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Wound debridement

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https://www.readbyqxmd.com/read/28336328/bone-healing-is-achievable-despite-extensive-wound-dehiscence-and-wide-plate-and-screws-exposure-in-children
#1
Elias Melhem, Wael Bayoud, Ismat Ghanem
BACKGROUD: Extensive wound dehiscence and wide plate and screw exposure in the early weeks following orthopaedic surgery in children is usually managed either by extensive debridement, lavage and secondary closure or hardware removal and external fixation. PATIENTS: Three children with LCP plate and screws exposure were managed by simple repetitive debridement and local wound care without any IV antibiotics, nor secondary closure or hardware removal. All three cases occurred in the tibia, one following tibial osteotomy in lateral hemimelia with a long history of previous surgeries, one following wide excision of a tibial Ewing sarcoma with chemo and radiotherapy, and the third following wide excision of a 12cm necrotic tibial segment due to chronic osteomyelitis...
March 20, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28333393/laser-generated-shockwaves-enhance-antibacterial-activity-against-biofilms-in-vitro
#2
William Yao, Edward C Kuan, Nathan C Francis, Maie A St John, Warren S Grundfest, Zachary D Taylor
BACKGROUND AND OBJECTIVES: Bacterial biofilm formation within chronic wound beds, which provides an effective barrier against antibiotics, is a known cause of recalcitrant infections and a significant healthcare burden, often requiring repeated surgical debridements. Laser-generated shockwaves (LGS) is a novel, minimally invasive, and nonthermal modality for biofilm mechanical debridement which utilizes compressive stress waves, generated by photonic absorption in thin titanium films to mechanically disrupt the biofilm...
March 23, 2017: Lasers in Surgery and Medicine
https://www.readbyqxmd.com/read/28328683/surgical-support-during-the-terrorist-attacks-in-paris-13-november-2015-experience-at-b%C3%A3-gin-military-teaching-hospital
#3
Olivier Barbier, Brice Malgras, Camille Choufani, Antoine Bouchard, Didier Ollat, Gilbert Versier
BACKGROUND: Recent conflicts have allowed the French Army Health Service to improve management quality for wartime-injured people during military operations. On 13 November 2015, it was in Paris that France was directly attacked and Bégin Military Teaching Hospital, like several hospitals in Paris, had to face a large number of gunshot victims. Thanks to our operational experience, injured people hospitalized in military hospitals benefited from a management based on triage and damage control (DC) principles...
March 21, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28328662/surgical-management-of-hidradenitis-suppurativa-a-14-year-retrospective-review-of-98-consecutive-patients
#4
Kathleen S Romanowski, Alice Fagin, Bridget Werling, Gretchen Kass, Junlin Liao, Thomas Granchi, Gerald P Kealey, Lucy Wibbenmeyer
Hidradenitis suppurativa (HS) is a debilitating suppurative disease of the apocrine/follicular glands. Medical treatment has some efficacy in early-stage disease but is costly and requires frequent physician visits. Advanced disease usually requires surgical intervention. This treatment has not been well described in the literature. We sought to review our experience with HS treatment in a large surgical cohort. A retrospective review of 98 consecutive HS patients from 2000 to 2014 was performed. A two-stage operative approach was used...
March 15, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28326157/partial-calcanectomy-and-ilizarov-external-fixation-may-reduce-amputation-need-in-severe-diabetic-calcaneal-ulcers
#5
Mehmet Orçun Akkurt, Ismail Demirkale, Ali Öznur
Objective: The treatment of diabetic hindfoot ulcers is a challenging problem. In addition to serial surgical debridements, hyperbaric oxygen therapy and local wound care play important roles in the surgeon's armamentarium, for both superficial infection and gangrene of the soft tissue, often complicated by osteomyelitis of the calcaneus. The purpose of this study was to evaluate the results of an aggressive approach from diagnosis to treatment of calcaneal osteomyelitis in foot-threatening diabetic calcaneal ulcers...
2017: Diabetic Foot & Ankle
https://www.readbyqxmd.com/read/28321572/the-extent-of-environmental-and-body-contamination-through-aerosols-by-hydro-surgical-debridement-in-the-lumbar-spine
#6
David Putzer, Ricarda Lechner, Debora Coraca-Huber, Astrid Mayr, Michael Nogler, Martin Thaler
INTRODUCTION: Surgical site infections occur in 1-6% of spinal surgeries. Effective treatment includes early diagnosis, parenteral antibiotics and early surgical debridement of the wound surface. MATERIALS AND METHODS: On a human cadaver, we executed a complete hydro-surgery debridement including a full surgical setup such as draping. The irrigation fluid was artificially contaminated with Staphylococcus aureus (ATCC 6538). Surveillance cultures were used to detect environmental and body contamination of the surgical team...
March 20, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28304144/efficacy-of-dermal-substitute-on-deep-dermal-to-full-thickness-burn-injury-a-systematic-review
#7
REVIEW
Winy Widjaja, Juen Tan, Peter K M Maitz
BACKGROUND: The study aims to systematically examine the efficacy of dermal regeneration templates (DRTs) in comparison to split thickness skin grafting (STSG) in the management of acute burn injuries post-excision and debridement. METHODS: Systematic literature search was conducted by two independent reviewers from the following databases: MEDLINE, EMBASE and Cochrane Library with selection criteria set a priori. Only randomized controlled trials (RCTs) were included...
March 17, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28302117/the-effects-of-music-intervention-on-burn-patients-during-treatment-procedures-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#8
Jinyi Li, Liang Zhou, Yungui Wang
BACKGROUND: The treatment of burn patients is very challenging because burn injuries are one of the most severe traumas that can be experienced. The effect of music therapy on burn patients has been widely reported, but the results have been inconsistent. Thus, we performed a systematic review and meta-analysis of randomized controlled trials in burn patients to determine the effect of music during treatments. METHODS: We searched a variety of electronic databases, including MEDLINE (via PubMed), EMBASE, Cochrane Library, Psychinfo, VIP Database for Chinese Technical Periodicals (VIP) and China National Knowledge Infrastructure (CNKI) for relevant trials on the basis of predetermined eligibility criteria...
March 17, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28301366/management-of-mastectomy-skin-necrosis-in-implant-based-breast-reconstruction
#9
Gloria R Sue, Chao Long, Gordon K Lee
BACKGROUND: Mastectomy skin necrosis is a significant problem after breast reconstruction. This complication may lead to poor wound healing and need for implant removal, which may delay subsequent oncologic treatment. We sought to characterize factors associated with mastectomy skin necrosis and propose a management algorithm. METHODS: A retrospective review was performed on consecutive patients undergoing implant-based breast reconstruction by the senior author from 2006 through 2015...
March 16, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28299216/successful-treatment-of-necrotizing-fasciitis-and-streptococcal-toxic-shock-syndrome-with-the-addition-of-linezolid
#10
Hana Rac, Karine D Bojikian, Jose Lucar, Katie E Barber
Necrotizing fasciitis is a deep-seated subcutaneous tissue infection that is commonly associated with streptococcal toxic shock syndrome (TSS). Surgical debridement plus penicillin and clindamycin are the current standard of care. We report a case of necrotizing fasciitis and streptococcal TSS where linezolid was added after a failure to improve with standard therapy. Briefly after isolation of Streptococcus pyogenes from tissue cultures, the patient underwent two surgical debridement procedures and was changed to standard of care therapy...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28296723/surgical-treatment-for-bacterial-meningitis-after-spinal-surgery-a-case-report
#11
Li-Min Zhang, Liang Ren, Zhen-Qi Zhao, Yan-Rui Zhao, Yin-Feng Zheng, Jun-Lin Zhou
RATIONALE: Bacterial meningitis (BM) has been recognized as a rare complication of spinal surgery. However, there are few reports on the management of postoperative BM in patients who have undergone spinal surgery. The initial approach to the treatment of patients suspected with acute BM depends on the stage at which the syndrome is recognized, the speed of the diagnostic evaluation, and the need for antimicrobial and adjunctive therapy. PATIENT CONCERNS: Here, we report the case of a patient with lumbar spinal stenosis and underwent a transforaminal lumbar interbody fusion at L4-L5...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28295126/gluteus-maximus-advancement-flap-procedure-for-reconstruction-of-posterior-soft-tissue-deficiency-in-revision-total-hip-arthroplasty
#12
Benjamin F Ricciardi, Peter W Henderson, Alexander S McLawhorn, Geoffrey H Westrich, Mathias P Bostrom, Lloyd B Gayle
The current study describes the surgical technique and early outcomes of a gluteus maximus advancement flap procedure for the treatment of posterior soft tissue insufficiency among patients with complex revision total hip arthroplasty. This retrospective case series was conducted with a prospective, single-institution arthroplasty registry. Patients who underwent a gluteus maximus advancement flap procedure in the setting of revision total hip arthroplasty between January 2012 and January 2016 were eligible for inclusion (N=7)...
March 14, 2017: Orthopedics
https://www.readbyqxmd.com/read/28294481/mycoplasma-hominis-periaortic-abscess-following-heart-lung-transplantation
#13
Hideharu Hagiya, Hisao Yoshida, Norihisa Yamamoto, Keigo Kimura, Akiko Ueda, Isao Nishi, Yukihiro Akeda, Kazunori Tomono
We report the first case of Mycoplasma hominis periaortic abscess after heart-lung transplantation, to our knowledge. The absence of sternal wound infection delayed the diagnosis, but the patient successfully recovered with debridement surgeries and long-term antibiotic therapy. Owing to the difficulty in detection and the intrinsic resistance to beta-lactams, M. hominis infections are prone to being misdiagnosed and undertreated. M. hominis should be suspected in cases where conventional microbiological identification and treatment approaches fail...
March 13, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28293640/cost-analysis-of-a-novel-enzymatic-debriding-agent-for-management-of-burn-wounds
#14
Giuseppe Giudice, Angela Filoni, Giulio Maggio, Domenico Bonamonte, Michelangelo Vestita
Introduction. Given its efficacy and safety, NexoBrid™ (NXB) has become part of our therapeutic options in burns treatment with satisfactory results. However, no cost analysis comparing NXB to the standard of care (SOC) has been carried out as of today. Aim. To assess the cost of treatment with NXB and compare it to the SOC cost. Methods. 20 patients with 14-22% of TBSA with an intermediate-deep thermal burn related injury were retrospectively and consecutively included. 10 of these patients were treated with the SOC, while the other 10 with NXB...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28292542/prevention-of-infection-in-open-fractures
#15
REVIEW
Charalampos G Zalavras
Open fractures are complex injuries that are associated with increased risk for complications, such as infection and nonunion. The goals of open fracture management are prevention of infection, fracture union, and restoration of function. These goals are best achieved by careful patient and injury assessment, early administration of systemic antibiotics supplemented by local delivery of antibiotics in severe injuries, thorough surgical debridement, wound management with soft tissue coverage if needed, and stable fracture fixation...
March 11, 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28289362/study-on-biofilm-formation-in-burn-wound-infection-in-a-pediatric-hospital-in-chennai-india
#16
M Ramakrishnan, S Putli Bai, M Babu
Infection is one of the major causes of death in pediatric burns in India. This work was conducted in an exclusive Children's Hospital (KKCTH) with a total of 220 beds, of which ten beds in the burn unit and two isolation beds in the 28-bed PICU are for burns patients (more than 20% TBSA burns) with sepsis. In this study, 30 burn wound swab isolates obtained from 14 pediatric burns patients (admitted to the burns ward and transferred to PICU) from November 2013 to March 2014 were investigated. Cultures were done on the first day for all patients and empirical antibiotic administration was started for those with septic burns (14 in total) with piperacillin-tazobactam and vancomycin...
December 31, 2016: Annals of Burns and Fire Disasters
https://www.readbyqxmd.com/read/28288080/management-of-pediatric-type-i-open-fractures-in-the-emergency-department-or-operating-room-a-multicenter-perspective
#17
Jenna Godfrey, Paul D Choi, Lior Shabtai, Sarah B Nossov, Amy Williams, Antoinette W Lindberg, Selina Silva, Michelle S Caird, Mathew D Schur, Alexandre Arkader
BACKGROUND: The management of pediatric type I open fractures remains controversial. The aim of this study is to compare outcomes in type I open fractures managed with superficial wound debridement and antibiotics in the emergency department (ED) (nonoperative management) to patients managed with operative debridement and antibiotics (operative management). METHODS: A multicenter retrospective review was performed of all pediatric type I open forearm, wrist, and tibia fractures treated at 4 high volume pediatric centers between 2000 and 2015...
March 10, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28285897/arthrofibrosis-associated-with-total-knee-arthroplasty
#18
REVIEW
Victor A Cheuy, Jared R H Foran, Roger J Paxton, Michael J Bade, Joseph A Zeni, Jennifer E Stevens-Lapsley
The purpose of this article is to review the etiology, economic burden, treatment strategies, and future research directions of arthrofibrosis after total knee arthroplasty (TKA). Arthrofibrosis is a debilitating postoperative complication of TKA. This condition is one of the leading causes of hospital readmission and a predominant reason for TKA failure. The prevalence of arthrofibrosis will increase as the annual incidence of TKA in the United States rises into the millions. Characterized by the excessive proliferation of scar tissue during an impaired wound healing response, the resulting stiffness of arthrofibrosis causes functional deficits in activities of daily living, such as walking, stair climbing, and standing from a chair...
February 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28277993/maggot-therapy-for-wound-care-in-iran-a-case-series-of-the-first-28-patients
#19
A Mirabzadeh, M J Ladani, B Imani, S A B Rosen, R A Sherman
OBJECTIVE: The need for improved wound care is receiving considerable attention in the Islamic Republic of Iran. Beginning in 2003, maggot therapy (MT) became part of Iran's effort to advance its wound care technology. The first cohort of patients treated with MT was analysed to evaluate the use of this treatment. METHOD: Patients treated with MT at three hospitals in Tehran were analysed retrospectively. Primary outcomes were time to wound debridement and time to wound healing...
March 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28274882/vacuum-sealing-drainage-as-a-pre-surgical-adjunct-in-the-treatment-of-complex-open-hand-injuries-report-of-17-cases
#20
Xiao-Feng Niu, Jian-Hua Yi, Guo-Qin Zha, Jun Hu, Yun-Jiang Liu, Liang-Bao Xiao
BACKGROUND: Few studies have been conducted to explore the use of the vacuum sealing drainage (VSD) technique in complex hand injuries. The aim of this study was to report outcomes in patients with complex hand injuries receiving VSD as a coadjuvant treatment prior to second-stage surgery. METHODS: This case series study retrospectively reviewed the patients who underwent VSD for treatment of hand injuries. Inclusion criteria for the study were: (1) traumatic soft tissue defects of the hand and wrist, accompanied by different degrees of injury and exposure of bone, tendon, or blood vessel; (2) the wound surface of hand and wrist was seriously contaminated and direct wound closure was not possible; and (3) the soft tissues of hand and wrist were seriously lacerated or avulsed, and showed necrosis or acute infection...
March 5, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
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