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https://www.readbyqxmd.com/read/29678204/are-large-clinical-trials-in-orthopaedic-trauma-justified
#1
Sheila Sprague, Paul Tornetta, Gerard P Slobogean, Nathan N O'Hara, Paula McKay, Brad Petrisor, Kyle J Jeray, Emil H Schemitsch, David Sanders, Mohit Bhandari
BACKGROUND: The objective of this analysis is to evaluate the necessity of large clinical trials using FLOW trial data. METHODS: The FLOW pilot study and definitive trial were factorial trials evaluating the effect of different irrigation solutions and pressures on re-operation. To explore treatment effects over time, we analyzed data from the pilot and definitive trial in increments of 250 patients until the final sample size of 2447 patients was reached. At each increment we calculated the relative risk (RR) and associated 95% confidence interval (CI) for the treatment effect, and compared the results that would have been reported at the smaller enrolments with those seen in the final, adequately powered study...
April 20, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29675345/comparison-of-endoscopic-and-external-dacryocystorhinostomy-for-treatment-of-primary-acquired-nasolacrimal-duct-obstruction
#2
Pei-Yuan Su
PURPOSE: The purpose of this study is to compare the success rates of endoscopic endonasal dacryocystorhinostomy (EN-DCR) and external DCR (EX-DCR) for the treatment of primary acquired nasolacrimal duct obstruction (PANLDO). DESIGN: This was a retrospective, comparative, nonrandomized clinical study. METHODS: Reviewed medical records of PANLDO underwent DCR at Far-Eastern Memorial Hospital from May 2011 to June 2017. Data regarding the lacrimal passage system, comorbidities, surgical outcomes, and postoperative complications were analyzed...
January 2018: Taiwan Journal of Ophthalmology
https://www.readbyqxmd.com/read/29659349/control-of-body-temperature-and-immune-function-in-patients-undergoing-open-surgery-for-gastric-cancer
#3
Li Shao, Nannan Pang, Ping Yan, Fengju Jia, Qi Sun, Wenjuan Ma, Yi Yang
The influence of mild perioperative hypothermia on the immune function and incidence of postoperative wound infections has been suggested, but the specific mechanism is unclear. This study aimed to analyze the body temperature, immune function, and wound infection rates in patients receiving open surgery for gastric cancer. Body temperature was controlled in each patient using one of four different methods: wrapping limbs, head and neck; insulated blankets; warming infusion fluids and insulated blankets; and warming fluids without insulated blankets...
April 9, 2018: Bosnian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/29644315/limb-salvage-and-reconstruction-following-a-zebra-attack
#4
Jacob T Carlson, James C Yuen, Matthew R Smeds
Animal bites are fairly rare events but can cause devastating traumatic injuries to the victim. In addition to the soft tissue, vascular, and orthopedic trauma inflicted by these occurrences, bite injuries also have the potential to introduce an inoculum of microbes, which may progress to an infection if not treated properly and expeditiously. We present the case of a healthy male who sustained multiple bite wounds from a domestic zebra to his left upper extremity. This attack caused severe damage, including devascularization of the arm at the brachial artery, disruption of the distal biceps and brachialis, stripping of the forearm nerves, and shearing of the overlying soft tissue...
June 2017: Trauma Case Reports
https://www.readbyqxmd.com/read/29643795/ocular-injury-due-to-potassium-permanganate-granules
#5
Chareenun Chirapapaisan, Pinnita Prabhasawat, Sabong Srivannaboon, Vatookarn Roongpoovapatr, Piyada Chitsuthipakorn
Purpose: We report a rare case of ocular injury due to potassium permanganate (KMnO4 ) granules in a child. Methods: This is a retrospective case report. Results: A 2-year-old boy was transferred to our emergency room with severe pain in his right eye, inflamed eyelids, and brownish stains on his fingers. Chemical injury was suspected. Copious eye irrigation was immediately performed. Diffuse brownish splotches were then observed at the inferior bulbar conjunctiva...
January 2018: Case Reports in Ophthalmology
https://www.readbyqxmd.com/read/29627258/does-prior-failed-debridement-compromise-the-outcome-of-subsequent-two-stage-revision-done-for-periprosthetic-joint-infection-following-total-knee-arthroplasty
#6
Ashok Rajgopal, Inayat Panda, Arun Rao, Vivek Dahiya, Himanshu Gupta
BACKGROUND: There has been a debate regarding the outcomes of 2-stage revision total knee arthroplasty (TKA) when debridement, antibiotics, irrigation, and implant retention (DAIR) had been carried out previously. The purpose of this study is to evaluate the influence of prior failed DAIR (F-DAIR) on the outcomes of 2-stage revision TKA done for periprosthetic joint infection (PJI). METHODS: This is a retrospective study of a consecutive series of 184 knees that completed 2-stage revision TKA for PJI, operated by a single surgeon between January 2000 and July 2011...
March 9, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29623994/clinical-features-and-outcome-of-patients-with-cutaneous-melioidosis-during-a-nosocomial-outbreak-in-a-temperate-region-of-australia
#7
Benjamin Clark, Adam Merritt, Tim Inglis, Laurens Manning
Six cases of cutaneous melioidosis from southwestern Australia, a non-endemic region occurred as a result of Burkholderia pseudomallei contamination of normal saline that was used for irrigating superficial wounds. Treatment with parenteral meropenem, given by continuous infusion for 2 weeks, followed by oral antibiotics was successful in all cases.
April 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29609860/prophylaxis-of-surgical-site-infection-in-adult-spine-surgery-a-systematic-review
#8
REVIEW
Reina Yao, Terence Tan, Jin Wee Tee, John Street
INTRODUCTION: Surgical site infection (SSI) remains a significant source of morbidity in spine surgery, with reported rates varying from 0.7 to 16%. OBJECTIVE: To systematically review and evaluate the evidence for strategies for prophylaxis of SSI in adult spine surgery in the last twenty years. METHODS: Two independent systematic searches were conducted, at two international spine centers, encompassing PubMed, ClinicalTrials.gov, Cochrane Database, EBSCO Medline, ScienceDirect, Ovid Medline, EMBASE (Ovid), and MEDLINE...
March 30, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29609435/retained-large-glass-fragments-for-over-40-years-in-the-maxillofacial-region
#9
Woong Gyu Na, Hyoseob Lim, Sung Hoon Koh, Sung Won Jung
Foreign body (FB) impaction in the maxillofacial area could be caused by knives, glass fragments, and vegetative materials. We present the rare case of a 62-year-old man with a large glass FB in the left cheek retained for over 40 years. He had traffic accident over 40 years ago and glass fragments impacted on his left cheek. Glass fragments were retained around the zygomatic arch with dimpled scar and unclear serous discharge, but other facial motor or sensory dysfunction was not observed. We confirmed three glass fragments with radiologic examination including plain radiograph and computed tomographic image...
March 2018: Archives of Craniofacial Surgery
https://www.readbyqxmd.com/read/29606292/randomized-prospective-evaluation-of-the-wound-integrity-of-primary-clear-corneal-incisions-made-with-a-femtosecond-laser-versus-a-manual-keratome
#10
Eric Donnenfeld, Eric Rosenberg, Henry Boozan, Zac Davis, Alanna Nattis
PURPOSE: To compare the wound integrity of femtosecond laser-assisted 110-degree reverse side-cut clear corneal incisions (CCIs) with femtosecond laser-assisted 70-degree forward side-cut and manual CCIs in patients having cataract surgery. SETTING: Island Eye Surgicenter, Carle Place, New York, USA. DESIGN: Prospective case series. METHODS: Patients having cataract surgery were randomized into 3 treatment groups as follows: Group A had 110-degree femtosecond reverse side-cut CCIs, Group B had 70-degree femtosecond forward side-cut CCIs, Group C had manual CCIs...
March 29, 2018: Journal of Cataract and Refractive Surgery
https://www.readbyqxmd.com/read/29590411/wartime-soft-tissue-coverage-techniques-for-the-deployed-surgeon
#11
Vilas Saldanha, Nathan Tiedeken, Brandon Godfrey, Nichole Ingalls
Background: Since the start of the conflict in the Middle East in 2001, military orthopedic surgeons have faced complex orthopedic injuries including high-energy soft tissue wounds, traumatic amputations, and open fractures. Although orthopedic surgeons are well trained in the management of osseous injuries, the treatment of soft tissue injuries can be technically challenging and unfamiliar. Early washout, debridement of devitalized tissue, external fixation of bony injuries, and antibiotic therapy remain the foundation of early wound management...
March 26, 2018: Military Medicine
https://www.readbyqxmd.com/read/29572038/high-efficiency-particulate-air-filters-do-not-affect-acute-infection-rates-during-primary-total-joint-arthroplasty-using-forced-air-warmers
#12
Gannon L Curtis, Mhamad Faour, Jaiben George, Alison K Klika, Wael K Barsoum, Carlos A Higuera
BACKGROUND: Studies have suggested that forced-air warmers (FAWs) increase contamination of the surgical site. In response, FAWs with high efficiency particulate air filters (FAW-HEPA) were introduced. This study compared infection rates following primary total joint arthroplasty (TJA) using FAW and FAW-HEPA. METHODS: Primary TJA patients at a single healthcare system were retrospectively reviewed. A total of 5405 THA (n = 2419) and TKA (n = 2986) consecutive cases in 2013 and 2015 were identified...
February 5, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29544509/local-control-of-polymicrobial-infections-via-a-dual-antibiotic-delivery-system
#13
David J Tennent, Stefanie M Shiels, Jessica A Jennings, Warren O Haggard, Joseph C Wenke
BACKGROUND: Contaminated traumatic open orthopedic wounds are frequently complicated by polymicrobial contamination and infection. In high-risk wounds, the standard of care comprises debridement and irrigation combined with antibiotics which can be applied directly or combined with systemic antibiotics. Recently, bioabsorbable chitosan sponges have been shown to be an effective single-agent delivery device for local antibiotics with and without negative pressure wound therapy (NPWT). Severely contaminated orthopedic wounds, however, are often complicated by polymicrobial infections, necessitating multiple antibiotic agents...
March 15, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29527250/temporary-abdominal-closure-combined-with-an-irrigating-system-utilizing-hypochlorous-acid-solution-to-decrease-abdominal-mucopurulence
#14
Marc R Matthews, Asia N Quan, Alexandra S Weir, Kevin N Foster, Daniel M Caruso
Introduction: Leaving the abdominal cavity open is a well-described and frequently utilized technique in the treatment of severe intra-abdominal sepsis. Irrigation through a negative pressure wound therapy device is a technique employed to assist in the closure of wounds as well as the reduction of bacterial contamination. Furthermore, hypochlorous acid has been found to be safe and effective in microorganismal elimination from extremity wounds. There is no literature regarding the infusion of hypochlorous solution into the abdominal cavity for intra-abdominal sepsis or mucopurulent abscesses or biofilm...
2018: Eplasty
https://www.readbyqxmd.com/read/29523908/a-novel-wound-retractor-combining-continuous-irrigation-and-barrier-protection-reduces-incisional-contamination-in-colorectal-surgery
#15
Harry T Papaconstantinou, Rocco Ricciardi, David A Margolin, Roberto Bergamaschi, Robert C Moesinger, Warren E Lichliter, Elisa H Birnbaum
BACKGROUND: Surgical site infection (SSI) remains a persistent and morbid problem in colorectal surgery. Key to its pathogenesis is the degree of intraoperative bacterial contamination at the surgical site. The purpose of this study was to evaluate a novel wound retractor at reducing bacterial contamination. METHODS: A prospective multicenter pilot study utilizing a novel wound retractor combining continuous irrigation and barrier protection was conducted in patients undergoing elective colorectal resections...
March 9, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29509625/the-impact-of-specialty-on-cases-performed-during-hand-surgery-fellowship-training
#16
Jason Silvestre, Joseph Upton, Benjamin Chang, David R Steinberg
BACKGROUND: Hand surgery fellowship programs in the United States are predominately sponsored by departments or divisions of orthopaedic surgery or plastic surgery. This study compares the operative experiences of hand surgery fellows graduating from orthopaedic or plastic surgery hand surgery fellowships. METHODS: Operative case logs of 3 cohorts of hand surgery fellows graduating during the academic years of 2012-2013, 2013-2014, and 2014-2015 were analyzed. The median case volumes were compared by specialty via Mann-Whitney U tests...
March 7, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29487999/complication-of-aquafilling-%C3%A2-gel-injection-for-breast-augmentation-case-report-of-one-case-and-review-of-literature
#17
Bok Ki Jung, In Sik Yun, Young Seok Kim, Tai Suk Roh
INTRODUCTION: Augmentation mammoplasty is one of the most popular aesthetic operations in the world. In Korea, one of the fillers used for breast augmentation is AQUAfilling® gel (Biomedica. spol, s,r,o, Czech Republic). AQUAfilling® gel is a hydrophilic gel composed of 98% sodium chloride solution (0.9%) and 2% cation copolyamide. METHODS: This is a case report describing a patient that suffered complications after AQUAfilling® gel injection for breast augmentation...
February 27, 2018: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/29481377/management-of-early-deep-wound-infection-after-thoracolumbar-instrumentation-continuous-irrigation-suction-system-versus-vacuum-assisted-closure-system
#18
Wei Yuan, Xuan Liu, Xiaoshu Zhou, Lei Pei, Yue Zhu
STUDY DESIGN: A retrospective study. OBJECTIVE: To compare the clinical outcomes of continues irrigation suction systems (CISS) or vacuum assisted closure system (VACS) in early deep wound infection (DWI) after thoracolumbar instrumentation. SUMMARY OF BACKGROUND DATA: DWI after thoracolumbar instrumentation is challenging and debridement followed by either CISS or VACS has been proven to be effective. So far which one of the system has more advantages over the other remains unclear...
February 23, 2018: Spine
https://www.readbyqxmd.com/read/29481349/is-ns-edta-effective-in-clearing-bacteria-from-infected-wounds-in-a-rat-model
#19
Hongyi Zhu, Bingbo Bao, Xianyou Zheng
BACKGROUND: Irrigation is one of the key procedures in open fracture management to eliminate pathogens and prevent infection. Metal ion deprivation could inhibit bacterial adhesins and weaken adhesion to the host tissue. EDTA in solution can competitively bind to a metal ion and thus might be able to inhibit bacterial adhesins. QUESTIONS/PURPOSES: (1) Is normal saline-EDTA toxic to fibroblasts and endothelial cells? (2) In a contaminated wound rat model, does irrigation with normal saline-EDTA solution decrease the risk of positive bacterial cultures and infection when compared with normal saline and soap solutions? (3) In an infected wound rat model, are fewer surgical débridements and irrigations with normal saline-EDTA solution required to obtain culture-free wounds when compared with normal saline and soap controls? METHODS: Normal saline-EDTA solution refers to 1 mmol/L EDTA dissolved in normal saline (pH adjusted to 7...
February 23, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29471273/effect-of-simultaneously-induced-environmental-stimuli-on-electrical-signalling-and-gas-exchange-in-maize-plants
#20
Jasmin Vuralhan-Eckert, Silke Lautner, Jörg Fromm
Electrical signalling in response to environmental stimuli is a well-known phenomenon in higher plants. For example, in maize, different stimuli, such as wounding or re-irrigation after drought, incite characteristic electrical signals which have quite particular effects on gas exchange. What is less well understood is how plants (specifically maize) respond when two different environmental stimuli are applied simultaneously. To explore this, a three-stage experiment was designed. In the first stage, drought conditions were simulated by decreasing the soil water content to 30-40 % of field capacity...
February 10, 2018: Journal of Plant Physiology
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