bluuebunny/crossref_metadata_2025_split huggingface dataset:
The protective effects of a new preparation on wound edges
Authors: Neander K-D. , Hesse F. 
Published: May 2014

Objective:This study investigated the effect of Cavilon No Sting Barrier Film (NSBF) (3M Healthcare) on erythema on the edges of highly exuding wounds in patients with venous stasis ulcers.Method:An intra-individual double-blind randomised test was performed on 239 patients. The two sides of each wound on each patient were treated with two different dressings: Cavilon NSBF was applied to the wound edges of one side and a control (water) to the edges of the other. Erythema was assessed daily using a chromameter.Results:These are based on the 227 patients who completed the study. The researchers were surprised by their unambiguity: in 88.1% of patients, the erythema completely disappeared within three days of treatment with the test material; in the remaining 11.9% it had completely disappeared after four days. With the control, erythema intensity remained more or less unchanged throughout the four-day observation period.Conclusion:This study demonstrates that Cavilon NSBF helped control erythema in all the patients: in 97.3% examined, the measurable and objectively recordable erythema receded within two days.Declaration of interest:None.
A novel formulation of metal ions and citric acid reduces reactive oxygen species in vitro
Authors: Van Den Berg A.J.J. , Halkes S.B.A. , Quarles Van Ufford H.C. , Hoekstra M.J. , Beukelman C.J. 
Published: May 2014

Objective: Reactive oxygen species, including superoxide anions, are thought to play an important role in impairing wound healing. Additionally, superoxide anions react with nitric oxide produced by macrophages to form peroxynitrite, another strong oxidant with detrimental effects on surrounding tissue. This in vitro study investigated whether samples of metal ions and citric acid are able to reduce levels of reactive oxygen species. Method: Samples of materials were tested in assays for the following: inhibition of reactive oxygen species production by human polymorphonuclear neutrophils (PMNs); antioxidant activity (scavenging of superoxide anions in a cell-free system); inhibition of human complement (limiting the generation of complement factors that attract and stimulate PMNs, thereby reducing levels of reactive oxygen species). Results: Metal ions were shown to inhibit both PMN production of reactive oxygen species and the activation of complement via the classical pathway, whereas citric acid was found to be a scavenger of superoxide anions. Conclusion: The beneficial effects of using formulations containing metal ions and citric acid on chronic wounds may be explained in part by a reduction of reactive oxygen species in these wounds. Declaration of interest: The research was financed by Greystone Medical Group.
A comparison of the antimicrobial effects of four silver-containing dressings on three organisms
Authors: Thomas S. , McCubbin P. 
Published: May 2014

Objective: To compare the antimicrobial activity of four silver-containing dressings: Acticoat (Smith and Nephew), Actisorb Silver 220 (Johnson and Johnson), Avance (SSL International) and Contreet-H (Coloplast). Method: The dressings were tested against three micro-organisms: a Gram-positive bacterium, Staphylococcus aureus; a Gram-negative organism, Escherichia coli; and a yeast, Candida albicans, using three different techniques. Each dressing also had its silver content analysed. Results: Acticoat is likely to produce the most rapid antimicrobial effect in vitro because of the rapid release of relatively large concentrations of highly active silver ions. Contreet-H has broadly similar antimicrobial activity to Acticoat, but has a slower onset of action. Actisorb Silver 220 appears to offer less prospect of killing bacteria within the wound itself, but the dressing is capable of removing micro-organisms from wound exudate and sequestering them until they are inactivated by the silver within the charcoal fibres. Little convincing evidence for any antimicrobial activity of Avance was found. Conclusion: Although caution must always be exercised when extrapolating the results of laboratory-based studies to the clinical situation, potentially important differences were detected in the antimicrobial activity of the four products examined. It is also possible that the silver ions released by the dressings may have effects on wound healing that are unrelated to their antimicrobial activity. Further work is needed to address this issue. Declaration of interest: This study was supported by Smith and Nephew.
Short-stretch versus multilayer compression for venous leg ulcers: a comparison of healing rates
Authors: Ukat A. , Konig M. , Vanscheidt W. , Münter K-C. 
Published: May 2014

Objective: To compare the performance of two compression systems, (multilayer elastic [Profore], Smith and Nephew) and (short stretch [Comprilan], Beiersdorf), in the treatment of venous leg ulcers in a randomised controlled trial. Method: Eighty-nine patients with venous leg ulcers were randomised to receive treatment with Profore (44 patients) or short-stretch (45 patients) compression bandages. Allevyn (Smith and Nephew) was used as the wound contact layer under both systems. Results: Patients treated with Profore healed significantly faster than those treated with short stretch (p=0.03) and were 2.9 times more likely to heal at any given time during the study period. Younger wounds healed significantly faster than older wounds (p=0.01). Conclusion: Patients treated with Profore healed faster than those treated with short-stretch bandages. In addition, treatment costs are lower with Profore. In this trial the average cost per patient was €1345 (short stretch) and €587 (Profore). Declaration of interest: The study was supported by a research grant from Smith and Nephew GmbH, Lohfelden, Germany.
Clinical performance of a new silver dressing, Contreet Foam, for chronic exuding venous leg ulcers
Authors: Karlsmark T. , Agerslev R.H. , Bendz S.H. , Larsen J.R. , Roed-Petersen J. , Andersen K.E. 
Published: May 2014

Objective: This study aimed to evaluate the safety and performance of a new sustained silver-releasing dressing, Contreet Foam (Coloplast A/S), in the treatment of moderately to highly exuding chronic venous leg ulcers in which healing is delayed due to the presence of bacteria. Method: The clinical performance of Contreet Foam was studied for four weeks in 25 patients with moderately to highly exuding delayed-healing venous leg ulcers. Healing was assessed on a weekly basis with reference to the wound-bed tissue composition, degree of odour and pain, dressing performance and the dressing's effect on the peri-ulcer area. Blood samples were analysed for silver content. Results: Twenty-three out of 25 patients completed the study. One ulcer healed and no wound infections occurred during the study period. A mean 56% reduction in ulcer area (from 15.6 to 6.9cm2) was recorded during the four weeks, and there was a mean 25% reduction in granulation tissue from dull to healthy after one week. Wound odour reduced significantly after one week. Mean dressing wear time was 3.1 days, and there were only minimal incidences of leakage. Serum silver levels did not exceed reference values. Conclusion: Contreet Foam was found to be safe and performed well when used in the treatment of delayed-healing chronic venous leg ulcers, combining effective antibacterial properties with excellent exudate management. Declaration of interest: This study was supported by Coloplast A/S, Humlebæk, Denmark.
A silver sulphadiazine-impregnated lipidocolloid wound dressing to treat second-degree burns
Authors: Carsin H. , Wasserman D. , Pannier M. , Dumas R. , Bohbot S.A. 
Published: May 2014

Objective: To evaluate the efficacy and tolerance of Urgotul SSD dressing (Laboratoires Urgo) in the treatment of second-degree burns. Method: This was a national multicentre phase III non-comparative open-label prospective study involving 10 burns units. The 41 subjects were non-immunosuppressed adults with second-degree thermal burn(s), which were clinically non-infected, less than 24 hours old, had a surface area less than 500cm2 and warranted the local use of silver sulphadiazine. For four weeks, subjects were followed up weekly with a clinical assessment, bacteriological swabs and photographic recording. Results: Of the 41 patients, 24 healed within a mean of 10.8 days and 13 had a skin graft on the study burn within a mean of 11.5 days. There were four premature study withdrawals. The total number of cumulative treatment days was 445, and 298 treatments were performed (including 257 dressing changes). Mean dressing wear time was 1.73 days. None of the subjects acquired a secondary infection. Researchers took 121 bacteriological samples, and wound colonisation with Staphylococcus aureus was found in only one patient. At follow-up nursing staff reported that dressing acceptability was good. Conclusion: Use Of Urgotul Ssd Led To A Good Wound Outcome — Wounds Healed Or Were Grafted. Declaration of interest: This study was sponsored by Laboratoires Urgo, Dijon, France.
Acceptability to patients of a honey dressing for non-healing venous leg ulcers
Authors: Dunford C.E. , Hanano R. 
Published: May 2014

Objectives: This four-centre feasibility study was undertaken to determine whether Medihoney, a proprietary blend of honeys, is an acceptable treatment for patients with leg ulcers in terms of pain relief, odour control and overall patient satisfaction. Method: Forty patients whose leg ulcers had not responded to 12 weeks of compression therapy were recruited. Medihoney dressings were applied on their ulcers for the 12-week study period. All other aspects of their care, including the use of compression bandaging, remained unchanged. Their leg ulcers were assessed every two weeks. This included the use of a patient questionnaire. Results: Overall, ulcer pain and size decreased significantly and odorous wounds were deodorised promptly. This had a positive impact on patient satisfaction with the Medihoney treatment. Conclusion: The results support the previously reported positive effects of honey and revealed a high patient acceptance for this treatment. Following these results, comparative clinical trials, which should also consider pain, are now recommended. Declaration of interest: This study was supported by Paul Hartmann AG, Germany.
The effectiveness of oral nutritional supplementation in the healing of pressure ulcers
Authors: Frias Soriano L. , Lage Vzquez M.A. , Prez-Portabella Maristany C. , Xandri Graupera J.M. , Wouters-Wesseling W. , Wagenaar L. 
Published: May 2014

Objective: To investigate the effectiveness of an oral nutritional supplement that is rich in protein and enriched with arginine, vitamin C and zinc on the healing of pressure ulcers. Method: Thirty-nine patients with grade III or IV pressure ulcers were enrolled into this open intervention study. Subjects received an oral nutritional supplement daily for three weeks. Wound area and the wound condition of the ulcers were assessed weekly. Results: After three weeks of supplementation, median wound area reduced significantly (p<0.001) from 23.6cm2 (1.6–176.6cm2) to 19.2cm2 (1.2–132.7cm2), a reduction of 29%. Median healing of wound area was 0.34cm2 per day, taking approximately two days to heal 1cm2. Within three weeks the amount of exudate in infected ulcers (p=0.012) and the incidence of necrotic tissue (p=0.001) reduced significantly. Conclusion: Nutritional intervention in the form of a specific oral nutritional supplement resulted in a significant reduction in wound area and an improvement in wound condition in patients with grade III and IV pressure ulcers within three weeks. Declaration of interest: This study was supported by Nutricia, Madrid, Spain.
Linguistic validation of the Cardiff Wound Impact Schedule into French, German and US English
Authors: Acquadro C. , Price P. , Wollina U. 
Published: May 2014

Objective: Chronic leg wounds can represent a major health problem and have a negative emotional impact on patients’ lives. The Cardiff Wound Impact Schedule (CWIS) was developed by the Wound Healing Research Unit at University of Wales College of Medicine to assess the quality of life in patients with chronic wounds. Method: To perform the linguistic validation (translation) of the CWIS into German, French and US English as a first step in making the questionnaire available globally. The standard linguistic validation process employed by the Mapi Research Institute was used to translate the CWIS into French and German. An adjusted process was used for the US English translation. Results: The linguistic validation of the US English version was straightforward as it shares the same root language with the original UK version. The problems encountered in the French and German translations were mostly related to semantics and syntax. Conclusion: The CWIS is now available for further validation testing by the international community (the psychometric evaluation of each translated questionnaire). These translations will be useful to health-care providers undertaking formal quality-of-life assessments of patients with chronic leg wounds. Declaration of interest: Sponsored by Ethicon SAS, Johnson & Johnson Wound Management.
A study comparing two objective methods of quantifying the production of wound exudate
Authors: Dealey C. , Cameron J. , Arrowsmith M. 
Published: May 2014

Objective: The objective assessment of chronic wound therapies for exudate management (WRAP study) tested a variety of methods that could be used to improve understanding of dressing performance in the presence of wound exudate, including measurement of the levels of exudate production. The aim of this study was to identify a valid and reliable method of measuring wound exudate production per unit area of wound surface. Method: Two methods were tested. Method A measured the weight of exudate collected in dressings by ‘before and after’ weighing of all dressing materials that came into contact with wound exudate. Method B measured wound exudate collected as part of topical negative pressure (TNP) therapy. Results: Method A: Complete data were collected on three patients (at which point the study was halted), but it was only possible to obtain accurate measurements for two of these. Exudate production was 0.10g/cm2/24 hours and 0.21g/cm2/24 hours. It was time-consuming and required special equipment. Method B: Fifteen measurements from five patients were analysed and showed a mean exudate production of 1.3g/cm2/24 hours. Conclusion: There are problems with both methods of exudate measurement, but measuring wound fluid collected in TNP canisters seems simpler than weighing dressings and deserves further investigation. Declaration of interest: This study was part of the Wrap project and was funded by the Engineering and Physical Science Research Council.
A cost analysis of monoplace hyperbaric oxygen therapy with and without recirculation
Authors: Treweek S. , James P.B. 
Published: May 2014

Objective: Hyperbaric oxygen therapy is covered by the NHS under Specialist Services Definition Set 28. The indications and availability of the therapy have been influenced by educational failures, perceived costs and, compared with drug studies, the small number of controlled trials. This study aimed to inform this debate by calculating the direct costs to the health service of hyperbaric oxygen therapy for inpatients using a single, one-person chamber. Method: The costs included in this cost analysis were: hyperbaric chambers, staff, oxygen, property and cleaning, miscellaneous and general overheads. All costs are for 2004. Results: Lower and upper costs were calculated. Start-up costs range from £64,800 to £110,000 depending on the hardware selected. Annual costs, including 10-year amortisation of capital costs, range from £40,069 to £57,618 and per-treatment costs range from £30 to £41. Oxygen recirculation becomes cost effective after four to six years. Conclusion: Hyperbaric oxygen therapy is an inexpensive treatment that should be routinely available for conditions where evidence indicates that tissue hypoxia is a significant component of the injury or disease. Declaration of interest: None.
Pressure ulcer predictors in ICU patients: nursing skin assessment versus objective parameters
Authors: Compton F. , Hoffmann F. , Hortig T. , Strauß M. , Frey J. , Zidek W. , Schäfer J-H. 
Published: May 2014

Objective:To evaluate objective parameters and subjective nursing assessment as pressure ulcer risk factors for intensive care unit (ICU) patients, and compared them with the performance of a general assessment tool (Waterlow scale). To validate the newly developed assessment method.Method:This prospective epidemiological study involved 698 patients admitted to an ICU between April 2001 and December 2004 without pressure ulcers and who stayed in the ICU for more than 72 hours. Objective parameters routinely determined during the first 24 hours in the ICU as well as subjective nursing assessment on admission were analysed for their significance as pressure ulcer risk predictors.Results:Of the 698 patients 121 (17%) developed pressure ulcers in the ICU. With univariate analysis, a variety of objectively measurable parameters relating to organ dysfunction, circulatory impairment and sepsis showed significant association with the occurrence of pressure ulcers. When multiple logistic regression was performed, subjective nursing skin assessment parameters outweighed these parameters as pressure ulcer risk predictors. A risk function comprised of five skin-related and one other parameter yielded an overall correct pressure ulcer prediction proportion of 84.6%. With receiver-operator characteristic curve analysis, the area under the curve (AUC) was 0.82. Results were validated in 329 patients treated in the same ICU between January 2005 and May 2006, yielding an AUC of 0.80.Conclusion:Nursing skin assessment is an important pressure ulcer risk stratification tool in the ICU despite the availability of a large number of objectively measureable ICU specific parameters in these patients.Declaration of interest:None.
Bacteriophage therapy of venous leg ulcers in humans: results of a phase I safety trial
Authors: Rhoads D.D. , Wolcott R.D. , Kuskowski M.A. , Wolcott B.M. , Ward L.S. , Sulakvelidze A. 
Published: May 2014

Objective: This phase 1 trial set out to examine the safety of a bacteriophage-based preparation for difficult-to-treat wounds. Method: The intention-to-treat sample comprised 42 patients with chronic venous leg ulcers (VLUs); 39 patients completed the trial. The ulcers were treated for 12 weeks with either a saline control or bacteriophages targeted against Pseudomonas aeruginosa, Staphylococcus aureus and Escherichia coli. Follow-up continued until week 24. Results: No adverse events were attributed to the study product. No signifi cant difference (p>0.05) was determined between the test and control groups for frequency of adverse events, rate of healing, or frequency of healing. Conclusion: This study found no safety concerns with the bacteriophage treatment. Efficacy of the preparation will need to be evaluated in a phase II efficacy study. Declaration of interest: One of the authors (AS) holds an equity interest in Intralytix. The other authors do not have any interest in commercial activities.
Bacterial diversity in surgical site infections: not just aerobic cocci any more
Authors: Wolcott R.D. , Gontcharova V. , Sun Y. , Zischakau A. , Dowd S.E. 
Published: May 2014

Objective:To evaluate the microbial diversity in chronic surgical site infections (SSIs).Method:Bacterial populations in 23 chronic SSIs were identified using bacterial tag-encoded FLX amplicon pyrosequencing (bTEFAP), which is an universal bacterial identification method. These results were then validated using quantitative polymerase chain reaction (qPCR).Results:bTEFAP identified two previously uncharacterised Bacteroidales in all of the SSIs and showed that it was the predominant population in the majority of these chronic wounds. Other bacteria identifi ed included Corynebacterium spp., Peptoniphilus spp., Staphylococcus spp., Staphylococcus aureus, Serratia marcescens, Prevotella spp. and Pseudomonas aeruginosa. Rarefaction analysis of the data indicated that, on average, six genera occurred in any given SSI, suggesting that such infections are multispecies. On average, over 60% of the bacteria evaluated in the SSIs were anaerobic bacilli. The previous literature indicates that aerobic cocci predominate in such wounds.Conclusion:This modern molecular survey indicates that our previous understanding of which bacteria cause SSIs may be faulty. The high prevalence of anaerobic bacilli and the overwhelming predominance of two previously uncharacterised Bacteroidales suggest that such bacteria may be a leading contributor to such infections. Further research on the identification and treatment of such bacteria are warranted.Declaration of interest:Scott E. Dowd is director of a clinical molecular diagnostic company.
In vitro comparison of antimicrobial activity of iodine and silver dressings against biofilms
Authors: Thorn R.M.S. , Austin A.J. , Greenman J. , Wilkins J.P.G. , Davis P.J. 
Published: May 2014

Objective: To compare the antimicrobial effectiveness of silver- and iodine-containing wound dressings against preformed mature biofilms of pathogenic wound bacteria grown in vitro. Method: Biofilms of Pseudomonas aeruginosa and Staphylococcus aureus were grown within an in vitro flat bed perfusion biofilm model. Mature biofilms were removed and exposed to wound dressings containing either silver or iodine (Aquacel Ag and Iodozyme) within a static diffusion method, for up to 24 hours. This method was designed to reflect certain key features that determine antimicrobial activity within the wound. The numbers of viable bacteria surviving in the biofilms were determined at set time intervals over the test period. Results: Both test dressings exerted an antimicrobial effect against the target species biofilms, although the iodine dressing was more efficacious under the experimental conditions employed. Conclusion: There are large and potentially significant differences (as measured in vitro) in the effectiveness of wound dressings containing broad-spectrum antimicrobial agents such as silver and iodine against specific types of bacterial biofilms. Declaration of interest: Prof. Paul Davis is an employee of Insense; John Wilkins and Andrew Austin are funded by Insense; Robin Thorn's PhD studies have been supported by a grant from Insense.