agar and Wounds-and-Injuries

Negative pressure wound therapy (NPWT) is a widely accepted and effective treatment for various wound types, including complex wounds. Negative pressure with instillation was initially used as a gravity-fed system whereby reticulated, open-cell foam in the wound bed was periodically exposed to cycles of soaking with instillation solution followed by NPWT. Recent publications have alluded to positive outcomes with continuous instillation, where fluid is delivered simultaneously with negative pressure. To evaluate the distribution of instillation solutions to wound beds in conjunction with negative pressure, agar-based models were developed and exposed to coloured instillation solutions to identify exposure intensity via agar staining. This model allowed comparison of continuous- versus periodic-instillation therapy with negative pressure. Continuous instillation at a rate of 30 cc/hour with negative pressure showed isolated exposure of instillation fluid to wound beds in agar wound models with and without undermining and tunnelling. In contrast, periodic instillation illustrated uniform exposure of the additive to the entire wound bed including undermined and tunnel areas, with increased staining with each instillation cycle. These findings suggest that periodic instillation facilitates more uniform exposure throughout the wound, including tunnels and undermining, to instillation solutions, thereby providing therapy consistent with the clinician-ordered treatment.

Topics: Agar; Anti-Bacterial Agents; Humans; Instillation, Drug; Models, Biological; Negative-Pressure Wound Therapy; Therapeutic Irrigation; Treatment Outcome; Wound Healing; Wound Infection; Wounds and Injuries

Free split skin grafting is now widely practised on a routine basis in accident surgery. All conventional wound dressing methods have considerable drawbacks, and this is one of the reasons why successful skin grafting is still an unsafe procedure even under the very best of conditions and quite often resembles an experiment more than a scientific procedure, with an unpredictable outcome. Today, however, we can command over a wound dressing, using the polyacrylamide agar hydrogel developed by the Max Planck Institute of Immunobiology at Freiburg and which is being marketed under the trade name of Geliperm. This dressing can maintain the physiological wound environment during the first few critical days following grafting; it enables conditioning of the wound; it protects the wound against bacterial invasion and prevents drying-out of the graft and the base of the wound; and it is capable of absorbing wound secretion to a certain degree. Healing chances of the graft can be considerably improved by the use of Geliperm. Thanks to its high measure of elasticity it can adapt itself to the wound surface without sticking to it. The transparent nature of the material enables to observe and assess the healing processes at any time and to recognize possible complications during healing. Failures are almost always due to prolonged deposition of the gel plates, but this can be safely avoided by regularly changing the deposit. Deposits inadvertently left for too long, so that they have started drying at the wound surface, can be detached without any trouble and painlessly without any risk of damaging the graft.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Acrylamides; Adult; Agar; Bandages; Female; Humans; Male; Middle Aged; Skin Transplantation; Wound Healing; Wounds and Injuries

Topics: Agar; Cell Movement; Glaucoma; Humans; Leukocytes; Opisthorchiasis; Shock; Time Factors; Wounds and Injuries

Topics: Agar; Connective Tissue; Polysaccharides; Wounds and Injuries