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Wound debridement

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https://www.readbyqxmd.com/read/28097252/enterococcus-faecalis-causing-delayed-spondylodiscitis-in-a-case-with-retained-intraspinal-bullet
#1
Siddharth N Aiyer, Ajoy Prasad Shetty, Rishi Kanna, Srikanth Reddy, Shanmuganathan Rajasekaran
Delayed presentations have been reported following gunshot wounds (GSW) with retained intraspinal bullets due to migration of projectile or lead intoxication. We report on the rare occurrence of delayed pyogenic spondylodiscitis and neurological dysfunction following injury from low velocity GSW to the spine with a retained projectile. A 55-year-old male presented 4 months following GSW to the abdomen which resulted in colonic injury and L5 fracture. The patient was treated initially with ileo-transverse anastomosis, antibiotics, without retrieval of the bullet...
December 2016: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28095386/in-vitro-evaluation-of-the-cleansing-effect-of-a-monofilament-fiber-debridement-pad-compared-to-gauze-swabs
#2
Cornelia Wiegand, Kirsten Reddersen, Uta-Christina Hipler, Martin Abel, Peter Ruth, Anneke Andriessen
BACKGROUND: Removal of nonvital tissue is an accepted method to eradicate biofilms and to stimulate wound healing. Debridement using a monofilament polyester fiber pad has clinically been shown to be effective as well as pain and trauma free. METHODS: For in vitro determination of the cleansing capacity of this product compared to gauze swabs, a wound debridement model was used with glass plates coated with a bovine serum albumin solution, stained with hematoxylin...
January 18, 2017: Skin Pharmacology and Physiology
https://www.readbyqxmd.com/read/28092169/national-athletic-trainers-association-position-statement-management-of-acute-skin-trauma
#3
Joel W Beam, Bernadette Buckley, William R Holcomb, Mario Ciocca
OBJECTIVE:   To present recommendations for the cleansing, debridement, dressing, and monitoring of acute skin trauma in patients. BACKGROUND:   Acute skin trauma is common during participation in athletic and recreational activities. Clinical decisions and intervention protocols after injury vary among athletic trainers and are often based on ritualistic practices. An understanding of cleansing, debridement, and dressing techniques; clinical features of infection and adverse reactions; and monitoring of acute skin trauma is critical for certified athletic trainers and other allied health and medical professionals to create a local wound environment that promotes healing and lessens the risk of complications...
December 2016: Journal of Athletic Training
https://www.readbyqxmd.com/read/28090708/effect-of-semi-quantitative-culture-results-from-complex-host-surgical-wounds-on-dehiscence-rates
#4
Tammer Elmarsafi, Caitlin S Garwood, John S Steinberg, Karen K Evans, Christopher E Attinger, Paul J Kim
The primary aim of this study was to determine the effect of positive bacterial cultures at the time of closure on dehiscence rates. Pre and post-débridement wound cultures from patients undergoing serial surgical débridement of infected wounds were compared with outcomes 30 days postoperatively. One-hundred patients were enrolled; 35 were excluded for incomplete culture data. Sixty-five patients were evaluated for species counts, including Coagulase negative Staphylococcus, and semi-quantitative culture data for each débridement...
January 16, 2017: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/28090519/a-rare-case-of-a-blood-clot-masquerading-as-a-retained-surgical-drain
#5
Sean Wl Ho, Ivan Th Chua
Surgical drains are commonly used in surgery to reduce post-operative fluid collections. Whilst rare, a retained surgical drain may result in clinical complications and distress to the patient. A retained surgical drain is a potentially avoidable event and surgeons should be aware on how to confirm the presence of a retained surgical drain. We report a rare case of a blood clot masquerading as a retained surgical drain in a patient. The patient is a 55-year-old Malay male who presented with left gluteal necrotizing fasciitis...
December 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28088939/complications-in-the-management-of-closed-high-energy-proximal-tibial-plateau-fractures
#6
Kavin Khatri, Vijay Sharma, Darsh Goyal, Kamran Farooque
PURPOSE: To report complications in the management of complex closed proximal tibial fractures. METHOD: A retrospective study was conducted to analyze the infectious and noninfectious complications encountered in the management of high-energy Schatzker type V and VI tibial plateau fractures. All patients were treated at the level 1 trauma centre between January 2011 and March 2014. Sixty two patients were included in the study. The mean patient age was (43.16 ± 11...
December 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28088938/clinical-analysis-of-54-cases-of-large-area-soft-tissue-avulsion-in-the-lower-limb
#7
Yu Chen, Lei Liu
OBJECTIVE: To assess the clinical curative effect of different treatment methods for large area avulsion injury in the lower limb. METHODS: Between January 2010 and December 2013, 54 patients with large area avulsion injury in the lower limb were treated in the trauma center of our hospital, including 34 males and 20 females with a mean age of 35.7 years (range, 16-65 years). The injury mechanism was traffic accident in 44 cases, hitting by heavy objects in 8 cases, and fall from height in 2 cases, involving 31 thighs, 19 legs and 4 feet involved...
December 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28088934/clinical-diagnosis-and-treatment-of-intraorbital-wooden-foreign-bodies
#8
Jia Li, Li-Ping Zhou, Jing Jin, Hong-Feng Yuan
PURPOSE: The intraorbital wooden foreign body is often misdiagnosed or missed on computed tomog- raphy (CT) scan, due to the invisible or unclear images. The residual foreign bodies often occur during surgical removal. The clinical manifestations, imaging features and treatment of intraorbital wooden foreign bodies were discussed in this study. METHOD: We retrospectively analyzed 14 cases of intraorbital wooden foreign bodies managed at our hospital between January 2007 and May 2015...
December 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28088375/two-stage-management-of-cierny-mader-type-iv-chronic-osteomyelitis-of-the-long-bones
#9
Hongri Wu, Jie Shen, Xin Yu, Jingshu Fu, Shengpeng Yu, Dong Sun, Zhao Xie
INTRODUCTION: Cierny-Mader (C-M) type IV chronic osteomyelitis represents a complex clinical challenge with permeation of extensive bone and soft tissue involvement. Aggressive debridement through viable tissue margin includes en bloc resection improves the odds of eradication of infection, which creates large bone and soft tissue loss in treating this type of osteomyelitis. The potentially large defects increase reconstruction problems with traditional reconstruction technique. The newly staged induced membrane technique presents length-independent, potential as an alternative reconstruction method for segmental bone defects due to type IV chronic osteomyelitis...
January 6, 2017: Injury
https://www.readbyqxmd.com/read/28079549/contemporary-methods-allowing-for-safe-and-convenient-use-of-amniotic-membrane-as-a-biologic-wound-dressing-for-burns
#10
David N Herndon, Ludwik K Branski
Partial-thickness burns involve damage to the upper layer of skin, which leaves nerve endings exposed, and therefore represent the most painful of several categories of thermal injuries. Historically, partial-thickness burns were treated conservatively by debriding the blisters, by daily tubbing and washing, and the application of new bandages with topical medications. Human amniotic membrane has been used for centuries as a biological wound dressing. In the past 20 years, there has been an increasing body of literature addressing the use of amniotic tissue in chronic wounds and burns...
February 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28070472/utilizing-the-veraflo%C3%A2-instillation-negative-pressure-wound-therapy-system-with-advanced-care-for-a-case-study
#11
Rita K Driver
BACKGROUND:  Mankind has always suffered wounds throughout time due to trauma, disease, and lifestyles. Many wounds are non-healing and have continued to be challenging. However, utilizing advanced wound care treatments, such as negative pressure wound treatment with instillation and dwell time (NPWTi-d), has proven beneficial. NPWTi-d is indicated in a variety of wounds, such as trauma, surgical, acute, pressure injuries, diabetic foot ulcers, and venous leg ulcers. Bacteria and bioburden interrupts wound healing by increasing the metabolic needs, ingesting, and robbing the necessary nutrients and oxygen...
November 30, 2016: Curēus
https://www.readbyqxmd.com/read/28065968/therapeutic-uses-of-pineapple-extracted-bromelain-in-surgical-care-a-review
#12
Zehra Abdul Muhammad, Tashfeen Ahmad
Bromelain is an extract obtained from the pineapple plant and is used as a traditional folk remedy for several ailments. In this review, a comprehensive electronic database search was carried out to compile available literature on therapeutic implications of bromelain. Pharmaceutical value of bromelain has been demonstrated in different surgical sub-specialties. Diverse biological processes like anti-inflammatory, anti-oedematous, analgesic, anti-thrombotic, exfoliation etc. are involved in bromelain's therapeutic actions, mediated through the kallikrein-kinin and arachidonic acid pathways as well as through effects on cell mediated immunity...
January 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28062435/flaccid-paralysis-in-an-infant-associated-with-a-dirty-wound-and-application-of-honey
#13
Charlotte Jane Joseph, Teik Beng Khoo, Keng Yee Lee
An infant, who was born preterm at 36 weeks, presented with fever and ulcer at umbilical region which progressed to necrotising fasciitis of anterior abdominal wall. He was treated with intravenous penicillin, intravenous cloxacillin and local application of medicated honey. Subsequently, he required wound debridement. Postoperatively, he required prolonged invasive ventilation due to poor respiratory effort which was associated with hypotonia and areflexia. Nerve conduction study revealed absent responses...
January 6, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28060006/resolving-epibole-with-polymeric-membrane-dressings-in-home-care
#14
Kimberly S Bare, Jerri Drain
BACKGROUND: The management of chronic (nonhealing) wounds with epibole is challenging and costly, especially when the problem is not promptly identified or the patient is intolerant to conventional treatments. CASE DESCRIPTION: We describe the use of a polymeric membrane dressing (PMD) in 3 patients with chronic (nonhealing) wounds and epibole who were unable to be treated with traditional interventions such as silver nitrate or sharp debridement. Patient 1 was a 51 year-old male with a right foot stasis ulcer with 60% fibrin/slough to the wound bed, patient 2 was a 58-year-old female with a stage 4 pressure injury of the left hip with undermining, and patient 3 was a 62-year-old female with a dehisced abdominal surgical wound...
January 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28056476/-advanced-systemic-sclerosis-endovascular-reconstruction-of-the-aortic-bifurcation-for-limb-salvage
#15
Florian Stein, Lars Kamper, Konstantinos Meletiadis, Ulrich Kusenack, Patrick Haage
History and admission findings A 69-year-old patient was initially hospitalized because of a 1.5 cm ulceration at the back of the right foot which had existed for the last year and become increasingly swollen and painful. Medical history revealed PmScl-positive systemic sclerosis presenting with a massive calcinosis cutis, advanced pulmonary fibrosis and peripheral artery disease. Examinations Inflammatory markers were normal. MR-Angiography of the lower extremities revealed a multi-segmental high-grade stenosis of the aortic bifurcation due to extensively calcified plaques...
January 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28056436/one-stage-posterior-surgical-management-of-lumbosacral-spinal-tuberculosis-with-nonstructural-autograft
#16
Jia-Ming Liu, Yang Zhou, Ai-Fen Peng, Xuan-Yin Chen, Wen-Zhao Chen, Xin-Hua Long, Shan-Hu Huang, Zhi-Li Liu
OBJECTIVE: Lumbosacral spinal tuberculosis is rare in current population. Previous studies have reported effective outcomes about anterior, antero-posterior and posterior surgery for treating tuberculosis of lumbosacral region. However, the bone grafts used in these studies are mainly structural bone and mesh cage. The purpose of this study is to evaluate the efficacy and safety of nonstructural autograft in the surgical treatment of lumbosacral tuberculosis by one-stage posterior procedure...
December 28, 2016: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28036317/complicated-skin-and-soft-tissue-infection-with-mycobacterium-fortuitum-following-excision-of-a-sebaceous-cyst-in-taiwan
#17
Shih-Chen Tsai, Li-Hsin Chen, Hsien-Hua Liao, Chih-Yu Chiang, Wea-Lung Lin, Shiuan-Chih Chen, Shih-Ming Tsao, Hung-Chang Hung, Yuan-Ti Lee
Mycobacterium fortuitum group (M. fortuitum), also known as rapidly growing Mycobacteria, can cause pyogenic infections in human beings, most commonly in immunocompromised patients. Herein, we present a 40-year-old immunocompetent male patient who underwent planned excision of a sebaceous cyst in the abdominal wall. He suffered from tender erythematous lesions with purulent discharge around the healing wound that developed 2 weeks after surgery. Gram stain, bacterial and fungal culture results of the wound were negative...
December 30, 2016: Journal of Infection in Developing Countries
https://www.readbyqxmd.com/read/28031850/isolated-mycobacterium-kansasii-wound-infection-and-osteomyelitis-in-an-immunocompetent-patient
#18
Tarek Turk, Mohamed Faher Almahmoud, Khulood Raslan
Mycobacterium kansasii is a slow growing acid-fast non-tuberculosis mycobacterium. It most commonly causes pulmonary disease with tuberculosis-like manifestations. Mycobacterium kansasii-induced skin and soft tissue infections (SSTIs) are very uncommon, especially in the absence of obvious risk factors. In this report, we present a rare case of M. kansasii-associated SSTI complicated by tendonitis and osteomyelitis in an immunocompetent patient. This case highlights the importance of considering non-tuberculosis mycobacteria while investigating chronic, relapsing, non-healing SSTIs and osteomyelitis...
November 2016: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/28028957/allogeneic-vs-autologous-skin-grafts-in-the-therapy-of-patients-with-burn-injuries-a-restrospective-open-label-clinical-study-with-pair-matching
#19
Diana Kitala, Marek Kawecki, Agnieszka Klama-Baryła, Wojciech Łabuś, Małgorzata Kraut, Justyna Glik, Ireneusz Ryszkiel, Marek P Kawecki, Mariusz Nowak
BACKGROUND: Early application of autologous skin may lead to the loss of split thickness skin graft due to unclarified wound bed. Allogeneic skin grafts are performed on patients with extensive burn injuries after escharotomy, tangential excisions and deep debridement for the purpose of stabilizing the general condition and reducing the scope of local complications. OBJECTIVES: The aim of this paper is to determine how the use of allografts improves the conditions for the intake of autografts in burns treatment, and how it accelerates wound healing in comparison to the autografts-only option...
September 2016: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/28027261/evidence-based-medicine-the-evaluation-and-treatment-of-pressure-injuries
#20
Joseph A Ricci, Lauren R Bayer, Dennis P Orgill
LEARNING OBJECTIVE: After studying this article, the participant should be able to: 1. Discuss the approach to and rationale for pressure injury management, including specific techniques for prevention and preoperative evaluation. 2. Develop a management algorithm for these wounds that includes operative and nonoperative modalities. 3. Understand how to identify and manage the complications of surgical intervention for pressure injuries, including recurrence. SUMMARY: Pressure injuries are a common problem associated with great morbidity and cost, often presenting as complex challenges for plastic surgeons...
January 2017: Plastic and Reconstructive Surgery
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