1. Section Editor(s): Hess, Cathy Thomas BSN, RN, CWOCN

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With a $94,000 grant from the National Institute of Nursing Research, Joyce K. Stechmiller, PhD, ARNP, Associate Professor and Chair to the Department of Adult and Elderly Nursing at the University of Florida, is conducting a study to determine whether arginine supplements affect the healing of pressure ulcers in the elderly. The human body normally produces and maintains arginine; however, arginine may not be produced fast enough to keep up with the body's needs when it experiences stress. Elderly people are particularly vulnerable because they face an increased risk of infection and their wounds may heal slowly due to the effects of aging.


For the study, researchers are randomizing nursing home residents aged 65 years or older with at least 1 pressure ulcer into 2 groups. One group will receive 8.5 g of supplemental arginine and the other group will receive a standard protein powder supplement in cherry syrup for 4 weeks. Immune function will be measured by assessing mitogen-induced lymphocyte proliferation, interleukin-2 production, neutrophil oxidative burst and CD44/CD45 expression, delayed type hypersensitivity, and incidence of infection prior to supplementation, 4 weeks after supplementation, and after a washout period of 10 weeks.



The Food and Drug Administration (FDA) has approved the use of moxifloxacin HCl (Avelox) the second fluoroquinolone antibiotic from Bayer Corporation, West Haven, CT, as a once-daily treatment for uncomplicated skin and skin structure infections due to Staphylococcus aureus and Streptococcus pyogenes. The approval was based on the FDA's review of a study supporting the use of Avelox in uncomplicated skin and skin structure infections and review of several safety studies completed by Bayer as part of the company's postmarketing commitments. Avelox has been used to treat common, adult, community-acquired respiratory tract infections since its approval in December 1999.


A randomized, double-blind, controlled trial conducted in the United States compared the safety and efficacy of Avelox (400 mg taken once daily for 7 days) with a standard regimen of cephalexin HCl, a cephalosporin (500 mg taken 3 times daily for 7 days), for the treatment of mild to moderate, acute, uncomplicated skin and skin structure infections. The study showed that Avelox was clinically and bacteriologically equivalent in efficacy to cephalexin in eradicating the pathogens commonly found to cause uncomplicated skin infections.


In clinical trials, the most common adverse events related to Avelox were nausea (8%), diarrhea (6%), dizziness (3%), headache (2%), abdominal pain (2%), and vomiting (2%). Avelox is contraindicated in persons with a history of hypersensitivity to Avelox or any quinolone antibiotic.



Bioengineers at the University of Buffalo, Buffalo, NY, and the Shriners Burns Hospital, Boston, MA, have created a genetically engineered skin that expresses a protein that promotes wound healing, believed to be the only artificial tissue designed to express keratinocyte growth factor (KGF). Their research, published in the April 1, 2001, FASEB Journal of the Federation of American Societies of Experimental Biology, suggests a skin substitute could be developed that would accelerate the generation of new skin following severe injuries or burns. The research demonstrates for the first time that a growth factor can bring about significant changes in the 3-dimensional organization and function of a skin equivalent in vitro. The authors have submitted a grant proposal for animal studies to confirm whether the artificial skin would have a therapeutic effect.



The results of a comparative study show that Mepilex Border was less damaging to the skin than other brands tested. Mepilex Border is a self-adherent, soft silicone dressing with selective microadherence from Molnlycke Health Care, Eddystone, PA.


The study, published in the February 2001 Journal of Wound Care, measured the peel force required to remove different dressings from prestained skin in relation to the amount of stratum corneum removed. Mepilex Border and 5 other self-adherent wound dressings were compared in 20 normal volunteers aged 18 to 65. Each product was applied for 3 consecutive 24-hour periods; the peel force was measured at 24, 48, and 72 hours. When measuring the damage caused by the dressing, Mepilex Border had removed less dye than the other dressings.


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