Soft Dressings Research Articles

Trends in the Management of Fifth Metacarpal Neck Fractures

To describe management trends of fifth metacarpal neck (5MCN) fractures within a large health care system. We aimed to define patient and surgeon factors associated with nonsurgical versus surgical treatment, as well as to identify factors associated with receiving care only in the emergency department (ED). We identified all 5MCN fractures within our system for the years 2012-2020 and recorded baseline demographics for cases. Injury, treatment, and fracture characteristics were all recorded. For fractures treated nonsurgically, we determined the type of immobilization used (if any) and recorded whether patients were seen only in the ED or received subsequent outpatient follow-up. Demographic comparisons were made between groups, and adjusted logistic regression models were generated to predict the odds of having a surgical 5MCN fracture or being seen in the ED only. There were 611 5MCN fractures over an 8-year period, of which 10% were treated surgically. During the first half of the study period, 8% of isolated cases were treated surgically compared with 7% of cases in the second half. Soft dressings were increasingly used. There were no nonsurgically managed cases that underwent subsequent surgical procedures for symptomatic nonunion or malunion. Twenty-one percent of patients were seen only in the ED. Fracture angulation, associated injuries, insurance status, and treatment by a hand surgeon were all significantly associated with an increased likelihood of surgery. Of the 611 5MCN fractures identified, 90% were treated nonsurgically. Patient and surgeon factors were associated with increased odds of surgery. Of patients who sought care for 5MCN injuries, >20% received no follow-up care outside of the ED. These data can be used to assess future changes in management trends and suggest that nonunion and symptomatic malunions are uncommon occurrences. Prognostic IV.

Removable Rigid Dressings for the Post-Operative Management of Leg Amputations

Two systematic reviews and 1 randomized controlled trial provided evidence on the clinical effectiveness and safety of removable rigid dressings compared to soft dressings. Overall, there was limited evidence suggesting that removable rigid dressings had beneficial or neutral effects compared to soft dressings, and both types of dressings were associated with few adverse events. Limitations that may reduce the certainty of the evidence include small sample sizes, lack of randomization in non-randomized studies, lack of blinding, and selective reporting. Three evidence-based guidelines based on low-quality evidence were identified that provided recommendations related to removable rigid dressings. The Australian, Dutch, and US guidelines recommend the rigid dressings for transtibial amputations, although Australian and Dutch guidelines specified removable rigid dressings. The Dutch guideline recommends against the use of rigid dressings for transfemoral amputations. No evidence was identified on the cost-effectiveness of removable rigid dressings compared to alternative dressings.

Revisiting the conformally soft sector with celestial diamonds

Celestial diamonds encode the structure of global conformal multiplets in 2D celestial CFT and offer a natural language for describing the conformally soft sector. The operators appearing at their left and right corners give rise to conformally soft factorization theorems, the bottom corners correspond to conserved charges, and the top corners to conformal dressings. We show that conformally soft charges can be expressed in terms of light ray integrals that select modes of the appropriate conformal weights. They reside at the bottom corners of memory diamonds, and ascend to generalized currents. We then identify the top corners of the associated Goldstone diamonds with conformal Faddeev-Kulish dressings and compute the sub-leading conformally soft dressings in gauge theory and gravity which are important for finding nontrivial central extensions. Finally, we combine these ingredients to speculate on 2D effective descriptions for the conformally soft sector of celestial CFT.

Meta-analysis of self-adhesive soft silicone film dressings on preventing and treating radioactive skin lesion

Objective To systematically assess the effects of self-adhesive soft silicone film dressings on preventing and treating radioactive skin lesion. Methods Randomized controlled trials (RCT) about self-adhesive soft silicone film dressings on preventing and treating radioactive skin lesion were retrieved from PubMed, Web of Science, Cochrane Library, Embase, CNKI, VIP and Wanfang databases, and RevMan 5.3 was used for Meta-analysis of the trials which met the inclusion criteria. Results Totally 10 RCTs were included, with a sample size of 1 231 cases. Meta-analysis revealed that self-adhesive soft silicone film dressings could reducethe incidence of GradeⅡ or above radiodermatitis (OR=0.14, 95%CI 0.08-0.25, P<0.01) , shorten the occurrence time of radiodermatitis within the field of radiotherapy (OR=0.07, 95%CI 0.02-0.32, P<0.01) , and reduce subjective and objective symptom scores of radiodermatitis (Radiation-induced Skin Reaction Assessment Scale, RISRAS) (MD=-3.33, 95%CI-5.96--0.70, P<0.05) . Conclusions Self-adhesive soft silicone film dressings applied on the cutaneous surface within the field of radiotherapy can reduce the severity of radiodermatitis, shorten the occurrence time of radioactive skin lesion within the field of radiotherapy, and effectively ameliorate cutaneous discomfort within the field of radiotherapy and the effects of radiotherapy-induced skin reaction on daily activities. Key words: Radiodermatitis; Self-adhesive soft silicone film dressings; Skin lesion; Malignant neoplasms; Meta-analysis

Subleading soft dressings of asymptotic states in QED and perturbative quantum gravity

We construct Faddeev-Kulish states in QED and perturbative quantum gravity to subleading order in the soft momentum expansion and to first order in the coupling constant, using the charge conservation formula of asymptotic symmetries associated with the tree-level subleading soft theorems. We demonstrate that the emission and absorption of soft photons/gravitons in dressed amplitudes vanish. The fact that no additional soft radiation may be added to a dressed amplitude supports the claim that, in the dressed state formalism, the soft and hard sectors of scattering processes are correlated. We also show that the dressed virtual amplitudes are equivalent to the infrared-finite part of the traditional amplitudes constructed using Fock states. Since there is no real soft radiation in the asymptotic Hilbert space, the dressed state formalism gives the same cross sections as the Bloch-Nordsieck method.

Rigid dressings versus soft dressings for transtibial amputations.

Rigid dressings versus soft dressings for transtibial amputations.

Stump healing in below knee amputations using soft versus rigid dressing

Introductions: Different techniques of postsurgical dressings are used after a below-knee amputation (BKA). This study compares the application of soft dressings versus rigid dressings on healing time and hospital stay after BKA.&#x0D; Methods: In this cross sectional prospective analysis of outcome of two types of post-operative dressings after BKA during January 2012 to January 2018 at Shree Bhawani Hospital Birgunj, Nepal. Wound healing time and hospitalisation were compared between soft and rigid dressings.&#x0D; Results: Out of 37 BKA, 20 received soft dressings with knee immobiliser and 17 rigid plaster dressings. Average age of patients in soft dressing group was 41 years (range 10-70) and in plaster dressing group 37.7 years (range 10-70). Two out of 20 (10%) with soft dressing and 13 out of 18 (76.47%) with the rigid dressing healed primarily, p &lt;0.001. Patients treated with soft dressings stayed in the hospital on an average of 35.2 days (range 22-49 days) and rigid dressings 18.4 days (range12-31 days).&#x0D; Conclusions: The patients with rigid dressings after BKA had significantly more primary wound healings and shorter length of hospitalisation compared to soft dressing.

Soft photon hair on Schwarzschild horizon from a Wilson line perspective

We develop a unified framework for the construction of soft dressings at boundaries of spacetime, such as the null infinity of Minkowski spacetime and the horizon of a Schwarzschild black hole. The construction is based on an old proposal of Mandelstam for quantizing QED and considers matter fields dressed by Wilson lines. Along time-like paths, the Wilson lines puncturing the boundary are the analogs of flat space Faddeev-Kulish dressings. We focus on the Schwarzschild black hole where our framework provides a quantum-field-theoretical perspective of the Hawking-Perry-Strominger viewpoint that black holes carry soft hair, through a study of the Wilson line dressings, localized on the horizon.

Determination of silver in soft silicone wound dressings using dodecylbenzene sulfonic acid digestion and inductively coupled plasma optical emission spectroscopy

Silver was determined in soft silicone wound dressings using dodecylbenzene sulfonic acid digestion as a novel approach.

Rigid dressings versus soft dressings for transtibial amputations

Rigid dressings versus soft dressings for transtibial amputations

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.

Economic evaluation of soft silicon foam dressings versus sterile gauze for the treatment of pressure ulcers in China

Economic evaluation of soft silicon foam dressings versus sterile gauze for the treatment of pressure ulcers in China

A Comparison of Rigid vs Soft Dressings in the Healing of Below Knee Amputations (BKA)

Introduction and objectives: There is no standard protocol for the selection of surgical dressings after a below knee amputation (BKA). The purpose of this study was to compare rigid dressings with soft dressings on the healing times of BKA. We hypothesized that rigid dressings would facilitate faster wound healing and residual limb maturation by minimizing postsurgical edema and pain, preventing knee flexion contracture, and protecting the residual limb from trauma. Methods: Our retrospective analysis compared 151 patients who underwent BKA from 2000 to 2012 at Yale New Haven Hospital, after which 60 patients received soft dressings and knee immobilizers (soft) after the amputation, and 92 were placed in a rigid plastic or plaster prosthesis (rigid). Demographics and outcomes, including time between amputation and initial casting of prosthesis, were compared. Results: Age and diabetic status was not statistically different between the soft (61.0 years, 82.8% with diabetes) and rigid groups (58.6 years, 78.0% with diabetes). After BKA, the rigid dressing group demonstrated significantly decreased time spans from amputation to initial casting, as shown by the Fig (P .02 by log-rank and Wilcoxon test) and the Table. After 60 days, 58.24% of the rigid group was cast, compared with 38.33% of soft group (P .03 by t test). Conclusions: Use of a rigid dressing after a BKA significantly shortened the time to healing, as assessed by the time to casting. Use of a rigid prosthesis allows for consistent dressing changes of the healing BKA stump while facilitating inspection of the limb. Table. Days to casting

Arthroscopic Total Trapeziectomy

Trapeziometacarpal osteoarthritis is a common pathology resulting in severe impairments in daily living activities. Many procedures have been described in the treatment of stages Eaton II, III and IV. Bibliographical research evidences that other techniques could not improve the results of the simple trapeziectomy. A surgical technique with an arthroscopically assisted total resection of the trapezium is described. This technique is carried out with a 2.7-mm arthroscope, using the conventional portals (1R and 1U) and a fluoroscan. Surgery ends with soft dressings and rehabilitation begins immediately. In the last 9 years, we treated more than 70 patients. Video-assisted total trapeziectomy offers a simple technique with sufficient postoperative comfort that allows an early return to the daily living activities.

The application of soft silicone foam dressings in the management of middle-thickness skin graft donor site wounds

Objective To determine the effect of Soft Silicone Foam Dressings in the Management of Middle-Thickness Skin Graft Donor Site Wounds.Methods 30 patiants were included in this study.The skins graft donor site wounds were randomly divided into two groups to receive either petrolatum gauze (control group) or Soft Silicone Foam Dressings( Mepilex,therapy group).Outer dressings were changed at 3 days after operation and inner dressings were changed at 5 days after operation.Then dressings were changed every 2 days and observate the wound healing.Results The pain was released obviously in therapy group by 5, 7, 9 days post-operation.Better bacteriostatic effect existed in therapy group with significant difference compared with control group.And There was significant difference between the two groups on the healing rate, with the dry therapy group (97.4 ±5.3) and the control group (80.5±11.2) by 11 days post-operation (P<0.01).Conclusions In the Management of Middle-Thickness Skin Graft Donor Site Wounds, the Application of Soft Silicone Foam Dressings has obvious effect in releasing pain, depressing infection rate and accelerating wound healing. Key words: Soft silicone soam dressings; Skins graft donor site wounds; Healing; Pain

Removable rigid dressings

This study investigated the validity of post-amputation application of removable rigid dressings (RRDs) for trans-tibial amputees, regarding preparation for prosthetic management and key rehabilitation timelines. It was hypothesised that the use of RRDs would result in faster preparation of the residual limb for prosthetic management and shorter rehabilitation times, compared with conventional soft dressings. A retrospective case-note audit was conducted, in which consecutive trans-tibial amputees who underwent amputation in the 2 years before RRD implementation (non-RRD group, n = 37) and in the 2 years after RRD implementation (RRD group, n = 28) were eligible for inclusion. There was a significant reduction in the geometric mean time-to-first-prosthetic-casting in the RRD group, compared with the soft-dressing group (36.4 days vs. 27.6 days, respectively, p < 0.05). A significant reduction in acute length of stay (LOS) for the RRD group was also identified (15.9 days vs. 8.7 days, respectively, p < 0.001). There were no significant differences in other rehabilitation timeframes, such as rehabilitation LOS, total LOS, outpatient rehabilitation days, and total rehabilitation days between the two groups. This study shows that the application of RRDs reduces acute LOS and time-to-first-prosthetic-casting, thereby providing substantial benefits in preparing the trans-tibial amputee for early rehabilitation and prosthetic intervention.

PR_159: Rigid Versus Soft Dressings in the Postoperative Wound Management of Transtibial Amputations

Objective: To test the hypothesis that, in patients receiving transtibial amputation, rigid dressings result in better postoperative outcomes in terms of wound complications and functional mobility at hospital discharge when compared with soft dressings. Design: Retrospective cohort study. Setting: Large academic teaching hospital and Veterans Administration (VA) hospital. Participants: All patients receiving transtibial amputation from 2001 through 2003 (N=128; VA patients, n=38); with a mean age of 62.5 years and 89 patients were men.

A Cotton Batting Compression Dressing and Fiberglass Cast used Safely in the Immediate Postoperative Period After Hindfoot or Ankle Surgery

Patients undergoing surgery on the foot and ankle who require immobilization are typically placed in splints or soft compression dressings after surgery to avoid complications associated with swelling. As swelling subsides, this temporary immobilization is removed and replaced with a short-leg cast, making an additional office visit necessary, which adds to the cost as well as patient discomfort. We apply a cast in the operating room using a special padding technique to accommodate postoperative swelling. It is supportive enough that it does not need to be replaced shortly after surgery. This cast was applied to 38 patients having surgery on the hindfoot or ankle between March, 2003, and February, 2004. All patients tolerated the cast during the initial 2 weeks after surgery, and there were no complications. The purpose of this study was to describe the casting technique and document its safety for use immediately after surgery on the hindfoot and ankle.

Stump management after trans-tibial amputation

In order to achieve stump healing after trans-tibial amputation, various methods are applied, such as soft dressings followed by elastic wrapping of the stump, rigid dressings, semi-rigid dressings, and more recently the application of silicon or gel-liners. A systematic literature search was performed to identify the optimal post-amputation management. The methodological quality of the studies was systematically evaluated by using a predefined list of criteria. Only 11 controlled studies were identified and evaluated for their methodological quality. From these studies, no studies were classified as A-level studies, whereas three were classified as B-level, and 8 were classified as C-level studies. Relevant literature appears heterogeneous with respect to patient selection, intervention and outcome measures. Despite the large variability of included studies, this review reveals a trend in favour of rigid and semi-rigid dressings for achieving stump healing and reduction of stump volume. No conclusions can be drawn with regard to the effect on functional outcome. The literature is not conclusive on the effects of early weight bearing on stump healing, volume reduction, and functional outcome. More research is needed for the development of evidence-based clinical practice guidelines concerning management after transtibial amputation.

Postoperative Dressing and Management Strategies for Transtibial Amputations: A Critical Review

Postamputation management is an important determinant of recovery from amputation. However, consensus on the most effective postoperative management strategies for individuals undergoing transtibial amputation (TTA) is lacking. Dressings can include simple soft gauze dressings, thigh-high rigid cast dressings, shorter removable rigid dressings, and prefabricated pneumatic dressings. Postoperative prosthetic attachments can be added to all but simple soft dressings. These dressings address the need to cleanly cover a fresh surgical wound, but not all postoperative dressings are designed to facilitate the strategic goals of preventing knee contractures, reducing edema, protecting from external trauma, or facilitating early weight bearing. The type of dressing and management strategy often overlap and are certainly interrelated. Current protocols and decisions are based on local practice, skill, and intuition. The current available literature is challenging, and difficulties include variations in healing potential, in comorbidity, in surgical-level selection, in techniques and skill, in experience with postoperative strategies, and with poorly defined outcome criteria. This paper reviews the published literature and compares measures of safety, efficacy, and clinical outcomes of the various techniques. Analysis of 10 controlled studies supported only 4 of the 14 claims cited in uncontrolled, descriptive studies.