bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of two compression systems in the management of VLUs: results of a European RCT
Authors: Lazareth I. , Moffatt C. , Dissemond J. , Padieu A.S. Lesne , Truchetet F. , Beissert S. , Wicks G. , Tilbe H. , Sauvadet A. , Bohbot S. , Meaume S. 
Published: May 2014

• Objective: To evaluate the efficacy, tolerance and acceptability an innovative two-layer system (KTwo; Laboratoires URGO) versus an established four-layer bandage system (Profore; Smith & Nephew) in the local management of venous leg ulcers. • Method: A non-inferiority European randomised controlled trial, conducted in 37 centres, in three countries (France, UK and Germany), on patients presenting with venous leg ulcers (VLUs). Participants were adult, non-immunosuppressed patients who presented with non-infected, non-malignant leg ulcers, predominantly of venous origin (ABPI > 0.8), with a surface area of 2–50cm2 and duration 1-24 months. Patients were followed-up every 2 weeks for a period of 12 weeks, or until full closure. Visits included a clinical examination, wound area tracings and photographic evidence. The primary endpoint was the percentage of leg ulcers healed after the 12 weeks, with secondary endpoints of relative wound area reduction (RWAR), absolute wound area reduction (AWAR) and the percentage of wounds with RWAR ≥ 40%. • Results: In total, 187 patients were randomised to either the two-layer bandage (2LB, n=94) or four-layer bandage (4LB; n=93) system. The two groups were comparable, with regard to wound and patient characteristics, at baseline. By week 12, 44% of VLUs in the 2LB group and 39% in the 4LB group had healed (intention-to-treat [ITT] analysis). The per-protocol (PP) analysis showed that complete wound closure was obtained in 48% and 38% of the 2LB and 4LB groups, respectively. A non-inferiority margin within -10% is considered as demonstrating a 95% and 97.5% confidence interval (p=0.001). The AWAR was 6.6cm2 in the test and 4.9cm2 in the control group. The percentage of wounds with a RWAR ≥ 40% was 47% and 44% for the 2LB and 4LB systems, respectively. Pain between dressing changes was reported in 27% of the test and 40% of the control group, and the incidence of adverse events was 17% and 25%, respectively. The 2LB compression system was considered to be significantly easier to apply than the 4LB (p=0.038). • Conclusion: The 2LB system (KTwo) was not seen to be any less effective than a well-known 4LB system (Profore) in the management of VLUs. Furthermore, the 2LB system was considered to be easier to apply, representing an alternative to the conventional treatment with 4LB currently available. • Declaration of interest: This study was sponsored by a grant from Laboratoires URGO, manufacturers of KTwo. S. Bohbot and A. Sauvadet are employees of Laboratoires Urgo. S. Meaume has received monetary compensation as a speaker for Laboratoires Urgo. Data management and statistical analyses were conducted by Vertical (J.C. Kerihuel; Paris, France).
Effcacy of a silver lipidocolloid dressing on heavily colonised wounds: a republished RCT
Authors: Lazareth I. , Meaume S. , Sigal-Grinberg M.L. , Combemale P. , Guyadec T. Le , Zagnoli A. , Perrot J.L. , Sauvadet A. , Bohbot S. 
Published: May 2014

Objective: To assess the ability of a silver lipidocolloid contact layer to promote the healing process of venous leg ulcers (VLUs) presenting inflammatory signs, suggesting a heavy bacteria colonisation, and then delayed healing, in comparison with the same wound dressing not impregnated with silver salts. Method: This was an open-labelled, randomised, controlled trial. VLU presenting at least 3 out of 5 clinical signs suggesting heavy bacterial colonisation were recruited. Patients were treated with contact-layer silver-dressing (ClS; Urgotul Silver [URGO Laboratories]) or contact-layer dressing (Cl; Urgotul [URGO laboratories]) for 4 weeks, then all treated ulcers were treated with CL for 4 additional weeks. Wound evaluation and area measurements were conducted weekly, during the first 4 weeks, and then at weeks 6 and 8. Main efficacy criterion was absolute wound area decrease (AD) at week 4 and week 8. Results: Patients (n=102) were randomised and treated. ulcers were present for nearly 11 months on average; 65% were recurrent and mean area was 20.0 ± 17.8cm2. almost 80% of the treated VLU were stagnating/aggravating with their previous treatment. by week 4, mean surface area decreased by 6.5 ± 13.4cm2 (median: 4.2cm2) and 1.3 ± 9.0cm2 (median: 1.1cm2) in ClS and CL groups, respectively (p=0.023). at week 8, median decrease was 5.9cm2 vs 0.8cm2 (p=0.002), with a wound percentage decrease of 48% and 5.6% (p=0.036). Median closure rate was 0.145cm2/day vs 0.044cm2/day (p=0.009) at week 4 and remained higher in the ClS group up to week 8, even after switching to CL dressing in these patients (p=0.001). odds ratio (multinomial logistic regression) of the chance to reach a ≥40% wound area reduction was 2.7 (95%CI: 1.1;6.7, p=0.038) for silver-treated ulcers. Dressing tolerance was good in both groups. Conclusion: a 4-week treatment with silver-releasing lipidocolloid contact layer promotes a sustained increase of closure rate of venous leg ulcers presenting inflammatory signs, suggesting a high bacterial load. Declaration of interest: This study was funded by a grant from URGO laboratories. Dr Meaume and Dr Lazareth have served as paid speakers for URGO Laboratories. Dr Sauvadet and Dr Bohbot are employees of URGO Laboratories.
A systematic review of the ASEPSIS scoring system used in non-cardiac-related surgery
Authors: Siah C.J. , Childs C. 
Published: May 2014

Objective: To assess the validity, reliability and sensitivity of the ASEPSIS scoring system, used to assess non-cardiac related surgery for surgical wound infection. Method: Five studies were included in this review. One study discussed the development of the ASEPSIS scoring system; two studies were on its reliability, one study on the sensitivity and the final compared the ASEPSIS scoring system against other surgical wound infection criteria and definitions. Due to variation in study designs, the findings were summarised and presented in a narrative format. Results: Validity and reliability were not established in assessing non-cardiac surgical sites. Sensitivity level was reported for non-cardiac surgical sites, but its reliability level declined as the severity of infection worsened. Conclusion: This review revealed that there are limited choices of scoring systems to assess different surgical sites for surgical wound infection. Currently, only the ASEPSIS scoring system is available, but it is not validated for use with non-sternal wounds. Therefore, it should be used cautiously when assessing non-cardiac surgical wound infection. Declaration of interest: The authors have no conflict of interest to declare. There were no external sources of funding for this systematic review.
Efficacy and safety of hyaluronic acid in treatment of leg ulcers: a double-blind RCT
Authors: Dereure O. , Czubek M. , Combemale P. 
Published: May 2014

Objective: To investigate the efficacy and safety of hyaluronic acid in the local treatment of leg ulcers of venous or mixed aetiology, compared with a neutral vehicle. Method: A 60-day double-blind, randomised, multicentre, controlled superiority trial. The primary endpoint was the percentage wound size reduction after 45 days of treatment. Secondary endpoints included pain intensity, rate of complete ulcer healing, and aspect of the wound (percentage of necrotic, fibrinous or granulation tissue) and of the peri-ulcer skin. Results: A total of 101 patients were randomised and analysed in the intention-to-treat (ITT) population (50 in the hyaluronic acid; 51 in the control group). Seventy-five patients were considered in the per protocol (PP) population (38 vs 37, respectively). At day 45, the percentage of ulcer surface reduction was significantly greater in the hyaluronic acid treatment group (39 ± 6%) compared with the neutral vehicle (control) group (5 ± 9%) (p=0.002). A similar result was obtained at day 15, day 30 and day 60. From day 0 to day 45, pain intensity (VAS) decreased by mean 9.8 ± 3.5mm in the hyaluronic acid group, but slightly increased by 0.8 ± 3.2mm in the control group (p=0.029). Burden of pain, as estimated by the area under the curve of daily pain (from day 0 to day 60), was significantly lower in the hyaluronic acid group (121.9 ± 20.7mm2) than in the control group (207.4 ± 32.9mm2; p=0.028). Other secondary endpoints (rate of complete healing, characteristics of the wound and peri-ulcer skin) were not significantly different between the two groups. Treatments were well tolerated and adverse events were comparable between the two groups in terms of their frequency, relationship to treatment and severity. Conclusion: Hyaluronic acid cream was significantly more effective than the neutral vehicle in the local treatment of leg ulcers of venous or mixed aetiology, in terms of wound size reduction and reducing the burden of pain, with a good safety profile. Declaration of interest: This study was sponsored by Laboratoires Genévrier. The authors received honoraria for their contributions to the study, but have no other conflicts of interests to declare.
Prospective RCT comparing two hydrocolloid dressings in acute trauma wounds in South Korea
Authors: Kim S.W. , Lee J.H. , Seo B.F. , Rhie J.W. 
Published: May 2014

Objective: To compare the efficacy of two hydrocolloid dressings (Medifoam H; Genewel Co. Ltd. and DuoDERM; ConvaTec Inc.) for the management of lacerations, abrasions, and minor operation incisions. Method: Patients with lacerations, abrasions, and minor operation incisions were randomly allocated to receive either Medifoam H or DuoDERM. Data collected included wound assessment (amount of exudate, wound infection, rate of wound closure, and the percentage of necrotic, sloughy, fibrous, granulation, and epithelial tissue present in the wound bed) and patient evaluation of itching, burning, leakage of exudate, pain and discomfort incurred from dressing and dressing change. Results: In total, 66 patients were included in the study. No significant difference in wound assessment or in patient evaluation was detected between two groups. Conclusion: The data collected from this study gave no evidence for any difference in efficacy between Medifoam H and DuoDERM for minor, acute trauma wound management. Declaration of interest: This study was supported by The Medical Devices Clinical Comparison and Performance Evaluation Support Project, which was sponsored by small and medium business administration grants and conducted by the Korea Medical Devices Industrial Cooperative Association (project number ND322759). The authors have no conflicts of interest to report.
Review of patients' experiences with fungating wounds and associated quality of life
Authors: Gibson S. , Green J. 
Published: May 2014

Objective: To investigate the evidence exploring the experiences of patients with fungating wounds and associated quality of life, and to subsequently provide recommendations to how these implications may be addressed in practice. Method: Using a systematic approach, a comprehensive literature search was conducted to investigate the most appropriate and relevant evidence regarding the experiences of patients with fungating wounds. Results: Studies unveiled the enormity of the unrelenting, unique and devastating consequences that these wounds have on an individual's life and that every domain of their life is negatively affected. Conclusion: These findings must galvanise nurses to become aware of the extent of the devastation experienced and aspects of life affected by these wounds. The issues raised have multifaceted and challenging implications for practice; however, all aspects need to be addressed and satisfied in an attempt to improve the quality of life of individuals with fungating wounds. Declaration of interest: There were no external sources of funding for this study. The authors have no conflicts of interest to declare.
An evaluation of dehydrated human amniotic membrane allografts in patients with DFUs
Authors: Zelen C.M. 
Published: May 2014

Objective: To evaluate healing of chronic diabetic foot ulcers (DFUs) with use of dehydrated human amniotic membrane (dHAM) in patients failing under standard of care treatment. Method: The study population was identified from patients with chronic DFUs enrolled in a randomised trial comparing standard care with standard care with the addition of dHAM. The present study included patients that failed to heal (defined as <50% decrease in wound size after 6 weeks, or not completely healed by 12 weeks of treatment) with standard care. One week after withdrawal from the randomised trial, these patients were offered treatment with standard care and bi-weekly application of dHAM. Subsequent evaluation of clinical records was made with IRB approval and patient consent. Each patient was used as their own control to compare wound size reduction between treatment periods, and healing rates within the 12-week dHAM treatment period. Results: Eleven patients were included in the study. Mean wound chronicity was 21.1 ± 12.4 weeks (range 11–54 weeks) and mean wound size was 4.7 ± 5.0cm 2 , at baseline. Complete healing was achieved in 55% by 4 weeks, 64% by 6 weeks and 91% by 12 weeks with bi-weekly dHAM application. Mean weeks to complete healing was 4.2 ± 3.1 weeks for the 10 patients healed. After 4 weeks of standard care, wounds had decreased in size an average of 26.8 ± 45.3% versus 87.6 ± 16.0% after 4 weeks of dHAM treatment (two applications; p <0.001). Conclusion: This study provides evidence that the incorporation of dHAM into standard of care for patients with chronic DFUs can be beneficial. The results suggest that dHAM is a viable option for the treatment of recalcitrant DFUs Declaration of interest: This study was sponsored and funded by MiMedx. The Professional Education and Research Institute received research funds to conduct the trial. The author has no conflicts of interest to declare.
Sleep disruption in patients with chronic leg ulcers
Authors: Upton D. , Andrews A. 
Published: May 2014

• Objective:To investigate the incidence of sleep disruption in people with chronic leg ulcers and to explore which factors may contribute to sleep problems. • Method:A questionnaire survey was completed by a convenience sample of 52 leg ulcer patients attending community-based Leg Clubs in England and Wales. the questionnaire assessed wound pain, quality of sleep, factors contributing to sleep disruption and general health. • Results:Sixty-nine per cent (n=36) of leg ulcer patients reported sleep disruption, with 88% stating that they wake at least once during the night. General wound pain was the most frequently-cited cause (58%), while pain associated with treatment affected the sleep of 38% of respondents. Additionally, nearly a third (n=14) expressed that worrying about their wound impacted on their sleep. A significant correlation was found between wound pain and sleep disruption. • Conclusion:The findings suggest that the majority of leg ulcer patients suffer sleep disruption, either as a direct consequence of wound pain or due to treatment-related or psychological issues associated with the wound. This has important implications for patient quality of life and also for the healing process; therefore, assessment and management of sleep problems in leg ulcer patients is essential. • Declaration of interest:This study was supported by a financial grant from Mölnlycke Health Care. The authors have no commercial or social conflicts of interest with respect to the article or its content.
Wound pruritus: prevalence, aetiology and treatment
Authors: Upton D. , Richardson C. , Andrews A. , Rippon M. 
Published: May 2014

• Objective: to review the literature into itching or pruritus, in relation to burns or other types of wound, with a focus on the physiological mechanisms underlying itching and the issues associated with itching in people with wounds.• Method: A literature search was conducted using pubmed, meDlIne and Google Scholar, including english-language papers published up to 2012. the search terms used were: [‘pruritus’ or ‘itching’] or [‘chronic’] AnD [‘wounds’ or ‘burns’]. Studies were included in the review if they addressed the implications of pruritus in relation to burns and acute or chronic wounds.• Results: All types of wound may be associated with acute or chronic itching, depending on their pathology and the severity of the trauma. burns have a very high incidence of itch and this can be an issue many years after healing in some patients. the impact of itch can be severe, leading to issues such as anxiety, depression, reduced sleep, and impaired quality of life. Furthermore, scratching may lead to infection recurrence and delayed healing through exacerbating the patient's physical and psychological condition.• Conclusion: Itching is a signifcant issue for people with burns and other types of wound, causing a range of physical and psychological difficulties, impairing quality of life, and potentially leading to delayed healing. It is therefore essential that clear guidelines are developed in relation to treatment options for people with burns and other wounds who experience itching.• Declaration of interest: this study was supported by a financial grant from mölnlycke Health Care. m. rippon is an employee of mölnlycke Health Care; D. Upton, C. richardson and A. Andrews have no commercial or social conflicts of interest with respect to the article or its content.
Treatment for wound pruritus following burns
Authors: Richardson C. , Upton D. , Rippon M. 
Published: May 2014

Objective:To review the current literature on the treatment of itching, or pruritus, in people with burn wounds.Method:A literature search using the databases PubMed, MEDLINE and Google Scholar was undertaken. Studies were included in the review if they discussed or evaluated different treatment options for pruritus in patients with burn wounds.Results:A variety of treatments are available for the relief of pruritus in patients with burns wounds, ranging from antihistamines and topical emollients to psychological therapies, massage and dermatological treatments. Oral antihistamines are used most commonly, yet research indicates that these are not always effective. Few studies are methodologically robust. In recent years, there has been an attempt to design and implement treatment strategies and algorithms, however, there is currently no agreed and consistent management plan for the treatment of pruritus due to burn injury.Conclusion:Simple single therapies should be the frst line therapy for the treatment of pruritus due to burns, however, if these are unsuccessful, combination therapy should be introduced early to try to reduce the onset of chronic itch. Current algorithms and treatment plans based on the stage of healing show promise but need further modifcation and testing before they can be recommended for common use.Declaration of interest:There were no external sources of funding for this study. The authors have no conficts of interests to declare.
The production and measurement of sub-bandage pressure: Laplace's Law revisited
Authors: Thomas S. 
Published: May 2014

Objective: The present study was undertaken to demonstrate that the pressures produced by multiple layers of compression bandages applied to artificial limbs of known circumference with predetermined levels of tension can be predicted accurately using the modified Laplace equation. Method: Up to four layers of different bandage types were applied in a carefully controlled fashion to cylinders of known circumference, with tensions ranging from around 200–2000 grams/10cm width. The pressures generated were measured using pneumatic pressure sensors previously shown to possess the required degree of accuracy for this type of experimental system. Results: Good correlation was observed between the mean and standard deviation of each pair of experimental and calculated pressure values for all combinations of bandage type, application tension and cylinder circumference. Over the clinically relevant range of pressures, the difference between data sets was generally less than 1.0mmHg. Conclusion: The results of this experimental study unequivocally prove that provided accurate values for all the relevant variables are known, it is possible to predict the pressure that will be developed by a compression bandage on a limb of known size. However, it is important to recognise that other factors such as the elastomeric properties of the fabric will have a major effect upon the ability of a bandage system to sustain initial compression values. Furthermore, the variation in radius of curvature around a limb will mean that point pressures readings recorded at individual locations around the circumference may vary dramatically from the average value predicted by the modified Laplace equation, calling into question the value of sub-bandage pressure measuring devices for this application. Declaration of interest: This project was generously supported by 3M Healthcare who provided a small research grant to assist with the costs associated with the construction of the test equipment.
Prehospital induction techniques: mild hypothermia during advanced life support
Authors: Stefano Bernardelli , Elisa Rebesan , Alessandra Culoma Luciana , Rita Riolfi , Elena Colombaroli 
Published: May 2014

The use of therapeutic hypothermia has been proposed as a potential treatment for a number of medical conditions including head injury and cerebral vascular accidents. This article aims to explore the different techniques used to induce hypothermia during prehospital cardiovascular arrest. The review of the necessary literature has been made in order to answer the question ‘What are the possible cooling methods to reach therapeutic hypothermia in out-of-hospital cardiac arrest?’. The research took place between May–November 2008. Ovid database was examined/questioned initially and the research was carried out simultaneously using Ovid Medline, Pubmed and CINAHL. The research showed that inclusion and exclusion criteria were similar in all the analysed studies. The chosen patients were aged 18–70 years. Only one article included patients older than 70 years who were affected by extra-hospital cardiocirculatory arrest and were treated with therapeutic hypothermia with infusion of cold liquids or use of correspondent remedies. A total of 627 620 articles were found during the search term research. Boolean operators were used to review the research. ‘AND’ was used to combine to the operator limit. ‘OR’ was used to include orthographic alternatives. All this reduced the research to four articles. Cutting off and mesh researches were used in ‘include relative terms’ within the Ovid control panel. The analysis of the four studies showed the effectiveness of introducing hypothermia in prehospital treatment dealing with the reduction of the oesophageal temperature. In all studies, the temperature reduction is relevant, presenting values of −1–4°C. The infusion of cold solutions is a technique that is easy to apply and has low costs. Infusion with cold pads, on the other hand, proves more difficult and requires greater attention and daily maintenance.
Endotracheal adrenaline in cardiac arrest due to near-fatal asthma: a case study
Authors: Smart Gary 
Published: May 2014

A case report of respiratory arrest in a patient with an out-of-hospital, near fatal asthma (NFA) attack; successfully resuscitated with treatment that included endotracheal adrenaline is described. This report demonstrates that endotracheal epinephrine (adrenaline may have a role in the resuscitation of asphyxic asthma. Adrenaline is a recognised β2 agonist and its smooth muscle relaxation properties are known to reverse bronchospasm. Ventilating patients with severe bronchospasm resulting from asphyxic asthma is known to be difficult. This report shows that instilling adrenaline via the endotracheal tube to a patient in cardio-respiratory arrest, resulted in relief of bronchospasm, reduction in airways resistance and a subsequent improvement of the operator's ability to ventilate.