Objective
To analyze the related risk factors of the orthopedic surgical site infection and investigate application of Wechat follow-up so as to provide reference for reducing infection after orthopedic surgery.
Method
A total of 1 453 patients with orthopedic surgery from Jan. 2016 to Dec. 2016 were selected and retrospectively analyzed the related risk factors of the orthopedic surgical site infection at the time of hospitalization and post-discharge.
Results
Among 1 453 patients with orthopedic surgery, there were 26 cases of surgical site infection, accounting for 1.79%; the surgical site infection occurred in 8 of 1 427 patients after discharge, accounting for 0.56%. Age, basic disease, the time of operation, implant situation, incision situation at discharge, and follow-up visit were the factors that might cause orthopedic surgical site infection, with statistically significant differences (P<0.05).
Conclusions
There are many factors that are related to the orthopedic surgical site infection, thus it is necessary to implement strictly the preoperative evaluation and preparation, intraoperative sterile operation and tissue protection, postoperative aseptic dressing during hospitalization. After the discharge, we should add Wechat follow-up on the basis of telephone follow-up, it can increase the knowledge of postoperative care to reduce the surgical site infection.
Key words:
Orthopedic surgery; Infection; Risk factor; Wechat follow-up
Bigu is a Taoist fasting technique interpreted as avoiding grains in the Encyclopedia of China. This technique has been used from ancient times to the present day in China and other parts of the world to achieve good health, weight loss, longevity, and even immortality. A variety of health problems have been identified in relation to the severe diet during Bigu. However, perforation of the alimentary canal has not been reported to be associated with Bigu. In the present study, we illustrated an unusual case of perforation of the alimentary canal in relation to Bigu.A 36-year-old woman was admitted to our hospital after falling into a coma. One month before admission, she had black stool accompanied by dizziness and fatigue, while the symptoms progressively worsened. The patient reported that she stopped the intake of meat for 5 years, and further practiced Bigu for 5 months, eating only fruits and vegetables, and avoiding grains and meat.Preformation of the alimentary canal.Gastric bypass operation, also known as Roux-en-Y anastomosis, was undertaken. Since the patient developed thrombus with edema on the right upper limb after surgical intervention, she was subsequently treated with anticoagulation therapy using low-molecular weight heparin.The patient's symptoms were remarkably improved and exhibited signs of recovery in follow-up examinations.The case has raises serious concerns about practicing Bigu. Furthermore, it is strongly advocated that a state of Bigu for a long period of time can even be dangerous.
A myxofibrosarcoma (MFS) is a malignant fibroblastic tumor that tends to occur in the lower and upper extremities. The reported incidence of head and neck MFSs is extremely rare. We report a 46-year-old male with "a neoplasm in the scalp" who was hospitalized and diagnosed with an MFS (highly malignant with massive necrotic lesions) based on histologic and immunohistochemistry evaluations. The magnetic resonance imaging manifestations did not demonstrate the "tail sign" mentioned in several studies, which resulted in a great challenge to establish an imaging diagnosis. The treatment plan is closely associated with the anatomic location and histologic grade, and more importantly, aggressive surgery and adjuvant radiotherapy may be helpful. Hence, we report the case and share some valuable information about the disease.A 46-year-old male with "a neoplasm in the scalp for 6 mo" was hospitalized. Initially, the tumor was about the size of a soybean, without algesia or ulceration. The patient ignored the growth, did not seek treatment, and thus, did not receive treatment. Recently, the tumor increased to the size of an egg; there was no bleeding or algesia. His family history was unremarkable. No abnormalities were found upon laboratory testing, including routine hematologic, biochemistry, and tumor markers. Computed tomography showed an ovoid mass (6.25 cm × 3.29 cm × 3.09 cm in size) in the left frontal scalp with low density intermingled with equidense strips in adjacent areas of the scalp. Magnetic resonance imaging revealed a lesion with an irregular surface and an approximate size of 3.55 cm × 6.34 cm in the left frontal region, with clear boundaries and visible separation. Adjacent areas of the skull were damaged and the dura mater was involved. Contrast enhancement showed an uneven enhancement pattern. Surgery was performed and postoperative adjuvant radiotherapy was administered to avoid recurrence or metastasis. The post-operative pathologic diagnosis confirmed an MFS. A repeat computed tomography scan showed no local recurrence or distant metastasis 19 mo post-operatively.The case reported herein of MFS was demonstrated in an extremely rare location on the scalp and had atypical magnetic resonance imaging findings, which serves as a reminder to radiologists of the possibility of this diagnosis to assist in clinical treatment. Given the special anatomic location and the high malignant potential of this rare tumor, combined surgical and adjuvant radiotherapy should be considered to avoid local recurrence and distant metastasis. The significance of regular follow-up is strongly recommended to improve the long-term survival rate.
Objective: To conduct a systematic review and Meta-analysis of the literature on the efficacy and safety of B-TURP versus HoLEP for the treatment of benign prostatic hyperplasia (BPH) in terms of demographic and clinical baseline characteristics, peri-operative variables, and postoperative outcomes and complications.Methods: Trials comparing B-TURP and HoLEP were identified systematically using Pubmed, Embase, CNKI, Web of Science and the Cochrane Library. Primary outcomes were the peak urinary flow rate (Qmax), post-void residual volume (PVR) and international prostate symptom score (IPSS). Secondary outcomes were operation time, irrigation duration, catheterization duration, resected tissue and complications.Results: Four trials assessing B-TURP and HoLEP were considered eligible for Meta-analysis, including three randomized controlled trials (RCTs) and one retrospective study. There was no statistically significant difference between B-TURP and HoLEP in terms of Qmax, IPSS, PVR at 3–6 months follow-up, operation duration, catheterization duration, resected tissue and complications (p > 0.05). HoLEP was associated with a significantly shorter irrigation time as compared with B-TURP (p < 0.05).Conclusion: Both B-TURP and HoLEP are safe and minimally invasive techniques that are similar in terms of symptomatic relief, although these findings need further validation in larger RCTs involving larger numbers of patients and over a longer follow-up duration for B-TURP or HoLEP before a new gold standard procedure emerges for surgical treatment of BPH.
PURPOSE:To evaluate the clinical effect of treatment of teeth with open apices using mineral trioxide aggregate(MTA)as apical barrier under surgical operating microscope.METHODS:The root canals of 23 teeth with open apices were cleaned and shaped,and disinfected with calcium hydroxide.The MTA mixture were then carried into the apical part of the root canals to create a 3-5 mm apical barrier.The remainder of the canals were filled with AH plus and ObturaⅡgutta-percha.The revisit times,the period and result of the treatment were recorded for all cases.RESULTS:The treatment of all cases was accomplished within 2 or 3 weeks.Postoperative X-ray films showed that the canals of 16 teeth were obturated very well.7 teeth showed 1-2 mm over-filling.All recalled patients declared their teeth to be asymptomatic.The recall radiographs indicated that the apical radiolucent areas of teeth with pre-existing apical lesion decreased apparently or disappeared completely.No new radiolucency was found around the roots.CONCLUSION:MTA is effective and quick in treatment of teeth with open apices,even thought there is slight over-filling of the material.Supported by 2004 Key Clinical Project of Medical Systems Affiliated to Ministry of Public Health.
Objective
To develop a risk-based quality management plan for general surgery department applying failure mode and effect analysis (FMEA) tools.
Methods
The surgical procedures of 850 surgical patients at general surgery department in 2016 were reviewed to determine the potential failure modes. The failure modes’ severity, incidence, and detectability were scored; the risk priority number was calculated; and the countermeasures were proposed.
Results
The high-priority failure modes were all significantly reduced; and the RPN for medical device sterilization failure was declined by 82.86% after implementing corrective measures. In 2017, the surgical site infection at general surgery department also decreased from 0.94% (8/850) in 2016 to 0.11% (1/894), with a statistical difference (χ2=4.33, P<0.05).
Conclusion
FMEA technology can quantify the hidden risks of SSI in a forward-looking manner, standardize risk management, and effectively prevent and control the SSI at general surgery department, so as to reduce the occurrence of SSI.
Key words:
Failure mode and effect analysis; General surgery department; Surgical site infection
Objectives: Part I analyzes the clinical characteristics of JO-RRP and AO-RRP. Part II explores the influencing factors of surgical intervals. Methods: Part I: Clinical features were analyzed in 168 RRP patients (59 JO-RRP and 109 AO-RRP) diagnosed and treated in our hospital. Part II: The correlation of interoperative time with onset age, gender, Derkay anatomical score or surgical methods were analyzed in JO-RRP patients. Results: The interoperative time between operations in the JO-RRP group was 116.3±75.9 days, and in the AO-RRP group was 169.1±141.7 days (p<0.05). In the JO-RRP group, the CO2 laser treatment interval (186.2±140.1 days) was significantly longer than that of the microdebrider group (124.7±114.5 days) (p=0.011). Conclusions: 1. JO-RRP patients had higher Derkay score, higher surgical frequency and shorter surgical interval. 2. The surgical intervals lengthened with age and shortened with higher Derkay scores. CO2 laser surgery has the longest interoperative time.
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