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[PMID]:28745707
[Au] Autor:Bystrov SA; Bezborodov AI; Katorkin SE
[Ad] Endereço:Samara State Medical University, Ministry of Health, Department of Hospital Surgery, Head of the department: Candidate of Medical Sciences S.E. Katorkin, Samara, Russia.
[Ti] Título:[Treatment of purulent wounds with wound dressing on a foamy basis with Hydrofiber technology].
[Ti] Título:Lechenie gnoinykh ran s primeneniem ranevykh pokrytii na pennoi osnove s tekhnologiei Gidrofaiber..
[So] Source:Khirurgiia (Mosk);(7):49-53, 2017.
[Is] ISSN:0023-1207
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:AIM: to evaluate the effectiveness of modern approaches to the treatment of purulent wounds with the use of foam-based wound coatings with the Hydrofiber technology in comparison with the traditional method of wounds. MATERIAL AND METHODS: An analysis of the results of treatment of 34 patients with purulent wounds of various etiologies was performed. Patients were divided into two groups: control and basic. In the main group, local treatment of wounds was carried out using a foam-based wound coating with Hydrofiber technology. In the control group, local treatment of wounds was carried out using traditional methods with the use of gauze bandages. RESULTS: With the use of foam-based wound coatings with Hydrofiber® technology, the inflammation process in the wound and surrounding tissues is more rapidly eliminated, the periods of purification and microbial decontamination in the purulent focus are reduced.
[Mh] Termos MeSH primário: Curativos Hidrocoloides
Administração dos Cuidados ao Paciente/métodos
Staphylococcus aureus
Cicatrização/efeitos dos fármacos
Infecção dos Ferimentos
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Masculino
Meia-Idade
Staphylococcus aureus/efeitos dos fármacos
Staphylococcus aureus/isolamento & purificação
Resultado do Tratamento
Cicatrização/fisiologia
Infecção dos Ferimentos/microbiologia
Infecção dos Ferimentos/fisiopatologia
Infecção dos Ferimentos/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171130
[Lr] Data última revisão:
171130
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170727
[St] Status:MEDLINE
[do] DOI:10.17116/hirurgia2017749-53


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[PMID]:28745705
[Au] Autor:Karyakin NN; Klemenova IA; Luzan AS
[Ad] Endereço:Volga Federal Medical Research Center, Health Ministry of Russia, Nizhny Novgorod, Russia.
[Ti] Título:[The outcomes of lower extremities burn wounds management by using of controlled moist environment].
[Ti] Título:Rezul'taty lecheniia ozhogovykh ran konechnostei v usloviiakh vlazhnoi sredy..
[So] Source:Khirurgiia (Mosk);(7):40-43, 2017.
[Is] ISSN:0023-1207
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:AIM: To the outcomes of lower extremities burn wounds management by using of controlled moist environment. MATERIAL AND METHODS: Burn wounds management by using of controlled moist environment in 23 patients is presented in the article. Physiological moist conditions on the surface of wounds were created with isotonic sodium chloride solution and sterile polyethylene diaphanous containers. Сontrol group included 12 patients who were treated with hydrocolloid patch. RESULTS: It was shown that burn wounds management with moist environment allows to use and improve this method further. This technique gives good analgesic effect within the first days after burn trauma, allows to implement permanent clinical monitoring of the wound and preserve functional activity of the limbs.
[Mh] Termos MeSH primário: Curativos Hidrocoloides
Queimaduras
Traumatismos da Perna
Administração dos Cuidados ao Paciente/métodos
Cloreto de Sódio/uso terapêutico
Cicatrização
[Mh] Termos MeSH secundário: Adulto
Queimaduras/diagnóstico
Queimaduras/etiologia
Queimaduras/fisiopatologia
Queimaduras/cirurgia
Feminino
Seres Humanos
Soluções Isotônicas/uso terapêutico
Traumatismos da Perna/diagnóstico
Traumatismos da Perna/etiologia
Traumatismos da Perna/cirurgia
Masculino
Manejo da Dor/métodos
Federação Russa
Índices de Gravidade do Trauma
Resultado do Tratamento
Cicatrização/efeitos dos fármacos
Cicatrização/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Isotonic Solutions); 451W47IQ8X (Sodium Chloride)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171130
[Lr] Data última revisão:
171130
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170727
[St] Status:MEDLINE
[do] DOI:10.17116/hirurgia2017740-43


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[PMID]:28954098
[Au] Autor:Oliveira MG; Abbade LPF; Miot HA; Ferreira RR; Deffune E
[Ad] Endereço:Department of Nursing, Botucatu Medical School - São Paulo State University "Júlio de Mesquita Filho" (UNESP) - Botucatu (SP), Brazil.
[Ti] Título:Pilot study of homologous platelet gel in venous ulcers.
[So] Source:An Bras Dermatol;92(4):499-504, 2017 Jul-Aug.
[Is] ISSN:1806-4841
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:Background:: Venous ulcers represent 70% of the lower limb ulcers. They are difficult to heal, requiring a correct diagnostic and therapeutic approach. Many products have been developed to healing, such as homologous platelet gel obtained from the platelet concentrate exceeding from blood transfusion. Objective:: To evaluate the safety and efficacy of homologous platelet gel in venous ulcers compared with hydrocolloid dressing. Method:: A pilot randomized clinical trial in patients with venous ulcers. Randomized groups (homologous platelet gel and hydrocolloid groups) were followed for 90 days and were assessed through the evolution of ulcerated area, qualitative analysis of vascularization and adverse events. Both groups used elastic compression. Results:: We included 16 participants, with a total of 21 venous ulcers. Both treatments promoted a reduction of the areas of the ulcers in 90 days (mean 69%), there was significant difference between the groups concerning the gradual reduction of the ulcers areas, favorably to the hydrocolloid (70% vs 64%; p <0.01). There were some mild adverse events in both groups. Study limitations:: Single-center study with a small number of patients, preventing more accurate assessment of the effects of platelet gel. Conclusion:: The homologous platelet gel associated with the elastic compression can be an alternative to the venous ulcer treatment and is safe due to the occurrence of a few mild local adverse events and no serious adverse events. Clinical trials with larger numbers of patients must be performed to maintain the indication of this treatment for venous ulcer.
[Mh] Termos MeSH primário: Curativos Hidrocoloides
Plasma Rico em Plaquetas
Úlcera Varicosa/terapia
Cicatrização/fisiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Curativos Hidrocoloides/efeitos adversos
Curativos Hidrocoloides/normas
Géis
Seres Humanos
Meia-Idade
Projetos Piloto
Estudos Prospectivos
Resultado do Tratamento
Cicatrização/efeitos dos fármacos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Gels)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170928
[St] Status:MEDLINE


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[PMID]:28917483
[Au] Autor:Hsu CY; Lee WR; Shih YH
[Ad] Endereço:Department of Dermatology, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan.
[Ti] Título:Recalcitrant chronic leg ulcer: An indication for patch testing for hydrocolloid dressing.
[So] Source:J Am Acad Dermatol;77(4):e97-e98, 2017 10.
[Is] ISSN:1097-6787
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Curativos Hidrocoloides/efeitos adversos
Dermatite Alérgica de Contato/etiologia
Úlcera da Perna/terapia
Testes do Emplastro
Cicatrização/fisiologia
[Mh] Termos MeSH secundário: Doença Crônica
Dermatite Alérgica de Contato/imunologia
Progressão da Doença
Seguimentos
Seres Humanos
Úlcera da Perna/diagnóstico
Úlcera da Perna/imunologia
Medição de Risco
Suspensão de Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171018
[Lr] Data última revisão:
171018
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170918
[St] Status:MEDLINE


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[PMID]:28692373
[Au] Autor:Deutsch CJ; Edwards DM; Myers S
[Ad] Endereço:Clinical Fellow in Plastic Surgery, Department of Plastic Surgery, Royal London Hospital, London E1 1BB.
[Ti] Título:Wound dressings.
[So] Source:Br J Hosp Med (Lond);78(7):C103-C109, 2017 Jul 02.
[Is] ISSN:1750-8460
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Bandagens
Cicatrização
Ferimentos e Lesões/terapia
[Mh] Termos MeSH secundário: Alginatos
Curativos Hidrocoloides
Ácido Glucurônico
Ácidos Hexurônicos
Mel
Seres Humanos
Tratamento de Ferimentos com Pressão Negativa
Curativos Oclusivos
Poliuretanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Alginates); 0 (Hexuronic Acids); 0 (Polyurethanes); 8A5D83Q4RW (Glucuronic Acid); 8C3Z4148WZ (alginic acid)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170711
[St] Status:MEDLINE
[do] DOI:10.12968/hmed.2017.78.7.C103


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[PMID]:28639707
[Au] Autor:Westby MJ; Dumville JC; Soares MO; Stubbs N; Norman G
[Ad] Endereço:Division of Nursing, Midwifery & Social Work, School of Health Sciences, Faculty of Biology, Medicine & Health, University of Manchester, Manchester Academic Health Science Centre, Jean McFarlane Building, Oxford Road, Manchester, UK, M13 9PL.
[Ti] Título:Dressings and topical agents for treating pressure ulcers.
[So] Source:Cochrane Database Syst Rev;6:CD011947, 2017 06 22.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Pressure ulcers, also known as bedsores, decubitus ulcers and pressure injuries, are localised areas of injury to the skin or the underlying tissue, or both. Dressings are widely used to treat pressure ulcers and promote healing, and there are many options to choose from including alginate, hydrocolloid and protease-modulating dressings. Topical agents have also been used as alternatives to dressings in order to promote healing.A clear and current overview of all the evidence is required to facilitate decision-making regarding the use of dressings or topical agents for the treatment of pressure ulcers. Such a review would ideally help people with pressure ulcers and health professionals assess the best treatment options. This review is a network meta-analysis (NMA) which assesses the probability of complete ulcer healing associated with alternative dressings and topical agents. OBJECTIVES: To assess the effects of dressings and topical agents for healing pressure ulcers in any care setting. We aimed to examine this evidence base as a whole, determining probabilities that each treatment is the best, with full assessment of uncertainty and evidence quality. SEARCH METHODS: In July 2016 we searched the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid Embase and EBSCO CINAHL Plus. We also searched clinical trials registries for ongoing and unpublished studies, and scanned reference lists of relevant included studies as well as reviews, meta-analyses, guidelines and health technology reports to identify additional studies. There were no restrictions with respect to language, date of publication or study setting. SELECTION CRITERIA: Published or unpublished randomised controlled trials (RCTs) comparing the effects of at least one of the following interventions with any other intervention in the treatment of pressure ulcers (Stage 2 or above): any dressing, or any topical agent applied directly to an open pressure ulcer and left in situ. We excluded from this review dressings attached to external devices such as negative pressure wound therapies, skin grafts, growth factor treatments, platelet gels and larval therapy. DATA COLLECTION AND ANALYSIS: Two review authors independently performed study selection, risk of bias assessment and data extraction. We conducted network meta-analysis using frequentist mega-regression methods for the efficacy outcome, probability of complete healing. We modelled the relative effectiveness of any two treatments as a function of each treatment relative to the reference treatment (saline gauze). We assumed that treatment effects were similar within dressings classes (e.g. hydrocolloid, foam). We present estimates of effect with their 95% confidence intervals for individual treatments compared with every other, and we report ranking probabilities for each intervention (probability of being the best, second best, etc treatment). We assessed the certainty (quality) of the body of evidence using GRADE for each network comparison and for the network as whole. MAIN RESULTS: We included 51 studies (2947 participants) in this review and carried out NMA in a network of linked interventions for the sole outcome of probability of complete healing. The network included 21 different interventions (13 dressings, 6 topical agents and 2 supplementary linking interventions) and was informed by 39 studies in 2127 participants, of whom 783 had completely healed wounds.We judged the network to be sparse: overall, there were relatively few participants, with few events, both for the number of interventions and the number of mixed treatment contrasts; most studies were small or very small. The consequence of this sparseness is high imprecision in the evidence, and this, coupled with the (mainly) high risk of bias in the studies informing the network, means that we judged the vast majority of the evidence to be of low or very low certainty. We have no confidence in the findings regarding the rank order of interventions in this review (very low-certainty evidence), but we report here a summary of results for some comparisons of interventions compared with saline gauze. We present here only the findings from evidence which we did not consider to be very low certainty, but these reported results should still be interpreted in the context of the very low certainty of the network as a whole.It is not clear whether regimens involving protease-modulating dressings increase the probability of pressure ulcer healing compared with saline gauze (risk ratio (RR) 1.65, 95% confidence interval (CI) 0.92 to 2.94) (moderate-certainty evidence: low risk of bias, downgraded for imprecision). This risk ratio of 1.65 corresponds to an absolute difference of 102 more people healed with protease modulating dressings per 1000 people treated than with saline gauze alone (95% CI 13 fewer to 302 more). It is unclear whether the following interventions increase the probability of healing compared with saline gauze (low-certainty evidence): collagenase ointment (RR 2.12, 95% CI 1.06 to 4.22); foam dressings (RR 1.52, 95% CI 1.03 to 2.26); basic wound contact dressings (RR 1.30, 95% CI 0.65 to 2.58) and polyvinylpyrrolidone plus zinc oxide (RR 1.31, 95% CI 0.37 to 4.62); the latter two interventions both had confidence intervals consistent with both a clinically important benefit and a clinically important harm, and the former two interventions each had high risk of bias as well as imprecision. AUTHORS' CONCLUSIONS: A network meta-analysis (NMA) of data from 39 studies (evaluating 21 dressings and topical agents for pressure ulcers) is sparse and the evidence is of low or very low certainty (due mainly to risk of bias and imprecision). Consequently we are unable to determine which dressings or topical agents are the most likely to heal pressure ulcers, and it is generally unclear whether the treatments examined are more effective than saline gauze.More research is needed to determine whether particular dressings or topical agents improve the probability of healing of pressure ulcers. The NMA is uninformative regarding which interventions might best be included in a large trial, and it may be that research is directed towards prevention, leaving clinicians to decide which treatment to use on the basis of wound symptoms, clinical experience, patient preference and cost.
[Mh] Termos MeSH primário: Bandagens
Fármacos Dermatológicos/uso terapêutico
Lesão por Pressão/terapia
Cicatrização
[Mh] Termos MeSH secundário: Alginatos/uso terapêutico
Curativos Hidrocoloides
Colagenases/uso terapêutico
Clara de Ovo
Géis/uso terapêutico
Ácido Glucurônico/uso terapêutico
Ácidos Hexurônicos/uso terapêutico
Seres Humanos
Metanálise em Rede
Pomadas/uso terapêutico
Excipientes Farmacêuticos/uso terapêutico
Fenitoína/uso terapêutico
Povidona/uso terapêutico
Ensaios Clínicos Controlados Aleatórios como Assunto
Óxido de Zinco/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Alginates); 0 (Dermatologic Agents); 0 (Gels); 0 (Hexuronic Acids); 0 (Ointments); 0 (Pharmaceutic Aids); 6158TKW0C5 (Phenytoin); 8A5D83Q4RW (Glucuronic Acid); 8C3Z4148WZ (alginic acid); EC 3.4.24.- (Collagenases); FZ989GH94E (Povidone); SOI2LOH54Z (Zinc Oxide)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170623
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD011947.pub2


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[PMID]:28613416
[Au] Autor:Dumville JC; Lipsky BA; Hoey C; Cruciani M; Fiscon M; Xia J
[Ad] Endereço:Division of Nursing, Midwifery & Social Work, School of Health Sciences, Faculty of Biology, Medicine & Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK, M13 9PL.
[Ti] Título:Topical antimicrobial agents for treating foot ulcers in people with diabetes.
[So] Source:Cochrane Database Syst Rev;6:CD011038, 2017 06 14.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: People with diabetes are at high risk for developing foot ulcers, which often become infected. These wounds, especially when infected, cause substantial morbidity. Wound treatments should aim to alleviate symptoms, promote healing, and avoid adverse outcomes, especially lower extremity amputation. Topical antimicrobial therapy has been used on diabetic foot ulcers, either as a treatment for clinically infected wounds, or to prevent infection in clinically uninfected wounds. OBJECTIVES: To evaluate the effects of treatment with topical antimicrobial agents on: the resolution of signs and symptoms of infection; the healing of infected diabetic foot ulcers; and preventing infection and improving healing in clinically uninfected diabetic foot ulcers. SEARCH METHODS: We searched the Cochrane Wounds Specialised Register, CENTRAL, Ovid MEDLINE, Ovid MEDLINE (In-Process & Other Non-Indexed Citations), Ovid Embase, and EBSCO CINAHL Plus in August 2016. We also searched clinical trials registries for ongoing and unpublished studies, and checked reference lists to identify additional studies. We used no restrictions with respect to language, date of publication, or study setting. SELECTION CRITERIA: We included randomised controlled trials conducted in any setting (inpatient or outpatient) that evaluated topical treatment with any type of solid or liquid (e.g., cream, gel, ointment) antimicrobial agent, including antiseptics, antibiotics, and antimicrobial dressings, in people with diabetes mellitus who were diagnosed with an ulcer or open wound of the foot, whether clinically infected or uninfected. DATA COLLECTION AND ANALYSIS: Two review authors independently performed study selection, 'Risk of bias' assessment, and data extraction. Initial disagreements were resolved by discussion, or by including a third review author when necessary. MAIN RESULTS: We found 22 trials that met our inclusion criteria with a total of over 2310 participants (one study did not report number of participants). The included studies mostly had small numbers of participants (from 4 to 317) and relatively short follow-up periods (4 to 24 weeks). At baseline, six trials included only people with ulcers that were clinically infected; one trial included people with both infected and uninfected ulcers; two trials included people with non-infected ulcers; and the remaining 13 studies did not report infection status.Included studies employed various topical antimicrobial treatments, including antimicrobial dressings (e.g. silver, iodides), super-oxidised aqueous solutions, zinc hyaluronate, silver sulphadiazine, tretinoin, pexiganan cream, and chloramine. We performed the following five comparisons based on the included studies: Antimicrobial dressings compared with non-antimicrobial dressings: Pooled data from five trials with a total of 945 participants suggest (based on the average treatment effect from a random-effects model) that more wounds may heal when treated with an antimicrobial dressing than with a non-antimicrobial dressing: risk ratio (RR) 1.28, 95% confidence interval (CI) 1.12 to 1.45. These results correspond to an additional 119 healing events in the antimicrobial-dressing arm per 1000 participants (95% CI 51 to 191 more). We consider this low-certainty evidence (downgraded twice due to risk of bias). The evidence on adverse events or other outcomes was uncertain (very low-certainty evidence, frequently downgraded due to risk of bias and imprecision). Antimicrobial topical treatments (non dressings) compared with non-antimicrobial topical treatments (non dressings): There were four trials with a total of 132 participants in this comparison that contributed variously to the estimates of outcome data. Evidence was generally of low or very low certainty, and the 95% CIs spanned benefit and harm: proportion of wounds healed RR 2.82 (95% CI 0.56 to 14.23; 112 participants; 3 trials; very low-certainty evidence); achieving resolution of infection RR 1.16 (95% CI 0.54 to 2.51; 40 participants; 1 trial; low-certainty evidence); undergoing surgical resection RR 1.67 (95% CI 0.47 to 5.90; 40 participants; 1 trial; low-certainty evidence); and sustaining an adverse event (no events in either arm; 81 participants; 2 trials; very low-certainty evidence). Comparison of different topical antimicrobial treatments: We included eight studies with a total of 250 participants, but all of the comparisons were different and no data could be appropriately pooled. Reported outcome data were limited and we are uncertain about the relative effects of antimicrobial topical agents for each of our review outcomes for this comparison, that is wound healing, resolution of infection, surgical resection, and adverse events (all very low-certainty evidence). Topical antimicrobials compared with systemic antibiotics : We included four studies with a total of 937 participants. These studies reported no wound-healing data, and the evidence was uncertain for the relative effects on resolution of infection in infected ulcers and surgical resection (very low certainty). On average, there is probably little difference in the risk of adverse events between the compared topical antimicrobial and systemic antibiotics treatments: RR 0.91 (95% CI 0.78 to 1.06; moderate-certainty evidence - downgraded once for inconsistency). Topical antimicrobial agents compared with growth factor: We included one study with 40 participants. The only review-relevant outcome reported was number of ulcers healed, and these data were uncertain (very low-certainty evidence). AUTHORS' CONCLUSIONS: The randomised controlled trial data on the effectiveness and safety of topical antimicrobial treatments for diabetic foot ulcers is limited by the availability of relatively few, mostly small, and often poorly designed trials. Based on our systematic review and analysis of the literature, we suggest that: 1) use of an antimicrobial dressing instead of a non-antimicrobial dressing may increase the number of diabetic foot ulcers healed over a medium-term follow-up period (low-certainty evidence); and 2) there is probably little difference in the risk of adverse events related to treatment between systemic antibiotics and topical antimicrobial treatments based on the available studies (moderate-certainty evidence). For each of the other outcomes we examined there were either no reported data or the available data left us uncertain as to whether or not there were any differences between the compared treatments. Given the high, and increasing, frequency of diabetic foot wounds, we encourage investigators to undertake properly designed randomised controlled trials in this area to evaluate the effects of topical antimicrobial treatments for both the prevention and the treatment of infection in these wounds and ultimately the effects on wound healing.
[Mh] Termos MeSH primário: Antibacterianos/administração & dosagem
Infecções Bacterianas/tratamento farmacológico
Pé Diabético/tratamento farmacológico
[Mh] Termos MeSH secundário: Administração Tópica
Antibacterianos/efeitos adversos
Infecções Bacterianas/complicações
Infecções Bacterianas/epidemiologia
Curativos Hidrocoloides
Pé Diabético/complicações
Úlcera do Pé/tratamento farmacológico
Seres Humanos
Incidência
Peptídeos e Proteínas de Sinalização Intercelular/administração & dosagem
Ensaios Clínicos Controlados Aleatórios como Assunto/estatística & dados numéricos
Cicatrização/efeitos dos fármacos
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Intercellular Signaling Peptides and Proteins)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170816
[Lr] Data última revisão:
170816
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170615
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD011038.pub2


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[PMID]:28475446
[Au] Autor:Mohan A; Singh S
[Ad] Endereço:Plastic Surgery Senior House Officer; University Hospital Birmingham, Birmingham, UK.
[Ti] Título:Use of fat transfer to treat a chronic, non-healing, post-radiation ulcer: a case study.
[So] Source:J Wound Care;26(5):272-273, 2017 May 02.
[Is] ISSN:0969-0700
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Problematic wound healing and ulceration in radiation-damaged tissue is a surgical challenge. Clinical studies have shown that grafting fat tissue in an irradiated area can improve the quality of the skin and has regenerative effects. This case study describes how fat transfer led to the healing of a chronic ulcer resistant to other forms of treatment. CASE HISTORY: A 67-year-old lady with a chronic, non-healing ulcer in her leg had a squamous cell carcinoma excised, followed by radiotherapy. Despite multiple excisions, the ulcer continued to cause symptoms. Following an initial procedure in which fat was infiltrated around and under the ulcer, the patient underwent a wide local excision and split-thickness skin grafting. Histology demonstrated a post-radiation dermatitis ulcer with no evidence of malignancy. After a period of management with dressings showing a reduction in ulcer size, more fat was infiltrated around the lesion. Two months later, the ulcer had fully healed and has not recurred. CONCLUSION: The use of adipose-derived stem cells to heal wounds in irradiated tissue has been the focus of research for some time. This case highlights the potential of adipose tissue to improve damaged skin. Its use could negate the need for complex surgical procedures.
[Mh] Termos MeSH primário: Tecido Adiposo/transplante
Úlcera da Perna/terapia
Radiodermatite/terapia
Radioterapia Adjuvante/efeitos adversos
Cicatrização
[Mh] Termos MeSH secundário: Tecido Adiposo/citologia
Idoso
Curativos Hidrocoloides
Carcinoma de Células Escamosas/terapia
Feminino
Seres Humanos
Úlcera da Perna/etiologia
Radiodermatite/etiologia
Neoplasias Cutâneas/terapia
Transplante de Pele
Células-Tronco/citologia
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170713
[Lr] Data última revisão:
170713
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170506
[St] Status:MEDLINE
[do] DOI:10.12968/jowc.2017.26.5.272


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[PMID]:28379607
[Au] Autor:Hu Z; Guo D; Liu P; Cao X; Li S; Zhu J; Tang B
[Ad] Endereço:Department of Burn Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
[Ti] Título:Randomized clinical trial of autologous skin cell suspension for accelerating re-epithelialization of split-thickness donor sites.
[So] Source:Br J Surg;104(7):836-842, 2017 Jun.
[Is] ISSN:1365-2168
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Split-thickness skin graft (STSG) is used frequently, but may result in complications at the donor site. Rapid healing of donor-site wounds is critical to relieving morbidity. This study investigated whether autologous skin cell suspension could improve healing of STSG donor-site wounds. METHODS: Between September 2014 and February 2016, patients requiring STSGs were randomized to receive autologous skin cell suspension plus hydrocolloid dressings (experimental group) or hydrocolloid dressings alone (control group) for the donor site. The primary outcome was time to complete re-epithelialization. Secondary outcomes included pain and itching scores measured on a visual analogue scale, and adverse events. Patients were followed for 12 weeks to evaluate quality of healing. Analysis was by intention to treat. RESULTS: Some 106 patients were included, 53 in each group. Median time to complete re-epithelialization was 9·0 (95 per cent c.i. 8·3 to 9·7) days in the experimental group, compared with 13·0 (12·4 to 13·6) days in the control group (P < 0·001). Overall postoperative pain and itching scores were similar in both groups. No between-group differences in treatment-related complications were observed. Both patients and observers were more satisfied with healing quality after autologous skin cell suspension had been used. CONCLUSION: The use of autologous skin cell suspension with hydrocolloid dressings accelerated epithelialization and improved healing quality of the donor site compared with hydrocolloid dressings alone. Registration number: UMIN000015000 ( http://www.umin.ac.jp/ctr).
[Mh] Termos MeSH primário: Curativos Hidrocoloides
Transplante de Células/métodos
Reepitelização/fisiologia
Transplante de Pele/métodos
Pele/citologia
Sítio Doador de Transplante/fisiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Masculino
Meia-Idade
Dor Pós-Operatória/prevenção & controle
Cuidados Pós-Operatórios
Complicações Pós-Operatórias
Prurido/prevenção & controle
Método Simples-Cego
Transplante de Pele/efeitos adversos
Suspensões
Transplante Autólogo
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Suspensions)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170719
[Lr] Data última revisão:
170719
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170406
[St] Status:MEDLINE
[do] DOI:10.1002/bjs.10508


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[PMID]:28225152
[Au] Autor:Hao XY; Li HL; Su H; Cai H; Guo TK; Liu R; Jiang L; Shen YF
[Ad] Endereço:Department of General Surgery, The People's Hospital of Gansu Province, No. 204, Donggang West Road, Lanzhou City, Gansu, China, 730000.
[Ti] Título:Topical phenytoin for treating pressure ulcers.
[So] Source:Cochrane Database Syst Rev;2:CD008251, 2017 02 22.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Pressure ulcers are common in clinical practice and pose a significant health problem worldwide. Apart from causing suffering to patients, they also result in longer hospital stays and increase the cost of health care. A variety of methods are used for treating pressure ulcers, including pressure relief, patient repositioning, biophysical strategies, nutritional supplementation, debridement, topical negative pressure, and local treatments including dressings, ointments and creams such as bacitracin, silver sulphadiazine, neomycin, and phenytoin. Phenytoin is a drug more commonly used in the treatment of epilepsy, but may play an important role in accelerating ulcer healing. OBJECTIVES: To assess the effects of topical phenytoin on the rate of healing of pressure ulcers of any grade, in any care setting. SEARCH METHODS: In September 2016, we searched the following electronic databases to identify relevant randomized clinical trials: the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL; the Cochrane Library); Ovid MEDLINE; Ovid Embase; and EBSCO CINAHL Plus. We handsearched conference proceedings from the European Pressure Ulcer Advisory Panel, European Wound Management Association and the Tissue Viability Society for all available years. We searched the references of the retrieved trials to identify further relevant trials. We also searched clinical trials registries to identify ongoing and unpublished studies. There were no restrictions with respect to language, date of publication or study setting. SELECTION CRITERIA: We included all randomized controlled trials (RCTs) addressing the effects (both benefits and harms) of topical phenytoin on the healing of pressure ulcers of any grade compared with placebo or alternative treatments or no therapy, irrespective of blinding, language, and publication status. DATA COLLECTION AND ANALYSIS: Two review authors independently selected studies, extracted information on participants, interventions, methods and results and assessed risk of bias using Cochrane methodological procedures. For dichotomous variables, we calculated the risk ratio (RR) with 95% confidence interval (CI). For continuous variables, we calculated the mean difference with 95% CI. We rated the quality of the evidence by using Grading of Recommendations, Assessment, Development and Evaluation approach (GRADE). MAIN RESULTS: Three small RCTs met our inclusion criteria and included a total of 148 participants. These compared three treatments with topical phenytoin: hydrocolloid dressings, triple antibiotic ointment and simple dressings. In the three RCTs, 79% of participants had grade II ulcers, and 21% of participants had grade I ulcers; no participants had grade III or IV ulcers. Two RCTs had a high risk of bias overall and the other RCT was at unclear risk of bias due to poor reporting. Two RCTs had three intervention arms and the other had two intervention arms.Two studies compared topical phenytoin with hydrocolloid dressing (84 participants analysed). The available data suggest that hydrocolloid dressings may improve ulcer healing compared to topical phenytoin (39.3% ulcers healed for phenytoin versus 71.4% ulcers healed for hydrocolloid dressings (RR 0.55, 95% CI 0.33 to 0.92; 56 participants, 1 study; low quality evidence). We downgraded the evidence twice: once due to serious limitations (high risk of bias) and once due to the small sample size and small number of events. Two studies compared topical phenytoin with simple dressings (81 participants analysed). From the available data, we are uncertain whether topical phenytoin improves ulcer healing compared to simple dressings (39.3% ulcers healed for phenytoin versus 29.6% ulcers healed for the simple dressing (RR 1.33, 95% CI 0.63 to 2.78; 55 participants, 1 study; very low quality evidence). This evidence was downgraded once due to serious limitations (high risk of bias) and twice due to the low number of outcome events and resulting wide CI which included the possibility of both increased healing and reduced healing. We therefore considered it to be insufficient to determine the effect of topical phenytoin on ulcer healing. One study compared topical phenytoin with triple antibiotic ointment, however, none of the outcomes of interest to this review were reported. No adverse drug reactions or interactions were detected in any of the three RCTs. Minimal pain was reported in all groups in one trial that compared topical phenytoin with hydrocolloid dressings and triple antibiotic ointment. AUTHORS' CONCLUSIONS: This review has considered the available evidence and the result shows that it is uncertain whether topical phenytoin improves ulcer healing for patients with grade I and II pressure ulcers. No adverse events were reported from three small trials and minimal pain was reported in one trial. Therefore, further rigorous, adequately powered RCTs examining the effects of topical phenytoin for treating pressure ulcers, and to report on adverse events, quality of life and costs are necessary.
[Mh] Termos MeSH primário: Bandagens
Fármacos Dermatológicos/administração & dosagem
Fenitoína/administração & dosagem
Lesão por Pressão/tratamento farmacológico
[Mh] Termos MeSH secundário: Administração Tópica
Antibacterianos/administração & dosagem
Curativos Hidrocoloides
Seres Humanos
Pomadas
Lesão por Pressão/classificação
Ensaios Clínicos Controlados Aleatórios como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Dermatologic Agents); 0 (Ointments); 6158TKW0C5 (Phenytoin)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170614
[Lr] Data última revisão:
170614
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170223
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD008251.pub2



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