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Surgical irrigation

Jinlu Yu, Yunbao Guo, Baofeng Xu, Kan Xu
The middle meningeal artery (MMA) is a very important artery in neurosurgery. Many diseases, including dural arteriovenous fistula (DAVF), pseudoaneurysm, true aneurysm, traumatic arteriovenous fistula (AVF), moyamoya disease (MMD), recurrent chronic subdural hematoma (CSDH), migraine and meningioma, can involve the MMA. In these diseases, the lesions occur in either the MMA itself and treatment is necessary, or the MMA is used as the pathway to treat the lesions; therefore, the MMA is very important to the development and treatment of a variety of neurosurgical diseases...
2016: International Journal of Medical Sciences
Ru-Sen Zhu, Yi-Ming Ren, Jian-Jun Yuan, Zi-Jian Cui, Jun Wan, Bao-You Fan, Wei Lin, Xian-Hu Zhou, Xue-Li Zhang
Lumbar disc herniation (LDH) is a common disease and lumbar discectomy is the most common surgical procedure carried out for patients with low back pain and leg symptoms. Although most researchers are focusing on the surgical techniques during operation, the aim of this study is to evaluate the effect of local intervertebral lavage during microdiscectomy.In this retrospective study, 410 patients were operated on by microdiscectomy for LDH during 2011 to 2014. Retrospectively, 213 of them (group A) accepted local intervertebral irrigation with saline water before wound closure and 197 patients (group B) only had their operative field irrigated with saline water...
October 2016: Medicine (Baltimore)
Or Friedman, Ehud Arad, Oded Ben Amotz
In the pursuit of success in sports, some athletes are not deterred by health risks associated with the (mis)use of black market preparations of dubious origin as performance-enhancing agents. Several studies published in the recent years demonstrated that anabolic-androgenic steroids, but also stimulants and growth hormones, are misused by numerous recreational athletes from all over the world. Trenbolone is an anabolic steroid routinely used in the finishing phase of beef production to improve animal performance and feed efficiency...
September 2016: Plastic and Reconstructive Surgery. Global Open
Daniel F Hanley, Richard E Thompson, John Muschelli, Michael Rosenblum, Nichol McBee, Karen Lane, Amanda J Bistran-Hall, Steven W Mayo, Penelope Keyl, Dheeraj Gandhi, Tim C Morgan, Natalie Ullman, W Andrew Mould, J Ricardo Carhuapoma, Carlos Kase, Wendy Ziai, Carol B Thompson, Gayane Yenokyan, Emily Huang, William C Broaddus, R Scott Graham, E Francois Aldrich, Robert Dodd, Cristanne Wijman, Jean-Louis Caron, Judy Huang, Paul Camarata, A David Mendelow, Barbara Gregson, Scott Janis, Paul Vespa, Neil Martin, Issam Awad, Mario Zuccarello
BACKGROUND: Craniotomy, according to the results from trials, does not improve functional outcome after intracerebral haemorrhage. Whether minimally invasive catheter evacuation followed by thrombolysis for clot removal is safe and can achieve a good functional outcome is not known. We investigated the safety and efficacy of alteplase, a recombinant tissue plasminogen activator, in combination with minimally invasive surgery (MIS) in patients with intracerebral haemorrhage. METHODS: MISTIE was an open-label, phase 2 trial that was done in 26 hospitals in the USA, Canada, the UK, and Germany...
November 2016: Lancet Neurology
Shunji Morita, Kimimasa Ikeda, Takamichi Komori, Tsukasa Tanida, Hisanori Hatano, Yoshito Tomimaru, Hiroshi Imamura, Keizo Dono
BACKGROUND: Emergency surgery for obstructing colorectal cancer is associated with high mortality and morbidity rates. OBJECTIVE: The purpose of this study was to assess outcomes of emergency surgery for obstructing colorectal cancer in a single hospital, where care was primarily provided by colorectal surgeons. DESIGN: This was a retrospective cohort study. SETTINGS: The study was conducted at the Toyonaka Municipal Hospital...
November 2016: Diseases of the Colon and Rectum
Manas Panigrahi, Manoranjitha Kumari, Sudhindra Vooturi
BACKGROUND: Keeping the operating field clean and visible is an important technique in neurosurgery. Continuous irrigation-suction (IS) of the surgical field is currently often done using devices available that are expensive and demand technical proficiency. We report a simple method of continuous ISusing widely available central venous catheter and controlled suction cannula. METHODS: We used a controlled suction cannula attached to a central suction system. Single lumen central venous catheter is passed through the key hole of a controlled suction cannula, which is connected to a continuous irrigation system...
October 12, 2016: World Neurosurgery
Stephanie Preuss, Claudius Kuechle, Stefan Wagenpfeil, Christoph Schmaderer, Lutz Renders, Uwe Heemann, Konrad Stock
The aim of this retrospective single-center study was to examine ultrasound-detected complications after diagnostic parenchymal renal biopsies. After 471 ultrasound-guided kidney biopsies (225 native kidneys and 246 renal allografts), ultrasound revealed hematomas (21.9%), arterio-venous fistulas (8.9%), active bleeding (1.1%) and hematuria (0.4%). Only 0.8% of all patients required invasive intervention such as coiling (n = 3) and surgical procedures (n = 1). Three episodes of bleeding (0.6%) were solved with manual compression...
October 13, 2016: Ultrasound in Medicine & Biology
Gediminas Žekonis, Jonas Žekonis, Alvydas Gleiznys, Viktorija Noreikienė, Ingrida Balnytė, Renata Šadzevičienė, Julija Narbutaitė
BACKGROUND Various studies have shown that non-surgical periodontal treatment is correlated with reduction in clinical parameters and plasma levels of inflammatory markers. The aim of this study was to evaluate the effect of long-term weekly supragingival irrigations with aerosolized 0.5% hydrogen peroxide as maintenance therapy followed by non-surgical periodontal treatment on clinical parameters, plasma levels of inflammatory markers, and morphological changes in gingival tissues of patients with periodontitis...
October 15, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Alessandro Giamberti, Francesca R Pluchinotta, Massimo Chessa, Alessandro Varrica, Raffaele Vitale, Alessandro Frigiola, Carlo Pappone, Marco Ranucci
AIMS: Supraventricular arrhythmias are a major cause of morbidity and mortality in adult patients with congenital heart disease (CHD). Intraoperative ablation offers an alternative for patients who failed ablation procedures or are requiring concomitant surgical intervention. We present our long-term results with the surgical treatment of arrhythmias in adults with CHD (ACHD) undergoing elective cardiac surgery and the clinical predictors for arrhythmia recurrence. METHODS AND RESULTS: Between 2002 and 2013, 80 consecutive patients with CHD, mean age of 39 years, underwent intraoperative ablation with monopolar irrigated radiofrequency during cardiac surgery procedures...
October 12, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Giuseppe Falco, Monica Foroni, Fabio Castagnetti, Luigi Marano, Daniele Bordoni, Nicola Rocco, Vanessa Marchesi, Valentina Iotti, Rita Vacondio, Guglielmo Ferrari
INTRODUCTION: Management of breast abscess in lactating women remains controversial. During pregnancy, women may develop different kinds of benign breast lesions that could require a surgical incision performed under general anesthesia with consequent breastfeeding interruption. The purpose of this study was to prospectively evaluate the management of large breast abscesses with ultrasound-assisted drainage aiming at breastfeeding preservation. MATERIAL AND METHODS: 34 lactating women with a diagnosis of unilateral breast abscess have been treated with an ultrasound (US)-assisted drainage of the abscess...
October 11, 2016: Breastfeeding Medicine: the Official Journal of the Academy of Breastfeeding Medicine
Sarah E Dodd, Christopher J Jankowski, Amy E Krambeck, Bhargavi Gali
Holmium laser enucleation of prostate (HoLEP) is being performed with increasing frequency as a minimally invasive alternative to transurethral resection of the prostate (TURP) for the surgical management of benign prostatic hyperplasia (BPH). HoLEP offers the advantage of use of normal saline for irrigation, instead of glycine which is utilized in TURP, decreasing the likelihood of fluid absorption and effects on serum electrolytes. We describe a patient who underwent HoLEP for BPH and subsequently developed non-ion gap metabolic acidosis and hemodilution associated with volume overload...
October 6, 2016: Journal of Anesthesia
Philip G Chen, Jae Murphy, Les M Alloju, Sam Boase, Peter-John Wormald
OBJECTIVES: Nasal irrigation is standard in the management of chronic rhinosinusitis both before and after surgical intervention. Numerous irrigation devices are commercially available. The aim of this study was to compare the efficacy of a handheld pulse irrigation device against the gold standard manual squeeze bottle after endoscopic sinus surgery (ESS). METHODS: Five cadaveric specimens were prepared with video visualization ports into each sinus. Endoscopic sinus surgery was performed on each cadaver from minimal to maximal dissection...
September 29, 2016: Annals of Otology, Rhinology, and Laryngology
Douglas G Ridyard, Elizabeth A Phillips, William Vincent, Ricardo Munarriz
INTRODUCTION: Ischemic priapism is an uncommon urologic emergency characterized by a compartment syndrome-like ischemic insult to the corpora cavernosa of the penis. The goal of treatment in ischemic priapism is rapid detumescence to prevent long-term erectile dysfunction. Non-surgical treatment options include aspiration, irrigation, and intracavernous injections of sympathomimetic agents. At our institution, phenylephrine is used in the treatment of ischemic priapism at concentrations and doses that are higher than those recommended in established guidelines...
September 27, 2016: Journal of Sexual Medicine
J W P Kuiper, S Vos, T J Burger, S Colen
Recently, guidelines regarding diagnosis and treatment of periprosthetic joint infection (PJI) have been published, but it is unknown how well these are -followed in the Netherlands and Belgium. Therefore, a survey study was performed in the Netherlands and Belgium. 81 orthopedic departments responded (54% in the Netherlands, 52% in Belgium). The majority used protocols for antibiotic and surgical treatment. To discriminate between early and late infection, differences in periods used were seen between respondents, and between countries...
August 2016: Acta Orthopaedica Belgica
Krishna Patel, Kathleyn Brandstetter
Allogenic implants are an effective alternative to autologous grafts in the reconstruction of facial defects. These implants are used to reconstruct a variety of bony and soft-tissue defects, including the frontal and temporal regions; internal orbit; infraorbital rim; malar, paranasal, and nasal regions; mandible; and chin. In comparison to their autologous counterparts, alloplastic materials are more readily available, lack donor-site morbidity, decrease surgical time and cost, and still have relatively good postoperative tissue tolerance...
October 2016: Facial Plastic Surgery: FPS
Charles E Edmiston, David J Leaper
BACKGROUND: Intra-operative surgical site irrigation (lavage) is common practice in surgical procedures in general, with all disciplines advocating some form of irrigation before incision closure. This practice, however, has been neither standardized nor is there compelling evidence that it effectively reduces the risk of surgical site infection (SSI). This narrative review addresses the laboratory and clinical evidence that is available to support the practice of irrigation of the abdominal cavity and superficial/deep incisional tissues, using specific irrigation solutions at the end of an operative procedure to reduce the microbial burden at wound closure...
September 27, 2016: Surgical Infections
R Green, R Gohil, P Ross
BACKGROUND: Historically dacryocystorhinostomy (DCR) has been performed externally with very good outcomes. Current literature shows comparable success rates between endonasal and external approaches. A common reason for the failure of a DCR is the reclosure of the nasolacrimal stoma by granulation tissue and synechiae. OBJECTIVE OF REVIEW: A systematic review and critical evaluation of the evidence relating to the preservation of nasal mucosal flaps in DCR surgery...
September 23, 2016: Clinical Otolaryngology
Heather C Yun, Clinton K Murray, Kenneth J Nelson, Michael J Bosse
Trauma to the extremities is disproportionately represented in casualties of recent conflicts, accounting for >50% of injuries sustained during operations in Iraq and Afghanistan. Infectious complications have been reported in >25% of those evacuated for trauma, and 50% of such patients were treated in the intensive care unit (ICU). Osteomyelitis has been reported in 9% (14% of intensive care unit patients), and deep-wound infection in 27% of type III open-tibia fractures. Infections complicating extremity trauma are frequently caused by multidrug-resistant bacteria and have been demonstrated to lead to failure of limb salvage, unplanned operative take-backs, late amputations, and decreased likelihood of returning to duty...
October 2016: Journal of Orthopaedic Trauma
Hyun Ho Han, Byung Yeun Kwon, Sung No Jung, Suk-Ho Moon
Occupational injuries to digits due to hydrofluoric acid (HFA) are frequently encountered. They have distinctive features, including intense pain, progressive tissue necrosis, and possible bone erosion. To minimize tissue damage, it is of great importance to execute prudent preoperative assessment and determine the correct surgical modality to reconstruct and maintain the function of the hand. However, proper protocols for fingers have not been presented in previous studies. Eight cases with HFA burn to digits were presented to the emergency room...
September 17, 2016: Burns: Journal of the International Society for Burn Injuries
Yutaro Yamashita, Hiroaki Nagae, Ichiro Hashimoto
Pilonidal sinus is a cystic disease that occurs most often in the sacrococcygeal region. Surgical excision and coverage with a skin flap require postoperative bed rest. Most affected patients are young adults who find it difficult to obtain adequate postoperative bed rest owing to their work. The purpose of this study is to review the effectiveness of our ambulatory surgery procedure for pilonidal sinus, which involves tract excision and open treatment followed by at-home irrigation. We reviewed the 9 cases of chronic pilonidal sinus treated at our out-patient clinic by ambulatory surgery consisting of open excision without skin closure...
2016: Journal of Medical Investigation: JMI
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