scholarly journals Comparative Observation on the Effect of Vancomycin-Loaded Calcium Sulfate on Promoting the Natural Healing of the Docking site of Bone Transport

2021 ◽  
Author(s):  
Xuede Guo ◽  
Guanjun Cui ◽  
Cishan Wang ◽  
Hongya Meng ◽  
Shujie Huang ◽  
...  
Keyword(s):  
External Fixation ◽  
Healing Rate ◽  
Functional Results ◽  
Healing Time ◽  
Fixation Index ◽  
Control Group ◽  
Docking Site ◽  
Incarceration Rate ◽  
Natural Healing ◽  
Experimental Group

Abstract Objectives: Observe the efficacy of vancomycin-loaded calcium sulfate（VCS）in promoting the natural healing of bone transport's docking site.Methods: We retrospectively analyzed 48 patients who used bone transfer to treat the tibia's infectious bone defects from 2013 to 2018. The patients were randomly divided into an experimental group receiving VCS treatment or a control group not receiving VCS treatment. After treatment, the two groups of docking site healing time, skin incarceration rate, natural healing rate, external fixation index, bony results, and functional results were compared.Results: The experimental group achieved bone healing in the docking site union for an average of (15.30±6.32) months after the operation. Among them, 25 cases healed spontaneously, two patients healed after bone cleaning and grafting; the average external fixation index was (2.10 ± 0.28) months/cm; Bone results: excellent in 19 cases, right in 7 patients, low in 1 case, functional derivatives: excellent in 16 points, good in 9 cases, and fair in 2 cases. The control group achieved bone healing at the docking site for an average of (15.29±5.36) months after the operation. Among them, 11 cases healed spontaneously at the docking site, and 10 cases of non-natural healing (6 points of skin incarceration) healed after cleaning and bone grafting; the average external fixation index was (2.09±0.25) months/cm; Bone results: excellent in 15 cases, right in 5 patients, fair in 1 case, functional products: excellent in 12 points, good in 8 cases, and fitting in 1 case. There was no significant difference in the healing time, bony results, functional results, and external fixation index between the two groups at the docking site (P>0.05). The experimental group's skin incarceration rate was lower than that of the control group, and the natural healing rate was higher than that of the control group (P<0.05).Conclusion: In bone removal surgery, the implantation of VCS in the infected bone defect area helps prevent the docking site skin incarceration and promotes the docking site's natural healing.

Effectiveness of patching traumatic eardrum perforations with lens cleaning paper via an otoscope

2017 ◽  
Vol 131 (9) ◽  
pp. 805-808 ◽  
Author(s):  
K Yan ◽  
M Lv ◽  
E Xu ◽  
F Fan ◽  
Y Lei ◽  
...  
Keyword(s):  
Healing Rate ◽  
Clinical Effect ◽  
Healing Time ◽  
Control Group ◽  
Closure Rate ◽  
The Difference

AbstractObjective:To study the clinical effect of lens cleaning paper patching on traumatic eardrum perforations.Methods:A total of 122 patients were divided into 2 groups, of which 56 patients were treated with lens cleaning paper patching and 66 acted as controls. The closure rate and healing time were compared between the two groups.Results:The healing rate of small perforations was 96.4 per cent (27 out of 28) in the patching group and 90 per cent (27 out of 30) in the control group. The difference was not statistically significant (p > 0.05). The healing rate of large perforations was 89.3 per cent (25 out of 28) and 80.6 per cent (29 out of 36) in the two groups, respectively. The difference was statistically significant (p < 0.05). The healing time of large perforations was shorter in the patching group than in the control group (p < 0.01).Conclusion:Patching with lens cleaning paper under an endoscope can accelerate the closure of large traumatic eardrum perforations.

scholarly journals Study on the Effect of Removing the Slide Wire Screw on Locking Plate by Nail Groove Reconstruction Method

2021 ◽  
Author(s):  
Guanglei Zheng ◽  
Yingjie Qi
Keyword(s):  
Blood Loss ◽  
Locking Plate ◽  
Operation Time ◽  
Healing Time ◽  
Control Group ◽  
Reconstruction Method ◽  
Intraoperative Blood Loss ◽  
Limb Function ◽  
Experimental Group ◽  
Tungsten Steel

Abstract Background: This paper is to describe and evaluate the nail groove reconstruction method in removing slide wire screw on locking plate. Then compare the method with tungsten steel drilling nail method, to explore a new method of removing slide wire screw on locking plate.Method: A total of 1254 patients with removal fracture internal fixation devices were collected from the Affiliated Hospital of Hangzhou Normal University from July 2015 to September 2021, of which 62 cases met the inclusion and exclusion criteria. All patients were randomly divided into the experimental group and the control group. 31 people per group. There were 19 males and 12 females in the experimental group, the age of patients was 35.68±11.70years; while 18 males and 13 females in the control group, the age of patients was 36.27±10.37years. Nail groove reconstruction method was used in the experimental group, and the tungsten steel drilling nail method was used in the control group. Collect and count surgical-related indicators, the data of two groups were compared and analyzed from four aspects: intraoperative blood loss, operation time, incision healing time and limb function recovery time.Result: All slide wire screws were removed successfully, and all patients had no serious postoperative complications such as internal fixation retention and neurovascular injury. The experimental group was better than the control group in the following three aspects: the amount of intraoperative blood loss, the operative time, the recovery time of limb function, and the differences were statistically significant(p < 0.05). There was no significant difference in incision healing time between the two groups.Conclusion: The nail groove reconstruction method has less damage to the bone and soft tissue, less intraoperative blood loss, shorter operation time, and faster postoperative recovery of limb function. The nail groove reconstruction method is a simple and effective method, it has obvious advantages compared with the traditional method.

scholarly journals HEALING RATE IN DIABETIC FOOT ULCERS TREATED WITH BIOMEMBRANE AND HYDROCOLLOID POWDER: RANDOMIZED CLINICAL TRIAL

2021 ◽  
Author(s):  
Manuela de Mendonça Figueirêdo Coelho ◽  
Luciana Catunda Gomes de Menezes ◽  
Shérida Karanini Paz de Oliveira ◽  
Ana Débora Alcantara Coêlho Bonfim ◽  
Viviane Mamede Vasconcelos Cavalcante ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Diabetic Foot ◽  
Healing Rate ◽  
Foot Ulcers ◽  
Calotropis Procera ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Diabetic Foot Ulcers ◽  
Clinical Trial Registry ◽  
Experimental Group

Objective: to evaluate the rate of healing in diabetic foot ulcers treated with a biomembrane of latex proteins from Calotropis procera (BioMem CpLP) when compared to powdered hydrocolloid. Method: randomized controlled clinical trial, registered by the Brazilian Clinical Trial Registry (REBEC), according to protocol RBR-98f3j9, carried out with eight people with diabetic foot, in a diabetic foot clinic, from March to July 2019. In the experimental group (n = 04), biomembrane was applied; in the control group (n = 04), hydrocolloid powder was used. The healing rate was assessed at 30 and 60 days after starting treatment. Results: no statistical differences were found between the healing rates of the control group and the experimental group in the temporal analysis of the initial 30 days (p = 0.726) and in the 60 days following the start of treatment (p = 0.562). Conclusion: BioMem CpLP presented healing rates similar to the conventional product, being an effective and low cost alternative for the treatment of diabetic feet.

scholarly journals Treatment of tibial shaft fractures with Mitkovic type external fixation: Analysis of 100 patients

2017 ◽  
Vol 145 (11-12) ◽  
pp. 605-610
Author(s):  
Aleksandar Bozovic ◽  
Rade Grbic ◽  
Dragisa Milovic ◽  
Zlatan Elek ◽  
Dusan Petrovic ◽  
...  
Keyword(s):  
External Fixation ◽  
Functional Results ◽  
Healing Time ◽  
Type I ◽  
Tibial Shaft ◽  
Adult Males ◽  
Results Of Treatment ◽  
Shaft Fractures ◽  
Pin Site ◽  
Tibial Shaft Fractures

Introduction/Objective. Tibial shaft fractures (TSF) are one of the most common fractures. External fixation (EF) may be used to treat TSF. The aim of this study was to analyze the treatment of TSF with Mitkovic EF. Methods. The study included 100 patients with TSF treated with Mitkovic EF as the primary and definite method of treatment. The results are compared to those in the literature. Results. The patient group comprised 67% male and 33% female patients aged 10?71years. TSF is common in adult males in the fourth and fifth decades of life. The most common cause is falling with the twisting of the leg (59%). Closed fractures were observed in 76 patients (57.4% of type A AO, 25.4% of type B AO, and 17.1% of type C AO), and open fractures in 34 patients (50% of type I GA, 32.35% of type II GA, and 17.64% of type III GA). The average time period from injury to surgery was 2.5 days (the range being 4 hours to 9 days). Bone healing was achieved in 93% of patients. The average healing time was 18.4 weeks (the range being 11?32 weeks). The distribution of complications is as follows: 10% for minor pin site infections; 4% for major pin site infections; 6% for nonunion; 1% for acute respiratory distress syndrome; 2% for osteitis. There was no deep vein thrombosis nor neurovascular damage. EuroQol score was excellent in 82% of the patients. Conclusion. Mitkovic EF can be used for treating all types of TSF. Functional results of treatment by this method are excellent. The data analysis of the series does not differ from the data in the literature.

scholarly journals The Clinical Outcome of the Reduction of the Patellar Inferior Pole Fracture with Wire Cerclage Through A Generated Bone hole, in Combination with Patellar Concentrator: A Retrospective Comparative Study

2021 ◽  
Author(s):  
Rong Chen ◽  
Hong Cao ◽  
Zhibo Sun ◽  
Liangbo Jiang ◽  
Xiangwei Li ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Blood Loss ◽  
Operation Time ◽  
Healing Time ◽  
Control Group ◽  
Operative Blood Loss ◽  
Inferior Pole ◽  
Wire Cerclage ◽  
Post Operation ◽  
Experimental Group

Abstract Objective: The patellar inferior pole fracture is typically comminuted. Hence, achieving firm fixation and early activity is highly challenging. In this article, we employed the method of wire cerclage through a generated bone hole to reduce the fracture. Our objective was to compare the clinical efficacy of patellar concentrator alone with a combination of cerclage and patellar concentrator in the treatment of patellar inferior pole fracture.Methods: We conducted a retrospective review of patients with patellar inferior pole fractures, who underwent patellar concentrator fixation only (the control group) or cerclage combined with patellar concentrator fixation (the experimental group), performed by a single surgeon, between July 2015 and October 2019. Our analysis included surgical indexes like7 aspects (fracture gap after operation, operation time, intra-operative blood loss,intra-operative number of C-arm fluoroscopies conducted, Insall-Salvati ratio calculated immediately after operation, initial range of motion on the 7th day after operation, and fracture healing time), as well as the Bostman score and complications recorded on 1-, 3-, 6-, and 12-month follow up post operation.Results:A total of 94 patients with patellar inferior pole fracture and a minimum 1-year followup were recruited. Following operation, the control group had 33(71.74%) patients with a fracture gap of 0-2 mm and 13(28.26%)patients with a fracture gapgreater than 2 mm(P=0.002). Conversely,the experimental grouphad46(95.83%)patients with a fracture gap of 0-2 mm and 2(4.17%) patients with a fracture gapgreater than 2 mm(P=0.002). Compared to the control group, the experimental group did not experience enhanced operation time or intra-operative blood loss (P=0.811, P=0.823). The Insall-Salvati ratio and initial range of motion in the experimental group were larger than the control group (P=0.037, P=0.000). Alternately, the number of intra-operative C-arm fluoroscopies conductedand fracture healing time of the experimental group were considerably less than the control group (P=0.003,P=0.000).Moreover, at 1-, 3-, 6-, and 12-month follow ups after operation, the Bostman scores of the experimental group were remarkably higher than the control group (P< 0.05).At 12 months post operation, 23 cases (50%) were classified as excellent, 22 cases (47.83%) were good, and 1 case (2.17%) was poor in the control group(P=0.005). In the meantime, in the experimental group, 38 cases (79.17%) were deemed as excellent and 10 cases (20.83%) were good (P=0.005).Lastly, complications were detected in 3 cases (6.52%;1 case of internal fixation loss,2 cases of hematoma) within the control group, and in 1 case(2.08%; marginal wound necrosis) within the experimental group. There was no wound infection, implant discomfort, or broken fixation in eithergroup.Conclusion: Managingthe patellar inferior pole fracture with wire cerclage through a generated bone hole is both simple and effective. Moreover, an additional step of patellar concentrator fixation facilitates early functional exercise, with satisfactory clinical outcome.

scholarly journals The Effectiveness of a Mobile Nutrition Application to Promote the Nutritional Status and Wound Healing Rate in Patients with Pressure Ulcers Receiving Long-Term Care in Thailand

2019 ◽  
Vol 6 (1) ◽  
pp. 1-6
Author(s):  
Jinpitcha Mamom ◽  
Keyword(s):  
Wound Healing ◽  
Nutritional Status ◽  
Healing Rate ◽  
Long Term Care ◽  
Research Study ◽  
Conventional Care ◽  
Control Group ◽  
Term Care ◽  
Experimental Group

This innovative developmental research study aims to determine the effects of a mobile nutrition application on the nutritional status and wound healing of 72 immobilized patients in long-term care in Thailand. The patients were randomized into two groups, a control group receiving conventional care and an experimental group using the mobile nutrition application

scholarly journals Observation on the Clinical Effect of Modified Circumcision in the Treatment of Phimosis and Excessive Foreskin

2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Jiechang Ju
Keyword(s):  
Clinical Effect ◽  
Treatment Plan ◽  
Operation Time ◽  
Healing Time ◽  
Control Group ◽  
Clinical Effects ◽  
The Difference ◽  
And Control ◽  
Wound Healing Time ◽  
Experimental Group

Objective: To study the clinical effect of modified circumcision in the treatment of phimosis and excessive foreskin. Methods: 110 patients with overly long foreskin or phimosis were divided into experimental group and control group by random number table method, with 55 cases in each group. The experimental group was treated with modified circumcision, and the control group was treated with traditional manual cutting and suture. Then the clinical effects of the two treatments were compared. Results: Two different surgical procedures were performed. During the operation, the blood loss of the experimental group was less than that of the control group; the operation time and wound healing time were shorter than those of the control group; after the operation, the incidence of related complications in the experimental group was 14.55%, which was significantly lower than For 25.45% of the control group, the clinical treatment effect was obvious, and the difference was statistically significant (P<0.05). Conclusion: The clinical effect of modified circumcision in the treatment of patients with phimosis and excessive foreskin is good. Compared with the traditional manual cutting and suture treatment, it not only has the advantages of simple operation and clinical application, but also benefits the rehabilitation of patients. Rehabilitation time reduces the incidence of postoperative complications. It is an ideal treatment plan for this type of disease in the current clinic, and it is worthy of popularization and application in general surgery and reproductive surgery.

Clinical Study of Platelet-Rich Plasma (PRP) for Lower Extremity Venous Ulcers: A Meta-Analysis and Systematic Review

2021 ◽  
pp. 153473462110462
Author(s):  
Qiangwei Fang ◽  
Yufan Zhang ◽  
Lijun Tang ◽  
Xiaomei Li ◽  
Xiaowei Zhang ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Healing Rate ◽  
Platelet Rich Plasma ◽  
Meta Analysis ◽  
Control Group ◽  
Quality Of Evidence ◽  
Venous Ulcers ◽  
End Of Treatment ◽  
Experimental Group

To systematically evaluate the clinical effects of platelet-rich plasma in the treatment of lower limb venous ulcers by applying a meta-analysis method. The Pubmed, Cochrance Library, Embase, and OVID EBM Reviews databases were searched for the search terms’platelet-rich plasma” or “Plasma, Platelet-Rich” or “Platelet Rich Plasma” and “lower extremity venous ulcers’ or “Leg Ulcers’ or “Ulcer, Leg”, and a meta-analysis was performed on the published research literature on platelet-rich plasma for lower extremity venous ulcers from January 1900 to April 2021. The outcome indicators were: post-treatment trauma area and healing rate. Revman 5.3 statistical software was applied for meta-analysis. A total of 294 patients with lower extremity venous ulcers were included in six publications, including 148 patients in the experimental group treated with PRP versus 146 patients in the control group treated with conventional therapy. There was a statistically significant difference in the Formula of an ellipse at the end of treatment (CM²) between the experimental group and the control group, with a mean difference of −1.19 (95% CI −1.80 to −0.58, P = .0001; 6 studies, 294 participants moderate quality of evidence). The difference between the healing rate of the experimental group and the control group was statistically significant, with a risk ratio (RR) of 5.73 (95% CI 3.29 – 9.99, P < .00001; 5 studies, 248 participants moderate quality of evidence).There may be publication bias for both Formula of an ellipse at the end of treatment and healing rate. This comprehensive meta-analysis of available evidence suggests that the application of PRP for lower extremity venous ulcers accelerates the wound healing process and improves wound healing rates.

scholarly journals Presentation and management outcome of tibial infected non‑union with Ilizarov technique

2019 ◽  
Vol 35 (1) ◽  
Author(s):  
Karim Bakhsh ◽  
Atiq-Ur- Rehman ◽  
Faridullah Khan Zimri ◽  
Eid Mohammad ◽  
Wazir Ahmed ◽  
...  
Keyword(s):  
External Fixation ◽  
Case Series ◽  
Functional Results ◽  
Rehabilitation Medicine ◽  
Bone Transport ◽  
Fixation Index ◽  
Ilizarov Method ◽  
Fixation Time ◽  
Ilizarov Technique ◽  
Non Union

Objective: To document the presentation of tibial infected non-union and analyze the management outcome with Ilizarov technique in terms of bone results, functional outcome, bone transport time, external fixation time, external fixation index and any complications. Methods: This case series was conducted at the Departments of Orthopedic Surgery, National Institute of Rehabilitation Medicine (NIRM), Islamabad and Civil hospital, Quetta over a period of 3-years. Results: There were 56 patients with 53(94.64%) males and 3(5.35%) females. The age range was 16-50 years with a mean of 32.58±9.98years. According to ASAMI criteria, bone results were excellent in 37(66%), good in 10(17.85%), fair in 6(10.71%) and poor in 3(5.35%). The functional results were excellent in 37(66%), good in 9(16%), fair in 7(12.5%) and poor in 3(5.35%). The bone union rate was 98.21%. Conclusion: Ilizarov method beautifully addresses the formidable issue of infected non union of tibia with good outcome in terms of bone healing and infection eradication. The treatment period is relatively lengthy and hence patience on part of patient as well as the surgical team is imperative for achieving favourable outcomes. How to cite this:Bakhsh K, Atiq-Ur-Rehman, Zimri FK, Mohammad E, Ahmed W, Saaiq M. Presentation and management outcome of tibial infected non‑union with Ilizarov technique. Pak J Med Sci. 2019;35(1):---------. doi: https://doi.org/10.12669/pjms.35.1.67 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Double-level fixator-assisted nailing (DL-FAN)

2019 ◽  
Vol 101-B (2) ◽  
pp. 178-188
Author(s):  
M. M. Chaudhary ◽  
P. H. Lakhani
Keyword(s):  
External Fixation ◽  
Bone Transport ◽  
Fixation Index ◽  
Functional Score ◽  
Control Group ◽  
Study Group ◽  
Safe Procedure ◽  
Cost Effective Treatment ◽  
Custom Made ◽  
The Mean

AimsDouble-level lengthening, bone transport, and bifocal compression-distraction are commonly undertaken using Ilizarov or other fixators. We performed double-level fixator-assisted nailing, mainly for the correction of deformity and lengthening in the same segment, using a straight intramedullary nail to reduce the time in a fixator.Patients and MethodsA total of 23 patients underwent this surgery, involving 27 segments (23 femora and four tibiae), over a period of ten years. The most common indication was polio in ten segments and rickets in eight; 20 nails were inserted retrograde and seven antegrade. A total of 15 lengthenings were performed in 11 femora and four tibiae, and 12 double-level corrections of deformity without lengthening were performed in the femur. The mean follow-up was 4.9 years (1.1 to 11.4). Four patients with polio had tibial lengthening with arthrodesis of the ankle. We compared the length of time in a fixator and the external fixation index (EFI) with a control group of 27 patients (27 segments) who had double-level procedures with external fixation. The groups were matched for the gain in length, age, and level of difficulty score.ResultsThe mean gain in length was statistically similar in the two groups: 3.9 cm (1.5 to 9.0) in the study group and 4.2 cm (3.4 to 5.0) in the control group (p = 0.350). The mean time in a fixator was significantly less in the study group compared with the control group: 8.6 weeks (2.0 to 22.8) versus 30.2 weeks (25.0 to 35.4; p < 0.001). The mean EFI was significantly lower in the study group compared with the control group: 17.7 days/cm (10.6 to 35.6) versus 73.4 days/cm (44.5 to 102.3; p < 0.001). The ASAMI (Association for the Study and Application of the Method of Ilizarov) bone score was excellent in 22, good in four, and fair in one. The ASAMI functional score was excellent in 20 and good in seven. There were no infections, superficial or deep.ConclusionDouble-level osteotomies or two procedures using a custom-made straight nail and external fixation can be used to correct deformities or to treat nonunion or malunion and may be combined with arthrodesis of the ankle with lengthening. It is a reasonably safe procedure that allows accurate and cost-effective treatment with a relatively short time in a fixator.

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