Modern Wound Dressings Research Articles

Modern and Convensional Wound Dressing to Interleukin 1 and Interleukin 6 in Diabetic wound

Introduction: Holistic wound care is one of the ways to prevent gangrene and amputation, modern wound dressing is more effective than convensional with increasing transforming growth factor and cytokine, especially interleukin. This study aims to identify the effectiveness of Modern and Convensional Wound Dressing to Interleukin 1 (IL-1) and Interleukin 6 (IL-6) in Diabetic wound.Methods:A Quasi eksperimental pre-post with control group design was used. The intervention given was modern wound dressing and Control group by convensional wound dressing, This study was conducted in Makassar with 32 samples (16 in intervention group and 16 in control group). Results: The result of Pooled T- test showed that p = 0.00 (p < 0.05), it means that there was signifi cant correlation between modern wound dressing to IL-6 and IL-1 than Convensional wound dressing. Conclusion: Process of wound healing was produced growth factor and cytokine (IL-1 and IL-6), it will stimulated by wound dressing, modern wound dressing (Calcium alginat) can absorb wound drainage, non oklusive, non adhesif, and autolytic debridement.

Investigation of Nano Bacterial Cellulose Coated by Sesamum Oil for Wound Dressing Application

Bacterial cellulose (BC) as a nano fiber hydrogel has many applications in burn treatment and traditionally Sesamum oil was used for this purpose. Accordingly in this research we used purified bacterial cellulose layers which coated by Sesamum oil. The bending property and wettability of specimens were evaluated and the morphology of BC was characterized by AFM and SEM. The obtained result indicated that the amount of bending in coated layer with Sesamum oil is 50% less than untreated wet layer. It is also represent dramatically decrease in layer wettability. In addition the antibacterial property of treated layer has been investigated. All coated layer has shown considerable antibacterial property against gram-positive and -negative bacteria. According to the obtained results, microbial cellulose coated with Sesamum oil has high potential for applying as a modern wound dressing.

Effect of Purification on Nano Microbial Cellulose Pellicle Properties

Nano Microbial Cellulose (NMC) is one of the most effective biopolymer in treating the injury. It has many applications in medical field due to unique properties such as high water absorption, compatibility with body and transparency for medical examination.Accordingly, this research attempts to evaluate the characteristic of raw and purified microbial cellulose for medical usage. The chemical and physical structure of microbial cellulose layer was assessed by FTIR and XRD. In addition, water absorption, wettability and permeability of raw and purified microbial cellulose pellicle were investigated and SEM was applied for assessing the surface of nanocellulose pellicle.FTIR result confirmed the cellulosic structure of pellicle and XRD represented that the crystallinity of NMC was more than cotton (plant cellulose). The obtained result indicated that the amount of water absorption of purified layer is 10% less than raw layer but wettability of the treated layer is increased more than 50%. No permeability was representing against air pressure in raw and purified samples in wet and dry forms at 25Pa. Therefore, applying purification treatment improved the NMC pellicle properties for modern wound dressing.

Exploring use of warp-knitted spacer fabric as a substitute for the absorbent layer for advanced wound dressing

Wound management has become more sophisticated as modern wound dressings now focus more on providing an optimal microclimate for wound healing. As a novel three-dimensional textile material, warp-knitted spacer fabrics are versatile enough to meet special requirements when their parameters are changed. This paper reports on an experimental study on the required physical properties of warp-knitted spacer fabrics that can be developed as an absorbent layer for advanced wound dressing. Three types of wound dressings available on the market have been chosen that are especially used for burns and ulcers, as they are designed to provide good absorbing of extrudes and a cushioning effect. The physical properties of spacer fabrics, including air permeability, thermal conductivity, water vapor permeability, absorbency and compression, are evaluated and compared with those of existing wound dressings. The results show that the air and water vapor permeabilities and the thermal conductivity of warp-knitted spacer fabrics are competitive enough to prove that spacer fabrics can also provide a good ventilated environment for wound healing. Their good compressional resistance and compressional resilience indicate that warp-knitted spacer fabrics can provide good protection as wound dressings. Although their absorbency is only somewhat better than some of the wound dressings, they are also good for wounds with no heavy extrudes.

Antimicrobial efficacy of modern wound dressings: Oligodynamic bactericidal versus hydrophobic adsorption effect

Locally infected wounds and wounds colonised with multidrug-resistant bacteria are commonly treated with local antimicrobial agents. Recently, wound dressings have been introduced into clinical practice that reduces bacteria by adsorbing bacteria on the dressing surface by a hydrophobic effect. Our aim was to investigate, whether this hydrophobic effect is only present in dressings coated with dialkyl carbamoyl chloride (DACC) or also in other modern wound dressings. To determine the hydrophobicity of the dressing surface contact angle measurements were performed. In addition, for selected wound dressings, the bacteria eliminating effect of the wound dressings for Methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa were measured. 31 of the 34 wound dressings presented with a hydrophobic surface. The reduction factor (RF) of one wound dressing without coating was 1.6 for MRSA and RF 2.1 for P. aeruginosa. One with a DACC coated dressing showed a RF of 0.7 (MRSA) and 1.2 (P. aeruginosa). The RF of a wound dressing that releases silver ions was 6.1 for MRSA and 7.5 for P. aeruginosa respectively. The results show that both uncoated and with DACC coated wound dressings can have hydrophobic surfaces. These hydrophobic dressings are able to adsorb bacteria onto their surface and consequently remove them from the wound. However, the RF for wound dressings that release silver ions is significantly higher. Depending on the degree of contamination, these results can have an effect on the clinical decision to choose certain products. We assume that for e.g. infected or critically colonised wounds, wound dressings with a hydrophobic effect may not be sufficient to significantly improve the microbiological wound condition. However, this assumption has to be verified in clinical studies.

Efficacy and cost‐effectiveness of octenidine wound gel in the treatment of chronic venous leg ulcers in comparison to modern wound dressings

The aim of this study was to determine the efficacy, safety and cost-effectiveness of an octenidine-based wound gel in the treatment of chronic venous leg ulcers. For this purpose, 49 wounds were treated with either modern wound-phase-adapted dressings alone (treatment arm 1; n = 17), octenidine wound gel plus modern wound-phase-adapted dressings (treatment arm 2; n = 17) or octenidine wound gel alone (treatment arm 3; n = 15). During the study period of 42 days with dressing changes every 3-5 days, wound healing characteristics and treatment costs of different dressings were analysed. Wound size reduction was significantly better (P = 0·028) in both octenidine wound gel treatment arms compared to modern dressings alone with total reductions of 14·6%, 64·1% and 96·2% in treatment arms 1-3. Early wound healing was merely observed under octenidine wound gel treatment (n = 9), whereby lowest treatment costs were generated by octenidine wound gel alone (€20·34/dressing change). As a result, the octenidine wound gel is cost-effective and well suitable for the treatment of chronic venous leg ulcers, considering both safety and promotion of wound healing.

Coated Cotton Gauze with Ag/ZnO/chitosan Nanocomposite as a Modern Wound Dressing

Cotton gauze is one of the most successful wound dressings which utilize the intrinsic properties of cotton fibers. Modern wound dressings, however, require other properties such as antibacterial and moisture maintaining capabilities. In this study, conventional cotton gauze was treated with chitosan/Ag/ZnO nanocomposite for achieving modern wound dressing properties. Cotton gauze samples were impregnated with chitosan/Ag/ZnO nanocomposite by the dip, dry, and cure method. Samples were characterized by scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR) and UV-Vis reflective spectroscopy (UV-Vis); and their water absorbency ability, wicking effect, and antibacterial activity determined. The results show that coated cotton gauze with chitosan/Ag/ZnO nanocomposite has increased drying time (78%) and water absorbency (38%). Furthermore, their antibacterial efficiency was 96% for Escherichia coli (E. Coli) and 99% for Staphylococcus aureus (S. aureus).

Management of Split-Thickness Skin Graft Donor Sites: A Randomized Controlled Trial of Calcium Alginate versus Polyurethane Film Dressing

Background: Split-thickness skin graft (STSG) donor sites sometimes cause more postoperative morbidity for patients than the wound covered with the graft. Yet, there is no consensus on which dressings are best suited to treat these donor sites. Objective: To evaluate two commonly used modern wound dressings in the postoperative healing of STSG donor sites in a prospective randomized controlled trial. Methods: 38 patients were randomly assigned to treatment of an STSG donor site with an alginate dressing or a polyurethane film dressing. The primary outcome measures were postoperative pain scores, secondary outcome variables were time to epithelialization, dressing changes and complications. Results: Postoperative pain on day 1 was significantly lower in the polyurethane film group (2.05 vs. 0.79, p = 0.035) as compared to the alginate group. This difference was not detected on day 5 (0.89 vs. 0.53, p = 0.52). Time to epithelialization did not differ significantly between the two dressing groups. There were more dressing changes in the polyurethane film group and problems with leakage. Conclusion: Whereas film dressings resulted in initially lower pain scores, alginate dressings caused fewer additional dressing changes and less leakage.

Investigation of Microbial Cellulose/Cotton/Silver Nanobiocomposite as a Modern Wound Dressing

In this study the nanobiocomposite of Microbial cellulose/Cotton/Silver is introduced as a modern wound dressing. Microbial cellulose was synthesized in situ on cotton gauze. The static medium culture (Hestrin & Scharm) and Acetobacter Xylinum used for microbial cellulose synthesis and 6 days formed layers used for experiments. Half of 6 days samples were reverse after 3 days in order to form double coated gauze. One or two coated sides specimens were deactivated purified and dipped in a 500ppm nanosilver concentration. Specimens were analyzed by X-ray diffraction method, Fourier transform infra-red spectroscopy, Scanning electron microscopy and transmission electron microscopy. Their water and moisture absorption determined and their antibacterial efficiency evaluated by AATCC 100 antibacterial test method. Results showed about 30% increase in water absorption with less than 8% moisture regain. Microscopic images showed a proper distribution of nanosilver without agglomerations at surface and inside nanobiocomposite which caused improved antimicrobial efficiency. The obtained results indicated that nanocomposite (double coated gauze) has high potential for applying as a modern wound dressing.

An evidence-based review of enhanced recovery interventions in knee replacement surgery

Total knee replacement (TKR) is a very common surgical procedure. Improved pain management techniques, surgical practices and the introduction of novel interventions have enhanced the patient's postoperative experience after TKR. Safe, efficient pathways are needed to address the increasing need for knee arthroplasty in the UK. Enhanced recovery programmes can help to reduce hospital stays following knee replacements while maintaining patient safety and satisfaction. This review outlines common evidence-based pre, intra and postoperative interventions in use in enhanced recovery protocols following TKR. A thorough literature search of the electronic healthcare databases (MEDLINE(®), Embase™ and the Cochrane Library) was conducted to identify articles and studies concerned with enhanced recovery and fast track pathways for TKR. A literature review revealed several non-operative and operative interventions that are effective in enhanced recovery following TKR including preoperative patient education, pre-emptive and local infiltration analgesia, preoperative nutrition, neuromuscular electrical stimulation, pulsed electromagnetic fields, perioperative rehabilitation, modern wound dressings, different standard surgical techniques, minimally invasive surgery and computer assisted surgery. Enhanced recovery programmes require a multidisciplinary team of dedicated professionals, principally involving preoperative education, multimodal pain control and accelerated rehabilitation; this will be boosted if combined with minimally invasive surgery. The current economic climate and restricted healthcare budget further necessitate brief hospitalisation while minimising costs. These non-operative interventions are the way forward to achieve such requirements.

Nanofibers and their biomedical use

The idea of creating replacement for damaged or diseased tissue, which will mimic the physiological conditions and simultaneously promote regeneration by patients' own cells, has been a major challenge in the biomedicine for more than a decade. Therefore, nanofibers are a promising solution to address these challenges. These are solid polymer fibers with nanosized diameter, which show improved properties compared to the materials of larger dimensions or forms and therefore cause different biological responses. On the nanometric level, nanofibers provide a biomimetic environment, on the micrometric scale three-dimensional architecture with the desired surface properties regarding the intended application within the body, while on the macrometric scale mechanical strength and physiological acceptability. In the review, the development of nanofibers as tissue scaffolds, modern wound dressings for chronic wound therapy and drug delivery systems is highlighted. Research substantiates the effectiveness of nanofibers for enhanced tissue regeneration, but ascertains that evidences from clinical studies are currently lacking. Nevertheless, due to the development of nano- and bio-sciences, products on the market can be expected in the near future.

Hydrocellular foam dressing promotes wound healing along with increases in hyaluronan synthase 3 and PPARα gene expression in epidermis.

BackgroundHydrocellular foam dressing, modern wound dressing, induces moist wound environment and promotes wound healing: however, the regulatory mechanisms responsible for these effects are poorly understood. This study was aimed to reveal the effect of hydrocellular foam dressing on hyaluronan, which has been shown to have positive effects on wound healing, and examined its regulatory mechanisms in rat skin.Methodology/Principal FindingsWe created two full-thickness wounds on the dorsolateral skin of rats. Each wound was covered with either a hydrocellular foam dressing or a film dressing and hyaluronan levels in the periwound skin was measured. We also investigated the mechanism by which the hydrocellular foam dressing regulates hyaluronan production by measuring the gene expression of hyaluronan synthase 3 (Has3), peroxisome proliferator-activated receptor α (PPARα), and CD44. Hydrocellular foam dressing promoted wound healing and upregulated hyaluronan synthesis, along with an increase in the mRNA levels of Has3, which plays a primary role in hyaluronan synthesis in epidermis. In addition, hydrocellular foam dressing enhanced the mRNA levels of PPARα, which upregulates Has3 gene expression, and the major hyaluronan receptor CD44.Conclusions/SignificanceThese findings suggests that hydrocellular foam dressing may be beneficial for wound healing along with increases in hyaluronan synthase 3 and PPARα gene expression in epidermis. We believe that the present study would contribute to the elucidation of the mechanisms underlying the effects of hydrocellular foam dressing-induced moist environment on wound healing and practice evidence-based wound care.

Reviewing the evidence for advanced dressings

The principles of moist wound healing have become widely accepted since the seminal work of George Winter in the 1960s. In the subsequent 50 years, many publications have extolled the clinical value of modern or advanced wound dressings. This article reviews the findings of two studies arguing that the benefits of advanced wound care products, which are based largely on th principles of moist wound healing, cannot be justified in terms of healing outcomes or cost effectiveness. These studies have the potential to affect clinical practice and decision making, and the article highlights the importance of analysing and interpreting the findings of such studies cautiously.

Modern wound treatment with devices working according to various physical principles

The prevalence of venous diseases in Europe is 25.2%. According to studies of the University of Bonn this number can be as high as 90%. Optimistic estimates suggest this number to be 27.5% in Hungary, 21.5% in Germany. Treatment costs of varicosis and its complications are covered by 2% of the annual healthcare expenditure in Western countries. Chronic venous insufficiency (CVI, or chronic venous disease, CVD) affects 1.7% of European population, and can lead to venous ulcers. In Hungary 0.5-1% of the population suffers from venous ulcers, which is a result of primary or secondary varicosity. Although an increasing number of modern wound dressings have appeared during the last decade, the treatment of ulcerous wounds in necrotic and exudative phases requires additional methods, either conventional or surgical. Infrared light is used to discover pathologic veins. Beside sclerotherapy and surgical treatment external and internal (so called intraluminal) methods are used. Leg ulcers of venous origin in various phases can be cleaned with ultrasound devices, vacuum therapy or high pressure water. Hyperbaric oxygen treatment, keratinocytes, magnetic treatment, laser wound care and skin transplantation can be used as adjuvant. Authors present the aforementioned procedures with examples. New devices and methods help to reduce healing time and to avoid amputation in cases that are often considered hopeless. Technical advancement and modern wound dressings permit successful treatment and healing of wounds that earlier were untreatable, however monetary shortage and the current status of healthcare. DOI: 10.17489/biohun/2013/1/02

Modification of cellulose non-woven substrates for preparation of modern wound dressings

Different ways are presented of modifying cellulosic non-woven substrates, which can serve as potential wound dressings with satisfactory antimicrobial and hydrophilic properties. For safe attachment of silver particles without a measurable release from the used materials, a sol–gel derived process was used. Alkaline and oxygen plasma treatments were used to improve the hydrophilicity of the materials. Their efficiency was determined by measuring contact angles and water retention values. Scanning electron microscopy (SEM) was used for determination of sample morphology prior to and after treatment. The efficiency of silver attachment and activity was evaluated by in vitro release studies and antimicrobial tests. Atomic force microscopy (AFM) and SEM, combined with dynamic light scattering, were used for determination of silver particle size. Additionally, we evaluated the influence of treatment on technological parameters, important for application performance, i.e. mechanical properties and air permeability.

Contact Sensitization to Modern Wound Dressings in 70 Patients With Chronic Leg Ulcers

Patients with chronic leg ulcers typically experience contact allergy to topical treatments. Although declared as hypoallergenic, modern wound dressings have caused several reported cases of contact allergy. The aim of the study was to evaluate any allergenic potential of modern wound dressings in patients with leg ulcers. Seventy-one patients were included in our prospective observation. Patch tests were performed with a selection of 10 modern wound dressings and with selected allergens according to series of the German Contact Dermatitis Research Group (DKG). Of 70 patients eligible for evaluation, 12 (17%) were positive for the hydrogel NuGel, followed by the hydrocolloid NuDerm (n = 7/70, 10%) and the ionic silver-containing wound dressing Aquacel Ag and the gauze Adaptic (both n = 4/70, 5%). Patients with recalcitrant ulcers of prolonged duration showed a significant higher number of epicutaneous sensitizations to wound dressings than patients with shorter ulcer duration. The allergenic potential of modern wound dressings should not be underestimated. There is need for precise declaration of all ingredients.

Peri-operative interventions producing better functional outcomes and enhanced recovery following total hip and knee arthroplasty: an evidence-based review

The increasing numbers of patients undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA), combined with the rapidly growing repertoire of surgical techniques and interventions available have put considerable pressure on surgeons and other healthcare professionals to produce excellent results with early functional recovery and short hospital stays. The current economic climate and the restricted healthcare budgets further necessitate brief hospitalization while minimizing costs.Clinical pathways and protocols introduced to achieve these goals include a variety of peri-operative interventions to fulfill patient expectations and achieve the desired outcomes.In this review, we present an evidence-based summary of common interventions available to achieve enhanced recovery, reduce hospital stay, and improve functional outcomes following THA and TKA. It covers pre-operative patient education and nutrition, pre-emptive analgesia, neuromuscular electrical stimulation, pulsed electromagnetic fields, peri-operative rehabilitation, modern wound dressings, standard surgical techniques, minimally invasive surgery, and fast-track arthroplasty units.

Alginate Dressing and Polyurethane Film Versus Paraffin Gauze in the Treatment of Split-Thickness Skin Graft Donor Sites

To compare postoperative healing of split-thickness skin graft (STSG) donor sites using traditional dressings (paraffin gauze) or modern wound dressings (alginate dressing and polyurethane film) in a randomized controlled trial. Thirty patients were randomly assigned to treatment of an STSG donor site with an alginate dressing and a polyurethane film or nonadherent paraffin gauze. Outcome variables were pain (measured with a visual analog scale), amount of dressing changes, healing time, cosmetic outcome, treatment costs, and overall satisfaction with the procedure. There was no significant difference in pain (postoperative day 1: 2.1 vs 1.2, P = .26; postoperative days 5-7: 1.0 vs 0.9, P = .47; final removal: 1.9 vs 1.0, P = .19) and time to healing (18.1 vs 15.4 days, P = .29) between alginate/polyurethane film dressing and nonadherent paraffin gauze. The semiocclusive dressings with polyurethane film required multiple dressing changes, whereas the nonadherent paraffin gauze could be left in place until complete epithelialization. Treatment costs were substantially lower for paraffin gauze. Semiocclusive dressings with alginate dressings and polyurethane film showed no advantages over treatment with paraffin gauze. With lower costs and better patient acceptance, paraffin gauze dressings were the preferred treatment for STSG donor sites.

Taking the trauma out of wound care: the importance of undisturbed healing

Significant advances in wound dressing technology have resulted in a myriad of dressing choices for wound-care clinicians, providing more than just an inert wound cover. The establishment of a moist wound environment under modern wound dressings and the optimisation of the healing response are now the goals expected of these dressings. However, the use of wound dressings, particularly traditional dressings such as gauze, frequently results in wound and peri-wound tissue damage that impairs the wound healing response, counteracting any of the dressings' healing benefits. Therefore, in order to maximise the healing benefits wounds covered by today's wound dressings must minimise tissue disturbance (physical as well as chemical). This review aims to consider the ways traditional, as well as modern, wound dressings may disturb wounds, summarising the potential areas of wound disturbance, and suggesting how best to address this aspect of the use of wound dressings to treat acute as well as chronic wounds.

Collagen Wound Dressings with Anti-Inflammatory Activity

The aim of this study was to develop modern wound dressings such as controlled drug delivery systems. These systems consist in collagen as release support and niflumic acid as drug. The scaffolds were prepared by lyophilization in order to obtain porous structures and were evaluated by release profile of niflumic acid, water absorption, collagenase degradation and biocompatibility with fibroblast cells. The collagen scaffold with 0.75% niflumic acid solved in laurel oil was optimal in terms of biodegradability, absorbability and fibroblast cells biocompatibility. Thus, the obtained collagen scaffolds could be used as wound dressings with absorbent, antibacterial and anti-inflammatory properties.