Dressings for Acute and Chronic Wounds

Chaby, G.; Senet, Patricia; Vaneau, Michel; Martel, Philippe; Guillaume, J; Meaume, Sylvie; Téot, Luc; Debure, C.; Dompmartin, Anne; Bachelet, Hélène; Carsin, H.; Matz, Véronique; Richard, J.-L.; Rochet, Jean Michel; Sales-Aussias, Nathalie; Zagnoli, Anne; Denis, C.; Guillot, B.; Chosidow, Olivier

doi:10.1001/archderm.143.10.1297

Cited by 213 publications

(131 citation statements)

References 81 publications

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“…However, overall data on the use of these products even in adults are extremely limited, with a recent assessment of published randomized controlled trials, meta-analyses, and cost-effectiveness studies providing only weak levels of clinical efficacy. 16 There are currently only a limited number of published clinical guidelines for the evaluation and management of wounds in the neonatal and pediatric populations. 2,13,[17][18][19][20][21] None of these have undergone the rigorous assessment required for the generation of evidence-based guidelines.…”

Section: Overview Of Wound Care In Pediatricsmentioning

confidence: 99%

Dressings and Products in Pediatric Wound Care

King

Stellar

Blevins

et al. 2014

Advances in Wound Care

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Significance: The increasing complexity of medical and surgical care provided to pediatric patients has resulted in a population at significant risk for complications such as pressure ulcers, nonhealing surgical wounds, and moistureassociated skin damage. Wound care practices for neonatal and pediatric patients, including the choice of specific dressings or other wound care products, are currently based on a combination of provider experience and preference and a small number of published clinical guidelines based on expert opinion; rigorous evidence-based clinical guidelines for wound management in these populations is lacking. Recent Advances: Advances in the understanding of the pathophysiology of wound healing have contributed to an ever-increasing number of specialized wound care products, most of which are predominantly marketed to adult patients and that have not been evaluated for safety and efficacy in the neonatal and pediatric populations. This review aims to discuss the available data on the use of both more traditional wound care products and newer wound care technologies in these populations, including medical-grade honey, nanocrystalline silver, and soft silicone-based adhesive technology. Critical Issues: Evidence-based wound care practices and demonstration of the safety, efficacy, and appropriate utilization of available wound care dressings and products in the neonatal and pediatric populations should be established to address specific concerns regarding wound management in these populations. Future Directions: The creation and implementation of evidence-based guidelines for the treatment of common wounds in the neonatal and pediatric populations is essential. In addition to an evaluation of currently marketed wound care dressings and products used in the adult population, newer wound care technologies should also be evaluated for use in neonates and children. In addition, further investigation of the specific pathophysiology of wound healing in neonates and children is indicated to promote the development of wound care dressings and products with specific applications in these populations. SCOPE AND SIGNIFICANCEGiven the lack of consensus on the optimal strategies for common wound care management issues in the neonatal and pediatric populations and the large number of wound care products on the market today, it can be challenging to make informed decisions regarding wound care in these populations. A comprehensive review of the literature on the following specific areas of focus: pressure ulcers, surgical wounds, epidermal stripping, intravenous extravasation injuries, moisture-associated skin damage (MASD), and use of negative-pressure wound therapy (NPWT) is presented, along with management recommendations based on the clinical experience of the authors.

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Section: Overview Of Wound Care In Pediatricsmentioning

confidence: 99%

Dressings and Products in Pediatric Wound Care

King

Stellar

Blevins

et al. 2014

Advances in Wound Care

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“…Wounds can be classified into two categories: acute and chronic. Acute wounds heal in a well-organized process within a predictable time frame, resulting in constant recovery of anatomical and functional integrity, while chronic wounds fail to progress through these stages [5]. In developed countries, approximately one to two percent of the population will experience a chronic wound during their lifetime [6].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and antibiotic susceptibility of bacteria from acute and chronic wounds in Malaysian subjects

Wong

Manikam

Muniandy

2015

J Infect Dev Ctries

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Introduction: Chronic wounds represent a major health burden worldwide. It has been hypothesized that the polymicrobial nature of wounds plays an important role in their healing process. Thus, a review of pathogen frequency and susceptibility patterns in wounds is necessary to provide appropriate guidelines for antimicrobial usage. Methodology: In this study, microbiota and antimicrobial resistance in both acute and chronic wound patients treated at the University of Malaya Medical Centre, Malaysia, were compared. Wound swabs from 84 patients with acute wounds and 84 patients with chronic wounds were collected. The specimens were cultured using standard microbiological techniques. Isolates were then tested for antibiotic sensitivity with the broth microdilution method. Results: Of 210 pathogenic bacteria isolates, Staphylococcus aureus (49; 23.3%) and Pseudomonas aeruginosa (31; 14.8%) were the most prevalent bacteria found in wounds. Staphylococcus aureus was found significantly more often in patients with chronic wounds (41; 48.8%) than in patients with acute wounds (8; 9.5%), while Staphylococcus epidermidis was found predominantly in acute wounds (15; 17.9%). At the time of study, patients with chronic wounds (58.3%) had received more antibiotic treatments in the past previous 12 months compared with patients with acute wounds (16.7%). In the antibiotic susceptibility test, Staphylococcus spp. revealed highest resistance towards penicillin and ampicillin. Isolates showed no decrease in susceptibility against a number of newly developed antibiotics (linezolid, daptomycin, and tigecycline). Conclusions: Our finding showed that bacteria diversity and antimicrobial-resistant strains are more frequently found in chronic wounds than in acute wounds.

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“…16 While the differences in time to reepithelialization found in our study are large and clearly of clinical relevance, the clinical significance of the 0.7-mm difference in scar thickness and 14% difference in scar contraction at 28 days between the two study groups is unclear. Other distinct advantages of the triple-antibiotic ointment are the fact that it is readily available without a prescription, inexpensive, and cosmetically more appealing than an opaque film or cream, and there is no need for an overlying dressing on areas such as the face.…”

Section: Discussionmentioning

confidence: 56%

Topical Antibiotic Ointment Versus Silver-containing Foam Dressing for Second-degree Burns in Swine

et al. 2015

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Objectives: Second-degree burns are very common but their management is controversial. These burns may be treated with either topical antimicrobial agents or advanced occlusive dressings; however, there is no established treatment comparator for preclinical studies. This study was designed to determine which of two commonly used comparator therapies (a silver-containing advanced dressing or a topical antibiotic ointment) resulted in faster reepithelialization and less scarring. The hypothesis was that second-degree burns treated with a topical antimicrobial ointment would heal faster and with less scarring than those treated with a silver-containing occlusive foam dressing in a porcine model. Methods:Deep partial-thickness burns were created on the flanks of three anesthetized female domestic pigs (20 to 25 kg) using a 150-g aluminum bar preheated in 80°C water bath and applied to the skin for 20 seconds using a force of 2 kg. The burn eschars were excised 48 hours later with an electric dermatome set at a depth of 0.75 mm. The wound beds were treated with a thin layer of triple-antibiotic petrolatum-based ointment (changed three times weekly) or a silver-containing foam dressing (changed once weekly). Full-thickness punch biopsies were obtained at 9, 11, 14, 16, 18, and 21 days for determination of percentage complete wound reepithelialization and at 28 days for measurement of scar depth.Results: At all dressing changes the wounds treated with the topical antibiotic appeared moist, while those treated with the silver-based dressings appeared dry. At day 21 all wounds treated with the ointment were completely reepithelialized, while only 55% of those treated with the silver dressing were reepithelialized (p < 0.001). Scar depth at day 28 was also significantly less in wounds treated with the topical antibiotic ointment (4.3 mm vs. 5.1 mm, difference = 0.7 mm; 95% confidence interval [CI] = 0.1 to 1.4 mm). There was less scar contraction in wounds treated with the topical antibiotic compared with the silver-based dressing (mean AE SD = 25.0% AE 14.6% vs. 38.9% AE 16.9%, difference = 13.9%; 95% CI = 5.7% to 22.0%).Conclusions: In this model of excised deep partial-thickness burns, a triple-antibiotic ointment enhanced reepithelialization and reduced scar depth and contraction compared with a silver-based foam dressing. This triple-antibiotic ointment should be considered as a control for studies evaluating novel topical burn therapies.ACADEMIC EMERGENCY MEDICINE 2015;22:927-933 © 2015 by the Society for Academic Emergency Medicine S econd-degree (partial-thickness) burns are very common, but their management is controversial. These burns are usually treated with either a topical antimicrobial cream or ointment or one of many advanced, silver-containing occlusive dressings. Over the past decade a large number of advanced burn dressings have been introduced into the marketplace. Many of these dressings contain silver due to its antimi-

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Dressings for Acute and Chronic Wounds

Cited by 213 publications

References 81 publications

Dressings and Products in Pediatric Wound Care

Dressings and Products in Pediatric Wound Care

Prevalence and antibiotic susceptibility of bacteria from acute and chronic wounds in Malaysian subjects

Topical Antibiotic Ointment Versus Silver-containing Foam Dressing for Second-degree Burns in Swine

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