Management of Leg Ulcers With Hydrocolloid Occlusive Dressing

Friedman, Stephen J.

doi:10.1001/archderm.1984.01650460069022

Cited by 103 publications

(20 citation statements)

References 17 publications

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“…As compared with wet or dry, nonadherent dressings, occlusive hydrocolloidal dressings resulted in a greater reduction in pain but in minimal or no improvement in the ulcer healing rate. [89][90][91][92][93] Similarly, the rate of ulcer healing was no different in patients treated with Unna boots as compared with occlusive hydrocolloidal dressings, but patients preferred the occlusive dressing because of ease of ulcer care. 92 Unna boots must be applied by trained personnel once or twice per week, whereas occlusive hydrocolloidal dressings can be changed at home by the patient every 3 to 7 days.…”

Section: Mechanical Therapymentioning

confidence: 97%

Chronic Venous Insufficiency and Venous Ulceration

Alguire

Mathes

1997

J Gen Intern Med

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OBJECTIVE:To review and summarize the literature on the normal venous circulation of the leg, and the epidemiology, pathophysiology, and treatment of chronic venous insufficiency (CVI).DATA SOURCES: English-language articles identified through a MEDLINE search using the terms venous insufficiency or varicose ulcer and epidemiology, pathophysiology, diagnosis, and clinical trial (pt), and selected cross-references. STUDY SELECTION:Articles on epidemiology, pathophysiology, and treatment of CVI. Randomized, controlled studies were specifically sought for treatment efficacy. DATA EXTRACTION:Data were manually extracted from selected studies and reviews; emphasis was placed on information relevant to the general internist. pproximately 5 million people in the United States exhibit some evidence of chronic venous insufficiency (CVI) and between 400,000 and 500,000 of these individuals have or will develop a venous leg ulcer. 1-3 The signs of CVI include engorgement of the cutaneous veins and dependent edema in mildly affected patients to pigmentation, dermatitis, and ulceration in the more severe cases. Although most patients are asymptomatic, others have leg heaviness and aching or recurrent and recalcitrant leg ulcers punctuated by bouts of cellulitis. These more severe cases are associated with recurrent hospitalization, high health-care costs, and disability. 4,5 Venous insufficiency with trophic skin changes or ulceration is a frustrating problem, which many physicians approach with a sense of ennui. This may be due to the chronic and remitting nature of the problem, the need for lifestyle modification, inconvenient therapies, and contradictory information regarding medical and surgical management. Nevertheless, CVI, including ulceration, is a manageable problem. The purpose of this review is to present the normal anatomy and physiology of the venous circulation and to summarize the epidemiology, pathophysiology, and treatment of CVI. DATA SYNTHESIS: METHODSA MEDLINE search for relevant English-language articles published between 1966 and 1996 was completed using the following MeSH terms: venous insufficiency or varicose ulcer and epidemiology, pathophysiology, diagnosis, and clinical trial (pt). When selecting articles on treatment, randomized, controlled trials were reviewed whenever possible. Emphasis was placed on reviewing articles with clinical relevance for internal medicine physicians. ANATOMY AND NORMAL PHYSIOLOGYVenous blood from the skin and subcutaneous fat is collected in a system of superficial venules and veins that drain toward the deep venous system underneath the fascia via three major pathways: (1) through the long or short saphenous veins, which join the deep system at the saphenofemoral and saphenopopliteal junctions; (2) through the perforating veins originating from the long or short saphenous veins or their branches; or (3) directly into the deep venous system or bypass the deep system entirely and enter the pelvis. 6 Deep veins are categorized as either intramuscular or intermuscular; o...

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Section: Mechanical Therapymentioning

confidence: 97%

Chronic Venous Insufficiency and Venous Ulceration

Alguire

Mathes

1997

J Gen Intern Med

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“…An ideal wound dressing is one, which induces host cells to regenerate, prevent infection, act like an osmotic regulator,1 providing optimal environment for healing to take place quickly 2. Although occlusive dressings possess clinical benefit in treatments of wounds,3, 4 they may provide a favorable environment for the microflora of wound to further proliferate and grow 5. Microbes, entering the wound, delay healing by initiating infection, leading to wound fluid exudation, and have a number of deleterious effects on the healing process 6, 7.…”

Section: Introductionmentioning

confidence: 99%

Design and delivery of silver sulfadiazine from alginate microspheres‐impregnated collagen scaffold

et al. 2005

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A reconstituted collagen scaffold impregnated with silver sulfadiazine (SSD) loaded alginate microspheres, capable of delivering the drug in a controlled manner has been developed. SSD-loaded alginate microspheres were prepared by modified water-in-oil emulsion technique through interfacial ionic gelation of alginate using CaCl2. The SSD-loaded microspheres were impregnated in pepsin-solubilized collagen, in situ, while inducing fibrillation and cast as thin scaffold. Morphological features of microspheres and microsphere-impregnated collagen were analyzed through SEM. Distribution homogeneity of impregnated microspheres, their in vitro behavior in (Dulbecco's modified minimal essential media) DMEM, and antibacterial efficiency against ATCC pathogens were determined. Initial drug load of 20% (w/w) with respect to alginate and 40% (v/v) of 2% alginate with respect to oil phase were found to produce microspheres of optimum drug entrapment (3%) and required size range (300-370 microm). In vitro drug release studies from the scaffold showed an initial burst release of 47.5% and a controlled release for 72 h with equilibrium concentration of 68.8%. SSD-loaded microspheres exhibited minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) levels of 32 and 40.2 microg/mL to both K. pneumoniae and E. coli respectively. P. aeruginosa showed MIC and MBC levels of 44.8 and 51.2 microg/mL respectively, while Staphylococcus aureus exhibited MIC and MBC at the same concentration range (57.6 microg/mL). The collagen-based scaffold impregnated with SSD-loaded alginate microspheres can deliver SSD in a controlled fashion, can control infection for extended time period with lesser dressing frequencies, and will enable easier assessment of wound.

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“… There is no report other than expert opinions concerning the selection of dressing materials and topical agents for the acute phase, and the evidence level is VI. However, as the use of dressing materials and Vaseline‐based ointments for moist wound healing is an appropriate choice, and as they are used widely in clinical sittings, the recommendation level except ointments containing antibiotics (antibacterial agents), which may allow the development of resistant strains on long‐term use, was set as B. Since pressure ulcer is unstable during the acute phase, the determination of the necrotic area is difficult, and tissue resistance to infection is weak.…”

Section: Pressure Ulcer In the Acute Phase Cq10: What Topical Treatmementioning

confidence: 99%

The wound/burn guidelines – 2: Guidelines for the diagnosis and treatment for pressure ulcers

Tachibana

Imafuku

Irisawa

et al. 2016

The Journal of Dermatology

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The Wound/Burn Guidelines Committee consists of members commissioned by the Board of Directors of the Japanese Dermatological Association (JDA). It held several meetings and evaluations in writing since October 2008, and drafted five guidelines for the diagnosis and treatment including commentaries on wounds in general and the Guidelines for the Diagnosis and Treatment for Pressure Ulcers by taking opinions of the Scientific Committee and Board of Directors of JDA into consideration.Key words: body position changes, nutritional support, pressure ulcer, reactive erythema, skin care.Correspondence: Hironobu Ihn, M.D., Ph.D., Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan. Email: ihn-der@kumamoto-u.ac.jp This is the secondary English version of the original Japanese manuscript for The wound/burn guidelines -2: Guidelines for the diagnosis and treatment for pressure ulcers published in

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Management of Leg Ulcers With Hydrocolloid Occlusive Dressing

Cited by 103 publications

References 17 publications

Chronic Venous Insufficiency and Venous Ulceration

Chronic Venous Insufficiency and Venous Ulceration

Design and delivery of silver sulfadiazine from alginate microspheres‐impregnated collagen scaffold

The wound/burn guidelines – 2: Guidelines for the diagnosis and treatment for pressure ulcers

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