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Turnbull MJ, Grigsby I, Unertl K, Sokol K, Nordby T, Liu C, Bailey A, Spiewak B, Smith G, McNulty AK. Comparison of Medical Tape Performance Using Skin Response Quantitative Measurements on Healthy Volunteers. Cureus 2024; 16:e56548. [PMID: 38646282 PMCID: PMC11027027 DOI: 10.7759/cureus.56548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2024] [Indexed: 04/23/2024] Open
Abstract
BACKGROUND Medical tapes can lead to skin damage upon removal in susceptible patients with fragile skin and at higher risk of developing tissue injury. PURPOSE We compared the effect of medical tapes with silicone-based versus acrylate-based adhesives on the back or volar forearm stratum corneum using analytical techniques to assess skin condition and potential damage post product removal on 88 healthy volunteers. METHODS Two studies were conducted in separate facilities (Study 1: 3M In-house Clinical Facility, St. Paul, Minnesota; Study 2: DermiCo, LLC, Broomall, Pennsylvania). Four commercially available tapes were the same in both studies, two for each type of adhesive. We evaluated adhesion to the skin, total proteins and corneocytes removed by the tapes, changes in transepidermal water loss (TEWL), and induction of the inflammatory cytokine interleukin-1 alpha (IL-1a). RESULTS One of the silicone tapes displayed the strongest adhesion at 24 hours, and one of the acrylate tapes had the lowest adhesion, showing differences in performance within adhesive categories. The adhesion forces did not correlate with the amount of total protein or corneocytes removed. Silicone adhesives removed less total protein and corneocytes than acrylate adhesives. Silicone adhesives did not alter TEWL, whereas acrylate adhesives significantly raised TEWL. There were no differences in interleukin-1alpha induction. CONCLUSION The silicone adhesive tapes were less disruptive to the skin barrier than the acrylate adhesive tapes, even in healthy volunteers whose skin is not as fragile as what is observed in typical patients. This type of data could guide clinical product usage decisions.
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Affiliation(s)
| | - Iwen Grigsby
- Medical Solutions Division, 3M Health Care, St. Paul, USA
| | - Karl Unertl
- Medical Solutions Division, 3M Health Care, St. Paul, USA
| | - Kerry Sokol
- Medical Solutions Division, 3M Health Care, St. Paul, USA
| | - Tera Nordby
- Global Medical and Clinical Affairs, 3M Health Care, St. Paul, USA
| | - Cedric Liu
- Medical Solutions Division, 3M Health Care, St. Paul, USA
| | - Anna Bailey
- Medical Solutions Division, 3M Health Care, St. Paul, USA
| | - Brian Spiewak
- Medical Solutions Division, 3M Health Care, St. Paul, USA
| | - Graham Smith
- Global Medical and Clinical Affairs, 3M Health Care, St. Paul, USA
| | - Amy K McNulty
- Medical Solutions Division, 3M Health Care, St. Paul, USA
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Mbithi F, Worsley PR. Adhesives for medical application - Peel strength testing and evaluation of biophysical skin response. J Mech Behav Biomed Mater 2023; 148:106168. [PMID: 37847959 DOI: 10.1016/j.jmbbm.2023.106168] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 10/03/2023] [Accepted: 10/06/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND Medical adhesives are commonly used for securing wound dressings and medical devices used for diagnostic or therapeutic purposes. Mechanical irritation of skin due to adhesive stripping and repeated application can lead to discomfort and device removal. This study aims to examine the peel strength and skin response to different medical adhesives in a cohort of healthy volunteers. METHOD Twelve healthy participants were recruited for peel strength testing of three candidate adhesive tapes, and evaluation of the skin response after adhesive removal. A modified ASTM D903 peel strength testing was performed at 180° peeling angle and a rate of 300 mm/min on the forehead, upper back and forearm skin. A longitudinal study was conducted on the forearm and back, with the adhesive samples left in-situ for up to 60 h for analysis of repeat application. The effects of two skin preparation approaches (water and alcohol cleaning) prior to adhesive application were also assessed. Skin biophysical properties were assessed at baseline and at various timepoints following adhesive removal using transepidermal water loss (TEWL), erythema and hydration. RESULTS Peel strength reduced uniformly with repeat application over prolonged periods for all the adhesive samples tested. Skin preparation with water and alcohol cleansing prior to adhesive application increased peel strength at both the back (1.1% and 2.9%), and forearm (21.3% and 20%) sites. There was statistically significant increase from baseline to post-tape application for TEWL, skin redness and hydration (p < 0.001). However, there were no statistically significant differences between adhesive types (TEWL: p = 0.38, SR: p = 0.53, HY: p = 0.46). TEWL increased the most post-adhesion across all test sites and adhesive samples with repeat application (p < 0.05). Two-way ANOVA tests revealed no statistically significant interactions between the effects of application duration and adhesive on skin redness or TEWL for both the back and forearm sites (p > 0.05), though a significant interaction was indicted for hydration at the back site (p = 0.01). CONCLUSION This study revealed that site and duration of adhesive application effected peel strength. The corresponding changes in skin properties identified that skin barrier function was disrupted with long-term application of adhesives. The back site was identified to be most reliable for adhesion testing and skin response assessment for future work.
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Affiliation(s)
- Florence Mbithi
- Skin Sensing Research Group, School of Health Sciences, University of Southampton, Southampton, UK.
| | - Peter R Worsley
- Skin Sensing Research Group, School of Health Sciences, University of Southampton, Southampton, UK.
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Santamaria N, Woo K, Beeckman D, Alves P, Cullen B, Gefen A, Lázaro‐Martínez JL, Lev‐Tov H, Najafi B, Sharpe A, Swanson T. Clinical performance characteristics for bordered foam dressings in the treatment of complex wounds: An international wound dressing technology expert panel review. Int Wound J 2023; 20:3467-3473. [PMID: 37139846 PMCID: PMC10588323 DOI: 10.1111/iwj.14217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/15/2023] [Accepted: 04/17/2023] [Indexed: 05/05/2023] Open
Abstract
The aim of this article is to identify and describe clinical practice performance characteristics for bordered foam dressings in the treatment of complex wounds. Our recently published systematic review of outcomes and applied measurement instruments for the use of bordered foam dressings in complex wounds has led to us identifying a range of important clinical and patient-centred issues related to this dressing class. Specifically, here, we focus on an overview of performance criteria in the areas of application, adhesion, exudate management and debridement functions of bordered foam dressings. Our hope is that by highlighting the clinical performance criteria, future testing standards for wound dressings will more closely match our clinical expectations and, thereby, assist clinicians to make better wound treatment choices based on meaningful and clinically relevant dressing product performance standards. complex wounds, complex wound care, treatment, bordered foam dressings, dressing performance.
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Affiliation(s)
- Nick Santamaria
- School of Health SciencesUniversity of MelbourneMelbourneVictoriaAustralia
| | - Kevin Woo
- School of NursingQueen's UniversityKingstonOntarioCanada
| | - Dimitri Beeckman
- Skin Integrity Research Group (SKINT)University Centre for Nursing and MidwiferyGhentBelgium
- Department of Public Health and Primary CareGhent UniversityGhentBelgium
- Swedish Centre for Skin and Wound Research, Faculty of Health and Medicine, School of Health SciencesÖrebro UniversityÖrebroSweden
- Research Unit of Plastic Surgery, Department of Clinical ResearchFaculty of Health SciencesOdenseDenmark
- School of Nursing & MidwiferyRoyal College of Surgeons in Ireland (RCSI)DublinIreland
| | - Paulo Alves
- Wounds Research Lab ‐ Centre for Interdisciplinary Research in HealthUniversidade Catolica PortuguesaPortugal
| | | | - Amit Gefen
- Department of Biomedical EngineeringFaculty of Engineering, Tel Aviv UniversityTel AvivIsrael
| | | | - Hadar Lev‐Tov
- Dr. Phillip Frost Department of Dermatology and Cutaneous SurgeryUniversity of Miami Hospital Miller School of MedicineMiamiFloridaUSA
| | - Bijan Najafi
- Michael E. DeBakey Department of Surgery, Baylor College of MedicineInterdisciplinary Consortium on Advanced Motion Performance (iCAMP)HoustonTexasUSA
| | - Andrew Sharpe
- Podiatry DepartmentSalford Royal NHS Foundation Trust, Salford Care OrganisationSalfordUK
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Allen A, Zana-Taïeb E. Recommendations for use of adhesives on hospitalized newborns: A systematic review of the literature. Arch Pediatr 2023; 30:486-492. [PMID: 37604760 DOI: 10.1016/j.arcped.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 06/04/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND The skin is the largest organ in the human body. It provides multiple barrier functions, tactile or defensive, and acts as a mediator allowing for the attachment of vital monitoring devices with medical adhesives. Adhesives consist of several layers with varying compositions and properties. We aimed to provide recommendations for their use in the care of hospitalized neonates on the basis of a systematic literature review. METHODS We searched PubMed for English or French articles published before May 29, 2020, using the keywords "adhesive," "tape,", "skin," and "neonat*." Recommendations were developed after review by a multidisciplinary group including 15 professionals and parent representatives. RESULTS We identified 295 studies, and from 30 eligible studies we developed six recommendations according to four perspectives: assessment of the skin condition to improve the methods of application of the different adhesives and their removal; use of adhesives as a platform; and discouraging the regular use of semi-permeable dressings to compensate for the immaturity of the skin barrier. CONCLUSION Skin lesions are common for hospitalized neonates. Use of adhesives may increase the occurrence of such lesions. Adhesives should be subject to good clinical practice guidelines. Health professionals caring for newborns should know the tools for screening and preventing skin lesions.
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Affiliation(s)
- Aurore Allen
- Department of Neonatal Medicine, Cochin-Port Royal Hospital, FHU PREMA, AP-HP, Paris, 75014, France; Group of Reflection and Evaluation of the Environment of Newborns (GREEN) study group from the French Neonatal Society
| | - Elodie Zana-Taïeb
- Department of Neonatal Medicine, Cochin-Port Royal Hospital, FHU PREMA, AP-HP, Paris, 75014, France; Group of Reflection and Evaluation of the Environment of Newborns (GREEN) study group from the French Neonatal Society
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Seok M, Choi Y, Cho YH. Reusable and Porous Skin Patches with Thermopneumatic Adhesion Control Capability and High Water Vapor Permeability. ACS APPLIED MATERIALS & INTERFACES 2023; 15:42395-42403. [PMID: 37655485 DOI: 10.1021/acsami.3c10603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
We present a reusable and porous skin patch (RPS patch) capable of controlling adhesion force with a thermal-pneumatic method for repetitive use as well as improving moisture permeability for long-term use without skin troubles. Previous skin patches cause skin troubles due to high adhesion force (∼30 kPa) and low moisture permeability (∼382 g/m2/day), hindering them from repeatable and long-term use. We control the skin adhesion force of the RPS patch using thermopneumatic pressure generated by an embedded heater on multiple chamber arrays. The RPS patch controls the adhesion force ranging from 8 to 29 kPa on both dry and wet skin while keeping the stable adhesion force for 48 h. It shows repeatable adhesion up to 100 times, and the adhesion force is restored after the RPS patch is washed with water, thus enabling repetitive skin adhesion. We improve the moisture permeability of the RPS patch to 733 g/m2/day while maintaining the adhesion force by making the RPS patch with porous materials. The RPS patch shows no skin troubles for 7 days of attachment, thereby being available for long-term skin attachment. The RPS patch, having adhesion control capability and high moisture permeability, shows potential for use in daily life in biomedical applications, including wearable sensors, medical adhesives, and rehabilitation robots.
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Affiliation(s)
- Minho Seok
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Yuseong-gu, Daejeon 34141, Republic of Korea
| | - Yebin Choi
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Yuseong-gu, Daejeon 34141, Republic of Korea
| | - Young-Ho Cho
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291 Daehak-ro, Yuseong-gu, Daejeon 34141, Republic of Korea
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Abstract
Significance: Healthy skin provides a barrier to contaminants. Breaches in skin integrity are often encountered in the patient health care journey, owing to intrinsic health issues or to various procedures and medical devices used. The time has come to move clinical practice beyond mere awareness of medical adhesive-related skin injury and toward improved care and outcomes. Recent Advances: Methods developed in research settings allow quantitative assessments of skin damage based on the measurement of baseline skin properties. These properties become altered by stress and over time. Assessment methods typically used by the cosmetic industry to compare product performance could offer new possibilities to improve clinical practice by providing better information on the status of patient skin. This review summarizes available skin assessment methods as well as specific patient risks for skin damage. Critical Issues: Patients in health care settings may be at risk for skin damage owing to predisposing medical conditions, health status, medications taken, and procedures or devices used in their treatment. Skin injuries come as an additional burden to these medical circumstances and could be prevented. Technology should be leveraged to improve care, help maintain patient skin health, and better characterize functional wound closure. Future Directions: Skin testing methods developed to evaluate cosmetic products or assess damage caused by occupational exposure can provide detailed, quantitative information on the integrity of skin. Such methods have the potential to guide prevention and treatment efforts to improve the care of patients suffering from skin integrity issues while in the health care system.
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Affiliation(s)
- Stéphanie F. Bernatchez
- 3M Health Care, St. Paul, Minnesota, USA.,Correspondence: 3M Health Care, St. Paul, MN 55144-1000, USA
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Barrett S, Rippon MG, Rogers AA. Effectiveness of wound contact layers in enabling undisturbed wound management: a case series. J Wound Care 2023; 32:134-144. [PMID: 36930187 DOI: 10.12968/jowc.2023.32.3.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
OBJECTIVE Wound contact layers (WCLs) are intended to protect and support wounds during the healing process. An open, non comparative, case series clinical evaluation was undertaken to assess the impact of these dressings on establishing an undisturbed wound environment that supports effective wound management, and to allow the establishment of limits of duration of the wear time for the experimental WCLs. METHOD The primary objectives of this clinical evaluation were to assess the ability of the WCLs to prevent tissue disturbance to the wound and surrounding skin and for the clinicians to have confidence to extend the wear time of the WCL dressings. For them to have confidence in leaving the dressings in place for extended periods, the assessment of the wound and periwound skin condition and an assessment of patient comfort was performed: assessment of wound and periwound condition in relation to tissue adherence of the dressing to the wound resulting in tissue damage/bleeding (to wound and/or periwound skin) and cellular infiltration into the WCL; assessment of patient wearing comfort and satisfaction; assessment of WCL wear time, relating to times between dressing changes as judged by the clinician. RESULTS Based upon five parameters used to assess the extent to which the WCLs Atrauman, Atrauman Silicone and Atrauman Ag (HARTMANN, Germany) disturbed the underlying tissues-bleeding, wound tissue damage, periwound skin damage, tissue ingrowth and dressing adherence-the majority (>95%) of assessments indicated low or no disturbance of tissue. Over the 14 days of study assessment, the mean (±standard deviation) wear time was 7.3±1.2 days for the Atrauman group, 9.9±2.8 days for the Atrauman Silicone group, and 5.8±1.0 days for the Atrauman Ag group. All dressings were well tolerated by patients and rated highly in terms of in-use dressing performance. CONCLUSION The results indicate that Atrauman WCLs are suitable for the management of a variety of wounds as they promote an undisturbed wound environment, including extended wear time.
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Affiliation(s)
- Simon Barrett
- Humber NHS Foundation Trust, The Grange Hessle, Hull, UK
| | - Mark G Rippon
- Huddersfield University, Huddersfield, UK
- Daneriver Consultancy Ltd, Holmes Chapel, Cheshire, UK
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8
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Muacevic A, Adler JR, Bjork J, Turnbull M, Sieracki J. Finite Element Analysis Modelling of Negative Pressure Wound Therapy Drapes. Cureus 2023; 15:e33412. [PMID: 36751188 PMCID: PMC9897684 DOI: 10.7759/cureus.33412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2022] [Indexed: 01/07/2023] Open
Abstract
Negative pressure wound therapy (NPWT) drape removal from the skin may be painful for patients and inadvertently cause skin damage during the length of therapy. Most NPWT drapes utilize an acrylate adhesive to achieve the seal. To improve the experience associated with NPWT drape removal, a novel hybrid drape was developed. This drape is composed of areas of acrylate adhesive and areas of silicone adhesive. To more fully understand how the removal of the hybrid drape versus the acrylate drape affects the skin, drape removal models were developed to assess the differences in strain profiles for acrylate versus hybrid NPWT drapes using finite element analysis (FEA) to measure the strain and deformation that occurs at the tissue interface with the NPWT drape. The FEA modeling showed that the maximum principal strain associated with the removal of the acrylate drape was 47.3%, whereas the maximum principal strain associated with the removal of the hybrid drape was 21.5%. The average peel force associated with the acrylate drape was 66.1 gf/in, while the peel force for the hybrid drape was 112.5 gf/in. NPWT drape removal may, in certain instances, be related to pain and periwound skin injury. The hybrid drape tested may provide clinicians with an option for NPWT that is gentler for the skin.
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9
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Gefen A, Alves P, Beeckman D, Lázaro-Martínez JL, Lev-Tov H, Najafi B, Swanson T, Woo K. Mechanical and contact characteristics of foam materials within wound dressings: Theoretical and practical considerations in treatment. Int Wound J 2022. [PMID: 36564958 DOI: 10.1111/iwj.14056] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 12/05/2022] [Indexed: 12/25/2022] Open
Abstract
In the treatment of acute and chronic wounds, the clinical performance of a given foam-based dressing, and, ultimately, the wound healing and cost of care outcomes are strongly influenced by the mechanical performance of the foam material/s within that dressing. Most aspects of the mechanical performance of foam materials, for example, their stiffness, frictional properties, conformability, swelling characteristics and durability, and the overall mechanical protection provided by a foam-based dressing to a wound strongly depend on the microstructure of the foam components, particularly on their microtopography, density and porosity. This article, therefore, provides, for the first time, a comprehensive, self-inclusive compilation of clinically relevant theoretical and practical considerations, based on published analytical and experimental research as well as clinical experience related to the mechanical performance of foams in foam-based wound dressings. The current bioengineering information is useful for establishing understanding of the importance of mechanical properties of foams in foam-based dressings among clinicians and researchers in industry and academia, and other potential stakeholders in the wound care field, for example, regulators and buyers. This information is also particularly important for the development of standardised test methods for the evaluation of foam-based wound dressings and resulting standard mechanical performance metrics for these dressings.
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Affiliation(s)
- Amit Gefen
- Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel
| | - Paulo Alves
- Wounds Research Lab - Centre for Interdisciplinary Research in Health, Catholic University of Portugal, Porto, Portugal
| | - Dimitri Beeckman
- Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.,Swedish Centre for Skin and Wound Research, Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
| | | | - Hadar Lev-Tov
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Hospital Miller School of Medicine, Miami, Florida, USA
| | - Bijan Najafi
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Terry Swanson
- Wound Education Research Consultancy (WERC), Warrnambool, Victoria, Australia
| | - Kevin Woo
- School of Nursing, Queen's University, Kingston, Ontario, Canada
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10
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Longobardi Y, Galli J, Di Cesare T, D'Alatri L, Settimi S, Mele D, Bussu F, Parrilla C. Optimizing Pulmonary Outcomes After Total Laryngectomy: Crossover Study on New Heat and Moisture Exchangers. Otolaryngol Head Neck Surg 2022; 167:929-940. [PMID: 35316144 DOI: 10.1177/01945998221086200] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To evaluate the effects of new devices-heat and moisture exchangers (HMEs) and adhesives-on pulmonary symptoms, subject adherence, quality of life, dermatologic symptoms, and patient satisfaction after laryngectomy. STUDY DESIGN Prospective crossover study. SETTING Between December 2020 and April 2021, 40 patients were enrolled who had undergone laryngectomy, routinely used HMEs and adhesive, and were followed in our Department of Otolaryngology-Head and Neck Surgery. METHODS Patients were allocated into group A (new products) or group B (usual care) for 6 weeks. Then the 2 groups reversed, and each patient acted as his or her own control. Patients kept a diary and cough tally sheet. At baseline and after each 6-week period, 2 questionnaires were administered: EQ-5D (European Quality of Life-5 Dimensions) and CASA-Q (Cough and Sputum Assessment Questionnaire). RESULTS Six weeks of using new products resulted in the following effects for both groups: (1) a significant reduction in daily forced expectoration and dry coughs, (2) a significant improvement in all domains of the CASA-Q, (3) an increase in adherence to HME use, (4) a significant reduction in shortness of breath and skin irritation, and (5) significantly better scores in the anxiety/depression domain of the EQ-5D. CONCLUSION Achieving this reduction in patients who were already highly adherent to HME use is clinically relevant and underscores the importance of using better-performing HMEs that can compensate for the humidification deficit. Improving pulmonary symptomatology could reduce patient restrictions in daily life and avoidance of social activity, with a consequent positive effect on quality of life.
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Affiliation(s)
- Ylenia Longobardi
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Clinica di Otorinolaringoiatria, Roma-Università Cattolica del Sacro Cuore, Milan, Italy
| | - Jacopo Galli
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Clinica di Otorinolaringoiatria, Roma-Università Cattolica del Sacro Cuore, Milan, Italy
| | - Tiziana Di Cesare
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Clinica di Otorinolaringoiatria, Roma-Università Cattolica del Sacro Cuore, Milan, Italy
| | - Lucia D'Alatri
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Clinica di Otorinolaringoiatria, Roma-Università Cattolica del Sacro Cuore, Milan, Italy
| | - Stefano Settimi
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Clinica di Otorinolaringoiatria, Roma-Università Cattolica del Sacro Cuore, Milan, Italy
| | - Dario Mele
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Clinica di Otorinolaringoiatria, Roma-Università Cattolica del Sacro Cuore, Milan, Italy
| | - Francesco Bussu
- Otolaryngology Division, Azienda Ospedaliero Universitaria Sassari, Rome, Italy
| | - Claudio Parrilla
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Clinica di Otorinolaringoiatria, Roma-Università Cattolica del Sacro Cuore, Milan, Italy
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11
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Punjataewakupt A, Aramwit P. Wound dressing adherence: a review. J Wound Care 2022; 31:406-423. [PMID: 35579308 DOI: 10.12968/jowc.2022.31.5.406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Wound dressing adherence is an important problem that is frequently encountered in wound care, and is associated with both clinical and economic burdens. However, only a few review articles have focused on this issue. The objective of this review was to present a comprehensive discussion of wound dressing adherence, including the mechanism of dressing adherence, adverse consequences (clinical burdens and economic burdens), factors affecting adherence (dressing-, patient- and wound-related factors, and factors related to the wound care procedure), tests to assess dressing adherence (in vitro assay, in vivo assay and clinical trials), and reduction of wound adherence (modification of dressing adherence and special care in particular patients). Accordingly, this review article emphasises an awareness of dressing adherence, and is intended to be an informative source for the development of new dressings and for wound management.
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Affiliation(s)
- Apirujee Punjataewakupt
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences and Center of Excellence in Bioactive Resources for Innovative Clinical Applications, Chulalongkorn University, Bangkok, Thailand
| | - Pornanong Aramwit
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences and Center of Excellence in Bioactive Resources for Innovative Clinical Applications, Chulalongkorn University, Bangkok, Thailand.,The Academy of Science, The Royal Society of Thailand, Dusit, Bangkok, Thailand
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12
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Shetty R, Chitnis A, Puppala P, Mistry G, Shetty O. Comparative evaluation of the efficacy of two medical grade adhesives for the retention of extraoral maxillofacial prosthesis. ADVANCES IN HUMAN BIOLOGY 2022. [DOI: 10.4103/2321-8568.334589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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13
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Shiraishi T, Ogawa H, Katayama C, Osone K, Okada T, Katoh R, Sano A, Sakai M, Sohda M, Shirabe K, Saeki H. The presurgical controlling nutritional status (CONUT) score is independently associated with severe peristomal skin disorders: a single-center retrospective cohort study. Sci Rep 2021; 11:18857. [PMID: 34552173 PMCID: PMC8458467 DOI: 10.1038/s41598-021-98369-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 09/06/2021] [Indexed: 11/22/2022] Open
Abstract
While nutritional interventions may potentially lower the risk of peristomal skin disorders (PSDs) and their exacerbation, no previous studies have evaluated the relationship between PSDs and nutritional status using the Controlling Nutritional Status (CONUT) score. The purpose of this study was to assess the impact of preoperative nutritional status on stoma health, and determine risk factors for postoperative PSDs, including severe PSDs. A retrospective analysis was performed of 116 consecutive patients with rectal cancer who underwent radical surgery with ileostomy or colostomy creation. PSDs were diagnosed in 32 patients (27.6%); including 10 cases (8.7%) that were defined as severe based on the ABCD-stoma score. Multivariable logistic regression showed that smoking (odds ratio [OR] 3.451, 95% confidence interval [CI] 1.240–9.607, p = 0.018) and ileostomy (OR 3.287, 95% CI 1.278–8.458, p = 0.014) were independent risk factors for PSDs. A separate multivariable logistic regression analysis of risk factors for severe PSDs, found that the only independent risk factor was the CONUT score (OR 10.040, 95% CI 1.191–84.651, p = 0.034). Severe PSDs are associated with preoperative nutritional disorders, as determined by the CONUT score. Furthermore, nutritional disorders may increase the severity of PSDs, regardless of the stoma type.
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Affiliation(s)
- Takuya Shiraishi
- Division of Gastroenterological Surgery, Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Hiroomi Ogawa
- Division of Gastroenterological Surgery, Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Chika Katayama
- Division of Gastroenterological Surgery, Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Katsuya Osone
- Division of Gastroenterological Surgery, Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Takuhisa Okada
- Division of Gastroenterological Surgery, Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Ryuji Katoh
- Division of Gastroenterological Surgery, Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Akihiko Sano
- Division of Gastroenterological Surgery, Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Makoto Sakai
- Division of Gastroenterological Surgery, Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Makoto Sohda
- Division of Gastroenterological Surgery, Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
| | - Ken Shirabe
- Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Hiroshi Saeki
- Division of Gastroenterological Surgery, Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan
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14
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Ogai K, Shibata K, Takahashi N, Ogura K, Okamoto S, Sugama J. Amplicon-based skin microbiome profiles collected by tape stripping with different adhesive film dressings: a comparative study. BMC Microbiol 2021; 21:54. [PMID: 33602131 PMCID: PMC7891171 DOI: 10.1186/s12866-021-02122-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 02/09/2021] [Indexed: 12/12/2022] Open
Abstract
Background Medical film dressings have been used to obtain skin microbiota for skin microbiome studies, although their adhesive force may be so strong that the skin could be injured when applied to those who have fragile skin, such as older people. Several products with less adhesive force are available, although their applicability for skin microbiome studies remains unknown. This study aimed to test whether the dressings with less adhesive force could be used for amplicon-based skin microbiome studies. A set of three different film dressings, with acrylic, urethane, or silicone adhesive, was applied to the back skin of nine healthy young participants. The copy number of the 16S ribosomal RNA (rRNA) gene, microbial compositions, and alpha and beta diversity indices were analyzed by amplicon analysis of the 16S rRNA gene using next-generation sequencing and were compared among the three film dressings. Results The dressing with acrylic adhesive yielded the highest copy number of 16S rRNA genes, followed by that with urethane adhesive. The silicone-adhesive dressing yielded a significantly lower copy number of the 16S rRNA gene. The microbial composition of skin microbiota was similar among the three film dressings, although significant differences in the relative abundance of Pseudomonas species and alpha diversity indices were found in the silicone-adhesive dressing. The Bray–Curtis dissimilarity was significantly higher between the acrylic- and silicone-adhesive dressings than between the acrylic- and urethane-adhesive dressings. No adverse effects related to tape stripping were observed for any of the film dressings. Conclusion We recommend dressings with acrylic or urethane adhesive for amplicon-based skin microbiome studies. An acrylic adhesive has an advantage in the yield of skin microbiota, and a urethane adhesive should be chosen when applied to fragile skin. The adhesive force of the dressing with silicone adhesive was too weak to be used for collecting skin microbiota. Supplementary Information The online version contains supplementary material available at 10.1186/s12866-021-02122-4.
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Affiliation(s)
- Kazuhiro Ogai
- AI Hospital/Macro Signal Dynamics Research and Development Center, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 9200942, Japan. .,Department of Nursing, Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 9200942, Japan.
| | - Kana Shibata
- Department of Clinical Laboratory Science, Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 9200942, Japan
| | - Natsuki Takahashi
- Department of Clinical Laboratory Science, Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 9200942, Japan
| | - Kohei Ogura
- Advanced Health Care Science Research Unit, Institute for Frontier Science Initiative, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 9200942, Japan
| | - Shigefumi Okamoto
- Department of Clinical Laboratory Science, Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 9200942, Japan
| | - Junko Sugama
- Department of Nursing, Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 9200942, Japan. .,Advanced Health Care Science Research Unit, Institute for Frontier Science Initiative, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 9200942, Japan.
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15
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Ye S, Feng S, Huang L, Bian S. Recent Progress in Wearable Biosensors: From Healthcare Monitoring to Sports Analytics. BIOSENSORS 2020; 10:E205. [PMID: 33333888 PMCID: PMC7765261 DOI: 10.3390/bios10120205] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/11/2020] [Accepted: 12/13/2020] [Indexed: 02/07/2023]
Abstract
Recent advances in lab-on-a-chip technology establish solid foundations for wearable biosensors. These newly emerging wearable biosensors are capable of non-invasive, continuous monitoring by miniaturization of electronics and integration with microfluidics. The advent of flexible electronics, biochemical sensors, soft microfluidics, and pain-free microneedles have created new generations of wearable biosensors that explore brand-new avenues to interface with the human epidermis for monitoring physiological status. However, these devices are relatively underexplored for sports monitoring and analytics, which may be largely facilitated by the recent emergence of wearable biosensors characterized by real-time, non-invasive, and non-irritating sensing capacities. Here, we present a systematic review of wearable biosensing technologies with a focus on materials and fabrication strategies, sampling modalities, sensing modalities, as well as key analytes and wearable biosensing platforms for healthcare and sports monitoring with an emphasis on sweat and interstitial fluid biosensing. This review concludes with a summary of unresolved challenges and opportunities for future researchers interested in these technologies. With an in-depth understanding of the state-of-the-art wearable biosensing technologies, wearable biosensors for sports analytics would have a significant impact on the rapidly growing field-microfluidics for biosensing.
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Affiliation(s)
- Shun Ye
- Microfluidics Research & Innovation Laboratory, School of Sport Science, Beijing Sport University, Beijing 100084, China;
- Biomedical Engineering Department, College of Engineering, Pennsylvania State University, University Park, PA 16802, USA
- State Key Laboratory of Microbial Resources, Institute of Microbiology, Chinese Academy of Sciences, Beijing 100101, China
| | - Shilun Feng
- State Key Laboratory of Transducer Technology, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai 200050, China;
- School of Electrical and Electronic Engineering, Nanyang Technological University, Singapore 639798, Singapore
| | - Liang Huang
- School of Instrument Science and Opto–Electronics Engineering, Hefei University of Technology, Hefei 230009, China;
| | - Shengtai Bian
- Microfluidics Research & Innovation Laboratory, School of Sport Science, Beijing Sport University, Beijing 100084, China;
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16
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Barton A. Medical adhesive-related skin injuries associated with vascular access: minimising risk with Appeel Sterile. ACTA ACUST UNITED AC 2020; 29:S20-S27. [DOI: 10.12968/bjon.2020.29.8.s20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Vascular access device insertion is a common procedure in healthcare, and complications associated with vascular access can be serious and cause considerable patient harm. The use of care bundles to reduce the risks of these complications is well documented. However, the removal of devices, especially those associated with medical adhesive, can cause significant skin injuries, which often could be avoided if this aspect is included in the care bundle and the risk factors are better understood in healthcare. Appeel Sterile is an effective sterile silicone-based medical adhesive remover that is available in a variety of formats. It is the only sterile medical adhesive remover available, which makes it the safest choice for use with vascular access devices.
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Affiliation(s)
- Andrew Barton
- Advanced Nurse Practitioner IV Therapy and Vascular Access, IVAS Lead Nurse, Frimley Health NHS Foundation Trust; Chair, National Infusion and Vascular Access Society (NIVAS)
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17
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Collier M. Minimising pain and medical adhesive related skin injuries in vulnerable patients. ACTA ACUST UNITED AC 2019; 28:S26-S32. [DOI: 10.12968/bjon.2019.28.15.s26] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The skin is the largest and one of the most important organs of the body and as such it is essential that skin integrity is maintained to preserve normal body functions as much as possible at all times. Health professionals must endeavour to minimise any pain and trauma likely to be encountered by their patients through the use of a variety of medical products and devices that are designed to adhere to the skin, especially as the use of dermatological and wound-management products in particular, that incorporate adhesives to help keep them secure and in place, has grown in line with the increasingly ageing population and changing demographics throughout the UK. This article reviews the literature related to the causes of medical-adhesive-related skin injuries (MARSIs) and the reported patient effects, in particular pain and skin trauma and highlight some ‘at-risk’ patient groups and potential actions to minimise risk. A sterile silicone medical adhesive remover—Appeel Sterile—is introduced and the clinical benefits highlighted through the discussion of clinical evidence and case studies undertaken on a range of patients with varied aetiologies.
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Affiliation(s)
- Mark Collier
- Nurse Consultant and Associate Lecturer – Tissue Viability, Lincolnshire
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18
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Kusari A, Han AM, Virgen CA, Matiz C, Rasmussen M, Friedlander SF, Eichenfield DZ. Evidence-based skin care in preterm infants. Pediatr Dermatol 2019; 36:16-23. [PMID: 30548578 DOI: 10.1111/pde.13725] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Revised: 09/07/2018] [Accepted: 10/02/2018] [Indexed: 12/11/2022]
Abstract
Most guidelines on neonatal skin care emphasize issues pertaining to healthy, term infants. Few address the complex task of skin barrier maintenance in preterm, very preterm, and extremely preterm infants. Here, we provide an evidence-based review of the literature on skin care of preterm neonates. Interestingly, the stratum corneum does not fully develop until late in the third trimester, and as such, the barrier function of preterm skin is significantly compromised. Numerous interventions are available to augment the weak skin barrier of neonates. Plastic wraps reduce the incidence of hypothermia while semipermeable and transparent adhesive dressings improve skin quality and decrease the incidence of electrolyte abnormalities. Tub bathing causes less body temperature variability than sponge bathing and can be performed as infrequently as once every four days without increasing bacterial colonization of the skin. Topical emollients, particularly sunflower seed oil, appear to reduce the incidence of skin infections in premature neonates-but only in developing countries. In developed countries, studies indicate that topical petrolatum ointment increases the risk of candidemia and coagulase-negative Staphylococcus infection in the preterm population, perhaps by creating a milieu similar to occlusive dressings. For preterm infants with catheters, povidone-iodine and chlorhexidine are comparably effective at preventing catheter colonization. Further studies are necessary to examine the safety and efficacy of various skin care interventions in premature infants with an emphasis placed on subclassifying the patient population. In the interim, it may be beneficial to develop guidelines based on the current body of evidence.
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Affiliation(s)
- Ayan Kusari
- Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital, San Diego, California
- Departments of Dermatology and Pediatrics, University of California, San Diego School of Medicine, San Diego, California
| | - Allison M Han
- Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital, San Diego, California
- Departments of Dermatology and Pediatrics, University of California, San Diego School of Medicine, San Diego, California
| | - Cesar A Virgen
- Department of Dermatology, University of California, Irvine School of Medicine, San Diego, California
| | - Catalina Matiz
- Department of Dermatology, Southern California Permanente Medical Group, San Diego, California
| | | | - Sheila F Friedlander
- Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital, San Diego, California
- Departments of Dermatology and Pediatrics, University of California, San Diego School of Medicine, San Diego, California
| | - Dawn Z Eichenfield
- Department of Dermatology, University of California, San Diego School of Medicine, San Diego, California
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19
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Kim JH, Kim SR, Kil HJ, Kim YC, Park JW. Highly Conformable, Transparent Electrodes for Epidermal Electronics. NANO LETTERS 2018; 18:4531-4540. [PMID: 29923729 DOI: 10.1021/acs.nanolett.8b01743] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
We present a highly conformable, stretchable, and transparent electrode for application in epidermal electronics based on polydimethylsiloxane (PDMS) and Ag nanowire (AgNW) networks. With the addition of a small amount of a commercially available nonionic surfactant, Triton X, PDMS became highly adhesive and mechanically compliant, key factors for the development of conformable and stretchable substrates. The polar functional groups present in Triton X interacted with the Pt catalyst present in the PDMS curing agent, thereby hindering the cross-linking reaction of PDMS and modulating the mechanical properties of the polymer. Due to the strong interactions that occur between the polar functional groups of Triton X and AgNWs, AgNWs were effectively embedded in the adhesive PDMS (a-PDMS) matrix, and the highly enhanced conformability, mechanical stretchability, and transparency of the a-PDMS matrix were maintained in the resulting AgNW-embedded a-PDMS matrix. Finally, wearable strain and electrocardiogram (ECG) sensors were fabricated from the AgNW-embedded a-PDMS. The a-PDMS-based strain and ECG sensors exhibited significantly improved sensing performances compared with those of the bare PDMS-based sensors because of the better stretchability and conformability to the skin of the former sensors.
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Affiliation(s)
- Jin-Hoon Kim
- Department of Materials Science and Engineering , Yonsei University , Seoul 03722 , Korea
| | - Seung-Rok Kim
- Department of Materials Science and Engineering , Yonsei University , Seoul 03722 , Korea
| | - Hye-Jun Kil
- Biomedical Research Institute, Korea Institute of Science and Technology , Seoul 02792 , Korea
| | - Yu-Chan Kim
- Biomedical Research Institute, Korea Institute of Science and Technology , Seoul 02792 , Korea
| | - Jin-Woo Park
- Department of Materials Science and Engineering , Yonsei University , Seoul 03722 , Korea
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20
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Hur H, Park H. Newborn Pain and Skin Reaction according to the Method of Removing the Eyepatch Used for Phototherapy. CHILD HEALTH NURSING RESEARCH 2018. [DOI: 10.4094/chnr.2018.24.1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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21
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David F, Wurtz JL, Breton N, Bisch O, Gazeu P, Kerihuel JC, Guibon O. A randomised, controlled, non-inferiority trial comparing the performance of a soft silicone-coated wound contact layer (Mepitel One) with a lipidocolloid wound contact layer (UrgoTul) in the treatment of acute wounds. Int Wound J 2017; 15:159-169. [PMID: 29205809 DOI: 10.1111/iwj.12853] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 10/06/2017] [Accepted: 10/11/2017] [Indexed: 11/28/2022] Open
Abstract
Wound contact layer (WCL) dressings are intended to protect tissue during the healing process. A randomised controlled trial was undertaken to compare 2 such dressings. Outpatients with acute wounds were randomly allocated to treatment with either a soft silicone-coated WCL (intervention group, n = 59) or a lipidocolloid-impregnated WCL (control group, n = 62). At the first dressing removal (day 3), 89.8% of patients in the intervention group experienced non-painful dressing removal (defined as a pain rating <30 mm on a 100 mm visual analogue scale), compared with 73.6% of patients in the control group (P = .017) (per protocol population). At day 21, wounds were considered as healed in 66.1% of patients in the intervention group compared with 43.5% in the control group (P = .012) (intention-to-treat population). Both dressings were well tolerated and rated highly in terms of in-use characteristics, although the soft silicone-coated WCL was rated significantly higher than the lipidocolloid-impregnated WCL in terms of its ability to remain in place (P= .016). The results indicate that the soft silicone-coated WCL is suitable for the management of acute wounds as it can minimise dressing-associated pain and support healing.
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Affiliation(s)
| | | | | | | | | | | | - Odile Guibon
- Medical Affairs Department, Mölnlycke Health Care, Wasquehal, France
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22
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Liu L, Kuffel K, Scott DK, Constantinescu G, Chung HJ, Rieger J. Silicone-based adhesives for long-term skin application: cleaning protocols and their effect on peel strength. Biomed Phys Eng Express 2017. [DOI: 10.1088/2057-1976/aa91fb] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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23
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Lee BK, Ryu JH, Baek IB, Kim Y, Jang WI, Kim SH, Yoon YS, Kim SH, Hong SG, Byun S, Yu HY. Silicone-Based Adhesives with Highly Tunable Adhesion Force for Skin-Contact Applications. Adv Healthc Mater 2017; 6. [PMID: 28795496 DOI: 10.1002/adhm.201700621] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 06/30/2017] [Indexed: 11/10/2022]
Abstract
A fundamental approach to fabricating silicone-based adhesives with highly tunable adhesion force for the skin-contact applications is presented. Liquid blends consisting of vinyl-multifunctional polydimethylsiloxane (V-PDMS), hydride-terminated PDMS (H-PDMS), and a tackifier composed of a silanol-terminated PDMS/MQ resin mixture and the MQ resin are used as the adhesive materials. The peel adhesion force of addition-cured adhesives on the skin is increased by increasing the H-PDMS molecular weights and the tackifier content, and decreasing the H-PDMS/V-PDMS ratio. There is an inverse relationship between the adhesion force and the Young's modulus. The low-modulus adhesives with a low H-PDMS/V-PDMS ratio exhibit enhanced adhesion properties. The low-modulus adhesives with the high MQ resin content show significantly enhanced adhesion properties. These adhesives exhibit a wide range of modulus (2-499 kPa), and their adhesion force (0.04-5.38 N) is superior to commercially available soft silicone adhesives (0.82-2.79 N). The strong adhesives (>≈2 N) provide sufficient adhesion for fixing the flexible electrocardiogram (ECG) device to the skin in most daily activity. The human ECG signals are successfully recorded in real time. These results suggest that the silicone-based adhesives should be useful as an atraumatic adhesive for the skin-contact applications.
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Affiliation(s)
- Bong Kuk Lee
- Electronics & Telecommunications Research Institute; 218 Gajeong-ro Yuseong-gu Daejeon 34129 South Korea
| | - Jin Hwa Ryu
- Electronics & Telecommunications Research Institute; 218 Gajeong-ro Yuseong-gu Daejeon 34129 South Korea
| | - In-Bok Baek
- Electronics & Telecommunications Research Institute; 218 Gajeong-ro Yuseong-gu Daejeon 34129 South Korea
| | - Yarkyeon Kim
- Electronics & Telecommunications Research Institute; 218 Gajeong-ro Yuseong-gu Daejeon 34129 South Korea
| | - Won Ick Jang
- Electronics & Telecommunications Research Institute; 218 Gajeong-ro Yuseong-gu Daejeon 34129 South Korea
| | - Sang-Hyeob Kim
- Electronics & Telecommunications Research Institute; 218 Gajeong-ro Yuseong-gu Daejeon 34129 South Korea
| | - Yong Sun Yoon
- Electronics & Telecommunications Research Institute; 218 Gajeong-ro Yuseong-gu Daejeon 34129 South Korea
| | - Seung Hwan Kim
- Electronics & Telecommunications Research Institute; 218 Gajeong-ro Yuseong-gu Daejeon 34129 South Korea
| | - Seong-Gu Hong
- Korea Research Institute of Standards and Science (KRISS); 267 Gajeong-ro Yuseong-gu Daejeon 34113 South Korea
| | - Sangwon Byun
- Department of Electronics Engineering; Incheon National University; Incheon 22012 South Korea
| | - Han Young Yu
- Electronics & Telecommunications Research Institute; 218 Gajeong-ro Yuseong-gu Daejeon 34129 South Korea
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24
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Almutairi D, LeBlanc K, Alavi A. Peristomal skin complications: what dermatologists need to know. Int J Dermatol 2017; 57:257-264. [DOI: 10.1111/ijd.13710] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Revised: 06/18/2017] [Accepted: 06/23/2017] [Indexed: 12/13/2022]
Affiliation(s)
- Dalal Almutairi
- Division of Dermatology; Department of Medicine; University of Toronto; Toronto ON Canada
- Women's College Hospital; Toronto ON Canada
| | - Kimberly LeBlanc
- School of Nursing; Faculty of Health Sciences; Queen's University; Kingston ON Canada
- KDS Professional Consulting; Kingston ON Canada
| | - Afsaneh Alavi
- Division of Dermatology; Department of Medicine; University of Toronto; Toronto ON Canada
- Women's College Hospital; Toronto ON Canada
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25
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Abstract
The abstract book contains the abstracts of keynote lectures, focus sessions, symposia, workshops, AIUC annual meeting, AISLEC annual meeting, EPUAP annual meeting, ETRS special session, sponsor symposia, oral presentations, poster presentations and the subject index.
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26
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Wilhelm KP, Wilhelm D, Bielfeldt S. Models of wound healing: an emphasis on clinical studies. Skin Res Technol 2016; 23:3-12. [PMID: 27503009 DOI: 10.1111/srt.12317] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND The healing of wounds has always provided challenges for the medical community whether chronic or acute. Understanding the processes which enable wounds to heal is primarily carried out by the use of models, in vitro, animal and human. It is generally accepted that the use of human models offers the best opportunity to understand the factors that influence wound healing as well as to evaluate efficacy of treatments applied to wounds. OBJECTIVES The objective of this article is to provide an overview of the different methodologies that are currently used to experimentally induce wounds of various depths in human volunteers and examines the information that may be gained from them. METHODS There is a number of human volunteer healing models available varying in their invasiveness to reflect the different possible depth levels of wounds. RESULTS Currently available wound healing models include sequential tape stripping, suction blister, abrasion, laser, dermatome, and biopsy techniques. The various techniques can be utilized to induce wounds of variable depth, from removing solely the stratum corneum barrier, the epidermis to even split-thickness or full thickness wounds. CONCLUSION Depending on the study objective, a number of models exist to study wound healing in humans. These models provide efficient and reliable results to evaluate treatment modalities.
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Affiliation(s)
- K-P Wilhelm
- proDERM Institute for Applied Dermatological Research, Schenefeld/Hamburg, Germany.,Lübeck University, Lübeck, Germany
| | - D Wilhelm
- proDERM Institute for Applied Dermatological Research, Schenefeld/Hamburg, Germany
| | - S Bielfeldt
- proDERM Institute for Applied Dermatological Research, Schenefeld/Hamburg, Germany
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27
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Comparison of Medical Adhesive Tapes in Patients at Risk of Facial Skin Trauma under Anesthesia. Anesthesiol Res Pract 2016; 2016:4878246. [PMID: 27382368 PMCID: PMC4921133 DOI: 10.1155/2016/4878246] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Accepted: 05/17/2016] [Indexed: 11/18/2022] Open
Abstract
Introduction. Adhesive tapes are used for taping eyelids closed and securing endotracheal tubes during general anesthesia. These tapes can cause facial skin injury. We compared the incidence of facial skin injury and patient satisfaction with different tapes used. Methods. A total of 60 adult patients at risk of skin trauma were randomized to use 3M™ Kind Removal Silicone Tape or standard acrylate tapes: 3M Durapore (endotracheal tube) and Medipore (eyelids). Patients were blinded to tape used. Postoperatively, a blinded recovery nurse assessed erythema, edema, and denudation of skin. Anesthesiologist in charge also assessed skin injury. On postoperative day 1, patients rated satisfaction with the condition of their skin over the eyelids and face on a 5-point Likert scale. Results. More patients had denudation of skin with standard tapes, 4 (13.3%) versus 0 with silicone tape (p = 0.026) and in anesthesiologist-evaluated skin injury 11 (37%) with standard versus 1 (3%) with silicone (p = 0.002). No significant differences were found in erythema and edema. Patient satisfaction score was higher with silicone tape: over eyelids: mean 3.83 (standard) versus 4.53 (silicone), Mann-Whitney U test, p < 0.001; over face: mean 3.87 (standard) versus 4.57 (silicone) (p < 0.001). Conclusion. Silicone tape use had less skin injury and greater patient satisfaction than standard acrylate tapes.
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28
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Dhatariya K, Gooday C, Franke B, Pilling T, Flanagan A, Zeidan L. An open, non-comparative, multicentre evaluation of performance and safety using an antimicrobial exudate transfer dressing on diabetic foot ulcers: a case series. J Wound Care 2016; 25:256-65. [DOI: 10.12968/jowc.2016.25.5.256] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- K. Dhatariya
- Elsie Bertram Diabetes Centre, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich United Kingdom
| | - C. Gooday
- Elsie Bertram Diabetes Centre, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich United Kingdom
| | - B. Franke
- The Rotherham NHS Foundation Trust, Rotherham
| | - T. Pilling
- The Rotherham NHS Foundation Trust, Rotherham
| | - A. Flanagan
- The Rotherham NHS Foundation Trust, Rotherham
| | - L. Zeidan
- The Rotherham NHS Foundation Trust, Rotherham
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29
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Cinibulak Z, Aschoff A, Apedjinou A, Kaminsky J, Trost HA, Krauss JK. Current practice of external ventricular drainage: a survey among neurosurgical departments in Germany. Acta Neurochir (Wien) 2016; 158:847-53. [PMID: 26928728 DOI: 10.1007/s00701-016-2747-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 02/16/2016] [Indexed: 11/24/2022]
Abstract
BACKGROUND There are various recommendations, but no generally accepted guidelines, to reduce the risk of external ventricular drainage (EVD)-associated infections. The primary objective of the present study was to evaluate the current practice of EVD in a European country and to set the results in perspective to published data. METHOD A standardised questionnaire prepared by the Commission of Technical Standards and Norms of the German Society of Neurosurgery was sent to 127 neurosurgical units in Germany. RESULTS Data were analysed from 99 out of 127 neurosurgical units which had been contacted. Overall, more than 10,000 EVD procedures appear to be performed in Germany annually. There is disagreement about the location where the EVD is inserted, and most EVDs are still inserted in the operation theatre. Most units apply subcutaneous tunnelling. Impregnated EVD catheters are used regularly in only about 20 % of units. Single-shot antibiotic prophylaxis is given in more than half of the units, while continued antibiotic prophylaxis is installed in only 15/99 units at a regular basis. There are discrepancies in the management of prolonged EVD use with regard to replacement policies. Regular cerebrospinal fluid (CSF) sampling is still performed widely. There were no statistical differences in policies with regard to academic versus non-academic units. CONCLUSIONS This survey clearly shows that some newer recommendations drawn from published studies penetrate much slower into clinical routine, such as the use of impregnated catheters, for example. It remains unclear how different policies actually impact quality and outcome in daily routine.
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Affiliation(s)
- Zafer Cinibulak
- Department of Neurosurgery, Medical School Hannover, Carl-Neuberg Str. 1, 30625, Hannover, Germany.
- Commission of Technical Standards and Norms, German Society of Neurosurgery, Messe-Allee 1, 04356, Leipzig, Germany.
| | - Alfred Aschoff
- Commission of Technical Standards and Norms, German Society of Neurosurgery, Messe-Allee 1, 04356, Leipzig, Germany
- Department of Neurosurgery, University of Heidelberg, Heidelberg, Germany
| | - Anani Apedjinou
- Department of Neurosurgery, Medical School Hannover, Carl-Neuberg Str. 1, 30625, Hannover, Germany
| | - Jan Kaminsky
- Commission of Technical Standards and Norms, German Society of Neurosurgery, Messe-Allee 1, 04356, Leipzig, Germany
- Department of Neurosurgery, Sankt Gertrauden Hospital, Berlin, Germany
| | - Hans A Trost
- Commission of Technical Standards and Norms, German Society of Neurosurgery, Messe-Allee 1, 04356, Leipzig, Germany
- Department of Neurosurgery, Bayreuth Hospital, Bayreuth, Germany
| | - Joachim K Krauss
- Department of Neurosurgery, Medical School Hannover, Carl-Neuberg Str. 1, 30625, Hannover, Germany
- Commission of Technical Standards and Norms, German Society of Neurosurgery, Messe-Allee 1, 04356, Leipzig, Germany
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Kim JY, Kim NK, Lee YJ. A descriptive study of Korean nurses' perception of pain and skin tearing at dressing change. Int Wound J 2016; 13 Suppl 1:47-51. [PMID: 26847938 DOI: 10.1111/iwj.12539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 10/08/2015] [Accepted: 10/11/2015] [Indexed: 11/29/2022] Open
Abstract
This study aimed to investigate Korean nurses' level of awareness of pain and skin tearing in wound bed and/or peri-wound skin at dressing change. A descriptive study was performed. Convenience sampling was employed and registered nurses were recruited from attendees of continuing education program. A total of 399 participants (RN) completed questionnaire. Data was collected from September to November 2014. Many of them perceived skin tearing and wound related pain associated with dressing changing, but most of them did not assess and record pain and skin tearing at dressing change. More than half of respondents reported that they did not provide nursing intervention to prevent pain and skin tearing. Many of them reported that a systematic educational program for preventing pain and skin tearing at dressing change was needed. In conclusion, many of respondents were aware of pain and skin tearing at dressing change, but did not take any further necessary measures, including nursing intervention, for the most appropriate, systematic pain and skin tearing management. Therefore, this study suggested that a systematic and comprehensive educational program for Korean healthcare professions needs to be developed and implemented in Korea's hospital settings.
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Affiliation(s)
- Jung Yoon Kim
- WOCN, Department of Nursing, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | - Na Kyung Kim
- Ward Team leader, Department of Nursing, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | - Yun Jin Lee
- WOCN, Department of Nursing, Severance Hospital, Seoul, Republic of Korea
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Gavin NC, Webster J, Chan RJ, Rickard CM. Frequency of dressing changes for central venous access devices on catheter-related infections. Cochrane Database Syst Rev 2016; 2:CD009213. [PMID: 26827714 PMCID: PMC8765739 DOI: 10.1002/14651858.cd009213.pub2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND People admitted to intensive care units and those with chronic health care problems often require long-term vascular access. Central venous access devices (CVADs) are used for administering intravenous medications and blood sampling. CVADs are covered with a dressing and secured with an adhesive or adhesive tape to protect them from infection and reduce movement. Dressings are changed when they become soiled with blood or start to come away from the skin. Repeated removal and application of dressings can cause damage to the skin. The skin is an important barrier that protects the body against infection. Less frequent dressing changes may reduce skin damage, but it is unclear whether this practice affects the frequency of catheter-related infections. OBJECTIVES To assess the effect of the frequency of CVAD dressing changes on the incidence of catheter-related infections and other outcomes including pain and skin damage. SEARCH METHODS In June 2015 we searched: The Cochrane Wounds Specialised Register; The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE and EBSCO CINAHL. We also searched clinical trials registries for registered trials. There were no restrictions with respect to language, date of publication or study setting. SELECTION CRITERIA All randomised controlled trials (RCTs) evaluating the effect of the frequency of CVAD dressing changes on the incidence of catheter-related infections on all patients in any healthcare setting. DATA COLLECTION AND ANALYSIS We used standard Cochrane review methodology. Two review authors independently assessed studies for inclusion, performed risk of bias assessment and data extraction. We undertook meta-analysis where appropriate or otherwise synthesised data descriptively when heterogeneous. MAIN RESULTS We included five RCTs (2277 participants) that compared different frequencies of CVAD dressing changes. The studies were all conducted in Europe and published between 1995 and 2009. Participants were recruited from the intensive care and cancer care departments of one children's and four adult hospitals. The studies used a variety of transparent dressings and compared a longer interval between dressing changes (5 to15 days; intervention) with a shorter interval between changes (2 to 5 days; control). In each study participants were followed up until the CVAD was removed or until discharge from ICU or hospital. Confirmed catheter-related bloodstream infection (CRBSI)One trial randomised 995 people receiving central venous catheters to a longer or shorter interval between dressing changes and measured CRBSI. It is unclear whether there is a difference in the risk of CRBSI between people having long or short intervals between dressing changes (RR 1.42, 95% confidence interval (CI) 0.40 to 4.98) (low quality evidence). Suspected catheter-related bloodstream infection Two trials randomised a total of 151 participants to longer or shorter dressing intervals and measured suspected CRBSI. It is unclear whether there is a difference in the risk of suspected CRBSI between people having long or short intervals between dressing changes (RR 0.70, 95% CI 0.23 to 2.10) (low quality evidence). All cause mortalityThree trials randomised a total of 896 participants to longer or shorter dressing intervals and measured all cause mortality. It is unclear whether there is a difference in the risk of death from any cause between people having long or short intervals between dressing changes (RR 1.06, 95% CI 0.90 to 1.25) (low quality evidence). Catheter-site infectionTwo trials randomised a total of 371 participants to longer or shorter dressing intervals and measured catheter-site infection. It is unclear whether there is a difference in risk of catheter-site infection between people having long or short intervals between dressing changes (RR 1.07, 95% CI 0.71 to 1.63) (low quality evidence). Skin damage One small trial (112 children) and three trials (1475 adults) measured skin damage. There was very low quality evidence for the effect of long intervals between dressing changes on skin damage compared with short intervals (children: RR of scoring ≥ 2 on the skin damage scale 0.33, 95% CI 0.16 to 0.68; data for adults not pooled). PainTwo studies involving 193 participants measured pain. It is unclear if there is a difference between long and short interval dressing changes on pain during dressing removal (RR 0.80, 95% CI 0.46 to 1.38) (low quality evidence). AUTHORS' CONCLUSIONS The best available evidence is currently inconclusive regarding whether longer intervals between CVAD dressing changes are associated with more or less catheter-related infection, mortality or pain than shorter intervals.
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Affiliation(s)
- Nicole C Gavin
- Royal Brisbane and Women's HospitalCancer Care ServicesButterfield StreetHerstonQueenslandAustralia4029
- Griffith UniversityNHMRC Centre of Research Excellence in Nursing, Centre for Health Practice Innovation, Menzies Health Institute QueenslandBrisbaneQueenslandAustralia
| | - Joan Webster
- Griffith UniversityNHMRC Centre of Research Excellence in Nursing, Centre for Health Practice Innovation, Menzies Health Institute QueenslandBrisbaneQueenslandAustralia
- Royal Brisbane and Women's HospitalCentre for Clinical NursingLevel 2, Building 34Butterfield StreetBrisbaneQueenslandAustralia4029
- University of QueenslandSchool of Nursing and MidwiferyBrisbaneQueenslandAustralia
| | - Raymond J Chan
- Queensland University of TechnologyInstitute of Health and Biomedical InnovationBrisbaneQueenslandAustralia
| | - Claire M Rickard
- Griffith UniversityNHMRC Centre of Research Excellence in Nursing, Centre for Health Practice Innovation, Menzies Health Institute QueenslandBrisbaneQueenslandAustralia
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Scientific and Clinical Abstracts From the WOCN® Society's 47th Annual Conference. J Wound Ostomy Continence Nurs 2015; 42 Suppl 3S:S1-S74. [DOI: 10.1097/won.0000000000000148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Glat P, Zhang SH, Burkey B, Davis W. Clinical evaluation of a silver-impregnated foam dressing in paediatric partial-thickness burns. J Wound Care 2015; 24 Suppl 4a:S4-S10. [DOI: 10.12968/jowc.2015.24.sup4a.s4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- P.M. Glat
- Drexel University College of Medicine, St. Christopher's Hospital for Children, Philadelphia, PA
| | - S-H. Zhang
- Drexel University College of Medicine, St. Christopher's Hospital for Children, Philadelphia, PA
| | - B.A. Burkey
- Drexel University College of Medicine, St. Christopher's Hospital for Children, Philadelphia, PA
| | - W.J. Davis
- Drexel University College of Medicine, St. Christopher's Hospital for Children, Philadelphia, PA
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Keeling N. Patient perspectives of silicone technology in stoma care. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2015; 24:S20, S22-4. [PMID: 25757738 DOI: 10.12968/bjon.2015.24.sup5.s20] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Kohta M, Iwasaki T. The effect of concentration of tackifying agent on adhesive and skin-protective properties of ceramide 2-containing hydrocolloid dressings. J Wound Care 2014; 24:41-8. [PMID: 25543822 DOI: 10.12968/jowc.2015.24.1.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE In the treatment of pressure ulcers and leg ulcers it is necessary to achieve an effective balance between adhesive and skin-protective properties. We speculated that addition of a tackifying agent (TA) to ceramide 2-containing hydrocolloid dressings would increase their adhesiveness under dry conditions and reduce their adhesiveness under wet conditions because dry tack converts to wet tack after water absorption. METHOD We prepared ceramide 2-containing hydrocolloid dressings with varying amounts of TA. Basic characteristics of the test ceraminde dressings, such as initial tack force and peeling force, were evaluated using standard methods. Peeling force and stratum corneum (SC) removal on healthy human skin were also evaluated at 20 minutes, 7 hours, and 72 hours. In addition, the effect of 10 repeated applications on transepidermal water loss (TEWL) was investigated on the skin of hairless mice under dry and wet conditions. Statistical analyses were performed using one-way analysis of variance followed by Dunnett's multiple comparison test. A p-value of <0.05 was considered statistically significant. RESULTS On a stainless steel substrate, initial tack force and 180° peeling force increased as TA content increased. Twenty minutes after application on human skin, peeling force and SC removal increased with increasing TA content. When TA contents were over 10%, significant differences in peeling force and SC removal were obtained compared with ceramide 2-containing hydrocolloid dressings without TA (p<0.05). However, a TA content-dependent increase in peeling force was not evident 7 hours and 72 hours after application. Under dry conditions, TEWL increased with repeated application and peeling. Conversely, no significant increases in TEWL were evident under wet conditions after 10 repeated applications and peelings. CONCLUSION Our data demonstrate that the initial attachment of ceramide 2-containing hydrocolloid dressings to the skin increases with addition of TA. Skin damage can be avoided by conversion of the adhesive system to wet tack with water absorption. DECLARATION OF INTEREST Masushi Kohta and Tetsuji IwasakI are employees of ALCARE Co., Ltd., Japan. This project was supported by an unrestricted grant from ALCARE.
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Affiliation(s)
- M Kohta
- Research fellow, at Medical Engineering Laboratory, ALCARE Co., Ltd., 1-21-10 Kyoshima, Sumida-ku, Tokyo 131-0046, Japan
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Derbyshire A. Using a silicone-based dressing as a primary wound contact layer. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2014; 23 Suppl 20:S14-S20. [PMID: 25382127 DOI: 10.12968/bjon.2014.23.sup20.s14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The use of silicone-based dressings as a primary contact layer for wound care can prevent epithelial stripping, pain and sensitivity and have been widely available for nearly 20 years. Cuticell Contact from BSN medical is the latest silicone-based dressing to add to the armoury of the wound care clinician. Using documented case studies the author explores the reasoning behind why clinicians should consider re-examining the use of silicone dressings.
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Affiliation(s)
- Adam Derbyshire
- Senior ANP, Albany House Medical Centre, Wellingborough, Northamptonshire
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Meuleneire F. A vapour-permeable film dressing used on superficial wounds. ACTA ACUST UNITED AC 2014; 23:S36, S38-43. [DOI: 10.12968/bjon.2014.23.sup15.s36] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Frans Meuleneire
- Wound Care Specialist, Wound Care and Diabetic Foot Centre, Zottegem, Belgium
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Stephen-Haynes J. The outcomes of barrier protection in periwound skin and stoma care. ACTA ACUST UNITED AC 2014; 23:S26, S28-30. [DOI: 10.12968/bjon.2014.23.sup5.s26] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Jackie Stephen-Haynes
- Professor and Consultant Nurse, Practice Development Unit, Birmingham City University and Tissue Viability, Worcestershire Health and Care Trust
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Abstract
This review and case study report considers the evidence to indicate that the progress of wound healing is negatively affected by the presence of stressors and in circumstances where patients are in pain. It considers the relationship between perceptions of pain, stress and delayed wound healing with a specific focus on guidance for clinical practice. It is appreciated that although the literature has examined these issues in the management of acute wounds, demonstrating that psychological stress can have detrimental effects on the wound-healing process, the evidence to support this link in relation to chronic wounds is limited. The review considers evidence indicating that punch biopsy wounds heal more slowly in subjects under stress on account of caring for family members with long-term illnesses and also considers briefly the relationship between cortisol secretion in response to stress and the consequent influences on cytokine levels and the wound-healing process.
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Affiliation(s)
- Kyoichi Matsuzaki
- Department of Plastic and Reconstructive Surgery, Kawasaki Municipal Tama Hospital, Kawasaki
| | - Dominic Upton
- Department of Plastic and Reconstructive Surgery, Kawasaki Municipal Tama Hospital, Kawasaki, JapanDepartment of Plastic and Reconstructive Surgery, St. Marianna University School of Medicine, Kawasaki, JapanInstitute of Health and Society, University of Worcester, Worcester, UK
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Barrett S. Mepitel One: a wound contact layer with Safetac technology. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2013; 21:1271-2, 1274-7. [PMID: 23469510 DOI: 10.12968/bjon.2012.21.21.1271] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This article examines the use of Mepitel One, a wound contact layer that promotes wound healing by using the clinical benefits of Safetac technology. A wide range of clinical evidence shows that dressings with Safetac prevent trauma, minimise wound pain and associated psychological stress, while facilitating undisturbed wound healing. Mepitel One has been developed as a highly transparent wound contact layer with Safetac on the wound contact surface alone; this makes it easy to apply without sticking to gloves, and allows it to be used with a choice of secondary dressings. The dressing can stay in place for up to 14 days and allows examination of the wound without removal. The clinical evidence reviewed here shows that Mepitel One is a versatile option for use on a wide range of wound types to promote undisturbed healing and minimise pain at dressing changes.
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An Open, Prospective, Randomized Pilot Investigation Evaluating Pain With the Use of a Soft Silicone Wound Contact Layer Vs Bridal Veil and Staples on Split Thickness Skin Grafts as a Primary Dressing. J Burn Care Res 2013; 34:674-81. [DOI: 10.1097/bcr.0b013e3182853cd6] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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A Randomized and Controlled Comparison of Gentleness of 2 Medical Adhesive Tapes in Healthy Human Subjects. J Wound Ostomy Continence Nurs 2013. [DOI: 10.1097/won.0b013e318276f2a4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Rippon M, Butcher M. Dressings with Safetac®: addressing the clinical and economic challenges of burns. J Wound Care 2012. [DOI: 10.12968/jowc.2012.21.sup9.s8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Mark Rippon
- Medical Marketing Manager, Molnlycke Health Care, Gothenburg, Sweden
| | - Martyn Butcher
- Independent Tissue Viability and Wound Care Consultant, Devon, UK
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Matsumura H, Imai R, Ahmatjan N, Ida Y, Gondo M, Shibata D, Wanatabe K. Removal of adhesive wound dressing and its effects on the stratum corneum of the skin: comparison of eight different adhesive wound dressings. Int Wound J 2012; 11:50-4. [PMID: 22883604 DOI: 10.1111/j.1742-481x.2012.01061.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
In recent years, adhesive wound dressings have been increasingly applied postoperatively because of their ease of use as they can be kept in place without having to cut and apply surgical tapes and they can cover a wound securely. However, if a wound dressing strongly adheres to the wound, a large amount of stratum corneum is removed from the newly formed epithelium or healthy periwound skin. Various types of adhesives are used on adhesive wound dressings and the extent of skin damage depends on how much an adhesive sticks to the wound or skin surface. We quantitatively determined and compared the amount of stratum corneum removed by eight different wound dressings including polyurethane foam using acrylic adhesive, silicone-based adhesive dressing, composite hydrocolloid and self-adhesive polyurethane foam in healthy volunteers. The results showed that wound dressings with silicone adhesive and self-adhesive polyurethane foam removed less stratum corneum, whereas composite hydrocolloid and polyurethane foam using acrylic adhesive removed more stratum corneum.
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Affiliation(s)
- Hajime Matsumura
- Department of Plastic and Reconstructive Surgery, Tokyo Medical University, Tokyo, Japan
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Matsumura H, Ahmatjan N, Ida Y, Imai R, Wanatabe K. A model for quantitative evaluation of skin damage at adhesive wound dressing removal. Int Wound J 2012; 10:291-4. [PMID: 22533468 DOI: 10.1111/j.1742-481x.2012.00975.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The removal of adhesive wound dressings from the wound surface involves a risk of damaging the intact stratum corneum and regenerating epithelium. Pain associated with the removal of wound dressings is a major issue for patients and medical personnel. Recently, wound dressings coated with a silicone adhesive have been developed to reduce such skin damage and pain on removal and they have received good evaluation in various clinical settings. However, there is neither a standard method to quantify whether or not the integrity of the stratum corneum and regenerating epithelium is retained or if both structures are damaged by the removal of wound dressings, nor are there standardised values with which to assess skin damage. We applied six different types of adhesive wound dressing on plain copy paper printed with black ink by a laser printer, removed the dressings, examined the adhesive-coated surface of the wound dressings using a high-power videoscope, and examined the stripped areas. Wound dressings coated with a silicone adhesive showed significantly less detachment of the stratum corneum and regenerating epithelium, followed by those coated with polyurethane, hydrocolloid, and acrylic adhesives. The assessment method utilised in this study revealed distinct differences between wound dressing types, but less variation in the evaluation outcome of each type. This assessment method may be useful for the evaluation of adhesive wound dressings, particularly during product development. However, further studies will be needed to examine the effectiveness of this assessment method in the clinical setting because the adherent properties of polyurethane and hydrocolloid adhesives may be altered by the absorption of water from the skin.
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Affiliation(s)
- Hajime Matsumura
- Department of Plastic and Reconstructive Surgery, Tokyo Medical University, Tokyo 160-0023, Japan.
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Abstract
The skin is a vital organ with key protective functions. Infants in the NICU are at risk for skin injury because of developmental immaturity and intensive care treatments. When skin injury occurs, the neonatal nurse is challenged to provide wound care to optimize functional and cosmetic healing. Optimal wound care requires basic knowledge of the mechanisms of injury, physiology of wound healing, host factors affecting wound healing, and wound assessment. This knowledge provides the basis for determining appropriate wound treatment, including dressing selection. Attention to pain issues associated with wound care is difficult because of the infant's developmental stage, but is essential because of the potentially negative life-long impact of pain. The premature infant's propensity for skin stripping limits the selection of appropriate dressing, as does the paucity of research examining wound care products in this population.
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Matsumura H, Imai R, Gondo M, Watanabe K. Evaluation of pain intensity measurement during the removal of wound dressing material using 'the PainVision™ system' for quantitative analysis of perception and pain sensation in healthy subjects. Int Wound J 2012; 9:451-5. [PMID: 22264336 DOI: 10.1111/j.1742-481x.2011.00911.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Reducing pain caused by the removal of adhesive wound dressing materials is very important in clinical practice and is also one of the factors to consider when choosing dressing materials. A visual analogue scale is the most popular method for assessing pain, but it is subjective and is difficult to evaluate quantitatively or statistically. Recently, a new method for the quantitative measurement of pain intensity using a painless electrical stimulation system, PainVision™, has been developed. In this study, we evaluated pain intensity during the removal of wound dressing materials in healthy volunteers by comparing pain during the removal of wound dressing materials, which use acrylic pressure-sensitive adhesive and pain during the removal of materials, which use soft silicone adhesive, as evaluated using the PainVision™ system. Pain intensity was significantly lower with the dressing materials, which use soft silicone adhesive when measured with the PainVision™ system. The PainVision™ system promises to be useful for the quantitative assessment of pain caused by the removal of adhesive wound dressing materials. Further studies are needed to determine whether the PainVision™ system is also effective in measuring pain caused by the removal of wound dressing materials in actual wounds.
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Affiliation(s)
- Hajime Matsumura
- FACS Department of Plastic and Reconstructive Surgery, Tokyo Medical University, Tokyo, Japan.
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Campanella S, Rapley P, Ramelet AS. A randomised controlled pilot study comparing Mepitel® and SurfaSoft® on paediatric donor sites treated with Recell®. Burns 2011; 37:1334-42. [DOI: 10.1016/j.burns.2011.04.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2011] [Accepted: 04/21/2011] [Indexed: 11/29/2022]
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