Calcium-based antimicrobial peptide compounds cooling gel for the treatment of atopic dermatitis: a randomized, double-blind controlled clinical study / 中华皮肤科杂志

Objective:To evaluate clinical efficacy and safety of calcium-based antimicrobial peptide compounds cooling gel (CAPCS cooling gel) in the treatment of atopic dermatitis (AD) .Methods:A randomized, double-blind, active-controlled clinical study was conducted. From July 2019 to May 2020, 80 adult patients with mild-to-moderate AD were enrolled from Beijing Friendship Hospital, Capital Medical University, and randomly and equally divided into 2 groups: test group topically treated with CAPCS cooling gel, control group topically treated with hydrocortisone cream, and the treatment was performed thrice a day for 4 consecutive weeks. Before, 1, 2 and 4 weeks after the start of treatment, efficacy was evaluated according to the Eczema Area and Severity Index (EASI), Visual Analog Scale (VAS), and Investigator′s Global Assessment (IGA) scores, and adverse events were recorded. Efficacy and safety were compared by using repeated measures analysis of variance and chi-square test.Results:Of the 80 patients with AD, 43 were males and 37 were females, and the age was 52.71 ± 16.71 years. Before the treatment, there was no significant difference in gender, age, EASI, VAS or IGA scores between the two groups (all P > 0.05). After 1- and 2-week treatment, there was no significant difference in the response rate between the test group (10.00% [4/40], 57.50% [23/40], respectively) and control group (15.00% [6/40], 52.50% [21/40] respectively, both P > 0.05). After 4-week treatment, the response rate was significantly higher in the test group (82.50%, 33/40) than in the control group (57.50%, 23/40, P < 0.05). Compared with the control group, the test group showed significantly decreased VAS scores after 1-, 2- and 4-week treatment ( U = 1253.00, 1121.00, 1091.50, respectively, all P < 0.05). No drug-related adverse events were observed in either of the groups. Conclusion:CAPCS cooling gel is safe and effective in the treatment of mild-to-moderate AD in adults, and can be applied in clinic.

Actividad antioxidante y quelante de sistemas hidrocoloides mixtos formados por hidrolizados proteicos de Phaseolus vulgaris endurecido y goma modificada de flamboyán (Delonix regia) / Antioxidant and metal-chelating activities of mixed hydrocolloid systems formed by hard-to-cook Phaseolus vulgaris protein hydrolysates and flamboyant (Delonix regia) modified gum

Las proteínas y polisacáridos con frecuencia son utilizados simultáneamente en la industria de alimentos. Las interacciones entre ambos biopolímeros juegan un papel importante en la estructura y estabilidad de muchos alimentos procesados ya que pueden resultar en un sistema con propiedades bioactivas diferentes como ocurre en el caso de las funcionales. Objetivo. Evaluar los cambios en la capacidad antioxidante de un sistema hidrocoloide mixto formado por un hidrolizado enzimático proteico de frijol endurecido (P. vulgaris) y goma modificada de flamboyán (Delonix regia) (SHM). Materiales y métodos. El estudio se hizo entre febrero-octubre, 2014, en Mérida, México. Se modificó enzimáticamente el concentrado proteico de P. vulgaris con Pepsina-Pancreatina® y la goma extraída del flamboyán mediante carboximetilación, preparando dispersiones al 1% de cada uno de los biopolímeros, determinado la fluorescencia intrínseca de Trp (FIT) como indicador de la interacción entre ambos biopolímeros y la actividad antioxidante y quelante del sistema resultante. Resultados. Se obtuvo un hidrolizado proteico extensivo con 28,8% de grado de hidrólisis y una goma de flamboyán con grado de sustitución de 0,91. La mayor interacción entre ambos biopolímeros, se obtuvo empleando una relación 5:1 del SHM a pH 4 de acuerdo con el valor de FIT. Conclusiones. Los sistemas hidrocoloides mixtos preparados con hidrolizado extensivo de las proteínas Phaseolus vulgaris y goma modificada de flamboyán presentaron un incremento en la actividad antioxidante, respecto del hidrolizado dependiendo del mecanismo de oxidación, así como de las condiciones de pH en que se encuentra el sistema y la interacción entre ambos componentes(AU)

Proteins and polysaccharides are frequently used simultaneously in the food industry. The interactions between both biopolymers play an important role in the structure and stability of many processed foods since they can result in a system with different bioactive properties as in the case of functional ones. Objective. Evaluate the changes in the antioxidant capacity of mixed hydrocolloid system formed by a hard to cook bean (P. vulgaris) protein enzymatic hydrolyzate and modified flamboyant gum (Delonix regia) (SHM). Materials and methods. The study was conducted from February to October 2014 in Merida, Mexico. For this, the protein concentrate of P. vulgaris was treated with Pepsin-Pancreatin® and the gum extracted from the flamboyant were modified enzymatically by carboxymethylation, preparing 1% dispersions of each of the biopolymers, determining the intrinsic Trp fluorescence (FIT) as an indicator of the interaction between both biopolymers and the antioxidant and chelating activity of the resulting system. Results. The main results indicated that an extensive protein hydrolyzate with 28.8% degree of hydrolysis and a flamboyant gum with a substitution degree of 0.91 were obtained. The greatest interaction between both biopolymers was obtained using a 5:1 ratio of SHM to pH 4 according to the FIT value. Conclusions. The mixed hydrocolloid systems prepared with extensive hydrolyzate of the hard to cook P. vulgaris and modified flamboyant gum proteins showed an increase in antioxidant activity, compared to the hydrolyzate depending on the oxidation mechanism, as well as the pH conditions used and interaction between both component(AU)

Efficacy of a cooling gel containing calcium-based antimicrobial peptide compounds combined with desonide cream in the treatment of atopic dermatitis in children: a randomized, double-blind controlled clinical study / 中华皮肤科杂志

Objective:To evaluate short-term clinical efficacy and safety of a cooling gel containing calcium-based antimicrobial peptide compounds (CAPCS cooling gel) combined with desonide cream in the treatment of atopic dermatitis (AD) in children.Methods:From November 2019 to September 2020, a randomized, double-blind controlled clinical trial was conducted in 60 children with AD enrolled from Department of Dermatology and Venereology, West China Hospital, Sichuan University. The 60 patients were randomly and equally divided into 2 groups: test group treated with topical desonide cream in the morning and evening as well as topical CAPCS cooling gel at noon during the first 3 days of treatment, followed by topical CAPCS cooling gel in the morning, at midday and in the evening for 11 days; control group treated with topical desonide cream in the morning and evening as well as topical CAPCS-free placebo gel at noon during the first 3 days of treatment, followed by topical CAPCS-free placebo gel in the morning, at midday and in the evening for 11 days. The treatment lasted 2 weeks. Finally, 56 AD patients completed the follow-up, and 28 in each group were included into the following analysis. Clinical indices, such as eczema area and severity index (EASI) , visual analogue scale (VAS) , investigator′s global assessment (IGA) and dermatology life quality index (DLQI) , were recorded before, 7 ± 3 days and 14 ± 3 days after the treatment, so were adverse reactions.Results:After 1-week treatment, 1 patient in the test group and 1 in the control group showed response to the treatment, with the response rate being 3.57% in both groups; after 2-week treatment, 12 patients in the test group and 2 in the control group showed response to the treatment, with response rates being 42.86% and 7.14% respectively; there were significant differences in the treatment outcomes between the two groups after 1- and 2-week treatment ( Z = -4.318, -5.474, respectively, both P < 0.05) . There was no significant difference in the EASI, VAS, IGA or DLQI score between the two groups before treatment (all P > 0.05) ; nonparametric Friedman test showed a significant difference in the changing trend of the EASI score over time between the two groups ( χ2 = 45.720, P < 0.05) . Two-way repeated measurement analysis of variance showed a significant difference in the VAS score ( F = 10.738, P = 0.002) , but no significant difference in IGA or DLQI score between the test group and control group after 1-week treatment ( F = 0.066, 0.804, P = 0.135, 0.374, respectively) ; after 2-week treatment, there were significant differences in the VAS, IGA and DLQI score between the 2 groups ( F = 67.313, 38.949, 51.503, respectively, all P < 0.001) . During the clinical study period, 1 adverse event occurred in the test group and control group each, which manifested as tingling or irritating sensation at the topically treated sites, and there was no significant difference in the incidence rate of adverse events between the two groups ( P > 0.05) . Conclusion:Short-term topical application of CAPCS cooling gel combined with desonide cream is effective for the treatment of AD in children, and does not increase the incidence of adverse reactions compared with the placebo.

In search of ideal donor site wound dressings

Background: Split skin grafting (SSG) is a commonly used reconstructive technique for wound cover. Donor site wounds (DSW) after split-skin graft harvesting are rather clean wounds. Depending on the thickness of the SSG, the DSW should re-epithelialize completely in 7 to 21 days. This study was initiated with a background to look for an ideal dressing for the management of DSW. Aim of the study was to compare efficacy of Cellulose acetate mesh, Collagen sheet, Hydrocolloid dressings and chlorhexidine tulle for donor site wound management after harvesting split thickness skin graft.Methods: 100 patients with 100 donor site wounds were included in the study. Patients were randomized into four different groups of 25 each, depending upon the type of dressings used to cover the wound. Data regarding time to complete wound healing and pain at the donor site were recorded on visual analogue scale (VAS). Requirement of pain killers during post-operative period were recorded. Complications like infection or hyper-granulation were also recorded.Results: The study included 72 males and 28 females. The primary objective was to observe the effectiveness of wound dressings in the treatment of DSWs and time to complete wound healing. In this context, collagen dressing was found to be the most effective in current study (p<0.07) and also the least pain was experienced by the patients where collagen dressings were used.Conclusions: The study concluded that collagen dressings was best amongst the various dressings studied with average healing time of 9 days with least pain score over DSW.

Análisis del potencial de innovación en apósitos para tratar heridas crónicas en la ciudad de Lima, Perú / Analysis Of The Potential Of Innovation In Dressings To Treat Chronic Wounds In The City Of Lima, Peru

Objetivo: Analizar el potencial de innovación en apósitos para tratar heridas crónicas en la Ciudad de Lima. Métodos: Se realizó un estudio cualitativo mediante una encuesta y análisis de las entrevistas realizadas a expertos médicos y gestores de compras en insumos para el tratamiento de heridas de difícil resolución en 8 instituciones representativas de salud pública con categorías 1 ­ 4 dentro de las 54 existentes solo en Lima Metropolitana, Perú - 2018. Resultados: Se determinó que en las instituciones de salud pública son atendidos un promedio 17 pacientes mensualmente (60% provenientes de hospitalización y 40% de consultorio externo). Equivale decir que 11,016 pacientes presentan heridas crónicas de difícil resolución al año, los cuales requerirán de tratamiento especializado y una demanda anual promedio de 110,160 apósitos en stock. Los apósitos con mayor demanda corresponden a los Hidrogeles e Hidrocoloides, respectivamente que son utilizados por los resultados positivos que ofrecen en la curación de las heridas, aunque en ocasiones la limitante es el aspecto económico. En el mercado, el precio unitario oscila entre los 20 y 90 soles, esto representa una inversión económica de 1500 soles en promedio por paciente, produciendo en algunos casos complicaciones o abandono del tratamiento cuando los recursos son escasos. Conclusiones: La demanda de pacientes con heridas crónicas de difícil resolución en las instituciones de salud públicas de Lima metropolitana es alta. Es importante promover e incentivar la investigación de nuevas alternativas terapéuticas y/o dispositivos biomédicos que favorezcan su curación.

Objective: To analyze the potential for innovation in dressings to treat chronic wounds in the City of Lima. Methods: A qualitative study was carried out by means of interviews to medical experts and purchasing managers of medical supplies for the treatment of difficult-to-resolve wounds in 8 representative public health institutions with categories 1-4 within the only 54 of Lima, Peru - 2018. Results: It was determined that an average of 17 patients is treated in public health institutions on a monthly basis (60% from hospitalization and 40% from an outpatient office). It is equivalent to say that 11,016 patients present chronic wounds of difficult resolution each year, which will require specialized treatment and an average annual demand of 110,160 dressings in stock. The dressings with the highest demand correspond to the Hydrogels and Hydrocolloids, respectively; used because of the positive results they offer in wound healing, despite economic limitations. The market price per unit ranges between 20 and 90 soles (S/.), representing an economic investment of 1500 soles on average per patient, in some cases causing complications or abandonment of treatment when resources are scarce. Conclusions: There is a high demand for patients with chronic wounds of difficult resolution in the public health institutions of Lima. It is important to promote and incentivize the investigation of new therapeutic alternatives and / or biomedical devices that favor its treatment.

Network Meta-analysis of five common dressings in the treatment of pressure ulcer / 中国组织工程研究

BACKGROUND: There are many kinds of dressings for external use in treating pressure ulcer. Selecting a kind of dressing which is convenient, safe and effective can effectively increase the healing rate of pressure ulcer. OBJECTIVE: To evaluate the effects of five common dressings on the treatment of pressure ulcer. METHODS: A systematic search of Embase, PubMed, VIP, Elsevier, WanFang and CNKI were carried out with an end-point of July 2018. Randomized controlled trials about the therapeutic effects of different dressings on pressure ulcer were collected. All data were screened, extracted and assessed by two researchers independently. The ADDIS 1.16.8 software was adopted for data analysis. RESULTS AND CONCLUSION: A total of 24 randomized control trials (1201 patients) which involved 5 kinds of dressings were included. The results of network Meta-analysis showed that the effect of hydrocolloid dressing and foam dressing were superior to aseptic gauze and vaseline gauze in treating pressure ulcer (P 0.05). Based on the probability ranking table, the therapeutic effects of five kinds of dressl ngs in pressure ulcer were ranked as follows: hydrocolloid dressing > foam dressing > hydrogel dressing > sterile gauze > vaseline gauze. Hydrocolloid dressing and foam dressing were superior to the other dressings in the treatment of pressure ulcer.

Curativo gel de clorexidina no transplante de células-tronco hematopoéticas / Vendaje gel de clorhexidina en el trasplante de células madre hematopoyéticas / Chlorhexidine gel dressing in hematopoietic stem cell transplantation

Resumo Objetivo Acompanhar o uso do curativo gel de clorexidina em cateter venoso central de crianças e adultos submetidos ao transplante de células-tronco hematopoéticas para verificar a ocorrência de infecção da corrente sanguínea relacionada ao cateter e irritação cutânea na vigência deste curativo. Métodos Estudo observacional e prospectivo, com 25 pacientes com cateter venoso central inserido para realização do transplante de células-tronco hematopoéticas. Diariamente avaliou-se as características do curativo, da pele, clínicas do paciente e relacionadas a infecção. Os pacientes foram acompanhados a partir do primeiro dia da inserção do CVC até a sua remoção, até o limite de 45 dias a partir da data de inserção do CVC. Resultados A infecção da corrente sanguínea relacionada ao cateter ocorreu em 28% dos pacientes, houve associação entre neutropenia febril e infecção (p<0,01). A irritação cutânea foi identificada em 24% dos pacientes. Não foi identificada associação entre infecção da corrente sanguínea relacionada ao cateter e a irritação cutânea (p=0,51). Houve associação significativa entre irritação cutânea e suspensão do uso do curativo (p=0,03). As trocas não programadas ocorreram em 50% das trocas identificadas e o principal motivo foi a presença de sangue no curativo (57,8%). Conclusão O uso do curativo gel de clorexidina em pacientes submetidos ao TCTH demonstrou ser uma medida eficaz na redução da ocorrência de infecções relacionadas ao cateter, quando comparado aos dados da literatura. Os casos de ICSRC encontrados foram associados, principalmente, à condição de neutropenia, muito comum nesta população. Os casos de irritação cutânea relacionados ao curativo identificados e a presença de sangue como principal motivo de troca não programada salientam a importância do conhecimento relacionado ao uso do curativo por parte dos enfermeiros assistenciais, a fim de criar protocolos que indiquem o uso e manejo do curativo com segurança.

Resumen Objetivo Hacer un seguimiento del uso del vendaje gel de clorhexidina en catéter venoso central (CVC) en niños y adultos sometidos al trasplante de células madre hematopoyéticas (TCMH) para verificar los casos de infección del flujo sanguíneo relacionados con el catéter (IFSRC) y la irritación cutánea durante la validez de este vendaje. Métodos Estudio observacional y prospectivo, con 25 pacientes con catéter venoso central insertado para realizar el trasplante de células madre hematopoyéticas. Diariamente se evaluaron las características del vendaje y de la piel, las características clínicas del paciente y las relacionadas con la infección. Los pacientes recibieron un seguimiento a partir del primer día de la inserción del CVC hasta su retirada, con un límite de 45 días a partir de la fecha de inserción del CVC. Resultados La infección del flujo sanguíneo relacionada con el catéter se presentó en el 28% de los pacientes, hubo relación entre neutropenia febril e infección (p<0,01). Se identificó irritación cutánea en el 24% de los pacientes. No se identificó relación entre la infección del flujo sanguíneo relacionada con el catéter y la irritación cutánea (p=0,51). Hubo relación significativa entre la irritación cutánea y la suspensión del uso del vendaje (p=0,03). Los cambios no programados sucedieron en el 50% de los cambios registrados, y el motivo principal fue la presencia de sangre en el vendaje (57,8%). Conclusión El uso del vendaje gel de clorhexidina en pacientes sometidos al TCMH demostró ser una medida eficaz para la reducción de casos de infecciones relacionadas con el catéter, en comparación con los datos de la literatura. Los casos de IFSRC encontrados se relacionaron principalmente con la condición de neutropenia, muy común en esta población. Los casos identificados de irritación cutánea relacionados con el vendaje y la presencia de sangre como principal motivo de cambio no programado resaltan la importancia del conocimiento del uso del vendaje por parte de los enfermeros asistenciales, a fin de crear protocolos que indiquen el uso y manejo seguro del vendaje.

Abstract Objective Monitor the use of chlorhexidine gel dressing in the central venous catheter of children and adults submitted to hematopoietic stem cell transplantation (HSCT) to check for catheter-related bloodstream infection and skin irritation while using this dressing. Methods This is a prospective observational study with 25 patients with central venous catheters (CVC) inserted for hematopoietic stem cell transplantation. Dressing characteristics, skin characteristics, clinical conditions of patients and infection-related characteristics were evaluated daily. Patients were monitored from the first day of CVC insertion until removal, up to 45 days from the CVC insertion date. Results Catheter-related bloodstream infection (CRBSI) occurred in 28% of all patients, with an association between febrile neutropenia and infection (p<0.01). Skin irritation was identified in 24% of patients. No association was found between catheter-related bloodstream infection and skin irritation (p=0.51). A significant association was observed between skin irritation and dressing removal (p=0.03). Unscheduled dressing changes corresponded to 50% of all dressing changes identified during the study, and the main reason was presence of blood in the dressing (57.8%). Conclusion Using chlorhexidine gel dressing in patients submitted to HSCT proved to be an effective measure to reduce the occurrence of catheter-related infections, when compared to literature data. The cases of CRBSI found in this study were mainly associated with the condition of neutropenia, which is very common in this population. The cases of dressing-related skin irritation and presence of blood as the main reason for unscheduled change highlight the importance of nurses having proper knowledge about how to use this dressing in order to create protocols for safe dressing use and handling.

Application of two different nursing schemes in cancer patients with moderate and severe incontinence dermatitis / 中国实用护理杂志

Objective@#To investigate the effects of two intervention methods, hydroglue dressing and skin powder combined with skin protective film, in severe tumor patients with moderate and severe incontinence dermatitis.@*Methods@#A total of 68 patients with moderate and severe incontinence dermatitis were selected from ICU in Shanghai Oncology Hospital, and randomly divided into 2 groups by random digit table, each group included 34 cases, on the basis of the consistency of skin care, the experimental group used water adhesive dressing protection, every 1-3 days replacement, the control group used skin care powder joint skin protective film, three times a day, two groups of intervention for 10 days in a row. The healing effect, healing time, nursing time and nursing cost of IAD were observed.@*Results@#Of the 68 patients, 2 were transferred to the local hospital for treatment and 1 died. Finally, 65 patients were completed, 32 in the control group and 33 in the experimental group. In the average nursing time, the difference was statistically significant in the experimental group (1.83 ± 0.78) min and the control group (4.45 ± 0.52) min (t= 15.908, P<0.01). The experimental group took less time to care for IAD than the control group, which were (45.78 ± 25.45)min and (110.97 ± 27.22) min. The difference was statistically significant (t= 9.967, P <0.01). The cost of care in the experimental group was lower than that in the control group, which was (164.06 ± 60.32)yuan and (280 ± 0.00)yuan. The difference was statistically significant (t= 11.041, P <0.01).@*Conclusions@#The water glue dressing can be used for the nursing of moderate and severe incontinence dermatitis, and it can effectively reduce the nursing time of nursing staff and reduce the economic cost.

Effects of five different dressings in the treatment of donor site:a network meta-analysis / 中国组织工程研究

BACKGROUND: At present, there is no consensus on the effect of different dressings in the healing of donor site, and few studies have directly compared the healing effect of different dressings. OBJECTIVE: To evaluate the healing effect of five different dressings on donor site wounds by network meta-analysis. METHODS: Randomized controlled trials about different dressings in the treatment of donor site wounds were retrieved by computer in PubMed, EMBASE, Cochrane, Chinese Academic Journal Full Text Database, Chinese Biomedical Literature CD-ROM Database, WanFang Data Platform and Chinese Science and Technology Journal Database. The retrieval time limit was from inception until May 2018. Literature screening, quality evaluation and data extraction were conducted independently by two postgraduates. Winbugs 1.4.3 and Stata 13.0 softwares were used for data analysis. RESULTS AND CONCLUSION: A total of 13 randomized controlled trials were included. In the observation group, foam dressing, hydrocolloid dressing, alginate dressing or silver dressing was used. In the control group, vaseline gauze was used. The results of network meta-analysis showed that the healing time of donor sites for alginate dressing, silver dressing, hydrocolloid dressing and foam dressing was significantly shorter than that of vaseline gauze (P < 0.05) , but there was no difference in wound healing time between foam dressing, hydrocolloid dressing, alginate dressing and silver dressing at the donor site (P> 0.05) . The healing effects of different dressings were ranked as follows (from good to bad) : alginate dressing, silver dressing, hydrocolloid dressing, foam dressing and vaseline gauze. Overall findings indicate that alginate dressing may be the best choice to shorten the healing time of donor site, and further investigations are warranted.

Application of two different nursing schemes in cancer patients with moderate and severe incontinence dermatitis / 中国实用护理杂志

Objective To investigate the effects of two intervention methods, hydroglue dressing and skin powder combined with skin protective film, in severe tumor patients with moderate and severe incontinence dermatitis. Methods A total of 68 patients with moderate and severe incontinence dermatitis were selected from ICU in Shanghai Oncology Hospital, and randomly divided into 2 groups by random digit table, each group included 34 cases, on the basis of the consistency of skin care, the experimental group used water adhesive dressing protection, every 1-3 days replacement, the control group used skin care powder joint skin protective film, three times a day, two groups of intervention for 10 days in a row. The healing effect, healing time, nursing time and nursing cost of IAD were observed. Results Of the 68 patients, 2 were transferred to the local hospital for treatment and 1 died. Finally, 65 patients were completed, 32 in the control group and 33 in the experimental group. In the average nursing time, the difference was statistically significant in the experimental group (1.83 ± 0.78) min and the control group (4.45 ± 0.52) min (t = 15.908, P<0.01). The experimental group took less time to care for IAD than the control group, which were (45.78 ± 25.45)min and (110.97 ± 27.22) min. The difference was statistically significant (t=9.967, P<0.01). The cost of care in the experimental group was lower than that in the control group, which was (164.06 ± 60.32)yuan and (280 ± 0.00)yuan. The difference was statistically significant (t=11.041, P<0.01). Conclusions The water glue dressing can be used for the nursing of moderate and severe incontinence dermatitis, and it can effectively reduce the nursing time of nursing staff and reduce the economic cost.

Uso de apósitos hidrocoloides en la prevención de úlceras por presión en pacientes de alto riesgo: una cohorte retrospectiva / Uso de curativos hidrocoloides na prevenção de úlceras por pressão em pacientes de alto risco: uma coorte retrospectiva / Use of Hydrocolloid Dressings in Preventing Pressure Ulcers in High-risk Patients: a Retrospective Cohort

Objective. This work sought to evaluate the association between using preventive hydrocolloid dressings and the onset of pressure ulcers in hospitalized patients. Methods. Retrospective cohort study that included adult patients with high risk of pressure ulcers (PU) evaluated according to the Braden scale and who had been admitted with preventive purposes to a skin care program. The preventive care prescribed by the nursing staff included using hydrocolloid dressing plus conventional care (HD+CC) or only conventional care (CC), in a tier IV hospital in Bogotá, Colombia. Information was obtained from the clinical records of the demographic variables, health, and complications during hospitalization. Results. One-hundred seventy subjects were included in the study (23 in HD+CC and 147 in CC). In all, 30.4% of the patients in the HD+CC group and 17% in the CC group had PU during follow up (p=0.15). The ratio between the type of preventive treatment received and the development of PU obtained a raw Hazzard ratio (HR) of 1.35 (CI95%: 0.58-3.14; p=0.48) and HR adjusted for confounding variables of 1.06 (CI95%: 0.29-3.84 p=0.92). Conclusion. Our results showed no superiority of HD+CC against CC in preventing PU in adult patients with high risk according to the Braden scale. The cohort study did not reveal significant differences between both interventions. It is necessary to promote and develop clinical trials to evaluate the effectiveness of using dressings and other conventional care in high-risk patients for this type of event. (AU)

Objetivo. Evaluar la asociación entre el uso de apósitos hidrocoloides preventivos y la aparición de úlceras por presión en pacientes hospitalizados. Métodos. Estudio de cohorte retrospectivo que incluyó pacientes adultos con alto riesgo de úlceras por presión (UPP) evaluados según escala Braden y que habían sido admitidos con fines preventivos en un programa de cuidado de la piel, en un hospital de cuarto nivel de atención, en Bogotá, Colombia. Los cuidados preventivos prescritos por el personal de enfermería incluyeron el uso de apósito hidrocoloide más cuidado convencional (AH+CC) o solo cuidado convencional (CC). Se obtuvo información de las historias clínicas de las variables demográficas, de salud y complicaciones durante hospitalización. Resultados. Se incluyeron en el estudio un total de 170 pacientes (23 de AH+CC y 147de CC). El 30.4% en el grupo AH+CC y el 17% de CC presentó UPP durante el seguimiento (p=0.15). La relación entre el tipo de tratamiento preventivo recibido y el desarrollo de UPP obtuvo un HR crudo de 1.35 (IC95%: 0.58-3.14; p=0.48) y un HR ajustado por factores de confusión de 1.06 (IC95%: 0.29-3.84 p=0.92). Conclusión. Nuestros resultados mostraron no superioridad de AH+CC frente al CC enfermero en la prevención de UPP en pacientes adultos con alto riesgo según Braden. El estudio de la cohorte no reveló diferencias significativas entre las dos intervenciones. Se hace necesario la promoción y desarrollo de ensayos clínicos que evalúen la efectividad del uso de los apósitos y otros cuidados convencionales en pacientes de alto riesgo para este tipo de evento (AU)

Objetivo. Avaliar a associação entre o uso de curativos hidrocoloides preventivos e a aparição de úlceras por pressão em pacientes hospitalizados. Métodos. Estudo de coorte retrospectivo que incluiu pacientes adultos com alto risco de úlceras por pressão (UPP) avaliados segundo escala Braden e que haviam sido admitidos com fins preventivos num programa de cuidado da pele, num hospital de quarto nível de atenção, em Bogotá, Colômbia. Os cuidados preventivos prescritos pelo pessoal de enfermagem incluíram o uso de curativo hidrocoloide mais cuidado convencional (AH+CC) ou só cuidado convencional (CC). Se obteve informação das histórias clínicas das variáveis demográficas, de saúde e complicações durante hospitalização. Resultados. Um total de 170 pacientes foram incluídos no estudo (23 de AH+CC e 147de CC). 30.4% no grupo AH+CC e 17% de CC apresentaram UPP durante o seguimento (p=0.15). A relação entre o tipo de tratamento preventivo recebido e o desenvolvimento de UPP obteve um HR cru de 1.35 (IC95%: 0.58-3.14; p=0.48) e um HR ajustado por fatores de confusão de 1.06 (IC95%: 0.29-3.84 p=0.92). Conclusão. Nossos resultados mostraram não superioridade de AH+CC frente a CC enfermeiro na prevenção de UPP em pacientes adultos com alto risco segundo Braden. O estudo da coorte não revelou diferencias significativas entre as duas intervenções. Se faz necessário a promoção e desenvolvimento de ensaios clínicos que avaliem a efetividade do uso dos curativos e outros cuidados convencionais em pacientes de alto risco para este tipo de evento.(AU)

A utilização de coberturas oclusivas: a influência sobre a cicatrização de feridas excisionais em camundongos / The use of occlusive coverages: the influence on the healing of excisional wounds in mice

INTRODUÇÃO: O cuidado do paciente com feridas é um constante desafio na prática clínica do enfermeiro. As coberturas oclusivas e não oclusivas são utilizadas no tratamento de feridas e existe uma lacuna de conhecimento sobre a influência dessas indicações no processo de cicatrização. OBJETIVO: O objetivo do presente estudo foi avaliar a influência de coberturas oclusivas sobre a cicatrização de feridas cutâneas excisionais em camundongos C57BL/6. MATERIAIS E MÉTODOS: Trata-se de um estudo translacional pré-clínico, comparativo e controlado. Os camundongos foram divididos em três grupos experimentais e o tratamento das feridas excisionais deles foram classificados como: animais que receberam oclusão com hidrocolóide (HD), animais que receberam oclusão com filme transparente de poliuretano (FT) e animais sem oclusão (SO). Os grupos foram avaliados quanto: a taxa de fechamento das feridas, o infiltrado de neutrófilos e macrófagos, dosagem da citocina TNF-α, o fator de crescimento angiogênico VEGF, a expressão protéica de HIF-1α e, histologicamente, o desenvolvimento de novos vasos sanguíneos. As cicatrizes das feridas foram analisadas por juízes independentes quanto à apresentação estética no décimo quarto dia de segmento. RESULTADO: No terceiro dia do processo de cicatrização, foi possível observar, macroscopicamente, que o fechamento das feridas cutâneas excisionais foi acelerado nos animais cuja ferida foi ocluída, utilizando-se tanto filme transparente quanto o hidrocolóide. Ainda no período de três dias, observou-se diminuição nos níveis da citocina pró-inflamatória TNF-α nas feridas ocluídas com hidrocolóide quando comparada com os grupos SO e FT. O acúmulo de neutrófilos também diminuiu, significativamente, ao terceiro dia de cicatrização no grupo tratado com hidrocolóide, quando comparado aos grupos SO e FT, respectivamente. O conteúdo dos macrófagos apresentou níveis significativamente mais altos ao terceiro dia no grupo FT quando comparado a SO. Ao sexto dia de estudo, evidenciaram-se dosagens significativamente aumentadas de macrófagos no grupo HD, contrastando com os grupos SO e FT. Os níveis de VEGF apresentaramse expressivamente aumentados ao sexto dia de cicatrização, nos animais cujas feridas estavam ocluídas com filme transparente de poliuretano e hidrocolóide. Houve aumento dos níveis do fator indutor de hipóxia 1-alfa nos animais submetidos a oclusão quando comparados aos sem oclusão. A análise qualitativa do reparo em cicatriz das feridas permitiu afirmar que houve concordância moderada e significativa entre os juízes no grupo HD e concordância substancial e significativa nas cicatrizes dos animais SO. CONSIDERAÇÕES FINAIS: Considerando-se que a resposta inflamatória é um processo imunológico fundamental para o processo de reparo de feridas, quando ocorre de forma controlada, sugere-se que a oclusão modula a resposta inflamatória. Tal achado é evidenciado por meio da inibição parcial da citocina pró-inflamatória TNF- α, da redução de acúmulo de neutrófilos e dos níveis mais altos de macrófagos. A oclusão das feridas não evidenciou aumento quantitativo de capilares em relação ao grupo sem oclusão.(AU)

INTRODUCTION: The care of the wounded patient is a constant challenge in the nurse's clinical practice. Occlusive and non-occlusive coverages are used to treat wounds and there is a lack of knowledge about the impact of these indications on the healing process. OBJECTIVE: The objective of the present study was to evaluate the influence of occlusive coatings on the cicatrization of cutaneous excisional wounds in C57BL / 6 mice. MATERIALS AND METHODS: It is a pre-clinical, comparative and controlled translational study. The mice were divided into three experimental groups and the treatment of excisional wounds of these were classified as: animals that received occlusion with hydrocolloid (HD), animals that received occlusion with transparent polyurethane film (FT) and animals without occlusion (SO). The groups were evaluated for: wound closure rate, neutrophil and macrophage infiltration, TNF-α cytokine dosing, VEGF angiogenic growth factor, HIF-1α protein expression and, histologically, the development of new blood vessels. Wound scars were analyzed by independent judges regarding the aesthetic presentation on the fourteenth day of the segment. RESULTS: On the third day of the healing process it was possible to observe, macroscopically, that the closure of excisional skin wounds was accelerated in animals whose wound was occluded using both transparent and hydrocolloid films. Also, in the three-day period, there was a decrease in TNF-α proinflammatory cytokine levels in the hydrocolloid occluded wounds when compared to the SO and FT groups. Neutrophil accumulation also significantly decreased on the third day of healing in the group treated with hydrocolloid occlusion when compared to the SO and FT groups, respectively. Macrophage content had significantly higher levels, on day 3, in the FT group, when compared to OS. On the sixth day of the study, significantly increased dosages of macrophages were detected in the HD group, contrasting with the SO and FT groups. VEGF levels were expressively increased on the sixth day of healing in animals whose wound was occluded with transparent polyurethane film and hydrocolloid film. There was an increase in levels of the factor inducing 1-alpha hypoxia in the animals submitted to occlusion when compared to those without occlusion. The qualitative analysis of the wound healing repair allowed to affirm that there was moderate and significant agreement, between the judges, in the HD group and substantial and significant concordance in the scars of the SO animals. FINAL CONSIDERATIONS: Considering that the inflammatory response is a fundamental immunological process for the wound repair process, when it occurs in a controlled way, it is suggested that the occlusion modulates the inflammatory response. Such a finding is evidenced by partial inhibition of the proinflammatory cytokine TNF-α, reduction of neutrophil accumulation, and higher levels of macrophages. The wounds occlusion did not show a quantitative increase of capillary vessels in relation to the group without occlusion.(AU)

Study on the Usage of Acne Patches in Patients with Acne / 대한피부과학회지

BACKGROUND: Patients with acne are at risk of using various over-the-counter drugs (OTCs). In addition, several OTCs are introduced in pharmacies in Korea. However, only few drugs are supported by well-established data. Among the treatments, acne patches are easy to purchase and use. Thus, they are widely used by patients. OBJECTIVE: This study aimed to investigate the patient's perception and usage of acne patches. METHODS: A questionnaire survey was conducted on 80 patients with acne who visited the outpatient department of the National Medical Center for 2 months. RESULTS: A total of 42 (52.5%) patients answered that they had used acne patches, and 38 (47.5%) patients stated that they had never used patches. Moreover, 27 (64.29%) patients responded that they used the patches on inflammatory lesions. Moreover, several patients were using acne patches after pricking themselves. There was only one response to confirm the ingredient when purchasing acne patch. Moreover, 14 (33.33%) participants responded that they noted side effects after using acne patches. Overall, the satisfaction score for the use of acne patches was 5.05. CONCLUSION: Patients often use acne patches because they can be easily purchased and used. However, they do not know how to properly choose and use the product that fits their skin. Therefore, doctors must educate patients on how to properly select and use the products.

The effects of hydrocolloid dressing on neonatal scleredema / 中华护理杂志

Objective To explore the effects of hydrocolloid dressing on neonatal scleredema.Methods Forty patients with neonatal scleredema were enrolled from Department of Neonatology,Affiliated Hospital of Qingdao University from February 2015 to February 2017.The patients were assigned to the experimental group and the control group by random number table with 20 cases in each group.The experimental group was treated with hydrocolloid dressing besides routine comprehensive treatment,and the hydrocolloid dressing was changed every 3～4 d until swelling disappeared.The control group was treated with routine comprehensive treatment.Body temperature,response and swelling of two groups were observed.Results For therapeutic effects between two groups,the total effective rate of the experiment group was 95％,and was significantly better than that of the control group which was 65％(P＜0.05).The recovery time of body temperature and the time of swelling disappear in the experiment group were 38.25±17.33 h and 3.05±1.00 d;while those in the control group were 57.35±32.21 h and 4.65±1.57 d,and the differences were statistically significant(P＜0.05).Conclusion Applying hydrocolloid dressing at swelling site in premature infants can significantly shorten the time of skin swelling,promote body temperature recovery,and improve treatment effects.

Evident-Based Nursing Practice for a Ovarian cancer chemotherapy Patient with puncture piont infection of Peripherally Inserted Central catheter / 中国实用护理杂志

Objective To formulate a rational adjuvant therapeutic evidence-based nursing plan for a ovarian cancer chemotherapy patient with puncture piont infection of peripherally inserted central catheter(PICC).And practice in the clinic to solve the nursing problems in clinical nursing work. Methods According to the condition of the patient and using the PICO principle, we put forward clinical problems. We comprehensively searched the National Guideline Clearinghouse (NGC),Cochrane Library,Pub Med, EMbase,Medline,CNKI,VIP and Wanfang Data from 2007 to 2017. Relevant clinical guidelines, evidence summaries, systematic reviews/ Meta-analysis, randomized controlled trials (RCTs), and high quality reviews on nursing puncture piont infection of Peripherally Inserted Central catheter were collected and their authenticity, importance and applicability were evaluated. Results One Meta-analysis, fifteen RCTs, and one review were totally included. According to current evidence as well as the patient′s clinical conditions and preference, a comprehensive and effective adjuvant therapeutic and nursing programme was given to the patient. At the puncture point of PICC infection , PVP iodine was used to hydropathic compress for 15 minutes once a day.After naturally dried, cover with hydrocolloid dressing. After four-day treatment and nursing care, the patient with puncture piont infection had already recovered. Conclusion Evidence-based medicine approaches could help us develop comprehensive therapeutic plans for ovarian cancer chemotherapy patients with puncture piont infection of PICC, promote effectively the puncture point infection recovery,and ensure the normal safe use of PICC .Thereby alleviate pain, improve health, and increase patients′quality of life.

Cura húmeda de úlceras por presión. Atención en el ámbito domiciliar / Pressure ulcers humid healing: Attention within the home environment / Cura húmida de ulceras por pressão. Atenção no âmbito domiciliar

La necesidad de trabajar en el domicilio el tratamiento y prevención de las úlceras por presión (UPP) mediante sesiones basadas en cura húmeda es trascendente para la eversión y cicatrización en menor tiempo. Objetivo: Evaluar la eficacia del tratamiento de la cura húmeda en pacientes con UPP en un ambiente domiciliario. Método: Se realizó una intervención clínica con la técnica de cura húmeda en 11 UPP de 4 pacientes egresados del hospital con su problema de salud resuelto, pero no así las UPP observadas en puntos de presión, con lesiones grado II (n = 6) y grado III (n = 5). Se realizaron 12 curaciones, cada 72 h, en los domicilios de las personas. Se midió la severidad y su reversión con el instrumento Pressure Ulcers Scale for Healing (PUSH). Este instrumento tiene un alfa de Cronbach de 0.823. Resultados: Se curaron 9 UPP de 11; todas las de grado II (n = 6), mientras que de las de grado III se curaron 3 (n = 5). La cicatrización se dio en un lapso de 4 semanas, inferior a la cura tradicional que demora 2 veces más el tiempo de cicatrización. Conclusión: En el ámbito domiciliario, la cura húmeda fue eficaz para revertir las UPP de pacientes que las habían desarrollado durante su hospitalización y que egresaron sin tratamiento para ellas. La intervención se convierte en una opción para mejorar la calidad de vida de las personas y un medio que las instituciones de salud pueden poner en práctica.

The need to carry out prevention and treatment of pressure ulcers (PU) within the home environment by means of humid healing sessions is very important for the prompt eversion and cicatrization of the wounds. Objective: To assess the efficacy of the humid healing in patients with PU within the home environment. Method: A clinical intervention was performed using the humid healing technique on 11 PU in 4 discharged patients showing degree II lesions (n = 6), and degree III lesions (n = 5). Twelve healings every 72 h were carried out at the homes of these patients. The ulcers severity and progress were estimated using the Pressure Ulcers Scale for Healing (PUSH) instrument, which has a Cronbach alfa of 0.823. Results: Nine PU out of the total 11 healed-all degree II (n = 6) and 3 degree III (n = 5). The cicatrization process only took 4 weeks, a time which is much shorter than the usual 8 weeks which take the traditional healing. Conclusion: Within the home environment, humid healing was an effective method to address PU in patients previously discharged from hospitals. This kind of interventions represents an option which health institutions can promote in order to improve the quality of life of these patients.

A necessidade de trabalhar na residência o tratamento e prevenção das Ulceras por pressão (UPP) mediante sessões baseadas em cura húmida, é transcendente para a eversão e cicatrização em menor tempo. Objetivo: Avaliar a eficácia do tratamento da cura húmida em pacientes com UPP em um ambiente domiciliar. Método: Realizou-se uma intervenção clínica com a técnica de cura húmida em 11 UPP de quatro pacientes formados do hospital com seu problema de saúde resolvido, mas não assim as UPP observadas em pontos de pressão, com lesões grau II (n = 6) e III (n = 5). Realizaram-se 12 curas, cada 72 h nas residências das pessoas. Mediu-se a severidade e sua reversão com o instrumento Pressure Ulcers Scale for Healing (PUSH). Este instrumento tem um alfa de Cronbach de 0.80. Resultados: Foram curadas 9 UPP de 11, todas as de grau II (n = 6), enquanto que as de grau III, 3 (n = 5). A cicatrização deu-se em um lapso de 4 semanas, inferior à cura tradicional que demora duas vezes mais o tempo de cicatrização. Conclusão: No âmbito domiciliar, a cura húmida foi eficaz para reverter as UPP de pacientes que as tinham desenvolvido durante sua hospitalização e que se formaram sem tratamento para elas. A intervenção se tornou em una opção para melhorar a qualidade de vida das pessoas e um médio que as instituições de saúde podem pôr em prática.

Pilot study of homologous platelet gel in venous ulcers

Abstract: Background: Venous ulcers represent 70% of the lower limb ulcers. They are difficult to heal, requiring a correct diagnostic and therapeutic approach. Many products have been developed to healing, such as homologous platelet gel obtained from the platelet concentrate exceeding from blood transfusion. Objective: To evaluate the safety and efficacy of homologous platelet gel in venous ulcers compared with hydrocolloid dressing. Method: A pilot randomized clinical trial in patients with venous ulcers. Randomized groups (homologous platelet gel and hydrocolloid groups) were followed for 90 days and were assessed through the evolution of ulcerated area, qualitative analysis of vascularization and adverse events. Both groups used elastic compression. Results: We included 16 participants, with a total of 21 venous ulcers. Both treatments promoted a reduction of the areas of the ulcers in 90 days (mean 69%), there was significant difference between the groups concerning the gradual reduction of the ulcers areas, favorably to the hydrocolloid (70% vs 64%; p <0.01). There were some mild adverse events in both groups. Study limitations: Single-center study with a small number of patients, preventing more accurate assessment of the effects of platelet gel. Conclusion: The homologous platelet gel associated with the elastic compression can be an alternative to the venous ulcer treatment and is safe due to the occurrence of a few mild local adverse events and no serious adverse events. Clinical trials with larger numbers of patients must be performed to maintain the indication of this treatment for venous ulcer.

Prevention of central venous catheter associated infection with hydrocolloid dressings combined GreenCream Dressing:a randomized controlled trial / 中国实用护理杂志

Objective To apply the hydrocolloid dressings and hydrocolloid dressings combined GreenCream Dressing for central venous catheterization fixing, and to explore the effect of hydrocolloid dressings combined GreenCream Dressing in the prevention of venous catheter bacterial colonization and bacterial infection. Methods 470 patients who underwent the Inferior vena cava catheter were divided into 230 patients in the control group and 240 patients in the experimental group. The control group was fixed with hydrocolloid dressings after central venous catheter, and the experimental group was fixed with hydrocolloid dressings combined GreenCream Dressing after central vein catheter. The measurements included catheter bacterial colonization, catheter-related infections (CRIs) and catheter related blood stream infections (CR-BSIs), pathogenic bacteria colonization of the skin. At the same time, the skin safety was also confirmed. Results In the control group, 230 cases were retained for 1 419 catheter-days, and 240 cases in the experimental group were retained for 1 675 catheter-days. Compared with hydrocolloid dressings, hydrocolloid dressing combined GreenCream Dressing could reduce the incidence of CRIs from 1.8‰(3/1 675) to 0.7‰(1/1 675), and CR-BSIs from 2.4‰(4/1 675) to 0.7‰(1/1 675) respectively, with the statistically significant (χ2=6.39, 95%CI 1.30-31.41, andχ2=6.21, 95%CI 1.56-40.82;P<0.05). The results of bacterial colonization, CRIs and CR-BSIs showed that the most common bacteria were Staphylococcus and fungi. At the same time, compared with the hydrocolloid dressing, hydrocolloid dressing combined GreenCream dressing could reduce the incidence of skin pathogenic bacteria colonization, from 41.74%(96/230) to 28.33%(68/230),with the statistically significant (χ2=9.29,P=0.00);There was no difference between the two groups in the field of the incidence of abnormal skin manifestation (χ2=1.23, P=0.30), showing a good safety. Conclusions Hydrocolloid dressing combined GreenCream Dressing would be more effective to prevent bacterial colonization and bacterial infection of central venous catheter in department of neurosurgery.

Efficacy of hydrocolloid dressing on preventing mechanical phlebitis in-duced by peripherally inserted central catheter in cancer patients / 中国感染控制杂志

Objective To evaluate the efficacy of hydrocolloid dressings on preventing mechanical phlebitis induced by peripherally inserted central catheter (PICC)in cancer patients. Methods 100 cancer patients with PICC were divided into observation group (n= 50)and control group (n= 50). Hydrocolloid dressing was used in observation group and hot-wet compress was used in control group. Incidence of mechanical phlebitis,comfort degree,and im-plementation time between two groups were compared.Results The incidence of mechanical phlebitis in observation group and control group were 4.0% (2/50)and 22.0% (11/50)respectively,grade of mechanical phlebitis in obser-vation group was significantly lower than control group(P<0.05). The rates of skin irritation,activity limitation, and body exposure in observation group were all significantly lower than control group (0 vs 10 . 0% ,2 . 0% vs 14.0% ,0 vs 16.0% ,respectively,all P<0.05),the implementation time of observation group and control group were (2.8±1.1)and (35.2±7.4)minutes respectively,difference was statistically significant(P<0.05). Conclusion Hydrocolloid dressing can significantly reduce the mechanical phlebitis induced by PICC,enhance pa-tients'comfort degree,and reduce nurses'workload.

Fabrication and Characterization of Hydrocolloid Dressing with Silk Fibroin Nanoparticles for Wound Healing

Hydrocolloid dressings have been developed for many types of wound healing. In particular, dressing is a critical component in the successful recover of burn injuries, which causes a great number of people to not only suffer from physical but also psychological and economic anguish each year. Additionally, silk fibroin is the safest material for tissue engineering due to biocompatibility. In this study, we fabricated hydrocolloid dressings incorporating silk fibroin nanoparticles to enhance the efficacy of hydrocolloid dressing and then use this silk fibroin nanoparticle hydrocolloid dressing (SFNHD) in animal models to treat burn wounds. The structures and properties of SFNHD were characterized using tensile strength and Cell Counting Kit-8 assay. The results indicated the structural stability and the cellular biocompatibility of the hydrocolloid dressing suggesting that SFNHD can be applied to the treatment of wounds. To demonstrate the capacity of a silk fibroin hydrocolloid dressing to treat burn wounds, we compared SFNHD to gauze and Neoderm®, a commercially available dressing. This study clearly demonstrated accelerated wound healing with greater wound structural integrity and minimal wound size after treatment with SFNHD. These observations indicate that SFNHD may be an improvement upon current standard dressings such as Gauze and Neoderm® for burn wounds.