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Published in Henry J. Woodford, Essential Geriatrics, 2022
Non-gauze dressings are usually preferred because they require less frequent changes (typically every three to four days) and are associated with mildly improved healing rates.84 A wide range of dressings is available with differing clinical indications. The evidence to support efficacy of any dressing type is poor.85 The usual aim is to keep the ulcer bed moist and clean. The frequency of dressing changes can vary according to the product used. At each change, the ongoing suitability of that type of dressing should be reassessed. Commonly used types of dressings are outlined in Table 22.3.
The Neonate
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
Laura De Angelis, Luca Ramenghi
Prior to circumcision, infants should have completed transition, voided at least once, and been fasting for 1 hour prior to the procedure. Pain control should be utilized and can include dorsal penile nerve block, topical analgesic, or subcutaneous ring block. Sucrose solution and pacifier sucking may be used to reduce pain perception. Techniques for circumcision include the Mogen, Plastibell, and Gomco. After the procedure, breastfeeding or bottle feeding is an excellent pain control method. If needed, acetaminophen (12–15 mg/kg/dose) may be administered. A gauze wrap is no longer recommended after the procedure. The area should be kept clean with plain water and covered with lubricant for up to 1 week until completely healed. The parents should be told to expect a white-yellow discharge for 5–7 days.
Musculoskeletal Trauma
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
Exsanguinating external haemorrhage should be immediately controlled as part of <C>. Pressure and elevation are often all that are required, but other techniques, including tourniquets and topical haemo-static agents, are described in Chapter 8. Otherwise, bleeding from limb wounds can wait until the airway and chest have been effectively assessed and managed (A and B). Less serious external haemorrhage should be controlled with a pressure dressing and elevation. Saline-soaked gauze should be applied to the wound and held in place with a clear film dressing, and crepe bandages are effective for most bleeding wounds.6, 7 Iodine-based dressings should not be used. Circumferential crepe bandaging should be applied firmly, starting distally and progressing proximally.
Bilayer nanofibrous wound dressing prepared by electrospinning containing gallic acid and quercetin with improved biocompatibility, antibacterial, and antioxidant effects
Published in Pharmaceutical Development and Technology, 2023
Yuanju Lv, Wenli Wu, Zemei Liu, Guangyan Zheng, Lihong Wang, Xin Che
Healing of the damaged skin is a slow and complicated process, which generally experienced four stages, namely hemostasis, inflammation, cell proliferation, and tissue remodeling (Zhang et al. 2017; Yang et al. 2022). Mild injury can regenerate spontaneously by skin repair. But when the injury is serious, bacterial infection increases inflammation and the wound cannot be healed by skin repair (Selvaraj and Fathima 2017; Ajmal et al. 2019). A traditional wound dressing has been widely used in clinical practice, such as gauze and bandages, can protect the wound from external factors. However, they cannot inhibit the bacteria in the wound site, and it is easy to form tissue adhesion and make the wound dehydrated when they are used (Qu et al. 2018; Li et al. 2019; Memic et al. 2019; Demir et al. 2022).Therefore, developing a new wound dressing with good biocompatibility and antibacterial and antioxidant activities is highly desirable.
Fecal microbiota transplantation: a review on current formulations in Clostridioides difficile infection and future outlooks
Published in Expert Opinion on Biological Therapy, 2022
Adèle Rakotonirina, Tatiana Galperine, Eric Allémann
Concerning the sample preparation, magistral formulations allow minimization of microbiota manipulation and modification, as the main preparation steps are dilution, filtration and the addition of a cryoprotectant. Namely, the feces sample from the donor is first refined by diluting it with saline (ratio 1:3 of feces to saline) to reduce the amount of aggregates of processed food and fibers. Indeed, saline has proven more efficient as a diluent and has been adopted in routine procedures [67]. In fact, even though the sensitivity and resistance to nonosmotic media is species dependent, all living organisms survive better in isosmotic environments. For instance, some Gram-positive bacteria tend to resist less in water than Gram-negative bacteria [77]. After dilution, the mixture is homogenized to obtain a slurry and subsequently filtered to eliminate fibers and other large debris. This step should not be rushed, as minimal mechanical constraints are essential to keep the bacteria alive [62]. Loose gauze compresses are mostly used for filtration, but metallic sieves can also be an option if sterilization procedures can be implemented. Nonetheless, filtration might be the most time-consuming step, as it is mostly manual and the slurry is viscous. Finally, the filtered slurry is conditioned in 50 mL syringes for administration. Colonoscopy can allow the delivery of up to 250 mL of fecal suspension to the patient, whereas enema allows the delivery of up to 150 mL. Time and implementation constraints to properly deliver fresh FMT have led to other storage-friendly formulations.
A Comparative Efficacy Evaluation of Recombinant Topical Thrombin (RECOTHROM®) With A Gelatin Sponge Carrier Versus Topical Oxidized Regenerated Cellulose (TABOTAMP®/SURGICEL®) In A Porcine Liver Bleeding Model
Published in Journal of Investigative Surgery, 2021
Paul Slezak, Claudia Keibl, Dirk Labahn, Anna Schmidbauer, Yuri Genyk, Heinz Gulle
Once the hemostatic agent had been applied to the lesion, residual bleeding rates and time to hemostasis were assessed by application of fresh dry gauze over the hemostatic agent for 30 seconds followed by careful removal of the gauze and visual assessment of bleeding through and around the hemostatic agent for up to 1 minute. Hemostasis was defined as the absence of observable active bleeding or the absence of sustained soaking of blood into the hemostatic material within the observation period of 1 minute. In the case of bleeding during that period, fresh gauze was re-applied immediately for 30 seconds followed by another minute of observation. This was repeated for up to 10 minutes, or until hemostasis was achieved, whichever came first. A treatment was regarded as a failure if hemostasis was not achieved within 10 minutes.