Film Dressings Research Articles

Comparison of Acute Radiation Dermatitis Secondary to Proton Beam Therapy Between Corticosteroids Transdermal Delivery Plus Film Dressing and Film Dressing Alone

Acute radiation dermatitis (ARD) is one of the most common adverse events of proton beam therapy (PBT). Corticosteroid transdermal delivery (CTD) and film dressing (FD) have been recognized as effective treatments for ARD, however, ARD differs substantially between individuals, which makes it harder to provide the most appropriate treatment for patients. The purpose of this study was to examine the prophylactic effect of CTD plus FD on PBT-induced ARD as compared with FD alone in every patient. We conducted an institutional prospective study to manage separately on the right and left irradiated skin to a patient, namely placing an AIRWALL as FD after applying betamethasone valerate lotion as CTD on the right and putting an AIRWALL on the left. Fifty patients with prostate cancer were enrolled to the study from November 2017 to March 2018 and were irradiated a total dose of 70 Gy equivalent with 28 fractions using bilateral horizontal beams. It was not until the AIRWALL peeled off the skin spontaneously and completely that a new one was placed. Both sides of photographs were taken every weekday to evaluate ARD during the period of PBT. The patients’ median age was 68 (range, 47–81 years). Grade 0/1 ARD was seen in 28/22 patients on the right and 30/20 patients on the left, respectively. There was no significant difference between the both sides. The number of replacements of ARIWALL in a patient during PBT was 7.7 ± 4.8 (mean ± SD) on the right and 2.4 ± 1.4 on the left, respectively. A significant difference was seen between the two (p<0.0001). As far as patients with less 6 times replacement of AIRWALL in PBT, Grade 0/1 ARD was seen in 18/4 patients on the right and 14/8 patients on the left, respectively. Film dressing combined with corticosteroid transdermal delivery did not reduce the severity of ARD secondary to PBT for patients with prostate cancer compared with film dressing alone. Fewer replacement of film dressing in a patient may be a key to a synergistic effect of CTD and FD for reducing ARD.

Patient Outcomes with a Transparent Film Dressing for Reducing Acute Dermatitis from Post-Mastectomy Radiotherapy

Dermatitis remains a source of morbidity for post-mastectomy radiotherapy (PMRT) patients. We retrospectively report our experience, including patient-reported outcomes (PROs), with a transparent film dressing (Mepitel film) for reducing acute dermatitis from PMRT. Patients who underwent prophylactic application of Mepitel film over the irradiated chest wall during PMRT for breast cancer at our institution between September 2015 and August 2019 were included. Mepitel films were regularly checked every 1-2 weeks during treatment and changed or patched as needed. Adverse events were graded according to the Common Terminology Criteria for Adverse Events (CTCAE) Version 5. Selected PROs at baseline, PMRT completion, and 3-month follow-up were obtained from the PRO-CTCAE and the Breast Cancer Treatment Outcomes Scale. Descriptive and univariate analyses (e.g., Wilcoxon signed-rank test) were performed using SPSS Statistics Version 25. 139 patients with a mean (standard deviation) age of 52 (12) years at the time of treatment met the eligibility criteria. PMRT was administered with protons in 102 (73.4%) and photons in 37 (26.6%). Approximately half (50.4%) of patients had breast reconstruction at the time of PMRT. The median (range) number of total fractions given was 25 (15-33) with a median (range) total dose of 5000 (4005-6625) cGy. Chest wall boost was administered in 21 (15.1%), and lymph node boost in 26 (18.7%). Skin boluses were used in 35 (95%) of the 37 patients treated with photons. One (1.4%) patient developed an allergic reaction to Mepitel before treatment during a sampling trial. 24 (17.5%) discontinued Mepitel before PMRT completion, most commonly due to a skin reaction (allergic or irritation) (16 (11.7%)), or difficulty with its use (poor adherence, intolerance, or discomfort) (8 (5.8%)). The median (range) number of Mepitel patching and re-applications during PMRT was 3 (0-10). 71 (51.1%) patients developed grade 1 dermatitis, 60 (43.2%) developed grade 2 dermatitis, and eight (5.8%) developed grade 3 dermatitis. On a 5-point Likert scale (0 meaning not at all and 5 meaning very severe), the median self-rated severity at PMRT completion and 3-months were 2 (mild; range 1-5; n = 86) and 1 (none; range 1-4; n = 82), respectively. Self-reported ratings of other PROs (bleeding or leaking fluid, blistering, tenderness/discomfort, tightness, telangiectasia, flaking/peeling, changes in skin color, and itchiness) on a 10-point Likert scale were as expected. The use of Mepitel films in patients undergoing PMRT with photon- and proton-based radiotherapy is feasible. Rates of acute skin toxicity compare favorably with historical controls. Based on this preliminary experience, a phase 3 randomized controlled trial (A221803) comparing Mepitel versus best supportive care for patients undergoing PMRT is pending.

An Evaluation of Wound Healing Efficacy of a Film Dressing Made from Polymer-integrated Amnion Membrane

ABSTRACT A film dressing is an easy and common wound management, which is flexible to cover many types of superficial injuries. In a recent study, we developed a scaffold from poly (1,8-octanediolco-citrate) incorporated decellularized amnion membrane (DAM-POC). The DAM-POC scaffold was biocompatible and could enhance soft and hard tissue regeneration when applied to repair the cleft palate in rat. The efficacy of the DAM-POC scaffold in oral repair had led us to hypothesize that it could be employed extensively in the medical field as a wound dressing. This study aimed to investigate the feasibility and efficacy of the DAM-POC scaffold as a film dressing in accelerating wound healing when applied in multiple tissue injuries. Our results demonstrated that both the DAM and DAM-POC scaffolds were biocompatible and anti-adhesive without causing severe foreign body reactions when covering wounds in abdominal wall, back muscle, tibia bone, and liver. In addition, the DAM-POC scaffold was superior to the DAM scaffold in reducing inflammation, preventing fibrosis, and regenerating tissues. In conclusion, the DAM-POC scaffold might potentially be adopted as a film dressing in a wide range of therapeutic applications and healing situations to protect the damaged tissues from the external environment and prevent infections.

Dislodgement Forces and Cost Effectiveness of Dressings and Securement for Peripheral Intravenous Catheters: A Randomized Controlled Trial.

Objectives: Peripheral intravenous catheters (PIVC) are the most frequently used invasive devices in medicine. PIVC failure before treatment completion is a significant concern and occurs in 33–69% of patients. Partial dislodgement and accidental removal are some of the reasons for PIVC failure. The most effective dressing and securement method for preventing accidental removal remains unclear. It was the aim of this study to compare the force required to dislodge a PIVC with four commonly used dressing and securement methods. Additionally, costs were calculated. Methods: Truncated 18-gauge i.v. cannulas were attached onto the forearm of 209 volunteers using four different dressings and securements (sterile absorbent wound dressing covered by two different types of elastic polyester fleece, bordered and non-bordered polyurethane). The force during continuously stronger pulling until dislodgement was recorded. Results: The highest resistance against dislodgement forces could be observed with a sterile absorbent wound dressing covered by two incised elastic polyester fleece dressings. Commercially-manufactured bordered and non-bordered polyurethan film dressings were 20% to 75% more expensive than sterile absorbent wound dressings covered by elastic polyester fleece dressing. Conclusions: Elastic polyester fleece secured a PIVC against accidental removal by external force best, compared to commercially-manufactured bordered and non-bordered polyurethane film dressing.

Notes from the NICU: Analyzing the Chemical Content of Commonly Used Medical Products

Notes from the NICU: Analyzing the Chemical Content of Commonly Used Medical Products

Pilot-study switchable film dressing &amp; elderly skin/patients with chronic wounds: A non-interventional, non-placebo-controlled, national pilot study

Abstract Aim Film dressings were one of the first modern wound-dressing products. During the removal of the dressing skin stress occurs. An essential role is shearing force between skin and wound dressing playing [3]. This problem includes missing elasticity, flexibility and too strong adhesion [3,4]. The present study was initiated to evaluate if the switchable formulation of the adhesive ensures a durable and strong enough adhesion. Illumination of the film dressing with the UV-A lamp irreversibly switches the adhesion from strong to weak and guarantees a painless/comfortable removal of the dressing. Methods The present study evaluated suitability for use as well as user and patient satisfaction during use of the tested film on patients with chronic wounds. The used film dressing consists of a thin film backing with a non‑latex adhesive. Before removal the adhesion is reduced by illuminating the dressing with the UV-A lamp. Results 54 patients were included in the study. At each dressing change, pain level after dressing change was rated lower compared to the pain level before dressing change. Overall, pain level decreased over the study period. Reactions on the wound edge/wound surroundings have not been reported. Discussion The clinicians gave favourable scores for the tested film dressing. The overall satisfaction with the product was rated very good. Tolerability such as pain during wearing the dressing and upon removal were given good scores. Skin irritation caused in the use of the film dressing did not occur. Conclusion The switchable function of the adhesive allows the adhesion of the film dressing to the skin to be reduced when illuminated by the supplied UV-A lamp. The results of the present study show that the reduced adhesion upon illumination enables easy and comfortable removal of the dressing.

Topical insulin in the treatment of nonhealing erosions and ulcers of pemphigus vulgaris

Pemphigus vulgaris (PV) is characterized by cutaneous flaccid blisters, erosions, and crusts and mucosal erosions. 1 Grada A. Obagi Z. Phillips T. Management of chronic wounds in patients with pemphigus. Chronic Wound Care Manage Res. 2019; 6: 89-98 Crossref Google Scholar In severe PV, erosions may extend to the dermis and may transform into ulcers. Management of such ulcers includes optimum wound care with nonadherent gauze, transparent film, hydrocolloid, and hydrogel dressings. 1 Grada A. Obagi Z. Phillips T. Management of chronic wounds in patients with pemphigus. Chronic Wound Care Manage Res. 2019; 6: 89-98 Crossref Google Scholar Despite these measures, ulcers, especially located over the buttocks, are refractory to treatment.

Development and Characterization of Hemicellulose-Based Films for Antibacterial Wound-Dressing Application.

Hemicelluloses are biopolymers with versatile properties for biomedical applications. Herein, hemicellulose (arabinoxylan)-based antibacterial film dressings were prepared and characterized. Arabinoxylan was isolated from psyllium husk. Blank and gentamicin-loaded films were prepared by the solvent cast method using glycerol as the plasticizer. The appropriate composition of the films was obtained by varying the amounts of arabinoxylan, glycerol, and gentamicin. The films were found to be transparent, smooth, bubble-free, flexible, and easily peelable with 2% to 3% arabinoxylan. They had uniform thickness and swelled up to 60% of their initial size. The mechanical properties and water vapor transmission rate through the films were found to be suitable for wound-dressing application. Fourier transform infrared spectroscopy (FTIR) analysis confirmed drug–film compatibility. In an in vitro release study, more than 85% of the gentamicin was released from the films in 12 h. The antibacterial activities of the gentamicin-loaded films were found to be close to the standard gentamicin solution. The films were found to be cytocompatible in cell viability assay. These results suggested that hemicellulose-based films are promising materials for the dressing of infected wounds.

High body mass index is a strong predictor of intraoperative acquired pressure injury in spinal surgery patients when prophylactic film dressings are applied: A retrospective analysis prior to the BOSS Trial.

We reported the efficacy of soft silicone multilayered foam dressings in preventing intraoperatively acquired pressure injuries (IAPIs) in the prone position using a Relton-Hall frame (BOSS trial). The aim of this study was to clarify the incidence and extract the risk factors for IAPIs in cases in which polyurethane film dressing was used against IAPIs before the BOSS trial period. This study conducted as a retrospective dual-center cohort study between August 2014 and Jun 2015 using the medical records in the operating room. The incidence of IAPIs that developed within 24 hours after surgery was 7.1% (7/99). The multivariate logistic regression analysis revealed that body mass index (BMI) (P = .0016, odds ratio [OR]: 1.22, 95% confidence interval (CI) 1.08-1.4) and length of surgery (P < .0001, OR 2.47, 95% CI 1.86-3.51) were independently associated with the development of IAPIs. Since high BMI was not extracted in BOSS trial, we conclude that the application of soft silicone multilayer foam dressings is important for preventing the development of IAPIs in patients with high BMI values.

Preparation and characterization of a novel antimicrobial film dressing for wound healing application

Antibacterial activity and good mechanical properties are some of the characteristics required for an appropriate film dressing. A novel polymer blend was developed for wound healing application. Twenty-four formulations using the polymers chitosan, poly(vinyl alcohol) and/or ɛ-Polylysine and the plasticizer glycerol were designed using factorial design and then the films were prepared by the casting/solvent evaporation method. Seventeen films were obtained among the twenty-four proposed formulations that were characterized by Field Emission Scanning Electron Microscopy (FE-SEM) and Fourier Transform Infrared Spectroscopy (FTIR). Mechanical properties, such as tensile strength (σ), elongation at break (ɛ) and Young’s modulus (Y) as well as antibacterial properties were determined. The best candidate was then further analyzed with regard to porosity, Water Vapor Transmission Rate (WVTR), swelling and cytotoxicity experiments. The results showed a film with semi-occlusive characteristics, good mechanical properties and no toxic. Incorporation of ɛ-Polylysine increased antibacterial activity against gram-negative (Escherichia coli) and gram-positive (Staphylococcus aureus) bacteria.

Pilot-Study Lumina Switchable Post-Op Dressing &amp; Postsurgical Wounds: A Non-interventional, Non-placebo-controlled, National Pilot Study

Dressings applied to primarily closed surgical incisions should be appropriate interactive dressing [13] and demonstrate an ability to protect the wound from contaminants and trauma, manage exudate, and avoid excessive pressure to the incision line. Additionally, they should be flexible, well fixed to the skin on application, skin protective (e.g. reduce the risk of blistering or irritation, not excessively adhesive) and waterproof [14]. Film dressings were one of the first modern wound-dressing products. They are extremely flexible, transparent and adhesive. During the removal of the dressing skin stress occurs. An essential role are shearing and friction forces between skin and wound dressing playing. This problem includes missing elasticity, flexibility and too strong adhesion. A non-interventional, non-placebo-controlled, national pilot study was done to prove a new shearing force reducing technique and dressing. The used post-op dressing consists of a thin film backing with a switchable polyurethane adhesive and non-adhering absorption pad. Before removal the adhesion is reduced by illuminating the dressing with the UV-A lamp. 52 patients at a mean age of 55.79 years (SD±16.22) with a total of 52 wounds were included in the study, all of them finalized the 1-week study period. At baseline, pain was measured with a mean of 3.52 (SD±1.26), during the study period pain decreased to a mean of 2.10 (SD±0.97) (VAS 0=no pain, 10=excruciating pain). Significance was calculated as 0,000 (paired t-test). At each dressing change, pain level after dressing change was rated lower compared to the pain level before dressing change. Overall, pain level decreased over the study period. The removal of the dressing after illumination with the UV-A lamp was rated in mean with 1.79 (2. Visit) and 1.86 (3. Visit) on the 6–point-scale (1=very good – 6=insufficient). Significance was calculated as 0,000 for visit 3 (one sample t-test [test value=3,0]). Reactions on the wound edge/wound surroundings have not been reported. In contrast, a reduction of maceration and redness of the wound edge/wound surrounding was observed. The results confirm that the adhesive ensures a safe and effective occlusion/fixation of the dressing and that the strong adhesion enables dressing to function according to specification. There was no deterioration of the wound situation or an infection in any of the cases. The switchable function of the adhesive allows the adhesion of the post-op dressing to the skin to be reduced when illuminated by the supplied UV-A lamp. The results of the present study show that the reduced adhesion upon illumination enables easy and comfortable removal of the dressing.

Analysis of the Current Application of Peripheral Intravenous Catheter and Indwelling Failure in the Department of Hepatobiliary Surgery

Background: PIVC therapy is the most common hospital procedure. Its insertion and maintenance are easy to fail. Objective: To investigate the current application of peripheral venous catheter (PIVC) in the department of hepatobiliary surgery and the risk factors that lead to indwelling failure. Peripheral intravenous catheter therapy is one of the most common treatment procedures but has a relatively high failure rate during insertion and indwelling. Methods: A cross-sectional correlation study was adopted. Clinical data of patients receiving PIVC from March to June in 2019 in our hospital were collected. All patients were inserted with closed 24G IV catheters manufactured by BD Company, sealed with 50U/mL heparin saline and secured by 3M Tegaderm Film-Transparent film dressing. Estuation caused by any reasons within 72 hours that failed to complete the treatment was considered to be indwelling failure. Univariate analysis was performed to analyze the effect of gender and age on the indwelling time, and logistic regression was used to analyze the related factors of indwelling needle-induced complications. The methods were consistent with the STROBE criteria (Supplementary File 1). Results: 445 patients were enrolled and clinical data from 395 patients were analyzed eventually, with a total of 773 PIVC cases. The indwelling time varied from 0.5h to 329h (median time 49.00±0.86h). Indwelling site: back of the hand (61%), forearm (28%), joint (6%), upper arm (4%) and finger (1%). The success rate of one-time puncture was 92%. PIVC indwelling failure rate was 46% which appeared to be higher in females and older people. Complications included exudation (72%), phlebitis (8%), blockage (5%) and errhysis (4%). There were no statistically significant differences in the incidence of complications in each indwelling period (P>0.05). Logistic regression analysis showed that complications were independent risk factors for catheter indwelling failure (OR: 26.98, P<0.01). Conclusions: PIVC mostly performed on the back of the hand and its indwelling time was associated with patients’ gender and age in the department of hepatobiliary surgery. The occurrence of complications was an independent factor for PIVC failure.

The Effectiveness of Applying Soft Tissue Bonding Adhesive Composed of 2-Ethyl Cyanoacrylate to Epidural Catheter Fixations Using Film Dressings: An Open-Label, Randomized, Parallel-Group Comparative Study

(Anesth Analg. 2019;129(1):149–154) During a cesarean section, epidural catheters that are not adequately fixed can migrate or even fail; this failure can result in insufficient anesthesia for the patient. Although there are various fixation methods for epidural catheters, there is currently no commonly agreed upon technique. These authors conducted their study in patients having a cesarean delivery to determine if a film dressing used in combination with a surgical adhesive (Aron Alpha A) would provide superior fixation in comparison to a film dressing used independently.

Presence of Bisphenol A and Parabens in a Neonatal Intensive Care Unit: An Exploratory Study of Potential Sources of Exposure

Newborns in neonatal intensive care units (NICUs) are in contact with a variety of medical products whose production might include synthetic chemicals with hormonal activity. Our aim was to assess the content of bisphenol A (BPA) and parabens (PBs) and the hormone-like activities of a subset of medical products commonly used in NICUs in prolonged intimate contact with NICU newborns. Fifty-two NICU items were analyzed, determining the concentrations of BPA and PBs [methyl- (MeP), ethyl- (EtP), propyl- (PrP), and butylparaben (BuP)] and using the E-Screen and PALM-luciferase assays to measure the in vitro (anti-)estrogenic and (anti-)androgenic activity, respectively, of the extracts. Items found to have elevated BPA/PB content or hormone-like activities were further extracted using leaching methodologies. BPA was found in three-fifths and PBs in four-fifths of tested NICU items, and and of extracts evidenced estrogenic and anti-androgenic activity, respectively. The highest BPA content was found in the three-way stopcock (), followed by patterned transparent film dressing, gastro-duodenal feeding tubes, sterile gloves, single-lumen umbilical catheters, and intravenous (IV) infusion extension sets (concentrations ranged from 100 to BPA). A total PB concentration () was observed in several items, including light therapy protection glasses, patterned transparent film dressing, winged IV catheters, IV infusion extension sets, and textile tape. The highest estrogenic activity [ estradiol equivalent ()] was found in small dummy nipples, three-way stopcocks, and patterned transparent film dressing and the highest anti-androgenic activity [ procymidone equivalent units per gram ()] in small dummy nipples and three-way stopcocks. According to these findings, neonates might be exposed to multiple sources of BPA and PBs in NICUs via inhalation, dermal, oral, and IV/parenteral routes. There is a need to address the future health implications for these extremely vulnerable patients and to adopt precautionary preventive measures as a matter of urgency. https://doi.org/10.1289/EHP-embargotest.

Meta-analysis of self-adhesive soft silicone film dressings on preventing and treating radioactive skin lesion

Objective To systematically assess the effects of self-adhesive soft silicone film dressings on preventing and treating radioactive skin lesion. Methods Randomized controlled trials (RCT) about self-adhesive soft silicone film dressings on preventing and treating radioactive skin lesion were retrieved from PubMed, Web of Science, Cochrane Library, Embase, CNKI, VIP and Wanfang databases, and RevMan 5.3 was used for Meta-analysis of the trials which met the inclusion criteria. Results Totally 10 RCTs were included, with a sample size of 1 231 cases. Meta-analysis revealed that self-adhesive soft silicone film dressings could reducethe incidence of GradeⅡ or above radiodermatitis (OR=0.14, 95%CI 0.08-0.25, P<0.01) , shorten the occurrence time of radiodermatitis within the field of radiotherapy (OR=0.07, 95%CI 0.02-0.32, P<0.01) , and reduce subjective and objective symptom scores of radiodermatitis (Radiation-induced Skin Reaction Assessment Scale, RISRAS) (MD=-3.33, 95%CI-5.96--0.70, P<0.05) . Conclusions Self-adhesive soft silicone film dressings applied on the cutaneous surface within the field of radiotherapy can reduce the severity of radiodermatitis, shorten the occurrence time of radioactive skin lesion within the field of radiotherapy, and effectively ameliorate cutaneous discomfort within the field of radiotherapy and the effects of radiotherapy-induced skin reaction on daily activities. Key words: Radiodermatitis; Self-adhesive soft silicone film dressings; Skin lesion; Malignant neoplasms; Meta-analysis

Presence of Bisphenol A and Parabens in a Neonatal Intensive Care Unit: An Exploratory Study of Potential Sources of Exposure.

Background:Newborns in neonatal intensive care units (NICUs) are in contact with a variety of medical products whose production might include synthetic chemicals with hormonal activity.Objectives:Our aim was to assess the content of bisphenol A (BPA) and parabens (PBs) and the hormone-like activities of a subset of medical products commonly used in NICUs in prolonged intimate contact with NICU newborns.Methods:Fifty-two NICU items were analyzed, determining the concentrations of BPA and PBs [methyl- (MeP), ethyl- (EtP), propyl- (PrP), and butylparaben (BuP)] and using the E-Screen and PALM-luciferase assays to measure the in vitro (anti-)estrogenic and (anti-)androgenic activity, respectively, of the extracts. Items found to have elevated BPA/PB content or hormone-like activities were further extracted using leaching methodologies.Results:BPA was found in three-fifths and PBs in four-fifths of tested NICU items, and and of extracts evidenced estrogenic and anti-androgenic activity, respectively. The highest BPA content was found in the three-way stopcock (), followed by patterned transparent film dressing, gastro-duodenal feeding tubes, sterile gloves, single-lumen umbilical catheters, and intravenous (IV) infusion extension sets (concentrations ranged from 100 to BPA). A total PB concentration () was observed in several items, including light therapy protection glasses, patterned transparent film dressing, winged IV catheters, IV infusion extension sets, and textile tape. The highest estrogenic activity [ estradiol equivalent ()] was found in small dummy nipples, three-way stopcocks, and patterned transparent film dressing and the highest anti-androgenic activity [ procymidone equivalent units per gram ()] in small dummy nipples and three-way stopcocks.Discussion:According to these findings, neonates might be exposed to multiple sources of BPA and PBs in NICUs via inhalation, dermal, oral, and IV/parenteral routes. There is a need to address the future health implications for these extremely vulnerable patients and to adopt precautionary preventive measures as a matter of urgency. https://doi.org/10.1289/EHP5564

Evaluation of bioactive compounds-loaded chitosan films as a novel and potential diabetic wound dressing material

Delayed wound healing is a major complication of diabetes and the medical treatment of such wounds still remains a challenge. Among the modern wound dressings, film dressings are considered to be one of the major advances in wound management. In the current study, the feasibility of using a previously developed and optimized bioactive compounds-loaded chitosan film formulation as a functional wound dressing material for diabetic wounds was investigated. The antioxidant capacity, as well as the effect of the chitosan films on cell viability was assessed in vitro. Furthermore, the in vivo performance of the films was further evaluated, by using a streptozotocin-induced diabetic rat model. The chitosan film formulation provided a beneficial moist wound environment, reducing the risk of dehydration and favouring the closure of the wounds. Also, it exhibited good antioxidant activity, as well as a proliferative effect and adequate biocompatibility. The in vivo evaluation of the bioactive compounds-loaded chitosan film formulation confirmed that the biofilm stimulated wound contraction and accelerated the wound healing process. The results strongly support that the above mentioned chitosan film seems to be a promising formulation, as well as a potential and novel biomaterial used for wound healing applications.

Film Dressings Based on Hydrogels: Simultaneous and Sustained-Release of Bioactive Compounds with Wound Healing Properties.

This research proposes the rational modeling, synthesis and evaluation of film dressing hydrogels based on polyvinyl alcohol crosslinked with 20 different kinds of dicarboxylic acids. These formulations would allow the sustained release of simultaneous bioactive compounds including allantoin, resveratrol, dexpanthenol and caffeic acid as a multi-target therapy in wound healing. Interaction energy calculations and molecular dynamics simulation studies allowed evaluating the intermolecular affinity of the above bioactive compounds by hydrogels crosslinked with the different dicarboxylic acids. According to the computational results, the hydrogels crosslinked with succinic, aspartic, maleic and malic acids were selected as the best candidates to be synthesized and evaluated experimentally. These four crosslinked hydrogels were prepared and characterized by FTIR, mechanical properties, SEM and equilibrium swelling ratio. The sustained release of the bioactive compounds from the film dressing was investigated in vitro and in vivo. The in vitro results indicate a good release profile for all four analyzed bioactive compounds. More importantly, in vivo experiments suggest that prepared formulations could considerably accelerate the healing rate of artificial wounds in rats. The histological studies show that these formulations help to successfully reconstruct and thicken epidermis during 14 days of wound healing. Moreover, the four film dressings developed and exhibited excellent biocompatibility. In conclusion, the novel film dressings based on hydrogels rationally designed with combinatorial and sustained release therapy could have significant promise as dressing materials for skin wound healing.

A Randomized Control Trial Comparing Transparent Film Dressings and Conventional Occlusive Dressings for Elective Surgical Procedures.

BACKGROUND:Surgical site infection is one of the major health-care-associated problems causing substantial morbidity and mortality and constituting a financial burden on hospitals as well. The wound management is one of the crucial evidence-based strategies in the reduction of surgical site infection ratesAIM:To study the impact of standardisation of transparent semipermeable dressing procedure on the rate of surgical site infection in comparison with conventional dressing in clean and clean-contaminated surgeries.METHODS:The study included 100 patients who were admitted to surgical wards in Cairo university hospitals, for clean and clean-contaminated operations, in the period from February 2017 to August 2017. Immunocompromised and uncontrolled diabetic patients were excluded. Patients were randomly allocated into two groups; in the first group, patients wounds were covered using transparent semipermeable dressing, while the second group patients’ wounds were covered using conventional occlusive gauze dressing. Patients were followed up for criteria of infection every other day during the first week then at two weeks, three weeks and four weeks.RESULTS:In clean and clean-contaminated operations, the transparent dressing group showed a significantly lesser rate of surgical site infection at (2%), compared with the conventional occlusive gauze dressing group with a surgical site infection rate of (14%) (p-value of 0.02).CONCLUSION:The transparent semipermeable dressing is effective in reducing surgical site infection rate in clean and clean-contaminated operations.

The Effectiveness of Applying Soft Tissue Bonding Adhesive Composed of 2-Ethyl Cyanoacrylate to Epidural Catheter Fixations Using Film Dressings: An Open-Label, Randomized, Parallel-Group Comparative Study.

Insufficient fixation of an epidural catheter may result in migration of the catheter and eventual catheter failure. However, the best fixation method remains to be established. Aron Alpha A (2-ethyl cyanoacrylate) adhesive is approved for clinical use and can be used for surgical adhesion to both skin and blood vessels. We hypothesized that the addition of Aron Alpha A adhesive to film dressing would result in consistent and dependable catheter fixation. In this study, 58 women who were scheduled for cesarean delivery under spinal and epidural anesthesia were recruited. Patients were randomly assigned to a control or treatment group. In the control group, the catheter was fixed solely by film dressing. In the treatment group, a small amount of Aron Alpha A was applied at 2 sites along the catheter. The fixation area was then covered by film dressing. The catheter insertion length was recorded after fixation (T0), immediately postoperatively (T1), on postoperative day 1 (T2), and when the catheter was removed (T3). The change in insertion length from T0 to T3 between the 2 groups was the primary outcome measure. The incidence of catheter failure was also recorded. For all comparisons, P < .05 was considered statistically significant. Initially, 58 women were enrolled; however, 3 patients were excluded. From the remaining 55 patients, 27 and 28 were assigned to the control and treatment groups, respectively, and were evaluated. The change in insertion length from T0 to T3 was significantly more in the control group compared with the treatment group (-1.9 ± 2.2 vs 0 ± 0 cm, respectively; P < .001). In the control group, 11 catheters (41%) failed; in the treatment group, all catheters provided effective analgesia throughout the study (P < .001). Epidural catheter fixation using film dressing combined with 2-ethyl cyanoacrylate adhesive application at 2 sites along the catheter resulted in secure fixation in patients receiving postoperative epidural analgesia for cesarean delivery.