scholarly journals Management of complex wounds treatment with a hydrofiber dressing in a public hospital in Bogota (Colombia)

2021 ◽  
Vol 8 (3) ◽  
pp. 26-34
Author(s):  
M. A. Salazar Trujillo
Keyword(s):  
Infection Control ◽  
Public Hospital ◽  
Chronic Wounds ◽  
Silver Ions ◽  
Complete Closure ◽  
Benzethonium Chloride ◽  
Time Required ◽  
Wound Bed Preparation ◽  
Complex Wounds

Objective. To evaluate the efficacy of the use of a last generation hydrofiber dressing with silver, for the treatment of complex wounds that are difficult to heal.Materials and research methods. A prospective observational case-follow-up study was carried out, which included patients with acute or chronic wounds that were difficult to heal, treated in the plastic surgery service of a public hospital in Bogota-Colombia, who underwent healing with hydrofiber dressings reinforced, with silver ions, benzethonium chloride and EDTA (Aquacel Agplus®, ConvaTec). The wound was monitored, evaluating infection control, exudate and biofilm, as well as the number of required dressings and the time required for the complete closure of the wound.Research results. A total of 55 patients were included, with a median age of 44 years. In all cases, a follow-up was carried out until the definitive closure of the wound. At the end of the study, it was observed that, in 35 (63.6 %) patients, the wounds evolved to complete closure by second intention in an average of 59.3 days, requiring 12.5 dressings. 20 (36.4 %) patients had adequate wound bed preparation for definitive surgical coverage with grafts, flaps or dermal substitutes, in an average of 31.4 days, requiring 6.5 dressings on average.33 (60.0 %) wounds were infected and adequate infection control was achieved on average with 5 dressings. A decrease in the direct and indirect signs of biofilm was achieved after 6 dressings.Conclusion. The results show that the dressing studied is effective to control exudate, infection and biofilm, as well as to prepare the bed for a definitive surgical coverage.

The Use of a Novel Super-Oxidized Solution on Top of Standard Treatment in the Home Care Management of Postsurgical Lesions of the Diabetic Foot Reduces Reinfections and Shortens Healing Time

2018 ◽  
Vol 17 (4) ◽  
pp. 268-274
Author(s):  
Elisabetta Iacopi ◽  
Lorenza Abbruzzese ◽  
Chiara Goretti ◽  
Nicola Riitano ◽  
Alberto Piaggesi
Keyword(s):  
Diabetic Foot ◽  
Chronic Wounds ◽  
Standard Of Care ◽  
Healing Time ◽  
Complete Healing ◽  
Group A ◽  
Reduced Rate ◽  
Group B ◽  
Time Required

There are still many unmet needs in the treatment of chronic wounds, especially regarding microenvironment modulation. Nexodyn is a novel super-oxidized solution capable of contrast bacterial proliferation. We aimed to evaluate if this solution, on top of standard of care, was safe and effective in improving diabetic foot outcome. We selected 50 patients admitted in our department to be submitted to surgery for acute diabetic foot infection. All patients were left open to heal for secondary intent. We divided patients into 2 groups: Group A (n = 25, male/female = 17/8, age = 67.3 ± 12.1 years, hemoglobin A1C = 7.9 ± 1.1%), patients treated with standard of care and, on top of this, Nexodyn solution, and Group B, treated only with standard of care. After discharge, patients continued Nexodyn application. We followed up patients until complete healing or up to 6 months. No differences between groups in healing rate, while time required for complete healing was significantly shorter in Group A (64.9 ± 12.1 days vs 147.4 ± 23.1 days, P < .01). During follow-up, the group treated with Nexodyn showed a reduced rate of reinfections (12 patients in Group B vs 3 patients in Group A, P < .05) and of further debridement procedures (1 patient in Group A vs 10 patients in Group B, P < .05). Nexodyn provided effective protection against reinfections in diabetic foot patients, thus reducing the necessity for debridement procedures and their healing time and presents a safety profile similar to saline solution.

Efficacy of a combined system of copper and silver and free chlorine for inactivation of Naegleria fowleri amoebas in water

1995 ◽  
Vol 31 (5-6) ◽  
pp. 119-122 ◽  
Author(s):  
J. M. Cassells ◽  
M. T. Yahya ◽  
C. P. Gerba ◽  
J. B. Rose
Keyword(s):  
Synergistic Effect ◽  
Exposure Time ◽  
Silver Ions ◽  
Free Chlorine ◽  
Log10 Reduction ◽  
Naegleria Fowleri ◽  
Combined System ◽  
Water Ph ◽  
Nægleria Fowleri ◽  
Time Required

Electrolytically generated copper and silver ions (400:40 and 800:80 μg/l) were evaluated, separately and combined with 1.0 mg/l free chlorine, for their efficacy in reducing the viable numbers of Naegleria fowleri amoebas in water (pH 7.3 and 23-25°C). Inactivation rates (k = log10 reduction/min) and T99 values (exposure time required to achieve a 99% or a 2 log10 reduction) of the disinfectants were determined. Copper and silver alone, at ratio of 400:40 to 800:80 μg/l caused no significant inactivation of N. fowleri even after 72 hours of exposure (k = 0.00017 and 0.00013, respectively). Addition of 1.0 mg/l free chlorine to water which contained 400:40 or 800:80 μg/l copper and silver resulted in enhanced inactivation rates (k = 0.458 and 0.515, respectively) compared to either chlorine alone (k = 0.33) or the metals alone. Water containing 800:80 μg/l copper and silver with 1.0 mg/l chlorine showed a T99 value of 3.9 minutes, while chlorine alone showed a T99 of 6.1 minutes. Enhanced inactivation of N. fowleri by a combined system of free chlorine and copper and silver may be attributed to the different mechanism that each disinfectant utilizes in inactivating the amoebas, and may suggest a synergistic effect.

WoundClot® Hemostatic Gauze Reduces Bleeding Time after Arterial Venous Fistula Decannulation

2021 ◽  
pp. 1-7
Author(s):  
Orit Kliuk-Ben Bassat ◽  
Doron Schwartz ◽  
Alexander Zubkov ◽  
Amir Gal-Oz ◽  
Alexander Gorevoy ◽  
...  
Keyword(s):  
Bleeding Time ◽  
Control Group ◽  
Dialysis Adequacy ◽  
Cotton Gauze ◽  
Single Center Study ◽  
Time Required ◽  
Venous Fistula ◽  
Thrombosis Rate

<b><i>Introduction:</i></b> Decannulation of the arteriovenous fistula (AVF) after each hemodialysis session requires a precise compression on the needle puncture site. The objective of our study was to evaluate the bleeding time (BT) needed to achieve hemostasis using WoundClot, an innovative hemostatic gauze, and to assess whether its long-term use can improve AVF preservation. <b><i>Methods:</i></b> This is a prospective single center study. Initially, the time to hemostasis after AVF decannulation was compared between WoundClot and cotton gauze in 24 prevalent hemodialysis patients. Thereafter, the patients continued to use WoundClot for 12 months and were compared to a control group consisting of 25 patients using regular cotton gauze. Follow-up data included parameters of dialysis adequacy, AVF interventions, and thrombotic events. <b><i>Results:</i></b> WoundClot use shortened significantly the time needed for hemostasis. Mean venous BT decreased by 3.99 (±4.6) min and mean arterial BT by 6.38 (±4.8) min when using WoundClot compared to cotton gauze (<i>p</i> &#x3c; 0.001). At the end of the study, dialysis adequacy expressed by spKt/V was higher in the WoundClot group compared to control (1.73 vs. 1.53, respectively, <i>p</i> = 0.047). Although patients in WoundClot group had a higher baseline BT, arterial and venous pressures did not differ between the groups after a median follow up of 10.8 months. AVF thrombosis rate was similar between the groups. <b><i>Conclusions:</i></b> WoundClot hemostatic gauze significantly reduced the time required for hemostasis after AVF decannulation and may be associated with better AVF preservation. We suggest using WoundClot for arterial BT longer than 15 min and for venous BT longer than 12.5 min.

scholarly journals Exoplanet mass estimation for a sample of targets for the Ariel mission

2021 ◽  
Author(s):  
J. R. Barnes ◽  
C. A. Haswell
Keyword(s):  
Radial Velocity ◽  
Input Parameter ◽  
Noise Sources ◽  
Time Commitment ◽  
Low Mass ◽  
Time Required ◽  
Fixed Input ◽  
The Impact ◽  
Quadrature Sampling

AbstractAriel’s ambitious goal to survey a quarter of known exoplanets will transform our knowledge of planetary atmospheres. Masses measured directly with the radial velocity technique are essential for well determined planetary bulk properties. Radial velocity masses will provide important checks of masses derived from atmospheric fits or alternatively can be treated as a fixed input parameter to reduce possible degeneracies in atmospheric retrievals. We quantify the impact of stellar activity on planet mass recovery for the Ariel mission sample using Sun-like spot models scaled for active stars combined with other noise sources. Planets with necessarily well-determined ephemerides will be selected for characterisation with Ariel. With this prior requirement, we simulate the derived planet mass precision as a function of the number of observations for a prospective sample of Ariel targets. We find that quadrature sampling can significantly reduce the time commitment required for follow-up RVs, and is most effective when the planetary RV signature is larger than the RV noise. For a typical radial velocity instrument operating on a 4 m class telescope and achieving 1 m s−1 precision, between ~17% and ~ 37% of the time commitment is spent on the 7% of planets with mass Mp < 10 M⊕. In many low activity cases, the time required is limited by asteroseismic and photon noise. For low mass or faint systems, we can recover masses with the same precision up to ~3 times more quickly with an instrumental precision of ~10 cm s−1.

scholarly journals Implementation of an Antimicrobial Stewardship Program in Five Colombian Hospitals in 2018

2020 ◽  
Vol 41 (S1) ◽  
pp. s273-s273
Author(s):  
Christian Pallares ◽  
María Virginia Villegas Botero
Keyword(s):  
Infection Control ◽  
Antimicrobial Stewardship ◽  
Control Strategies ◽  
Education And Training ◽  
Public Hospitals ◽  
International Standards ◽  
International Consensus ◽  
Stewardship Program ◽  
And Training

Background: More than 50% of antibiotics used in hospitals are unnecessary or inappropriate. The antimicrobial stewardship programs (ASPs) are coordinated efforts to promote the rational and effective use of antibiotics including appropriate selection, dosage, administration, and duration of therapy. When an ASP integrates infection control strategies, it is possible to decrease the transmission of multidrug-resistant pathogens. Methods: In 2018, 5 Colombian hospitals were selected to implement an ASP. Private and public hospitals from different cities were included in the study, ranging from 200 to 700 beds. Our team, consisting of an infectious disease and hospital epidemiologist, visited each hospital to establish the baseline of their ASP program, to define the ASP outcomes according to each hospital’s needs, and to set goals for ASP outcomes in the following 6–12 months. Follow-up was scheduled every 2 months through Skype video conference. The baseline diagnosis or preintervention evaluation was done using a tool adapted from previous reports (ie, international consensus and The Joint Commission international standards). Documentation related to ASPs, such as microbiological profiles, antimicrobial guidelines (AMG) and indicators for the adherence to them as well as antimicrobial resistance (AMR) prevention through protocols, were written and/or updated. Prevention and infection control requirements and protocols were also updated, and cleaning and antiseptic policies were created. Training in rational use of antibiotic, infection control and prevention, and cleaning and disinfection were carried out with the healthcare workers in each institution. Results: Before the intervention, the development of the ASP according to the tool was 27% (range, 5%–47%). The lowest institutional scores were the item related to ASP feedback and reports (11% on average), followed by education and training (14%), defined ASP responsibilities (23%), ASP function according to priorities (26%), and AMR surveillance (27%). After the intervention, the ASP development increased to 57% (range, 39%–81%) in the hospitals. The highest scores achieved were for education and training (90%), surveillance (75%), and the activities of the infection control committee (70%). The items that made the greatest contribution to ASP development were the individual antibiogram, including the bacteria resistance profile, and the development of the AMG based on the local epidemiology in each hospital. Conclusions: The implementation of an ASP should include training and education as well as defining outcomes according to the hospital’s needs. Once the strategy is implemented, follow-up is key to achieving the goals.Funding: NoneDisclosures: None

Effect of a wound cleansing solution on wound bed preparation and inflammation in chronic wounds: a single-blind RCT

2016 ◽  
Vol 25 (3) ◽  
pp. 160-168 ◽  
Author(s):  
A. Bellingeri ◽  
F. Falciani ◽  
P. Traspedini ◽  
A. Moscatelli ◽  
A. Russo ◽  
...  
Keyword(s):  
Chronic Wounds ◽  
Wound Bed Preparation ◽  
Single Blind

scholarly journals Infection Prevention Time Required for Construction and Design at a Large Tertiary-Care Hospital, 2019

2020 ◽  
Vol 41 (S1) ◽  
pp. s69-s70
Author(s):  
Angie Dains ◽  
Michael Edmond ◽  
Daniel Diekema ◽  
Stephanie Holley ◽  
Oluchi Abosi ◽  
...  
Keyword(s):  
Infection Control ◽  
Patient Care ◽  
Construction Projects ◽  
Small Scale ◽  
Care Hospital ◽  
Class Iii ◽  
Construction Sites ◽  
Wide Range ◽  
Time Required ◽  
Class Iv

Background: Including infection preventionists (IPs) in hospital design, construction, and renovation projects is important. According to the Joint Commission, “Infection control oversights during building design or renovations commonly result in regulatory problems, millions lost and even patient deaths.” We evaluated the number of active major construction projects at our 800-bed hospital with 6.0 IP FTEs and the IP time required for oversight. Methods: We reviewed construction records from October 2018 through October 2019. We classified projects as active if any construction occurred during the study period. We describe the types of projects: inpatient, outpatient, non–patient care, and the potential impact to patient health through infection control risk assessments (ICRA). ICRAs were classified as class I (non–patient-care area and minimal construction activity), class II (patients are not likely to be in the area and work is small scale), class III (patient care area and work requires demolition that generates dust), and class IV (any area requiring environmental precautions). We calculated the time spent visiting construction sites and in design meetings. Results: During October 2018–October 2019, there were 51 active construction projects with an average of 15 active sites per week. These sites included a wide range of projects from a new bone marrow transplant unit, labor and delivery expansion and renovation, space conversion to an inpatient unit to a project for multiple air handler replacements. All 51 projects were classified as class III or class IV. We visited, on average, 4 construction sites each week for 30 minutes per site, leaving 11 sites unobserved due to time constraints. We spent an average of 120 minutes weekly, but 450 minutes would have been required to observe all 15 sites. Yearly, the required hours to observe these active construction sites once weekly would be 390 hours. In addition to the observational hours, 124 hours were spent in design meetings alone, not considering the preparation time and follow-up required for these meetings. Conclusions: In a large academic medical center, IPs had time available to visit only a quarter of active projects on an ongoing basis. Increasing dedicated IP time in construction projects is essential to mitigating infection control risks in large hospitals.Funding: NoneDisclosures: None

scholarly journals Closure of the nasal cavities in the treatment of refractory hereditary haemorrhagic telangiectasia

1997 ◽  
Vol 111 (1) ◽  
pp. 30-33 ◽  
Author(s):  
Valerie J. Lund ◽  
David J. Howard
Keyword(s):  
Hormone Therapy ◽  
Laser Coagulation ◽  
Hereditary Haemorrhagic Telangiectasia ◽  
Nasal Cavities ◽  
Complete Closure ◽  
The One

AbstractFrom a cohort of 35 patients with hereditary haemorrhagic telangiectasia (HHT), 12 patients have undergone closure of the one or both nasal cavities during the last three years for refractory epistaxis. All had failed other forms of treatment including hormone therapy, laser coagulation and septodermoplasty. All patients were available for follow-up at six months or longer. In all patients where complete closure was achieved (11 out of 12) bleeding ceased completely from the operated side.

Immediate and early results of closure of moderate to large patent arterial ducts using the new Amplatzer™ device

2000 ◽  
Vol 10 (3) ◽  
pp. 208-211 ◽  
Author(s):  
Ashutosh Marwah ◽  
S. Radhakrishnan ◽  
Savitri Shrivastava
Keyword(s):  
Flow Mapping ◽  
Residual Shunt ◽  
Complete Closure ◽  
Early Results ◽  
Amplatzer Device ◽  
Amplatzer Occluder ◽  
Efficacious Treatment ◽  
Long Term Follow Up ◽  
The One

AbstractObjectiveOur aim was to assess the immediate and short term results of closure of moderate and large patent arterial ducts using the self-expanding and repositionable Amplatzer device.MethodWe attempted closure in 25 patients (10 Females and 15 males) using the Amplatzer occluder. Their median age was 48 months with a range from 8months to 26years and median weight of 14kg with a range from 4.5kg to 48kg. The mean ductal diameter was 4 (S.D 1.51mm). A 6F/7F long sheath was used to deliver the device. Follow up was performed with colour- flow mapping of the pulmonary trunk within 24 hours, at 3 months, and 6 months of closure.ResultsOf the 25 patients, the device was placed successfully in 23. Concurrent angiography showed immediate closure in 12 patients, while 8 had trivial shunting and 3 had mild shunting. Within 24 hours, Doppler examination revealed complete closure in all but three patients, who had a mild residual shunt. Two attempts were unsuccessful. Both these patients underwent successful surgical ligation. All except one patient were discharged on the next day. Of the 23 patients, 15 (65%) have been followed up for 3months, while 8 (35%) have completed 6 months of follow-up. Of the three patients initially with mild residual flow, two had completely closed at 3 months The one remaining patient is yet to be seen at the 3 month follow-up. Thus, at 3 months, all patients studies had shown complete closure.ConclusionAntegrade transcatheter closure using the Amplatzer duct occluder is an efficacious treatment for bigger patent arterial ducts. Long-term follow-up is necessary to show sustained benefits and confirm the absence of side effects.

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