Hydrocolloids

Effectiveness of 0.1% mometasone furoate under hydrocolloid dressing versus 0.1% mometasone furoate in patients with lichen simplex chronicus

There was a lack of high-quality, evidence-based treatment for lichen simplex chronicus (LSC). Topical steroid under hydrocolloid dressing treatment was investigated mostly in observational studies without investigation of the cost-effectiveness and the methodology of application also varied without standardisation. To investigate the cost-effectiveness of topical steroid under hydrocolloid dressing in the treatment of moderate to severe lichen simplex chronicus (LSC). The study aimed to provide a clear methodology that was replicable. A single-blinded randomized controlled trial was carried out to compare the efficacy of 0.1% mometasone furoate cream with or without hydrocolloid dressing in patients suffering from moderate to severe LSC. Physician Global Assessment (PGA) score, Eczema Area and Severity Index (EASI) individual components score were assessed by a Dermatologist through clinical photos at week 0, 2, and 4. Pruritis Numerical Rating Scale (PNRS) was rated. Forty adult patients were recruited. The group with hydrocolloid dressing showed superior treatment efficacy. 20 out of 20 patients benefited from the hydrocolloid dressing with topical steroid while only 6 out of 20 patients benefited from topical steroid alone at week 2 regarding PGA. Similar result was obtained at week 4. Extra HK$ 132 was needed for each patient in hydrocolloid with topical steroid group. The number needed to treat (NNT) was 1.43 (95% CI: 1.42-1.44) at week 2 and 1.42 (95% CI: 1.41-1.44) at week 4 regarding PGA score improvement of ≥2. NNT analysis supported the cost-effectiveness of adjunctive hydrocolloid dressing usage as the first-line treatment in patients with moderate to severe LSC. This study added evidence to LSC treatment with a detailed and reproducible methodology.

Wearable Smart Bandage-Based Bio-Sensors

Bandage is a well-established industry, whereas wearable electronics is an emerging industry. This review presents the bandage as the base of wearable bioelectronics. It begins with introducing a detailed background to bandages and the development of bandage-based smart sensors, which is followed by a sequential discussion of the technical characteristics of the existing bandages, a more practical methodology for future applications, and manufacturing processes of bandage-based wearable biosensors. The review then elaborates on the advantages of basing the next generation of wearables, such as acceptance by the customers and system approvals, and disposal.

Dressing Materials: A Comprehensive Review

Injury to the skin provides a difficult challenge, as wound healing is a complex and dynamic process. Wound healing process recruits three different phases: inflammation, proliferation, and maturation. The sequence of events involved in wound healing can be affected by numerous disease processes, resulting in chronic, non-healing wounds that give significant discomfort and distress to the patients while draining the medical fraternity of enormous resources. Wound tissue never reaches its pre-injured strength and multiple aberrant healing states can result in chronic non-healing wounds. There is a growing concern about the usage of correct materials for wound dressings. The development of new and effective treatments in wound care still remains an area of intense research. There are a number of wound dressings available in the market. The objective of the article is to enhance knowledge about characteristics of an ideal wound dressing and guide in finding the correct dressing material. It also provides a detailed classification of traditional and modern wound dressings.

Advances in Skin Tissue Engineering and Regenerative Medicine

There are an estimated 500,000 patients treated with full-thickness wounds in the United States every year. Fire-related burn injuries are among the most common and devastating types of wounds that require advanced clinical treatment. Autologous split-thickness skin grafting is the clinical gold standard for the treatment of large burn wounds. However, skin grafting has several limitations, particularly in large burn wounds, where there may be a limited area of non-wounded skin to use for grafting. Non-cellular dermal substitutes have been developed but have their own challenges; they are expensive to produce, may require immunosuppression depending on design and allogenic cell inclusion. There is a need for more advanced treatments for devastating burns and wounds. This manuscript provides a brief overview of some recent advances in wound care, including the use of advanced biomaterials, cell-based therapies for wound healing, biological skin substitutes, biological scaffolds, spray on skin and skin bioprinting. Finally, we provide insight into the future of wound care and technological areas that need to be addressed to support the development and incorporation of these technologies.

Fabrication and characterisation of a wound dressing composed of polyvinyl alcohol and quince seed mucilage

OBJECTIVE

Providing a suitable environment to improve the healing process is the main target of wound dressing that also protects the wound from additional harms. In the present study, fabrication and characterisation of a new kind of electrospun wound dressing composed of polyvinyl alcohol (PVA) and quince seed mucilage (QSM) is reported.

METHOD

QSM was extracted from quince seeds, purified, freeze-dried and used to produce aqueous solutions containing different amounts of PVA and QSM. The wound dressings were fabricated via the electrospinning method and their characteristics were investigated with scanning electron microscope (SEM) images, Fourier transform infrared (FTIR) spectra, tensile and swelling test, and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) cytotoxicity assay against fibroblast cells.

RESULTS

SEM images confirmed that proper, uniform, non-oriented nanofibres with an average diameter in the range of 60-240nm, depending on the QSM content had been fabricated. The tensile test showed that with increasing QSM content, the tensile strength of fibre increased while elongation at break was decreased, which was consistent with SEM images where the diameter of samples decreased by increasing QSM content. MTT assay showed significant biocompatibility against fibroblast cells; however, it was increased by increased QSM proportion. In addition, SEM images supported the proper adhesion of fibroblast cells on the sample one day after culturing.

CONCLUSION

Overall, the findings of the current study support the potential of PVA/QSM nanofibres as a proper candidate for biomedical applications, especially as a wound dressing.

Absorptive supramolecular elastomer wound dressing based on polydimethylsiloxane–(polyethylene glycol)–polydimethylsiloxane copolymer: preparation and characterization

The introducing of polyethylene glycol block could effectively enhance the hydrophilicity, water-absorbing rate, ability of cohesion and water vapor permeating rate of ESESi film, and help to promoting the wound healing processing.

Wound dressings - a review

Wound healing is a dynamic and complex process which requires suitable environment to promote healing process. With the advancement in technology, more than 3000 products have been developed to treat different types of wounds by targeting various aspects of healing process. The present review traces the history of dressings from its earliest inception to the current status and also discusses the advantage and limitations of the dressing materials.

A critical review of modern and emerging absorbent dressings used to treat exuding wounds

Wound management has progressed significantly over the last five decades. This emanates from a greater understanding of wound healing, technological progression and improved clinical and scientific research. There are currently a plethora of absorbent dressings on the wound care market which claim to have the ability to manage exudates whilst encouraging healing. However, it is becoming clear, from analysing randomised controlled trials, that some of these absorbent dressings are not meeting their expectations when applied in a clinical setting. Many clinicians now feel that there should be more focus, not only on a dressing's ability to manage exudate efficiently, but on a dressing's ability to proactively encourage healing and thus exudate reduction will ensue. This paper proposes to critically review modern and emerging absorbent wound care dressings used to manage exuding wounds and discuses some advances in this area.

French national wound management survey: choice criteria of dressings

Across Europe, wound care management is organized differently, and in some countries such as the UK or Denmark, wound healing centres have been implemented. In France, a large number of health professionals are not sufficiently educated in wound care management during their vocational training. The rapid evolution of dressings has changed wound management practices and has given rise to new professional recommendations. This national survey was carried out in France in 2009, including 465 health professionals, to determine the criteria they use to choose a dressing and their habits of care with acute or chronic wounds. Around 73% of respondents were nurses and, on average, participants took care of 43 wounds per month. It was also found that 89% of the health professionals who took part prefer the sequential treatment of the wound based on its appearance. Regardless of whether the wound is acute or chronic, the priorities for wound care and the choice of dressing are the management of the exudate and the prevention or treatment of infection. These results put into evidence the adequacy of the recommendations by these practitioners and the good correlation between the choice of dressing and the local therapeutic goal. To reach the same level of expertise, the professional training for health professionals who are less frequently involved in wound care is necessary.

Wound healing dressings and drug delivery systems: a review

The variety of wound types has resulted in a wide range of wound dressings with new products frequently introduced to target different aspects of the wound healing process. The ideal dressing should achieve rapid healing at reasonable cost with minimal inconvenience to the patient. This article offers a review of the common wound management dressings and emerging technologies for achieving improved wound healing. It also reviews many of the dressings and novel polymers used for the delivery of drugs to acute, chronic and other types of wound. These include hydrocolloids, alginates, hydrogels, polyurethane, collagen, chitosan, pectin and hyaluronic acid. There is also a brief section on the use of biological polymers as tissue engineered scaffolds and skin grafts. Pharmacological agents such as antibiotics, vitamins, minerals, growth factors and other wound healing accelerators that take active part in the healing process are discussed. Direct delivery of these agents to the wound site is desirable, particularly when systemic delivery could cause organ damage due to toxicological concerns associated with the preferred agents. This review concerns the requirement for formulations with improved properties for effective and accurate delivery of the required therapeutic agents. General formulation approaches towards achieving optimum physical properties and controlled delivery characteristics for an active wound healing dosage form are also considered briefly.

The use of gauze: will it ever change?

Although the benefits of healing in a moist environment have been published worldwide, the use of woven gauze as a wound contact material still prevails in many countries. This article traces the history of gauze and problems associated with usage against the introduction of one of the first modern materials, the hydrocolloid. Why this revolution in dressing material did not herald an immediate change of practice away from gauze is examined. Since the 1970s, the range, availability and sophistication of these and other moisture-retentive dressings have increased dramatically, and yet it seems that some practitioners remain unconvinced. The processes that underpin personal and organisational change that may contribute to this reluctance are also considered.

Hydrocolloids in wound management: pros and cons

Hydrocolloids are interactive dressings which are well established in wound management. Because of their sophisticated composition, they can be used to manage a variety of wound types, from clean and granulating to sloughy and necrotic. While they may be more expensive per item than many other modern dressings, if used correctly they can be cost-effective, as they have a longer wear time. Hydrocolloid formulations appear to be changing and improving with ongoing research by manufacturers, but a significant limitation appears to be sensitivity reactions. Dressings that would benefit from improvement are those containing gelatin, and those containing colophony within the adhesive matrix. These known sensitizers are largely unpublicised, but can produce serious side effects in some individuals.

Clinical efficacy of Comfeel Plus Transparent Dressing

Hydrocolloid dressings have been in use for more than 20 years. They are indicated for the treatment of granulating, superficial wounds with low to moderate exudates. There are a number of hydrocolloid dressings available, one of which is Comfeel Plus Ulcer Dressing. This differs from the others by combining a hydrocolloid with calcium alginate in its formation to increase the absorptive capacity. This article examines another product of the Comfeel Plus range, Comfeel Plus Transparent Dressing (Coloplast A/S) and describes a small evaluation of the product. The conclusion is that Comfeel Plus Transparent Dressing performs well in terms of healing, compliance, adherence and flexibility. Furthermore, it is transparent and it is therefore possible to follow the wound healing process without removing the dressing.

Tegasorb hydrocolloid dressing: advanced formulation

Tegasorb advanced formulation hydrocolloid dressing from 3M Healthcare can be used on a variety of wounds, e.g. leg ulcers and donor sites. It encourages a moist wound-healing environment and can be used in all stages of wound healing, from black necrotic tissue to the epithelializing wound. Tegasorb is a well-established hydrocolloid dressing that has recently been relaunched as an advanced formulation.

The cost of wound care in the community

Prescriptions issued between July 1993 and June 1994 for wound management materials cost the NHS in Wales a total of 5.5 million pounds. A detailed analysis of Welsh PACT (prescribing analysis and cost) data suggests that this expenditure could be reduced by up to 140,000 pounds by the introduction of minor changes in prescribing patterns. These savings would be achieved with no reduction in the quality of care provided to patients, and in some instances the changes proposed would lead to the use of products which are superior in performance terms to those items that are currently being prescribed. More fundamental changes, involving the exclusion of some products of questionable efficacy, would result in additional savings up to a maximum of 527,000 pounds. As expenditure in Wales is generally considered to represent approximately 10% that of the UK as a whole, this figure could approach 5 million pounds on a national basis.