A prospective observational study of the efficacy of a novel hydroactive impregnated dressing.

OBJECTIVE: To assess the clinical efficacy, tolerance and acceptance of a novel, hydroactive-impregnated dressing (Hydrotul) in the local treatment of acute and chronic wounds. METHOD: In a prospective observational study 24 centres in France, Belgium, Germany and Austria recruited 74 patients. At each dressing change the investigators evaluated the condition of the wound, perilesional skin and patient-reported pain. Overall, five dressing changes were documented, or until complete healing occurred. The hydroactive properties of the dressing were assessed in laboratory tests by measuring fluid absorption capacity and kinetics. RESULTS: Patients were treated for an average of 17 days. The wound condition improved markedly during the observation period. The wound area covered with fibrinous slough decreased from 29% to 14%, epithelialisation increased from 19% to 54% and 22 wounds were completely healed by the end of the study. The number of patients reporting severe and moderate wound pain decreased from 35% to 19% and the proportion of patients without wound pain doubled from 27% to 60%. In laboratory tests, Hydrotul absorbed two to three times the amount of fluid compared with other impregnated wound dressings and the kinetics of absorption was much faster. CONCLUSION: The novel hydroactive impregnated dressing supports the healing process in patients with acute and chronic wounds and reduces wound pain. The dressing absorbs excess wound exudate while keeping the wound surface moist and protecting perilesional skin.

Clinical performance of a hydrogel dressing in chronic wounds: a prospective observational study.

OBJECTIVE: This prospective, multicentre application study was conducted to assess the clinical performance of Hydrosorb comfort hydrogel dressing. METHOD: Eighty-one patients (average age 67 years) with acute or chronic wounds received three dressing changes. The condition of the wound and patient-reported pain were assessed at the beginning and end of the study period. RESULTS: The mean proportion of the wound surface covered with slough fell from 63% to 34%, and the mean area of new granulation and epithelial tissue increased from 25% to 37% and 13% to 28%, respectively. The average wound size decreased from 4.7 x 2.9cm to 3.7 x 2.3cm; 29.6% of the patients reported no pain at baseline, increasing to 56.3% at the final assessment. CONCLUSION: Both acute and chronic wounds can be effectively treated with the Hydrosorb comfort hydrogel dressing.

Reduced cellular toxicity of a new silver-containing antimicrobial dressing and clinical performance in non-healing wounds.

Bacterial colonisation of wounds may delay wound healing. Modern silver-containing dressings are antimicrobial, yet cellular toxicity is a serious side-effect. We provide data for a newly formulated silver-containing ointment dressing, Atrauman Ag, for antimicrobial activity and cytotoxicity. Atrauman Ag effectively killed a panel of commensal skin as well as pathogenic bacterial strains while cytotoxicity for HaCaT keratinocytes was only around 10%. With these favourable in vitro tests, Atrauman Ag was analysed in 86 patients with traumatic and non-healing wounds of different aetiologies. The wound state was evaluated for 3 subsequent dressing changes. The slough score was reduced from 59.2 to 35.8%, granulation tissue increased from 27 to 40% and epithelialisation went up from 12.1 to 24%. We conclude that Atrauman Ag has a superior profile of antimicrobial activity over cellular toxicity and the low silver ion release rate may prevent interference with wound-healing mechanisms.

Efficacy of crisis intervention treatment with topical corticosteroid prednicarbat with and without partial wet-wrap dressing in atopic dermatitis.

BACKGROUND: The wet-wrap treatment has been reported to be beneficial in acute episodes of atopic dermatitis (AD) skin lesions. OBJECTIVE: The efficacy of topical corticosteroid prednicarbat with and without additional wet-wrap dressing was investigated in a prospective, randomized and controlled study. METHODS: In the left-right comparison study, 24 adults and children with an acute episode of AD were included. One arm or leg was randomly treated with the topical corticosteroid prednicarbat plus wet-wrap dressing; only prednicarbat was applied on the leg or arm of the other side. RESULTS: After 48-72 h of treatment, in both groups an improvement of the local SCORAD was observed. In comparison to the side of the body treated with corticosteroid alone, the decrease of the local SCORAD in the corticosteroid plus wet-wrap dressing group was significantly better. The severity of AD improved in the wet-wrap group at an average of 4.4 points, in the corticosteroid group 3.0 (p<0.011). CONCLUSIONS: Wet-wrap therapy with a topical corticosteroid is an effective treatment option in patients with exacerbated AD. The treatment is helpful in improving skin conditions, shortening the time of corticosteroid application.

Bronchopulmonary lavage for pulmonary alveolar proteinosis.

In summary, total-lung bronchopulmonary lavage was performed five times on two patients under general anesthesia with controlled ventilation using a Robert-Shaw double lumen ETT. One lavage was complicated by a hydrothorax that was treated without untoward sequelae. No significant hypoxemia, circulatory impairment or leakage of lavaged fluid into the opposite lung was noted on any occasion. The average time of all procedures was 108 minutes (range 80-150 minutes), and patients were extubated on all occasions 2 to 5 hours after the treatment. Patients were discharged 24 to 36 hours after the last lavage with improvement, though not resolution, of the alveolar infiltrates radiographically. The ABG analysis revealed minimal improvement in oxygenation in Case No.1 from a preoperative paO2 of 60 mmHg on room air to a paO2 of 74 mmHg on the day of discharge. However, the patient was able to resume his normal activity level. In Case No.2, the patient's resting paO2 did not improve significantly from the preoperative value of 82 mmHg. Subjectively, however, the patient noted marked improvement. Prior to bronchopulmonary lavage, this patient's SaO2 decreased from 97% to 81% after walking 800 feet. Approximately a week and a half after discharge, the patient reported being able to run without symptoms and generally was feeling well. With careful attention to detail and the coordination of resources from the departments of anesthesia, pulmonary medicine, respiratory therapy and nursing services, bronchopulmonary lavage can be performed safely and efficiently in order to curtail the progressive hypoxemia which often develops in patients with PAP.

Horner's syndrome after epidural block in early pregnancy.

Horner's syndrome after epidural block in a first-trimester parturient has not previously been reported. The authors describe a case of unilateral Horner's syndrome after single-dose epidural block in a 12-week pregnant female.