scholarly journals A rare and uncommon complication after use of hydrogen peroxide (H2O2): A review of use of H2O2 in orthopaedics

2020 ◽  
Vol 27 (2) ◽  
pp. 247-251
Author(s):  
Michael Matthew Chan ◽  
Tao Sun Tycus Tse ◽  
Yik-Cheung Samuel Wan ◽  
Yuk Wah Hung ◽  
Jason CH Fan

Hydrogen peroxide (H2O2) is a commonly used chemical agent in orthopaedic practice for antisepsis, haemostasis and preparation of bone bed for cementation. However, the associated risks of H2O2 usage are not widely known. We report a case of suspected air embolism after use of H2O2 during drainage of a septic arthritis of the shoulder. Upon our literature review, we were able to demonstrate H2O2 to be beneficial in antisepsis and care of chronic wounds. However, it has not been proven to be superior to other antiseptics commonly used in orthopaedic surgery. Regarding its use in cementation, there is evidence to show it is more effective than saline however, the use of pulsatile lavage appears to be the most important factor affecting the quality of cementation. H2O2 has not been shown to be helpful with haemostasis. Prior to the use of H2O2, one should be cautious and understand its associated risks and precautions.

2017 ◽  
Vol 2 (1) ◽  
pp. 3-9 ◽  
Author(s):  
Min Lu ◽  
Erik Nathan Hansen

Abstract. As the burden of deep hardware infections continues to rise in orthopaedics, there is increasing interest in strategies for more effective debridement of colonized tissues and biofilm. Hydrogen peroxide has been used medically for almost a century, but its applications in orthopaedic surgery have yet to be fully determined. The basic science and clinical research on the antiseptic efficacy of hydrogen peroxide have demonstrated its efficacy against bacteria, and it has demonstrated potential synergy with other irrigation solutions such as chlorhexidine and povidone-iodine. While hydrogen peroxide is effective in infection reduction, there are concerns with wound healing, cytotoxicity, and embolic phenomena, and we recommend against hydrogen peroxide usage in the treatment of partial knee replacements, hemiarthroplasties, or native joints. Additionally, due to the potential for oxygen gas formation, hydrogen peroxide should not be used in cases of dural compromise, when pressurizing medullary canals, or when irrigating smaller closed spaces to avoid the possibility of air embolism. Finally, we present our protocol for irrigation and debridement and exchange of modular components in total joint arthroplasty, incorporating hydrogen peroxide in combination with povidone-iodine and chlorhexidine.


2021 ◽  
Vol 11 (3) ◽  
pp. 291-295
Author(s):  
Mikhail S. Izyumov ◽  
Viktor V. Bulynin ◽  
Evgeniy S. Ovsyannikov ◽  
Andrey M. Bobrovskikh ◽  
Anastasia V. Medvedeva ◽  
...  

The aim of our research was to compare the nature and severity of the inflammatory process in the lungs, in the leaves of the visceral and parietal pleura, and in the adjacent subpleural tissues of the chest wall in experimental animals after pleurodesis with solutions of 3% and 6% hydrogen peroxide, and talc. Methods and Results: The experiment was carried out on 200 Wistar rats, weighing 160-180 grams, 10 specimens in a subgroup, depending on the time of the experiment, i.e. 50 specimens in each study group, including the control group. The main criterion by which we determined the comparative characteristics of the effectiveness of talc and 3% and 6% solutions of hydrogen peroxide as preparations used for chemical pleurodesis in the rats was a morphological characteristic of inflammation. This criterion was confirmed by counting free cell populations in lung tissue (lymphocytes, macrophages, neutrophils, histiocytes). All comparison groups were characterized by a gradual increase in the number of lymphocytes, macrophages and histiocytes, ranging from minimum to maximum values, and by a gradual decrease in the number of neutrophils, starting with max and ending with minimum values. The number of lymphocytes, macrophages and histiocytes were increasing faster. But at the same time, for the most part, their number was lower after pleurodesis with 6% hydrogen peroxide. The minimum number of neutrophils and the fastest possible reduction in all cases was observed in pleurodesis with 6% hydrogen peroxide. Conclusion: Pleurodesis with a 6% solution of hydrogen peroxide as a chemical agent significantly affects the quality of the inflammatory response, reducing its duration and severity in the organs and tissues of the rats’ chests, compared with a solution of 3% hydrogen peroxide and talc.


2013 ◽  
Vol 20 (3) ◽  
pp. 91-106 ◽  
Author(s):  
Rachel Pizarek ◽  
Valeriy Shafiro ◽  
Patricia McCarthy

Computerized auditory training (CAT) is a convenient, low-cost approach to improving communication of individuals with hearing loss or other communicative disorders. A number of CAT programs are being marketed to patients and audiologists. The present literature review is an examination of evidence for the effectiveness of CAT in improving speech perception in adults with hearing impairments. Six current CAT programs, used in 9 published studies, were reviewed. In all 9 studies, some benefit of CAT for speech perception was demonstrated. Although these results are encouraging, the overall quality of available evidence remains low, and many programs currently on the market have not yet been evaluated. Thus, caution is needed when selecting CAT programs for specific patients. It is hoped that future researchers will (a) examine a greater number of CAT programs using more rigorous experimental designs, (b) determine which program features and training regimens are most effective, and (c) indicate which patients may benefit from CAT the most.


2013 ◽  
Vol 1 (1) ◽  
pp. 100
Author(s):  
Selçuk Yurtsever

It has been known that both in the world and in Turkey a continuous change has been experienced in the provision of health services in recent years. In this sense by adopting the customer(client) focused approach of either public or private sector hospitals; it has been seen that they are in the struggle for presenting a right, fast, trustuble, comfy service. The purpose of this research is to measure the satisfaction degree, expectations and perceptions of the patients in Karabük State Hospital through comparison. In this context, the patient satisfaction scale which has been developed as a result of literature review has been used and by this scale it has been tried to measure the satisfaction levels of the patients in terms of material and human factors which are the two main factors of the service that was presented. In the study, with the scales of Servqual and 0-100 Points together, in the part of the analysis MANOVA have been used. The expectations and the perceptions of the patient has been compared first by generally and then by separating to different groups according to the various criterias and in thisway it has been tried to be measured their satisfaction levels. According to the results that were obtained, although, the satisfaction levels of the patients who have taken service from Karabük State Hospital are high in terms of thedoctors and the nurses; it has been reached to the result that their satisfaction levels are low in terms of the materials that have been used at the presenting of the service and the management.


2018 ◽  
Vol 4 (2) ◽  
pp. 59-68
Author(s):  
I. Yanishen ◽  
◽  
A. Iarova ◽  
O. Berezhnaia ◽  
A. Dolia ◽  
...  

Author(s):  
Mariek Vanden Abeele

Recent empirical work suggests that phubbing, a term used to describe the practice of snubbing someone with a phone during a face-to-face social interaction, harms the quality of social relationships. Based on a comprehensive literature review, this chapter presents a framework that integrates three concurrent mechanisms that explain the relational impact of phubbing: expectancy violations, ostracism, and attentional conflict. Based on this framework, theoretically grounded propositions are formulated that may serve as guidelines for future research on these mechanisms, the conditions under which they operate, and a number of potential issues that need to be considered to further validate and extend the framework.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1337.2-1337
Author(s):  
T. W. Swinnen ◽  
M. Willems ◽  
I. Jonkers ◽  
F. P. Luyten ◽  
J. Vanrenterghem ◽  
...  

Background:The personal and societal burden of knee osteoarthritis (KOA) urges the research community to identify factors that predict its onset and progression. A mechanistic understanding of disease is currently lacking but needed to develop targeted interventions. Traditionally, risk factors for KOA are termed ‘local’ to the joint or ‘systemic’ referring to whole-body systems. There are however clear indications in the scientific literature that contextual factors such as socioeconomic position merit further scientific scrutiny, in order to justify a more biopsychosocial view on risk factors in KOA.Objectives:The aims of this systematic literature review were to assess the inclusion of socioeconomic factors in KOA research and to identify the impact of socioeconomic factors on pain and function in KOA.Methods:Major bibliographic databases, namely Medline, Embase, CINAHL, Web of Science and Cochrane, were independently screened by two reviewers (plus one to resolve conflicts) to identify research articles dealing with socioeconomic factors in the KOA population without arthroplasty. Included studies had to quantify the relationship between socioeconomic factors and pain or function. Main exclusion criteria were: a qualitative design, subject age below 16 years and articles not written in English or Dutch. Methodological quality was assessed via the Cochrane risk of bias tools for randomized (ROB-II) and non-randomized intervention studies (ROBIN-I) and the Newcastle-Ottawa Scale for assessing the quality of non-randomised studies. Due to heterogeneity of studies with respect to outcomes assessed and analyses performed, no meta-analysis was performed.Results:Following de-duplication, 7639 articles were available for screening (120 conflicts resolved without a third reader). In 4112 articles, the KOA population was confirmed. 1906 (25%) were excluded because of knee arthroplasty and 1621 (21%) because of other issues related to the population definition. Socioeconomic factors could not be identified in 4058 (53%) papers and were adjusted for in 211 (3%) articles. In the remaining papers covering pain (n=110) and/or function (n=81), education (62%) and race (37%) were most frequently assessed as socioeconomic factors. A huge variety of mainly dichotomous or ordinal socioeconomic outcomes was found without further methodological justification nor sensitivity analysis to unravel the impact of selected categories. Although the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was the most popular instrument to assess pain and function, data pooling was not possible as socioeconomic factors estimates were part of multilevel models in most studies. Overall results showed that lower education and African American race were consistent predictors of pain and poor function, but those effects diminished or disappeared when psychological aspects (e.g. discrimination) or poverty estimates were taken into account. When function was assessed using self-reported outcomes, the impact of socioeconomic factors was more clear versus performance-based instruments. Quality of research was low to moderate and the moderating or mediating impact of socioeconomic factors on intervention effects in KOA is understudied.Conclusion:Research on contextual socioeconomic factors in KOA is insufficiently addressed and their assessment is highly variable methodologically. Following this systematic literature review, we can highlight the importance of implementing a standardised and feasible set of socioeconomic outcomes in KOA trials1, as well as the importance of public availability of research databases including these factors. Future research should prioritise the underlying mechanisms in the effect of especially education and race on pain and function and assess its impact on intervention effects to fuel novel (non-)pharmacological approaches in KOA.References:[1]Smith TO et al. The OMERACT-OARSI Core Domain Set for Measurement in Clinical Trials of Hip and/or Knee Osteoarthritis J Rheumatol 2019. 46:981–9.Disclosure of Interests:None declared.


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