scholarly journals A comparative study between fistulotomy and fistulectomy in management of low anal fistulae

2017 ◽  
Vol 4 (11) ◽  
pp. 3665 ◽  
Author(s):  
Ganesan R. ◽  
Karunakaran K. ◽  
Heber Anandan
Keyword(s):  
Wound Healing ◽  
Operating Time ◽  
Healing Time ◽  
Human Beings ◽  
Fistula In Ano ◽  
Post Surgery ◽  
Group I ◽  
Hospital Stays ◽  
Group Ii ◽  
Wound Healing Time

Background: Fistula in ano is a silent menace in human beings, the treatment is a challenging one even for experienced surgeons, fistula in ano forms a good majority of treatable benign lesions of rectum and anal canal. Aim was to study the efficacy of fistulotomy and fistulectomy in the treatment of low anal fistulae.Methods: A randomized control study was conducted to compare fistulotomy with fistulectomy in patients with low anal fistulae.Results: The operating time in fistulotomy group was 12.13minutes±2.11minutes and in fistulectomy group was 22.23±3.36minutes. The post-surgery hospital stays in Group I was 1.80±0.66days and in Group II was 2.60±0.563 days. The wound healing time in Group I was 24.20±2.95 days which was considerably less when compared to patients in Group II where it was 31.50±4.34 days.Conclusions: Fistulotomy has a slight edge over fistulectomy in the treatment of low anal fistulas since it has shorter operating time, less post-operative pain, less complications, quicker wound healing time, less incontinence and a comparable recurrence rate.

scholarly journals The results of experimental-clinical study of healing of burn wounds and prevention of their complications under the influence of nano-containing biodegradable polymer technologies

2020 ◽  
Vol 19 (1) ◽  
pp. 32-36
Author(s):  
O. Ya. Popadyuk ◽  
E. O. Kindrativ ◽  
K. O. Kirshak ◽  
A. M. Yavorsky
Keyword(s):  
Wound Healing ◽  
Polymer Film ◽  
Biodegradable Polymer ◽  
Initial Treatment ◽  
Secondary Infection ◽  
Animal Experiments ◽  
Healing Time ◽  
Burn Wounds ◽  
Group I ◽  
Wound Healing Time

Burns cause high rates of morbidity and mortality worldwide. Improper initial treatment or delayed initial treatment can have adverse consequences for further wound healing. Goal. To study the effect of biodegradable polymer films «biodep-nano» on the healing of burns of the skin and prevention of complications. The aim of the study was to investigate the effect of our developed biodegradable polymer film «biodep-nano», which is additionally saturated with hydrated fullerene C60 on the healing of severe suppurative burns in animal experiments and the effectiveness of this film in the prevention of secondary infection in patients with mild burns. Material and methods. Simulation of skin burns was performed on 50 adult white Wistar rats weighing an average of 300.0 g, St.Aureus was injected under the scab, after 3 days the scab was removed surgically and the wound was cleaned with a biodep-nano film, the material was replaced every 2 days. with planimetric, microbiological and pathomorphological examination on the 3rd, 7th, 14th and 21st day. In the conditions of the burn department of Ivano-Frankivsk OKL, the biodegradable polymer film “biodep nano” introduced into production was used to prevent secondary infection of burn wounds. Results. When using the film developed by us, the area decreased by 21.6 % on the 3rd day, by 44.5 % on the 7th day, by 67.8 % on the 14th day. By 21 days there was a complete closure of the wound defect. The results of the microbiological study indicate that the level of contamination of burn wounds after application of the studied film of zinc nanooxide decreased during treatment and on the 3rd day to (4.3±3.3)*105 CFU/ml, which is the level of bacteria that is not pathogenic. After the 14th day, the pathogen was not sown and the wounds healed well. The obtained data showed that in group I where the film was used, the secondary infection was 11 % lower, which in turn showed a shorter wound healing time, which was 2 days less than in group II. Conclusions. The biodegradable material developed by us reliably protects burn wounds from accidental infection, is safetyless, elastic, and in experimental research demonstrated high medical properties in relation to the purulent burn wounds of IIIb century.

PENGGUNAAN SELAPUT AMNION SEGAR PADA INSISI LUKA OPERASI SEKSIO SESAREA

2019 ◽  
Vol 1 (2) ◽  
pp. 47-55
Author(s):  
Syahredi Syaiful Adnani ◽  
Hafni Bachtiar
Keyword(s):  
Wound Healing ◽  
Caesarean Section ◽  
Amniotic Membrane ◽  
Healing Time ◽  
Cost Of Care ◽  
Control Group ◽  
P Value ◽  
Control Groups ◽  
And Control ◽  
Wound Healing Time

In the last few decades, the incidence of caesarean section is increasing in the world, especially in Indonesia. One of the way to treat tissue scar is through biologic and synthetic dressing where nowadays, amnion has been used as biologic dressing frequently. This study was conducted to determine the effect of the use of fresh amniotic membrane on wound incision Caesarean section compared with Caesarean section incision wound covered using regular gauze bandages and fixated with plaster in RS. Dr. Reksodiwiryo Padang. The design of this study is an experimen-tal study with Post test design with control group design. Sampling was done using a formula consecutive sampling two different test samples obtained an average of 72 people for each group. The analysis used include univariate and bivariate analyzes. The average wound healing time the difference was statistically significant (p value <0.05) in the treatment and control groups. There was highly significant difference in the proportion of local infection on day 3 between the treatment and control groups (p value <0.05). There were very significant differences in the proportion of local allergic reactions at day 3, and 5 between the treatment and control group (p <0.05). There are significant differences in terms of the cost of care per day between treatment and control groups (p <0.05). From this study, the average wound healing time has a very significant difference.Keywords: Fresh Amniotic Membrane, Wound Cesarean Section, Wound Healing

scholarly journals Evolution of voice after transoral laser cordectomy for precancerous lesions and early glottic cancer

2021 ◽  
Author(s):  
Lucia Staníková ◽  
Karol Zeleník ◽  
Martin Formánek ◽  
Jana Seko ◽  
Radana Walderová ◽  
...  
Keyword(s):  
Precancerous Lesions ◽  
Voice Quality ◽  
Quality Parameters ◽  
Substantial Improvement ◽  
Glottic Cancer ◽  
Early Glottic Cancer ◽  
Post Surgery ◽  
Group I ◽  
Group Ii ◽  
Laser Cordectomy

Abstract Purpose To evaluate voice quality evolution after a transoral laser cordectomy (TLC) for precancerous lesions and early glottic cancer. Methods This prospective study enrolled 18 patients scheduled for TLC for high-grade dysplasia, Tis, T1, and T2 glottic squamous cell cancers, from May 2017 to March 2020. Patients were grouped according to the extent of TLC: Group I (n = 11, 61.1%): unilateral subepithelial or subligamental cordectomy; Group II (n = 7, 38.9%): unilateral transmuscular, total, or extended cordectomy. Voice quality parameters, including dysphonia grade (G), roughness (R), breathiness (B), maximal phonation time (MPT), jitter, and shimmer, were evaluated before, and at 6 weeks and 6 months after the TLC. Results In Group I, the degree of G and R items remained without substantial improvement 6 weeks after surgery; however, improved above the pre-surgery level up to 6 months after surgery. The MPT, jitter, and shimmer did not change significantly at 6 weeks or 6 months post-TLC. In Group II, G, R, and B remained significantly impaired even 6 months post-surgery. Jitter, and shimmer worsened at 6 weeks, but reached preoperative levels at 6 months post-surgery. MPT was significantly worse at 6 weeks and remained deteriorated at 6 months post-surgery. All measured parameters were significantly worse in Group II than in Group I at 6 weeks and 6 months post-surgery. No patient required a phonosurgical procedure. Conclusion After a TLC, voice quality evolution depended on the extent of surgery. It did not improve at 6 weeks post-surgery. Improvements in less extent cordectomies occurred between 6 weeks and 6 months post-surgery. Understanding voice development over time is important for counseling patients when considering phonosurgical procedures.

scholarly journals Efficacy of Ruiyun procedure for hemorrhoids combined simplified Milligan–Morgan hemorrhoidectomy with dentate line-sparing in treating grade III/IV hemorrhoids: a retrospective study

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qiuxiang Yu ◽  
Congcong Zhi ◽  
Lansi Jia ◽  
Hui Li
Keyword(s):  
Wound Healing ◽  
Postoperative Complications ◽  
Recurrence Rate ◽  
Dentate Line ◽  
Healing Time ◽  
Post Operation ◽  
Time Required ◽  
Wound Healing Time ◽  
Normal Work ◽  
Grade Iii

Abstract Background Hemorrhoids are common. Hemorrhoidectomy should typically be offered to patients whose symptoms result from external hemorrhoids or combined internal and external hemorrhoids with prolapse (grades III/IV). However, none of the currently used surgical methods could be considered an ideal surgical option that is effective, safe, and painless. We hypothesized that a combination of Ruiyun procedure for hemorrhoids (RPH) and simplified Milligan–Morgan hemorrhoidectomy (sMMH) will increase the safety and effectiveness of surgical treatment hemorrhoids. This study aimed to evaluate the efficacy of Ruiyun procedure for hemorrhoids combined simplified Milligan–Morgan hemorrhoidectomy with dentate line-sparing (RPH + sMMH) to treat grade III/IV hemorrhoid. Methods Total 452 patients with hemorrhoids of grade III/IV were retrospectively reviewed in China-Japan Friendship Hospital, 244 cases were assigned to RPH + sMMH group, and 208 cases in MMH group. The primary efficacy outcome was rate of curative at 3 month after operation, and the recurrence rate within 12 months post operation. Secondary efficacy outcomes included wound healing time, time required to resume normal work, constipation symptom, quality of life, and pain post operation was also evaluated. The safety outcome included postoperative complications. Results There were no differences between the two groups in demographic characteristics. There was no statistically significant difference between the two groups in the curative rate. The recurrence rate after 12 months post operation in the RPH + sMMH (3.0%) was significantly lower than the sMMH group (7.8%) (P = 0.032). The wound healing time was significantly shorter in RPH + sMMH group than that in MMH group (P < 0.001). The time required to resume normal work in the RPH + sMMH group was significantly shorter than MMH group (P < 0.001). Compared with the MMH group, the RPH + sMMH therapy preserve better life quality and lower constipation symptom (all P < 0.05). Patients who underwent RPH + sMMH had significantly less postoperative pain than MMH therapy. The total rate of patients with postoperative complications in the RPH + sMMH group (8.6%) was significant lower than the MMH group (16.3%) (P = 0.012). Conclusion RPH + sMMH may more effective in treating patients with III/IV hemorrhoids, which indicated lower recurrence rate, lower postoperative complications and pain, shorter recovery and return to normal life.

A Comparative Effectiveness Evaluation of Percutaneous Adhesiolysis and Epidural Steroid Injections in Managing Lumbar Post Surgery Syndrome: A Randomized, Equivalence Controlled Trial

2009 ◽  
Vol 6;12 (6;12) ◽  
pp. E355-E368
Author(s):  
Laxmaiah Manchikanti
Keyword(s):  
Facet Joint ◽  
Low Back ◽  
Lumbar Surgery ◽  
Steroid Injections ◽  
Epidural Steroid Injections ◽  
Post Surgery ◽  
Group I ◽  
Group Ii ◽  
Epidural Steroid ◽  
Caudal Epidural

Background: Speculated causes of post lumbar surgery syndrome include epidural fibrosis, acquired stenosis, and facet joint pain among other causes. Even though fluoroscopically directed caudal epidural injections and facet joint interventions are effective in some patients, others continue to suffer with chronic persistent pain. Percutaneous adhesiolysis with target delivery of medications has been demonstrated to be effective in these patients. However, the evidence for percutaneous adhesiolysis in managing post surgery syndrome has been questioned, coupled with a paucity of controlled trials. Study Design: A randomized, equivalence, controlled trial. Setting: An interventional pain management practice, a specialty referral center, a private practice setting in the United States. Objectives: To evaluate the effectiveness of percutaneous epidural adhesiolysis in patients with chronic low back and lower extremity pain in post surgery syndrome and compare with fluoroscopically directed caudal epidural steroid injections. Methods: Patients were randomly assigned to one of 2 groups: Group I (60 patients) receiving caudal epidural injections with catheterization up to S3 with local anesthetic, steroids, and 0.9% sodium chloride solution serving as the control group, and Group II (60 patients) receiving percutaneous adhesiolysis with targeted delivery of lidocaine, 10% hypertonic sodium chloride solution, and non-particulate Betamethasone serving as the intervention group. Randomization was performed by computer-generated random allocation sequence by simple randomization. Outcomes Assessment: Multiple outcome measures were utilized including the Numeric Rating Scale (NRS), the Oswestry Disability Index 2.0 (ODI), employment status, and opioid intake with assessment at 3, 6, and 12 months post treatment. Significant pain relief was described as 50% or more, whereas significant improvement in the disability score was defined as a reduction of 40% or more. Results: Significant pain relief (≥ 50%) and functional status improvement was recorded in 73% of patients in Group II versus 12% in Group I (P < 0.001). The average procedures per year were 3.5 with an average total relief of 42 out of 52 weeks in Group II and 2.2 procedures with total relief per year of 13 weeks in Group I (P < 0.001). Limitations: The results of this study are limited by potentially inadequate double blinding, by the lack of a placebo group, and the preliminary report of one-year follow-up. Conclusions: Percutaneous adhesiolysis in chronic function-limiting, recalcitrant low back pain in post lumbar surgery syndrome demonstrated effectiveness in 73% of the patients. Key words: Post lumbar surgery syndrome, post lumbar laminectomy syndrome, chronic low back pain, epidural adhesions, epidural steroid injections, percutaneous adhesiolysis, epidural fibrosis, spinal stenosis, randomized trial, comparative effectiveness

scholarly journals FACTORS RELATED TO AMPUTATION LEVEL AND WOUND HEALING IN DIABETIC PATIENTS

2018 ◽  
Vol 26 (5) ◽  
pp. 342-345 ◽  
Author(s):  
Daniel Baumfeld ◽  
Tiago Baumfeld ◽  
Benjamim Macedo ◽  
Roberto Zambelli ◽  
Fernando Lopes ◽  
...  
Keyword(s):  
Wound Healing ◽  
Healing Time ◽  
Diabetic Patients ◽  
Distal Stump ◽  
Vascular Intervention ◽  
Laboratory Parameters ◽  
Amputation Level ◽  
Study Results ◽  
Preoperative Antibiotics ◽  
Wound Healing Time

ABSTRACT Objective: There are no specific criteria that define the level of amputation in diabetic patients. The objective of this study was to assess the influence of clinical and laboratory parameters in determining the level of amputation and the wound healing time. Methods: One hundred and thirty-nine diabetic patients were retrospectively assessed. They underwent surgical procedures due to infection and/or ischemic necrosis. Type of surgery, antibiotic use, laboratory parameters and length of hospital stay were evaluated in this study. Results: The most common amputation level was transmetatarsal, occurring in 26 patients (28.9%). The wound healing time increased with statistical significance in individuals undergoing debridement, who did not receive preoperative antibiotics and did not undergo vascular intervention. Higher levels of amputation were statistically related to limb ischemia, previous amputation and non-use of preoperative antibiotics. Conclusion: Patients with minor amputations undergo stump revision surgery more often, but the act of always targeting the most distal stump possible decreases energy expenditure while walking, allowing patients to achieve better quality of life. Risk factors for major amputations were ischemia and previous amputations. A protective factor was preoperative antibiotic therapy. Level of Evidence III, Retrospective Study.

scholarly journals Food Safety Knowledge and Hygienic Practices among Different Groups of Restaurants in Muscat, Oman

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Maryam Al-Ghazali ◽  
Ismail Al-Bulushi ◽  
Lyutha Al-Subhi ◽  
Mohammad Shafiur Rahman ◽  
Amani Al-Rawahi
Keyword(s):  
Food Safety ◽  
Food Poisoning ◽  
Inverse Association ◽  
Human Beings ◽  
Food Handlers ◽  
Group Iii ◽  
Hygiene Practices ◽  
Group I ◽  
Group Ii ◽  
Safety Knowledge

Food safety is vital to human beings as well as to the food industry. Therefore, knowledge and hygiene practice of food safety among food handlers are particularly important. Evaluation of food safety knowledge and hygienic practices among 18 restaurants in three different regions (i.e., districts) in the Governorate of Muscat was performed. In order to determine the quality level of restaurants, grouping (i.e., Region 1, Region 2, and Region 3; e.g., Group I, Group II, and Group III) was adopted from the regulations and assigned by the municipality based on the number of complaints against the restaurants. A questionnaire was designed to assess the knowledge of hygiene, food poisoning, food handling, cooking, and local regulations/rules of the food handlers in selected restaurants. The food handlers in the Region 1 restaurants showed significantly higher ( p < 0.05 ) overall knowledge (58.6%) in food safety as compared to Region 2 (52.1%) and Region 3 (53.2%). Overall knowledge of food handlers in Group I restaurants was significantly higher ( p < 0.05 ) (64.4%) as compared to Group II (53.1%) and Group III (48.1%). The hygiene practices in Group I restaurants were significantly higher ( p < 0.05 ) than those in Groups II and III. A small but significant inverse association ( r 2 = − 0.38 ) between total knowledge scores and hygiene practices was found. In conclusion, higher knowledge in the field is associated with better hygiene practices, and these are more likely to prevent food poisoning originating from restaurants. We recommend implementing specialized education courses and workshops for the food handlers as a requirement before embarking on service to decrease the risks of foodborne diseases.

scholarly journals Assessment of Frailty In Elderly Patients Attending A Multidisciplinary Wound Care Center: A Cohort Study.

2021 ◽  
Author(s):  
Mariona Espaulella-Ferrer ◽  
Joan Espaulella-Panicot ◽  
Rosa Noell-Boix ◽  
Marta Casals-Zorita ◽  
Marta Ferrer-Sola ◽  
...  
Keyword(s):  
Wound Healing ◽  
Elderly Patients ◽  
Healing Rate ◽  
Wound Care ◽  
Frailty Index ◽  
Healing Time ◽  
Venous Ulcers ◽  
Healing Wounds ◽  
Wound Healing Time ◽  
The Relationship

Abstract Background: The incidence of frailty and chronic wounds increases with patients’ age. Knowledge of the relationship between frailty and wound healing progress is greatly lacking. Methods: The aim of this study is to characterize the degree of frailty in elderly patients attending a multidisciplinary wound care centers (MWCC). Additionally, we seek to assess the impact of frailty on the wound healing rate and wound healing time. An open cohort study was conducted on 51 consecutive patients aged > 70 years treated for wounds at an MWCC of an intermediate care hospital. The frailty score was determined according to the Frail-VIG index. Data were collected through patient questionnaires at the beginning of the study, and at six months or upon wound healing. Wounds were followed up every two weeks. To analyze the relationship between two variables was used the Chi-square test and Student’s or the ANOVA model. The t-test for paired data was used to analyze the evolution of the frailty index during follow-up.Results: A total of 51 consecutive patients were included (aged 81.1 ± 6.1 years). Frailty prevalence was 74.5% according to the Frail-VIG index (47.1% mildly frail, 19.6% moderately frail, and 7.8% severely frail). Wounds healed in 69.6% of cases at six months. The frailty index (FI) was higher in patients with non-healing wounds in comparison with patients with healing wounds (IF 0.31 ± 0.15 vs IF 0.24 ± 0.11, p=0.043). A strong correlation between FI and wound healing results was observed in patients with non-venous ulcers (FI 0.37 ± 0.13 vs FI 0.27 ± 0.10, p=0.015). However, no correlation was observed in patients with venous ulcers (FI 0.17 ± 0.09 vs FI 0.19 ± 0.09, p=0.637). Wound healing rate is statically significantly higher in non-frail patients (3,26% wound reduction/day, P25-P75 0.8-8.8%/day) in comparison with frail patients (8.9% wound reduction/day, P25-P75 3.34-18.3%/day; p=0.044). Conclusion: Frailty is prevalent in elderly patients treated at an MWCC. Frailty degree is correlated with wound healing results and wound healing time.

Risk factors for corneal epithelial wound healing: Can sex play a role?

2021 ◽  
pp. 112067212110667
Author(s):  
Giulia Coco ◽  
Kevin J. Hamill ◽  
Lee D. Troughton ◽  
Stephen B. Kaye ◽  
Vito Romano
Keyword(s):  
Risk Factors ◽  
Wound Healing ◽  
Treatment Strategies ◽  
Case Series ◽  
Healing Time ◽  
Retrospective Case ◽  
Corneal Epithelial ◽  
Female Patients ◽  
Epithelial Wound Healing ◽  
Wound Healing Time

Purpose To determine if sex is associated with corneal epithelial wound healing time in patients with persistent corneal epithelial defects (PCEDs). Methods Retrospective case series on patients with PCED from November 2014 to January 2019. Records of 127 patients with diagnosis of PCED were reviewed. Patients with an epithelial defect that lasted more than two weeks in the absence of an active corneal infection were included. Main outcome was corneal epithelial wound healing time. Results 55 patients (29 males) with a mean age of 65.3 ± 16.5 years were included. No difference was found between female and male patients in terms of risk factors, age, treatment strategies or intervals between visits (median of 15 days in females and 12 days in males; p = 0.24). Median duration of the PCED was 51 days (IQR 32-130), with a median number of 5 clinical visits (IQR 4-8). Female patients had significantly longer healing times (p = 0.004) and a corresponding increase in the number of clinical visits (median of 7 visits vs. 5 clinical visits in males, p = 0.012). Conclusion Results from this study suggest female patients with PCED might have a longer corneal epithelial wound healing duration and may therefore require earlier intervention.

Evaluation of effectiveness of a new treatment method for healing infected wounds: an animal model

2021 ◽  
Vol 30 (4) ◽  
pp. 312-322
Author(s):  
Alexandr A Basov ◽  
Sergey R Fedosov ◽  
Vadim V Malyshko ◽  
Anna A Elkina ◽  
Oxana M Lyasota ◽  
...  
Keyword(s):  
Wound Healing ◽  
Animal Model ◽  
Active Agent ◽  
Treatment Method ◽  
Healing Time ◽  
Male Adult ◽  
New Device ◽  
Infected Wounds ◽  
New Treatment ◽  
Wound Healing Time

Objective: To evaluate the effectiveness of a new treatment method in healing superficial infected wounds compared with surgical debridement with chlorhexidine solution. Method: In this animal model, two wounds were created on the back of 10 male adult rabbits. Wounds treated by Method 1 were debrided using 0.02% chlorhexidine aqueous solution and an antibiotic topical ointment. Wounds treated by Method 2 wounds were treated using a newly developed device which enabled visual monitoring of the wound as it was treated with various pharmacological solutions (including antiseptic, antiseptic oxidant and an osmotically active agent) specifically formulated for each wound healing stage. Wound area size (using digital planimetry) and time taken to clean the wound were recorded, and biopsies were taken, at the beginning of the study and at various timepoints throughout. Result: It was observed that both wound cleaning and wound healing were accelerated by treatment with method 2 compared with method 1 (by 43.8% and 36.7%, respectively). There were also a significantly smaller number of complications in these wounds [p=0.0044] due to the positive ratios of neutrophils and fibroblasts in the wound cavities (from the third to the fourteenth day after wound modelling). Conclusion: Wounds treated with the new device in method 2 had a shorter wound healing time than wounds treated with a traditional method. The automated influx–outflow of solutions removed any fragments of necrotic tissue from the wound surface. Wounds were able to be monitored without the need to remove dressings. The transparent, airtight film, which allowed for wound monitoring without the need to remove dressings, meant that suturing was not required. This resulted in no complications in the wounds treated by this new method.

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