不同方法治疗压褥的临床效果比较

目的探讨不同方法治疗压疮的临床效果。方法将65例患者计Ⅱ～Ⅲ度溃疡84处按基本条件相当原则随机分成A、B、C三组，A组21例28处，伤口采用清创冲洗后，给予康惠尔水胶体敷料；B组23例30处，伤口采用湿润烧伤膏；C组21例26处，清创冲洗后，给予自制凡士林油纱敷料外敷溃疡面处。结果B组愈合率最高，且平均显效时间和愈合时间均较A、C两组明显缩短，且A、B组明显高于C组。结论采用清创冲洗后用湿润烧伤膏是治疗压疮较好的方法之一。     

Molecular Motion of Drugs in Hydrocolloids Measured by Electron Paramagnetic Resonance

The effects of a polymer, the Li-salt copolymer of methyl-methacrylic acid, and its methyl ester on the motion of drug molecules in hydrocolloids were studied. The investigation was carried out by means of electron paramagnetic resonance (EPR) using the model nitroxide tempol, and the spin-labeled drugs lidocaine (si-lid) and dexamethasone (sl-dex). Synthesis of sl-dex was performed. Spin-labeled molecules dissolved in hydrocolloids undergo a fast reorientation motion. The decreasing order of rotational correlation times () —sl-dex > si-lid > tempol—suggests that the size and the shape of the molecules strongly affect their motion. The inhibition of motion of larger molecules depends also on their flexibility. The values indicate proportionality of the microviscosity of hydrocolloids to the polymer concentration. Rotational motion is dependent on the local environment conditioned by the free spaces between polymer molecules.     

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.     

水胶体透明敷料预防神经外科中心静脉导管细菌定植和细菌感染的研究

目的比较透明薄膜敷料与水胶体透明敷料预防神经外科中心静脉导管细菌定植和细菌感染的效果,为合理选择中心静脉导管固定敷料提供依据。方法按照随机数字表法将神经外科行中心静脉置管患者470例分为对照组(230例)和观察组(240例),中心静脉置管后对照组采用透明薄膜敷料固定导管,观察组采用水胶体透明敷料固定导管。比较两组导管病原菌定植、导管相关性感染和导管相关性血源性感染、皮肤病原菌定植情况。结果观察组导管病原菌定植、导管相关性感染、导管相关性血源性感染以及皮肤病原菌定植的发生率显著低于对照组,导管感染发生时间显著延长(均P0.05)。结论水胶体透明敷料可以有效预防神经外科患者中心静脉导管细菌定植和细菌感染,具有良好的皮肤安全性。     

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.     

安普贴膏剂与安普贴联合治疗Ⅲ、Ⅳ期褥疮的效果评价

目的探讨安普贴膏剂与安普贴联合治疗Ⅲ、Ⅳ期褥疮的疗效。方法治疗组15例共31处褥疮,用生理盐水清洗创面后,5%碘伏消毒创面及边缘,安普贴膏剂薄敷在创面上,安普贴封闭褥疮面至边缘2~3cm,直到创口愈合修复;对照组10例共21处褥疮,采用碘伏加TDP灯照射治疗,观察2组疗效和愈合率。结果治疗组治疗2个月Ⅲ期褥疮愈合率为91.67%,Ⅳ期褥疮愈合率为57.14%,总有效率78.79%;对照组治疗2个月Ⅲ期褥疮愈合率为53.33%,Ⅳ期褥疮愈合率为33.33%,总有效率47.62%。结论安普贴膏剂与安普贴联合治疗Ⅲ、Ⅳ期褥疮疗效优于碘伏。     

PDCA循环管理在保护婴幼儿机械通气颜面皮肤效果应用

目的：通过PDCA（Plan Do Check Act）持续质量改进循环管理模式,提高水胶体敷料对气管插管患儿颜面皮肤的保护效果。方法：PICU病区护士长担任项目负责人,旨在减少因水胶体敷料介入程序的不规范而导致机械通气患儿颜面皮肤保护效果的差异。项目基于PDCA循环管理理论,遵循5个阶段包括准备,宣传,程序化,评估以及改进。机械通气患儿颜面皮肤问题进行统计学分析,并且与回顾性的数据资料进行比较。结果：①通过PDCA项目介入机械通气患儿应用水胶体敷料（包括有创机械通气和无创机械通气）,颜面问题发生率从57% t降至21%。项目提高了水胶体敷料的保护效果(P<0.05)。②建立水胶体敷料介入气管插管流程以及CPAP无创机械通气颜面皮肤保护固定标准。③因项目而创建的评估记录单作为一项工具有助于护理。结论：PDCA循环管理有效改进了水胶体敷料对机械通气患儿颜面皮肤保护的应用效果。     

A study on the effect on surface detail reproduction of alginate impressions disinfected with sodium hypochlorite and ultraviolet light — An In Vitro study

Objectives of the study

To evaluate the surface detail reproduction of dental casts with impressions made using commercially available alginate impression materials after disinfecting with chemical disinfectant sodium hypochlorite and physical means of disinfection using ultraviolet radiation.

Materials and methods

A stainless steel die was used to make impression according to ADA/ANSI specification No. 18 having 25, 50 and 75 µm lines. Totally 70 impressions were made and divided in to 7 groups. The impressions in the first group were only rinsed with 250 ml of water. The 2nd, 3rd and 4th groups were disinfected by immersing in sodium hypochlorite for 1, 5 and 10 minutes, respectively. Fifth, 6th and 7th group samples were disinfected by placing them in ultraviolet chamber for 6, 12 and 18 minutes, respectively. All the impressions were poured immediately using type III gypsum. The casts were recovered and subjected for evaluation of the 75 µm lines using stereomicroscope.

Results

There was no statistically significant change in the surface detail reproduction when disinfected with sodium hypochlorite or ultraviolet radiation.

Conclusion

Alginate impressions subjected to immersion disinfection using sodium hypochlorite for 1, 5 and 10 minutes and subjected to ultraviolet disinfection for 6, 12 and 18 minutes exhibited no statistically significant differences for surface detail reproduction compared to control groups.     

温熟水擦浴结合水胶体敷料治疗Ⅰ、Ⅱ期压疮的作用

目的 研究温熟水擦浴结合水胶体敷料治疗Ⅰ、Ⅱ期压疮的作用。 方法 随机对照试验,对符合条件的同济大学附属杨浦医院神经外科2012年1月～2013年12月期间住院合并Ⅰ或Ⅱ期压疮的患者共171例,分别予以40-50℃温熟水擦浴、生理盐水擦浴和温生水擦浴后创面覆盖水胶体敷料护理治疗,两周后观察压疮创面愈合情况。 结果 最终进入统计分析的166例患者中温熟水擦浴组患者压疮创面愈合率最高,温生水组患者压疮创面愈合率最低。按照患者是否肢体活动受限、营养不良及糖尿病分层研究结果表明温熟水擦浴护理在不同压疮患者中的疗效优于生理盐水和温生水,差异有统计学意义。 结论 40-50℃温熟水擦浴护理结合水胶体敷料对于Ⅰ、Ⅱ期压疮的疗效优于温生水或生理盐水结合水胶体敷料。该方法简单有效,提高压疮治愈率,值得在临床推广使用。     

康惠尔水胶体敷料应用于静脉炎的效果观察

目的：为了有效治疗静脉炎,为临床提供参考。方法：对采用康惠尔水胶体敷料外敷与土豆片外敷治疗静脉炎的疗效进行比较。结果：康惠尔水胶体敷料外敷治疗静脉炎的疗效好于土豆片外敷,操作方法简便,安全有效,病人活动不受限制。结论：康惠尔水胶体敷料应用于治疗静脉炎疗效好。