Gauze Group Research Articles

세 가지 구강간호방법에 따른 수술 후 환자의 갈증정도 및 구강상태 비교

Purpose: This study compared the effects of three oral care methods on thirst and oral status in patients after general anesthesia surgery. Methods: Sixty five surgical patients were prospectively randomized into three groups. Each group received one of three oral care methods: wet water gauze, frozen water gauze, or frozen normal saline gauze. The outcomes of thirst and oral status were assessed three times by trained investigators blinded to the oral care methods. Assessment times were right after a participant`s arrival to his/her room, and at 30 and 60 minutes after the pre-test. Results: The levels of thirst and oral status were significantly improved as time passed in all three oral care methods. While the level of thirst was not significantly different between the three groups, the level of oral status was significantly better with wet water gauze than frozen gauze groups, soaked in either water or normal saline. Conclusion: We recommend nurses choose one of three oral care methods based on patients` preferences since all three oral care methods showed similar effects in improving postoperative patients` levels of thirst and oral status.

Hemostatic Efficiency and Wound Healing Properties of Natural Zeolite Granules in a Lethal Rabbit Model of Complex Groin Injury

Quikclot has been used many years for treating external hemorrhage in the battle field. In this study, the hemostatic performance of NZG-JY (natural zeolite granules from Jinyun, China) was evaluated and compared with Quikclot in a lethal rabbit model of complex groin injury. Fifty-six anesthetized rabbits were randomized to three different groups: (1) NZG-JY (n = 19); (2) Quikclot (n = 19); and (3) medical gauze (n = 18). Survival was recorded three hours after the application of the hemostatic agents. The wound healing properties of the survived animals (n = 4 for each group) were observed a week later. The clotting efficiency is 100% for the animals in the NZG-JY and the Quikclot group, while only 5.6% in the gauze group. The mortality in the NZG-JY group (21.0%) is significantly less than that in the Quikclot group (52.6%) and the gauze group (66.7%). A good healing property was achieved in all animals that survived in the NZG-JY group, while three quarters of the animals in the Quikclot group had serious necrotic tissue. NZG-JY significantly decreases the mortality in a lethal rabbit model of complex groin injury and demonstrates good healing properties.

Efficacy of Biodegradable Synthetic Polyurethane Foam for Packing Nasal Bone Fractures

Nasal bone fracture is the most common traumatic disease among facial bone fractures. General treatment of this trauma is closed reduction, followed by intranasal packing. Vaseline or Furacin roll gauze, and Merocel are commonly used packing materials, but the pain produced while removing the packing is fearful for the patients. To compensate for this shortcoming, there has been an increased use of biodegradable synthetic polyurethane foam (SPF) recently. We performed a retrospective review to analyze the effectiveness of SPF after the closed reduction of nasal bone fracture. A retrospective review was conducted in 109 patients who underwent closed reduction for pure nasal bone fracture. One group was packed with Furacin roll gauze and the other was packed with SPF. Postoperative pain, hemostatic effect, supporting ability on the fractured segment, and healing of the injured nasal mucosa were compared between the 2 groups. A total of 109 patients were reviewed, with 61 patients packed with Furacin roll gauze (group A) and 48 patients packed with SPF (group B). Between the 2 groups, only visual analogue scale of pain at postoperative fourth day was statistically low in group B (P = 0.045) with other parameters showing no statistical difference. Nasal packing after closed reduction of nasal bone fractures support the reduced fractured bony segment and also has the main role on hemostasis and healing of mucosal injury. Removal of the packing is painful and fearful to the patients. SPF as nasal packing material provides superior outcome in terms of pain and satisfaction and, at the same time, is not inferior to the conventional packing materials with regard to bleeding control, mucosal wound healing, toxicity, and stability of reduced fracture segment.

The possibility of microbial cellulose for dressing and scaffold materials

In recent years, natural polymers such as cellulose, alginate and chitosan have been used worldwide as biomedical materials and devices, as they offer more advantages over synthetic polymers. The aim of this study was to clarify the usefulness of microbial cellulose (MC) for use as a dressing and scaffold material. For evaluating the biodegradability and toxicity of MC, we divided the rats (n = 12) into two groups (the implanted group and the non-implanted group). In the implanted group, we implanted the film type of MC in the backs of six rats. In the non-implanted group, however, we did not implant the film type of MC in the backs of the six rats. Four weeks later, we compared two groups by the gross, histological and biochemical characteristics by using blood and tissue samples. To evaluate the wound healing effects of MC, three full-thickness skin defects were made on the backs of each rat (n = 20). Three wounds on the backs of the same rats were treated with other dressing materials, namely, Vaseline gauze (group Con), Algisite M(®) (group Alg) and MC (group MC). We analysed the gross, histological and biochemical characteristics by western blotting. MC was found to be biodegradable and non-toxic. On day 3, the MC film was visible under the subcutaneous tissue; however, after 4 weeks, no remnants of the film were visible under the subcutaneous tissue. Furthermore, there was no evidence of MC-induced toxicity. Moreover, group MC showed more rapid wound healing compared with group Con. On day 14 after skin excision, group MC showed greater decrease in wound size compared with group Con (33% versus 7·2%). The wound healing effects were also substantiated by the histological findings (greater reduction in inflammation and rapid collagen deposition as well as neovascularisation) and western blotting (decreased expression of vascular endothelial growth factor and transforming growth factor-β1 in group MC on day 14 after skin excision, unlike group Con). This study showed that, in addition to having wound healing effects, MC is biodegradable and non-toxic and can, therefore, be used as a dressing and scaffold material.

Determination of efficacy of novel modified chitosan sponge dressing in a lethal arterial injury model in swine

Chitosan is a functional biopolymer that has been widely used as a hemostat. Recently, its efficacy has been questioned due to clinical failures as a result of poor adhesiveness. The purpose of this study was to compare, in a severe groin injury model in swine, the hemostatic properties of an unmodified standard chitosan sponge with standard gauze dressing and a novel hydrophobically modified (hm) chitosan sponge. Previous studies have demonstrated that hm-chitosan provides greatly enhanced cellular adhesion and hemostatic effect via noncovalent insertion of hydrophobic pendant groups into cell membranes. Twenty-four Yorkshire swine were randomized to receive hm-chitosan (n = 8), unmodified chitosan (n = 8), or standard Accu-Sorb gauze dressing (n = 8) for hemostatic control. A complex groin injury involving arterial puncture (4.4-mm punch) of the femoral artery was made after splenectomy. After 30 seconds of uncontrolled hemorrhage, the randomized dressing was applied and compression was held for 3 minutes. Fluid resuscitation was initiated to achieve and maintain the baseline mean arterial pressure and the wound was inspected for bleeding. Failure of hemostasis was defined as pooling of blood outside the wound. Animals were then monitored for 180 minutes and surviving animals were killed. Blood loss before treatment was similar between groups (p < 0.1). Compared with the hm-chitosan sponge group, which had no failures, the unmodified chitosan sponge group and the standard gauze group each had eight failures over the 180-minute observation period. For the unmodified chitosan sponge failures, six of which provided initial hemostasis, secondary rebleeding was observed 44 minutes ± 28 minutes after application. Standard gauze provided no initial hemostasis after the 3-minute compression interval. Hm-chitosan is superior to unmodified chitosan sponges (p < 0.001) or standard gauze for controlling bleeding from a lethal arterial injury. The hm-chitosan technology may provide an advantage over native chitosan-based dressings for control of active hemorrhage.

Shear bond strength between light polymerized hard reline resin and denture base resin subjected to long term water immersion

The effect of long-term water immersion on the shear bond strength between denture base resin and Triad visible-light-polymerized (VLP) direct hard reline resin is not known. The aim of this study was to investigate the bonding characteristics of Triad VLP direct hard reline resin to heat-polymerized denture base resin subjected to long-term water immersion. Ninety circular disks, 15mm in diameter and 3mm thick, of denture base resin were polymerized from a gypsum mold. Sixty specimens were subjected to water immersion and 30 were stored at ambient room temperature for 4months. Thirty water-immersed specimens were dried with gauze (group 1), while the other 30 water-immersed specimens were dried with a hair dryer (group 2). The dry specimens (n=30) represented the control group (group 3). All specimens were air abraded and painted with bonding agent before packing Triad VLP direct hard-reline resin. Specimens in each group were subjected to thermal cycling for 50,000 cycles between 4°C and 60°C water baths with 1-min dwell time at each temperature. The bond strength at which the bond failed under stress was recorded using a universal testing machine. One-way ANOVA and Tukey post hoc comparison were applied to find significant differences between groups (α=0.05). Significant differences in mean shear bond strength among the specimens existed because of variable water content in the denture base resin (P<0.05). Group 3 (dry) was higher than group 2 (desiccated), and the lowest was group 1 (saturated). The shear bond strength of Triad VLP direct hard reline resin to denture base resin depended on the water content in the denture base resin. The dry denture base resin demonstrated superior bond strength compared with the desiccated and water-saturated denture base resins.

A simple method preventing tangling of the guidewires during percutaneous coronary intervention for bifurcation lesions

The aim was to examine the efficacy of the simple technique that reduces tangling of the guidewires by utilizing wet gauze during percutaneous coronary intervention with multiple guidewires. We defined "Critical tangle of the guidewires" as occurring when it became impossible to insert balloon catheters into the bifurcation lesion due to tangling of the guidewires without withdrawing and reinserting one of the guidewires. We compared the rate of the critical tangle of the guidewires between the group taking no special tangle precaution ("NP Group"), and the group taking the tangle precaution with the wet gauze ("Gauze Group"). Eighty-four patients were enrolled in the study and randomly assigned to either NP Group (n=43) or Gauze Group (n=41). The kissing balloon technique success was 42/43 (97.7%) versus 40/41 (97.6%), in NP Group and Gauze Group, respectively. The rate of critical tangle of the guidewires was significantly lower in Gauze Group (27.9 vs. 7.3%, p=0.014). The manipulation of several guidewires utilizing gauze method will be a useful technique for reducing tangle of the guidewires during the procedure of kissing balloon technique.

Effects of Fat Preparation Methods on the Viabilities of Autologous Fat Grafts

Fat grafts are commonly used in plastic surgery, but their unpredictable absorption rates are a considerable disadvantage. Furthermore, no agreement has been reached regarding the method that best enables fat graft survival. This study aimed to evaluate the effects of different preparation methods on fat graft viability. Fat tissue was harvested from the remnants of transverse rectus abdominis musculocutaneous (TRAM) flaps by syringe aspiration. Harvested fat tissue was prepared using three different methods: centrifugation, metal sieve concentration, and cotton gauze concentration. To evaluate the viabilities of fat cells, XTT assays were performed. For the study, 18 nude mice were allocated to three groups: the centrifugation, metal sieve, and cotton gauze groups (6 mice per group). Prepared fat (1ml) was injected into the nuchal area of the mice, and 12weeks later, grafts were dissected to determine graft survival rates and subjected to histologic analysis. No significant differences were observed in graft survival rates and histologic findings (necrosis and vascularity) between the three groups. However, histologic analysis found the metal sieve group to have significantly lower fat cell viability and more inflammation than the other two groups. The findings suggest that the closed centrifugation technique has no advantage over the open cotton gauze technique in terms of fat graft viability, and that the metal sieve concentration method is deficient as a preparation method because it can cause grafted fat degradation.

Effectiveness of using bandage for punctured wound of postoperative patients with neurosurgical in-tervention treatment

Ohjective To know the proper wraping method for postoperative patients with neurosurgical intervention treatment. Methods Divided 94 patients with neurosurgical intervention treatment into the ban-dage group and the gauze group randomly, there were 47 cases in the each group. Bandage and gauze was used in the two groups for punctured wound respectively, and then compared the condition of complications and puncture location between the two groups. Results The incidence rate of puncture-associated comphcations in the bandage group was sinificant lower than that of in the gauze group. Conclusions Wraping by bandage for postoperative patients with neurosurgical intervention treatment is more effective than gauze method. Key words: Bandage; Intervention treatment; Complications

Keratin hydrogel increases survival time in femoral artery injury model via potential platelet adhesion mechanism

Keratin hydrogel is shown to be hemostatic in a porcine lethal extremity hemorrhage model compared to gauze and HemCon control groups with the presumptive mechanism of action being platelet adhesion and aggregation. Results showed that keratin hydrogels reduced shock index and increased survival time in comparison to both HemCon and gauze. Experiments to elucidate the mechanism of keratin hemostasis showed that platelets readily adhered to hydrogel films and that adherent cells contained numerous pseudopods, indicative of activation. Studies employing integrin function‐blocking antibodies reduced platelet adhesion. Collectively, these studies indicate that keratin promotes hemostasis via platelet adhesion by an integrin‐mediated process. Keratin hydrogels were shown to promote hemostasis and increase survival time in a lethal hemorrhage model with platelet adhesion and activation as the likely basis for the hemostatic property of keratin biomaterials.This work was supported by the US Army, SNS Nanofiber Technologies, American Heart Association, and Mid‐Atlantic Affiliate Grant‐in‐Aid.

Hemostatic Efficacy of Modified Amylopectin Powder in a Lethal Porcine Model of Extremity Arterial Injury

Rapid hemostasis is crucial in controlling severe extremity hemorrhage. Our objective is to evaluate the hemostatic efficacy of a newly modified amylopectin powder in a model of severe extremity arterial hemorrhage. Anesthetized pigs underwent severe, reproducible femoral artery injuries. Animals were randomized (nonblinded) to either modified amylopectin powder (n=10) or standard gauze application (n=6). Each hemostatic agent was applied through a pool of blood with manual compression for 3-minute intervals until hemostasis was achieved. Fluid resuscitation was infused as necessary to reestablish a mean arterial pressure within at least 80% of the preinjury mean arterial pressure if possible. The primary measured outcome was total blood loss. Secondary endpoints were survival, time to hemostasis, resuscitation mean arterial pressure, and resuscitation volume. Pretreatment blood losses were similar in both groups. Median (absolute average deviation of the median) posttreatment blood loss was significantly less in the modified amylopectin powder group than in the gauze group, 275 (108) mL versus 1,312 (171) mL. Resuscitation mean arterial pressure at 180 minutes after injury was 68% of preinjury mean arterial pressure in the modified amylopectin powder group and undetectable in all control animals. Fluid volume required for resuscitation was 1,962 (258) mL in the modified amylopectin powder group and 2,875 (150) mL in the gauze group. Time to hemostasis was 9.0 (2.1) minutes in the modified amylopectin powder group. Hemostasis was not achieved in any animal in the gauze group. Survival was 100% in the modified amylopectin powder group, whereas no animals survived in the gauze group. Modified amylopectin powder demonstrates the ability to control major vascular bleeding in a lethal arterial injury model during a 3-hour period.

Influence of polyester gauze on evaporation capacity and healing of the surface of microskin graft wound after escharectomy

To investigate the influence of polyester gauze on evaporation capacity and its clinical effect after escharectomy of deep burn wound and micro-skin grafting. Twenty patients with deep burn admitted within 24 hours after injury underwent escharectomy and Meek skin grafting. Two surfaces of wound with the area of about 1% as the whole wound surface were used, one covered by Meek skin graft and polyester gauze as inner dressing (polyester gauze group), and the other covered by split-thickness skin sheet 0.3 mm x 0.3 mm in size and vaseline oil gauze as inner dressing (vaseline oil gauze group). Five days after skin grafting, the evaporation capacities of the surface of inner dressing, wound surface without dressing (nude wound), and normal skin near the wound were tested by evaporation test equipment. The complete healing time and survival rate of skin sheet in both groups were observed. The degree of pain during dressing change was evaluated with visual analog scale. The evaporation capacity of the inner dressing surface of polyester gauze group was (24.8 +/- 5.2) ml x h(-1) x m(-2), significantly lower than those of the vaseline oil gauze group [(35.4 +/- 5.0) ml x h(-1) x m(-2), P < 0.01] and nude wound [(41.3 +/- 4.5) ml x h(-1) x m(-2), P < 0.01], and similar to that of the normal skin near the wound [(21.1 +/- 5.1) ml x h(-1) x m(-2), P > 0.05]. The evaporation capacity of the inner dressing surface of vaseline oil gauze group was significantly lower than nude wound [(40.7 +/- 3.6) ml x h(-1) x m(-2), P < 0.01], but significantly higher than the normal skin near the wound [(21.2 +/- 3.8) ml x h(-1) x m(-2), P < 0.01]. The survival rate of skin sheets of the polyester gauze group was 98% +/- 3%, not significantly different from that of the vaseline oil gauze group (98% +/- 2% , P > 0.05). The wound healing rates on days 10, 15, and 20 of the polyester gauze group were 80% +/- 20%, 96% +/- 7%, and 100% respectively, all significantly higher than those of the vaseline oil gauze group (70% +/- 33%, 81% +/- 21%, and 97% +/- 11% respectively, all P < 0.01). The complete healing time of the polyester gauze group was (13.6 +/- 1.9) days, significantly shorter than that of the vaseline oil gauze group [(16.7 +/- 2.6) days, P < 0.01]. The pain scores during dressing change 5 and 10 days after grafting of the polyester gauze group were (3.2 +/- 0.8) and (4.9 +/- 0.4) respectively, both significantly lower than those of the vaseline oil gauze group [(5.1 +/- 0.6) and (8.2 +/- 0.5) respectively, both P < 0.01]. Polyester gauze has quite good abilities to retain moisture and can promote the migration and proliferation of epithelial cells, relieves the pain caused by tearing of dressings off the wound, thus raising its acceptability. It is a relatively ideal carrier of skin grafting, as well as a new type of inner cover for the wound.

Avaliação do tipo de curativo utilizado em cateter venoso central para hemodiálise

OBJETIVOS: Avaliar a efetividade de dois tipos de curativos utilizados em cateter venoso central (CVC) em pacientes submetidos à hemodiálise; identificar a taxa de infecção no local de saída e de bacteremia comparando o curativo com gaze e micropore em relação ao filme transparente. MÉTODOS: Foi realizado um ensaio clínico randomizado controlado abrangendo 66 pacientes, sendo 33 nos grupos 1 e 2, respectivamente. No Grupo 1 o curativo utilizado foi gaze e micropore e no Grupo 2 filme transparente. Foram coletados os dados sócio demográficos, clínicos e os relacionados às infecções. Os 66 pacientes permaneceram no estudo até a indicação de retirada do cateter que ocorreu nos episódios de infecção quando foram realizadas culturas de óstio e da ponta do CVC e hemocultura quando indicado. RESULTADOS: Não houve diferença estatística significante quanto ao tipo de curativo e as variáveis estudadas. Os CVC posicionados a 90º em relação a pele apresentaram maior taxa de infecção por S. aureus. CONCLUSÃO: O uso do filme transparente não proporcionou redução de infecção, porém a análise qualitativa deste tipo de curativo teve melhor aceitação pelos pacientes e profissionais da Unidade de Diálise de um Hospital Universitário.

Conservative surgical debridement as a burn treatment: Supporting evidence from a porcine burn model

In thermal deep-dermal burns, surgical debridement is normally used in conjunction with skin grafting or skin substitutes and debridement alone as a burn treatment is not usually practiced. The current study addresses whether or not debridement alone would enhance burn wound healing on small deep-dermal-partial thickness burns. This was a prospective and blinded experimental trial using a porcine deep-dermal-partial thickness burn model. Four burns, approximately 50 cm(2) in size, were created on each of eight pigs. Two burns from each pig were immediately surgically debrided and the other two were not debrided as the internal control. Hydrate gel together with paraffin gauze were used to cover the burns for four pigs and silver dressings for the other four. Clinical assessment of wound healing was conducted over a 6-week period. Skin samples were collected at the end of the experiment and histopathological evaluation was performed. The results show thinner scar formation and lower scar height in the debrided compared with nondebrided wounds in the hydrate gel/paraffin gauze groups. There were no statistically significant differences in wound healing assessment between the debrided and nondebrided wounds dressed with silver dressings. This study provides supporting evidence that immediate debridement with an appropriate dressing and without skin grafting may promote wound healing, suggesting its potential benefit for clinical patients.

Occlusive vs Gauze Dressings for Local Wound Care in Surgical Patients

To compare effectiveness and costs of gauze-based vs occlusive, moist-environment dressing principles. Randomized clinical trial. Academic Medical Center, Amsterdam, the Netherlands. Two hundred eighty-five hospitalized surgical patients with open wounds. Patients received occlusive (ie, foams, alginates, hydrogels, hydrocolloids, hydrofibers, or films) or gauze-based dressings until their wounds were completely healed. Primary end points were complete wound healing, pain during dressing changes, and costs. Secondary end point was length of hospital stay. Time to complete wound healing did not differ significantly between occlusive (median, 66 days; interquartile range [IQR], 29-133 days) and gauze-based dressing groups (median, 45 days; IQR, 26-106 days; log-rank P = .31). Postoperative wounds (62% of the wounds included) healed significantly (P = .02) quicker using gauze dressings (median, 45 days; IQR, 22-93 days vs median, 72 days; IQR, 36-132 days). Median pain scores were low and similar in the occlusive (0.90; IQR, 0.29-2.34) and the gauze (0.64; IQR, 0.22-1.95) groups (P = .32). Daily costs of occlusive materials were significantly higher (occlusive, euro6.34 [US $9.95] vs gauze, euro1.85 [US $2.90]; P < .001), but nursing time costs per day were significantly higher when gauze was used (occlusive, euro1.28 [US $2.01] vs gauze, euro2.41 [US $3.78]; P < .001). Total cost for local wound care per patient per day during hospitalization was euro7.48 (US $11.74) in the occlusive group and euro3.98 (US $6.25) in the gauze-based group (P = .002). The occlusive, moist-environment dressing principle in the clinical surgical setting does not lead to quicker wound healing or less pain than gauze dressings. The lower costs of less frequent dressing changes do not balance the higher costs of occlusive materials. Trial Registration trialregister.nl Identifier: 56264738.

Comparison of homecare costs of local wound care in surgical patients randomized between occlusive and gauze dressings

To study the material and nursing costs and outcome of wound care at home comparing two dressing groups (occlusive vs. gauze-based) in surgical patients after hospital dismissal. The large variety in dressing materials and lack of convincing evidence make the choice for optimum local wound care at home cumbersome. Occlusive wound dressings require a lower change frequency than gauze-based dressings, which appears especially useful for homecare patients and could save costs. We investigated a consecutive series of 76 patients with wounds, included in a randomized trial comparing occlusive vs. gauze dressings. Daily dressing change frequency, consumption of dressing materials and need for district nursing visits were recorded until wound closure by means of diaries and at outpatient visits. Costs were expressed as means and 95% confidence intervals (CI) after calculation using non-parametric bootstrapping. Patient groups were similar regarding age, wound size and aetiology. Dressing change frequency in the occlusive group (median: 0.6/day) was significantly (p = 0.008) lower than in the gauze group (1.1/day). Mean daily material costs of modern dressings were euro5.31 vs. euro0.71 in the gauze group. Mean difference; euro4.60 (95% CI, euro2.68-euro6.83) while daily total (material plus nursing) costs showed no difference between the groups; mean euro2.86 (95% CI, euro-6.50-euro10.25). Wound healing in the gauze-treated group tended to be quicker than in the occlusive dressing group (medians: 30 vs. 48 days, respectively; log-rank p = 0.060). The use of occlusive dressings does not lead to a reduction in costs and wound healing time as compared with gauze dressings for surgical patients receiving wound care at home. District nurses should reconsider using gauze-based dressings, particularly in surgical patients with exudating wounds.

The Effect of Human Amniotic Membrane, Epidermal Cells and Marrow Mesenchymal Stem Cells in Healing a Skin Defect

Purpose: The purpose of this study was to investigate the transplantation results of human amniotic membrane (HAM), epidermal cells, or marrow mesenchymal stem cel ls (MSCs) in healing a skin defect. Materials and Methods: Defects (full-thickness) in rabbits were treated with HAM alone (group A), HAM injected with cultivated epidermal cells (group B), HAM injecte d with cultivated MSCs (group C), or Vaseline gauze (group D). Tissue granulation, regeneration, re-epithelization and healing time were measured. Defects and healed area were calculated 2 weeks after surgery. Results: The mean healing area was 67.5%, 81.7%, 83.2% and 49.5% in each group, with all treatment groups significantly different than group D (p＜0.01), and groups B and C compared higher than group A (p＜0.05). The healing time of groups A, B, and C was 5.7 to 6.4 days faster than that of group D (p＜0.01). Histologic analysis showed that the new epidermis covered nearly the whole wound surface in group B and C, and contained granulated tissue with fibroblasts, capillaries, and collagen. Conclusion: HAM grafts injected with cultivated epidermal cells or MSCs promoted healing of skin defects.

Randomised clinical trial of Hydrofiber dressing with silver versus povidone–iodine gauze in the management of open surgical and traumatic wounds

This prospective, randomised clinical trial compared pain, comfort, exudate management, wound healing and safety with Hydrofiber dressing with ionic silver (Hydrofiber Ag dressing) and with povidone-iodine gauze for the treatment of open surgical and traumatic wounds. Patients were treated with Hydrofiber Ag dressing or povidone-iodine gauze for up to 2 weeks. Pain severity was measured with a 10-cm visual analogue scale (VAS). Other parameters were assessed clinically with various scales. Pain VAS scores decreased during dressing removal in both groups, and decreased while the dressing was in place in the Hydrofiber Ag dressing group (n = 35) but not in the povidone-iodine gauze group (n = 32). Pain VAS scores were similar between treatment groups. At final evaluation, Hydrofiber Ag dressing was significantly better than povidone-iodine gauze for overall ability to manage pain (P < 0.001), overall comfort (P < or = 0.001), wound trauma on dressing removal (P = 0.001), exudate handling (P < 0.001) and ease of use (P < or = 0.001). Rates of complete healing at study completion were 23% for Hydrofiber Ag dressing and 9% for povidone-iodine gauze (P = ns). No adverse events were reported with Hydrofiber Ag dressing; one subject discontinued povidone-iodine gauze due to adverse skin reaction. Hydrofiber Ag dressing supported wound healing and reduced overall pain compared with povidone-iodine gauze in the treatment of open surgical wounds requiring an antimicrobial dressing.

A Salmon Thrombin-Fibrin Bandage Controls Arterial Bleeding in a Swine Aortotomy Model

Recently, a wide variety of bandages have been formulated to attempt to improve the effectiveness of emergency intervention in situations of uncontrolled bleeding. The best of these dressings contain a mixture of human thrombin and fibrinogen. The presence of human components in these bandages, although effective, increases the cost of the dressing and raises questions of availability of raw materials and transmission of pathogens. The purpose of this study was to investigate the efficacy of dressings composed of salmon thrombin and fibrinogen in a swine aortotomy model. A 4.4-mm aortotomy was produced in the abdominal aorta of 19 anesthetized, splenectomized swine. The United States Army standard field gauze was applied to 8 animals, and the salmon thrombin-fibrin dressing (SFD) was applied to 11 animals. Survival, blood loss, and other parameters were measured over a 60-minute period. All 11 animals that received the SFD survived the aortotomy injury, and bleeding stopped within 7.5 +/- 1.5 min. Seven of 8 animals in the control group were killed when bleeding continued and blood pressures decreased to the cutoff values as outlined in the animal protocol. Bleeding was significantly less in the SFD group compared with the gauze group (241 +/- 65.3 vs. 932.7 +/- 142.4 mL). Fibrin dressing using salmon-derived thrombin and fibrinogen is effective in controlling severe, uncontrolled bleeding. This dressing may offer an alternative to dressings composed of human coagulation proteins.

Application of a Granular Mineral-Based Hemostatic Agent (QuikClot) to Reduce Blood Loss After Grade V Liver Injury in Swine

Uncontrolled hemorrhage is a leading cause of death in cases of trauma. Many products currently are under development to control traumatic bleeding. One such Food and Drug Administration (FDA)-approved product is QuikClot. This study determined the efficacy of QuikClot, a hemostatic agent, in reducing blood loss and mortality in a standardized model of severe liver injury as well as the consequences of its use. Swine received either QuikClot or gauze treatment after induction of grade V liver injuries. Hemostasis, blood loss, resuscitation volume, 60-minute survival, and peak tissue temperatures were measured. Hemostasis was improved with QuikClot (p < 0.05), and resuscitation volume was consequently reduced (p < 0.05). Posttreatment blood loss was reduced (p < 0.01) with QuikClot (1,397 mL), as compared with gauze (5,338 mL). The survival rate was seven of eight in the QuikClot group and one of eight in the gauze group (p < 0.01). Peak temperature at the tissue interface was increased (p < 0.01) with QuikClot (93.3 +/- 10.5 degrees C), as compared with gauze (37.5 +/- 6.5 degrees C). QuikClot use was associated with both macro- and microscopic tissue damage caused by the exothermic reaction. QuikClot provides hemostasis and decreased mortality in this model of severe liver injury. The beneficial aspects of QuikClot treatment must, however, be balanced against the tissue-damaging effects of the exothermic reaction.