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Venous leg ulcers managed using polyurethane foam with a micropore dressing: two case reports

Nair HKR

J Wound Care, 2018 Sep 01;27(Sup9a):S37-S40.
PMID: 30207848 DOI: 10.12968/jowc.2018.27.Sup9a.S37

BACKGROUND: Cases of venous leg ulcers (VLU) are expected to rise due to the rapidly ageing population in Malaysia. Central to the management of these wounds is compression therapy together with an appropriate wound dressing. Pain and discomfort during dressing changes are common in these patients. Polyurethane foam dressings with SMARTPORE technology (micropore dressing; Mundipharma) facilitate vertical absorption of exudate to reduce risks of wound and periwound area maceration. They support easy dressing removal with less pain and trauma to the wound bed. Thus, the micropore dressing was chosen as a viable treatment option in these cases.
CASES: Case 1, a 74-year-old diabetic female was treated for bilateral VLUs with micropore dressing for several months, which she noted to be painless and convenient. Case 2, a 49-year-old housewife with a solitary VLU was treated with micropore dressing, leading to good treatment results and high satisfaction.
CONCLUSION: VLUs managed by the micropore dressing resulted in reduced pain and ease of use during dressing changes, as well as noticeable reduction in wound and periwound area maceration. The use of this type of dressing in these cases shows encouraging results and provides a desirable management option. More robust clinical studies are necessary to establish this.

Matched MeSH terms: Compression Bandages*
Benefit of triple-strap abdominal binder on voluntary cough in patients with spinal cord injury

Julia PE, Sa'ari MY, Hasnan N

Spinal Cord, 2011 Nov;49(11):1138-42.
PMID: 21577218 DOI: 10.1038/sc.2011.53

STUDY DESIGN: A cross-sectional experimental study.
OBJECTIVE: The purpose of this study is to examine the benefit of elastic abdominal binders on voluntary cough in persons with spinal cord injury.
SETTING: Spinal rehabilitation unit in a teaching hospital.
METHODS: We measured voluntary cough peak expiratory flow rate (in 21 subjects with spinal cord injury, (18 tetraplegia, 3 paraplegia) under three conditions: without abdominal binder as the baseline, with single-strap abdominal binder and triple-strap abdominal binder.
RESULTS: The results showed that the mean cough peak expiratory flow rate in all subjects without abdominal binder was 277.1 l per min. There was a significant increase in flow rate with the use of abdominal binders: 325.7 l per min with single-strap abdominal binder and 345.2 l per min with triple-strap abdominal binder (P<0.05, paired t-test). The mean cough peak expiratory flow rate in tetraplegic subjects using triple-strap abdominal binders was significantly higher compared with those using single-strap abdomina
l binders (322.1 l per min and 299.4 l per min, respectively).
CONCLUSION: Abdominal binders can be used as an effective method to improve cough ability in spinal cord injured patients, with triple-strap abdominal binder achieving greater cough peak expiratory flows.

Comment in: Frisbie JH. Question of stamina for the diaphragm. Spinal Cord. 2012 Jun;50(6):480. doi: 10.1038/sc.2011.164. Epub 2012 Jan 17. PubMed PMID: 22249332.

Matched MeSH terms: Compression Bandages*
Effects of pressure garment on spasticity and function of the arm in the early stages after stroke: a randomized controlled trial

Ooi HK, Chai SC, Kadar M

Clin Rehabil, 2020 Apr;34(4):515-523.
PMID: 32037862 DOI: 10.1177/0269215520905050

OBJECTIVE: To investigate the effects of pressure (Lycra) garment on the spasticity and function of the arm in the early stages after stroke.
DESIGN: A randomized controlled trial.
SETTING: Occupational therapy unit of a public hospital.
SUBJECTS: A total of 46 adults with stroke.
INTERVENTION: After random assignment, for six weeks, both intervention group and control group received a 2 hour/week conventional occupational therapy program, with the intervention group receiving an extra 6 hour/day pressure garment application (long glove).
MAIN MEASURES: Modified Modified Ashworth Scale, Disabilities of Arm, Shoulder and Hand Outcome Measure, and Jebsen-Taylor Hand Function Test. Eligibility measures: Mini Mental State Examination and Modified Modified Ashworth Scale. Assessments were performed at baseline and six weeks postintervention.
RESULTS: There were 21 participants with the mean age of 51.19 (8.28) years in the intervention group and 22 participants with the mean (SD) age of 52.82 (8.71) years in the control group. The intervention group had median (interquartile range (IQR)) post-stroke duration of 1 (1) month, while for the control group, they were 2 (2) months. There was no difference in spasticity, and both perceived and actual arm functions between the groups at six weeks after baseline.
CONCLUSION: Wearing a pressure garment on the arm for 6 hours daily had no effect in controlling spasticity or on improving arm function in the early stages after stroke.

Matched MeSH terms: Compression Bandages*
Fifty-Patient Study Evaluating the Efficacy of Modified Collagen With Glycerin in Periwound Skin Management

Nair HKR

Int J Low Extrem Wounds, 2018 Mar;17(1):54-61.
PMID: 29564953 DOI: 10.1177/1534734618762225

The management of chronic nonhealing ulcers pose a great challenge because they are associated with morbidity and increased costs. This report presents the observations of standard management along with application of modified collagen with glycerin (MCG) in the periwound area for management of nonhealing wounds. This observational report included 50 patients (33 male, 17 female) aged 24 to 94 years having nonhealing wounds. All wounds were treated using standard treatment protocols (TIME concept), whereas the periwound severity was assessed using the Harikrishna Periwound Skin Classification (HPSC). All patients received once-daily application of MCG lotion directly in the periwound areas and compression bandaging until there was complete wound healing. Patient compliance was ensured by regular follow-up and counseling. All diabetic patients were counseled to ensure glycemic control during the entire follow-up period. The criteria used for wound healing were based on clinical observation, and proper epithelialization of the wound was the end point. The median age of the wounds was 12.0 weeks (95% CI = 8.00 - 58.08). Majority of the non-healing wounds were diabetic foot ulcers with age of wound between 4 weeks to 15 years. The median time to complete wound healing was 12.71 (95% CI = 10.00-16.67) weeks. Standard treatment protocol of TIME principle with periwound area assessment based on HPSC 2015 and treatment accordingly with topical application of MCG along with additional measures has shown complete healing of nonhealing wounds. However, further large-scale comparative studies are needed to substantiate these effects on a larger population.

Matched MeSH terms: Compression Bandages*