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Wound management

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https://www.readbyqxmd.com/read/28643380/microscopy-visualisation-confirms-multi-species-biofilms-are-ubiquitous-in-diabetic-foot-ulcers
#1
Khalid Johani, Matthew Malone, Slade Jensen, Iain Gosbell, Hugh Dickson, Honhua Hu, Karen Vickery
Increasing evidence within the literature has identified the presence of biofilms in chronic wounds and proposed that they contribute to delayed wound healing. This research aimed to investigate the presence of biofilm in diabetic foot ulcers (DFUs) using microscopy and molecular approaches and define if these are predominantly mono- or multi-species. Secondary objectives were to correlate wound observations against microscopy results in ascertaining if clinical cues are useful in detecting wound biofilm. DFU tissue specimens were obtained from 65 subjects...
June 23, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28643061/reoperation-for-recurrent-hepatolithiasis-laparotomy-versus-laparoscopy
#2
Qingfan Pu, Chuanrong Zhang, Zhenfeng Huang, Yu Zeng
BACKGROUND: Laparoscopy has been proposed for the management of recurrent hepatolithiasis, but no comparative study of its relative efficacy versus laparotomy has been performed, and the patient selection criteria for laparoscopy are not clear. This study aimed to investigate the therapeutic effect of laparoscopy versus laparotomy for repeated hepatolithiasis and to highlight how to select patients best suited for laparoscopy. METHODS: We performed a cohort study of 94 patients who underwent laparotomy or laparoscopy for recurrent hepatolithiasis between January 2010 and May 2014...
June 22, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28640734/cost-effective-wound-management-a-survey-of-1717-nurses
#3
Heather Newton
Delivering high-quality wound care requires a mix of knowledge and skills, which nurses aim to update by attending educational events such as conferences and study days. This article describes the data obtained from 30 educational study days, which took place across England, Scotland and Wales. It will explore nurses' knowledge in relation to the cost-effectiveness and clinical efficacy of current wound care practices, based on the answers of 1717 delegates that attended the events. It will also outline the results in relation to reducing expenditure on wound dressings and the importance of performing an accurate wound assessment...
June 22, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28640728/wound-bed-preparation-a-vital-step-in-the-healing-process
#4
Simon Barrett
Non-healing wounds are a significant burden to healthcare systems, where it is estimated that 4-5% of the adult population has a problem wound at any one time ( Guest et al, 2017 ). It is suggested that infection is the most frequent complication in non-healing wounds where it can prolong patient treatment times and increase resource use ( Gottrup et al, 2013 ). Wound infection develops as a result of an imbalance between the patient's immune system and the conditions in the wound, which subsequently can promote bacterial proliferation ( Wounds UK, 2013 )...
June 22, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28640720/fungating-wounds-management-and-treatment-options
#5
Suzanne Tandler, Jackie Stephen-Haynes
This article defines fungating wounds and considers the underlying cause, location and presentation. The clinical challenges presented by fungating wounds are discussed, with reference to evidence-based care delivery. This includes wound assessment, cleansing, debridement and management of malodour, infection, bleeding and exudate. Guidance on the use of wound management dressings is considered in relation to symptom management. The importance of clinical decision-making and educational preparation in the delivery of evidenced-based care for those with fungating wounds is emphasised...
June 22, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28640177/the-efficacy-of-fibrin-sealant-patches-in-reducing-the-incidence-of-lymphatic-morbidity-after-radical-lymphadenectomy-a-meta-analysis
#6
Maria Luisa Gasparri, Ilary Ruscito, Daniele Bolla, Pierluigi Benedetti Panici, Michael D Mueller, Andrea Papadia
BACKGROUND: Although pivotal in the oncological management of most tumors, radical lymphadenectomy is associated with a significant number of lymphatic complications. The aim of this meta-analysis is to evaluate the efficacy of fibrinogen sealant patches in reducing lymphadenectomy-related postoperative complications. METHODS/MATERIALS: The electronic databases PubMed, Medline, and Scopus were searched using the terms "lymphadenectomy" or "lymph node dissection" and "TachoSil," "TachoComb," or "fibrin sealant patch...
July 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28638950/surgical-treatment-for-metastases-of-the-cervical-spine
#7
Farzam Vazifehdan, Vasilios G Karantzoulis, Vasilios G Igoumenou
BACKGROUND: There are limited information and inconclusive results for the management of patients with cervical spine metastases. Therefore, we performed this study to evaluate the survival and outcome of these patients, and the surgical risk and complications. MATERIALS AND METHODS: We retrospectively studied 24 patients [14 men and 10 women; mean age, 71 years (range 54-89 years)], with cervical spine metastases, who underwent palliative surgical treatment, from December 2010 to December 2016...
June 21, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28638294/persistent-sciatic-artery-a-favorable-anatomic-variant-in-a-setting-of-trauma
#8
William Shaffer, Mary Maher, Michael Maristany, Bahri Ustunsoz, Bradley Spieler
BACKGROUND: Persistent sciatic artery (PSA) is a rare congenital anomaly of the circulation of the lower limb that results from the persistence of an artery that normally regresses early in embryonic development. PSA is usually an incidental finding and is exceedingly rare to find bilaterally. CASE REPORT: We present the case of a rare presentation of PSA that resulted in a favorable outcome for a patient who sustained a gunshot wound to his midthigh and discuss the history, embryology, anatomy, classification schema, imaging evaluation, complications, diagnosis, and management of PSA...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28636059/clinical-outcome-and-complications-of-thoracic-and-pelvic-limb-stump-and-socket-prostheses
#9
Andrew Phillips, Elvin Kulendra, Edith Bishop, Michelle Monk, Kevin Parsons, Arthur House
OBJECTIVES: To describe the use, quality of life, compliance, complications, and outcome of animals fitted with stump socket prostheses. METHODS: Medical records of dogs fitted with a stump socket prosthesis were reviewed. Functional outcome, quality of life and complications were retrospectively assessed from an owner questionnaire. RESULTS: Thirteen stump socket prostheses (12 dogs) were fitted for a variety of reasons including trauma, congenital abnormalities, and neoplasia...
June 21, 2017: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
https://www.readbyqxmd.com/read/28635188/the-financial-and-quality-of-life-cost-to-patients-living-with-a-chronic-wound-in-the-community
#10
Suzanne Kapp, Nick Santamaria
Chronic wounds are associated with financial and personal costs. The system level expense associated with chronic wounds has been established, however, the out-of-pocket cost incurred by individuals who self-fund has not been the focus of extensive investigation. Recently, there has been renewed interest in evaluating quality of life, in line with the shift to patient enablement and self-care in chronic disease management. The objectives of this research were to describe the out-of-pocket wound treatment costs and the quality of life of people who have chronic wounds...
June 20, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28634840/self-inflicted-abdominal-stab-wounds-have-a-higher-rate-of-non-therapeutic-laparotomy-laparoscopy-and-a-lower-risk-of-injury
#11
Nikolay Bugaev, Kevin McKay, Janis L Breeze, Sandra S Arabian, Reuven Rabinovici
BACKGROUND: The profile and management of self-inflicted abdominal stab wounds (SI-ASW) patients is still obscure. METHODS: The National Trauma Data Bank (2012) was queried for adults with abdominal stab wounds (n = 9544). Patients with SI-ASW (n = 1724) and non-SI-ASW (n = 7820) were compared. Predictors for non-therapeutic laparotomy/laparoscopy (non-TL) in SI-ASW patients were identified. RESULTS: SI-ASW patients were older, had more females and behavioral disorders, similar physiology, but a lower Injury Severity Score...
June 20, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28634091/a-simple-method-associated-with-reduced-opioid-consumption-after-total-knee-arthroplasty
#12
Alfred C Kuo, Eva Grotkopp
BACKGROUND: Most patients experience moderate to severe pain after total knee arthroplasty (TKA). We hypothesized that intraoperative treatment of cut bone surfaces with local anesthetic (preimplantation immersion anesthesia, PIA) would lead to decreased postoperative pain and opioid consumption. METHODS: Records of 76 patients who underwent unilateral, cemented TKA were retrospectively reviewed. For PIA patients, surgical wounds were immersed in local anesthetic solution immediately prior to component implantation...
May 22, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28633147/tranexamic-acid-safely-reduced-blood-loss-in-hemi-and-total-hip-arthroplasty-for-acute-femoral-neck-fracture-a-randomized-clinical-trial
#13
Chad D Watts, Matthew T Houdek, S Andrew Sems, William W Cross, Mark W Pagnano
OBJECTIVES: We aimed to determine whether (1) tranexamic acid (TXA) reduces the incidence of transfusion (2) TXA reduces the calculated blood loss, and (3) there are any observable differences in 30- and 90-day complications with TXA administration during arthroplasty for femoral neck fracture (FNF). DESIGN: Prospective, double-blinded, randomized controlled trial. SETTING: Level 1 Academic Trauma Center. PATIENTS/PARTICIPANTS: One hundred thirty-eight patients who presented with a low-energy, isolated, FNF (AO 31B) treated with either hemi- or total hip arthroplasty within 72 hours of injury were randomized to either the TXA group (69 patients) or placebo group (69 patients)...
July 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28632833/-tetanus-after-cat-scratch-and-bites-in-a-previously-immunized-patient
#14
Alberto Fica, Daniela Gaínza, Pablo Ortigosa
Tetanus is declining due to vaccination, professional labor management and appropriate wound care. Tetanus cases have been reported despite immunization. We report the case of a previously healthy 21 years old female patient that presented a mild generalized tetanus requiring admission after mild and recurrent cat scratch and bites. She had received six vaccine shots during childhood, and a booster dose five years earlier after a rabbit bite. Symptoms appeared seven weeks after the last contact, and included headache, muscle spasms and mild opisthotonus...
April 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
https://www.readbyqxmd.com/read/28631912/-results-of-urethral-reconstruction-in-adults-after-multiple-hypospadias-repairs
#15
S I Gamidov, M G Shneiderman, D Yu Pushkar, A O Vasil'ev, A V Govorov, R I Ovchinnikov, A Yu Popova, R D Dusmukhamedov
AIM: To improve treatment results in patients after multiple hypospadias repairs by optimizing the postoperative management. MATERIALS AND METHODS: Eighty-two patients (mean age 48.1+/-15.3 years) with urethral strictures secondary to failed hypospadias repairs underwent staged graft urethroplasty using oral mucosa (cheek, lip, tongue) as a grafting material. In 62 patients, at the end of surgery the bladder was drained with a standard Foley catheter. In twenty patients the bladder was drained with a modified silicone urethral catheter, which had an additional channel for delivering drugs and removing the urethral wound effluent, and a second additional channel for inflating a balloon fixed to the catheter tube at different parts of the catheter...
June 2017: Urologii︠a︡
https://www.readbyqxmd.com/read/28630851/vacuum-assisted-closure-in-patients-with-post-operative-infections-after-instrumented-spine-surgery-a-series-of-12-cases
#16
Maya Kale, Pravin Padalkar, Varshil Mehta
INTRODUCTION: Post-operative wound infections after spinal surgery is a very serious problem, leading to a risk of significant morbidity which may even lead to prolonged hospitalization. Various treatment protocols have been recommended for debridement, antibiotic, and soft-tissue management, but with mixed results. However, the risk of morbidity is still high with these treatment options. Vacuum-assisted closure (VAC) system has been gaining popularity recently in the management of subacute, acute, and chronic wounds...
January 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28630267/a-structured-review-of-antithrombotic-therapy-in-peripheral-artery-disease-with-a-focus-on-revascularization-a-tasc-intersociety-consensus-for-the-management-of-peripheral-artery-disease-initiative
#17
REVIEW
Connie N Hess, Lars Norgren, Gary M Ansel, Warren H Capell, John P Fletcher, F Gerry R Fowkes, Anders Gottsäter, Kerry Hitos, Michael R Jaff, Joakim Nordanstig, William R Hiatt
Peripheral artery disease affects >200 million people worldwide and is associated with significant limb and cardiovascular morbidity and mortality. Limb revascularization is recommended to improve function and quality of life for symptomatic patients with peripheral artery disease with intermittent claudication who have not responded to medical treatment. For patients with critical limb ischemia, the goals of revascularization are to relieve pain, help wound healing, and prevent limb loss. The baseline risk of cardiovascular and limb-related events demonstrated among patients with stable peripheral artery disease is elevated after revascularization and related to atherothrombosis and restenosis...
June 20, 2017: Circulation
https://www.readbyqxmd.com/read/28629932/systemic-antimicrobial-prophylaxis-in-burn-patients-a-systematic-review
#18
REVIEW
Guillermo Enrique Ramos
OBJECTIVE: To review studies of systemic antibiotic prophylaxis in burn patients. METHODS: Human clinical trials during the period 1966-2016 where prophylactic systemic antibiotics were compared with placebo or no intervention were identified in electronic databases. RESULTS: Nineteen trials met the selection criteria. Early post-burn period prophylaxis was assessed in non severe burn patients (6 trials), and in severe burn patients (7 trials)...
June 16, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28629766/laparoscopic-assisted-approach-for-penetrating-abdominal-trauma-a-solution-for-multiple-bowel-injuries
#19
Oleh Yevhenovych Matsevych, Modise Zacharia Koto, Colleen Aldous
BACKGROUND: Therapeutic laparoscopy (TL) for penetrating abdominal trauma (PAT) is controversial because the management of multiple bowel injuries is challenging and the conversion rate is high. However, the laparoscopic-assisted approach (LAA) allows easy management of multiple bowel injuries but not investigated in a trauma setting. The aim of this study was to investigate its role in management of multiple bowel injuries and to compare LAA with therapeutic laparoscopy performed fully laparoscopically (FTL)...
June 16, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28629679/how-to-address-cerebrospinal-fluid-leakage-following-ossification-of-the-posterior-longitudinal-ligament-surgery
#20
Jung Hyeon Moon, Sungjoon Lee, Chun Kee Chung, Chi Heon Kim, Won Heo
BACKGROUND: Primary dural repair in ossification of posterior longitudinal ligament (OPLL) surgery via anterior is challenging because of limited space. Based on several years of our experiences, we present our concept for addressing cerebrospinal fluid (CSF) leakage following dural tear during anterior OPLL surgery. METHODS: We reviewed the medical records of 65 patients who underwent anterior OPLL surgery from 2003 to 2014. We included 7 patients whose operation records described dural tear followed by CSF leakage...
June 16, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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