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https://www.readbyqxmd.com/read/28538648/less-is-more-antibiotic-duration-and-outcomes-in-fournier-s-gangrene
#1
Margaret Lauerman, Olga Kolesnik, Kinjal Sethuraman, Ronald Rabinowitz, Manjari Joshi, Emily Clark, Deborah Stein, Thomas Scalea, Sharon Henry
BACKGROUND: Antibiotic management of Fournier's gangrene (FG) is without evidence-based guidelines, and is based on expert opinion. The effect of duration of antibiotic therapy on outcomes in FG is unknown. METHODS: A retrospective review was performed of FG patients from 2012-2015 at a single institution. Patients were managed by our institutional practice of complete primary wound closure as possible, with antibiotic duration according to physician judgement. Patients were stratified into multiple durations of antibiotic administration...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538579/the-split-pectoralis-flap-combining-the-benefits-of-pectoralis-major-advancement-and-turnover-techniques-in-one-flap
#2
Rodger H Brown, Safa E Sharabi, Katarzyna E Kania, Larry H Hollier, Shayan A Izaddoost
BACKGROUND: The pectoralis major is a versatile flap used as an advancement or turnover flap for sternal wound treatment. The advancement flap provides suboptimal inferior sternal coverage and poorly fills mediastinal dead space. The turnover flap covers the inferior sternum and fills dead space but requires disinsertion of the muscle from the humerus, resulting in functional loss and cosmetic deformity. METHODS: The authors describe a new technique of splitting the pectoralis muscle along its fibers, using the superior portion as an advancement flap and the inferior portion as a turnover flap...
June 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28538512/necrotizing-ulcer-after-bcg-vaccination-in-a-girl-with-leukocyte-adhesion-deficiency-type-1
#3
Hidemitsu Kurosawa, Tomoyuki Mizukami, Hiroyuki Nunoi, Masaya Kato, Yuya Sato, Mayuko Okuya, Keitaro Fukushima, Yoshihiko Katsuyama, Osamu Arisaka
Leukocyte-adhesion deficiency-1 is a recessively inherited disorder associated with recurrent bacterial infections, severe periodontitis, peripheral leukocytosis, and impaired wound healing. We diagnosed moderate-type leukocyte-adhesion deficiency-1 in a 7-year-old girl who developed a necrotizing ulcer after Bacillus Calmette-Guerin vaccination. The patient showed moderate expression of CD18 in neutrophils with a homozygous splice mutation with c.41_c.58+2dup20 of ITGB2 and experienced recurrent severe infections complicated with systemic lupus erythematosus...
May 22, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28538418/keystone-designed-buried-de-epithelialized-flap-a-novel-technique-for-obliterating-small-to-moderately-sized-dead-spaces
#4
Hoon Kim, Wan Cheol Ryu, Chi Sun Yoon, Kyu Nam Kim
Effective obliteration of dead space after reconstructive surgery facilitates a good cosmetic outcome and prevention of delayed wound healing and recurrent infection.We evaluated the efficacy of a keystone-designed buried de-epithelialized (KBD) flap for the obliteration of small to moderately sized surgical dead spaces.We reviewed the medical records of patients who received a KBD flap following removal of a mass or debridement of necrotic tissue from September 2015 to February 2016. The diagnosis, site, dead space dimensions, flap width, drain data, complications, and follow-up duration were recorded...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28538177/chemokine-signaling-and-the-regulation-of-bidirectional-leukocyte-migration-in-interstitial-tissues
#5
Davalyn Powell, Sebastien Tauzin, Laurel E Hind, Qing Deng, David J Beebe, Anna Huttenlocher
Motile cells navigate through complex tissue environments that include both attractive and repulsive cues. In response to tissue wounding, neutrophils, primary cells of the innate immune response, exhibit bidirectional migration that is orchestrated by chemokines and their receptors. Although progress has been made in identifying signals that mediate the recruitment phase, the mechanisms that regulate neutrophil reverse migration remain largely unknown. Here, we visualize bidirectional neutrophil migration to sterile wounds in zebrafish larvae and identify specific roles for the chemokine receptors Cxcr1 and Cxcr2 in neutrophil recruitment to sterile injury and infection...
May 23, 2017: Cell Reports
https://www.readbyqxmd.com/read/28535235/effect-of-cephalexin-plus-trimethoprim-sulfamethoxazole-vs-cephalexin-alone-on-clinical-cure-of-uncomplicated-cellulitis-a-randomized-clinical-trial
#6
Gregory J Moran, Anusha Krishnadasan, William R Mower, Fredrick M Abrahamian, Frank LoVecchio, Mark T Steele, Richard E Rothman, David J Karras, Rebecca Hoagland, Stephanie Pettibone, David A Talan
Importance: Emergency department visits for skin infections in the United States have increased with the emergence of methicillin-resistant Staphylococcus aureus (MRSA). For cellulitis without purulent drainage, β-hemolytic streptococci are presumed to be the predominant pathogens. It is unknown if antimicrobial regimens possessing in vitro MRSA activity provide improved outcomes compared with treatments lacking MRSA activity. Objective: To determine whether cephalexin plus trimethoprim-sulfamethoxazole yields a higher clinical cure rate of uncomplicated cellulitis than cephalexin alone...
May 23, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28534395/hyaluronic-acid-templated-ag-nanoparticles-graphene-oxide-composites-for-synergistic-therapy-of-bacteria-infection
#7
Xiang Ran, Ye Du, Zhenzhen Wang, Huan Wang, Fang Pu, Jinsong Ren, Xiaogang Qu
Developing methods of decreasing the harm to cell and increasing the antibacterial efficiency is becoming a potential topic to medical treatments. We demonstrated a hyaluronidase-triggered photothermal platform for killing bacteria based on AgNPs and graphene oxide (GO). The property of the HAase-triggered release provided excellent antibacterial activity against S. aureus. Upon illumination of NIR light, the GO-based nanomaterials locally raised the temperature, resulting in high mortality of bacterial. The HAase-triggered AgNPs releasing approach for antibacterial allows AgNPs to be protected by HA template without affecting mammalian cells...
May 23, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/28534258/closed-incision-prophylactic-negative-pressure-wound-therapy-in-patients-undergoing-major-complex-abdominal-wall-repair
#8
F E E de Vries, J J Atema, O Lapid, M C Obdeijn, M A Boermeester
PURPOSE: To evaluate if incisional prophylactic negative pressure wound therapy (pNPWT) reduces wound infections and other wound complications in high-risk patients undergoing major complex ventral abdominal wall repair. METHODS: Retrospective before-after comparison nested in a consecutive series of patients undergoing elective major complex abdominal wall repair. Starting January 2014, pNPWT was applied on the closed incisional wound for a minimum of 5 days. To minimize selection bias, we compared two periods of 14 months before and after January 2014...
May 23, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28534175/-aseptic-loosening-of-total-ankle-replacement-two-stage-revision-with-bone-augmentation-of-osseous-defects-and-secondary-prosthesis-implantation
#9
A Barg, M Wiewiorski, V Valderrabano
OBJECTIVE: To remove loosened ankle prosthesis components, perform osseous defect augmentation, and reimplant definitive prosthesis components to preserve ankle range of motion. INDICATIONS: Aseptic loosening of the tibial and/or talar ankle prosthesis components with substantial bone defect. CONTRAINDICATIONS: General surgical/anesthesiological risks, infections, critical soft tissue conditions, nonmanageable hindfoot instability, neurovascular impairment of the lower extremity, neuroarthropathy, substantial nonreconstructable osseous defects with or without cysts on the tibial and/or talar side, noncompliance, primary total ankle replacement (TAR) using intramedullary fixation (stem fixation), severely reduced bone quality, insulin-dependent diabetes mellitus, smoking, unrealistic patients' expectations, high activity in sports...
May 22, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28533536/a-systemic-review-and-an-updated-meta-analysis-minimally-invasive-vs-open-pancreaticoduodenectomy
#10
Zhanwei Zhao, Zifang Yin, Zhenning Hang, Gang Ji, Quanxin Feng, Qingchuan Zhao
The feasible of minimally invasive pancreaticoduodenectomy (MIPD) remains controversial when compared with open pancreaticoduodenectomy (OPD). We conducted a systemic review and meta-analysis to summarise the available evidence to compare MIPD vs OPD. We systemically searched PubMed, EMBASE and Web of Science for studies published through February 2016. The primary endpoint was postoperative pancreatic fistula (POPF, grade B/C). A total of 27 studies involving 14,231 patients (2,377 MIPD and 11,854 OPD) were included...
May 22, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28532963/fully-endoscopic-interlaminar-and-transforaminal-lumbar-discectomy-analysis-of-47-complications-encountered-in-a-series-of-835-patients
#11
Ali Güven Yörükoğlu, Burcu Göker, Alican Tahta, Mehmet Osman Akçakaya, Aydın Aydoseli, Pulat Akın Sabancı, Yavuz Aras, Görkem Alkır, Altay Sencer, Murat Imer, Nail Izgi, Ali Tuncay Canbolat
OBJECTIVE: To report perioperative complications in fully endoscopic lumbar discectomy (FELD). METHODS: From September 2010 to November 2016, 835 patients underwent FELD. In total, 865 disc levels were operated on. Of the 835 patients, the transforaminal (TF) approach was used in 174 patients, while 691 patients were operated on using the interlaminar (IL) approach. Surgical complications occurred in 47 patients, which were retrospectively analyzed. RESULTS: Neurological deficits occurred in six patients...
May 19, 2017: Neurocirugía
https://www.readbyqxmd.com/read/28532576/-tobacco-and-plastic-surgery-an-absolute-contraindication
#12
C Matusiak, A De Runz, H Maschino, M Brix, E Simon, F Claudot
INTRODUCTION: Smoking increases perioperative risk regarding wound healing, infection rate and failure of microsurgical procedures. There is no present consensus about plastic and aesthetic surgical indications concerning smoking patients. The aim of our study is to analyze French plastic surgeons practices concerning smokers. METHOD: A questionnaire was send by e-mail to French plastic surgeons in order to evaluate their own operative indications: patient information about smoking dangers, pre- and postoperative delay of smoking cessation, type of intervention carried out, smoking cessation supports, use of screening test and smoking limit associated to surgery refusing were studied...
May 19, 2017: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/28532074/highly-effective-cu-zn-carbon-micro-nanofiber-polymer-nanocomposite-based-wound-dressing-biomaterial-against-the-p-aeruginosa-multi-and-extensively-drug-resistant-strains
#13
Mohammad Ashfaq, Nishith Verma, Suphiya Khan
Pseudomonas aeruginosa (P. aeruginosa) is the most prevalent bacteria in the infections caused by burn, surgery, and traumatic injuries. Emergence of the P. aeruginosa bacterial resistance against various clinical drugs for wound treatment is the major concern nowadays. The present study describes the synthesis of the polyvinyl alcohol (PVA) and cellulose acetate phthalate (CAP) polymeric composite film (~0.2mm thickness) reinforced with the Cu/Zn bimetal-dispersed activated carbon micro/nanofiber (ACF/CNF), as a wound dressing material...
August 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/28532029/surfactin-loaded-polyvinyl-alcohol-pva-nanofibers-alters-adhesion-of-listeria-monocytogenes-to-polystyrene
#14
J J Ahire, D D Robertson, A J van Reenen, L M T Dicks
Surfactin-loaded polyvinyl alcohol (PVA) nanofibers were spun using gravity electrospinning. Scanning electron microscopy (SEM) images showed that nanofibers spun with surfactin are free from bead formation and uniform in diameter. The average nanofiber diameters were decreased (273±39nm, 259±39nm and 217±33nm) with increasing levels of surfactin (0.5, 1.0 and 1.5%, w/v) into PVA (10%, w/v). The 10% (w/v) PVA had average fiber diameter of 303±33nm. Atomic force microscopy (AFM) analysis showed that fibers spun with surfactin are not smooth as PVA fibers...
August 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/28532009/exploring-recent-developments-to-improve-antioxidant-anti-inflammatory-and-antimicrobial-efficacy-of-curcumin-a-review-of-new-trends-and-future-perspectives
#15
REVIEW
Zahid Hussain, Hnin Ei Thu, Muhammad Wahab Amjad, Fahad Hussain, Tarek A Ahmed, Shahzeb Khan
Curcumin derivatives have been well-documented due to their natural antioxidant, antimicrobial and anti-inflammatory activities. Curcuminoids have also gained widespread recognition due to their wide range of other activities which include anti-infective, anti-mutagenic, anticancer, anti-coagulant, antiarthrititc, and wound healing potential. Despite of having a wide range of activities, the inherent physicochemical characteristics (poor water solubility, low bioavailability, chemical instability, photodegradation, rapid metabolism and short half-life) of curcumin derivatives limit their pharmaceutical significance...
August 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/28531982/study-of-the-keratin-based-therapeutic-dermal-patches-for-the-delivery-of-bioactive-molecules-for-wound-treatment
#16
Kush Kumar Nayak, Pratima Gupta
In the present study, dressing materials were fabricated in the form of dermal patches. The keratin based biocompatible materials, namely Keratin/Alginate, Keratin/Agar, and Keratin/Gellan were developed as therapeutic dermal patches. The patches were coated with green synthesized silver nanoparticles to prevent the microbial infection and were found to be antimicrobial against pathogens. Papain was used in the patches to acquire the enzymatic cell debridement and its activity was measured by reduction rate of benzoyl-l-arginine ethyl ester...
August 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/28531930/in-reply-to-optimal-strategy-to-control-surgical-site-infection-following-deep-brain-stimulation-surgery-adequate-management-of-risk-factors-topical-application-of-vancomycin-powder-in-the-surgical-wound-and-preoperative-antibiotic-prophylaxis
#17
https://www.readbyqxmd.com/read/28531929/optimal-strategy-to-control-surgical-site-infection-following-deep-brain-stimulation-surgery-adequate-management-of-risk-factors-topical-application-of-vancomycin-powder-in-the-surgical-wound-and-preoperative-antibiotic-prophylaxis
#18
https://www.readbyqxmd.com/read/28531351/pharmaceutical-intermediate-modified-gold-nanoparticles-against-multidrug-resistant-bacteria-and-wound-healing-application-via-electrospun-scaffold
#19
Xinglong Yang, Junchuan Yang, Le Wang, Bei Ran, Yuexiao Jia, Lingmin Zhang, Guang Yang, Huawu Shao, Xingyu Jiang
Remedying multidrug-resistant (MDR) bacteria wound infection is major challenge due to the inability of conventional antibiotics in treating such infections against MDR bacteria. Thus, developing wound dressings for wound care, particularly against MDR bacteria, is in huge demand. Here, we present a strategy in designing wound dressings: we use a small molecule (6-aminopenicillanic acid, APA)-coated gold nanoparticles (AuNPs) to inhibit MDR bacteria. We dope the AuNPs into electrospun fibers of poly(ε-caprolactone) (PCL)/gelatin to yield materials that guard against wound infection by MDR bacteria...
May 22, 2017: ACS Nano
https://www.readbyqxmd.com/read/28530768/perioperative-management-of-rheumatoid-medications-in-orthopedic-surgery
#20
Kunal Sindhu, Brian Cohen, Joseph A Gil
Rheumatoid arthritis (RA) is a chronic, systemic autoimmune disorder known to cause progressive joint destruction. Over time, untreated RA can lead to pain and increasing disability, making orthopedic intervention necessary. The treatment of RA revolves around a variety of medications that blunt the overall immune response. However, this may increase the risk of infection and impair wound healing. Given the nature of this disease, orthopedists frequently encounter patients with RA in the operative setting. To optimize surgical outcomes, orthopedists must carefully manage and pay special attention to the adverse side effects of the complicated medication regimens of these patients perioperatively...
May 20, 2017: Orthopedics
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