Hydrocolloid Occlusive Dressing Research Articles

Occlusive Dressings and the Healing of Standardized Abrasions

Acute skin trauma during sport participation, resulting in partial-thickness abrasions, is common. The limited investigations focusing on the acute wound environment and dressing techniques and the subsequent lack of evidence-based standards complicate clinical wound care decisions. To examine the effects of occlusive dressings on healing of standardized, partial-thickness abrasions. Controlled, counterbalanced, repeated-measures design. University laboratory. Sixteen healthy women (n = 10) and men (n = 6). Four standardized, partial-thickness abrasions were inflicted. Film, hydrogel, and hydrocolloid occlusive dressings and no dressing (control) were applied. Participants returned on postwound days 1, 3, 5, 7, 10, and 14 for digital imaging. Wound healing time was measured by change in wound contraction (cm(2)) and change in wound color (chromatic red) and luminance in red, green, and blue color values. Wound contraction, color (chromatic red), and luminance. A day-by-dressing interaction was found for wound contraction, color, and luminance. Post hoc testing indicated that the film and hydrocolloid dressings produced greater wound contraction than the hydrogel and no dressing on days 7 and 10. Film, hydrogel, and hydrocolloid dressings also resulted in greater wound contraction than the control on day 14. Hydrocolloid dressings produced smaller measures of color and greater measures of luminance than no dressing on day 7. Film, hydrogel, and hydrocolloid dressings also resulted in smaller measures of color and greater measures of luminance compared with no dressing on days 10 and 14. When compared with the control (no dressing), the film, hydrogel, and hydrocolloid occlusive dressings were associated with a faster healing rate of partial-thickness abrasions across time measured by wound contraction, color, and luminance. Overall, these data indicate that occlusive dressings were more effective in healing than no dressing was.

Hydrocolloid occlusive dressing

Hydrocolloid occlusive dressing

ハイドロコロイド閉鎖ドレッシングにより二次治癒した肘部皮膚欠損の犬の１例

13歳, 雌の雑種犬の肘頭部の腫瘍摘出に伴い作製した皮弁の脱落で生じた欠損創に親水性ポリウレタンによる閉鎖ドレッシングを行ったが, 完全な創閉鎖には至らなかった。その後縫合創が肘頭を回避するように残りを二次閉鎖したが褥創のため同部に再び皮膚欠損を生じた。そこでハイドロコロイドによる閉鎖ドレッシングを行ったところ急速な上皮化により創閉鎖したが, 新生上皮は薄く容易に損傷されたため十分な厚さになるまで肘頭部の保護が必要であった。

Cost, Efficacy, Efficiency and Tolerability of Collagenase Ointment versus Hydrocolloid Occlusive Dressing in the Treatment of Pressure Ulcers

Objective: Pressure ulcers are a common and costly healthcare problem. It is imperative to devise treatment methods that are simultaneously efficacious and cost effective. The efficacy and tolerability of collagenase ointment and hydrocolloid occlusive dressing have been proven in the treatment of pressure ulcers, but no comparative cost-efficacy studies have been reported. The present study was carried out to compare the cost, efficacy, efficiency and tolerability of these two methods.

Clobetasol under Hydrocolloid Occlusion in Psoriasis Results in a Complete Block of Proliferation and in a Rebound of Lesions following Discontinuation

Background: It is a well-established fact that very potent corticosteroids are highly effective in the treatment of psoriatic plaques, and that the addition of a hydrocolloid occlusive dressing (HCD) enhances its efficacy. It is known that topical steroids induce normal differentiation and diminish hyperproliferation during treatment of psoriatic plaques. These changes are reflected by an increase in keratin 10 (K10) and a decrease in keratin 6 (K6), respectively. However, the influence of class IV corticosteroids under HCD on K10 and K6 subpopulations has never been studied. Objective: The present study was performed to study quantitatively the influence of a class IV topical steroid under HCD on the dynamics of K10 and K6 subpopulations. Methods: In the present study, we treated moderately severe stable psoriatic plaques with clobetasol-17-propionate under HCD until clearance was achieved. We took biopsies prior to treatment, after clearance and at relapse. Using flow cytometry, we studied the dynamics of K10 and K6 subpopulations. Results: Prior to treatment, 41.8% of all cells expressed K6. After treatment-induced clearance, this proportion decreased to 1.2%, which is below the normal range. At relapse, pre-treatment levels were observed again. A trend to an increasing number of basal cells and an increase in the proliferative activity of these basal cells at relapse compared to the stable situation prior to treatment was observed. Conclusion: We conclude that clobetasol under hydrocolloid occlusion induces virtually a total block of proliferation of the basal cell population and decreases hyperproliferation-associated keratins dramatically. Furthermore, based upon epidermal cell characteristics, we conclude that a rebound phenomenon occurs following discontinuation of therapy with clobetasol under hydrocolloid occlusion.

Topically Applied Bovine Collagen in the Treatment of Ulcerative Necrobiosis Lipoidica Diabeticorum

REPORT OF A CASE A 46-year-old man presented with a several-year history of an eruption involving the anterior right lower leg. Several variably sized ulcers subsequently developed at different sites within the lesion. A biopsy specimen showed a palisading, granulomatous dermatitis throughout the dermis consistent with necrobiosis lipoidica diabeticorum. The patient was otherwise healthy and his blood glucose level was normal. Several different methods had been used to treat the ulcers, including therapy with potent topical steroids, intralesional steroids, hydrocolloid occlusive dressings, pentoxifylline, and silver sulfadiazine cream. The smaller ulcerations healed; however, a large ulcer was unresponsive and increased in size (Figure 1). THERAPEUTIC CHALLENGE A variety of therapeutic strategies used in the management of ulcerative necrobiosis lipoidica diabeticorum (UNLD) have failed to consistently provide satisfactory results. The large, recalcitrant ulcer in this patient progressed despite treatment with a number of traditional therapies. Our challenge was to devise a treatment

The effect of a hydrocolloid occlusive dressing (DuoDERM E) on keratinization in psoriasis vulgaris.

The effect of a hydrocolloid occlusive dressing (DuoDERM E) on keratinization in psoriasis vulgaris.

Overview of wound healing in a moist environment

Maintaining a moist wound environment facilitates the wound-healing process. The beneficial effects of a moist versus a dry wound environment include: prevention of tissue dehydration and cell death, accelerated angiogenesis, increased breakdown of dead tissue and fibrin, i.e., pericapillary fibrin cuffs, and potentiating the interaction of growth factors with their target cells. In addition, pain is significantly reduced when wounds are covered with an occlusive dressing. Concerns that moisture in wounds would increase the risk of clinical infection over traditional therapies are unfounded. The use of hydrocolloid occlusive dressings in maintaining a moist wound environment has proved to be a useful adjunct in facilitating wound healing.

The immunohistochemical effect of a hydrocolloid occlusive dressing (DuoDERM E) in psoriasis vulgaris.

The topical application of a hydrocolloid occlusive dressing (HCD) has been shown in various studies to have an antipsoriatic effect as monotherapy but especially in combination with a topical corticosteroid. The aim of the present study was to assess the effect of 3 weeks of HCD monotherapy at the immunohistochemical level. Ten patients were treated. Before and after treatment, a biopsy was taken, and immunohistochemical stainings were carried out with markers for epidermal growth, keratinization, inflammation and endothelium. Suprabasal expression of keratin 16, the number of cycling epidermal cells and the number of polymorphonuclear leucocytes and T lymphocytes tended to decrease during treatment. The endothelial markers did not change during HCD treatment. This study confirms the antipsoriatic effect of HCD and demonstrates that its effect upon some markers of inflammation, epidermal proliferation and keratinization is modest.

Successful treatment of therapy-resistant atopic dermatitis with clobetasol propionate and a hydrocolloid occlusive dressing.

During recent years, 48 patients with therapy-resistant chronic skin lesions of atopic dermatitis have been treated once a week with clobetasol propionate lotion left under Duoderm occlusive patches. They had previously failed to respond, or responded only sparsely, to topical corticosteroids. The lesions resolved completely in 44 patients, while partial remission was observed in the remaining 4. The mean time needed to obtain complete remission was, for lichenifications, 2 weeks; pruriginous lichenoid papules, 12 days; chronic hand eczema, 2.5 weeks; nummular eczema, 8 days; perioral eczema, 11 days, and breast eczema, 10 days. Adverse experiences were mild and infrequent. The amount of topical corticosteroid required was reduced to at most one-twentieth and to as little as one-hundredth of the amount of common topical steroid treatment needed. We conclude that clobetasol propionate and Duoderm once a week is the best treatment for resistant lesions of atopic dermatitis.

Antipsoriatic Therapies Inhibit Epidermal Plasminogen Activator Activity

Urokinase (UK, Mr 55,000) and tissue-type plasminogen activator (tPA, Mr 74,000) are serine proteinases involved in many biological processes, ie, cell migration, neoplastic transformation, and extracellular proteolysis. Cutaneous fibrinolytic activity (dependent on the activity of UK and tPA) was studied with the autohistographic fibrin film method in 40 patients affected by psoriasis vulgaris before and after topical (anthralin, betamethasone valerate, hydrocolloid occlusive dressing) or systemic psoralen-ultraviolet-light (PUVA) treatments. Autohistographic studies also were performed after apposition of monoclonal antibodies directed against the catalytic site of UK and tPA. Finally, UK and tPA were localized immunohistochemically in the psoriatic plaques and in controls using the immunoperoxidase procedure based on the biotin/avidin system. UK and tPA immunoreactivity was present in the cytoplasm and around the outlines of keratinocytes in the psoriatic patches before treatment and in the patches not cleared after treatment, while it was not detectable in normal epidermis, in the unaffected psoriatic epidermis, and in the cleared psoriatic skin. Cutaneous fibrinolytic activity was present in the cases in which UK and tPA were detected histochemically and, in the psoriatic epidermis, it was abolished by preincubation with anti-tPA but not with anti-UK antibodies. This study suggests that established topical and systemic treatments for psoriasis possess UK and tPA antagonist activity.

Erratum: Management of radiation-Induced moist skin desquamation using hydrocolloid dressing

Moist skin desquamation has been of concern to radiation oncologists, nurses and patients since the inception of this mode of therapy. As radiation treatment machines became more sophisticated, severe reactions became less of a problem. However, with the increasing use of chemotherapy and radiation as combined modalities, moist skin reaction is occurring with greater frequency. A noncomparative study of 20 patients using a hydrocolloid occlusive dressing (Duoderm) was initiated. The purpose of the study was to determine whether moist occlusive healing would be beneficial. The dressing was evaluated on the basis of healing time, safety, wound temperature, bacterial growth, and comfort. Data were collected using photographs, bacterial cultures, temperature probes, and patient evaluations. Eighteen patients completed the study. All patients' skin reactions healed. There were no wound infections evident. Mean healing time was 12 days, with mean wound temperature relative to body core -0.8 degree C on day 1 and -1.2 degrees C on the healed site. Patient results on comfort were: 8 of 18 excellent, 7 of 18 good, 3 of 18 fair, and 0 of 18 poor. The results of this study indicate that a hydrocolloid occlusive dressing can be effective in the healing process of moist skin reaction that is due to radiation therapy.

Adverse Effects on Diabetic Foot Ulcers of Highly Adhesive Hydrocolloid Occlusive Dressing

Adverse Effects on Diabetic Foot Ulcers of Highly Adhesive Hydrocolloid Occlusive Dressing

Psoriasis therapy: Comparative studies with a hydrocolloid dressing, plastic film occlusion, and triamcinolone acetonide cream

The efficacy of a new hydrocolloid dressing occlusion, alone or with 0.1% triamcinolone cream, was compared with triamcinolone acetonide alone or under plastic film occlusion in the treatment of localized plaque-type psoriasis. Thirty-eight patients were randomly assigned to one of four bilateral, paired-comparison treatment groups. Patients underwent 3 weeks of treatment, after which they were followed up for an additional week. After 3 weeks hydrocolloid occlusion with triamcinolone acetonide yielded a significantly better response than the cream alone or the hydrocolloid dressing alone, but the new dressing was comparable to a plastic film occlusive dressing of triamcinolone acetonide. After discontinuation of treatment, however, the sites that had been treated with hydrocolloid-occluded triamcinolone acetonide retained the better results. Topical steroids under hydrocolloid occlusive dressing may be a useful alternative to steroids alone for treatment of localized recalcitrant psoriasis.

Occlusive hydrocolloid dressings applied to chronic neuropathic ulcers. A study of efficacy in patients at a rural South Indian Hospital.

The response of 47 chronic ulcers (41 neuropathic [leprosy], 3 stasis, 1 traumatic, and 2 of unknown etiology) to hydrocolloid occlusive dressings was evaluated at a rural south Indian hospital. The response to treatment was objectively evaluated by photographic estimation of the surface areas of the ulcers. Eight ulcers healed over the 2 months of the study, and all but one ulcer improved. This type of dressing may have a valuable role in the management of chronic ulcers in the tropics, particularly those due to leprosy.

Management of Psoriasis Vulgaris With a Hydrocolloid Occlusive Dressing

Because clinical improvement of psoriasis vulgaris was recently observed after the prolonged application of tape, 26 patients with symmetric plaque-type psoriasis were enrolled in a prospective bilateral comparison study evaluating the clinical efficacy of the adhesive hydrocolloid occlusive dressing (HCD). The majority of localized plaques of psoriasis achieved improvement (41%, 14/34) or resolution (47%, 16/34) with the prolonged application of HCD; also, HCD was therapeutically superior to twice-daily applications of fluocinolone acetonide cream, and was comparably effective as erythemogenic ultraviolet B treatment. Although the therapeutic mechanism is not completely understood, occlusive dressings have great potential in the management of limited psoriasis vulgaris.

Management of psoriasis vulgaris with a hydrocolloid occlusive dressing

Management of psoriasis vulgaris with a hydrocolloid occlusive dressing

Management of Leg Ulcers With Hydrocolloid Occlusive Dressing

Twenty-two patients with 31 leg ulcers of various causes received local wound management consisting of the application of an adhesive hydrocolloid (HC) occlusive dressing (DuoDerm). Group 1 comprised 15 patients (11 outpatients) with 19 ulcers. Approximately two thirds (12/19) of the ulcers healed when treated solely with the HC dressing; mean treatment time was 57 days. Group 2 comprised seven hospitalized patients with at least two leg ulcers of similar size and distribution. The 20 ulcers in the seven patients were treated with either mild topical antimicrobial wet dressings (Sweitzer's 1:32 solution) or HC dressings, with each patient serving as his own "control." All 20 ulcers healed; the average time to healing was 44 days with HC dressing and 42 days with wet dressing management. Most of the patients reported convenience in management and substantial relief of pain with the use of HC dressings.

Management of pressure ulcers with a hydrocolloid occlusive dressing: results in twenty-three patients.

Management of pressure ulcers with a hydrocolloid occlusive dressing: results in twenty-three patients.