Dans ces travaux de recherche, la préparation de fibres d'alginate de calcium revêtues de chitosane par un procédé de filage par mouillage et la caractérisation de ces fibres dont leur activité antibactérienne sont présentées. Un métier à filer à l'échelle pilote a été conçu et développé au cours de ces travaux de thèse pour l'élaboration de fibres d'alginate de calcium. Ces dernières, préalablement fabriquées, sont immergées dans une solution d'acétate de chitosane. Trois méthodes de coagulation de l'enduit de chitosane ont été explorés dont deux consistent en l'immersion des fibres dans un bain neutralisant : une solution de dihydroxyde de calcium ou une solution d'hydroxyde de potassium. La dernière méthode consistait à neutraliser le chitosane par séchage sous air chaud soufflé. Une caractérisation structurelle, mécanique et d'absorption des fibres, ainsi qu'un dosage du chitosane revêtu ont été réalisés. De plus, une évaluation antibactérienne a été accomplie par une méthode de comptage des UFC (Unité Formant Colonie) après 6 h d'incubation à 37 °C. L'incorporation de chitosane aux fibres d'alginate de calcium apporte une activité antibactérienne contre Staphylococcus epidermidis, Escherichia coli et divers Staphylococcus aureus tels que MSSA (Methicillin Sensitive Staphylococcus aureus), CA-MRSA (Community Associated Methicillin Resistant Staphylococcus aureus) et HA-MRSA (Healthcare Associated Methicillin Resistant Staphylococcus aureus). Ces fibres revêtues sont alors des candidats de choix pour l'élaboration de tissus destinés à la cicatrisation des plaies. Développer des compresses avec les propriétés hémostatiques et cicatrisantes de l'alginate de calcium combinées aux propriétés antibactériennes du chitosane peut être envisagé pour lutter contre les infections et plus particulièrement les maladies nosocomiales / In this work, the preparation of chitosan-coated alginate fibers by a wet spin process and the characterization of these fibers, particularly their antibacterial activities are presented. A pilot scale spinning machine was developed during this thesis for the elaboration of calcium alginate fibers. These last, preformed produced were immersed in chitosan acetate solutions. Three coagulation methods of the chitosan coating were explored two of which consist to the immersion of the fibers in a neutralizing bath: a calcium hydroxide solution or a potassium hydroxide solution. The last method is to neutralize chitosan by drying under hot air blown. Structural, mechanical and absorption characterization of fibers and a dose of the coated chitosan have been made. Furthermore, the antibacterial evaluation was achieved by a CFU (Colony-Forming Units) counting method after 6 h of incubation at 37 °C. The incorporation of chitosan on calcium alginate fibers brings antibacterial activities against Staphylococcus epidermidis, Escherichia coli and various Staphylococcus aureus strains namely MSSA (Methicillin Sensitive Staphylococcus aureus), CA-MRSA (Community Associated Methicillin Resistant Staphylococcus aureus) and HA-MRSA (Healthcare Associated Methicillin Resistant Staphylococcus aureus) which make these chitosan-coated fibers potential candidates for wound dressing materials. Developing a wound dressing with the haemostatic and healing properties of alginate combined with antibacterial properties of chitosan can be envisioned for fighting against the infections and more particularly nosocomial infections

No description available.

No description available.

No description available.

Polymeric electrospun nanofiber mats have recently emerged as a promising alternative to conventional wound dressings for non-healing wounds. Its large surface area, porosity and scalability are only a few of the promising characteristics of electrospun nanofibers.  Nanocellulose, separated from biomass, have also proven a suitable reinforcement to these electrospun nanofibers, giving them stability and strength. Lignin has shown to possess antimicrobial and antioxidant activity, that could aid the healing process. In this project, kraft lignin, polyvinyl alcohol (PVA) and (2,2,6,6-tetramethylpiperidine-1-oxyl radical)-mediated oxidised cellulose nanofibers (CNF) has been electrospun into nanofiber mats and their applicability as a wound dressing was investigated. The electrospinning process was evaluated at different ratios of PVA/lignin: CNF, and the obtained nanofiber mats were crosslinked to restrict water solubility. Physical crosslinking was made through a heat treatment and a freeze thawing process. Mechanical properties, swelling capacity and oxygen permeability were evaluated and analysed based on the CNF content of the electrospun solutions, as well as the crosslinking methods used. Results show that the electrospun nanofiber mats where stable in water after a heat treatment at 150 °C and 3 freeze-thawing cycles. These crosslinking methods did not affect the morphology or size of the fibers. However, tensile strength and elastic modulus was improved with it. The addition of 0.1 wt% CNF into the electrospinning solution improved oxygen permeability, mechanical properties, and swelling capacity, which can be attributed to a small fiber diameter and increased crystallinity. However, exceeding that level of CNF deteriorated the same properties because of uneven fibers with beading. This material is showing promising characteristics of a wound dressing, with high oxygen permeability and swelling capacity owing to thin nanofibers and a porous network.

Yes / Highly branched poly(N-isopropylacrylamide) (HB-PNIPAM), functionalized with vancomycin at the chain ends, acted as a bacterial adhesive and was incorporated into polyurethane foams to form semi-interpenetrating networks. The poly(N-isopropylacrylamide) was labelled with a solvatochromic dye, Nile red. It was found that the thermal response of the polymer was dependent on architecture and temperature dependent color changes were observed within the foam. The foams had open pore structures and the presence of the HB-PNIPAM substantially reduced the shrinkage of the foam as the temperature was increased upto 20 °C. The foams were selectively adhesive for Staphylococcus aureus (Gram-positive bacteria) compared to Pseudomonas aeruginosa (Gram-negative bacteria) and the presence of S. aureus was indicated by increased fluorescence intensity (590 to 800 nm).

Biopolymers are becoming more attractive as advanced wound dressings because of their naturally derived origin, abundance, low cost and high compatibility with the wound environment. Arabinoxylan (AX) is a class of polysaccharide polymers derived from cereal grains that are primarily used in food products and cosmetic additives. Its application as a wound dressing material has yet to be realized. In this two-pronged project, arabinoxylan ferulate (AXF) was fabricated into electrospun fibers and gel foams to be evaluated as platforms for wound dressing materials. In the first study, AXF was electrospun with varying amounts of gelatin. In the second study, AXF was dissolved in water, enzymatically crosslinked and lyophilized to form gel foams. The morphology, mechanical properties, porosity, drug release kinetics, fibroblast cell response and anti-microbial properties were examined for both platforms. Carbohydrate assay was conducted to validate the presence of arabinoxylan ferulate in the electrospun GEL-AXF fibers. Swelling and endotoxin quantification studies were done to evaluate the absorptive capacity and sterilization agent efficacy respectively in AXF foams. The results indicated successful fabrication of both platforms which validated the porous, absorptive, biocompatibility and drug release properties. The results also exhibited that silver impregnated AXF scaffolds inhibited growth of Pseudomonas aeruginosa, Staphylococcus aureus and Enterococcus faecalis bacteria species, anti-microbial properties necessary to function as advanced wound dressing materials. Future work will be done to improve the stability of both platforms as well as evaluate its applications in vivo.

A qualidade dos serviços desenvolvidos por uma instituição de saúde depende muito da competência técnica e da habilidade de interação e comunicação de seus trabalhadores para com o usuário. As intervenções técnicas realizadas pela equipe de enfermagem requerem avaliações permanentes face aos riscos que comportam. Este estudo, observacional e seccional, analisou a qualidade e o tempo de execução dos procedimentos, banho e curativo, realizados pela equipe de enfermagem em pacientes internados na unidade médico-cirúrgica de um Hospital Universitário no estado do Paraná, tomando por referência o grau de dependência assistencial desta clientela. A população alvo foi constituída dos seguintes procedimentos: banho, em três tipologias (aspersão, aspersão com auxílio de cadeira de banho e banho no leito) e curativos executados em pacientes classificados segundo grau de dependência da assistência de enfermagem (I, II, III e IV). A amostragem para ambos os procedimentos foi por conveniência. Os dados foram coletados por meio de observação direta com a utilização de um instrumento tipo check list (lista de verificação). A qualidade dos procedimentos foi analisada com base no Índice de Positividade (IP) para cada item do instrumento e no escore de acertos, obtidos em cada procedimento; o tempo de execução foi avaliado em minutos. A qualidade da execução do procedimento foi considerada satisfatória quando a mediana do IP e do escore mediano de acertos fosse ? 70%. Foram observados 258 banhos de aspersão (42,6% grau I, 42,6% grau II e 14,8% grau III); 98 de aspersão com auxílio de cadeira de banho (12,5% grau I, 26,5% grau II, 54,1% grau III e 7,1% grau IV) e 46 banhos no leito (4,3% grau I, 37% grau III e 58,7% grau IV). O IP superou 70% apenas no banho de aspersão com auxílio de cadeira de banho em pacientes classificados no grau IV e no banho no leito no grau I. Os itens mais comprometidos estão relacionados à orientação/comunicação/interação com o paciente, higiene oral, desinfecção concorrente do leito, inspeção das condições da pele e valorização das queixas do paciente. Os resultados obtidos nos scores medianos de acertos nas três tipologias de banho, nos quatro graus de dependência também evidenciaram baixa qualidade, uma vez que somente no banho de aspersão com auxílio de cadeira de banho, grau IV e banho no leito grau I, 50% dos procedimentos alcançaram scores de até 80% e 76,5% de acertos, respectivamente. No procedimento curativo dos 168 observados, 33,9% foram em pacientes de grau I, 38,7% de grau II, 19,6% de grau III e 7,8% de grau IV. Em todos os graus de dependência, alcançou-se o índice de positividade total recomendado (? 70%). Entretanto, itens como preparo adequado do ambiente, conferência do prazo de validade dos materiais, respeito aos princípios de assepsia e manutenção da seqüência lógica do procedimento mostram baixa positividade. Os scores medianos de acertos foram superiores a 70% em todos os graus de dependência, indicando que o procedimento atende um padrão de qualidade. Tanto nos banhos como nos curativos não foram observadas diferenças no tempo despendido entre os diferentes graus de dependência. / The quality of services offered by a health institution depends greatly on worker?s technical competence and interaction and communication abilities towards the client. Technical interventions performed by the nursing team require permanent evaluations of the risks involved. This observational and sectional study analyzed quality and time of execution of bathing and wound dressing procedures performed by the nursing team on hospitalized patients in a medical-surgical unit of a University Hospital in the State of Paraná, based on care dependency degrees of these clients. Target population was constituted by the following procedures: bathing, in three typologies (shower bath, shower bath with aid of a wheel chair and bed bath) and changing wound dressings on patients classified according to the nursing care dependency degree (I,II,III and IV). Convenience sampling was employed for both procedures. Data was collected through direct observation while using a check list instrument for documentation (verifying list). Procedure quality was analyzed based on the Positive Index (IP) for each item on the instrument and on the correct procedures score; execution time was evaluated in minutes. Quality of procedure execution was considered satisfactory when the IP median and the median correct procedure score was ? 70%. In this study 258 aspersion baths (42,6% degree I, 42,6& degree II and 14,8% degree III); 98 shower baths aided by wheel chair (12,5% degree I, 26,5% degree II, 54,1% degree III and 7,1% degree IV) and 46 bed baths (4,3% degree I, 37% degree III and 58,7% degree IV). The IP surpassed 70% only in the shower bath with aid of a wheel chair on patients classified as degree IV and on bed bath, degree I. The most frequently compromised items were related to orientation/communication/interaction with the patient, oral hygiene, bed disinfection, skin condition inspection and valuing patient complaints. Results obtained on the median of the correct procedures scores on the three bathing typologies, on the four dependency degrees also highlight low quality, because only in the shower bath with aid of a wheel chair, degree IV, and bed bath, degree I, 50% of the procedures reached 80% and 76,5% correct procedure scores, respectively. In the observed wound dressing procedures of the 168 patients, 33,9% were patients of degree I, 38,7% of degree II, 19,6% of degree III and 7,8% of degree IV. In all dependency degrees the recommended positivity index was reached (? 70%). Items such as adequate environment preparation, validity time frame checking, respect to aseptic principles and maintenance of procedure?s logical sequence, however, show low positivity. Medium scores were also superior to 70% in all dependency levels, indicating that the procedure meets a quality standard. It was not observed difference on time frame spent in the different dependency degrees in bathing and wound dressing procedures.

A qualidade dos serviços desenvolvidos por uma instituição de saúde depende muito da competência técnica e da habilidade de interação e comunicação de seus trabalhadores para com o usuário. As intervenções técnicas realizadas pela equipe de enfermagem requerem avaliações permanentes face aos riscos que comportam. Este estudo, observacional e seccional, analisou a qualidade e o tempo de execução dos procedimentos, banho e curativo, realizados pela equipe de enfermagem em pacientes internados na unidade médico-cirúrgica de um Hospital Universitário no estado do Paraná, tomando por referência o grau de dependência assistencial desta clientela. A população alvo foi constituída dos seguintes procedimentos: banho, em três tipologias (aspersão, aspersão com auxílio de cadeira de banho e banho no leito) e curativos executados em pacientes classificados segundo grau de dependência da assistência de enfermagem (I, II, III e IV). A amostragem para ambos os procedimentos foi por conveniência. Os dados foram coletados por meio de observação direta com a utilização de um instrumento tipo check list (lista de verificação). A qualidade dos procedimentos foi analisada com base no Índice de Positividade (IP) para cada item do instrumento e no escore de acertos, obtidos em cada procedimento; o tempo de execução foi avaliado em minutos. A qualidade da execução do procedimento foi considerada satisfatória quando a mediana do IP e do escore mediano de acertos fosse ? 70%. Foram observados 258 banhos de aspersão (42,6% grau I, 42,6% grau II e 14,8% grau III); 98 de aspersão com auxílio de cadeira de banho (12,5% grau I, 26,5% grau II, 54,1% grau III e 7,1% grau IV) e 46 banhos no leito (4,3% grau I, 37% grau III e 58,7% grau IV). O IP superou 70% apenas no banho de aspersão com auxílio de cadeira de banho em pacientes classificados no grau IV e no banho no leito no grau I. Os itens mais comprometidos estão relacionados à orientação/comunicação/interação com o paciente, higiene oral, desinfecção concorrente do leito, inspeção das condições da pele e valorização das queixas do paciente. Os resultados obtidos nos scores medianos de acertos nas três tipologias de banho, nos quatro graus de dependência também evidenciaram baixa qualidade, uma vez que somente no banho de aspersão com auxílio de cadeira de banho, grau IV e banho no leito grau I, 50% dos procedimentos alcançaram scores de até 80% e 76,5% de acertos, respectivamente. No procedimento curativo dos 168 observados, 33,9% foram em pacientes de grau I, 38,7% de grau II, 19,6% de grau III e 7,8% de grau IV. Em todos os graus de dependência, alcançou-se o índice de positividade total recomendado (? 70%). Entretanto, itens como preparo adequado do ambiente, conferência do prazo de validade dos materiais, respeito aos princípios de assepsia e manutenção da seqüência lógica do procedimento mostram baixa positividade. Os scores medianos de acertos foram superiores a 70% em todos os graus de dependência, indicando que o procedimento atende um padrão de qualidade. Tanto nos banhos como nos curativos não foram observadas diferenças no tempo despendido entre os diferentes graus de dependência. / The quality of services offered by a health institution depends greatly on worker?s technical competence and interaction and communication abilities towards the client. Technical interventions performed by the nursing team require permanent evaluations of the risks involved. This observational and sectional study analyzed quality and time of execution of bathing and wound dressing procedures performed by the nursing team on hospitalized patients in a medical-surgical unit of a University Hospital in the State of Paraná, based on care dependency degrees of these clients. Target population was constituted by the following procedures: bathing, in three typologies (shower bath, shower bath with aid of a wheel chair and bed bath) and changing wound dressings on patients classified according to the nursing care dependency degree (I,II,III and IV). Convenience sampling was employed for both procedures. Data was collected through direct observation while using a check list instrument for documentation (verifying list). Procedure quality was analyzed based on the Positive Index (IP) for each item on the instrument and on the correct procedures score; execution time was evaluated in minutes. Quality of procedure execution was considered satisfactory when the IP median and the median correct procedure score was ? 70%. In this study 258 aspersion baths (42,6% degree I, 42,6& degree II and 14,8% degree III); 98 shower baths aided by wheel chair (12,5% degree I, 26,5% degree II, 54,1% degree III and 7,1% degree IV) and 46 bed baths (4,3% degree I, 37% degree III and 58,7% degree IV). The IP surpassed 70% only in the shower bath with aid of a wheel chair on patients classified as degree IV and on bed bath, degree I. The most frequently compromised items were related to orientation/communication/interaction with the patient, oral hygiene, bed disinfection, skin condition inspection and valuing patient complaints. Results obtained on the median of the correct procedures scores on the three bathing typologies, on the four dependency degrees also highlight low quality, because only in the shower bath with aid of a wheel chair, degree IV, and bed bath, degree I, 50% of the procedures reached 80% and 76,5% correct procedure scores, respectively. In the observed wound dressing procedures of the 168 patients, 33,9% were patients of degree I, 38,7% of degree II, 19,6% of degree III and 7,8% of degree IV. In all dependency degrees the recommended positivity index was reached (? 70%). Items such as adequate environment preparation, validity time frame checking, respect to aseptic principles and maintenance of procedure?s logical sequence, however, show low positivity. Medium scores were also superior to 70% in all dependency levels, indicating that the procedure meets a quality standard. It was not observed difference on time frame spent in the different dependency degrees in bathing and wound dressing procedures.

No description available.