scholarly journals Evaluating Effectiveness of Medical Grade Honey-Containing Alginate Dressing in Patients with Chronic Lower Extremity Wounds

2021 ◽  
Vol 17 (3) ◽  
pp. 178-186
Author(s):  
Yeon Ji Lee ◽  
Kyeong Soo Park ◽  
Dong Yeon Kim ◽  
Hyung-Sup Shim
Keyword(s):  
Lower Extremity ◽  
Wound Closure ◽  
Chronic Wounds ◽  
Resistant Bacteria ◽  
Wound Area ◽  
Beneficial Effects ◽  
Number Of Patients ◽  
Group A ◽  
Group B ◽  
Time Required

Background: Chronic wounds of the lower extremities are challenging to treat. Recently, honey-based dressings have been shown beneficial effects in diabetic foot ulcers and venous ulcers. Here, we compared Medihoney alginate with a standard alginate dressing in lower extremity chronic wounds.Methods: We performed retrospective chart reviews of 37 patients between January 2019 and January 2021 with chronic lower extremity wounds who were treated with an Algisite M dressing (group A) or a Medihoney alginate dressing (group B). Microorganisms isolated from wound cultures, weekly decrease in wound area over 4 weeks, the number of patients who achieved complete wound closure, and the amount of time required for wound closure were compared between the two groups. Results: Sixteen patients were assigned to group A and 21 to group B. The isolated microorganisms were confirmed as methicillin-susceptible Staphylococcus aureus most commonly, followed by methicillin-resistant S. aureus. Wound area decreased from 12.71 to 2.34 cm<sup>2</sup> in group A and from 14.07 to 1.71 cm<sup>2</sup> in group B (P<0.05). Seven patients achieved complete wound closure in group A (43.75%) and 15 patients in group B (71.43%). Mean duration of wound closure was 36.31 days in group A and 34.62 days in group B.Conclusion: Considering the more rapid decrease in wound area in group B, application of a honey-containing alginate dressing to lower extremity chronic wounds, especially those infected with antibiotic-resistant bacteria, was proved to be a good treatment option.

The Use of a Novel Super-Oxidized Solution on Top of Standard Treatment in the Home Care Management of Postsurgical Lesions of the Diabetic Foot Reduces Reinfections and Shortens Healing Time

2018 ◽  
Vol 17 (4) ◽  
pp. 268-274
Author(s):  
Elisabetta Iacopi ◽  
Lorenza Abbruzzese ◽  
Chiara Goretti ◽  
Nicola Riitano ◽  
Alberto Piaggesi
Keyword(s):  
Diabetic Foot ◽  
Chronic Wounds ◽  
Standard Of Care ◽  
Healing Time ◽  
Complete Healing ◽  
Group A ◽  
Reduced Rate ◽  
Group B ◽  
Time Required

There are still many unmet needs in the treatment of chronic wounds, especially regarding microenvironment modulation. Nexodyn is a novel super-oxidized solution capable of contrast bacterial proliferation. We aimed to evaluate if this solution, on top of standard of care, was safe and effective in improving diabetic foot outcome. We selected 50 patients admitted in our department to be submitted to surgery for acute diabetic foot infection. All patients were left open to heal for secondary intent. We divided patients into 2 groups: Group A (n = 25, male/female = 17/8, age = 67.3 ± 12.1 years, hemoglobin A1C = 7.9 ± 1.1%), patients treated with standard of care and, on top of this, Nexodyn solution, and Group B, treated only with standard of care. After discharge, patients continued Nexodyn application. We followed up patients until complete healing or up to 6 months. No differences between groups in healing rate, while time required for complete healing was significantly shorter in Group A (64.9 ± 12.1 days vs 147.4 ± 23.1 days, P < .01). During follow-up, the group treated with Nexodyn showed a reduced rate of reinfections (12 patients in Group B vs 3 patients in Group A, P < .05) and of further debridement procedures (1 patient in Group A vs 10 patients in Group B, P < .05). Nexodyn provided effective protection against reinfections in diabetic foot patients, thus reducing the necessity for debridement procedures and their healing time and presents a safety profile similar to saline solution.

Effect of Vial shaking on Loading Time of Epirubicin into Drug-Eluting Bead

2015 ◽  
Vol 5 (3) ◽  
Author(s):  
Kenji Ikeda ◽  
Yusuke Kawamura ◽  
Masahiro Kobayashi ◽  
Taito Fukushima ◽  
Yushi Sorin ◽  
...  
Keyword(s):  
Antitumor Agent ◽  
Loading Rates ◽  
Vortex Mixer ◽  
Long Time ◽  
Group A ◽  
Drug Eluting ◽  
Large Hepatocellular Carcinoma ◽  
Group B ◽  
Time Required ◽  
Short Time

Background: Although DC Bead has been useful in treatment of multiple and large hepatocellular carcinoma, loading time of doxorubicin into the DC Bead takes a long time of 30-120 minutes. Epirubicin is also used as an antitumor agent together with DC Bead, but its loading efficiency was not sufficiently elucidated. Methods: To shorten loading time of epirubicin into DC Bead (100-300µm, 300-500µm, 500-700µm), we examined the following three methods after mixing the drug: (a) let stand in room temperature, (b) agitated for 30 seconds with Vortex mixer, and (c) sonicated for 30 seconds with ultrasonic cleaner. After loading of epirubicin by each method, supernatant concentration for epirubicin was assayed at 5, 10, 30, 60, and 120 minutes. Results: Epirubicin loading rates for small bead (100-300µm) at 5 minutes were 82.9 % in group a, 93.8% in group b, and 79.9 % in group c. Similarly, medium bead (300-500µm), 40.1% in group a, 65.7% in group b and 45.5% in group c, respectively. In large-sized bead (500-700µm), loaded rates of epirubicin were 38.8% in group a, 59.0% in group b and 48.0% in group c. Agitation of mixture of epirubicin and DC Bead with Vortex mixer significantly shortened the loading time, but sonication did not affect the time required. Microscopic examination did not lead to any morphological change of microspheres in all the methods. Conclusions: Short time of agitation with Vortex mixer reduced the necessary time for loading of epirubicin in every standard of DC Bead.

CLINICAL OUTCOME AND COST COMPARISON OF CARPAL TUNNEL WOUND CLOSURE WITH MONOCRYL® AND ETHILON®: A PROSPECTIVE STUDY

Hand Surgery ◽  
2013 ◽  
Vol 18 (02) ◽  
pp. 189-192 ◽  
Author(s):  
Anis Dosani ◽  
Sameer K. Khan ◽  
Sheila Gray ◽  
Steve Joseph ◽  
Ian A. Whittaker
Keyword(s):  
Carpal Tunnel ◽  
Wound Closure ◽  
Unit Cost ◽  
Cost Effective ◽  
Cost Comparison ◽  
Absorbable Suture ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
A Prospective Study

This prospective non-randomised two-cohort study compares the use of an absorbable suture (Poliglecrapone [Monocryl]: Group A) and a non-absorbable suture (Polyamide [Ethilon]: Group B) in wound closure after elective carpal tunnel decompression. The primary outcome was scar cosmesis as assessed by the Stonybrook Scar Evaluation Scale (SBSES); the financial cost of wound closure was compared as a secondary outocome. All fifty patients completed follow-up. At six weeks, there was no significant difference in the two groups regarding scar tenderness (p = 0.5), although residual swelling was more evident in the absorbable group (p = 0.2). The mean SBSES score at six weeks was 4.72 in Group A, and 4.8 in Group B (p = 0.3). The unit cost per closed wound of Monocryl was three times than Ethilon (p < 0.05). Ethilon is thus cost-effective without compromising the cosmetic outcome, and we recommend using this as the preferred suture for closure of carpal tunnel wounds.

scholarly journals Comparison between scalpel incision and electrocautery incision in midline abdominal surgery: a comparative study

2021 ◽  
Vol 8 (5) ◽  
pp. 1507
Author(s):  
Amit Yadav ◽  
Lakshman Agarwal ◽  
Sumit A. Jain ◽  
Sanjay Kumawat ◽  
Sandeep Sharma
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Abdominal Surgery ◽  
Wound Infection ◽  
Skin Incision ◽  
P Value ◽  
Wound Area ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Fear of poor wound healing have curtailed the use of diathermy for making skin incision. Scalpel produces little damage to surrounding tissue but causing more blood loss. Our aim of study was to compare electrocautery incision with scalpel incision in terms of incision time, blood loss, postoperative pain and wound infection.Methods: Total of 104 patients were included in the study undergoing midline abdominal surgery. Patients were randomized into electrocautery (group A) and scalpel (group B). The incision dimension, incision time and blood loss were noted intraoperatively. Postoperative pain was noted on postoperative day 2 using visual analog scale. Wound complications were recorded on every postoperative day till the patient was discharged.Results: 52 patients in each of the two groups were analyzed. There was significant difference found between group A and group B in terms of mean incision time per unit wound area, 8.16±1.59 s\cm2 and 11.02±1.72 s\cm2 respectively (p value=0.0001). The mean blood loss per unit wound area was found to be significantly lower in group A (0.31±0.04 ml\cm2) as compared to group B (1.21±0.21), p value=0.0001. There was no significant difference noted in terms of postoperative pain and wound infection between both groups.Conclusions: Electrocautery can be considered safe in making skin incision in midline laparotomy compared to scalpel incision with comparable postoperative pain and wound infection with less intraoperative blood loss and less time consuming.

scholarly journals INTRAVENOUS REGIONAL ANESTHESIA (BIERS BLOCK);

2012 ◽  
Vol 19 (05) ◽  
pp. 710-714
Author(s):  
Muhammad ASGHER ◽  
ASIM GHAURI ◽  
MUHAMMAD ABDULLAH ◽  
Tariq Abassi
Keyword(s):  
Regional Anaesthesia ◽  
Military Hospital ◽  
P Value ◽  
Complete Evaluation ◽  
Intravenous Regional Anesthesia ◽  
Number Of Patients ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Intravenous Regional Anaesthesia

Objective: To compare the analgesic effects of combination of 0.5% Lidocaine plus Ketorolac in intravenous regionalanaesthesia technique with those of Lidocaine (0.5%) alone to prevent post operative pain after intravenous regional anaesthesia (Biersblock). Study design: Randomized Control Trial. Place and duration of study: The study was carried out at Department of Anaesthesiology,Intensive Care and pain management, Combined Military hospital, Rawalpindi from July 2008 to February 2009. Patients and Methods: Thestudy was conducted after complete evaluation of risk / benefit ratio to the patients. On the basis of random number method the patients weredivided into two equal groups (group A and group B). The number of patients in each group was 75. Group A was assigned Lidocaine in a dose of200mg 40ml of 0.5% solution and group B was assigned injection Ketorolac 30mg added to Lidocaine in a dose of 200mg 40ml of 0.5% solution.The patients were kept in post anaesthesia care unit for two hours and pain intensity was measured by visual analogue scale(VAS) on 15,30minutes,1hour, 1.5 and at 2 hours after the cuff deflation. The analgesic efficacy recorded on the basis of visual analog scale of two groups, wascompared using student’s t - test. p value of less than 0.05 was considered statistically significant. Results: In group A 33 males and 42 femaleswere enrolled for the study while in group B there were 38 males and 37 females. The mean age of the patients in group A was 34.31 ± 6.03years while in group B was 32.99 ± 6.08 years. Patients were also classified according to ASA classification in which 87 patients were classifiedas ASA – I and 63 patients as ASA – II. Group B which received Ketorolac in addition to Lidocaine for Bier’s block had low visual analogue scoresas compared to group A which received only Lidocaine for Bier’s block. P values obtained after the comparison of the mean VAS of two groupsat 15 minutes, 30 minutes, 1 hour, 1.5 hours and 2 hours were all less than 0.05 (0.002 for 15 minutes, 0.004 for 30 minutes, 0.001 for 1 hour,0.004 for 1.5 hours and 0.001 for 2 hours). Conclusions: Ketorolac improves the postoperative analgesia markedly when used with Lidocainein intravenous regional anaesthesia.

Energy-Based Devices Affect the Aesthetic Outcome of Cervical Thyroidectomy and Parathyroidectomy. A Retrospective Study

2021 ◽  
Vol 39 ◽  
Author(s):  
Antonella Pino ◽  
◽  
Lorenzo Gasco ◽  
Daqi Zhang ◽  
Paolo Carcoforo ◽  
...  
Keyword(s):  
Body Dysmorphic Disorder ◽  
The Body ◽  
University Hospital ◽  
Aesthetic Outcome ◽  
Aesthetic Result ◽  
Scar Assessment ◽  
Number Of Patients ◽  
Group A ◽  
Group B ◽  
The Impact

Introduction: Thyroid and parathyroid diseases are very common. Most of these cases are in women and may be amenable to surgery. The patient’s perception that these are not life-threatening diseases leads them to expect an excellent aesthetic result, since the surgical incision area is clearly visible. Objective: To evaluate different scarring outcomes using three different energy-based devices (Harmonic Focus®, Johnson & Johnson, New Brunswick, NJ; Thunderbeat Open Fine Jaw®, Olympus Medical, Tokyo, Japan; LigaSure Small Jaw®, Medtronic, Dublin, Ireland) and to determine the impact of post-thyroidectomy/parathyroidectomy scars on the patient’s quality of life. Methods: One hundred female patients who underwent thyroidectomy or parathyroidectomy between September 2017 and September 2019 at the Endocrine and Minimally Invasive Surgery Department of Messina University Hospital were recruited. A retrospective analysis assessed the thickness of the cervical scar via ultrasound imaging, and the patient’s degree of satisfaction through the Patient and Observer Scar Assessment Scale (POSAS) and the Body Dysmorphic Disorder Questionnaire (BDDQ). Results: The patients were divided into three groups according to the energy-device used: group A (LigaSure SJ (n=38), group B (Harmonic F, n=32) and group C (Thunderbeat OFJ, n=30). The three groups were homogeneous with respect to number of patients, age and surgical procedures. The best aesthetic result, which correlated with the lowest scar thickness, was observed in group A; these patients were more satisfied than those in the other two groups. Moreover, correlations between scar thickness and quantitative variables (such as age or BMI) were not found in any of the groups. Conclusions: Based on the data collected and our experience, the LigaSure Small Jaw® (Medtronic) seems to offer the best aesthetic outcome in patients who undergo transverse cervicotomy for thyroid and parathyroid diseases. However, further prospective studies involving a greater number of cases are needed.

scholarly journals A comparative study between dexmedetomidine and dexamethasone as an intrathecal adjuvant for prevention of perioperative shivering in cesarean section

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Mohamed Abdul Mohsen Abdul Naiem Ismaiel ◽  
Omar Mohamed Taha El Safty ◽  
Ashraf El Sayed El-Agamy ◽  
Omar Mohamed Zafer Mohamed ◽  
Mohamed Mourad Mohsen Mohamed Ali
Keyword(s):  
Cesarean Section ◽  
Statistical Difference ◽  
Sensory Block ◽  
List Type ◽  
Hyperbaric Bupivacaine ◽  
Analgesic Requirement ◽  
Number Of Patients ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

Abstract Background One of the most common problems in parturients receiving regional anesthesia during cesarean section is shivering. It usually interferes with the readings of the oxygen plethysmography (SpO2) and electrocardiogram (ECG). It expands the needs for oxygen and increases creation of carbon dioxide about four folds. The aim of this work is to compare the efficacy of dexamethasone and dexmedetomidine in prevention of perioperative shivering when added to hyperbaric bupivacaine intrathecally in cesarean sections (CS) and their effect on the intraoperative hemodynamics, intensity of the block, sedation, and postoperative analgesic requirement. Results Study included 60 obstetric patients who fulfilled all the inclusion criteria and were randomized into 2 equal groups, each consisting of 30 patients, namely group A (dexmedetomidine group) and B (dexamethasone group). Group A patients received 5 μg dexmedetomidine with 12.5 mg hyperbaric bupivacaine 0.5% intrathecally. Group B patients received 8 mg dexamethasone then 12.5 mg hyperbaric bupivacaine 0.5% intrathecally. The comparison included assessment of intra- and postoperative hemodynamics, duration of surgery, assessment of sensory and motor block, assessment for shivering and sedation, and assessment of adverse events. This study showed that there were a small number of patients complaining of shivering (five patients in group A and seven patients in group B) with no statistical difference between both groups in the incidence and intensity of shivering. Time to two segment regression (minutes) was longer in group B compared to group A, and also, time to first analgesic rescue was longer in group B compared to group A. For sedation intensity, there was statistical difference between both groups as all patients in group A were sedated compared to six patients only in group B. There was no statistical difference between both groups as regards incidence of adverse effects. Conclusion We concluded that both drugs can be added safely to bupivacaine, and both dexmedetomidine and dexamethasone decreased the incidence and the intensity of shivering. Dexamethasone was found to prolong the duration of sensory block and delay opioid requirements post-operatively, while dexmedetomidine is more effective in sedating the patients intra- and postoperatively.

Effect of selective beta-blockade with bisoprolol in the treatment of recent-onset atrial fibrillation

Folia Medica ◽  
2012 ◽  
Vol 54 (2) ◽  
pp. 27-31 ◽  
Author(s):  
Maria N. Negreva ◽  
Atanas P. Penev
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Combined Therapy ◽  
Beta Blockade ◽  
Recent Onset ◽  
Number Of Patients ◽  
Group A ◽  
Clinically Significant ◽  
Group B ◽  
Onset Atrial Fibrillation

ABSTRACT The incidence of atrial fibrillation has been rapidly increasing in recent years. The increased tonus of the sympathetic nervous system is related to the development of atrial fibrillation. OBJECTIVE: To study the effect of bisoprolol, a highly selective beta-blocker, on patients with recent-onset atrial fibrillation (< 48 hours) for regularization of the rhythm using propafenone. PATIENTS AND METHODS: The study includes 164 patients (81 women, 83 men, age 59.09 ± 10.81) with successfully restored sinus rhythm in recent-onset atrial fibrillation. The patients received either propafenone (group A, n = 82) or a combination of propafenone and bisoprolol (group B, n = 82). The studied patients were randomly allocated to the groups. Propafenone was administered intravenously as a 2 mg/kg bolus followed by infusion of 0.0078 mg/kg/min for 120 min and orally in dosage of 300 mg three times every 8 hours if arrhythmia persisted. Bisoprolol was administered in a single dose at the very beginning of propafenone treatment and only in patients from group B at a dose of 5 or 10 mg. Regularization of the rhythm was assessed at the 3rd, 6th, 12th and 24th hour. RESULTS: In the initial stages of regularization the combined therapy restored the sinus rhythm in a greater number of patients in comparison with the monotherapy (at the 6th hour 67.07% in group B versus 48.78% in group A, P < 0.05; at the 12th hour it was 87.80% versus 75.60%, respectively, P < 0.05). CONCLUSION: Early regularization of rhythm in patients with recent-onset atrial fibrillation reduces the likelihood of recurrent episodes of arrhythmia. This makes the application of selective beta-blockade clinically significant.

scholarly journals Is Local Anesthetic Infiltration Prior to Intravenous Cannulation Beneficial to Patients?

2013 ◽  
Vol 8 (1) ◽  
pp. 10-13
Author(s):  
Babu Raja Shrestha ◽  
U Shrestha ◽  
A Shrestha ◽  
A Rana
Keyword(s):  
Heart Rate ◽  
Local Anesthetic ◽  
Randomized Study ◽  
Cardiovascular Responses ◽  
Control Group ◽  
Venous Cannulation ◽  
Number Of Patients ◽  
Group A ◽  
Group B ◽  
Local Anesthetic Infiltration

Aims: Intravenous cannulation causes pain, anxiety and frustration in patients along with changes in hemodynamic parameters. Infiltration of local anesthetic lessens the pain of intravenous cannulation. This study was performed to compare cardiovascular responses and verbal rating pain scores in two groups with and without local anesthetic infiltration prior to venous cannulation. Methods: This was a randomized study conducted in 100 elective surgical patients, divided into two study groups with 50 patients in each: group A (Control) and group B (local anesthetic infiltration). Prior to venous cannulation in group B, 0.5 ml of 1% lidocaine was infiltrated at the procedure site at dorsum of the wrist. Patients in group A were cannulated directly without local anesthetic infiltration. The hemodynamic changes pre and post cannulation and verbal pain rating scores were recorded by blind observers in all patients. Results: Demographic values in two groups were similar. Increase in heart rate from baseline value was significant in control group (p < 0.05). Post cannulation heart rate, systolic and diastolic blood pressure were significantly higher in group A compared to group B for the first three minutes (p < 0.05). Amongst higher number of patients in group A, verbal rating pain score was significantly higher. Ninety-four percent of the patients in group B were pain free, comfortable and satisfied with the procedure. Conclusions: Intravenous cannulation can be made pain free with patient satisfaction and hemodynamic stability if carried out with prior local anesthetic infiltration. Nepal Journal of Obstetrics and Gynaecology / Vol 8 / No. 1 / Issue 15 / Jan- June, 2013 / 10-13 DOI: http://dx.doi.org/10.3126/njog.v8i1.8853

scholarly journals Inhaled Tobramycin in Children with Acute Bacterial Rhinopharyngitis

2006 ◽  
Vol 19 (1) ◽  
pp. 205873920601900 ◽  
Author(s):  
A. Varricchio ◽  
D. Tricarico ◽  
A. DE Lucia ◽  
R. Utili ◽  
M.-F. Tripodi ◽  
...  
Keyword(s):  
Nasal Obstruction ◽  
Resistant Bacteria ◽  
Double Blind ◽  
Oral Amoxicillin ◽  
Parallel Group ◽  
Blind Children ◽  
Amoxicillin Clavulanate ◽  
Group A ◽  
Adenoidal Hypertrophy ◽  
Group B

Antibiotic abuse for treating rhinopharyngitis induces the occurrence of resistant bacteria. As topical drugs might reduce this phenomenon, the aims of our study were to evaluate inhaled tobramycin in children with acute bacterial rhinopharyngitis and to compare it with oral amoxicillin/clavulanate. The trial was conducted as randomized, parallel group and double blind. Children, aged 3–6 years, with acute bacterial rhinopharyngitis were treated with 15 mg of aerosolized tobramycin (Group A) or 50 mg/Kg of amoxicillin/clavulanate (Group B) twice daily for 10 days. The following parameters were assessed: nasal obstruction, mucopurulent rhinorrhea, post-nasal drip, adenoidal hypertrophy, tympanic inflammation, tympanogramm, rhinomanometry and cultures. Of 416 patients screened, 311 children (178 females and 133 males), median age 4.5 years, completed the study: 156 in Group A and 155 in Group B. Both treatments improved all parameters (p<0.01 for all). Intergroup analysis showed that inhaled tobramycin induced a better improvement versus amoxicillin/clavulanate concerning nasal obstruction (p<0.05), adenoidal hypertrophy (p<0.01), tympanic inflammation (p<0.01), rhinomanometry (p<0.01) and cultures (p<0.05). In conclusion, inhaled tobramycin may represent a valid treatment for acute bacterial rhinopharyngitis in children, as it is effective, safe, economic and simple to use.

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