Normal Saline Gauze Research Articles

Effectiveness of the Eye Care Protocol in the Intensive Care Unit Patients: A Randomized Controlled Trial

This study investigated the effects of an eye care protocol (ECP) on patients in the intensive care unit (ICU). This study utilized a randomized controlled design. Participants were patients who met the inclusion criteria and were admitted to the ICU (36 in the experimental group and 38 in the control group). The experimental group received an ECP, while the control group received standard eye care, starting the day after admission, for a duration of 10 days. The ECP classifies the degree of eyelid obstruction into three stages based on the degree of exposure to the lower eyelid conjunctiva and cornea. The protocol included cleansing with normal saline gauze, administering eye drops, applying silicone and polyurethane films, and recommending consultation with an ophthalmologist if necessary. The effectiveness of ECP was assessed by analyzing tear volume, hyperemia, chemosis, and eye discharge. Data analysis was conducted using SPSS 27.0, employing the Mann-Whitney U-test and generalized estimating equations. On day 5, the experimental group demonstrated a significant increase in tear volume in both eyes compared with the control group. However, no statistically significant differences were observed in the incidence of hyperemia, chemosis, and eye discharge on days 5 and 10 of the intervention. The application of the ECP in this study increased tear volume in ICU patients, thereby reducing discomfort caused by dry eyes. It has the potential to prevent complications such as damage to the surface of the eyeball resulting from decreased tear volume.

The effect of NPWT in wound healing and bacterial count on deep dermal burn injury model: An experimental study

BackgroundSepsis is one of the main causes in burn victim's mortality. The use of negative pressure wound therapy (NPWT) provides an ideal environment to accelerate wound healing. We compare the use of normal saline (NS), intermittent NPWT, continuous NPWT and silver sulfadiazine in wound healing process. MethodThis study involved 6 Yorkshire pigs; each pig was induced with 20 burns on the flank area. Burns were divided into 4 treatment groups: NS gauze, intermittent NPWT, continuous NPWT, and silver sulfadiazine dressing. Burns were evaluated on day 1,3,7,14, and 21 for its morphology and bacterial colonization and on day 14 and 21 for the remaining burn surface area. ResultWound that received NPWT therapy appeared better in both granulation and crust formation. Remaining burn surface area (mm2) on day 14 in NS group, intermittent NPWT, continuous NPWT, and silver sulfadiazine were 107.43 ± 83.43, 178.07 ± 74.83, 146.10 ± 69.1, 126.03 ± 83.22, respectively(p = 0.457); on day 21 in NS group, intermittent NPWT, continuous NPWT, and silver sulfadiazine were 13.16 ± 16.86, 59.49 ± 20.72, 54.79 ± 46.59, 48.95 ± 39.84, respectively(p=0.169). There were no significant differences in each treatment group bacterial colonization(p>0.05). There were no significant correlation between bacterial colonization and remaining burn surface area (p>0.05). ConclusionWhile morphologically, the wound in NPWT treatment groups appeared better in granulation and crust formation, the remaining wound surface area and the number of bacterial colonization were not significantly difference compared to standard therapy (silver sulfadiazine and NS gauze). There were no significant correlation between the amount of bacterial colonization and remaining wound surface area on every treatment group.

Severe kerion celsi effectively treated with skin debridement and antifungals

Background: Kerion celsi is a severe inflamed deep abscesses form of tinea capitis which mostly occurs in children population. Despite good regular treatment with antifungals, the prognosis of kerion celsi is poor with scarring alopecia. Case Illustration: A 5-year-old boy had history of an alopecia with locally large painful oedema on his scalp a month before treatment. From the physical examination, a painful large area with alopecia was found with abscess covered by thick crust. Pull test showed hair breakage and right retro-auricular lymphatic nodes enlargement was also found. Endo-ectothrix spores were positive in potassium-hydroxide examination and the culture showed colony of Trichophyton mentagrophytes . A surgical debridement was performed to remove the thick crust covering the abscess with alopecia and followed by application of normal saline gauze dressing and terbinafine cream on the top of the lesion for 6 weeks. Systemic micronized griseofulvin was also administered for 6 weeks. Combination treatment of debridement-topical and systemic antifungal gave a good result without scarring alopecia. Discussion: Kerion celsi was diagnosed based on clinical findings and mycological examination. From the laboratory examination, a dermatophyte fungal infection was found. Skin debridement was performed to create a good environment for topical antifungal application and wound healing, with 20mg/kg bodyweight of systemic griseofulvin administered as the first line therapy for tinea capitis. A good prognosis was achieved after those treatments combination. Conclusion: In this case, combination between skin debridement with topical and systemic antifungals gave a better result in treating kerion celsi. Keywords: antifungals, kerion celsi, skin debridement, tinea capitis

Effectiveness of Drawtex hydroconductive dressing in treatment of early implantation-associated infection and soft tissue defect after internal fixation of tibial fracture

To investigate the feasibility of Drawtex hydroconductive dressing in treatment of early implantation-associated infection and soft tissue defect after internal fixation of tibial fracture. Thirty-six New Zealand rabbits were used to prepare the model of early implantation-associated infection after internal fixation of tibial fracture, and randomly divided into 3 groups ( n=12) . The infected wounds were covered with Drawtex hydroconductive dressing (group A), chitosan solution gauze (group B), and normal saline gauze (group C), respectively. The dressing was changed every 2 days. X-ray films were performed at 1, 14, and 21 days. The gross observation, microbiological evaluation, and histological observation were done at 21 days. There was no significant difference in the wound grading according to the James' grading criteria between groups at 21 days ( χ2=3.713, P=0.156). X-ray films showed no bone destruction in all groups at 1 day; and there was no significant difference in radiographic scores between groups ( P>0.05). At 14 days, the mild osteolysis was observed in group B; the radiographic score was significantly lower in groups A and C than in group B ( P<0.05), but there was no significant difference between groups A and C ( P>0.05). At 21 days, the osteolysis and osteomyelitis were observed in groups B and C; the radiographic score was significantly lower in group A than in groups B and C ( P<0.05), but there was no significant difference between groups B and C ( P>0.05). Also, the microorganism in bone tissue of group A was less than that of groups B and C ( P<0.05); and the difference between group B and group C was not significant ( P>0.05). Histological observation showed the mild inflammatory cell infiltration in group A and many inflammatory cells in groups B and C. The Smeltzer histological score was significant lower in group A than in groups B and C ( P<0.05); and there was no significant difference between groups B and C ( P>0.05). Drawtex hydroconductive dressing can be used for the implantation-associated infection after tibial fracture internal fixation. And the effectiveness of Drawtex hydroconductive dressing is better than that of chitosan solution gauze and normal saline gauze.

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.

Vacuum-assisted closure therapy as a pretreatment for split thickness skin grafts.

To evaluate the effect of vacuum-assisted closure (VAC) therapy on wound management by measuring the graft take, wound healing time, need for any re-grafting and duration of hospitalization. Single blinded randomized controlled trial. This study was carried out in the Department of Plastic and Reconstructive Surgery, Pakistan Institute of Medical Sciences (PIMS), Islamabad, from October 2007 to December 2009. A total of 100 adult patients of either gender with acute traumatic wounds were included. Patients who needed flap coverage as the primary intervention, and those with Diabetes, malignancy, bleeding diathesis were excluded. Half of the patients were randomly assigned to the intervention group and the rest to the control group with lottery method. All wounds were initially subjected to thorough excision. Wound bed preparation for STSG (split thickness skin graft) was achieved using 10 days pre-treatment with VAC dressings in the intervention group while employing normal saline gauzes in the control group. All patients were subsequently treated with STSG. The primary outcome measure was graft take while the secondary outcome measures included wound healing time, need for any re-grafting and duration of hospital stay. Results were compared in both groups using chi-square test. Marked differences were found in favour of the VAC therapy group with respect to the various wound management outcome measures studied. i.e. graft take (greater than 95% graft take in 90% of VAC therapy group vs. 18% of controls), wound healing time (2 weeks postgrafting in 90% of VAC therapy group vs. 18% of controls), need for regrafting (none among VAC therapy group vs. 8% of controls) and duration of hospital stay (less than 3 weeks in 90% of VAC therapy group vs. 18% of controls). VAC therapy should be employed in the pre-treatment of wounds planned to be reconstructed with STSG, since it has marked advantages in the wound bed preparation compared with the traditional normal saline gauze dressings.

Wound-Product Selection and Innovations

INTRODUCTION: Extended healing time of dehiscence and nonhealing postsurgical wounds is a common problem. Expedited healing is key to decreasing the chance of infection. The following case studies demonstrate the effectiveness of a silver collagen amorphous gel and decreased healing time. CASE 1: 42-year-old female, history of hypotension and cardiac arrhythmia presented with a three-week old dehisced laceration to the left medial leg with a dry 95% necrotic wound bed. Prior treatments included wet to dry normal saline gauze. Silver collagen gel was applied and covered with adhesive foam and changed every three days. Due to development of a periwound rash, the cover was changed to dry gauze and frequency changed to every other day. After four weeks 50% healing, resolution within six weeks. CASE 2: 87-year-old male, history of prostate cancer, hypertension, squamous cell carcinoma of the ear and scalp presented two months postsurgical excision of the scalp site with a 100% dry necrotic wound bed. Prior treatments included a topical emulsion gel and antibiotic ointment. Silver collagen gel was applied and covered with adhesive foam and changed every three days. After one week 75% red granular wound bed, resolution within four weeks. CASE 3: 76-year-old female, history of anxiety, COPD, venous insufficiency, basal cell carcinoma of the scalp presented one week postsurgical excision of scalp with a wound bed of 50% dry necrotic, 10% dry red granulation, 40% bone. Prior treatments included topical emulsion gel. Silver collagen gel was applied and covered with a nonstick pad and changed daily. Cover was changed to foam after two weeks and changed every three days. At seven weeks 50% healing. At twelve weeks 95% healing, wound was accidentally reopened by adhesive. This wound continues to be followed. CONCLUSION: Silver collagen nanocrystalline/ionic gel is an excellent choice for postincisional and dehisced lesion healing.

The Cost and Efficacy of Two Wound Treatments

Using the physiology of moist wound healing as the framework, this nonexperimental, retrospective chart review compared the rate of wound healing and cost of wound care associated with wet-to-dry normal saline gauze dressings to the rate of wound healing and cost of wound care associated with amorphous hydrogel dressings for patients with infrainguinal arterial disease and diabetes. These patients were discharged from the hospital to home care for management of perioperative arterial surgical wound dehiscence and nonhealing ulcerations. The sample included 25 patients who used wet-to-dry normal saline gauze dressings and 25 patients who used amorphous hydrogel dressings. Repeated measures of analysis of covariance revealed a similar rate of wound healing in the two groups. The overall cost of wound care was significantly higher (P = .006) for patients in the normal saline group, with a higher number and cost of home nursing visits. The cost of supplies was not significantly different between groups, although amorphous hydrogel dressings cost an average of dollar 50 more than wet-to-dry normal saline gauze dressings. The two treatments are equally efficacious in promoting wound healing, but amorphous hydrogel dressings are significantly more cost effective and, thus, a better value for the home care dollar.