3,176 research outputs found
The evidence supporting the use of honey as a wound dressing
No full textSome clinicians are under the impression that there is little or no evidence to support the use of honey as a wound dressing. This impression is reinforced by it being concluded in systematic reviews that the evidence is not of a high standard. But likewise the evidence for modern wound dressing products is of not of a high standard. For evidence-based medicine to be practised in wound care, when deciding which product to use to dress a wound it is necessary to compare the evidence that does exist, rather than be influenced by advertising and other forms of sales promotion. To allow sound decisions to be made, this review has covered the various reports that have been published on the clinical usage of honey. Positive findings on honey in wound care have been reported from 17 randomised controlled trials involving a total of 1965 participants, and 5 clinical trials of other forms involving 97 participants treated with honey. The effectiveness of honey in assisting wound healing has also been demonstrated in 16 trials on a total of 533 wounds on experimental animals. There is also a large amount of evidence in the form of case studies that have been reported. Ten publications have reported on multiple cases, totalling 276 cases. There are also 35 reports of single cases. These various reports provide a large body of evidence to support honey having the beneficial actions of clearing and preventing wound infection, rapidly debriding wounds, suppressing inflammation and thus decreasing oedema, wound exudate and hypertophic scarring, and stimulating the growth of granulation tissue and epithelialisation. It has been shown to give good results on a very wide range of types of wound. Clinicians should look for the clinical evidence that exists to support the use of other wound care products to compare with the evidence that exists for honey
Bacterial Growth Kinetics under a Novel Flexible Methacrylate Dressing Serving as a Drug Delivery Vehicle for Antiseptics
No full textA flexible methacrylate powder dressing (Altrazeal®) transforms into a wound contour conforming matrix once in contact with wound exudate. We hypothesised that it may also serve as a drug delivery vehicle for antiseptics. The antimicrobial efficacy and influence on bacterial growth kinetics in combination with three antiseptics was investigated in an in vitro porcine wound model. Standardized in vitro wounds were contaminated with Staphylococcus aureus (MRSA; ATCC 33591) and divided into six groups: no dressing (negative control), methacrylate dressing alone, and combinations with application of 0.02% Polyhexamethylene Biguanide (PHMB), 0.4% PHMB, 0.1% PHMB + 0.1% betaine, 7.7 mg/mL Povidone-iodine (PVP-iodine), and 0.1% Octenidine-dihydrochloride (OCT) + 2% phenoxyethanol. Bacterial load per gram tissue was measured over five days. The highest reduction was observed with PVP-iodine at 24 h to log10 1.43 cfu/g, followed by OCT at 48 h to log10 2.41 cfu/g. Whilst 0.02% PHMB resulted in a stable bacterial load over 120 h to log10 4.00 cfu/g over 120 h, 0.1% PHMB + 0.1% betaine inhibited growth during the first 48 h, with slightly increasing bacterial numbers up to log10 5.38 cfu/g at 120 h. These results indicate that this flexible methacrylate dressing can be loaded with various antiseptics serving as drug delivery system. Depending on the selected combination, an individually shaped and controlled antibacterial effect may be achieved using the same type of wound dressing
Clinical usage of honey as a wound dressing: An update
No full textHoney is an ancient treatment that is increasingly earning its place in modern wound care. Evidence suggests it compares with other dressings in terms of its antibacterial properties, ease of use and ability to promote a moist environmen
The evidence and the rationale for the use of honey as wound dressing
No full textAlthough there are now several brands and types of honey wound-care products available as registered medical devices, there is little promotional advertising of honey products for wound care. The misconception that there is no evidence to support the use of honey, which seems to be quite common, may be due to this lack of advertising, and to the systematic reviews that have been published on honey concluding that the evidence is of low quality and/or there is a need for more evidence. However, the same lack of high-quality evidence exists with all the other options that clinicians have for dressing wounds. This places practitioners in a quandary. When clinical evidence of the highest level is not available, then decisions on modes of treatment need to be based on whatever evidence there is available. This review outlines the 16 randomised controlled trials (RCTs) of honey in wound care published since Molan reviewed the previous 17 in 2006, which bring the total of participants in the trials up from 1,965 to 3,556 and broadens the range of types of wounds on which trials with honey have been conducted. Another important factor influencing the choice by clinicians of which product to use on a wound is scientific rationale. This review covers the evidence and explanation of mode of action for various bioactivities in honey which aid wound healing: a very broad-spectrum antimicrobial activity that is effective on antibiotic-resistant strains; activation of autolytic debridement; anti-inflammatory activity; antioxidant activity; stimulation of growth of cells for tissue repair; and an osmotic action. The need for standardisation of these bioactivities is discussed
Achieving international consensus for the prevention of orthopaedic wound blistering: results of a Delphi survey
No full textThis article presents the results of an international 2 stage Delphi survey carried out via e-mail to achieve consensus as to the most effective postoperative wound management to prevent blistering and other complications. Seventeen prospective participants were invited to be members of the Delphi Panel of which 13 agreed to be involved. The panel suggested that an ideal wound dressing would conform easily to the wound, be easy to apply and remove, allow for swelling and minimise pain on removal. Participants were in agreement that the primary wound dressing should be left in situ for as long as possible, providing there was no excessive oozing or signs of infection. The authors recognise that the Delphi Panel was relatively compact; however, the study arguably provides some useful data that can be used to identify the consequences of wound blistering and important factors that need to be considered when choosing a wound dressing to prevent blistering
Laboratory evaluation of Drawtex Hydroconductive Dressing with LevaFiber technology
No full textGood wound bed preparation is an essential aspect of wound care and effective wound healing. Removal of dead and necrotic tissue either through autolytic or interventional debridement, followed by good exudate management, inhibition of matrix metalloproteases and bacterial bioburden control should allow the chronic wound to process to closure. It is known, still, that wound healing in these circumstances is not a simple process and that maintaining a healthy wound bed is central to the process.
Many practitioners rely on the TIME (Tissue, Infection/Inflammation, Moisture balance and wound Edge) framework to help them with wound bed preparation and there are a variety of dressings available to help with debridement, exudate management, reduction of bacterial bioburden and inhibit metalloproteases. The sequence of application of the various dressings will depend upon their function. This study describes the function of a dressing, Drawtex, a hydroconductive dressing, which can be used to assist with wound bed preparation through its absorption, sequestration and retention properties. The absorption over time, ability to sequester and retain bacteria were assessed in the laboratory using a variety of methods. Drawtex was shown to absorb eight times its own weight in fluid over time and it showed a 90% reduction in bacterial numbers over a 24hr period in sequestration experiments. Utilisation of direct observation by scanning electron microscopy demonstrated bacterial retention in the fibres
Dressing Device for Armless People
No full textPatent for a dressing device that aids in dressing people with no arms by buttoning and unbuttoning shirts and adjusting neckties. Illustrations included
Elid superfinishing of spherical bearings
No full textDriven by a requirement to extend the lifespan of self-aligning lined spherical bearings,
this research investigates the use of Elid (electrolytic in-process dressing) as a method
of improving ball surface finish. Elid is a continuous and self-regulating electrochemical
dressing process that modifies the surface of a grinding, lapping, or
superfinishing wheel. It provides improved grit protrusion, impedes wheel loading /
glazing and promotes effective cutting.
The characteristics of the newly-developed Elid superfinishing process are in many
ways fundamentally different to conventional superfinishing. The main difference is
that the use of super-abrasives prevents the wheel from self-sharpening; the normal
mechanism by which dulled conventional abrasives are removed and a wheel’s surface
refreshed. Because the wheel’s performance and condition is continually maintained inprocess
by the Elid system, metal resin bonded (MRB) wheels containing very small
super-abrasives can be used. It is the utilization of these fine abrasives (30 to 0.12 μm)
that enables surface roughness values below 5 nm Ra to be consistently produced on the
spherical surface of corrosion-resistant steel balls.
This research provides an in-depth understanding of the Elid spherical superfinishing
process; investigating the most effective use of the Elid system, wheel dressing
requirements and process performance. Optimisation is provided in terms of evaluating
the critical operating parameters, the most effective superfinishing cycle and the
implications to the complete ball production chain. A range of techniques are used to
evaluate processing performance and ball output quality. These include in-process
monitoring of Elid and wheel spindle power levels, analysis of wheel condition, rates of
ball surface generation and material removal, ball finish and form. Although
predominantly concentrated on corrosion-resistant steel, testing is also conducted on
titanium and various ball coatings.
In investigating various ways of using the Elid system, this work considers electrodischarge
truing, pre-process dressing, Elid 1, Elid 2, Elid 3, and Elid combined with
electrolytically assisted superfinishing. The initial process solution of Elid 3 (electrodeless)
superfinishing provides the capability of working on all standard size balls,
however the dressing system lacks stability. The development of a fixturing system that
has a small separate electrode enables Elid 1 (conventional) to be used on the majority of ball sizes. Elid 1 allows more aggressive and consistent dressing, a faster rate of ball
material removal and thus a substantially reduced processing time.
Results with a #12,000 wheel show that surface quality is vastly improved through the
use of Elid whilst maintaining current production standards of form accuracy. Surface
finishes of 2nm Ra are achieved, which is an order of magnitude better than balls
currently produced using barrelling / polishing. Processing times are equivalent or faster
when using Elid 1. Alternatively, consistently sub 10 nm Ra finishes can be reached
with a #2,000 wheel using Elid 2 (interval dressing). Generally MRB-CBN wheels
provide a more effective carbide cutting action than conventional superfinishing wheels.
Controlling wheel condition and achieving full and even ball to wheel conformity are
the two most significant contributory factors to the success of Elid spherical
superfinishing. Insufficient control of these factors results in poor output quality.
Monitoring of wheel spindle and Elid power usage provides useful information in
assessing the condition of the wheel and identifying potential problems. High spindle
power correlates with fast material removal and is a result of high loads and a free
cutting action. Elid processing can be employed for improving surface finish after the
conventional honing stage, or after cylindrical grinding for improving both ball form
and finish
Wound moisture tracking in the presence of antibacterial honey and during topical negative pressure therapy
No full textUnnecessary dressing changes during military operations in the hospital or at home compromise healing and may increase the risk of local infection. In this article, we describe a medical device that allows the control of moisture in the wound without having to change the dressing. We describe the results of two clinical studies. In the first, the moisture level of the injury is monitored during treatment with compression, with the application of medical honey ( Medihoney ™ Antibacterial Medical Honey ™ , Comvita ) , practiced in hospitals in Glasgow (NHS Greater Glasgow & Clyde ) and Jeddah (King Abdullazziz University Hospital). The first results of a second study involve monitoring of moisture levels of injury during a negative pressure therapy ( NPWT ) . The purpose of these studies is to determine whether you get a good level of moisture in the dressings for wound healing, and to evaluate the adequacy of monitoring the moisture level in the dressing using a disposable sensor CE marked as a medical device
Re-introducing honey in the management of wounds and ulcers - theory and practice
No full textDressing wounds with honey was standard practice in past times but went out of fashion when antibiotics came into use. There has been a renaissance in its usage now that antibiotic-resistant bacteria have become a widespread clinical problem, and laboratory studies and clinical trials have shown that it is a very effective broad-spectrum antibacterial agent with no adverse effects on wound tissues. Modern studies have also shown that as well as having an antibacterial action, honey has several other activities that are beneficial to the wound healing process. It gives rapid autolytic debridement and deodorising of wounds, and stimulates the growth of wound tissues thus hastening healing and starting the healing process in dormant wounds. Its anti-inflammatory activity rapidly reduces pain, edema and exudate and minimises hypertrophic scarring. It also provides a moist healing environment for wound tissues with no risk of maceration of surrounding skin, and completely prevents adherence of dressings to the wound bed so that there is no pain and no tissue damage when dressings are changed. By use of appropriate dressing practices any problems of messiness and difficulty of handling can be easily overcome
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