ABSTRACT
Silver sulfadiazine is the most commonly used topical antibacterial agent for the treatment of burn wounds. It has many clinical advantages, including a broad spectrum of antimicrobial activity, low toxicity, and minimal pain on application. The current formulation of silver sulfadiazine contains a lipid soluble carrier, polypropylene glycol, that has certain disadvantages, including pseudo-eschar formation and the need for twice daily application. The purpose of this investigation was to describe a new formulation of silver sulfadiazine in a water soluble gel, poloxamer 188. The antibacterial activity of this new gel has been compared to that of the commercially available silver sulfadiazine cream by in vitro and in vivo testing. The results of the in vitro antibacterial testing of these two different agents demonstrated the superiority of the new gel formulation. In experimental wounds, the antibacterial activity of the gel and the commercially available silver sulfadiazine cream were not significantly different when applied once a day. The antibacterial activity of the gel when applied once a day was comparable to that encountered by twice daily applications of the silver sulfadiazine cream by experimental wounds. The major advantage of this gel was its ease of application and removal that is attributed to its water solubility.
Subject(s)
Anti-Infective Agents, Local/pharmacology , Silver Sulfadiazine/pharmacology , Skin Diseases, Bacterial/drug therapy , Staphylococcal Infections/drug therapy , Staphylococcus aureus/drug effects , Wound Infection/drug therapy , Administration, Topical , Animals , Anti-Infective Agents, Local/chemistry , Chemistry, Pharmaceutical , Disease Models, Animal , Drug Delivery Systems , Drug Evaluation , Female , Gels , Rats , Rats, Sprague-Dawley , Silver Sulfadiazine/chemistry , Skin Diseases, Bacterial/microbiology , Skin Diseases, Bacterial/pathology , Solubility , Staphylococcal Infections/microbiology , Staphylococcal Infections/pathology , Staphylococcus aureus/isolation & purification , Wound Infection/microbiology , Wound Infection/pathologyABSTRACT
Continuous percutaneous and dermal suture closures have an important role in the approximation of long, linear lacerations in the emergency department. This report documents the scientific basis for these continuous closure techniques. In addition, a detailed description of these surgical closure techniques is presented.
Subject(s)
Suture Techniques , Evidence-Based Medicine , Humans , Needles , Surgical EquipmentABSTRACT
The purpose of this study was to identify the optimal knot construction for interrupted dermal sutures. A synthetic braided absorbable suture, sizes 3-0 and 5-0, was selected for this evaluation. With reproducible mechanical performance tests, we determined that the construction of secure knots without ears required one additional throw as compared with secure knots with 3-mm ears. The direction of applied tension did not alter knot security, with the exception of granny knots, which required an extra throw when tension was applied parallel to the suture loop. Because interrupted dermal knot construction is accomplished without knot ears and with an applied tension parallel to the wound, one additional throw must be added to the knot to ensure knot security.
Subject(s)
Suture Techniques , Humans , Materials TestingABSTRACT
Lactomer and Polyglactin 910 sutures are both made of copolymers of lactide and glycolide. Biomechanical performance tests demonstrated superior handling characteristics of the Lactomer sutures. Using sutures comparable in size and knot construction, the Lactomer sutures exhibited knot holding force superior to the Polyglactin 910. Moreover, the low knot rundown forces encountered by the Lactomer sutures facilitated construction of secure knots that failed by breakage rather than by slippage.
