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https://www.readbyqxmd.com/read/28954748/traumatic-elbow-arthrotomy-after-motorcycle-accident-not-evident-on-ct
#1
John C Bunyasaranand, Nicholas C Foeger, Paul M Ryan
An 84-year-old man sustained a motorcycle accident resulting in a left elbow laceration. Orthopaedics was consulted to rule out traumatic arthrotomy. Radiographs and CT of the left elbow showed no acute osseous abnormalities and no evidence of traumatic arthrotomy. The wound was irrigated, dressed and splinted. On follow-up, the patient reported that he had been given clindamycin on a return visit to the emergency department for increased drainage. On inspection, the patient's wound was found sutured and draining purulent fluid...
September 27, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28938387/critical-sized-bone-defects-sequence-and-planning
#2
Paul Toogood, Theodore Miclau
Bone defects associated with open fractures require a careful approach and planning. At initial presentation, an emergent irrigation and debridement is required. Immediate definitive fixation is frequently safe, with the exception of those injuries that normally require staged management or very severe type IIIB and IIIC injuries. Traumatic wounds that can be approximated primarily should be closed at the time of initial presentation. Wounds that cannot be closed should have a negative pressure wound therapy dressing applied...
October 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28935121/treatment-of-acute-ocular-chemical-burns
#3
REVIEW
Namrata Sharma, Manpreet Kaur, Tushar Agarwal, Virender S Sangwan, Rasik B Vajpayee
Ocular chemical burns are an ophthalmic emergency and are responsible for 11.5% to 22.1% of ocular injuries. Immediate copious irrigation is universally recommended in acute ocular burns to remove the offending agent and minimize damage. Conventional medical therapy consists of the use of agents that promote epithelialization, minimize inflammation, and prevent cicatricial complications. Biological fluids such as autologous serum, umbilical cord blood serum, platelet-rich plasma, and amniotic membrane suspension are a rich source of growth factors and promote healing when used as adjuncts to conventional therapy...
September 18, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/28933806/pediatric-wound-care-and-management-in-the-emergency-department
#4
Jennifer E. Sanders
Traumatic wounds and lacerations are common pediatric presenting complaints to emergency departments. Although there is a large body of literature on wound care, many emergency clinicians base management of wounds on theories and techniques that have been passed down, so controversial, conflicting, and unfounded recommendations are prevalent. This issue reviews evidence-based recommendations for wound care and management, including wound cleansing and irrigation, anxiolysis/sedation techniques, closure methods, and post-repair wound care...
October 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28895477/prospective-comparative-study-of-the-efficacy-and-safety-of-new-generation-versus-first-generation-system-for-super-mini-percutaneous-nephrolithotomy-a-revolutionary-approach-to-improve-endoscopic-vision-and-stone-removal
#5
Guohua Zeng, Wei Zhu, Yang Liu, Junhong Fan, Wayne Lam, Yu Lan, Chao Cai, Tuo Deng, Xiaohang Li, Zhijian Zhao
PURPOSE: The study sought to compare the procedural and clinical results of super-mini-percutaneous nephrolithotomy (SMP) with the use of first- and new-generation devices. METHODS: A prospective, comparative cohort study was carried out between February 2013 and January 2017. Patients who underwent either first- or new-generation SMP were eligible for the study. Inclusion criteria were adult patients with renal stone <4 cm, or in pediatric patients with renal stone <2...
October 10, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28875132/open-wound-management-of-esophagocutaneous-fistula-in-unstable-cervical-spine-after-corpectomy-and-multilevel-laminectomy-a-case-report-and-review-of-the-literature
#6
Hossein Elgafy, Mustafa Khan, Jacob Azurdia, Nicholas Peters
A 67-year-old female patient developed an esophagocutaneous fistula 4 mo after C4 and C5 partial corpectomy. Plain radiograph and computed tomography (CT) scan of cervical spine showed inferior screws pullout with plate migration that caused the esophageal perforation. Management included removal of anterior hardware, revision C4-5 corpectomy, iliac crest strut autograft and halo orthosis immobilization. The fistula was treated using antibiotics and a 10-french gauge rubber tube for daily irrigation and Penrose drain...
August 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28873062/a-prospective-randomized-controlled-clinical-trial-to-assess-use-of-2-lidocaine-irrigation-to-prevent-abdominal-surgical-site-infection
#7
Alejandro Quiroga-Garza, Juan Manuel Valdivia-Balderas, Miguel Ángel Trejo-Sánchez, Abraham Guadalupe Espinosa-Uribe, Cynthia Guadalupe Reyes-Hernández, Rodrigo Enrique Elizondo-Omaña
Surgical site infections (SSI) are the third most common nosocomial infection, increasing morbidity and mortality rates of patients as well as their costs of care, but longer-term follow up studies and data are limited. Lidocaine, in addition to being a readily available and accessible local anesthetic, is known to have bacteriostatic properties. A prospective, descriptive, controlled, randomized clinical trial was conducted among patients scheduled to undergo abdominal sur- gery in the general surgical unit of a Mexican hospital...
August 2017: Ostomy/wound Management
https://www.readbyqxmd.com/read/28870242/intraoperative-wound-irrigation-to-prevent-surgical-site-infection-after-laparotomy-iowisi-study-protocol-for-a-randomized-controlled-trial
#8
Tara C Mueller, Ulrich Nitsche, Victoria Kehl, Rebekka Schirren, Beate Schossow, Ruediger Goess, Helmut Friess, Daniel Reim
BACKGROUND: Postoperative surgical site infection (SSI) is one of the most common hospital infections and contributes substantially to postoperative morbidity and mortality. In addition, SSIs dramatically increase the treatment cost and length of hospital stay. Following visceral surgery by laparotomy, SSI rates are especially high (14-25%). Therefore, measures to prevent SSI in this field are urgently needed. Prophylactic intraoperative wound irrigation (IOWI) of the subcutaneous soft tissue before skin closure hypothetically represents an easy and economical option to reduce SSI rates and is already frequently used in clinical practice...
September 4, 2017: Trials
https://www.readbyqxmd.com/read/28867139/bite-wounds-caused-by-a-wild-boar-a-case-report
#9
Hiroki Nagasawa, Kazuhiko Omori, Hiroyuki Maeda, Ikuto Takeuchi, Suguru Kato, Takashi Iso, Kei Jitsuiki, Toshihiko Yoshizawa, Kouhei Ishikawa, Hiromichi Ohsaka, Youichi Yanagawa
A 74-year-old man was attacked by a wild boar while on his way home from his farm in the daytime in winter 2017 on the rural Izu peninsula. He did not provoke the boar; however, hunters were hunting animals in the mountains near the farm around the same time. The boar bit his left leg, and the man fell to the ground. The boar continued biting the man's left leg, and the man delivered a few kicks to the boar's face with his right leg. The boar then bit his right foot and ran away. The man was taken to a hospital, and a physical examination revealed 3 bite wounds on his left leg and right foot...
August 31, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28854408/wound-dehiscence-after-total-knee-arthroplasty
#10
Mohammad Ali Sazegari, Fateme Mirzaee, Fateme Bahramian, Zohreh Zafarani, Hamidreza Aslani
INTRODUCTION: Wound dehiscence is one of the most common complications of surgical ulcer, involving the breaking open of the surgical incision along the stitch. This condition is a severe complication of total knee arthroplasty. PRESENTATION OF CASE: We report a case of a 59-year-old female patient with diabetes who underwent a total knee arthroplasty in which all layers of wounds were dehiscence and prosthetic was exposed. DISCUSSION: Wound dehiscence is a complication after total knee arthroplasty especially in diabetic patient...
August 23, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28846497/the-efficacy-of-a-novel-surgical-device-in-preventing-intraoperative-wound-contamination-in-an-in-vivo-porcine-model
#11
Insoo Suh, Sarah A Long, Jonathan Coe, Jeremy Koehler, Donald Fry, Mark L Welton
BACKGROUND: Surgical site infections (SSIs) remain a morbid and costly complication in abdominal surgery. Topical antibiotic delivery via intraoperative irrigation and barrier wound protection are strategies for preventing SSI. We tested the safety and efficacy of a novel wound protector device with an integrated fluid irrigation platform in a porcine model. METHODS: A simulated colorectal resection model was designed and performed on adult female pigs with a standardized concentration of 10(9) colony-forming units (CFU) of Escherichia coli administered to the wound site in 10 mL of normal saline (n = 7)...
August 28, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28842287/determining-potential-of-pmma-as-a-depot-for-rifampin-to-treat-recalcitrant-orthopaedic-infections
#12
Stefanie M Shiels, David J Tennent, Kevin S Akers, Joseph C Wenke
BACKGROUND: Open fractures are often complicated by infection. In cases of severe soft tissue and vascular injury, systemic antibiotics may be ineffective due to their inability to reach and provide direct antimicrobial activity to the zone of injury. High antibiotic concentrations within the wound can be achieved with reduced systemic toxicity by using local antibiotic delivery. As bacteria associated with musculoskeletal injuries frequently form biofilms, antibiotic selection is important...
August 16, 2017: Injury
https://www.readbyqxmd.com/read/28834293/healing-of-chronic-venous-ulcer-with-topical-sevoflurane
#13
Adrian Imbernon-Moya, Francisco Javier Ortiz-de Frutos, Mónica Sanjuan-Alvarez, Isabel Portero-Sanchez, Raúl Merinero-Palomares, Victoria Alcazar
The present study assesses the efficacy and safety of topical sevoflurane in chronic venous ulcers and its impact on analgesia and healing. This retrospective study included 30 patients older than 65 years with painful refractory chronic venous ulcers. Patients were treated with topical sevoflurane prior to the usual ulcer cleaning every 2 days for a period of 1 month. Treatment was initiated with a saline solution, followed by direct irrigation of 1 ml of liquid sevoflurane over the wound size, which was measured as cm(2) ...
August 17, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28819614/acute-compartment-syndrome-after-an-olecranon-fracture-in-a-patient-with-mild-hemophilia-b
#14
John M Reynolds, Christy Christophersen, Mary K Mulcahey
INTRODUCTION: Compartment syndrome is a serious condition characterized by compartmental pressures within 20 mmHg of diastolic blood pressure, or clinical signs of pain, paresthesia, pallor, and lack of pulses. Often a surgical intervention is necessary. Increased surveillance for compartment syndrome is important when a patient with a bleeding disorder sustains a traumatic injury. CASE REPORT: We present a case of forearm compartment syndrome in a patient with mild hemophilia B who sustained an olecranon fracture...
March 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28807380/reconstruction-after-osteomyelitis-of-the-midfoot-from-high-pressure-washer-injury
#15
Matthew M Reiner, Wissam E Khoury, Audley Mackel, Duane J Ehredt, Mark C Razzante
Reports of ballistic injures to the extremities typically include those involving gunshot wounds. However, high-pressure washer injuries frequently lead to equally damaging injuries. These injuries should not be overlooked, because they can result in high morbidity and complication rates. Similar to the open fracture protocol, these injuries require prompt debridement and irrigation with administration of antibiotics to avoid limb loss. The present case report identified a delay in the treatment protocol that left limited options for the patient...
August 11, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28799963/factors-associated-with-health-related-quality-of-life-in-patients-with-open-fractures
#16
Sheila Sprague, Brad A Petrisor, Kyle J Jeray, Paula McKay, Taryn Scott, Diane Heels-Ansdell, Emil H Schemitsch, Susan Liew, Gordon H Guyatt, Stephen D Walter, Mohit Bhandari
OBJECTIVES: To analyze FLOW data to identify baseline patient, injury, fracture, and treatment factors associated with lower HRQL at 12-months post-fracture. DESIGN: Prognostic study using data from a prospective randomized controlled trial. SETTING: 31 clinical centers in the United States, Canada, Australia, and India. PATIENTS/PARTICIPANTS: 1427 open fracture patients from the FLOW trial with complete 12-month Short Form-12 (SF-12) follow-up assessment and no missing data for selected baseline factors...
July 26, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28734537/total-elbow-arthroplasty-for-primary-osteoarthritis
#17
Bradley S Schoch, Jean-David Werthel, Joaquín Sánchez-Sotelo, Bernard F Morrey, Mark Morrey
BACKGROUND: Primary osteoarthritis of the elbow is a less common indication for total elbow arthroplasty (TEA). Higher complication rates in younger, active patients may offset short-term improvements in pain and function. The purpose of this study was to determine pain relief, functional outcomes, complications, and survival of TEA in this population. METHODS: Between 1984 and 2011, 20 consecutive TEAs were performed for primary elbow osteoarthritis. Two patients died before the 2-year follow-up...
August 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28725123/polymicrobial-pyogenic-flexor-tenosynovitis-of-the-index-finger-and-first-ray-resulting-from-autophagia
#18
Andrew P Harris, Joey Johnson, Augusta Kluk, Neill Y Li, Avi D Goodman, Edward Akelman
Pyogenic flexor tenosynovitis (PFT) is a well known infectious condition of the hand, involving the inoculation of the flexor tendon sheath with microorganisms. Many cases have been reported, common causes including direct inoculation by a puncture wound and deep lacerations extending into the flexor tendon sheath. In this report, we present a case of a 50 year old female with PFT resulting from autophagia (consuming one's own body parts, in our case, fingers) successfully treated with irrigation and debridement, amputation of the index finger at the metacarpophalangeal joint and antibiotic therapy...
September 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28724193/saline-irrigation-for-the-management-of-skin-extravasation-injury-in-neonates
#19
REVIEW
P N Gopalakrishnan, Nitin Goel, Sujoy Banerjee
BACKGROUND: Extravasation injury, a complication commonly seen in the neonatal intensive care unit, can result in scarring with cosmetic and functional sequelae. A wide variety of treatments are available, including subcutaneous irrigation with saline (with or without hyaluronidase), liposuction, use of specific antidotes, topical applications, and normal wound care with dry or wet dressings. All such treatments aim to prevent or reduce the severity of complications. OBJECTIVES: Primary objective To compare the efficacy and safety of saline irrigation or saline irrigation with prior hyaluronidase infiltration versus no intervention or normal wound care for tissue healing in neonates with extravasation injury...
July 19, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28717295/animal-inflicted-maxillofacial-injuries-treatment-modalities-and-our-experience
#20
Anjani Kumar Yadav, Mehul Rajesh Jaisani, Leeza Pradhan, Ashok Dongol, Arpita Singh, Pradeep Acharya, Alok Sagtani
INTRODUCTION: Animal inflicted injuries to the face and neck are becoming much more common as people lavish affection on pets. Injuries caused by animal attacks to the face can cause complex injuries to soft and hard tissues, presented as perforations, lacerations, crushes, avulsion or fractures. An uncountable number of bacteria and virus can be found in such injuries, with a potential pathological effect to humans, regarding infections. Although the infection rate is low due to excellent blood supply to face, the injuries have disfiguring effect with possible psychological repercussion to the patients...
September 2017: Journal of Maxillofacial and Oral Surgery
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