Use of hydrocolloid dressing in infants requiring open chest management after cardiac surgery

Purpose Sternal splintage is known as an effective maneuver to stabilize hemodynamics during the immediate postoperative period, particularly in very sick infants. On the other hand, its wound management is not always straightforward. We employed dressing using a product made of a hydrocolloid material in such circumstances. This report describes our experience in utilizing the dressing in term of its potential advantages. Materials and methods Six infants needed open chest management following complicated procedures for congenital heart disease. A polytetrafluoroethylene patch was fixed to augment the skin defect at the time of sternal splintage, and a hydrocolloid dressing was applied to entirely cover the wound including the suture line. Result All patients survived their difficult circumstances. None of them suffered wound complications such as infection or healing problem during sternal splintage or subsequent to eventual chest closure. The dressing product was easy to handle with no adverse events associated with its material. Conclusions It is reconfirmed that a dressing made of hydrocolloid material was of practical use for sealing the wound in infants requiring open chest management after cardiac surgery.

Clinical Efficacy Test of Polyester Dressing Containing Herbal Extracts and Silver Sulfadiazine Cream Compared with Silver Sulfadiazine Cream in Healing Burn Wounds: A Prospective Randomized Controlled Trial

The standard burn wound treatment is the application of silver zinc sulfadiazine cream, covered with sterilized gauze dressing. This method has been used for decades because of its reasonable costs and applicability for larger wound sizes. However, gauze with a large pore size may stick to the wound bed and cause wound trauma, leading to delayed healing. The patient may also experience additional pain during changing the dressing. The non-adherent property of a hydrocolloid dressing coated with herbal extract (SIHERB) can promote wound healing as well as reduce pain. This study compared the two methods of burn wound treatment in the same patients, who were split into a “treatment group”, who were applied both silver sulfadiazine cream and hydrocolloid dressing, and “control group”, who were applied only silver sulfadiazine cream. The studied outcomes were the number of days for wound closure, the percentage epithelialization, and the pain score (evaluated every three days until epithelialization was completed). In total, 24 patients at the Burn Clinic, Siriraj Hospital were enrolled on this study. The starting wound areas were ranged from 210–220 cm2. The treatment group exhibited significant results regarding faster wound healing, referring to the number of days taken for wound closure (18 days in the control group vs. 15 days in the experimental group) and the percentage epithelialization compared to the control group. The average pain score in the experimental group was also lower on days 9, 12, and 15 after treatment (p < 0.05). No adverse effects were observed during the study. In conclusion, the combination of hydrocolloid dressing and silver sulfadiazine cream could reduce the wound shearing force and wound bed injury, accelerating the rate of wound closure and decreasing the pain during changing the dressing. This technique could improve upon the standard burn wound treatment.

Effectiveness of hydrocolloid nasal dressing pads in preventing nasal ulceration in preterm infants using non-invasive ventilation

Background: The use of non-invasive ventilation (NIV) in preterm infants is becoming increasingly common. The use of cannula in NIV can cause ulceration of the nasal bridge with the current practices using the thin foam patches. This study aims to evaluate the effectiveness of hydrocolloid nasal dressing pads in preventing nasal ulceration comparing to that of the thin foam patches. Methods: A prospective cohort study using hydrocolloid dressing pads (1 November to 30 April 2020) was compared to that of a historical control group using thin foam dressing (1 April to 15 October 2019) to evaluate the effectiveness of hydrocolloid dressing pads. All participants were preterm infants (less than 37 weeks of gestational age) and used nasal cannula NIV at the Department of Neonatal Intensive Care (NICU), Children's Hospital 1. Results: 71 infants used hydrocolloid dressing pads, and 42 used ordinary thin foam nasal dressings. In the hydrocolloid dressings group, two infants (2.8%) had nasal ulcers; among them, one was mild, and the other was moderate. In comparison, ten infants (23.8%) using thin foam dressings developed ulcers, of which seven were mild, two were moderate, and one was severe. Using hydrocolloid nasal dressings significantly reduced nasal ulceration compared to thin foam dressings (OR = 0.09, 95%CI = 0.02 – 0.45). Conclusion: Using hydrocolloid nasal dressings for preterm infants on nasal cannula NIV significantly reduced nasal ulceration compared to ordinary thin foam dressings.

Impact on quantitative fit test results after application of prophylactic hydrocolloid dressing under N95 respirators

Objective Discomfort and device-related pressure injury (DRPI) caused by N95 filtering facepiece respirators (FFRs) are common. The use of prophylactic hydrocolloid dressings is one of the strategies that may improve comfort and reduce DRPI. In this study, we investigated the impact of these dressings on N95 respirator fit. Methods We performed a repeat quantitative fit testing through the Respiratory Protection Program on 134 healthcare workers (HCWs), who applied hydrocolloid dressings on the bridge of their nose under the N95 FFRs that they passed the initial fit test but reported discomfort with. Results We found that the fit test pass rates, with the hydrocolloid dressings in place, for the semi-rigid cup style (3MTM 1860), the vertical flat-fold style (BYD), the duckbill style (BSN medical ProShield® and Halyard Fluidshield*), and the three-panel flat-fold style (3MTM Aura) N95 FFRs were 94% (108/115), 85% (44/52), 81% (87/108) and 100% (3/3) respectively. There was a statistically significant reduction in the overall fit factors for both the vertical flat-fold and duckbill type N95 respirators, after the application of hydrocolloid dressings. Conclusions Hydrocolloid dressings are likely to disturb the mask seal for non-rigid style N95 FFRs, in particular, the vertical flat-fold style and the duckbill style N95 FFRs. Given the risk of mask seal disturbance of N95 respirators as shown in this study, we advocate that any HCW requiring the use of prophylactic dressings should undergo repeat quantitative fit testing with the dressing in place prior to using the dressing and mask in combination.