Effect Of Negative Pressure Wound Therapy On The Bacterial Flora Of Wounds: A Prospective Randomized Study

20 patients were treated with negative pressure wound therapy (NPWT) and 20 patients by cotton gauze dressings. Bacterial cultures were done on 0, 4th and 8th day. The bacterial inoculates were compared between these two groups. NPWT was found to decrease pseudomonas species more than the S. aureus or E. coli species. The number of isolates of Pseudomonas decreased from day 0 (n=7) to day 8 (n=2) by NPWT. In the gauze dressing group, the number of isolates marginally increased from day 0 (n=5) to day4 (n=6) and then decreased to the baseline at day 8 (n=5). The number of isolates of E coli under gauze dressings also decreased from day 0 (n=12) to day 8 (n=6). Under NPWT however, lead an only marginal decrease in the number of isolates of E coli from day 0 (n=7) to Day 8 (n=6). Thus, NPWTis more effective to control obligate aerobic bacteria

Conservative Treatment of Stage of Pressure Ulcers with Ulmus

OBJECTIVE: To investigate the treatment effect of Ulmus, which has been traditionally used for the treatment of the pressure ulcers in Korea. METHOD: Thirteen cases with stage IV pressure ulcers (according to the National Pressure Ulcer Advisory Panel, 1989) were enrolled for the study. Seven cases were treated with Ulmus and 6 cases were treated with wet gauze as a control group. The sizes and stages of pressure ulcers were evaluated every 2 week for 12 weeks. RESULTS: After 12 weeks, the size of pressure ulcers decreased from 78.17+/-47.77 cm3 to 8.14+/-13.17 cm3 (mean S.D., n=7) in Ulmus treated group, whereas from 62.10+/-40.89 cm3 to 36.69+/-36.23 cm3 (mean+/-S.D., n=6)in wet gauze treated group. The size of pressure ulcers decreased more significantly (p<0.05) in Ulmus treated group than wet gauze dressed group. Among seven cases treated by Ulmus, 2 cases completely healed, 3 cases improved to stage II, and 2 cases remained to stage IV, whereas among 6 cases treated by wet gauze, 1 cases improved to stage II, 1 case to stage III, and 4 cases remained to stage IV. CONCLUSION: Ulmus was more effective in management of pressure ulcers than wet gauze. We suggest that Ulmus can be used as a useful method of conservative treatment for the stage IV pressure ulcers.

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.