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Occlusive Dressing

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1301. Boils and Carbuncles

A boil starts as a hard, tender, red nodule surrounding a hair follicle. It enlarges and becomes fluctuant (see definition under 'Management', below) over several days as an abscess forms. Later it may discharge pus from its centre, before healing and it may leave a scar. Boils arise in hair-bearing areas, especially where there is friction, occlusion and perspiration. This includes the neck, face, axillae, arms, wrists, fingers, buttocks and anogenital region. Boils may be isolated or multiple (...) or surgical but cover the lesion with a sterile dressing to prevent autoinoculation. Incision and drainage are indicated for lesions that are large, localised, painful and fluctuant. Observe the patient for signs of systemic upset. Most cases can be treated in primary care; however, the decision of whether to admit the person will depend on clinical judgement, taking into account the rapidity and degree of spread and comorbidities - eg, diabetes. Persistent and recurrent infection S. aureus

2008 Mentor

1302. Asteatotic Eczema (Eczema Craquele)

. These are unfortunately nonspecific findings found in many inflammatory conditions and the diagnosis is usually made clinically. Management [ ] Avoid long hot baths, excessive use of soap and harsh skin cleansers. Air-conditioned rooms should be humidified. Petroleum-based emollients and moisturisers should be used liberally. Mild topical steroids may be required for patients who do not respond to these measures. For resistant cases, a mid-strength steroid (eg, triamcinolone) under an occlusive dressing for 24-48

2008 Mentor

1303. Cold Injury

cellular damage, tissue loss or ongoing abnormality. Frostbite Frostbite involves freezing of the tissue with microvascular occlusion and subsequent tissue anoxia. Some of the tissue damage may result from reperfusion during re-warming. There is a four-tier classification in common use: First-degree: hyperaemia and oedema without skin necrosis. Second-degree: large clear vesicle formation in addition to hyperaemia and oedema with partial-thickness skin necrosis. Third-degree: full thickness (...) vera cream or gel if available. Protect from re-freezing and any direct trauma. Use large, dry, bulky dressings and elevate the body part if possible. Ensure the patient is rehydrated. Give warm fluids where possible. Avoid walking on a thawed lower limb (it may be acceptable if only the distal toes are affected). Early hospital management of frostbite [ , ] Treatment in hospital (or some kind of field clinic) follows the same principles as the early management in the field. There are some

2008 Mentor

1304. Amblyopia

and young children need urgent referral and treatment. A very large strawberry naevus can press on the cornea, so distorting it and causing a refractive error. Trauma can lead to amblyopia through various processes - eg, prolonged lid swelling, presence of a vitreous haemorrhage or traumatic cataract. Prolonged occlusive dressing would have the same effect. Screening for amblyopia See separate article for more detail. Treatment [ ] Amblyopia is treated by modifying the visual input into the affected eye (...) is to improve the quality of the visual input during the visual developmental period. The method will vary according to the underlying cause. Amblyopia is one of the most significant paediatric disorders in ophthalmic and orthotic practice and it is the most common cause of monocular visual loss. It is usually unilateral. It can be bilateral, usually where there is high bilateral refractive error or other binocular pathology. It is sometimes subdivided into: Functional - potentially responsive to occlusive

2008 Mentor

1305. Venous Leg Ulcer

or elevation. The treatment involves applying bandages to the leg, maximising the pressure at the ankle and gaiter area and reducing the pressure as one goes higher up the leg. This helps to control or reverse venous insufficiency. There are many options available in terms of types of dressing, number of layers and whether to use elasticated or non-elasticated bandages. For uncomplicated venous ulcers, SIGN recommends an elasticated multi-layer dressing (wool padding, dressing to keep padding in place (...) , elasticated bandage and outer cover). This approach was confirmed by a Cochrane review. This review also found that four-layer dressing promoted faster healing than short stretch bandaging. [ ] Debridement and cleaning - adherent slough should be debrided and any trapped pus released. Somewhat surprisingly, a randomised study found that cleaning traumatic soft tissue wounds with tap water resulted in a lower rate of infection than if sterile saline was used. Dressing - the treatment of choice for most

2008 Mentor

1306. Indwelling Venous Catheters

for their lines and advice on complications and what to do if they experience problems. [ ] When assessing a patient with a line in situ, it's a good idea to ask to see any literature they have regarding it, to confirm initial indication and see if any support is available to manage complications, or appropriate place of referral to deal with problems. Flushing To prevent occlusion and thrombosis, such devices require regular flushing, usually with a heparinised saline solution. This is usually done (...) on a daily- to alternate-day/twice-weekly basis. Patients (and healthcare professionals) should be aware that they shouldn't use force to flush an occluded catheter. Groshong® catheters require less frequent flushing (approximately weekly) and are purported to be cheaper to maintain and to occlude less frequently. However, comparative studies of use of Hickman® and Groshong® catheters in real-life clinical scenarios have shown little difference in occlusion or thrombosis rates or cost of maintenance

2008 Mentor

1307. Generalised Pustular Psoriasis

, lithium, phenylbutazone, oxyphenbutazone, trazodone, penicillin, hydroxychloroquine, calcipotriol, interferon alfa and recombinant interferon-beta injection. Topical medications causing irritation: coal tar, anthralin, steroids under occlusive dressing and zinc pyrithione in shampoos. Infections. Sunlight or phototherapy. Cholestatic jaundice. Hypocalcaemia. No cause is identified in many patients. Presentation [ , ] The skin becomes very red and tender. Clusters of pustules appear within hours

2008 Mentor

1308. Eye Trauma

therapy. Various therapies to promote re-epithelisation, support repair and control inflammation are used, including tear substitutes, ascorbic or citric acid, and acetylcysteine and bandage soft contact lenses. Steroids are used cautiously. After chemical injury, the goal is to restore a normal ocular surface and clarity. If extensive corneal scarring is present, surgical debridement, limbal stem cell grafting, amniotic membrane transplantation and keratoprosthesis can help restore vision. Deterrent (...) be avoided, as should local steroids unless there is marked oedema. Pads and bandages should not be used, as this may raise the temperature of the eye, which will exacerbate the effect of residual gas. In cases of military exposure in the past, ground water has been used by those affected, without realising that the ground water had also been contaminated. Chlorine exposure [ , ] was first used as a weapon in World War I; however, although its use is banned by the Geneva Convention it has been used again

2008 Mentor

1309. Cyanoacrylate instillation for occlusion of parotid sinuses (IPG42)

Cyanoacrylate instillation for occlusion of parotid sinuses (IPG42) Overview | Cyanoacrylate instillation for occlusion of parotid sinuses | Guidance | NICE Cyanoacrylate instillation for occlusion of parotid sinuses Interventional procedures guidance [IPG42] Published date: February 2004 Share Save Guidance The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on this procedure. As part (...) also cause chronic leakage of saliva. This procedure involves injecting a solution of lipiodiol and cyanoacrylate via the sinus into the parotid gland, sealing the sinus. The procedure may be repeated. Other interventions for parotid sinus include watchful waiting, bandaging, radiotherapy, local denervation of the gland or excision of the deep parotid lobe. Excision of the deep lobe risks damaging branches of the facial nerve. and for this guidance Your responsibility This guidance represents

2004 National Institute for Health and Clinical Excellence - Interventional Procedures

1310. Hyperkeratotic chronic tinea pedis treated with neticonazole cream. Neticonazole Study Group. (Abstract)

England Int J Dermatol 0243704 0011-9059 0 Antifungal Agents 0 Imidazoles 0 Ointments KVL61ZF9UO neticonazole IM Administration, Cutaneous Antifungal Agents administration & dosage therapeutic use Chronic Disease Colony Count, Microbial Erythema drug therapy Female Humans Imidazoles administration & dosage therapeutic use Keratosis drug therapy microbiology Male Mycology methods Occlusive Dressings Ointments Pruritus drug therapy Tinea Pedis drug therapy microbiology Trichophyton drug effects

1996 International Journal of Dermatology Controlled trial quality: uncertain

1311. Mepitel: a 'sticky' subject. (Abstract)

Mepitel: a 'sticky' subject. 9832753 1999 04 29 2006 11 15 0969-0700 7 8 1998 Sep Journal of wound care J Wound Care Mepitel: a 'sticky' subject. 429 Sheen A J AJ James N K NK Wilkinson B B eng Clinical Trial Comparative Study Letter Randomized Controlled Trial England J Wound Care 9417080 0969-0700 0 Alginates 0 Silicones 0 mepitel N Alginates therapeutic use Humans Occlusive Dressings Postoperative Care methods Silicones therapeutic use Skin Care methods Skin Transplantation nursing Wound

1999 Journal of wound care Controlled trial quality: uncertain

1312. Film subjects win the day. (Abstract)

Film subjects win the day. 9735810 1998 11 25 2004 11 17 0954-7762 94 24 1998 Jun 17-23 Nursing times Nurs Times Film subjects win the day. 80-2 Hampton S S Eastbourne Hospitals NHS Trust. eng Clinical Trial Journal Article Randomized Controlled Trial England Nurs Times 0423236 0954-7762 0 Acetates N Acetates Dermatitis etiology nursing Erythema etiology nursing Humans Nursing Assessment methods Occlusive Dressings standards Wound Healing 1998 9 15 1998 9 15 0 1 1998 9 15 0 0 ppublish 9735810

1998 Nursing times Controlled trial quality: uncertain

1313. Local tolerability of topically applied methylprednisolone aceponate. (Abstract)

-Blind Method Drug Tolerance Female Humans Irritants Male Methylprednisolone administration & dosage analogs & derivatives pharmacology Occlusive Dressings Ointments Prednisolone administration & dosage analogs & derivatives pharmacology Skin drug effects pathology Skin Tests 1993 5 1 1993 5 1 0 1 1993 5 1 0 0 ppublish 8496430 S0190-9622(09)80275-2

1993 Journal of the American Academy of Dermatology Controlled trial quality: uncertain

1314. Systemic effects of topically applied methylprednisolone aceponate in healthy volunteers. (Abstract)

Rhythm Clobetasol administration & dosage analogs & derivatives pharmacology Drug Tolerance Female Humans Hydrocortisone blood metabolism urine Male Methylprednisolone administration & dosage analogs & derivatives pharmacology Occlusive Dressings Ointments Time Factors 1993 5 1 1993 5 1 0 1 1993 5 1 0 0 ppublish 8496431 S0190-9622(09)80276-4

1993 Journal of the American Academy of Dermatology Controlled trial quality: uncertain

1315. [Two therapeutic models in venous leg ulcers are compared: better results with optimized compression]. (Abstract)

behandlingsmodeller vid venösa bensår jämförs. Optimerad kompression ger bättre resultat. Sweden Lakartidningen 0027707 0023-7205 IM Adult Aged Bandages Female Humans Leg Ulcer therapy Male Middle Aged Occlusive Dressings Pain Measurement Patient Satisfaction Varicose Veins therapy Wound Healing 1996 12 18 1996 12 18 0 1 1996 12 18 0 0 ppublish 9011730

1997 Lakartidningen Controlled trial quality: uncertain

1316. [Treatment of muscular injuries with diclofenac-diethylammonium emulsion gel]. (Abstract)

von Muskelverletzungen mit Diclofenac-Diethylammonium Emulgel. Germany Sportverletz Sportschaden 8904133 0932-0555 0 Anti-Inflammatory Agents, Non-Steroidal 0 Emulsions 144O8QL0L1 Diclofenac IM Administration, Topical Adult Anti-Inflammatory Agents, Non-Steroidal administration & dosage Athletic Injuries drug therapy Contusions drug therapy Diclofenac administration & dosage Emulsions Female Humans Joint Dislocations drug therapy Male Muscle, Skeletal injuries Occlusive Dressings Sprains

1996 Sportverletzung Sportschaden : Organ der Gesellschaft fur Orthopadisch-Traumatologische Sportmedizin Controlled trial quality: uncertain

1317. Use of eutectic mixture of local anesthetics: an effective topical anesthetic for slit-smear testing of patients with Hansen's disease. (Abstract)

Elbow Female Humans Knee Leprosy diagnosis microbiology Lidocaine administration & dosage Lidocaine, Prilocaine Drug Combination Male Occlusive Dressings Pain etiology prevention & control Pain Measurement Prilocaine administration & dosage Skin microbiology 1997 11 21 1997 11 21 0 1 1997 11 21 0 0 ppublish 9366838 S0190-9622(97)70125-7

1997 Journal of the American Academy of Dermatology Controlled trial quality: uncertain

1318. An open trial of topical urocanic acid for the treatment of stable plaque psoriasis. (Abstract)

Dermatologic Agents 0 Ointments 0 Tars G8D26XJJ3B Urocanic Acid U8CJK0JH5M Anthralin IM Administration, Cutaneous Administration, Topical Adult Aged Anthralin administration & dosage therapeutic use Anti-Inflammatory Agents administration & dosage therapeutic use Dermatologic Agents administration & dosage therapeutic use Epidermis drug effects Humans Middle Aged Occlusive Dressings Ointments Psoriasis drug therapy Severity of Illness Index Stereoisomerism Tars therapeutic use Urocanic Acid administration

1998 Photodermatology, photoimmunology & photomedicine Controlled trial quality: uncertain

1319. Bioengineered skin. (Abstract)

Bioengineered skin. 9343505 1997 11 21 2015 06 16 0140-6736 350 9085 1997 Oct 18 Lancet (London, England) Lancet Bioengineered skin. 1142 Muhart M M McFalls S S Kirsner R R Kerdel F F Eaglstein W H WH eng Clinical Trial Letter Randomized Controlled Trial England Lancet 2985213R 0140-6736 0 Polyurethanes AIM IM Humans Occlusive Dressings Polyurethanes Prospective Studies Skin Transplantation Skin, Artificial Transplantation, Autologous Wound Healing 1997 10 31 1997 10 31 0 1 1997 10 31 0 0

1997 Lancet (London, England) Controlled trial quality: uncertain

1320. A controlled clinical trial of topical silicone gel sheeting in the treatment of hypertrophic scars and keloids. (Abstract)

-U.S. Gov't United States J Am Acad Dermatol 7907132 0190-9622 0 Gels 0 Silicone Elastomers IM Administration, Topical Cicatrix, Hypertrophic pathology therapy Gels Humans Keloid pathology therapy Occlusive Dressings Recurrence Silicone Elastomers administration & dosage 1994 3 1 1994 3 1 0 1 1994 3 1 0 0 ppublish 8113473 S0190-9622(08)81956-1

1994 Journal of the American Academy of Dermatology Controlled trial quality: uncertain

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