulcer system

Wound‐dressing performances are affected by exudate viscosity, resistance to flow because of gravity, and bodyweight loads, the level of which is related to the body position. Here, we focussed on two dressing properties: (a) Sorptivity—the ability of dressings to transfer exudate away from the wound bed by capillary action—and (b) Durability—the capacity of dressings to maintain their integrity over time and during their removal. Both properties are critically important for avoiding further tissue damage but require the development of new laboratory tests for their measurement. A computer‐controlled phantom of an exuding sacral pressure ulcer has therefore been developed and used to compare the performances of Exufiber (Mölnlycke Health Care) vs an alternative market‐leading dressing. Sorptivity was determined using weight tests, and durability was measured through tensile tests of the used dressings. For a supine configuration, the Exufiber dressing demonstrated ~three times higher sorptivity and better durability, withstanding ~five times greater strain energy than the other product before failure occurred. This work paves the way for quantitative, standardised testing of dressings in all aspects of exudate management. The reported tests are further suitable for testing dressing combinations or how dressings interact with negative pressure wound therapy.     

A comparative study of three new occlusive dressings for healing of graft donor sites versus conventional therapy

Summary A comparative study of four skin graft donor site dressings was undertaken. This was a prospective and cross-over study of 25 consecutive patients with burns up to 40% TBSA treated with split skin grafts. Each donor site was divided into four sections and covered with different dressings in order to evaluate their effectiveness in healing, the time required for complete epithelialization, patient acceptance and any intolerance or local infection. The results showed that the occlusive hydrocolloid dressing significantly decreases (p<0.01) the mean time required for complete healing (7.45 days) compared with a semiocclusive hydrocolloid (10.29 days), a polyurethane sheet (9.4 days) and the conventional dressing (10.04 days).Presented at the IV European Burns Congress in Barcelona, Spain, September 25, 1991 (Abstract No. 117)     

短语小处方在门诊换药患者健康教育中的应用

【】目的 探讨短语小处方在门诊换药患者健康教育中的应用效果。方法 选取门诊换药室手外伤换药患者170例,按首次换药时间先后分为对照组85例,观察组85例;对照组在换药后予常规健康教育处方指导,观察组予健康教育短语小处方指导。观察两组患者健康教育知晓率、护理服务满意度、伤口愈合时间和感染发生率。结果 观察组健康教育知晓率、满意度均高于对照组,差异有统计学意义(均P<0.01),伤口感染发生率低于对照组(P<0.01),伤口愈合时间短于对照组(P<0.01)。结论 短语小处方提高患者健康教育知晓率,缩短伤口愈合时间,降低伤口感染发生率。     

A randomised controlled trial of the effectiveness of soft silicone multi‐layered foam dressings in the prevention of sacral and heel pressure ulcers in trauma and critically ill patients: the border trial

The prevention of hospital acquired pressure ulcers in critically ill patients remains a significant clinical challenge. The aim of this trial was to investigate the effectiveness of multi‐layered soft silicone foam dressings in preventing intensive care unit (ICU) pressure ulcers when applied in the emergency department to 440 trauma and critically ill patients. Intervention group patients (n = 219) had Mepilex^® Border Sacrum and Mepilex^® Heel dressings applied in the emergency department and maintained throughout their ICU stay. Results revealed that there were significantly fewer patients with pressure ulcers in the intervention group compared to the control group (5 versus 20, P = 0·001). This represented a 10% difference in incidence between the groups (3·1% versus 13·1%) and a number needed to treat of ten patients to prevent one pressure ulcer. Overall there were fewer sacral (2 versus 8, P = 0·05) and heel pressure ulcers (5 versus 19, P = 0·002) and pressure injuries overall (7 versus 27, P = 0·002) in interventions than in controls. The time to injury survival analysis indicated that intervention group patients had a hazard ratio of 0·19 (P = 0·002) compared to control group patients. We conclude that multi‐layered soft silicone foam dressings are effective in preventing pressure ulcers in critically ill patients when applied in the emergency department prior to ICU transfer.     

Management of burns

Burns are common injuries that vary in severity from small superficial scalds to massive full-thickness flame burns with high morbidity and mortality. The purpose of this article is to review common burn presentations and the pathophysiology of these injuries. In addition it gives the reader an overview of burns management from the emergency department through to the specialist burns centre and describes the latest multi-disciplinary approach to treating these injuries.     

1540nm点阵激光辅以类人骨胶原敷料治疗痤疮后早期表浅凹陷性瘢痕的疗效观察

目的：观察1540nm点阵激光辅以类人骨胶原敷料治疗痤疮后表浅凹陷性瘢痕的疗效。方法选择病程小于12个月,愈后留有表浅凹陷性瘢痕的痤疮患者60例,用1540点阵激光的各种不同治疗参数及能量进行治疗,激光治疗每次间隔1周,连续治疗4次。将患者随机分为实验组（36例）和对照组（24例）。实验组使用类人骨胶原敷料,对照组使用无纺布纯净水面膜,激光术后即刻敷用15-20min。每晚使用1次,每次15-20min,连续使用5d。结果实验组瘢痕治疗的有效率为91.67%,对照组的有效率为62.5%,实验组优于对照组,差异具有统计学意义（P〈0.05）。两组红斑治疗后临床评分差异无统计学意义（P〉0.05）。两组患者对保湿度、光滑度、满意度的评分差异有显著的统计学意义（P〈0.01）,实验组优于对照组。结论1540nm点阵激光无创伤,疼痛程度轻,术后不影响工作,辅以胶原蛋白敷料进行修复护理,无明显色素沉着及其他不良反应发生;患者依从性好,适用于对疼痛敏感且无时间休息的患者。     

Comparative Investigation of Collagen-Based Hybrid 3D Structures for Potential Biomedical Applications

Collagen is a key component for devices envisaging biomedical applications; however, current increasing requirements impose the use of multicomponent materials. Here, a series of hybrid collagen-based 3D materials, comprising also poly(ε-caprolactone) (PCL) and different concentrations of hyaluronic acid (HA)—in dense, porous or macroporous form—were characterized in comparison with a commercially available collagen sponge, used as control. Properties, such as water uptake ability, water vapour sorption, drug loading and delivery, were investigated in correlation with the material structural characteristics (composition and morphology). Methylene blue (MB) and curcumin (CU) were used as model drugs. For spongeous matrices, it was evidenced that, in contrast to the control sample, the multicomponent materials favor improved sustained release, the kinetics being controlled by composition and cross-linking degree. The other characteristics were within an acceptable range for the intended purpose of use. The obtained results demonstrate that such materials are promising for future biomedical applications (wound dressings and lab models).