Temporary tarsorrhaphy suture to prevent or treat scleral show and ectropion secondary to laser resurfacing or laser blepharoplasty

The temporary tarsorrhaphy suture is introduced as a simple effective technique to prevent scleral show or ectropion secondary to laser skin resurfacing or laser blepharoplasty. In all but severe cases of prior existing scleral show or ectropion, the temporary tarsorrhaphy suture has been completely effective. It is also successfully used to prevent scleral show and ectropion for patients with poor lid snap and loss of elasticity of the lower eyelid at the time of laser skin resurfacing and blepharoplasty. A 5-0 Prolene suture is placed through the gray line to approximate the upper and lower eyelids and is left in place for 5 days. This supports the lower eyelid during the critical period of dermal and epidermal regeneration and during the formation of new collagen and elastin.     

Lower eyelid blepharoplasty: analysis of indications and the treatment of 100 patients

Traditionally, lower lid blepharoplasty has been confined to a choice of skin or skin-muscle flap transcutaneous blepharoplasty. In the past decade, in particular, various new techniques and technologies have emerged, altering our ability to treat the lower eyelids. These techniques include transconjunctival blepharoplasty, a variety of canthopexy procedures, fat-conserving or fat-replacing methods, wedge excision, and laser resurfacing techniques, and they allow a more individualized approach based on variations in anatomical features and patient goals. A retrospective review of data for 100 consecutive patients (ranging in age from 30 to 80 years) who underwent lower eyelid procedures during a 12-month period is presented. Procedures were categorized as follows: lower lid blepharoplasty, 35 cases; lower lid transconjunctival blepharoplasty, 27 cases; lower lid transconjunctival blepharoplasty with laser resurfacing, 17 cases; lower lid laser resurfacing, 16 cases; tarsorrhaphy with lower lid operation, three cases; tarsorrhaphy with laser resurfacing, two cases. Two complications of retained fat pads (one medial and one lateral) were encountered and were addressed with a secondary operation using a transconjunctival blepharoplasty approach. The results indicate that laser treatment has become the predominant form of lower eyelid resurfacing and that transconjunctival blepharoplasty is now the most common surgical procedure for the lower eyelid. All of our tarsorrhaphy procedures were performed for patients who had previously undergone surgical treatment of the lower eyelids. An algorithm based on physical findings and these techniques has been developed, for appropriate tailoring of the procedure to each patient's specific concerns. With the availability of a variety of techniques, an individualized approach based on variations in anatomical features is feasible.     

Experimental evaluation of the effectiveness of wound dressings based on biologically active substances from marine hydrobionts

This article presents the experimental data on the testing of new wound dressings, viz., porous plates, prepared on the basis of chitosan and calcium alginate that contain biologically active substances (BASs) derived from marine hydrobionts. In a burn wound model in guinea pigs, we revealed a positive effect of tested samples of wound dressings on the wound-healing process; the data of planimetric and pathomorphological studies showing the acceleration of the process of regeneration in the wound are discussed. It was noted that the dynamics and patomorphological characteristics of the wound healing process differed depending on the structure of the BAS included into the composition of wound dressings (peptides, sulfated polysaccharides, a complex of amino acids and peptides).     

Temporary tarsorrhaphy in the rat

Temporarily suturing the eyelids together may be necessary in certain studies where corneal dryness or ulceration may appear as secondary complications to experimental manipulation. This column describes the surgical technique of tarsorrhaphy in general, and details its use in the rat.     

Cytotoxicity testing of wound-dressing materials

A method was developed for testing the cytotoxicity of various bandage-like wound dressings and gel wound dressings. In this method, the ability of human polymorphonuclear neutrophils (PMNs) to initiate a respiratory burst after exposure to the various wound dressings is used as a marker of cytotoxicity. Luminol-amplified chemiluminescence stimulated with opsonised zymosan or phorbol 12-myristate 13-acetate (PMA) is used to measure the degree of activation of the respiratory burst, i.e. the NADPH oxidase activity, after exposure to wound dressings. Opsonised zymosan (material from yeast cell walls) is a phagocytic stimulus that activates the NADPH oxidase by binding to FC-receptors and complement receptors, and functions as an artificial bacterium, whereas PMA activates the NADPH oxidase by direct activation of protein kinase C. NADPH oxidase activity was inhibited by several wound dressings. The down-regulation of the respiratory burst is detrimental to the bactericial effect of PMNs, and can be used as a marker for the cytotoxicity of wound dressing materials.     

Impacts of a Silver‐Coated Future

Silver is a compound that is well known for its adverse environmental effects. More recently, silver in the form of silver nanoparticles (Ag NPs) has begun to be produced in increasingly larger amounts for antibacterial purposes in, for instance, textiles, wound dressings, and cosmetics. Several authors have highlighted the potential environmental impact of these NPs. To contribute to a risk assessment of Ag NPs, we apply a suggested method named “particle flow analysis” to estimating current emissions from society to the environment. In addition, we set up explorative scenarios to account for potential technology diffusion of selected Ag NP applications. The results are uncertain and need to be refined, but they indicate that emissions from all applications included may increase significantly in the future. Ag NPs in textiles and electronic circuitry may increase more than in wound dressings due to the limited consumption of wound dressings. Due to the dissipative nature of Ag NPs in textiles, the results indicate that they may cause the highest emissions in the future, thus partly confirming the woes of both scientists and environmental organizations. Gaps in current knowledge are identified. In particular, the fate of Ag NPs during different waste‐handling processes is outlined as an area that requires more research.     

Clinical trials of amniotic membranes in burn wound care

Four test conditions of increasing complexity were used to evaluate the clinical efficacy of amniotic membranes as biologic dressings on donor sites and burn wounds in children. These were the clean-skin donor-site wound, the uncontaminated shallow partial-thickness burn wound, the bed of freshly excised full-thickness wounds, and the granulating surface of colonized burn wounds. The rate of epithelialization under amniotic membranes was the same as that under 5% scarlet red ointment or 0.5% silver nitrate solution dressings. Preservation of a healthy excised wound bed and maintenance of a low bacterial count in contaminated wounds paralleled the experience with human allograft dressings despite technical difficulties and the absence of vascularization of amniotic membrane and its fragile structure. Tentative conclusions are drawn as to the mechanisms by which biologic dressings exert their beneficial effects.     

Preparation and characterization of antimicrobial wound dressings based on silver, gellan, PVA and borax

Silver-loaded dressings are designed to provide the same antimicrobial activity of topical silver, with the advantages of a sustained silver release and a reduced number of dressing changes. Moreover, such type of dressing must provide a moist environment, avoiding fiber shedding, dehydration and adherence to the wound site. Here we describe the preparation of a novel silver-loaded dressing based on a Gellan/Hyaff(?) (Ge-H) non woven, treated with a polyvinyl alcohol (PVA)/borax system capable to enhance the entrapment of silver in the dressing and to modulate its release. The new hydrophilic non woven dressings show enhanced water uptake capability and slow dehydration rates. A sustained silver release is also achieved. The antibacterial activity was confirmed on Staphylococcus aureus and Pseudomonas aeruginosa.     

静电纺丝用作难愈合伤口敷料的研究进展

静电纺丝伤口敷料作为一种新型功能性敷料,具有较大的比表面积、可调控的孔隙率和良好的生物性能,既有益于细胞呼吸,又 可抑制细菌感染伤口,并能促进细胞增殖和加速创面愈合,是未来伤口敷料研发领域发展的新方向。介绍静电纺丝纳米纤维的原理、特点, 重点阐述各类聚合物、生物活性物质在静电纺丝伤口敷料制备中的应用进展。     

THE AVOIDANCE OF EXCESSIVE SUPERHEATING DURING STEAM STERILIZATION OF DRESSINGS

SUMMARY: During the steam sterilization of dressings some degree of superheating occurs. With dressings normally hydrated, that is with about 5% moisture content, the small degree of superheating which occurs is unlikely to be of consequence; but if dressings contain less than 1% of moisture before sterilization, a significant degree of superheating may occur. The use of drums is neither an advantage nor a disadvantage in regulating superheating, which occurs to the same degree whether the air is removed initially by vacuum pump or by downward displacement. The use of a high initial vacuum does not increase the risk of superheating.     

Gold weight lid load as a secondary procedure

This paper discusses the use of gold weight lid load as a secondary procedure. By using three representative patients, I emphasize the following points: First, the dominance of the eye must be determined so that postoperative changes in the eyelid height can be anticipated. Second, in order to obtain an accurate weight of the implant needed, the restrictive effect on the eyelid from the previous surgery (a tarsorrhaphy or an encircling band) must first be eliminated. Third, to ensure the best result and the patient's comfort, lacrimal function, Bell's phenomenon, and levator function must be assessed.     

Swelling of hydrocolloid dressings

Wound healing is promoted by dressings that maintain a moist environment. Specifically, hydrocolloid dressings allow excess fluid to escape without permitting wound desiccation. However, the fluid handling capacity of hydrocolloid dressings depends on many factors such as the physicochemical properties of the gel formulation, and the design of the dressing. We measured the moisture uptake kinetics of different hydrocolloid dressings by placing the gel side of a sample in contact with water. The time evolution of the thickness was measured by means of a video camera linked to a computer. The theory of Tanaka and Fillmore 1979 was used to predict the kinetics of uniaxial swelling of a cylindrical gel sample. The model allows to associate to an experimental curve a total thickness increase h_f — h₀ (where h_f and h₀ are respectively the final and initial thickness) and a characteristic time τ. The model also relates h_f — h₀ and τ to the physicochemical composition of the dressing, and to the initial thickness h₀. The influence of h₀ is discussed by means of experiments performed on dressings with different initial thickness.     

Wound dressings for a proteolytic-rich environment

Wound dressings have experienced continuous and significant changes over the years based on the knowledge of the biochemical events associated with chronic wounds. The development goes from natural materials used to just cover and conceal the wound to interactive materials that can facilitate the healing process, addressing specific issues in non-healing wounds. These new types of dressings often relate with the proteolytic wound environment and the bacteria load to enhance the healing. Recently, the wound dressing research is focusing on the replacement of synthetic polymers by natural protein materials to delivery bioactive agents to the wounds. This article provides an overview on the novel protein-based wound dressings such as silk fibroin keratin and elastin. The improved properties of these dressings, like the release of antibiotics and growth factors, are discussed. The different types of wounds and the effective parameters of healing process will be reviewed.     

Testing of promising dressing materials in cultures of fibroblasts and keratinocytes of human skin]

Cell cultures of epidermal keratinocytes and dermal fibroblasts were used to test collagen dressings in vitro. It was shown that effects of the dressings on skin major cell types might be differentially evaluated.     

The dependence of efficacy of cell growth on biosynthetic medicinal materials on the microstructure of their surface

The efficacy of the novel class of dressings was studied. The natural and synthetic polymeric components of them are arranged not in layers, but in a unified structure, i.e., form a new composite material. In particular, it was determined whether the interaction of a dressing surface with cells of injured tissue and/or culture grown in vitro depends on the microstructure of the surface. The efficiency of cell growth has been considered from the point of view of stimulation of cell growth. The microstructure of the surface was studied by the method of high-resolution electron microscopy. The results of the study showed that the structure of biosynthetic dressings depends on variations of the composition and ratio of components. The role of the microstructure of the dressing in the efficacy of its function was demonstrated. Factors producing the most significant effect on the regenerating properties of wound dressings were revealed.     

SCAB, CANKER, AND BRANCH BLISTER OF APPLE AT EAST MALLING IN RELATION TO NUTRITIONAL TREATMENT OF THE HOST

On the sandy loam at East Mailing, moderate annual dressings of inorganic sources of nitrogen and potash exerted no consistent influence on the incidence of apple scab, even when the dressings were continued over an eleven-year period on established trees of four different varieties on M.IX rootstock. Likewise, no influence of such dressings continued over five seasons was shown on the incidence of apple canker on the rootstock M.VIII, which was grown under conditions favourable for severe infection.
There was evidence from early observations that grassing-down to excess can reduce the incidence of scab, but only at the expense of nitrogen starvation in the trees. Short-term mixed leys had no such effect.
The incidence of branch blister, a functional disease associated with adverse soil conditions and retarded vigour, was greatly reduced in the variety Cox's Orange Pippin by potash manuring, and was further influenced by the rootstock.     

VACUUM DRYING OF STEAM STERILIZED DRESSINGS

SUMMARY: The degree of vacuum and time of application needed to dry steam sterilized dressings has been investigated. If the steam supply is dry, and the pressure in the drying stage is reduced to an absolute pressure of 50 mm Hg, dressings will be cool and dry without holding the vacuum, provided they are not damp before sterilization.     

Effects of mildew on the growth and yield of spring barley: 1969-72

Mildew decreased grain yield by decreasing ear number and grain size (but not grain number/ear), the damage depending on the earliness and severity of mildew. In 1971 when mildew was early and severe, ethirimol seed dressings at 0.22 kg a.i./ha, which gave only early protection, increased yield more than did ethirimol sprays applied to protect the flag leaf and ear. In 1972 sprays were better than seed dressings at this rate because mildew was less severe during the seedling stages.     

Effect of a controlled abacterial environment on the Pseudomonas aeruginosa infection of suppurative wounds

The present work deals with the data on the isolation rate of P. aeruginosa from suppurative wounds of different origin during their treatment by the commonly used methods under dressings and by the open method under the conditions of controlled germ-free environment. The results of the immunotyping of P. aeruginosa strains isolated from patients treated by different methods are presented. The dynamics of changes in the isolation rate of P. aeruginosa at different periods of treatment, both by the open method and with the use of dressings, is shown. Among P. aeruginosa strains isolated from suppurative wounds, those belonging to immunotypes 6, 7 and 2, as well as nontyping strains, occurred most frequently. Treatment in the controlled germ-free environment permits the protection of the wound surface from hospital infection. During treatment with the use of dressings the cases of hospital infection were revealed (31.3%). Such infection occurred, as a rule, at a later period of treatment.     

Effect of a Synthetic Dressing Formed on a Burn Wound in Rats: a Comparison of Allografts, Collagen Sheets, and Polyhydroxyethylmethacrylate in the Control of Wound Infection

Allograft dressings to control Pseudomonas wound infections in rats were studied on surgical wounds and escharectomized burn wounds. The effects of allografts were compared with a collagen sheet (Aviderm) and a synthetic dressing, polyhydroxyethylmethacrylate (Hydron), formed on the wound by mixing the polymer and the solvent. The results indicated that infections in surgical wounds were more easily controlled by dressings than similar contaminations in burn wounds. A procedure was described for the formation of a synthetic dressing directly on the wound from a mixture of polymer and solvent. This type of preparation completely filled the wound area and sealed the edges, preventing further contamination, and gave excellent coverage of the wound. With 24 h of coverage of escharectomized burn wounds, allografts provided the best dressing for reduction of wound organisms. At 96 h of coverage, Hydron and Aviderm produce significant reductions in the Pseudomonas resident in the burn wound. The results support the thesis that suitable dressings promote local host defense processes which kill the contaminating bacteria.