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https://www.readbyqxmd.com/read/27890067/clinical-issues-december-2016
#1
Lisa Spruce, Amber Wood
Head coverings Key words: head cover, bouffant, skull cap, hair, scalp. Skin preps Key words: skin preps, antiseptics, cesarean delivery, surgical site infections, abdomen. Pediatric surgical counts Key words: pediatrics, counts, surgical, retained surgical items, policy. Sterile set up Key words: sterile table, sterile set up, covering, monitoring, contamination. Surgical hand antisepsis Key words: surgical hand rub, application, surgical scrub, scrubbed areas.
December 2016: AORN Journal
https://www.readbyqxmd.com/read/27879993/randomized-clinical-trial-of-preoperative-skin-antisepsis-with-chlorhexidine-gluconate-or-povidone-iodine
#2
H M Park, S-S Han, E C Lee, S D Lee, H M Yoon, B W Eom, S H Kim, K W Ryu, S-J Park, Y W Kim, B Park
BACKGROUND: Skin antiseptic agents are used to prevent surgical-site infection (SSI); few trials have reported the superiority of any specific agent in clean-contaminated abdominal surgery. This RCT was designed to compare the effectiveness of chlorhexidine gluconate and povidone-iodine. METHODS: Consecutive patients who underwent clean-contaminated upper gastrointestinal or hepatobiliary-pancreatic open surgery between 2011 and 2014 were assigned randomly to either chlorhexidine gluconate or povidone-iodine...
November 23, 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27853817/history-of-external-fixation-for-treatment-of-fractures
#3
REVIEW
Philippe Hernigou
Surgery in the first half of the nineteenth century was primarily dominated by pain and fear of lethal infections. Therefore, the absolute majority of fractures and dislocations were treated non-operatively. Development of operative treatment of fractures was influenced by three major inventions: anaesthesia (1846), antisepsis (1865) and X-rays (1895). The first to use external fixation is traditionally considered to be Malgaigne (1843). However, his devices cannot be really considered as external fixation...
November 16, 2016: International Orthopaedics
https://www.readbyqxmd.com/read/27852461/the-development-of-intensive-care-in-the-military-environment
#4
REVIEW
Matthew J Roberts
If the history of critical care is to be addressed, the starting point must be the fundamental and defining qualities of intensive care units. These are the concentration of the sickest patients in a defined area of the hospital, staffed by the personnel most able to care for them (by virtue of specialist training), and the application of the most advanced monitoring or therapeutic techniques available at the time. In the military environment, the ability to provide critical care to ill or injured servicemen has developed in tandem with the civilian experience, but the pressures of the austere environment of the battlefield have, at times, held back military medical services from providing the highest level of care that servicemen might deserve and, indeed, expect in civilian life...
October 2016: Journal of Anesthesia History
https://www.readbyqxmd.com/read/27817826/the-impact-of-surgical-hand-antisepsis-technique-on-surgical-site-infection
#5
Brad S Oriel, Qi Chen, Kamal M F Itani
BACKGROUND: Limited evidence exists regarding the effect on superficial and deep incisional surgical site infections (SDSSIs) of alcohol-based hand rubs (ABR) versus traditional aqueous surgical scrubs (TSS). User preferences and practice are unknown. METHODS: A retrospective cohort study examining SDSSIs using VA Surgical Quality Improvement Program cases before ABR implementation (2007-2009, TSS group) and after (2013-2014, ABR group). A descriptive survey. RESULTS: SDSSI rates were 1...
October 8, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27765179/from-the-laboratory-bench-to-the-operating-room-the-role-of-the-surgeon-in-cancer-prevention
#6
Terry C Lairmore
BACKGROUND: The last 200 years have seen remarkable achievements in the art and clinical practice of surgery. These advances include the introduction of antisepsis, anesthesia, vascular anastomosis, antimicrobials, organ transplantation, and the widespread application of minimally invasive operative procedures. Very recently, a surgical procedure has been shown to cure diabetes, representing the most effective treatment of a metabolic disorder by surgeons. METHODS: The author reviewed the major surgical milestones in the modern surgical era and prepared this monograph for presentation as the Claude H...
September 30, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27729657/the-gut-microbiota-and-gastrointestinal-surgery
#7
REVIEW
Kristina Guyton, John C Alverdy
Surgery involving the gastrointestinal tract continues to prove challenging because of the persistence of unpredictable complications such as anastomotic leakage and life-threatening infections. Removal of diseased intestinal segments results in substantial catabolic stress and might require complex reconstructive surgery to maintain the functional continuity of the intestinal tract. As gastrointestinal surgery necessarily involves a breach of an epithelial barrier colonized by microorganisms, preoperative intestinal antisepsis is used to reduce infection-related complications...
October 12, 2016: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27720552/aqueous-chlorhexidine-for-intravitreal-injection-antisepsis-a-case-series-and-review-of-the-literature
#8
Rohan Merani, Zachary E McPherson, Alan P Luckie, Jagjit S Gilhotra, Jim Runciman, Shane Durkin, James Muecke, Mark Donaldson, Albert Aralar, Anupam Rao, Peter E Davies
PURPOSE: To determine the incidence of endophthalmitis in a large clinical series using aqueous chlorhexidine for antisepsis before intravitreal injection and to review the ophthalmic literature regarding chlorhexidine efficacy and safety. DESIGN: Multicenter retrospective case series. PARTICIPANTS: All patients receiving intravitreal injections from 7 retinal specialists. METHODS: An audit of intravitreal injections performed by retinal specialists who exclusively used aqueous chlorhexidine 0...
October 6, 2016: Ophthalmology
https://www.readbyqxmd.com/read/27718471/pyrazole-derived-ultra-short-antimicrobial-peptidomimetics-with-potent-anti-biofilm-activity
#9
Mija Ahn, Pethaiah Gunasekaran, Ganesan Rajasekaran, Eun Young Kim, Soo-Jae Lee, Geul Bang, Kun Cho, Jae-Kyung Hyun, Hyun-Ju Lee, Young Ho Jeon, Nam-Hyung Kim, Eun Kyoung Ryu, Song Yub Shin, Jeong Kyu Bang
In this study, we report on the first chemical synthesis of ultra-short pyrazole-arginine based antimicrobial peptidomimetics derived from the newly synthesized N-alkyl/aryl pyrazole amino acids. Through the systematic tuning of hydrophobicity, charge, and peptide length, we identified the shortest peptide Py11 with the most potent antimicrobial activity. Py11 displayed greater antimicrobial activity against antibiotic-resistant bacteria, including MRSA, MDRPA, and VREF, which was approximately 2-4 times higher than that of melittin...
September 23, 2016: European Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/27709647/multi-drug-resistant-acinetobacter-calcoaceticus-acinetobacter-baumannii-complex-infection-outbreak-in-dogs-and-cats-in-a-veterinary-hospital
#10
S Kuzi, S E Blum, N Kahane, A Adler, O Hussein, G Segev, I Aroch
BACKGROUND: Members of the Acinetobacter calcoaceticus-Acinetobacter baumannii complex cause severe outbreaks in humans, and are increasingly reported in animals. OBJECTIVE AND METHODS: A retrospective study, describing a severe outbreak in dogs and cats caused by a multidrug resistant member of the Acinetobacter calcoaceticus-Acinetobacter baumannii complex in a veterinary hospital, between July 2010 and November 2012. RESULTS: The study included 19 dogs and 4 cats...
October 5, 2016: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/27707940/chlorhexidine-vs-tincture-of-iodine-for-reduction-of-blood-culture-contamination-rates-a-prospective-randomized-crossover-study
#11
Elizabeth Story-Roller, Melvin P Weinstein
Blood cultures (BC) are the standard method for diagnosis of bloodstream infections (BSI). However, the average BC contamination rate (CR) in US hospitals is 2.9%, potentially resulting in unnecessary antibiotic use and excessive therapy costs. Several studies have compared various skin antisepsis agents without a clear consensus as to which agent is most effective in reducing contamination. A prospective, randomized crossover study was performed at Robert Wood Johnson University Hospital (RWJUH) directly comparing blood culture contamination rates using chlorhexidine vs...
October 5, 2016: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/27698874/anti-cancer-effect-of-ursolic-acid-activates-apoptosis-through-rock-pten-mediated-mitochondrial-translocation-of-cofilin-1-in-prostate-cancer
#12
Wen-Tao Gai, Da-Peng Yu, Xin-Sheng Wang, Pei-Tao Wang
Ursolic acid is a type of pentacyclic triterpene compound with multiple pharmacological activities including cancer resistance, protection from liver injury, antisepsis, anti-inflammation and antiviral activity. The present study aimed to investigate the anticancer effect of ursolic acid. Ursolic acid activates cell apoptosis and its pro-apoptotic mechanism remains to be fully elucidated. Cell Counting kit-8 assays, flow cytometric analysis and analysis of caspase-3 and caspase-9 activity were used to estimate the anticancer effect of ursolic acid on DU145 prostate cancer cells...
October 2016: Oncology Letters
https://www.readbyqxmd.com/read/27671220/acquired-resistance-to-chlorhexidine-is-it-time-to-establish-an-antiseptic-stewardship-initiative
#13
G Kampf
Chlorhexidine digluconate (CHG) is an antimicrobial agent used for different types of applications in hand hygiene, skin antisepsis, oral care, and patient washing. Increasing use raises concern regarding development of acquired bacterial resistance. Published data from clinical isolates with CHG minimum inhibitory concentrations (MICs) were reviewed and compared to epidemiological cut-off values to determine resistance. CHG resistance is rarely found in Escherichia coli, Salmonella spp., Staphylococcus aureus or coagulase-negative staphylococci...
August 26, 2016: Journal of Hospital Infection
https://www.readbyqxmd.com/read/27668910/daniel-molli%C3%A3-re-1848-1890-the-french-anatomist-and-surgeon-and-his-encounters-with-nosocomial-infections-in-the-operating-theatre
#14
Gregory Tsoucalas, Konstantinos Laios, Marianna Karamanou, Markos Sgantzos, George Androutsos
Daniel Mollière, was a French anatomist and surgeon, born in Lyon, who succeeded in his short life in making his mark in surgery. He was a prolific writer who left a series of medical treatises and a committed surgeon who was responsible for various significant innovative apparatuses in the medical sper. As he lived in an era when the role of microbe had already been recognized, he was among the first to use antisepsis and install extreme measures against microbes, both in the air and on the skin'. Fountains with fresh clean water, carbonic acid, cross ventilation, medical blouses, combined with Valette's apparatus for the dressing of amputations, were some of his precautions to reduce surgical infections and post-operative mortality...
September 1, 2016: Le Infezioni in Medicina
https://www.readbyqxmd.com/read/27661850/effect-of-hand-antisepsis-agent-selection-and-population-characteristics-on-surgical-site-infection-pathogens
#15
Brad S Oriel, Qi Chen, Kevin Wong, Kamal M F Itani
BACKGROUND: Selection of a pre-operative hand antisepsis agent has not been studied in relation to surgical site infection (SSI) culture data. In our hospital, we introduced an alcohol-based hand rub (ABR) in 2012 as an alternative to traditional aqueous surgical scrubs (TSS). It was the goal of this study to review any effect of this implementation on SSI pathogen characteristics. In addition, we sought to compare our SSI culture data with available National Healthcare Safety Network (NHSN) data...
September 23, 2016: Surgical Infections
https://www.readbyqxmd.com/read/27613722/nuclear-histones-major-virulence-factors-or-just-additional-early-sepsis-markers-a-comment
#16
Isaac Ginsburg, Erez Koren, James Varani, Ron Kohen
In 2009, Xu et al. and Chaput et al. in Nature Medicine had argued that the main cause of death in sepsis is the release from neutrophil nets of nuclear histone, highly toxic to endothelial cells and that these polycations are major and unique virulence factors. Since 2009, numerous researchers have also suggested the involvement of histones in the pathophysiology of many clinical disorders. If histones are indeed major unique virulence toxic agents, then heparin, activated protein C and antibodies to histone should prove excellent antisepsis agents...
October 2016: Inflammopharmacology
https://www.readbyqxmd.com/read/27568541/guideline-at-a-glance-skin-antisepsis
#17
Aorn
No abstract text is available yet for this article.
September 2016: AORN Journal
https://www.readbyqxmd.com/read/27515157/what-s-new-in-skin-antisepsis-for-short-term-intravascular-catheters-new-data-to-address-old-problems
#18
Olivier Mimoz, Vineet Chopra, Andreas Widmer
No abstract text is available yet for this article.
August 11, 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/27509413/zum-stellenwert-der-unterdruck-instillationstherapie-in-der-dermatologie
#19
REVIEW
Cornelia Sigrid Lissi Müller, Barbara Burgard, Monika Zimmerman, Thomas Vogt, Claudia Pföhler
Die Methoden zur Behandlung akuter und chronischer Wunden unterliegen einer steten Weiterentwicklung, Reevaluierung und Anwendung innovativer Therapieformen. Die Vakuumtherapie zur Wundbehandlung gehört zu den etablierten Behandlungsmodalitäten. Ein innovatives Verfahren kombiniert die Vakuumtherapie mit der automatisierten, kontrollierten Zufuhr und Drainage wirkstoffhaltiger Lösungen zur topischen Wundbehandlung im Wundbett und auch wirkstofffrei durch Instillation physiologischer Kochsalzlösung (Unterdruck-Instillationstherapie)...
August 2016: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/27509412/on-the-significance-of-negative-pressure-wound-therapy-with-instillation-in-dermatology
#20
REVIEW
Cornelia Sigrid Lissi Müller, Barbara Burgard, Monika Zimmerman, Thomas Vogt, Claudia Pföhler
Methods used in the treatment of acute and chronic wounds undergo constant evolution, reevaluation, and innovation. While negative-pressure wound therapy (NPWT) is an established treatment modality, the combination of NPWT and instillation of normal saline as well as solutions with active antiseptic components for topical treatment of the wound bed represents a novel approach. The well-known effects of NPWT may thus be combined with those of local antisepsis. They include a decrease in wound area, induction of granulation tissue, and reduction in bacterial colonization...
August 2016: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
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