scholarly journals Clinical efficacy of arthroscopic reconstruction of the anterior talofibular ligament with preservation of the stump

Author(s):  
Changcheng Liu ◽  
Guozhi Wu ◽  
HAO ZHANG ◽  
Kun Li

Abstract Background The purpose of this study was to investigate the clinical efficacy of anatomic reconstruction of the anterior talofbular ligament with preservation of the stump. Methods This retrospective study included 42 patients who underwent an endoscopic lateral ligament reconstruction between from June 2015 to June 2019.Fourteen consecutive patients (10 [71.4%] males and 4 [28.6%] female, mean age 27.79 ± 4.56[range 26 to 36] years) with preserved anterior tibiofibular ligament stump were enrolled in this study.On the other side ,there were 18 patients with unpreserved tibiofibular ligament stumps (unpreserved stump group), 12 males and 6 females, aged 20–36 years, mean (28.56 ± 5.67) years.The functional evaluation was carried out according to the Ankle-Hindfoot Score by the American Orthopaedic Foot and Ankle Society.The Tegner system was used to evaluate range of motion after the index procedure. Ankle proprioception was assessed using the visual analogue scale (VAS) to assess the degree of subjective pain symptoms. Operative time, fever time and wound healing time were also recorded. Results There were no statistically significant differences in postoperative outcomes such as postoperative fever time and wound healing time between the two groups (P > 0.05). The operative time was slightly longer in the stump-preserving group than in the non-stump-preserving group (94.14 ± 11.59 vs. 82.94 ± 15.61 P < 0.05). There were no statistically significant differences in preoperative AOFAS ankle-hindfoot scores, Tegner motor level scores, and VAS scores between patients in the retained-stump group and the non-reserved-stump group (P > 0.05). At 1 year after surgery, the AOFAS ankle-hindfoot scores and Tegner motor level scores improved and the VAS pain scores decreased in both the presurgical and non-presurgical groups. The AOFAS ankle-hindfoot scores and Tegner motion level scores 1 year after surgery were higher in the group with preserved stump than in the group without preserved stump (P < 0.05). Conclusion Arthroscopic reconstruction of the anterior talofibular ligament with and without preservation of the stump can achieve good clinical outcomes. Although arthroscopic anterior talofibular ligament reconstruction with preserved stump prolonged the operative time compared with surgery without preserved stump, it could better improve the subjective ankle function and motion status of patients and improve the prognosis.

2019 ◽  
Vol 1 (2) ◽  
pp. 47-55
Author(s):  
Syahredi Syaiful Adnani ◽  
Hafni Bachtiar

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


BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qiuxiang Yu ◽  
Congcong Zhi ◽  
Lansi Jia ◽  
Hui Li

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.


2018 ◽  
Vol 26 (5) ◽  
pp. 342-345 ◽  
Author(s):  
Daniel Baumfeld ◽  
Tiago Baumfeld ◽  
Benjamim Macedo ◽  
Roberto Zambelli ◽  
Fernando Lopes ◽  
...  

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.


2017 ◽  
Vol 4 (11) ◽  
pp. 3665 ◽  
Author(s):  
Ganesan R. ◽  
Karunakaran K. ◽  
Heber Anandan

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.


2021 ◽  
Author(s):  
Mariona Espaulella-Ferrer ◽  
Joan Espaulella-Panicot ◽  
Rosa Noell-Boix ◽  
Marta Casals-Zorita ◽  
Marta Ferrer-Sola ◽  
...  

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.


2021 ◽  
pp. 112067212110667
Author(s):  
Giulia Coco ◽  
Kevin J. Hamill ◽  
Lee D. Troughton ◽  
Stephen B. Kaye ◽  
Vito Romano

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.


2021 ◽  
Vol 30 (4) ◽  
pp. 312-322
Author(s):  
Alexandr A Basov ◽  
Sergey R Fedosov ◽  
Vadim V Malyshko ◽  
Anna A Elkina ◽  
Oxana M Lyasota ◽  
...  

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.


Author(s):  
Jie Zhang ◽  
Xiaolin Feng ◽  
Yuxia Wang ◽  
Dakang Chen ◽  
Bo Zhang

Research purposes: Autologous platelet-rich plasma gel (Platelet-Rich Plasma, PRP) was prepared and used for transplantation for the treatment of traumatic trauma wounds of extremities. Explore platelet-rich plasma gel (PRP) to promote the healing of exposed bone and tendon wounds. Methods: Fifteen patients with extremity bone and tendon exposed wounds were treated with autologous platelet-rich plasma gel (PRP) transplantation to observe the wound healing rate and wound healing time. Results: Among the 15 patients, 8 cases healed directly, 7 cases had active granulation growth, and second-stage skin graft wound healing; the wound healing rate was 100%, and the average wound healing time was 36 days. Conclusion: Autologous platelet-rich plasma gel (PRP) transplantation for the treatment of traumatic trauma hard wounds of the extremities, can inhibit the bacterial growth of the wounds, effectively promote the repair of soft tissue defects and accelerate the healing of bone and tendon wounds of the extremities.


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