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https://www.readbyqxmd.com/read/29791700/closing-the-gap-novel-abdominal-wound-closure-techniques
#1
James Dana Kondrup, Alaina M Qayyum
Traditionally, surgical procedures within the realm of both general and gynecological surgery employ the use of staples and interrupted sutures that run continuously with knot tying or subcuticular sutures to ensure closure of large wound incisions, subcuticular incisions, and fascial repair. However, these methods may not always be cosmetically favorable and, thus, result in an unpleasant outcome for the patient, adding to their surgery-related stress. It is, therefore, imperative that surgeons and gynecologists are aware of alternative methods of wound closure that are not only cosmetically favorable, but also ensure rapid wound recovery and infection control...
June 1, 2018: Surgical Technology International
https://www.readbyqxmd.com/read/29791437/a-randomized-controlled-trial-on-the-effect-of-a-silver-carboxymethylcellulose-dressing-on-surgical-site-infections-after-breast-cancer-surgery
#2
Gerson M Struik, Wietske W Vrijland, Erwin Birnie, Taco M A L Klem
BACKGROUND: The incidence of surgical site infections (SSIs) after breast cancer surgery is relatively high; ranging from 3 to 19%. The role of wound dressings in the prevention of SSI after breast cancer surgery is unclear. This study compares a silver carboxymethylcellulose dressing (AQUACEL Ag Surgical (Aquacel) with standard wound dressing in SSI rate after breast cancer surgery. PATIENTS AND METHODS: A single-centre randomized controlled trial among women ≥18 years, diagnosed with breast cancer, undergoing breast conserving or ablative surgery, was conducted in a combined in and outpatient setting...
2018: PloS One
https://www.readbyqxmd.com/read/29787547/interrupted-versus-continuous-fascial-closure-in-patients-undergoing-emergent-laparotomy-a-randomized-controlled-trial
#3
Thomas Peponis, Jordan D Bohnen, Sandra Muse, Eva Fuentes, Gwendolyn M van der Wilden, Ali Mejaddam, Hasan Alam, Haytham M A Kaafarani, Peter J Fagenholz, David R King, D Dante Yeh, George C Velmahos, Marc A de Moya
BACKGROUND: The optimal method of fascial closure, interrupted versus continuous (IFC and CFC respectively) has never been studied exclusively in the setting of emergency surgery. We hypothesized that IFC decreases postoperative incisional hernia development following emergent laparotomies. METHODS: Between August 2008 and September 2015, patients undergoing emergent laparotomies were consented and randomly assigned to either IFC or CFC. Patients were followed postoperatively for at least three months and assessed for incisional hernia, dehiscence, or wound infection...
May 4, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29785926/intramedullary-nail-fixation-versus-locking-plate-fixation-for-adults-with-a-fracture-of-the-distal-tibia-the-uk-fixdt-rct
#4
Matthew L Costa, Juul Achten, Susie Hennings, Nafisa Boota, James Griffin, Stavros Petrou, Mandy Maredza, Melina Dritsaki, Thomas Wood, James Masters, Ian Pallister, Sarah E Lamb, Nick R Parsons
BACKGROUND: The best treatment for fractures of the distal tibia remains controversial. Most of these fractures require surgical fixation, but the outcomes are unpredictable and complications are common. OBJECTIVES: To assess disability, quality of life, complications and resource use in patients treated with intramedullary (IM) nail fixation versus locking plate fixation in the 12 months following a fracture of the distal tibia. DESIGN: This was a multicentre randomised trial...
May 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29785265/a-randomized-controlled-trial-of-the-safety-and-efficacy-of-a-topical-gentamicin-collagen-sponge-in-diabetic-patients-with-a-mild-foot-ulcer-infection
#5
Ilker Uçkay, Benjamin Kressmann, Sébastien Di Tommaso, Marina Portela, Heba Alwan, Hubert Vuagnat, Sophie Maître, Christophe Paoli, Benjamin A Lipsky
Objectives: The initial phase of infection of a foot ulcer in a person with diabetes is often categorized as mild. Clinicians usually treat these infections with antimicrobial therapy, often applied topically. Some experts, however, believe that mild diabetic foot ulcer infections will usually heal with local wound care alone, without antimicrobial therapy or dressings. Methods: To evaluate the potential benefit of treatment with a topical antibiotic, we performed a single-center, investigator-blinded pilot study, randomizing (1:1) adult patients with a mild diabetic foot ulcer infection to treatment with a gentamicin-collagen sponge with local care versus local care alone...
2018: SAGE Open Medicine
https://www.readbyqxmd.com/read/29785086/the-utilization-of-an-ocular-wound-chamber-on-corneal-epithelial-wounds
#6
Jennifer S McDaniel, Andrew W Holt, Elaine D Por, Elof Eriksson, Anthony J Johnson, Gina L Griffith
Purpose: Currently available ocular moisture chambers are not adequate to manage the treatment of periocular burns, corneal injuries, and infection. The purpose of these studies was to demonstrate that a flexible, semi-transparent ocular wound chamber device adapted from technology currently used on dermal wounds is safe for use on corneal epithelial injuries. Materials and methods: A depilatory cream (Nair™, 30 seconds) was utilized to remove the excess hair surrounding the left eyes of anesthetized Institute Armand Frappier (IAF) hairless, female guinea pigs (Crl:HA-Hrhr)...
2018: Clinical Ophthalmology
https://www.readbyqxmd.com/read/29784040/antimicrobial-resistance-profile-of-staphylococcus-aureus-isolated-from-patients-with-infection-at-tikur-anbessa-specialized-hospital-addis-ababa-ethiopia
#7
Sileshi Tadesse, Haile Alemayehu, Admasu Tenna, Getachew Tadesse, Tefaye Sisay Tessema, Workineh Shibeshi, Tadesse Eguale
BACKGROUND: Staphylococcus aureus is one of the major pathogens of public health importance responsible for various forms of infection. Development of resistance to commonly used antimicrobials limited treatment options against infections due to this pathogen. Antimicrobial resistance profile of Staphylococcus aureus isolated from patients with surgical site infection and ear infection and corresponding nasal swab was investigated in Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia...
May 21, 2018: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29783681/encapsulation-and-characterization-of-gentamicin-sulfate-in-the-collagen-added-electrospun-nanofibers-for-skin-regeneration
#8
Wan Khartini Wan Abdul Khodir, Abdul Hakim Abdul Razak, Min Hwei Ng, Vincenzo Guarino, Deny Susanti
In the current practice, the clinical use of conventional skin substitutes such as autogenous skin grafts have shown several problems, mainly with respect to limited sources and donor site morbidity. In order to overcome these limitations, the use of smart synthetic biomaterials is tremendously diffusing as skin substitutes. Indeed, engineered skin grafts or analogues frequently play an important role in the treatment of chronic skin wounds, by supporting the regeneration of newly formed tissue, and at the same time preventing infections during the long-term treatment...
May 18, 2018: Journal of Functional Biomaterials
https://www.readbyqxmd.com/read/29783026/a-prolonged-and-large-outbreak-of-invasive-group-a-streptococcal-disease-within-a-nursing-home-repeated-intra-facility-transmission-of-a-single-strain
#9
S A Nanduri, B J Metcalf, M A Arwady, C Edens, M A Lavin, J Morgan, W Clegg, A Beron, J P Albertson, R Link-Gelles, A Ogundimu, J Gold, D Jackson, S Chochua, N Stone, C Van Beneden, K Fleming-Dutra, B Beall
OBJECTIVES: Multiple invasive group A streptococcal (GAS) infections were reported to public health by a skilled nursing facility (Facility A) in Illinois between May 2014 and August 2016. Cases continued despite interventions including antibiotic prophylaxis for all residents and staff. Two other geographically close facilities reported contemporaneous outbreaks of GAS. We investigated potential reasons for ongoing transmission. METHODS: We obtained epidemiologic data from chart review of cases and review of facility and public health records from previous investigations into the outbreak...
May 18, 2018: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29778340/prospective-randomized-controlled-trial-of-polymer-cable-ties-versus-standard-wire-closure-of-midline-sternotomy
#10
Silvana F Marasco, Louise Fuller, Adam Zimmet, David McGiffin, Michael Seitz, Stephanie Ch'ng, Shivanand Gangahanumaiah, Michael Bailey
OBJECTIVE: Midline sternotomy remains the most common access incision for cardiac operations. Traditionally, the sternum is closed with stainless steel wires. Wires are well known to stretch and break, however, leading to pain, nonunion, and potential deep sternal wound infection. We hypothesized that biocompatible plastic cable ties would achieve a more rigid sternal fixation, reducing postoperative pain and analgesia requirements. METHODS: A prospective, randomized study compared the ZIPFIX (De Puy Synthes, West Chester, Pa) sternal closure system (n = 58) with standard stainless steel wires (n = 60)...
April 16, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29771377/alternative-splicing-analysis-in-human-monocytes-and-macrophages-reveals-mbnl1-as-major-regulator
#11
Hongfei Liu, Paolo A Lorenzini, Fan Zhang, Shaohai Xu, Mei Su M Wong, Jie Zheng, Xavier Roca
We report the detailed transcriptomic profiles of human innate myeloid cells using RNA sequencing. Monocytes migrate from blood into infected or wounded tissue to differentiate into macrophages, and control inflammation via phagocytosis or cytokine secretion. We differentiated culture primary monocytes with either GM- or M-CSF to obtain pro- or anti-inflammatory macrophages, and respectively activated them with either LPS/IFNγ or anti-inflammatory cytokines. We also treated the THP-1 monocytic cell line with PMA and similar cytokines to mimic differentiation and activation...
May 16, 2018: Nucleic Acids Research
https://www.readbyqxmd.com/read/29766749/enhanced-sternal-healing-via-platelet-rich-plasma-and-biodegradable-gelatin-hydrogel
#12
Masafumi Shibata, Gen Takagi, Mitsuhiro Kudo, Jiro Kurita, Yoko Kawamoto, Yasuo Miyagi, Mikimoto Kanazashi, Takashi Sakatani, Zenya Naito, Yasuhiko Tabata, Masaaki Miyamoto, Takashi Nitta
Platelet-rich plasma (PRP) contains numerous growth factors and promotes bone fracture healing. The aim of this study was to evaluate the effectiveness of the controlled release of PRP from biodegradable gelatin hydrogel for promoting healing in a rabbit ischemic sternal model. PRP was prepared from the whole blood of a Japanese white rabbit. Sixteen rabbits were randomized into four groups (each n = 4) and all underwent median sternotomy and bilateral internal thoracic artery removal. Before the sternum was closed, the following solutions were applied between the sternum incisions in three of the groups: 30 mg of gelatin hydrogel incorporating 300 μL of phosphate-buffered saline, 300 μL of a solution form of PRP, or 30 mg of gelatin hydrogel incorporating 300 μL of PRP (PRP+Gel)...
May 16, 2018: Tissue Engineering. Part A
https://www.readbyqxmd.com/read/29764844/second-look-laparostomy-for-perforated-gangrenous-gastric-volvulus-to-prevent-total-gastrectomy
#13
Paul K Okeny, Omar Abbassi, Ali Warsi
A 42-year-old Caucasian woman presented to the emergency department with severe upper abdominal pain and vomiting. Clinically, she was septic, and abdominal examination suggested peritonitis. Following immediate resuscitation, the patient was stabilised and underwent urgent contrast-enhanced CT of the abdomen and pelvis. This revealed a mesenteroaxial gastric volvulus with traction on the mesentery and a small volume of free fluid. She underwent laparotomy revealing gangrenous gastric fundus perforation complicated by persistent intraoperative hypotension...
May 15, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29763982/bone-graft-in-posterior-spine-fusion-for-adolescent-idiopathic-scoliosis-a-meta-analysis
#14
REVIEW
Nathan Kirzner, Luke Hilliard, Catherine Martin, Gerald Quan, Susan Liew, Ali Humadi
BACKGROUNDS: The aim of this study was to systematically analyse and perform a meta-analysis on the current available literature comparing the fusion rates and complications associated with use of autograft, allograft and bone substitutes to supplement posterior spinal fusion for adolescent idiopathic scoliosis (AIS). METHODS: The electronic databases including Embase, PubMed, Medline, Cinahl and Cochrane Library were searched to identify relevant studies. A total of 12 studies with 2389 patients were included for meta-analysis...
May 15, 2018: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29756506/dislocation-rate-increases-with-bariatric-surgery-before-total-hip-arthroplasty
#15
Brian T Nickel, Mitchell R Klement, Colin Penrose, Cynthia L Green, Michael P Bolognesi, Thorsten M Seyler
INTRODUCTION: Annually in the USA, 113,000 patients with refractory obesity undergo bariatric surgery (BS), and a subset does so in order to lower body mass index to become a more desirable total hip arthroplasty (THA) candidate. This study aims to evaluate THA risk with and without bariatric surgery. METHODS: 12,160 patients were identified in a claim-based review of the entire Medicare database with ICD-9 codes to identify patients in three groups. Patients who underwent BS prior to THA (Group I: 1,545 experimental group) and two control groups that did not undergo BS but had either a body mass index >40 (Group II: 6,918 bariatric control) or <25 (Group III: 3,697 normal weight control)...
May 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29753896/autologous-cranioplasty-is-associated-with-increased-re-operation-rate-a-systematic-review-and-meta-analysis
#16
REVIEW
James G Malcolm, Zayan Mahmooth, Rima S Rindler, Jason W Allen, Jonathan A Grossberg, Gustavo Pradilla, Faiz U Ahmad
OBJECTIVE: Consensus regarding selection of synthetic versus autologous flap reimplantation for cranioplasty after decompressive craniectomy has not been reached and the multiple factors considered for each patient make comparative analysis challenging. This study examines the association between choice of material and related complications. METHODS: A systematic literature review and meta-analysis was performed using PubMed for articles reporting delayed cranioplasty after decompressive craniectomy using a cohort design comparing autologous bone and synthetic implants...
May 10, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29753454/response-of-a-local-hospital-to-a-burn-disaster-contributory-factors-leading-to-zero-mortality-outcomes
#17
Eng-Kean Yeong, Ciaran P O'Boyle, Hui-Fu Huang, Hao-Chih Tai, Yen-Chun Hsu, Shu-Yang Chuang, Yu-Feng Wu, Che-Wei Chang, Tom J Liu, Hong-Shiee Lai
OBJECTIVE: To investigate the outcomes of a local healthcare system in managing a burn mass casualty incident (BMCI). METHODS: Thirty-three victims admitted to the National Taiwan University Hospital within 96h of the explosion were included in the study. Data were recorded on: patient demographics, Baux score, laboratory data, management response, treatment strategies, and outcomes. Case notes from June 27, 2015 to November 2015 were reviewed with a focus on fluid resuscitation, ventilation support, nutrition, infection control, sepsis treatment, and wound closure plan...
May 9, 2018: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29752506/examination-of-intra-operative-core-temperature-in-joint-arthroplasty-a-single-institution-prospective-observational-study
#18
Jennifer R Matos, Julie R McSwain, Bethany J Wolf, J Wesley Doty, Sylvia H Wilson
PURPOSE: Peri-operative hypothermia is associated with increased blood loss, delayed wound healing, and surgical site infections. However, it is not known when or how rapidly hypothermia develops during arthroplasty. This study observed patients undergoing lower extremity arthroplasty to identify the times of greatest heat loss or gain. METHODS: This single-institution prospective observational study enrolled 120 patients undergoing elective knee or hip arthroplasty for peri-operative temporal temperature measurements at ten prespecified intervals...
May 11, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29745356/noninfectious-hospital-adverse-events-decline-after-elimination-of-contact-precautions-for-mrsa-and-vre
#19
Elise M Martin, Brandy Bryant, Tristan R Grogan, Zachary A Rubin, Dana L Russell, David Elashoff, Daniel Z Uslan
OBJECTIVETo evaluate the impact of discontinuing routine contact precautions (CP) for endemic methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) on hospital adverse events.DESIGNRetrospective, nonrandomized, observational, quasi-experimental study.SETTINGAcademic medical center with single-occupancy rooms.PARTICIPANTSInpatients.METHODSWe compared hospital reportable adverse events 1 year before and 1 year after discontinuation of routine CP for endemic MRSA and VRE (preintervention and postintervention periods, respectively)...
May 10, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29744466/chitosan-based-metallic-nanocomposite-scaffolds-as-antimicrobial-wound-dressings
#20
REVIEW
Annapoorna Mohandas, S Deepthi, Raja Biswas, R Jayakumar
Chitosan based nanocomposite scaffolds have attracted wider applications in medicine, in the area of drug delivery, tissue engineering and wound healing. Chitosan matrix incorporated with nanometallic components has immense potential in the area of wound dressings due to its antimicrobial properties. This review focuses on the different combinations of Chitosan metal nanocomposites such as Chitosan/nAg, Chitosan/nAu, Chitosan/nCu, Chitosan/nZnO and Chitosan/nTiO2 towards enhancement of healing or infection control with special reference to the antimicrobial mechanism of action and toxicity...
September 2018: Bioactive Materials
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