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Wound irrigation

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https://www.readbyqxmd.com/read/28321572/the-extent-of-environmental-and-body-contamination-through-aerosols-by-hydro-surgical-debridement-in-the-lumbar-spine
#1
David Putzer, Ricarda Lechner, Debora Coraca-Huber, Astrid Mayr, Michael Nogler, Martin Thaler
INTRODUCTION: Surgical site infections occur in 1-6% of spinal surgeries. Effective treatment includes early diagnosis, parenteral antibiotics and early surgical debridement of the wound surface. MATERIALS AND METHODS: On a human cadaver, we executed a complete hydro-surgery debridement including a full surgical setup such as draping. The irrigation fluid was artificially contaminated with Staphylococcus aureus (ATCC 6538). Surveillance cultures were used to detect environmental and body contamination of the surgical team...
March 20, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28288080/management-of-pediatric-type-i-open-fractures-in-the-emergency-department-or-operating-room-a-multicenter-perspective
#2
Jenna Godfrey, Paul D Choi, Lior Shabtai, Sarah B Nossov, Amy Williams, Antoinette W Lindberg, Selina Silva, Michelle S Caird, Mathew D Schur, Alexandre Arkader
BACKGROUND: The management of pediatric type I open fractures remains controversial. The aim of this study is to compare outcomes in type I open fractures managed with superficial wound debridement and antibiotics in the emergency department (ED) (nonoperative management) to patients managed with operative debridement and antibiotics (operative management). METHODS: A multicenter retrospective review was performed of all pediatric type I open forearm, wrist, and tibia fractures treated at 4 high volume pediatric centers between 2000 and 2015...
March 10, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28277997/effect-of-antiseptic-irrigation-on-infection-rates-of-traumatic-soft-tissue-wounds-a-longitudinal-cohort-study
#3
B Roth, R Neuenschwander, F Brill, F Wurmitzer, C Wegner, O Assadian, A Kramer
OBJECTIVE: Acute traumatic wounds are contaminated with bacteria and therefore an infection risk. Antiseptic wound irrigation before surgical intervention is routinely performed for contaminated wounds. However, a broad variety of different irrigation solutions are in use. The aim of this retrospective, non-randomised, controlled longitudinal cohort study was to assess the preventive effect of four different irrigation solutions before surgical treatment, on wound infection in traumatic soft tissue wounds...
March 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28266133/effectiveness-of-a-polyhexanide-irrigation-solution-on-methicillin-resistant-staphylococcus-aureus-biofilms-in-a-porcine-wound-model
#4
Stephen C Davis, Andrew Harding, Joel Gil, Fernando Parajon, Jose Valdes, Michael Solis, Alex Higa
Irrigation and removal of necrotic debris can be beneficial for proper healing. It is becoming increasingly evident that wounds colonized with biofilm forming bacteria, such as Staphylococcus aureus (SA), can be more difficult to eradicate. Here we report our findings of the effects of an irrigation solution containing propyl-betaine and polyhexanide (PHMB) on methicillin-resistant Staphylococcus aureus (MRSA) biofilms in a porcine wound model. Thirty-nine deep partial thickness wounds were created with six wounds assigned to one of six treatment groups: (i) PHMB, (ii) Ringer's solution, (iii) hypochlorous acid/sodium hypochlorite, (iv) sterile water, (v) octenidine dihydrochloride, and (vi) octenilin...
March 7, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28242396/aggressive-wound-care-by-a-multidisciplinary-team-improves-wound-healing-after-infrainguinal-bypass-in-patients-with-critical-limb-ischemia
#5
Shinsuke Mii, Kiyoshi Tanaka, Ryoichi Kyuragi, Hiroshi Ishimura, Shinsuke Yasukawa, Atsushi Guntani, Eisuke Kawakubo
BACKGROUND: A long period is generally required for ischemic ulcer to heal after revascularization. The strategy of postoperative wound care can affect wound healing. This study was conducted to investigate the degree to which aggressive wound care (AWC) by a team of multidisciplinary specialists actually shortens the time to wound healing and increases the rate of wound healing in limbs undergoing surgical bypass for ischemic tissue loss in a real clinical setting. METHODS: A total of consecutive 126 patients undergoing infrainguinal bypass for tissue loss from April 2011 to March 2015 were reviewed...
February 24, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28236536/-streptococcus-milleri-an-unusual-cause-of-skull-extensive-osteomyelitis-in-an-immunocompetent-patient
#6
C Duquenne, E Dernis, A Zehrouni, A Bizon, M Duquenne
INTRODUCTION: Streptococcus milleri (Streptococcus anginosus, intermedius and constellatus) are commensal organisms, which can become pathogenic and cause infection with frequent abscess formation, local or metastatic extension. Osteomyelitis of the skull has been rarely reported in this type of infection. CASE REPORT: Skull osteomyelitis due to Streptococcus milleri is reported in a 61-year-old immunocompetent man without any medical history, occurring 10 months after a head injury without any wound or complication at initial presentation...
February 21, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28231605/endonasal-versus-external-dacryocystorhinostomy-for-nasolacrimal-duct-obstruction
#7
REVIEW
Lona Jawaheer, Caroline J MacEwen, Deepa Anijeet
BACKGROUND: A dacryocystorhinostomy (DCR) procedure aims to restore drainage of tears by bypassing a blockage in the nasolacrimal duct, through the creation of a bony ostium that allows communication between the lacrimal sac and the nasal cavity. It can be performed using endonasal or external approaches. The comparative success rates of these two approaches have not yet been established and this review aims to evaluate the relevant up-to-date research. OBJECTIVES: The primary aim of this review is to compare the success rates of endonasal DCR with that of external DCR...
February 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28198170/antibacterial-effect-of-sevoflurane-and-isoflurane
#8
M Martínez-Serrano, M Gerónimo-Pardo, A Martínez-Monsalve, M D Crespo-Sánchez
OBJECTIVE: Multidrug resistant bacteria are increasing worldwide and therapeutic options are limited. Some anaesthetics have shown antibacterial activity before. In this study, we have investigated the antibacterial effect of the halogenated anaesthetic agents sevoflurane and isoflurane against a range of resistant pathogens. METHODS: Two experiments were conducted. In the first, bacterial suspensions of both ATCC and resistant strains of Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa were exposed to liquid sevoflurane and isoflurane during 15, 30 and 60 minutes...
February 15, 2017: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/28144716/bicompartmental-individualized-knee-replacement-use-of-patient-specific-implants-and-instruments-iduo%C3%A2
#9
A F Steinert, J Beckmann, B M Holzapfel, M Rudert, J Arnholdt
OBJECTIVE: Bicompartmental knee replacement in patients with combined osteoarthritis (OA) of the medial or lateral and patellofemoral compartment. Patient-specific instruments and implants (ConforMIS iDuo™) with a planning protocol for optimal implant fit. INDICATIONS: Bicompartmental OA of the knee (Kellgren & Lawrence stage IV) affecting both the medial or lateral and patellofemoral compartment after unsuccessful conservative or joint-preserving surgery. CONTRAINDICATIONS: Tricompartmental OA, knee ligament instabilities, knee deformities >15° (varus, valgus, extension deficit)...
February 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28134091/irrigation-solutions-in-open-fractures-of-the-lower-extremities-evaluation-of-isotonic-saline-and-distilled-water
#10
Olukemi Temiloluwa Olufemi, Adeolu Ikechukwu Adeyeye
INTRODUCTION: Open fractures are widely considered as orthopaedic emergencies requiring immediate intervention. The initial management of these injuries usually affects the ultimate outcome because open fractures may be associated with significant morbidity. Wound irrigation forms one of the pivotal principles in the treatment of open fractures. The choice of irrigation fluid has since been a source of debate. This study aimed to evaluate and compare the effects of isotonic saline and distilled water as irrigation solutions in the management of open fractures of the lower extremities...
2017: SICOT-J
https://www.readbyqxmd.com/read/28121963/the-effect-of-vancomycin-and-gentamicin-antibiotics-on-human-osteoblast-proliferation-metabolic-function-and-bone-mineralization
#11
Ashleigh M Philp, Saroop Raja, Andrew Philp, Matthew P Newton Ede, Simon W Jones
STUDY DESIGN: The present study investigates the effect of vancomycin and gentamicin antibiotics on primary human osteoblasts. Osteoblasts were incubated with vancomycin, gentamicin, or with povidone-iodine (PVI), at concentrations advocated for wound irrigation. Osteoblast proliferation, metabolic function, and bone mineralization were measured. OBJECTIVE: The aim of the study was to model gentamicin and vancomycin wound irrigation in vitro and to examine the effect on osteoblast viability and cellular function in comparison to 0...
February 2017: Spine
https://www.readbyqxmd.com/read/28069270/treatment-of-subcutaneous-abscesses-in-children-with-incision-and-loop-drainage-a-simplified-method-of-care
#12
Charles J Aprahamian, Hilana H Nashad, Nerina M DiSomma, Breanna M Elger, Joseph R Esparaz, Thomas J McMorrow, Alexandria M Shadid, Angela M Kao, Mark J Holterman, Robert C Kanard, Richard H Pearl
PURPOSE: The aim of this study was to expand on our previous report of 115 patients after more than a decade-long experience using incision and loop drainage for pediatric subcutaneous abscess management. This report comprises the largest consecutive series of pediatric abscess patients from a single institution ever recorded. METHODS: A retrospective study was performed of all pediatric patients who underwent incision and loop drainage of subcutaneous abscesses at our institution between January 2002 and December 2014...
December 30, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28043851/negative-pressure-wound-therapy-in-orthopaedic-surgery
#13
REVIEW
N Robert
Negative pressure wound therapy (NPWT) consists in applying subatmospheric pressure to a wound that is sealed off by a specially designed dressing and connected by a tube to a suction pump and drainage collection system. Skin defects are extremely common in orthopaedic and trauma surgery. NPWT is valuable across a range of indications. Proven effects include an increase in blood flow, stimulation of angiogenesis, and a decrease in wound surface area. NPWT can be used to treat post-traumatic and surgical wounds, burns, and chronic wounds such as pressure sores and ulcers...
December 30, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28013376/a-high-vacuum-wound-drainage-system-reduces-pain-and-length-of-treatment-for-pediatric-soft-tissue-abscesses
#14
Chao Yang, Shan Wang, Chang-Chun Li, Xiang-Ru Kong, Zhenzhen Zhao, Xiao-Bin Deng, Liang Peng, Jun Zhang
Open incision and drainage (I&D) and wound packing is accepted as the standard treatment for soft tissue abscesses. However, conventional I&D has a number of problems in practice which prompt us to improve the I&D methods that would minimize the pain associated with packing during dressing changes. In order to compare the pain associated with dressing changes in the conventional I&D group to the vacuum system group and the treatment time of both groups, we performed a randomized trial in pediatric patients between 0 and 18 years of age who are undergoing abscess drainage in the operating room from April 2011 to April 2015...
February 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/27989501/a-randomized-blinded-multicenter-trial-of-a-gentamicin-vancomycin-gel-dfa-02-in-patients-undergoing-abdominal-surgery
#15
Elliott Bennett-Guerrero, Scott M Berry, Sergio D Bergese, Phillip R Fleshner, Harold S Minkowitz, Alvaro M Segura-Vasi, Kamal M F Itani, Karen W Henderson, Felicia P Rackowski, Laura H Aberle, Martin E Stryjewski, G Ralph Corey, Kent S Allenby
BACKGROUND: SI is a significant medical problem. DFA-02 is an investigational bioresorbable modified release gel consisting of both gentamicin (16.8 mg/mL) and vancomycin (18.8 mg/mL). A Phase 2a study, where the drug was applied during surgical incision closure, suggested safety and tolerability but was not designed to assess its efficacy. STUDY DESIGN: In a Phase 2b randomized, blinded trial patients undergoing abdominal, primarily colorectal, surgery were randomized (4:1:1) to one of three study arms: DFA-02, matching placebo gel, or standard of care (SOC) involving irrigation of the wound with normal saline...
November 18, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27988849/bacterial-reduction-and-shift-with-npwt-after-surgical-debridements-a-retrospective-cohort-study
#16
Thorsten Jentzsch, Georg Osterhoff, Pawel Zwolak, Burkhardt Seifert, Valentin Neuhaus, Hans-Peter Simmen, Gerrolt N Jukema
BACKGROUND: Surgical debridement, negative-pressure wound therapy (NPWT) and antibiotics are used for the treatment of open wounds. However, it remains unclear whether this treatment regimen is successful in the reduction and shift of the bacterial load. METHODS: After debridement in the operating room, NPWT, and antibiotic treatment, primary and secondary consecutive microbiological samples of 115 patients with 120 open wounds with bacterial or yeast growth in ≥1 swab or tissue microbiological sample(s) were compared for bacterial growth, Gram staining and oxygen use at a level one trauma center in 2011...
January 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/27974013/a-narrative-review-of-microbial-biofilm-in-postoperative-surgical-site-infections-clinical-presentation-and-treatment
#17
REVIEW
C E Edmiston, A J McBain, M Kiernan, D J Leaper
OBJECTIVE: The global impact of surgical site infections (SSIs) on health-care systems is considerable: many are related to the formation of a microbial biofilm. Biofilm plays a significant role in the pathogenesis of implantable device-related infections and are also important in persistent postoperative skin and soft tissue wound infections. METHOD: PubMed and OVID databases were searched for relevant articles regarding biofilm-associated infection in surgery, including epidemiology, diagnosis, treatment and management...
December 2, 2016: Journal of Wound Care
https://www.readbyqxmd.com/read/27925543/minor-traumatic-wounds
#18
Emily Davis
What was the nature of the CPD activity, practice-related feedback and/or event and/or experience in your practice? The article focused on the management of minor traumatic wounds. It provided an overview of the techniques used in the care of patients with minor wounds, and discussed the recommended anaesthetic agents when debriding and irrigating wound beds. The article considered the benefits of using staples, sutures and glue, with the aim of reducing scar formation.
December 7, 2016: Nursing Standard
https://www.readbyqxmd.com/read/27923216/efficacy-of-a-cellular-bone-allograft-for-foot-and-ankle-arthrodesis-and-revision-nonunion-procedures
#19
Travis J Dekker, Peter White, Samuel B Adams
BACKGROUND: Bone graft substitutes are often required in patients at risk for nonunion, and therefore, an allograft that most closely mimics an autograft is highly sought after. This study explored the utility and efficacy of a cellular bone allograft used for foot and ankle arthrodesis and revision nonunion procedures in a patient population at risk for nonunion. METHODS: An institutional review board-approved retrospective review of consecutive patients who underwent arthrodesis and revision nonunion procedures with a cellular bone allograft was performed at a single academic institution...
March 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/27922792/wound-bed-preparation-a-novel-approach-using-hydrotherapy
#20
Leanne Atkin, Karen Ousey
Wounds that fail to heal quickly are often encountered by community nursing staff. An important step in assisting these chronic or stalled wounds progress through healing is debridement to remove devitalised tissue, including slough and eschar, that can prevent the wound from healing. A unique wound treatment called HydroTherapy aims to provide an optimal healing environment. The first step of HydroTherapy involves HydroClean plus™, this dressing enables removal of devitalised tissue through autolytic debridement and absorption of wound fluid...
December 2016: British Journal of Community Nursing
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