Effect of shaped polyurethane foam dressing on healing of scalp donor sites in the patients with extensive burn / 上海交通大学学报（医学版）

Objective • To evaluate shaped polyurethane foam dressing applied on scalp donor sites in the patients with extensive burn. Methods • The extensively burned adult patients without chronic diseases before injury, who were hospitalized in the Department of Burns and Plastic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from October, 2017 to October, 2018 were selected. Their scalps as skin donor sites during all past grafting surgeries were divided into two groups by different treatments, i.e. control group and research group. The scalps in control group were covered by gauze clipped by the skulls. Those in research group were covered by shaped polyurethane foam dressing. Afterwards, the wound healing time for the scalps, the intervals between the two adjacent grafting operations, the post-operation pain assessed by visual analogue scale (VAS), and the workload of medical staffs were analyzed and compared between the two groups. Results • The mean time of wound healing for scalp donor sites in research group was (6.77±0.10) d, whereas it was (9.73±0.17) d in control group. For the intervals between the two contiguous operations, they were (9.33±0.16) d in research group and (11.90±0.22) d in control group, respectively. The differences in these two indexes between the two groups were statistically significant (P=0.000). Also, the VAS scores were significantly lower in research group compared with those in control group at all the points after operations (P=0.000). The application of shaped polyurethane foam dressing evidently reduced the treatment time for turning bed and had no need of lamp-aid treatment, so it reduced the workload for medical staffs. Conclusion • The application of shaped polyurethane foam dressing on extensively burned patients' scalp may significantly accelerate its wound healing, shorten the intervals between two grafting operations, which will be beneficial in closing the wounds of these patients earlier eventually. Meanwhile, its application may also alleviate pains of the patients and reduce the burdens of post-operation nursing.

Polyurethane Foam Template for Simple Design of Digital Island Flap

PURPOSE: Various techniques have been attempted for design of the flaps. However, there are some disadvantages. They have thin, pliable, and two dimensional methods. The aim of this study is to report usefulness of polyurethane foam dressing materials for three dimensional design of the digital island flap. METHODS: From June of 2007 to september of 2008, 10 patients received digital island flap surgery for soft tissue defect of the finger. After minimal debridement of the wound, size and shape of the defect were measured using polyurethane foam. We used Medifoam-5(R) And then, designed this inset the wound. The flap was designed on the donor site with a arterial pedicle as the central axis according to size and shape. A full thickness skin graft from the groin is applied on the flap donor defect and secured with a tieover bolster dressing. RESULTS: Reviewing sizes of the flaps, the length and width of flaps ranged from 1.5 to 3.3 cm and 1.0 to 2.5 cm. The PACS(Picture Archiving Communication System) program allows identification of the donor depth of finger. The distance for the soft tissue ranged from 4.3 mm to 6.7 mm. Mean depth of donor site was 5.3+/-0.6 mm. Also, the thickness of Medifoam-5(R) ranged nearly 5 mm. On flap insetting, full-thickness skin graft was necessary. We did not experience any problems in the recipient site size either, regardless of the extended flaps. CONCLUSION: Polyurethane foam has many advantages over the more conventional templates. Refinements in flap design and surgical technique resulted in favorable functional and cosmetic results. Especially, for beginner, Polyurethane foam dressing material is a simple and safe tool and therefore is an excellent choice for design of the island flap..

Comparative Study of Acticoat(R) & Allevyn(R) on Infected Full-thickness Wound of the Rat Skin

PURPOSE: Allevyn(R)(Smith & Nephew, England) is a type of polyurethane foam material with good wound discharge absorption. Acticoat(R)(Smith & Nephew, England) is a silver coated dressing material which is effective in infected wound. The purpose of this study is to compare the effects of dry gauze, Acticoat(R) and Allevyn(R) on infected full-thickness wound healing in rat. METHODS: One hundred and twenty rats were divided into 3 groups: group I(dressing with dry gauze, n=40), group II(dressing with Allevyn(R), n=40), group III(dressing with Acticoat(R), n=40). A 15x15mm square full-thickness wound was made on the dorsum and left open for 24 hours. The size of wound defects were measured each dressing changes. The histological evaluation was performed on the 3rd day, 7th day, 14th day, 21th day. RESULTS: After the wound was left open for 24 hours, typical findings of bacterial infection was observed. After the 7th day, group III showed larger area of epithelialization, smaller defect size compared to those of two other groups. Complete replacement by fibrotic scar tissue was observed in group III with no signs of inflammation on the 14th day. By day 21, the average defect size in group III was decreased from initial 100% to 3.63%. while in group I and II, it was decreased to 62.66% and 53.62%, respectively. CONCLUSION: Acticoat(R) is an effective tool in the treatment of infected wound.

Comparison of Effect of Polyurethane Foam Dressings on Epithelialization of White Rat

Polyurethane foam dressings are becoming widely used in partial and full thickness skin wounds since they are safe and convenient for both patients and physicians. However, the influence of polyurethane foam dressings on epithelialization has not been fully determined yet. This study was designed to compare 2 internationally available polyurethane foams and 3 locally made polyurethane foams as to their effects on the epithelialization in vivo. Twenty white rats were used. A 5 mm punch was employed to excise skin and subcutaneous tissue in a round fashion at six sites in the back area of 10 rats. After creating 6 open wounds, above mentioned 5 polyurethane foams and gauze dressings were applied. On the 5th day the lengths of the nonepithelialized area were measured under light microscope. In addition, partial thickness wounds were created using carbon dioxide laser at six sites on the back of the another 10 rats. Six dressings were applied on the wounds as same as above. On the 4th day the degree of the epithelialization was measured and compared. In full thickness wound study the best wound closing was also seen in chitin mixed Medifoam-N group. In partial thickness wound study the best epithelialization was seen in chitin mixed Medifoam-N and chitosan mixed Medifoam-N groups. These results demonstrated that polyurethane foam dressings influenced the epithelialization, and chitin mixed Medifoam-N showed the best result.