Semi-occlusive dressing as non-operative treatment vs. operative treatment for fingertip amputations: A retrospective cohort study

INTRODUCTION@#Treatment of fingertip amputations have demonstrated good outcomes with both surgical and nonsurgical management.@*OBJECTIVE@#The objective of this study was to compare non-operative treatment with semi-occlusive dressing with any surgical treatment for fingertip amputations in adult fingers, Allen types I-III in a retrospective cohort review.@*METHODS@#A retrospective chart review was done on adult patients with fingertip amputations Allen types I-III from January 1, 2018 to December 31, 2020. Patients included in the studies were distributed into two treatment groups: non-operative and operative groups. Outcomes to be measured were time to full healing, range of motion, nail deformities, Tinel’s sign, and discoloration of the reconstructed fingertip.@*RESULTS@#A total of 38 patients with 40 digits were included (19 patients with 20 digits for each treatment group). The results showed a larger defect for the operative group (3 cm2 vs 2.1 cm2), with shorter time to healing (1.4 months vs 2.2 months). There were more complications in the operative group like the Tinel’s sign, nail deformity and discoloration, as well as joint contractures. Range of motion was better for patients treated non-operatively.@*CONCLUSION@#Treatment with semi-occlusive dressing showed similar results in terms of wound healing but takes a longer time and less complications compared to operative treatment.

An influence study of the different types of wound dressings on red light transmittance / 中华老年医学杂志

Objective:To investigate the influence of different types of wound dressings on red light transmittance.Methods:A treatment environment for wounds exposed to red light was simulated.Red light transmittance of four types of 19 dressings commonly used in clinic were detected respectively and compared.The transmittance was calculated as the ratio of the intensity of the red light through the dressing to the intensity of the injected red light.Results:The red light transmittance for each dressing was the following: (1)Cotton gauze and pad: 29.4% for one piece of coarse gauze, 10.5% for one cotton pad; (2)Oil dressings: 73.0%~79.1% for light-color oil dressings, 41.7% for dark-color oil dressings-Atrauman ?; (3)Hydrocolloid dressings: 87.8%~90.2%; (4)Foams: 74.7% for light-color ultra-thin foam-Mepilex ? sheet, 0.8% for black-color thicker foam dressings-Mepilex ? Ag dressing, and 20.5%-54.2% for the other foam dressings. Conclusions:The red light transmittance of hydrocolloid dressing, light-colored oil gauze dressing and light-colored ultra-thin foam dressing is higher, with less red light-blocking effect, and the dark-color or thicker dressings had more blocking effect, which showed different therapeutic effect on wound.Gauze and cotton pad have great blocking influence on red light transmittance, and are not suitable for temporary covering of wound during red light treatment.Hence, the effect of wound dressing on red light transmittance should be taken into account when the wound is treated with red light.

Retrospective observational study about patient friendly and cost effective wound care by newer concept of open dressing

Background: The choice of dressing material and to give wound cover varies according to the type of ulcer and the surgeon’s experience. It is practically not possible to do comparative evaluation among different types of dressing material and method to dress. The ideal dressing material and method to dress must be cost effective, comfortable to patient and early wound healing with minimal sequel of scar tissue. The article discusses about a newer method cost effective and patient friendly dressing to achieve effective end result in wound healing.Methods: Retrospective analysis of 50 patients treated from 01 April 2019 to 31 August 2019 by open dressing with written informed consent of patient and fulfilling ethical requirements at Rajiv Gandhi Medical College, Thane, Mumbai. The selection criteria of patients were cases with pressure dressing are excluded. The diabetic (40%), venous (20%) and traumatic (20%) ulcers are selected.Results: Out of 50 cases, in 76% sample cases ulcer healed by secondary intention without skin grafting. It was noticed better early improved status of the ulcer by excellent granulation tissue and without deterioration in status of large ulcers (24%), operated for skin grafting. The concept of covering wound by washed cotton cloth after regular wound wash, antiseptic ointment, and adjuvant conservative therapy, helped to improve patient’s comfort during outpatient department visit and inpatient department stay.Conclusions: It concludes that the newer concept of wound cover by washed cotton cloth is patient friendly and cost effective without compromising the status of wound healing.

Preparation and characterization of a novel antimicrobial film dressing for wound healing application

Antibacterial activity and good mechanical properties are some of the characteristics required for an appropriate film dressing. A novel polymer blend was developed for wound healing application. Twenty-four formulations using the polymers chitosan, poly(vinyl alcohol) and/or ɛ-Polylysine and the plasticizer glycerol were designed using factorial design and then the films were prepared by the casting/solvent evaporation method. Seventeen films were obtained among the twenty-four proposed formulations that were characterized by Field Emission Scanning Electron Microscopy (FE-SEM) and Fourier Transform Infrared Spectroscopy (FTIR). Mechanical properties, such as tensile strength (σ), elongation at break (ɛ) and Young's modulus (Y) as well as antibacterial properties were determined. The best candidate was then further analyzed with regard to porosity, Water Vapor Transmission Rate (WVTR), swelling and cytotoxicity experiments. The results showed a film with semi-occlusive characteristics, good mechanical properties and no toxic. Incorporation of ɛ-Polylysine increased antibacterial activity against gram-negative (Escherichia coli) and gram-positive (Staphylococcus aureus) bacteria

Role of the Surgical Glove in Modified Vacuum-Assisted Wound Healing

Vacuum-assisted wound healing has been proven to be more efficacious than conventional dressings. Vacuum dressing has been frequently modified given the restrictions in resources available. Here we present a modified method of vacuum dressing by using surgical or gynaecological gloves for lower and upper limb wounds. Vacuum dressing was applied with parts of a surgical or gynaecological glove and Opsite with T-tailing of the suction outlet. Vacuum-assisted wound healing using the surgical gloves showed relatively good wound healing in the amputation stump, finger, arm, and leg in the cases studied.

Chromoblastomycosis Treated with Occlusive Dressing of Amphotericin B Cream / 대한의진균학회지

We report a case of chromoblastomycosis in a 65 year-old woman. She had a 3x4 cm sized, annular, erythematous, plaque with crusts and ulcers on the right lower arm. The lesion had grown slowly for 2 years. In fungal and histopathologic examinations, several muriform cells were found in dermis as well as in scales and crusts on the lesional skin surface. Isolated fungus was identified as Fonsecaea pedrosoi. We treated the patient occlusive dressing of amphotericin B (3%) ointment for 8 weeks and achieved a good response without any evidence of recurrence. We propose that the occlusive dressing therapy of amphotericin B cream is a good modality among the various treatments of small localized chromoblastomycosis.

Repair of Defect Caused by Surgical Removal of Skin Cancers by Secondary Intention / 대한피부과학회지

BACKGROUND: There are a few methods, including primary intention, deleyed primary closure and secondary intention, to irpair several types of defects. But commonly-used primary intentional repair of a defect after surgical removal of a skin cancer by graft, flap or simple closure has several limitations such as the need of a skillful technique and various complications. OBJECTIVE: We undertook a secondary intention using occlusive dressing with a polyurethane film after skin cancer surgery instead of a primary repair and evaluated its efficacy, particularly in points of simplicity and safety, and cosmetic results. METHODS: We randomly chose 14 cases of skin cancers in 13 patients who had undergone simple surgical excision or Mohs micrographic surgery and then undertook secondary intention with polyurethane film after informed consent. Postsurgical wound care included cleansing with normal saline or boric acid, then covering the defect with antibiotic ointment, gauze and film a at regular intervals.

Efficacy of hydrocolloid occlusive dressing technique in decubitus ulcer treatment: a comparative study

The efficacy of hydrocolloid occlusive dressing technique was compared with that of the conventional wet-to-dry gauze dressing technique in decubitus ulcer of stage I and II. Forty-four patients were randomly divided into two treatment groups and each received treatment according to the two different protocols. As a result, 80.8% of the hydrocolloid occlusive dressing group (group 1) and 77.8% of the conventional wet-to-dry gauze dressing group (group 2) healed completely with no statistically significant difference between the two groups. However, the time required for complete healing was shorter in group 1 with 18.9 days compared to 24.3 days in group 2. Ulcer healing speed was also slightly faster in group 1 with 9.1 mm2/day compared to 7.9 mm2/day for group 2. Average treatment time spent by a medical staff member was significantly shorter in group 1 with 20.4 minutes/day compared to 2017 minutes/day in group 2. The hospital cost of the ulcer treatment was higher in group 2 compared to group 1 even without taking into consideration the medical personnel's labor cost. These results indicate that the hydrocolloid occlusive dressing technique offers less time consuming and less expensive method of treatment compared to the conventional technique in stage I andII decubitus ulcers.

In Vivo Assessment of Percutaneous Anesthetic Patch (4 % Tetracaine Cream) II / 대한마취과학회지

We have evaluated the onset time and frequency of allergic reactions after topical application of tetracaine cream. Tetracaine cream was prepared on the antecubital area of forearm in 21 voluteers and antiinflammatory cream was applied also on same side forearm under an impermeable occlusive patch dressing. The mean anesthetic onset time of tetracaine site was 24.90+/-7.47 minutes and significant allergic reactions were not found. The ideal percutaneous local anesthetic formulation should have a comparatively low-concetration of drugs and provide a rapid onset of action combined with a deep and relatively prolonged anesthesia of the skin surface, in addition to underlying tissue. Although EMLA cream has been available, it requires a minimum application period of 1 hour using 2.5 g of preparation in combination with an occlusive dressing. The result of this study indicate that 4% tetracaine in carbomer base and in addition with sodium bicarbonate (Imeq/g) provided more rapid onset and prolonged anesthesia without any significant allergic reactions. So, we advise this 4% tetracaine cream for epicutaneous procedures (tattooing, removal of warts or senile ketatitis), venipuncture and venous cannulations, especially in children.