A novel non-adherant lipocolloid dressing
The purpose of the research is to test the efficacy of lipocolloid dressings in the management of acute conditions( like burns) and chronic wounds. Urgotul is the prototype dressing. The basis for the research is that no one dressing combines all the desirable features of a dressing for wound healing, like maintenance of a moist environment, removal of excess exudates, possess thermal insulation, allow gaseous exchange, be impervious to bacteria, be non adherent to allow pain free removal, and be free of toxic wound materials.
No one dressing caters to all the three phases of wound healing, like inflammation, tissue formation and tissue remodeling. The current use of petrolatum gauze/ silicone film dressings allows reepithelisation to continue when fresh granulation tissue forms over wounds, to proceed unhindered, as it is non adherent, but often require hydrocolloid dressing over it to absorb wound discharge, making the whole thing messy. Thus there may be role of lipocolloid dressings like Urgotul, which combine the benefits of both these dressings.
Urgotul is a polyester open weave impregnated with hydrocolloid polymers dispersed within petrolatum impregnated mesh. This non greasy, light and soft gauze allows easy conformability of the dressing over the wound, and the hydrocolloid component absorbs the wound discharge. The dressing maintains a wound ph of 6. 5-7. 5, which is ideal for wound healing. Methodology – this dressing was tested in a multicentre non-controlled clinical trial involving a total of 92 patients. The patients were followed up for 4 weeks or upto healing.
Patients aged 18 years or over, with acute or chronic wounds, with surface area of lee than 100 cm? , with clean wounds were included. Any etiology except cancer was accepted. Wound surveillance was done on first visit with photographic and planimetry measurements, and the dressing was applied. Thereafter the visits were weekly or earlier if frequent dressing change was necessary. The group included 20 burns patients with partial thickness wounds. Data from all the patients was included for descriptive analysis.
The study was a qualitative design, evaluating the effectiveness of the new dressing. The factors that were studied were healing rates. This was studied by decrease in surface area measurements. It was found that surface area decreased by average of 76% in the acute, 63. 5% in the leg ulcers and 44% in chronic wounds over the 4 week period. Burn patients achieved complete healing in 5-19 days. The other factors studied was dressing changes. The authors report that the dressing conformed well to the wound surface and dressing application was confortable in all the cases.
The dressing was painless and non macerating. The last factor studied was the local tolerability. The main event noted was periwound inflammation in 7 patients in the ulcer group and 2 in the burns group. These were managed conservatively. Reliability and valididty The biggest drawback of the study is that it is non-controlled. Though the study presents impressive healing rates, there is no data presented on the healing rates of plain petrolatum gauze and hydrocolloid dressing. Why it is superior to that dressing is still not clear. Also the cost factor is not raised.
If the cost is significantly higher than the previous dressings, without a manifold gain in healing, this dressing will not stand the test of time. Also a large number of dressings are available for burns like integra, collagen and biological dressings. How this agent compares to them has not been highlighted. Though the results are valid, and reliable, but how clinically useful they are, is a matter of debate. The study has failed to highlight the clinical significance of this dressing in comparison to the other well established ones Summary
The authors conclude that Urgotul is a promising new generation of dressing due to excellent conformability, non macerating nature, did not promote pain or bleeding, and was non adherent. Such a dressing comes close to an ideal dressing, and it allows the natural wound healing process to continue unhindered. Recommendations The authors recommend this dressing for acute and chronic wounds. However in its present state and lack of controlled trials to validate its efficacy and cost effectiveness, it is not useful to recommend the article in any forum yet.Sample Essay of AssignmentExpert.com