A Randomized Controlled Trial of Novel Loop Drainage Technique Versus Standard Incision and Drainage in the Treatment of Skin Abscesses

2020 ◽  
Vol 27 (12) ◽  
pp. 1229-1240
Author(s):  
Jay Ladde ◽  
Sara Baker ◽  
Natali Lilburn ◽  
Michelle Wan ◽  
Linda Papa
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Incision And Drainage ◽  
Randomized Controlled ◽  
Drainage Technique

scholarly journals A Randomized Controlled Trial Comparing Packing with Nonpacking of Perianal Abscess Cav

2016 ◽  
Vol 12 (2) ◽  
pp. 111-116
Author(s):  
Md Tanvirul Islam ◽  
Md Mahbubur Rahman ◽  
Nasrin Begum
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Perianal Abscess ◽  
Fistula Formation ◽  
Anorectal Abscess ◽  
Duration Of Symptoms ◽  
Incision And Drainage ◽  
Randomized Controlled ◽  
Residual Cavity

Introduction: Anorectal abscess is a potentially debilitating condition and one of the common anorectal conditions encountered in practice. Anorectal abscesses are defined by the anatomic space in which they develop and are more common in the perianal and ischiorectal spaces. Traditional management of perianal abscess involves early incision, drainage, curettage and packing of the residual cavity. Cavity packing and dressings are problematic in that they cause significant discomfort and require multiple visits to change the packing until healing. An alternative to the traditional approach is to perform adequate incision and drainage and then to allow healing without the use of cavity dressings. Objective: To compare the effects of packing with nonpacking of the perianal abscess cavity on patient discomfort and wound healing and subsidiary evaluation of the clinical outcomes. Materials and Methods: This single centre randomized controlled trial was carried out on 50 patients who were operated upon for perianal abscess in Combined Military Hospital, Dhaka during the period of July 2014 to June 2016. Patients were randomly assigned to receive either packing or nonpacking treatment through allocation by sealed envelope. The packing (control) group was instructed to report to a single nursing staff for subsequent dressing with packing of the residual cavity. The nonpacking group was discharged with a superficial protective dressing; they did not undergo wound dressing but managed their own wounds until follow-up. Outcome measures were time of healing, abscess recurrence, fistula formation and post operative pain. Results: A total of 54 patients were enrolled (4 lost in follow-up): 24 in the packing and 26 in the nonpacking arm. The two groups were comparable in terms of age and gender distribution, type, size of the abscess, duration of symptoms and length of follow-up. Healing in the non-packing group was faster compared to that of the packing group: mean 24.08 days versus 34.13 days (P=0.000). The rate of abscess recurrence was similar (P=0.664). Post operative fistula rates were similar (P=0.623). Pain scores appeared less in the nonpacking arm and statistically significant (7.25 vs. 4.24, P=0.000). Conclusion: Small size of the study population was the limitation of this study. In order to obtain a higher level of evidence, an adequately powered multicentre based prospective randomized controlled trial is required to definitely address the question of packing of the cavity and its beneficial outcome following incision and drainage in the management of perianal abscess. Journal of Armed Forces Medical College Bangladesh Vol.12(2) 2016: 111-116

Treatment Fidelity Procedures for an Aphasia Intervention Within a Randomized Controlled Trial: Design, Feasibility, and Results

2020 ◽  
Vol 29 (1S) ◽  
pp. 412-424
Author(s):  
Elissa L. Conlon ◽  
Emily J. Braun ◽  
Edna M. Babbitt ◽  
Leora R. Cherney
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Treatment Protocol ◽  
Treatment Fidelity ◽  
Protocol Adherence ◽  
Study Condition ◽  
Randomized Controlled ◽  
Aphasia Therapy ◽  
Percent Accuracy ◽  
Over Time

Purpose This study reports on the treatment fidelity procedures implemented during a 5-year randomized controlled trial comparing intensive and distributed comprehensive aphasia therapy. Specifically, the results of 1 treatment, verb network strengthening treatment (VNeST), are examined. Method Eight participants were recruited for each of 7 consecutive cohorts for a total of 56 participants. Participants completed 60 hr of aphasia therapy, including 15 hr of VNeST. Two experienced speech-language pathologists delivered the treatment. To promote treatment fidelity, the study team developed a detailed manual of procedures and fidelity checklists, completed role plays to standardize treatment administration, and video-recorded all treatment sessions for review. To assess protocol adherence during treatment delivery, trained research assistants not involved in the treatment reviewed video recordings of a subset of randomly selected VNeST treatment sessions and completed the fidelity checklists. This process was completed for 32 participants representing 2 early cohorts and 2 later cohorts, which allowed for measurement of protocol adherence over time. Percent accuracy of protocol adherence was calculated across clinicians, cohorts, and study condition (intensive vs. distributed therapy). Results The fidelity procedures were sufficient to promote and verify a high level of adherence to the treatment protocol across clinicians, cohorts, and study condition. Conclusion Treatment fidelity strategies and monitoring are feasible when incorporated into the study design. Treatment fidelity monitoring should be completed at regular intervals during the course of a study to ensure that high levels of protocol adherence are maintained over time and across conditions.

Phonomotor Versus Semantic Feature Analysis Treatment for Anomia in 58 Persons With Aphasia: A Randomized Controlled Trial

2019 ◽  
Vol 62 (12) ◽  
pp. 4464-4482 ◽  
Author(s):  
Diane L. Kendall ◽  
Megan Oelke Moldestad ◽  
Wesley Allen ◽  
Janaki Torrence ◽  
Stephen E. Nadeau
Keyword(s):  
Randomized Controlled Trial ◽  
Response Latency ◽  
Controlled Trial ◽  
Semantic Knowledge ◽  
Semantic Feature ◽  
Feature Analysis ◽  
Group Differences ◽  
Randomized Controlled ◽  
Confrontation Naming ◽  
Semantic Feature Analysis

Purpose The ultimate goal of anomia treatment should be to achieve gains in exemplars trained in the therapy session, as well as generalization to untrained exemplars and contexts. The purpose of this study was to test the efficacy of phonomotor treatment, a treatment focusing on enhancement of phonological sequence knowledge, against semantic feature analysis (SFA), a lexical-semantic therapy that focuses on enhancement of semantic knowledge and is well known and commonly used to treat anomia in aphasia. Method In a between-groups randomized controlled trial, 58 persons with aphasia characterized by anomia and phonological dysfunction were randomized to receive 56–60 hr of intensively delivered treatment over 6 weeks with testing pretreatment, posttreatment, and 3 months posttreatment termination. Results There was no significant between-groups difference on the primary outcome measure (untrained nouns phonologically and semantically unrelated to each treatment) at 3 months posttreatment. Significant within-group immediately posttreatment acquisition effects for confrontation naming and response latency were observed for both groups. Treatment-specific generalization effects for confrontation naming were observed for both groups immediately and 3 months posttreatment; a significant decrease in response latency was observed at both time points for the SFA group only. Finally, significant within-group differences on the Comprehensive Aphasia Test–Disability Questionnaire ( Swinburn, Porter, & Howard, 2004 ) were observed both immediately and 3 months posttreatment for the SFA group, and significant within-group differences on the Functional Outcome Questionnaire ( Glueckauf et al., 2003 ) were found for both treatment groups 3 months posttreatment. Discussion Our results are consistent with those of prior studies that have shown that SFA treatment and phonomotor treatment generalize to untrained words that share features (semantic or phonological sequence, respectively) with the training set. However, they show that there is no significant generalization to untrained words that do not share semantic features or phonological sequence features.

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