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Principles of wound care
Published in Nicola Neale, Joanne Sale, Developing Practical Nursing Skills, 2022
Dressings for diabetic foot ulcers must be chosen with particular care as excess moisture and occlusive environments can cause bacteria to multiply quickly, and spread infection. People with diabetes do not display the classic signs of infection, and their circulation can be affected by peripheral arterial disease. Historically, hydrocolloid dressings have been avoided in people with diabetes, favouring antimicrobial products such as iodine and honey. Dumville et al. (2017) has reviewed their use and suggest that the use of an antimicrobial dressing instead of a non-antimicrobial dressing may increase the number of diabetic foot ulcers healed and there is probably little difference between the risk of adverse events between systemic antibiotic and antimicrobial treatments for diabetic foot ulcers.
Dermatological problems and treatment in long-term/nursing-home care
Published in Robert A. Norman, Geriatric Dermatology, 2020
Wound cleansing: flush the wound with normal saline or commercial wound cleanser. Dry the surrounding skin; an option is to apply a skin prepping solution to the area round the wound. If the wound has no or a small to moderate amount of exudate (Figure 4): Cleanse;Apply hydrocolloid dressing;Change 3 times per week and PRN if loose or soiled (NB The dressing may not adhere well to the buttocks when incontinence is a problem).
Treatment of Pressure Sores
Published in J G Webster, Prevention of Pressure Sores, 2019
Many synthetic occlusive dressings are available and can be divided into four groupings, each with its advantages and disadvantages (Mulder and LaPan 1988). Figure 14.6 points out the advantages and disadvantages of each type of synthetic occlusive dressing when used on pressure sores. Hydrocolloid dressings are adhesive, gel-producing, water-impermeable membranes. They can be left on for up to one week, and commonly have an adhesive wound contact face, an impermeable outer face, and an exudate-absorbing component that is usually carboxymethylcellulose. They are easy to apply, but may be messy and disruptive when used on high-exudate wounds. Polyurethane and thin film dressings are transparent-adhesive dressings that are often difficult to use. They can be troublesome to apply and may be disrupted or removed by patient movement. It is also common to have exudate leakage due to the minimal absorption of the dressing. Bio-dressings and gels are similar groupings of dressings. They are usually hydrogels of water and polyethylene oxide, have a reinforced polyethylene film, and have a high water content. They are more appropriate for use on abrasions and superficial wounds than pressure sores.
COVID-19 and dermatological personal protective equipment considerations
Published in Baylor University Medical Center Proceedings, 2021
Travis S. Dowdle, Mallory Thompson, Mahmud Alkul, Jeannie M. Nguyen, Ashley L. E. Sturgeon
Pressure-related injury can also be a consequence of masks and goggles. Similar to protection against contact dermatitis, the AAD recommends using an alcohol-free barrier film as a skin sealant before donning an N95 respirator or goggles. Other methods to relieve pressure at high-impact points, such as adding cushions to the bridge of the nose, have been studied. In one study, six topical products worn under N95 respirators were compared and tested for pathogen contamination using fluorescent lotion as a simulation.19 An important result of this study was that the thin hydrocolloid dressing, when applied under the N95 respirator, improved skin irritation from pressure and did not result in contamination or disrupt the mask seal. These methods require further testing, as the AAD still does not recommend any material or cushioning for N95 respirator use at this time due to possible disruption of the seal. Another factor in pressure-related injury is excessive tightness of either mask or goggles. It is important to note that increased tightness of the straps or mask itself does not improve the efficacy of the PPE but rather increases the risk of skin damage and subsequent mask manipulation.12 Masks should be fit tested according to standards of the Occupational Safety and Health Administration to ensure proper seal and protection.20
Comparative lyophilized platelet-rich plasma wafer and powder for wound-healing enhancement: formulation, in vitro and in vivo studies
Published in Drug Development and Industrial Pharmacy, 2019
Ghada E. Yassin, Marwa H. S. Dawoud, Reham Wasfi, Ahmed Maher, Ahmed M. Fayez
In addition, wafers are classified according to their disintegration time and drug release into rapid disintegration wafers and sustained release wafers. In general, the polymer type and structure of a wafer determines its release profile. Furthermore, wafers can be classified into single-layer and multi-layer wafers according to their structure. The polymers used can be water soluble or insoluble, pH sensitive and/or muco-adhesive. The administration route, site of application, indications, and release profile are based on the desired type of wafer. Wafers can be used topically or internally. They have a high drug loading capacity, effective drug absorption, and long contact time [20,21]. Various hydrocolloids (e.g. sodium carboxymethylcellulose, Na CMC) can be used to prepare wafers, which are commonly used in the dressings as it absorbs the liquid from the wound exudate, form a gel, and keeps the moisture at the wound site [28]. Hydrocolloids absorb liquid and form a gel in the presence of wound exudate. Hydrocolloid dressings are used for different types of ulcers in diabetic or non-diabetic patients. Na CMC is selected for wafer preparation as it is non-toxic, biodegradable, non-immunogenic, water soluble, and highly viscous [29].
Clinical efficacy of 1,444nm Nd:YAG laser for xanthelasma palpebrarum
Published in Journal of Cosmetic and Laser Therapy, 2020
Ji Hyun Park, Sook in Ryu, Il-Hwan Kim
Before the procedure, patient’s eyes were protected using eyeshields. Lesions were anesthetized with an injection of lidocaine combined with 1:105 epinephrine. All the lesions were treated with 1,444 nm Nd:YAG laser (Accusculpt; Lutronic Corp., Goyang, Korea) using a fiber-type internal probe, and the total energy was within the range of 2.0 W-2.8 W. The treatment endpoint was the moment when the color of the lesion changed. The treated patients were educated to apply antibiotic ointment and cover with hydrocolloid dressings for 10–14 days. If the lesion recurred or residual lesion persisted, the procedure was repeated. If the patient was satisfied with the clinical result, no further treatment was performed.