Plastic Dressings Research Articles

Study About the Efficacy of an Aerosol Plastic Dressing in Wound Prevention After Compressive Adhesive Dressing Application in Plastic Surgery Procedures.

The use of compressive adhesive bandages is widely extended in the field of plastic, aesthetic, and reconstructive surgery, and the apparition of skin damage after its removal is a relatively frequent complication. The aim of this study was to evaluate the capacity of an aerosol plastic dressing for protecting the skin from the apparition of damage caused by adhesive dressings. A prospective, randomized, simple-blind study was performed, evaluating skin damage incidence after removal of adhesive compressive bandages in 80 subjects. The patients carried for 48 hr an adhesive compressive dressing on their abdomen placed over a layer of an aerosol plastic dressing and another bandage placed directly over the skin. A statistically significant decrease in skin damage incidence was observed in areas in which the aerosol plastic dressing was applied as a layer between the adhesive dressing and the skin. Furthermore, a reduction in symptoms associated with the use of these adhesive dressings was found. The results of this study support the use of aerosol plastic dressings as a barrier for skin protection in patients in whom an adhesive compressive dressing is applied to reduce the incidence of skin damage.

Study About the Efficacy of an Aerosol Plastic Dressing in Wound Prevention After Compressive Adhesive Dressing Application in Plastic Surgery Procedures

Study About the Efficacy of an Aerosol Plastic Dressing in Wound Prevention After Compressive Adhesive Dressing Application in Plastic Surgery Procedures

A Comparison of Immediate Postoperative Rigid and Soft Dressings for Below-Knee Amputations

A variety of postsurgical dressings are used after a below-knee amputation (BKA), but there is no evidence-based guideline on which dressing to use. The purpose of this study was to compare the application of immediate postoperative rigid dressings or soft dressings on the healing times of BKA. In this retrospective analysis we compared 151 patients who underwent BKA from 2000 to 2012 at Yale New Haven Hospital. Patient demographics were collected and the type of postoperative dressing utilized was recorded. Ninety-one patients received a rigid plaster or plastic dressing and 60 received a soft gauze dressing with knee immobilizer. Time was measured between amputation and initial casting of prosthesis. Average age for the rigid dressing group was 58.6 years, with 78.2% presenting with diabetes mellitus, compared with the soft dressing group of 61.0 years, with 82.8%, respectively. Using a Kaplan-Meier analysis, patients fit with a rigid dressing demonstrated significantly decreased healing time from BKA to initial casting for a prosthesis (P = 0.02). After the first 60 days, 58.24% of patients who received a rigid dressing were ready to be cast, compared with 38.33% of patients receiving a soft dressing (P = 0.03). Below-knee amputees had a significantly quicker healing time, as measured by the time to be cast for prosthesis, when a rigid dressing was used compared with a soft dressing. Consideration should be given to the use of a rigid dressing after BKA to expedite healing and promote earlier ambulation.

Efficacy, Safety and Tolerability of an Optimized Avulsion Technique with Onyster® (40% Urea Ointment with Plastic Dressing) Ointment Compared to Bifonazole-Urea Ointment for Removal of the Clinically Infected Nail in Toenail Onychomycosis: a Randomized Evaluator-Blinded Controlled Study

Background: Toenail onychomycosis is highly prevalent, with 14-28% of people aged 60 or over suffering from the disease. Use of a topical antifungal alone in toenail onychomycosis is associated with low cure rates. This may be due to limited penetration of the topical antifungal through the diseased nail. The objective of the present study was to compare two treatment modalities to obtain diseased nail chemical avulsion in toenail onychomycosis. Methods: In this European, multicenter, randomized, parallel-group, open-label, active-controlled study, male or female adult patients with distal-lateral or lateral subungual dermatophyte onychomycosis on at least 12.5% of the great toenail were randomized either to a 40% urea ointment with plastic dressing group (n = 53) or to a bifonazole-urea ointment group (n = 52). The ointments were applied daily for a maximum of 3 weeks according to the summary of product characteristics. After assessment of infected nail debridement, topical antifungal treatment with bifonazole cream was applied daily in both groups for 8 weeks. 102 patients were evaluated, i.e. 51 in the 40% urea ointment with plastic dressing group and 51 in the bifonazole-urea group. The primary end point was complete removal of the nail plate at day 21 (D21). Secondary end points were: complete cure and mycological cure evaluated at D105. Ease of use and local tolerability were also assessed. Results: Complete removal of the clinically infected target nail plate area, assessed by blinded evaluators, was significantly higher in the 40% urea ointment with plastic dressing group (61.2%) than in the control group (39.2%), showing the superiority of 40% urea ointment with plastic dressing (p = 0.028). The same results were observed in the per-protocol population (63.0 vs. 36.6%; p = 0.014). Complete removal of the infected area assessed by the investigator at D21 showed a significantly higher success rate in patients treated with 40% urea ointment with plastic dressing (86.3%) as compared to patients treated with bifonazole-urea (60.8%), confirming the superiority of 40% urea ointment with plastic dressing (p = 0.004). At D105, the complete cure of onychomycosis, a criterion combining clinical and mycological assessments, showed a success rate of 27.7% for 40% urea ointment with plastic dressing versus 20.8% for the control group. No statistical difference was observed between the two treatment groups. The number of patients with at least one adverse event was twice as high in the bifonazole-urea group in comparison to the 40% urea ointment with plastic dressing group. Overall assessment of local tolerability by the investigator was considered good/very good in 98.0% of the 40% urea ointment with plastic dressing patients versus 90.4% of the bifonazole-urea patients, at D21, with no significant difference between both groups. Conclusion: This study shows the superiority of 40% urea ointment with plastic dressing to bifonazole-urea ointment for complete removal of the infected target nail assessed by blinded evaluators and by the investigators. Further studies are needed to assess the impact of preliminary chemical nail avulsion on the efficacy of topical treatment of onychomycosis as assessed by complete cure at 1 year.

Continuous EEG–SEP monitoring of severely brain injured patients in NICU: methods and feasibility

Aims To evaluate the feasibility of a continuous neurophysiologic monitoring (electroencephalography (EEG)–somatosensory evoked potentials (SEPs)) in the neuro-intensive care unit (NICU), taking into account both the technical and medical aspects that are specific of this environment. Methods We used an extension of the recording software that is routinely used in our unit of clinical neurophysiology. It performs cycles of alternate EEG and SEP recordings. Raw traces and trends are simultaneously displayed. Patient head and stimulator box are placed behind the bed and linked to the ICU monitoring terminal through optic fibers. The NICU staff has been trained to note directly clinical events, main artefacts and therapeutic changes. The hospital local area network (LAN) enables remote monitoring survey. Results Continuous EEG (CEEG)–SEP monitoring was performed in 44 patients. Problems of needle detachment were seldomly encountered, thanks to the use of a sterile plastic dressing, which covers needles. We never had infection or skin lesions due to needles or the electrical stimulator. The frequent administration of sedative at high doses prevented us from having a clinically valuable EEG in several cases but SEPs were always monitorable, independently of the level of EEG suppression. The diagnosis of seizures and non-epileptic status was based on raw EEG, while quantitative EEG (QEEG) was used to quantify ictal activity as a guide to treatment. Conclusions EEG and EP waveforms collected in NICU were of comparable quality to routine clinical measurements and contained the same clinical information. A continuous SEP monitoring in a comatose and sedated patient in NICU is not technically more difficult and potentially less useful than in operating room. This monitoring appears to be feasible provided the observance of some requirement regarding setting, electrodes, montages, personnel integration, consulting and software.

Topical amitriptyline in healthy volunteers

Background and Objectives: The antidepressant amitriptyline is used as an adjuvant in the treatment of a variety of chronic pain conditions. This drug interacts with many receptors and ion channels, such as Na + channels. In a randomized, double-blinded, and placebo-controlled trial, we investigated whether amitriptyline also is capable of providing cutaneous analgesia when applied topically in 14 healthy volunteers. Methods: Amitriptyline hydrochloride was prepared as a 45% water/45% isopropanol/10% glycerin solution and titrated to pH 8.5 with sodium hydroxide. Four areas, 2 on each arm, of approximately 1 cm 2 each were marked on the ventral aspect of the upper arm. A piece of gauze, placed on each of the marked areas and affixed to the arm with an occlusive plastic dressing, was saturated via syringe with placebo and amitriptyline solutions (10 mmol/L, 50 mmol/L, and 100 mmol/L). After 1 hour, the dressings and gauze were removed. A 16-G blunt needle was used to grade the pain at the marked area once per hour (1 = complete analgesia, 10 = normal pain sensation). Results: The analgesic effects of 50 mmol/L and 100 mmol/L solutions of amitriptyline were significantly higher than those of the placebo or the 10 mmol/L solution. However, no significant difference was found between the analgesia provided by the placebo solution versus the 10 mmol/L solution or between the 50 mmol/L versus the 100 mmol/L solution. The only side effect observed was a concentration-dependent redness of the skin. Conclusions: Topically applied amitriptyline is effective as an analgesic in humans. Different vehicles may improve its efficacy and decrease the skin redness observed.

Prevention of vascular catheter-related infections

Infection is the most common serious complication of intravascular catheters. Most cases of catheter-related infection are caused by staphylococci that originate either from the skin of the patient and migrate along the external surface of the catheter or from a contaminated catheter hub and migrate along the internal surface of the catheter. Major risk factors predisposing to catheter-related infection include prolonged duration of catheter placement, frequent manipulation of the catheter, use of thrombogenic catheter material, location of the catheter, and use of occlusive transparent plastic dressings. A number of measures have been reported in prospective, randomized clinical trials to protect against vascular catheter-related infection. This paper summarizes the clinical efficacy of various preventive measures, such as placement and maintenance of vascular catheters by a skilled infusion therapy team, institution of maximal sterile barriers, use of silver-impregnated subcutaneous cuff, antimicrobial coating of catheters with either antibiotics or antiseptics, use of an antiseptic catheter hub, application of topical disinfectants, and flushing catheters with the combination of antimicrobial and antithrombotic agents.

Vascular-Access Infections in Hospitalized Patients

Vascular catheters are a common source of nosocomial infections, although many of these infections are potentially preventable. A long duration of catheterization, multiple catheter manipulations, the inexperience of some inserters, use of transparent plastic dressings, violations of aseptic technique, the use of multilumen catheters, and inadequate sterilization of reusable pressure transducers all increase the risk of these infections. The only interventions that have been proved to reduce the risk are standardized insertion and maintenance technique by an intravenous-therapy team, preinsertion skin preparation with chlorhexidine gluconate, and the use of topical antibiotics at the insertion site. The goal of the physician should be to prevent catheter infection, because the treatment of established infection can be difficult and costly. Treatment must be individualized for each patient on the basis of the clinical presentation and the causative organism.

4359815 Machining center with a robot: Kenichi Toyoda assigned to Fujitsu Fanue Limited

Infection is the most common serious complication of intravascular catheters. Most cases of catheter-related infection are caused by staphylococci that originate either from the skin of the patient and migrate along the external surface of the catheter or from a contaminated catheter hub and migrate along the internal surface of the catheter. Major risk factors predisposing to catheter-related infection include prolonged duration of catheter placement, frequent manipulation of the catheter, use of thrombogenic catheter material, location of the catheter, and use of occlusive transparent plastic dressings. A number of measures have been reported in prospective, randomized clinical trials to protect against vascular catheter-related infection. This paper summarizes the clinical efficacy of various preventive measures, such as placement and maintenance of vascular catheters by a skilled infusion therapy team, institution of maximal sterile barriers, use of silver-impregnated subcutaneous cuff, antimicrobial coating of catheters with either antibiotics or antiseptics, use of an antiseptic catheter hub, application of topical disinfectants, and flushing catheters with the combination of antimicrobial and antithrombotic agents.

Etude de la résorption transcutanée du 21-acétate de 16 alpha, 17 alpha-cyclopentylène dioxytriamcinolone

The authors try to estimate the percutaneous absorption of a new corticosteroid, derived from triamcinolone: Amcinonide, which is presented as a cream and 0.1% ointment. The study was carried out on 13 patients; cream was applied to 5 of them under occlusive dressings during 48 h, 4 other had ordinary topical applications of the cream, and the 4 remaining patients were treated with the ointment. The parameters studied were 17-ketosteroids and 17-hydroxysteroids in the 24-hour urine, daily sodium and potassium urinary elimination, plasma cortisol levels and ACTH stimulation test before and after treatment. Only extensive occlusive plastic dressings (50--90% of the body area) lead to a temporary decrease in the activity of the pituitary adrenal system (lowering of the 17-hydroxysteroids in the 24-hour urine in all patients, lowering of the normal adrenocortical response after stimulation with exogenous ACTH in 1 patient). On the other hand, the elimination of urinary ions is not significantly modified. With ordinary topical application of cream or ointment no systemic effect could be observed.

Treatment of Hyperkeratotic Dermatitis of the Palms

The sequential use of a keratolytic gel and corticosteroid ointment in the treatment of hyperkeratotic eczematous dermatitis and psoriasis of the palms and soles was studied. Application of the gel for two to four hours followed by application of corticosteroid ointment overnight, both under plastic dressings, proved to be much more effective than occlusive therapy with a corticosteroid ointment alone. This was particularly true for fissuring and hyperkeratosis.

TOPICAL TREATMENT OF RHEUMATOID ARTHRITIS WITH FLUOCINOLONE ACETONIDE UNDER OCCULSIVE DRESSING.

SummaryTwenty arthritic patients, 15 with rheumatoid arthritis, 4 with arthritis psoriatica and one with arthritis supervening on sarcoidosis, suffering from symmetric arthritic changes in the finger joints were treated with fluocinolone acetonide in propylene glycol under occlusive plastic dressing. The investigation was performed as a doubleblind test. The reduction of volume of the hands treated with fluocinolone acetonide was significantly greater than that of the hands treated only with the solvent. Most of the patients treated with fluocinolone acetonide were less stiff in the morning, more mobile and felt less tenderness when making movements. This topical form of treatment is suggested for arthritics with pronounced symptoms, but where oral steroid treatment is contraindicated.

PLASMA CORTISOL SUPPRESSION BY STEROID CREAMS.

Studies of plasma cortisol levels during treatment with fluocinolone acetonide, flurandrenolone acetonide, and triamcinolone acetonide creams under occlusive plastic dressings revealed a definite suppression with total body occlusion in four patients with psoriasis. The suppression of plasma cortisol was temporary, and there was a prompt return to pretreatment levels when treatment was stopped. No significant plasma cortisol suppression was observed in one normal and two subjects with alopecia treated with steroid creams under total body occlusion. Although a similar, but less pronounced, suppression of urinary 17-ketosteroids and 17-hydroxycorticosteroids was observed in several subjects, these determinations were not as reliable as plasma cortisol for detection of suppression of the adrenal-pituitary axis in these subjects.

PLASTIC ACIDS FOR OCCLUSIVE THERAPY.

The use of surface steroid preparations combined with occlusive plastic dressings is now well known and widely used. As with other forms of therapy, prolonged experience reveals some difficulties and obstacles which further experience is able to overcome. It has been found to be difficult to apply these plastic dressings to certain parts of the body, and this difficulty is increased if the patient lives alone and must apply them himself. In addition there is the frequently seen disadvantage of rolling and loosening of plastic sheets which are applied over joints or over wide areas of the extremities. The lack of experience of patients carrying out treatment at home and of nurses carrying out treatment in the hospitals makes it necessary for the clinician to demonstrate or train each one individually. Finally, the application of plastic dressings to large areas of the body requires considerable time, up to two hours for each dressing, and is a motivation

Occlusion, topical corticosteroids and heat in psoriasis.

Observations on the therapeutic effectiveness of topically applied corticosteroids under occlusive plastic dressings in psoriasis with and without application of heat are reported. A better and more rapid clinical response was observed with the application of heat. Maceration by occlusion alone was not effective. Total body injunction with corticosteroids did not produce any demonstrable absorption. Complete histologic clearance does not occur when the lesions are clinically clear.

The use of plastic dressings in treating industrial wounds.

The use of plastic dressings in treating industrial wounds.

An investigation of plastic dressings for clinical use

Three plastic dressings for clinical use were investigated. The surface on which these dressings are used must be dry to obtain an impermeable film. An antimicrobial substance is a necessary additive to such dressings.

Use of a plastic film as a dressing for wounds.

Significant interest in the use of plastic films as dressings for wounds has been manifest during recent years. 1-9 The films can cover a wide variety of wounds, are not toxic, and are easy to use. These plastic dressings for wounds usually consist of suitable ingredients dissolved in an organic solvent to form a solution which is capable of creating a plastic film following the evaporation of the solvent. The plastic substances used in such preparations frequently belong to the classes of compounds known as vinyls, acrylates, and cellulosics. In some instances these materials are combined with softening agents or plasticizers which will make the films soft and pliable and will allow them to conform readily to the surfaces and contours of the body. Any plastic film used as a dressing for a wound should possess a combination of physical properties which insures its satisfactory adhesion to the skin, good

Plastic Surgical Dressing

Plastic Surgical Dressing

CLINICAL TRIAL OF OCCLUSIVE PLASTIC DRESSINGS

CLINICAL TRIAL OF OCCLUSIVE PLASTIC DRESSINGS