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Surgical Wounds (surgical + wound)
Terms modified by Surgical Wounds Selected AbstractsThe purse-string suture revisited: a useful technique for the closure of cutaneous surgical woundsINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 4 2007Philip R. Cohen MD The purse-string suture provides complete or partial closure of round postoperative skin defects. It is a rapid and simple procedure to perform. Tension placed on the suture uniformly advances the skin from the entire periphery of the wound, resulting in a significant reduction of the defect size and enhancement of hemostasis at the wound edge. The history, modifications of the technique, advantages, and potential complications of the purse-string suture are reviewed. It is not only useful following the removal of nonmelanoma skin cancer but also after the local excision of melanoma. In addition, this technique is especially suitable for the repair of round surgical wounds for patients who are unable to modify their active lifestyles during the week following surgery, individuals concurrently being treated with anticoagulants, antiplatelet agents or both, and people with extensive postoperative defects that would otherwise require either a skin graft or a large cutaneous flap. Typically, the site of the surgical wound following partial or complete closure with the purse-string suture demonstrates excellent long-term cosmetic and functional results. [source] Study of intussusceptive angiogenesis in inflammatory regional lymph nodes by scanning electron microscopyMICROSCOPY RESEARCH AND TECHNIQUE, Issue 1 2010Tíssiana Rachel Rossi-Schneider Abstract The aim of the present study was to verify the occurrence of intussusceptive angiogenesis in blood vessels from submandibular lymph nodes responsible for lymphatic drainage of the tongue. A surgical wound inflicted on the ventral tongue of male Wistar rats and submandibular regional lymph nodes were evaluated at different postoperative periods. Scanning electron microscopy (SEM) was used to observe 123 lymph nodes at times 2, 3, 7, 10, 14, and 21 postoperative days. During the analysis of the vascular models with SEM, intussusceptive angiogenesis was observed in all groups evaluated. This was more extensive on the second and third postoperative days (83.33% and 80%, respectively), representing in these groups the expansion of the vascular chain of lymph nodes. At 21 postoperative days, intussusceptive angiogenesis (42.85%) was suggestive of vascular remodeling. Microsc. Res. Tech. 2009. © 2009 Wiley-Liss, Inc. [source] POST-SURGICAL NEUROPATHIC PAINANZ JOURNAL OF SURGERY, Issue 7 2008Edward Shipton Surgeons and anaesthetists are involved in Pain Medicine, as they have a responsibility to contribute to postoperative pain management and are often consulted about longer-term pain problems as well. A large component of persistent pain after surgery can be defined as neuropathic pain (NP). Nerves are injured during surgery and pain can persist after the surgical wound has healed. NP is because of a primary lesion or dysfunction of the peripheral or central nervous system. Prevalence estimates indicate that 2,3% of the population in the developed world experience NP. Persistent post-surgical NP is a mostly unrecognized clinical problem. The chronicity and persistence of post-surgical NP is often severely debilitating and impinges on the psychosocial, physical, economic and emotional well-being of patients. Options for treatment of any neuropathic factors are based on understanding the pain mechanisms involved. The current understandings of the mechanisms involved are presented. There is reasonable evidence for the efficacy of pharmacological management for NP. The aim of this article was to appraise the prevention, diagnostic work-up, the physical and particularly the pharmacological management of post-surgical NP and to provide a glimpse of advances in the field. It is a practical approach to post-surgical NP for all surgeons and anaesthetists. The take-home message is that prevention is better than waiting for post-surgical NP to become persistent. [source] Use of adhesive surgical tape with the absorbable continuous subcuticular sutureANZ JOURNAL OF SURGERY, Issue 8 2003Jeremy D. Kolt Background: The absorbable continuous subcuticular suture is frequently used to close surgical incisions where the aim is healing by primary intention. A form of adhesive surgical tape is commonly also placed over the wound but this combination closure seems to have its development based on anecdotal, rather than experimental evidence. The present study reviews the scientific literature on the development of sutureless wound closure and presents the current evidence for the use of combination wound closure. Methods: Review was undertaken of the medical literature using the PubMed Internet database and cross-referencing major articles on the subject. The following combinations of key words were searched: skin closure, wound closure, suture technique, sutureless, adhesive tape, op-site, staples, subcuticular suture, complication, infection and scars. Results: Taped closure alone has advantages of lower wound infection rates and greater wound tensile strength, but disadvantages of epidermal reaction, skin edge inversion, doubtful safety and time required for meticulous surgical technique. The use of the continuous absorbable subcuticular suture allows accurate skin edge approximation, which increases the safety margin. The combination closure has a slightly superior cosmetic result to sutureless techniques but no study has been performed to compare the results of combination subcuticular suture and tape, with tape or subcuticular suture alone. Conclusions: There is no evidence in the scientific literature to justify or support the practice of closing a surgical wound with both subcuticular suture and adhesive surgical tape. [source] Pharmacokinetics and tissue distribution of intravenous pefloxacin for antibiotic prophylaxis in biliary surgeryBIOPHARMACEUTICS AND DRUG DISPOSITION, Issue 7 2002A.R. Gascón Abstract The plasma levels and tissue penetration of pefloxacin were studied after prophylactic administration to patients undergoing elective biliary surgery. Pefloxacin was administered as a single dose of 800 mg given intravenously as an infusion 1 h before surgery. Over a period of two years, cultures of bile and stone were performed after cholecystectomy in order to find the main pathogens present in the geographical area of the hospital of Txagorritxu (Vitoria, Spain), as well as to test the antimicrobial susceptibility of these bacteria to pefloxacin. Thirty seven per cent of the bile and stone cultures were positive, and 75 different species were isolated. E. coli was the predominant microorganism (25%). Other frequent microorganisms were E. faecium (9.3%), S. epidermidis (6.6%) and Cl. perfringens (6.6%). Most species isolated were susceptible to pefloxacin, with MIC90 values of 0.125 ,g/ml for E. coli, 0.5 ,g/ml for S. epidermidis and 1 ,g/ml for Cl. perfringens. E. faecium was resistant, with a MIC90 value of 8 ,g/ml but a MIC50 of 4 ,g/ml (intermediate). After pefloxacin infusion, adequate drug plasma levels (>MIC90) for the most frequent pathogens were found throughout the procedure. Elimination half-life was estimated as 22.03±6.91 h; the area under the concentration,time curve from zero to infinite had a value of 275.07±130.02 mg h/l and the values for volume of distribution at steady-state and plasma clearance were 96.48±28.65 L and 3.60±1.83 l/h, respectively. Bile pefloxacin concentrations generally exceeded the minimum inhibitory concentrations for most relevant pathogens. Drug levels in gallbladder and subcutaneous tissues were also above the MIC90 for extended periods. Patients were observed daily throughout their hospital stay. This included examination of the surgical wound and recording of body temperature. No cases of anaerobic infection were noted in the study patients. Other constants such as hospitalization stay and time of recuperation were normal for this type of surgery. According to these results, pefloxacin presents many features that make it suitable for use as a therapeutic prophylactic agent, such as its broad spectrum of antimicrobial activity and favorable pharmacokinetic properties. Copyright © 2002 John Wiley & Sons, Ltd. [source] 1351: Eyelid splitting and extirpation of hair follicles for treatment of trichiasisACTA OPHTHALMOLOGICA, Issue 2010M ROSNER Purpose To review the background for developing the surgical technique of eyelid splitting and extirpation of hair follicles for treatment of acquired trichiasis, to demonstrate the technique, and to highlight its indications, advantages and complications. Methods Personal experience is used to demonstrate the technique, its indications, advantages and complications. This includes the follow-up data of 12 eyelids of 8 consecutive patients who were treated by splitting the eyelid margin using radiosurgical technique and others where the splitting of the lid margin was performed using CO2 laser or Colorado needle. This was followed by extirpation of the hair follicles of the trichiatic eyelashes using surgical microscope. Results Complete recovery of the trichiatic eyelashes at the site of the treatment occurred in most eyelids. There were no complications during or after healing of the surgical wound during the follow-up period. Conclusion Eyelid splitting and extirpation of hair follicles provides a simple and relatively rapid modification of the surgical treatment for acquired trichiasis, with good functional results. [source] 1352: Glass beads implantation in the scleral cavity during eviscerationACTA OPHTHALMOLOGICA, Issue 2010N ROSEN Purpose To review the background for developing the surgical modification of glass bead implantation in the scleral cavity during evisceration, to demonstrate the technique, and to highlight its indications, advantages and complications. Methods Personal experience is used to demonstrate the technique, its indications, advantages and complications. This includes the follow-up data of 17 patients who underwent evisceration with glass bead implantation during 1993-1996 and our experience from 164 eviscerations performed in our eye institute during the last 14 years. Results All patients achieved good cosmetic results with relatively good motility of the prosthesis. Complications included transient chemosis at the early postoperative period; three patients had local dehiscence of the wound, two patients developed a cyst in the socket and one patient was afflicted with thinning of the conjunctiva over the surgical wound. Conclusion The use of glass beads to fill the scleral cavity during evisceration has the advantage of an excellent fit in accordance with the scleral cavity volume, as well as ease of treatment in case of extrusion. The prosthesis movement is good because of its engagement with the scleral bulges caused by the glass beads. [source] Pemphigus Foliaceus Masquerading as Postoperative Wound Infection: Report of a Case and Review of the Koebner and Related Phenomenon following Surgical ProceduresDERMATOLOGIC SURGERY, Issue 2 2005Adam M. Rotunda MD Background The Koebner phenomenon, also known as the isomorphic response, is the development of preexisting skin disease following trauma to uninvolved skin. Various cutaneous disorders have been described to arise at surgical wounds and scars. Moreover, dermatologic procedures, such as cold-steel and laser surgery, can evoke koebnerization. Objective To describe a case of pemphigus foliaceus arising in postoperative wounds and to present a review of dermatologic disorders triggered by surgical procedures. Methods We report a case of pemphigus foliaceus initially presenting at sites of Mohs' micrographic surgery, shave biopsy, and cryotherapy and, subsequently, at a nonsurgical site. We reviewed the English literature in MEDLINE from November 1955 to April 2004 for reports of Koebner and related phenomenon following surgical procedures. Results To our knowledge, this is the first reported case of pemphigus foliaceus erupting at surgical and cryotherapy wounds. The clinical appearance can mimic wound infection. In addition to inducing preexisting disease, cutaneous procedures can also trigger the onset of new disease, which can either be limited only to the surgical site or subsequently become generalized. Conclusion Postoperative Koebner or related responses should be included in the differential diagnosis of poorly healing surgical wounds. Skin biopsies for histopathology and immunologic studies may be necessary for definitive diagnosis and optimal management. ADAM M. ROTUNDA, MD, ANAND R. BHUPATHY, DO, ROBERT DYE, MD, AND TERESA T. SORIANO, MD, HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS. [source] The purse-string suture revisited: a useful technique for the closure of cutaneous surgical woundsINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 4 2007Philip R. Cohen MD The purse-string suture provides complete or partial closure of round postoperative skin defects. It is a rapid and simple procedure to perform. Tension placed on the suture uniformly advances the skin from the entire periphery of the wound, resulting in a significant reduction of the defect size and enhancement of hemostasis at the wound edge. The history, modifications of the technique, advantages, and potential complications of the purse-string suture are reviewed. It is not only useful following the removal of nonmelanoma skin cancer but also after the local excision of melanoma. In addition, this technique is especially suitable for the repair of round surgical wounds for patients who are unable to modify their active lifestyles during the week following surgery, individuals concurrently being treated with anticoagulants, antiplatelet agents or both, and people with extensive postoperative defects that would otherwise require either a skin graft or a large cutaneous flap. Typically, the site of the surgical wound following partial or complete closure with the purse-string suture demonstrates excellent long-term cosmetic and functional results. [source] A randomised controlled trial of the effects of cryotherapy on pain, eyelid oedema and facial ecchymosis after craniotomyJOURNAL OF CLINICAL NURSING, Issue 21 2009Yong Soon Shin Aim., To identify the effects of cryotherapy on patient discomfort following craniotomy. Background., Following craniotomy, many patients suffer from unexpected discomfort, including pain, eyelid oedema and ecchymosis. Cryotherapy is regarded as a safe method for managing these postcraniotomy problems. Design., Randomised controlled trial. Methods., A total of 97 Korean patients who underwent elective supratentorial craniotomy were randomly assigned to a cryotherapy or a control group. In the cryotherapy group, ice bags were applied to surgical wounds, and cold gel packs were applied to periorbital areas, for 20 minutes per hour, beginning three hours postoperatively and for three days thereafter. The level of patient pain was measured using the visual analogue scale while the eyelid oedema was measured using the Kara & Gokalan's scale. Ecchymosis was also classified according to its extent. Results., The level of pain three hours after craniotomy was similar in the cryotherapy and control groups (57·9 vs. 58·7). Three days after surgery, pain had significantly decreased in the cryotherapy group (p = 0·021). After adjusting diagnosis by analysis of covariance (ancova), pain score did not differ significantly between the two groups. The mean eyelid oedema scores were lower in the cryotherapy group than in the control group (0·59 vs. 2·29, p < 0·001), with ancova showing that cryotherapy had a significant effect on eyelid oedema (p < 0·001). Pain (p = 0·047) and eyelid oedema (p < 0·001) in the cryotherapy group were significantly decreased over time. Ecchymosis were significantly less frequent in the cryotherapy (11/48, 22·9%) than in the control (26/49, 53·1%) group (p = 0·003). Logistic regression analysis showed that cryotherapy affected ecchymosis (p = 0·001). Conclusion., These results indicate that cryotherapy can control pain, eyelid oedema and facial ecchymosis after craniotomy. Relevance to clinical practice., Cryotherapy, which is both convenient and cost-effective, can be used to prevent postoperative discomforts in a clinical setting. [source] A systematic review of honey uses and its potential value within oncology careJOURNAL OF CLINICAL NURSING, Issue 19 2008Joy Bardy Aim., To synthesise the evidence regarding honey's role in health care and to identify whether this evidence applies more specifically to cancer care. Design., Systematic review. Methods., The inclusion and exclusion criteria were agreed by two reviewers and a keyword strategy was developed. EMBASE, CINAHL, AMED, MEDLINE, COCHRANE and PUBMED databases were screened to identify suitable articles. The citation list from each included study was also screened for potentially suitable papers. The key findings from each study were entered onto a data extraction sheet. Results., In total, 43 studies were included in the systematic review, which included studies in relation to wounds (n = 19), burns (n = 11), skin (n = 3), cancer (n = 5) and others (n = 5). In addition, a systematic review regarding honey use in wound care was also included. While the majority of studies noted the efficacy of honey in clinical use, five studies found honey to be equally as effective as the comparator and three found honey to be less effective than the comparator treatment. Other research did not illustrate any significant difference between standard treatment regimes vs. honey treatment. Studies were generally poor in quality because of small sample sizes, lack of randomisation and absence of blinding. Conclusions., Honey was found to be a suitable alternative for wound healing, burns and various skin conditions and to potentially have a role within cancer care. Relevance to clinical practice., In the cancer setting, honey may be used for radiation-induced mucositis, radiotherapy-induced skin reactions, hand and foot skin reactions in chemotherapy patients and for oral cavity and external surgical wounds. [source] Commentary on Vermeulen H, Ubbink DT, Schreuder SM and Lubbers MJ (2007) Inter- and intra-observer (dis)agreement among nurses and doctors to classify colour and exudation of open surgical wounds according to the Red,Yellow,Black scheme.JOURNAL OF CLINICAL NURSING, Issue 12 2008Journal of Clinical Nursing1, Kitagawa A (2007) A study of the efficiency, Konya C, Matsui Y, Okuwa M, Sanada H, Sugama J, convenience of an advanced portable wound measurement system (VISITRAKTM). [source] The gel swelling properties of alginate fibers and their applications in wound managementPOLYMERS FOR ADVANCED TECHNOLOGIES, Issue 1 2008Yimin Qin Abstract Calcium alginate fibers have a novel gel-forming capability in that, upon the ion exchange between sodium ions in the contact solution and calcium ions in the fiber, the fiber slowly transforms into a fibrous gel. This paper reviews the principles of the gel-forming process for alginate fibers and analyzed the gelling behavior of various types of alginate fibers. The absorption characteristics of alginate wound dressings were analyzed and it was found that alginate wound dressings absorb a large quantity of liquid into the fiber structure, in addition to those held between the fibers in the textile structure. This gives rise to the unique gel blocking properties of alginate wound dressings. In addition, alginate wound dressings also have novel hemostatic and antimicrobial properties as well as the ability to promote wound healing. They are now widely used in the management of highly exuding wounds such as leg ulcers, pressure sores, and surgical wounds. Copyright © 2007 John Wiley & Sons, Ltd. [source] Ulceration and antihypertensive use are risk factors for infection after skin lesion excisionANZ JOURNAL OF SURGERY, Issue 9 2010Anthony Penington Abstract Background:, A prospective audit was performed of wound complications of skin lesion excision in a private practice setting. Methods:, For 924 consecutive skin lesion excisions performed by a single surgeon, information was collected on tumour size and site, closure method and on risk factors of age, known diabetes, use of steroids, antihypertensives or anticoagulants and ulceration of the lesion. Patients were given written instructions to wet the wound in the shower after one or two days. A wound ,infection' event was recorded if the wound appeared inflamed or if the patient had been treated with antibiotics by any practitioner. Wound bleeding was recorded if the patient returned or attended elsewhere for management of bleeding. Results:, Sixty-seven wounds (7.25%) met the broad definition of ,infection' and 18 (1.9%) wounds suffered bleeding. Ulceration (odds ratio (OR) 3.15, P= 0.008) and use of antihypertensives (OR 2.5, P= 0.006) were independent risk factors for infection along with site and closure method. The patients who did not wet their wounds post-operatively were also at an increased risk of infection (OR 2.1, P= 0.018). Aspirin caused a slight, non-statistically significant increase in bleeding rate, and warfarin caused a larger, but still not statistically significant, increase in bleeding. Use of other anticoagulants caused a significant increase in bleeding (OR 10.9, P= 0.006). Conclusion:, Ulceration of the skin lesion and use of antihypertensives are significant risk factors for wound infection. Wetting surgical wounds with clean tap water does not increase, and may even reduce, wound infection rate. [source] Original Article: Lignocaine gel in minimally invasive surgery , A pilot cohort studyAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 4 2010Natasha BEG Background:, The administration of local anaesthetic at the conclusion of minimally invasive procedures has been shown to reduce postoperative pain. However, it is often not feasible to reach target surgical sites using a needle, making it difficult to administer injectable local anaesthetic. Formulations currently available for topical use are also not sterile, adhere poorly, and are not adjusted to neutral pH at the time of use. To address these limitations, a new sterile, aqueous 4.8% lignocaine gel was formulated for topical application on surgical wounds. Aims:, To determine the clinical feasibility, safety and tolerability of the topical lignocaine gel. Methods:, A total of 125 female patients underwent minimally invasive gynaecological procedures. The lignocaine gel was applied to any intra-abdominal, intra-uterine or intra-vaginal surgical wounds. The incidence of any intra- or postoperative complications was determined via retrospective review of surgical reports, hospital files and outpatient clinic files. Results:, In all cases, the surgeon was able to apply the gel successfully to the desired site. There were no intra-operative complications. There were no adverse events encountered during recovery or hospitalisation which are likely to be associated with the lignocaine gel. Eight patients experienced adverse events during the postoperative period which could be linked to the use of the gel. However, the incidence of these was within the known range of adverse events for these procedures. Conclusions:, A sterile lignocaine gel can be safely used in minimally invasive surgery. [source] Letter: Systematic review of dressings and topical agents for surgical wounds healing by secondary intention (Br J Surg 2005; 92: 665-672)BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 12 2005I. Loefler The Editors welcome topical correspondence from readers relating to articles published in the Journal. Responses can be sent electronically via the BJS website (http://www.bjs.co.uk) or by post. All letters will be reviewed and, if approved, appear on the website. A selection of these will be edited and published in the Journal. Letters must be no more than 250 words in length. Letters submitted by post should be typed on A4-sized paper in double spacing and should be accompanied by a disk. [source] Authors' reply: Systematic review of dressings and topical agents for surgical wounds healing by secondary intention (Br J Surg 2005; 92: 665-672)BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 12 2005H. Vermeulen No abstract is available for this article. [source] | ||||||||||||||||||||||