Treatment of granulating wounds with silastic foam dressings

We have examined the usefulness of a Silastic foam dressing in the management of open granulating wounds in 55 outpatients. It is an acceptable and comfortable dressing, which allows earlier discharge from hospital. The method of making the dressing, and the daily care of the wound are described. Improved wound care is achieved by providing two dressings, so that when one is in place the other is being thoroughly cleaned. This technique has been shown to reduce bacterial contamination of the wounds and to improve wound healing (p less than 0.02).     

A comparison of two dressings in the management of chronic wounds

A hydropolymer dressing (Tielle) and a hydrocolloid dressing (Granuflex) were compared in a randomised controlled clinical study involving 100 patients with leg ulcers and 99 patients with pressure sores in the community. Statistically significant differences in favour of the hydropolymer dressing were detected for dressing leakage and odour production, but no statistically significant differences were recorded in the number of patients with either leg ulcers or pressure sores who healed in each treatment group.     

Tissue viability. Post-operative wounds: a nurse-led change in wound dressings

In an attempt to ascertain whether the type of dressing used in hip replacement surgery can affect the risk of patients haemorrhaging post-operatively, a survey was carried out on a 25-bedded orthopaedic ward. It was found that thinly dressed wounds were more likely to lead to haemorrhage. As a result of this nursing-led initiative, the consultants agreed to use thickly padded dressings and there has since been a reduction in the number of patients haemorrhaging.     

A study of the concentration of orally administered sparfloxacin found in exudates from suture wounds beneath occlusive dressings

We have developed a simple algorithm for scalp localization for craniotomy. Using a series of CT/MRI data, the point on the scalp closest to the center of the lesion (T) is determined by our program. A plane (plane R) is defined by three points: bilateral auditory meati and T. Point S is the intersection of three planes: the plane R, the scalp surface and the midsagittal plane. The distance from either S or the ipsilateral external auditory meatus to T is measured along the scalp surface on the plane R. The distance from the nasion to S along the scalp surface on the midsagittal plane is also measured. To determine the craniotomy site, these distances are measured directly on a patient's scalp in the operating room. This simple and accurate method for scalp localization could be used by installing our program in conventional CT/MR scanners.     

Something's rotten: a nosocomial outbreak of malodorous Pseudomonas aeruginosa

From July 1994 through November 1996, a phenotypically unique strain of Pseudomonas aeruginosa producing a pungent, "rotten-potato" odor and a positive lysine decarboxylase reaction was isolated from 39 patients at UCLA Medical Center (Los Angeles). Most cases (95%) were in intensive care units and had clinical infections (72%). Most isolates (74%) were recovered from cultures of respiratory secretions. To determine risk factors for acquisition of the organism, 23 cases were compared with 23 randomly selected controls matched by service and isolate date. Multivariate analysis revealed that isolation of malodorous P. aeruginosa was associated with mechanical ventilation of > 24 hours' duration (odds ratio [OR] = 9.4; P = .001) and transfer from an outside hospital (OR = 5.7; P = .04). DNA from outbreak strains hybridized to P. aeruginosa-specific toxin A and phospholipase C gene probes and all outbreak isolates tested were found to be identical by use of pulsed-field gel electrophoresis. An unusual phenotypic characteristic of the strain led to the recognition of a nosocomial outbreak of P. aeruginosa infection associated with mechanical ventilation.     

Establishing a dressings formulary

Choices have to be made between the multitude of dressings available, and especially between products with the same characteristics and features. This article describes how to compile, maintain, monitor and review a dressings formulary.     

Equal unpleasantness matching of malodorous substances in the community.

5 different odorants, produced through combustion procedures of animal manure, were matched with hydrogen sulfide with regard to unpleasantness by 30 female 20-47 yr olds. Power functions described the unpleasantness matchings for 5 combustion toilets tested. The exponents of the equal sensation functions indicated a relative invariance of the various combustion procedures on the exponent. Different combustion procedures resulted in different levels of odor unpleasantness, but these differences were small from a practical point of view. Results demonstrate the practical applicability of psychophysical methods in environmental health research. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emergency laparoscopy for abdominal stab wounds

BACKGROUND: The roles of endoscopy and surgery in the management of Ascaris lumbricoides affecting the hepatobiliary and pancreatic system in adults were determined. METHODS: All patients undergoing endoscopic retrograde pancreatography for ascariasis of the biliary or pancreatic system unresponsive to standard medical therapy were analysed. Worms were extracted using snare, Dormia basket or biopsy forceps. Success was defined as clearance of worms and eradication of symptoms. RESULTS: Endoscopic extraction was performed in 25 patients with success in 19. Failures occurred in one patient with Ascaris in the gallbladder, and in five with associated strictures or stones. All six patients were treated successfully by surgery. CONCLUSION: Endoscopy was successful in the treatment of Ascaris infestation resistant to medical therapy in 19 of 25 patients. Surgery remains important in the management of infestations complicated by biliary or pancreatic strictures and stones, or worms in the gallbladder.     

Costs of dressings in the community

This study compares the costs of dressings used in the treatment of patients with a variety of wound aetiologies. The two dressings investigated were a hydrocolloid dressing and a hydrocellular dressing. Secondary objectives included a comparison of dressing durability, time to complete healing, ease of wound cleansing and dressing removal. The study was an open prospective single-centre randomised parallel group trial involving 100 patients, treated in the community, who were randomised to the two dressing groups. For all aetiologies except pressure sores, the costs of the hydrocolloid dressing were less than the costs of the hydrocellular dressings. Similar healing rates were observed in the leg ulcer and 'other wound' groups. There were, however, significant differences in the number of healed wounds observed in patients with pressure sores treated with the hydrocellular dressing.     

Allergic contact dermatitis from hydrocolloid dressings

A 4-month-old infant presented with aneurysm of patent ductus arteriosus (PDA) which was causing obstruction of the left main bronchus. The patient had elevated pulmonary vascular resistance (PVR) at 6.1 um2. The aneurysm was resected on cardiopulmonary bypass. The patient required phenoxybenzamine and prostacycline after the operation for elevated PVR. Postoperative progress was prolonged but 12 months after surgery the patient is well, growing normally without any respiratory symptoms.     

Dressing wounds

This article describes the choice and method of application of wound dressing in a variety of situations. The types of wounds covered include those in awkward areas, cavity wounds and fungating wounds. The problems of patients with allergies to wound dressings are also discussed.