-
International Journal of Nursing Studies Mar 2022There is need for improvement in effective pressure ulcers preventive strategies. (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
There is need for improvement in effective pressure ulcers preventive strategies.
OBJECTIVE
To study whether a multi-layer silicone-adhesive polyurethane foam dressing shaped for the sacrum prevents PUs development in addition to standard PU preventive care for at-risk hospitalized patients.
DESIGN
Open-label, parallel group, multi-center randomized controlled trial.
PARTICIPANTS AND SETTING
709 in-hospital patients at risk for pressure ulcers from 25 medical, surgical, and intensive care units of 12 Italian hospitals.
METHODS
A multi-layer silicone-adhesive polyurethane foam was applied to the sacrum in addition to standard PUs preventive care in the intervention group. In the control group, standard preventive care alone, including systematic pressure ulcer risk assessment, skin assessment three times per day, routine positioning every 4 h, use of active support surface as appropriate, and incontinence skin care, was guaranteed. Primary outcome was incidence of sacral pressure ulcers of any stage at seven days from hospital admission. Secondary outcomes were incidence of sacral pressure ulcers ≥ II stage, number of days needed to PU development, number of skin adverse events due to the foam dressing, number of dressings used for each patient, number of withdrawing patients due to discomfort caused by the foam dressing. Participants were evaluated at baseline and at seven days.
RESULTS
In patients admitted to medical units, 15/113 controls and 4/118 in the intervention group developed sacral pressure ulcers (p = 0.010; absolute reduction 9.2%; NNT for benefit 11, 95% CI 6 to 44). In patients admitted to surgical units, 21/144 controls and 8/142 in the intervention group developed sacral pressure ulcers (p = 0.010; absolute reduction 8.9%; NNT for benefit 11 95% CI 6 to 49). Pressure ulcers incidence was not significantly different between the randomization arms (5.2% experimental vs 10.4% control, p = 0.141) in patients admitted to intensive care units. Overall, 46/358 (12.8%) controls and 17/351 (4.8%) in the intervention group developed sacral pressure ulcers (p<0.001; absolute reduction 8%; number needed to treat (NNT) for benefit 12, 95% CI 8 to 26). Incidence of sacral pressure ulcers ≥ II stage did not differ significantly between the two groups. No adverse skin reactions and discomfort attributable to the foam application were reported.
CONCLUSION
A sacral multi-layer silicone-adhesive polyurethane foam in addition to standard preventive care is effective for pressure ulcers prevention in at-risk hospitalized patients admitted to medical and surgical units.
TRIAL REGISTRATION
ClinicalTrials.gov NCT03900455. The registration (April 1st, 2019) occurred before the first patient was enrolled (October 21st, 2019).
Topics: Adhesives; Bandages; Humans; Polyurethanes; Pressure Ulcer; Silicones
PubMed: 35124474
DOI: 10.1016/j.ijnurstu.2022.104172 -
Molecules (Basel, Switzerland) Jan 2021A number of mono- and dioligosilanylated silocanes were prepared. Compounds included silocanes with 1-methyl-1-tris(trimethylsilyl)silyl,...
A number of mono- and dioligosilanylated silocanes were prepared. Compounds included silocanes with 1-methyl-1-tris(trimethylsilyl)silyl, 1,1-bis[tris(trimethylsilyl)silyl], and 1,1-bis[tris(trimethylsilyl)germyl] substitution pattern as well as two examples where the silocane silicon atom is part of a cyclosilane or oxacyclosilane ring. The mono-tris(trimethylsilyl)silylated compound could be converted to the respective silocanylbis(trimethylsilyl)silanides by reaction with KOBu and in similar reactions the cyclosilanes were transformed to oligosilane-1,3-diides. However, the reaction of the 1,1-bis[tris(trimethylsilyl)silylated] silocane with two equivalents of KOBu leads to the replacement of one tris(trimethylsilyl)silyl unit with a -butoxy substituent followed by silanide formation via KOBu attack at one of the SiMe units of remaining tris(trimethylsilyl)silyl group. For none of the silylated silocanes, signs of hypercoordinative interaction between the nitrogen and silicon silocane atoms were detected either in the solid state. by single crystal XRD analysis, nor in solution by Si-NMR spectroscopy. This was further confirmed by cyclic voltammetry and a DFT study, which demonstrated that the N-Si distance in silocanes is not only dependent on the energy of a potential N-Si interaction, but also on steric factors and through-space interactions of the neighboring groups at Si and N, imposing the orientation of the p(N) orbital relative to the N-Si-X axis.
Topics: Organosilicon Compounds; Silanes; Silicon
PubMed: 33466467
DOI: 10.3390/molecules26010244 -
The British Journal of Dermatology Jul 2021Silicone adhesive multilayer foam dressings are used as adjuvant therapy to prevent hospital-acquired pressure ulcers (PUs). (Randomized Controlled Trial)
Randomized Controlled Trial
Silicone adhesive multilayer foam dressings as adjuvant prophylactic therapy to prevent hospital-acquired pressure ulcers: a pragmatic noncommercial multicentre randomized open-label parallel-group medical device trial.
BACKGROUND
Silicone adhesive multilayer foam dressings are used as adjuvant therapy to prevent hospital-acquired pressure ulcers (PUs).
OBJECTIVES
To determine whether silicone foam dressings in addition to standard prevention reduce the incidence of PUs of category 2 or worse compared with standard prevention alone.
METHODS
This was a multicentre, randomized controlled medical device trial conducted in eight Belgian hospitals. At-risk adult patients were centrally randomized (n = 1633) to study groups based on a 1 : 1 : 1 allocation: experimental groups 1 (n = 542) and 2 (n = 545) - pooled as the treatment group - and the control group (n = 546). The experimental groups received PU prevention according to hospital protocol, and a silicone foam dressing on the relevant body sites. The control group received standard of care. The primary endpoint was the incidence of a new PU of category 2 or worse at the studied body sites.
RESULTS
In the intention-to-treat population (n = 1605), PUs of category 2 or worse occurred in 4·0% of patients in the treatment group and 6·3% in the control group [relative risk (RR) 0·64, 95% confidence interval (CI) 0·41-0·99, P = 0·04]. Sacral PUs were observed in 2·8% and 4·8% of the patients in the treatment group and the control group, respectively (RR 0·59, 95% CI 0·35-0·98, P = 0·04). Heel PUs occurred in 1·4% and 1·9% of patients in the treatment and control groups, respectively (RR 0·76, 95% CI 0·34-1·68, P = 0·49).
CONCLUSIONS
Silicone foam dressings reduce the incidence of PUs of category 2 or worse in hospitalized at-risk patients when used in addition to standard of care. The results show a decrease for the sacrum, but no statistical difference for the heel and trochanter areas.
Topics: Adhesives; Adult; Bandages; Hospitals; Humans; Pressure Ulcer; Silicones
PubMed: 33216969
DOI: 10.1111/bjd.19689 -
Molecules (Basel, Switzerland) Mar 2021In this study, new biodegradable and biocompatible amphiphilic polymers were obtained by modifying the peripheral hydroxyl groups of branched polyethers and polyesters...
In this study, new biodegradable and biocompatible amphiphilic polymers were obtained by modifying the peripheral hydroxyl groups of branched polyethers and polyesters with organosilicon substituents. The structures of the synthesized polymers were confirmed by NMR and GPC. Organosilicon moieties of the polymers were formed by silatranes and trimethylsilyl blocks and displayed hydrophilic and hydrophobic properties, respectively. The effect of the ratio of hydrophilic to hydrophobic organosilicon structures on the surface activity and biological activity of macromolecules was studied, together with the effect on these activities of the macromolecules' molecular weight and chemical structure. In particular, the critical micelle concentrations were determined, the effect of the structure of the polymers on their wetting with aqueous solutions on glass and parafilm was described, and the aggregation stability of emulsions was studied. Finally, the effect of the polymer structures on their antifungal activity and seed germination stimulation was examined.
Topics: Antifungal Agents; Ascomycota; Biocompatible Materials; Bridged Bicyclo Compounds, Heterocyclic; Micelles; Molecular Structure; Organosilicon Compounds; Polyesters
PubMed: 33810558
DOI: 10.3390/molecules26071893 -
Environmental Science & Technology Nov 2022Volatile methyl siloxanes (VMS) are ubiquitous in indoor environments due to their use in personal care products. This paper builds on previous work identifying sources...
Volatile methyl siloxanes (VMS) are ubiquitous in indoor environments due to their use in personal care products. This paper builds on previous work identifying sources of VMS by synthesizing time-resolved proton-transfer reaction time-of-flight mass spectrometer VMS concentration measurements from four multiweek indoor air campaigns to elucidate emission sources and removal processes. Temporal patterns of VMS emissions display both continuous and episodic behavior, with the relative importance varying among species. We find that the cyclic siloxane D5 is consistently the most abundant VMS species, mainly attributable to personal care product use. Two other cyclic siloxanes, D3 and D4, are emitted from oven and personal care product use, with continuous sources also apparent. Two linear siloxanes, L4 and L5, are also emitted from personal care product use, with apparent additional continuous sources. We report measurements for three other organosilicon compounds found in personal care products. The primary air removal pathway of the species examined in this paper is ventilation to the outdoors, which has implications for atmospheric chemistry. The net removal rate is slower for linear siloxanes, which persist for days indoors after episodic release events. This work highlights the diversity in sources of organosilicon species and their persistence indoors.
Topics: Siloxanes; Environmental Monitoring; Organosilicon Compounds; Ventilation
PubMed: 36327170
DOI: 10.1021/acs.est.2c05438 -
Clinical & Experimental Optometry Apr 2022Contact lens prescribing data serve as a benchmark for eye care clinicians in assessing their own prescribing patterns and provide useful contextual information for...
CLINICAL RELEVANCE
Contact lens prescribing data serve as a benchmark for eye care clinicians in assessing their own prescribing patterns and provide useful contextual information for researchers and the contact lens industry.
PURPOSE
To document global trends in contact lens prescribing during the first two decades of this century.
METHODS
A longitudinal survey of contact lens prescribing was conducted by asking contact lens practitioners to provide 11 items of information from 10 consecutive contact lens fits between January and March each year from 1996 to 2020, inclusive.
RESULTS
Data relating to 406,859 contact lens fits were collected from 71 countries between 1996 and 2020, generating 4.5 million data points. Demographic analysis for 61 nations returning ≥100 fits demonstrated that a majority of lenses (65-70%) were fitted to females. The average age of lens wearers was 30.8 ± 13.9 years for males and 32.5 ± 14.3 years for females. Trend analysis of 20 countries returning prescribing data for ≥13 years between 2000 and 2020 revealed the following: increase in the age of lens wearers; dramatic rise in the extent of fitting silicone hydrogel and daily disposable lenses; increased fitting of soft toric and multifocal lenses; increasing proportion of rigid lens fits in specialist (non-spherical) designs; incomplete provision of near contact lens corrections for contact lens wearing presbyopes; ongoing low levels of extended wear fits; and almost exclusive use of multi-purpose care systems. Daily disposable lenses were used for both full-time and part-time wear, whereas rigid and soft reusable lenses were primarily worn full time.
CONCLUSIONS
The evolution of international contact lens fitting over the first two decades of this century is documented. The data presented here may assist all stakeholders in advancing contact lens clinical practice, informing contact lens research, and guiding contact lens manufacturers.
Topics: Adolescent; Adult; Contact Lenses; Contact Lenses, Hydrophilic; Female; Humans; Male; Optometry; Prescriptions; Silicones; Surveys and Questionnaires; Young Adult
PubMed: 35184672
DOI: 10.1080/08164622.2022.2033604 -
Molecules (Basel, Switzerland) Feb 2021Intrinsic hydrophobicity is the reason for efficient bacterial settlement and biofilm growth on silicone materials. Those unwelcomed phenomena may play an important role...
Intrinsic hydrophobicity is the reason for efficient bacterial settlement and biofilm growth on silicone materials. Those unwelcomed phenomena may play an important role in pathogen transmission. We have proposed an approach towards the development of new anti-biofilm strategies that resulted in novel antimicrobial hydrophobic silicones. Those functionalized polysiloxanes grafted with side 2-(carboxymethylthioethyl)-, 2-(-propylamidomethylthioethyl)- and 2-(mercaptoethylamidomethylthioethyl)- groups showed a wide range of antimicrobial properties towards selected strains of bacteria (reference strains , and water-borne isolates , ), fungi () and algae (), which makes them valuable antibacterial and antibiofilm agents. Tested microorganisms showed various levels of biofilm formation, but particularly effective antibiofilm activity was demonstrated for bacterial isolate with high adhesion abilities. In the case of modified surfaces, the relative coefficient of adhesion for this strain was 18 times lower in comparison to the control glass sample.
Topics: Anti-Infective Agents; Cell Adhesion; Hydrophobic and Hydrophilic Interactions; Siloxanes
PubMed: 33557279
DOI: 10.3390/molecules26040814 -
Scientific Reports Feb 2021Previous studies have reported silicone oil (SO) applied to needles and syringes in the vitreous of patients after intravitreal injections. We evaluated four syringes...
Previous studies have reported silicone oil (SO) applied to needles and syringes in the vitreous of patients after intravitreal injections. We evaluated four syringes (SR 1-mL insulin, Saldanha-Rodrigues; BD 1-mL Tuberculin Slip Tip, Becton-Dickinson; BD Ultra-Fine 0.3 mL, HSW Norm-Ject Tuberculin, Henke Sass Wolf) and 10 needles (BD PrecisionGlide 27- and 30-gauge (G); BD Eclipse and JBP Nanoneedle 27-, 30-, 33- and 34-G; TSK Invisible Needle and 27 and 30-G Steriject Control Hub). The protein-free buffer samples injected into the syringes and needles under study were collected in an Eppendorf tube and taken to Flow imaging microscopy, that characterized the concentration and morphology of the microsized particles. The number of particles was analyzed. The coefficients of variation (CV) were the primary outcome. The Feltz and Miller test compared the CVs. The significance level was 5%. Numerous particles and high CVs were associated with both devices, needles and syringes; the comparisons among them did not reach significance. The BD Ultrafine 0.3 mL syringe (149.7%) had the highest CV and the SO-free HSW Norm-Ject (66.4%) syringe the lowest, and the TSK Invisible needle (149.5%) had the highest and the BD Precision Glide 30G needle (35.9%) needle the lowest. In conclusion, particle release, including those with SO morphology, varied greatly among instruments, even from the same lots, which is relevant considering that fewer particles are injected into some eyes compared with others.
Topics: Needles; Reproducibility of Results; Silicon; Silicone Oils; Syringes
PubMed: 33633285
DOI: 10.1038/s41598-021-84158-0 -
Journal of Indian Prosthodontic Society 2021This study aimed to perform an integrative review of the literature on the use of silicone finger prostheses in amputee patients. Searches were performed in the PubMed,... (Review)
Review
This study aimed to perform an integrative review of the literature on the use of silicone finger prostheses in amputee patients. Searches were performed in the PubMed, EMBASE, Web of Science, Scielo, and Cochrane Library databases until July 2021. Descriptors used in this article were: Silicone, finger, rehabilitation, and prosthesis. Clinical research and clinical reports on silicone finger prostheses, available in full and in English were included. Initially, 152 articles were identified. After establishing the inclusion/exclusion criteria, 23 studies were identified and constituted the final sample. Regarding the publication date of the included studies, 17.2% of them were published between 2012 and 2016. Most of the rehabilitations occurred in India (69.9%; n = 16), and the mean age of patients who used prostheses was 38.1 years. The level of scientific evidence of the included studies was IV and VI. Therefore, patients rehabilitated with silicone finger prostheses highlighted significant improvements in functional range of motion, restoration of self-esteem, advantages in psychological therapy, more pleasant social interaction, and changes in their quality of life.
Topics: Adult; Amputees; Artificial Limbs; Fingers; Humans; Quality of Life; Silicones
PubMed: 34810361
DOI: 10.4103/jips.jips_175_21 -
Farmacia Hospitalaria : Organo Oficial... 2024The off-label use in clinical practice of non-approved syringes for intravitreal drug administration has resulted in the detection of silicone oil drops in the vitreous... (Review)
Review
OBJECTIVE
The off-label use in clinical practice of non-approved syringes for intravitreal drug administration has resulted in the detection of silicone oil drops in the vitreous of some patients. This situation derives from the lack of approved syringes for intraocular use in the Spanish market. The aim of this work is to review the use of syringes for intraocular administration, as well as to search for alternatives that meet the legal requirements for these unmet needs.
METHOD
A systematic review was performed following the PRISMA 2020 Guidelines by searching PubMed with the descriptors: "silicone" AND "syringes" AND ("intraocular" OR "intravitreal") and filtering all existing publications from January 2006 to December 2023, including all those articles dealing with silicone oil release in intravitreal injections and analysing the possible consequences.
RESULTS
Sixty-eight results were found, 23 of which were excluded because they did not deal with the subject under study, leaving a total of 45 articles for the systematic review. These were classified according to the conclusions obtained in 4 groups: the adverse reactions produced by silicone, the administration technique, the physicochemical aspects of silicone release, and the characteristics of the medical device. After reviewing the current manufacturers and technical data sheets of commercialized syringes, the existing syringes for this use have been collected, finding two that will probably be commercialized in Spain at the beginning of 2024: Zero Residual™ 0.2 ml SiO-free and VitreJect® Ophthalmic.
CONCLUSIONS
From the results obtained, it can be interpreted that the use of syringes and needles with silicone for intravitreal use is a concern for health professionals due to the implications and consequences that may arise in patients, the most important being adverse reactions, so it is necessary to have silicone-free syringes on the market that are specific for intraocular use. Safety and legality in the use of intraocular syringes and needles is essential to guarantee ocular integrity and patient health.
Topics: Syringes; Humans; Silicone Oils; Intravitreal Injections; Off-Label Use; Spain
PubMed: 38556370
DOI: 10.1016/j.farma.2024.01.008