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Improved Pressure Sore Healing With Hydrocolloid Dressings

Improved Pressure Sore Healing With Hydrocolloid Dressings Abstract † We prospectively followed inpatients receiving treatment for pressure sores to identify the better of two local treatment regimens. Twenty-seven patients with 76 pressure sores received treatment with hydrocolloid dressings (HCDs) and 25 patients with 52 pressure sores received treatment with Dakin's solution (chloramine-T)-soaked wet-to-dry dressings. Thirty-eight (73%) patients initially had severe nutritional depletion. The mean serum albumin value of the pressure sore treatment groups was lower than that of an age-matched group without pressure sores. In the HCD group, 66 (86.8%) pressure sores improved compared with 36 (69.2%) pressure sores in the wet-to-dry dressings group. The HCD regimen was more efficacious even in a subgroup of patients who received inadequate nutritional support during treatment. Adequate nutritional intake during the study was associated with better healing in both local treatment groups. (Arch Dermatol 1987;123:766-771) References 1. Dinsdale SM: Decubitus ulcers: Role of pressure and friction in causation . Arch Phys Med Rehabil 1974;55:147-152. 2. Petersen NC, Bittmann S: The epidemiology of pressure sores . Scand J Plast Reconstr Surg 1971;5:62-66.Crossref 3. Cooney TG, Reuler JB: Pressure sores . West J Med 1984; 140:622-624. 4. Anderson KE, Jensen O, Kvorning SA, et al: Prevention of pressure sores by identifying patients at risk . Br Med J 1982; 284:1370-1371.Crossref 5. Reuler JB, Cooney TG: The pressure sore: Pathophysiology and principles of management . Ann Intern Med 1981;94:661-666.Crossref 6. Moolten SE: Bedsores in the chronically ill patient . Arch Phys Med Rehabil 1972;53:430-438. 7. Galpin JE, Chow AW, Bayer AS, et al: Sepsis associated with decubitus ulcers . Am J Med 1976;61:346-350.Crossref 8. Sugarman B, Hawes S, Musher DM, et al: Osteomyelitis beneath pressure sores . Arch Intern Med 1983;143:683-688.Crossref 9. Morgan JE: Topical therapy of pressure ulcers . Surg Gynecol Obstet 1975;141:945-947. 10. David JA: Pressure sore treatment: A literature review . Int J Nurs Stud 1982;19:183-191.Crossref 11. El-Toraei I, Chung B: The management of pressure sores . J Dermatol Surg Oncol 1977;3:507-511.Crossref 12. Aronoff GR, Friedman SJ, Doedens DJ, et al: Increased serum iodide concentration from iodine absorption through wounds treated topically with povidone-iodine . Am J Med Sci 1980;279:173-176.Crossref 13. Constantian MB, Jackson HS: Biology and care of the pressure ulcer wound , in Constantian MB (ed): Pressure Ulcers, Principles and Techniques of Management . Boston, Little Brown & Co Inc, 1980, pp 69-100. 14. Alvarez DM, Mertz PM, Eaglstein WH: The effect of occlusive dressings on collagen synthesis and re-epithelialization in superficial wounds . J Surg Res 1983;35:142-148.Crossref 15. Yarkony GM, Kramer E, King R, et al: Pressure sore management: Efficacy of a moisture reactive occlusive dressing . Arch Phys Med Rehabil 1984;65:597-600. 16. Gerber RM, Van Ort SR: Topical application of insulin in decubitus ulcers . Nurs Res 1979;28:16-19.Crossref 17. Seltzer MH, Bastidas JA, Cooper DM, et al: Instant nutritional assessment . JPEN 1979;3:157-159.Crossref 18. Seltzer MH, Slocum BA, Cataldi-Betcher EL, et al: Instant nutritional assessment: Absolute weight loss and surgical mortality . JPEN 1982;6:218-220.Crossref 19. Seltzer MH, Fletcher HS, Slocum BA, et al: Instant nutritional assessment in the intensive care unit . JPEN 1981;5:70-72.Crossref 20. Kaminski MV, Jeejeebhoy KN: Modern clinical nutrition: I. Nutritional assessment-diagnosis of malnutrition and selection of therapy . Am JIV Ther Clin Nutr 1979;6:31-50. 21. Blackburn GL, Thornton PA: Nutritional assessment of the hospitalized patient . Med Clin North Am 1979;63:1103-1115. 22. Friedman SJ, Su WPD: Management of leg ulcers with hydrocolloid occlusive dressing . Arch Dermatol 1984;120:1329-1336.Crossref 23. Vetra H, Whittaker D: Hydrotherapy and topical collagenase for decubitus ulcers . Geriatrics 1975;30:53-58. 24. Hislop HH, Pritchard JG: A clinical trial of creams for the prevention and treatment of pressure sores in geriatric patients . Br J Clin Pract 1962;16:409-412. 25. Shea JD: Pressure sores: Classification and management . Clin Orthop 1975;112:89-100.Crossref 26. Daniel RK, Hall EJ, MacLeod MK: Pressure sores: A reappraisal . Ann Plast Surg 1979;3:53-63.Crossref 27. Olivari N, Schrudde J, Wahle H: The surgical treatment of bedsores in paraplegics . Plast Reconstr Surg 1972;50:477-482.Crossref 28. Allman RM, Laprade CA, Noel LB, et al: Pressure sores among hospitalized patients . Ann Intern Med 1986;105:337-342.Crossref 29. Ruberg RL: Role of nutrition in wound healing . Surg Clin North Am 1984;64:705-714. 30. Rhoads JE, Alexander CE: Nutritional problems of surgical patients . Ann NY Acad Sci 1955;63:268-275.Crossref 31. Daltrey DC, Rhodes B, Chattwood JG: Investigation into the microbial flora of healing and non-healing decubitus ulcers . J Clin Pathol 1981;34:701-705.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

Improved Pressure Sore Healing With Hydrocolloid Dressings

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Publisher
American Medical Association
Copyright
Copyright © 1987 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1987.01660300088018
Publisher site
See Article on Publisher Site

Abstract

Abstract † We prospectively followed inpatients receiving treatment for pressure sores to identify the better of two local treatment regimens. Twenty-seven patients with 76 pressure sores received treatment with hydrocolloid dressings (HCDs) and 25 patients with 52 pressure sores received treatment with Dakin's solution (chloramine-T)-soaked wet-to-dry dressings. Thirty-eight (73%) patients initially had severe nutritional depletion. The mean serum albumin value of the pressure sore treatment groups was lower than that of an age-matched group without pressure sores. In the HCD group, 66 (86.8%) pressure sores improved compared with 36 (69.2%) pressure sores in the wet-to-dry dressings group. The HCD regimen was more efficacious even in a subgroup of patients who received inadequate nutritional support during treatment. Adequate nutritional intake during the study was associated with better healing in both local treatment groups. (Arch Dermatol 1987;123:766-771) References 1. Dinsdale SM: Decubitus ulcers: Role of pressure and friction in causation . Arch Phys Med Rehabil 1974;55:147-152. 2. Petersen NC, Bittmann S: The epidemiology of pressure sores . Scand J Plast Reconstr Surg 1971;5:62-66.Crossref 3. Cooney TG, Reuler JB: Pressure sores . West J Med 1984; 140:622-624. 4. Anderson KE, Jensen O, Kvorning SA, et al: Prevention of pressure sores by identifying patients at risk . Br Med J 1982; 284:1370-1371.Crossref 5. Reuler JB, Cooney TG: The pressure sore: Pathophysiology and principles of management . Ann Intern Med 1981;94:661-666.Crossref 6. Moolten SE: Bedsores in the chronically ill patient . Arch Phys Med Rehabil 1972;53:430-438. 7. Galpin JE, Chow AW, Bayer AS, et al: Sepsis associated with decubitus ulcers . Am J Med 1976;61:346-350.Crossref 8. Sugarman B, Hawes S, Musher DM, et al: Osteomyelitis beneath pressure sores . Arch Intern Med 1983;143:683-688.Crossref 9. Morgan JE: Topical therapy of pressure ulcers . Surg Gynecol Obstet 1975;141:945-947. 10. David JA: Pressure sore treatment: A literature review . Int J Nurs Stud 1982;19:183-191.Crossref 11. El-Toraei I, Chung B: The management of pressure sores . J Dermatol Surg Oncol 1977;3:507-511.Crossref 12. Aronoff GR, Friedman SJ, Doedens DJ, et al: Increased serum iodide concentration from iodine absorption through wounds treated topically with povidone-iodine . Am J Med Sci 1980;279:173-176.Crossref 13. Constantian MB, Jackson HS: Biology and care of the pressure ulcer wound , in Constantian MB (ed): Pressure Ulcers, Principles and Techniques of Management . Boston, Little Brown & Co Inc, 1980, pp 69-100. 14. Alvarez DM, Mertz PM, Eaglstein WH: The effect of occlusive dressings on collagen synthesis and re-epithelialization in superficial wounds . J Surg Res 1983;35:142-148.Crossref 15. Yarkony GM, Kramer E, King R, et al: Pressure sore management: Efficacy of a moisture reactive occlusive dressing . Arch Phys Med Rehabil 1984;65:597-600. 16. Gerber RM, Van Ort SR: Topical application of insulin in decubitus ulcers . Nurs Res 1979;28:16-19.Crossref 17. Seltzer MH, Bastidas JA, Cooper DM, et al: Instant nutritional assessment . JPEN 1979;3:157-159.Crossref 18. Seltzer MH, Slocum BA, Cataldi-Betcher EL, et al: Instant nutritional assessment: Absolute weight loss and surgical mortality . JPEN 1982;6:218-220.Crossref 19. Seltzer MH, Fletcher HS, Slocum BA, et al: Instant nutritional assessment in the intensive care unit . JPEN 1981;5:70-72.Crossref 20. Kaminski MV, Jeejeebhoy KN: Modern clinical nutrition: I. Nutritional assessment-diagnosis of malnutrition and selection of therapy . Am JIV Ther Clin Nutr 1979;6:31-50. 21. Blackburn GL, Thornton PA: Nutritional assessment of the hospitalized patient . Med Clin North Am 1979;63:1103-1115. 22. Friedman SJ, Su WPD: Management of leg ulcers with hydrocolloid occlusive dressing . Arch Dermatol 1984;120:1329-1336.Crossref 23. Vetra H, Whittaker D: Hydrotherapy and topical collagenase for decubitus ulcers . Geriatrics 1975;30:53-58. 24. Hislop HH, Pritchard JG: A clinical trial of creams for the prevention and treatment of pressure sores in geriatric patients . Br J Clin Pract 1962;16:409-412. 25. Shea JD: Pressure sores: Classification and management . Clin Orthop 1975;112:89-100.Crossref 26. Daniel RK, Hall EJ, MacLeod MK: Pressure sores: A reappraisal . Ann Plast Surg 1979;3:53-63.Crossref 27. Olivari N, Schrudde J, Wahle H: The surgical treatment of bedsores in paraplegics . Plast Reconstr Surg 1972;50:477-482.Crossref 28. Allman RM, Laprade CA, Noel LB, et al: Pressure sores among hospitalized patients . Ann Intern Med 1986;105:337-342.Crossref 29. Ruberg RL: Role of nutrition in wound healing . Surg Clin North Am 1984;64:705-714. 30. Rhoads JE, Alexander CE: Nutritional problems of surgical patients . Ann NY Acad Sci 1955;63:268-275.Crossref 31. Daltrey DC, Rhodes B, Chattwood JG: Investigation into the microbial flora of healing and non-healing decubitus ulcers . J Clin Pathol 1981;34:701-705.Crossref

Journal

Archives of DermatologyAmerican Medical Association

Published: Jun 1, 1987

References