Advances in skin & wound care
-
Adv Skin Wound Care · Sep 2012
Comparative StudyA retrospective study evaluating silver-impregnated dressings on cesarean wound healing.
This retrospective study was designed to assess the effectiveness of silver-impregnated dressings in reducing postoperative wound care visits. ⋯ Although there was no observed difference in the number of women requiring additional wound care visits, the significantly greater number of comorbidities noted in the silver-impregnated dressing group should have theoretically placed them at increased risk for SSIs and additional postoperative wound care visits, suggesting that silver-impregnated dressings may have more of a protective effect than is appreciated in this study. A randomized prospective study is planned to further assess its usefulness in decreasing the incidence of wound infections along with its potential benefits regarding wound appearance.
-
Adv Skin Wound Care · Jun 2012
ReviewEvidence for interventional procedures as an adjunct therapy in the treatment of shingles pain.
To enhance the learner's competence with knowledge of interventional procedures as an adjunct therapy in the treatment of shingles pain. ⋯ Shingles (herpes zoster) is a painful manifestation of infection of the dorsal root ganglia of the spine and seen as blisters or vesicles in linear formation, usually on the upper torso. Up to one-third of those afflicted will experience complications, with the most common complication being postherpetic neuralgia (PHN). The risk of PHN increases for each decade of life after age 50 years, and the pain associated with this complication has the potential to endure for years, be unrelenting, and decrease an individual's quality of life. Treatment options, including adjunct interventional procedures, are presented to address the common complication of PHN. Although no conclusive evidence base is present for the use of any particular interventional procedure in the treatment of acute pain or refractory pain of shingles, a number of therapies have been indicated to have some level of effectiveness. Standard therapy options in the form of oral medications and topical agents should be used first. For those situations of refractory pain, a referral to an interventional pain management specialist is warranted to explore possible adjunct procedures to lessen the pain of PHN. A comprehensive care management approach, incorporating interventional pain management procedures as an adjunct therapy, will enable patients to have their pain treated as effectively as possible by utilizing appropriate methods available.
-
Adv Skin Wound Care · May 2012
Randomized Controlled Trial Comparative StudyA prospective, single-center, nonblinded, comparative, postmarket clinical evaluation of a bovine-derived collagen with ionic silver dressing versus a carboxymethylcellulose and ionic silver dressing for the reduction of bioburden in variable-etiology, bilateral lower-extremity wounds.
There are numerous dressings designed to manage the overabundance of matrix metalloproteinases, while also addressing the excessive bioburden found in chronic wounds. The authors compared the efficacy of 2 such dressings: a sodium carboxymethylcellulose/1.2% ionic silver (CMC), which theoretically reduces bacteria by providing silver ions, versus a bovine native collagen (BDC)/ionic silver dressing, which also delivers silver ions in an aqueous environment. Both dressings theoretically modulate the wound bed; CMC through moist wound care and fibrin ingrowth and BDC through matrix metalloproteinase balancing. ⋯ Both CMC and BDC silver dressings appeared to have statistically similar efficacy regarding the rate of wound healing and little impact on the actual bioburden in chronic lower-extremity wounds. Interestingly, there was no correlation in the size of the wound and any effect on bioburden. Although the BDC dressing showed a higher absolute rate of wound closure, neither technology demonstrated a statistically significant difference in wound closure rate when corrected for initial wound size.