Wound irrigation

Human amniotic membrane (hAM) is a collagen-based extracellular matrix that facilitates regenerative wound care. hAM offers several advantageous properties that promote epithelial cell growth, granulation, and angiogenesis. This case report demonstrates how Vivex Cygnus Matrix (Vivex Biologics, Miami, FL, USA) amniotic membrane was used over four weeks to graft a traumatic index finger injury that occurred while fishing. Cygnus Matrix allograft was first placed 72 hours after the accident. Following graft placement, the patient noted an immediate relief in pain and was able to return to all normal daily work activities within 48 hours of graft placement...

BACKGROUND: Pylephlebitis, a rare and lethal form of portal venous septic thrombophlebitis, often arises from infections in regions drained by the portal vein. Herein, we report a case of peritonitis with portal vein thrombosis due to acute severe appendicitis, managed with intensive intraperitoneal drainage via open abdominal management (OAM). CASE PRESENTATION: A 19-year-old male with severe appendicitis, liver abscesses, and portal vein thrombosis developed septic shock and multi-organ failure...

For preoperative skin antisepsis, alcohol-containing iodine solutions and octenidine are suitable. For wound antisepsis, polyhexanide and hypochlorous acid (HOCL) are also available, but only PVP-iodine and HOCL can be applied to cartilage. Chlorhexidine should only be used as mouth- and bodywash for Staphylococcus aureus (MRSA) decolonization. For the many other throat antiseptics, evidence of clinical efficacy is lacking. For decolonization of the nares, polyhexanide and octenidine are available as nasal gels, but these are inferior to mupirocin for MRSA decolonization...

Cochlear implantation (CI) is the most effective solution for patients with severe-to-profound sensorineural hearing loss, especially in children. However, a major postoperative complication, known as chronic suppurative otitis media (CSOM), poses challenges for both doctors and families of the patients, which can affect post-CI hearing outcomes. We present the case of post-CI CSOM in a 15-year-old girl. She had been utilizing a unilateral cochlear implant for 7 years and had been experiencing intermittent earache and discharge in her only audible ear for the past 15 months...

Background: Total knee arthroplasty (TKA) is one of the most common inpatient and outpatient surgical procedures performed in the United States and is predicted to increase 401% by 2040. Surgical site infections (SSIs) at an incidence rate of approximately 2% are costly post-operative complications in TKA. Intra-operative surgical irrigants are used to decrease contaminating microbial bioburden within the surgical site to prevent SSI. The primary objective of this retrospective study was to evaluate the impact of a novel surgical irrigant called XPERIENCE® Advanced Surgical Irrigation (XP; Next Science, Jacksonville, FL) on SSI incidence in primary TKA performed at an ambulatory surgery center (ASC)...

Crush injuries to the foot have become increasingly prevalent in contemporary settings, primarily arising from incidents such as the impact of large objects falling onto the foot or involvement in traffic accidents. The complexity of treating these injuries is compounded by the intricate anatomy of the foot. In specific scenarios, the implementation of an integrated management approach could prove advantageous. In this report, we depict the case of a 23-year-old male who visited the Shalya OPD with a wound on his left foot caused by trauma...

PURPOSE: To identify associations with unplanned repeat irrigation and debridement (I&D) after arthrotomy for native septic arthritis. METHODS: A retrospective review identified patients with native septic arthritis treated with open arthrotomies. The primary outcome was unplanned repeat I&D within 90 days. Associations evaluated for included comorbidities, ability to bear weight, fever, immunosuppressed status, purulence, C-reactive protein, erythrocyte sedimentation rate, white blood cell count (synovial fluid and serum levels), and synovial fluid polymorphonuclear cell percentage (PMN%)...

Objective: To explore the epidemiological characteristics and risk factors of catheter-associated urinary tract infections in patients with perineal and/or hip burns. Methods: This study was a retrospective case series study. From January 2018 to December 2022, 260 patients with perineal and/or hip burns and urinary catheters indwelling who met the inclusion criteria were admitted to the Department of Burns and Wound Repair of the Second Affiliated Hospital of Zhejiang University School of Medicine, including 192 males and 68 females, aged 20-93 years...

INTRODUCTION: Retained hemothorax (HTX) is a common complication following thoracic trauma. Small studies demonstrate the benefit of thoracic cavity irrigation at the time of tube thoracostomy for the prevention of retained HTX. We sought to assess the effectiveness of chest irrigation in preventing retained HTX leading to a secondary surgical intervention. METHODS: We performed a single-center retrospective study from 2017-2021 at a Level I trauma center comparing bedside thoracic cavity irrigation via tube thoracostomy (TT) versus no irrigation...

BACKGROUND: Tobacco use significantly increases the rate of wound complications in patients undergoing total ankle arthroplasty (TAA). Preoperative optimization through smoking cessation programs significantly minimizes the rate of infection and improves wound healing in arthroplasty procedures. Despite its utility, minimal research has examined the cost-effectiveness of preoperative smoking cessation programs to reduce the need for extracapsular irrigation and debridement (I&D) due to wound complications following TAA...

INTRODUCTION: Patellofemoral arthroplasty (PFA) has been shown to provide symptomatic improvement for isolated patellofemoral osteoarthritis (PFOA). The efficacy of robotic-assisted PFA and the most suitable PFA implant design, however, remain ongoing matters of debate. This study sought to compare clinical outcomes between patients who underwent robotic-assisted versus conventional PFAs with inlay and onlay prosthetic designs. METHODS: A single-center retrospective review found 237 knees (211 patients) which underwent PFA between 2011 and 2021...

INTRODUCTION: Reports on medial gastrocnemius myocutaneous (MGM) flaps with extended inferior and posterior boundaries are rare, and information about the MGM flaps with extended anterior boundaries is unavailable. Thus, this study aimed to investigate the vascular anatomical basis and clinical reliability of the modified MGM flap with extended anterior, inferior and/or posterior boundaries. METHODS: Five fresh lower limb specimens from patients with recurrent tumours in the thigh were immediately irrigated and perfused...

BACKGROUND: Irrigation is used to minimize infection of open wounds. Sterile saline is preferred, but potable water is becoming more widely accepted. However, the large volumes of water that are recommended are usually not available in austere environments. This study determined the long-term antimicrobial effectiveness of military purification powder compared with currently available civilian methods. The study also compared the physical characteristics and outcomes under the logistical constraints...

PURPOSE: To investigate the effect of ellagic acid (EA) in gingival tissues injury in rats. METHODS: Twenty rats were categorized into two groups. In burn group, an excisional wound area was created by removing a 4-mm diameter flap from the left molar region in the mucoperiosteal region of the gingiva. In burn + ellagic acid group, 1.2 mg/mL EA was administered as irrigation for one week. Animals was sacrificed under anesthesia at the end of experiment. Malondialdehyde (MDA), myeloperoxidase (MPO) and glutathione (GSH) level were measured...

Pyogenic myositis is a bacterial infection of skeletal muscle that is usually caused by Staphylococcus aureus and is common in tropical regions. Recently, this infection has also been reported in immunocompromised patients in temperate regions. The lower extremities and trunk are most affected, while involvement of the chest wall is rare. We report a case of pectoralis major pyomyositis caused by Morganella morganii in an 82-year-old Japanese man with type 2 diabetes mellitus who had undergone stenting for myocardial infarction...

Pin tract infections are virtually universal complications with the use of external fixation. While most are superficial and respond to oral antibiotics and local care, septic loosening may occur at the bone-pin interface, which may lead to instability of the fixator, catastrophic failure, fracture, and long-term osteomyelitis. Classification systems and prevention protocols have been developed to address this ubiquitous complication. Treatment of severe pin tract infections often requires debridement, parenteral antibiotics, and removal of the offending pin or the entire external fixator...

Post-operative management of chronic rhinosinusitis is very crucial for outcomes following surgery, Normal saline nasal irrigation and steroid spray form the standard treatment of care in this period. However nasal irrigation may not be adequate and spray is usually started after 2 weeks of surgery which in any case does not deliver optimum dosage of drug to the paranasal sinus mucosa. Budesonide nasal irrigation in a high-volume low-pressure system could be the solution for a better outcome. A double blinded randomized control trial with 88 patients in 2 groups of 44 each received normal saline or Budesonide nasal irrigation (0...

Alligator bites in humans present a significant concern for public safety in the southern United States, especially in states like Florida with substantial alligator populations. Although these reptiles play a vital role in the local ecology, encounters with humans can lead to severe injuries and even fatalities. A case report is presented of a 58-year-old male who suffered an alligator bite while attempting to take a selfie with the reptile during a hunting trip in rural Florida. The patient's injuries included multiple lacerations on the dorsum of his right hand...

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BACKGROUND: Open fractures of the talar body and neck are uncommon. Previous reports of associated deep infection rates and resulting surgical requirements vary widely. The primary objective of this study is to report the incidence of deep infections for isolated open talar body and neck fractures, and secondarily the incidence and number of total surgeries performed (TSP), secondary salvage procedures (SSPs), and nonsalvage procedures (NSPs). METHODS: Retrospective case-control study of 32 consecutive isolated open talus fracture patients (22 neck, 10 body) were followed for an average of 39...