The use of tissue adhesive as an adjunct to wound closure in knee arthroplasty does not reduce wound ooze

Patients and methods@#Forty-three patients undergoing total knee arthroplasty (TKA) by a single surgeon were studied. All wounds were closed using staples with or without tissue adhesive. Post-operatively, the wounds were reviewed daily for ooze. Dressings were changed only if soaked > 50% or if there was persistent wound discharge of more than 2 × 2 cm at 72 h. @*Results@#There were 21 patients in the tissue adhesive (group 1), 22 in the non-tissue adhesive (group 2) with the average age for group 1 of 72.2 years and for group 2 of 69.3 years. The median length of stay for both groups was 4 days (range of 3–7 days for group 1 and 2–6 days for group 2) (P = 0.960). The tissue adhesive group showed a statistically significant reduction in wound ooze on day 1 (P = 0.019); however, the difference was not significant on the following days. The median for the number of dressing changes for group 1 was zero changes and for group 2, one change. This was not statistically significant (P = 0.112). No complications were observed in both groups and there were no reactions to the tissue adhesive. @*Conclusion@#The data from this case series suggest that the use of tissue adhesive may reduce wound ooze on day 1 only. The latter is most likely due to significant tensile forces to which the knee arthroplasty wound is subjected in the immediate post-operative rehabilitation. Further, the cost of tissue adhesive is not offset by reduced dressing changes or length of hospital stay.

The use of tissue adhesive as an adjunct to wound closure in knee arthroplasty does not reduce wound ooze

Patients and methods@#Forty-three patients undergoing total knee arthroplasty (TKA) by a single surgeon were studied. All wounds were closed using staples with or without tissue adhesive. Post-operatively, the wounds were reviewed daily for ooze. Dressings were changed only if soaked > 50% or if there was persistent wound discharge of more than 2 × 2 cm at 72 h. @*Results@#There were 21 patients in the tissue adhesive (group 1), 22 in the non-tissue adhesive (group 2) with the average age for group 1 of 72.2 years and for group 2 of 69.3 years. The median length of stay for both groups was 4 days (range of 3–7 days for group 1 and 2–6 days for group 2) (P = 0.960). The tissue adhesive group showed a statistically significant reduction in wound ooze on day 1 (P = 0.019); however, the difference was not significant on the following days. The median for the number of dressing changes for group 1 was zero changes and for group 2, one change. This was not statistically significant (P = 0.112). No complications were observed in both groups and there were no reactions to the tissue adhesive. @*Conclusion@#The data from this case series suggest that the use of tissue adhesive may reduce wound ooze on day 1 only. The latter is most likely due to significant tensile forces to which the knee arthroplasty wound is subjected in the immediate post-operative rehabilitation. Further, the cost of tissue adhesive is not offset by reduced dressing changes or length of hospital stay.

Using eye tracking technology to compare the effectiveness of malignant hyperthermia cognitive aid design / 대한마취과학회지

BACKGROUND: Malignant hyperthermia is a rare but potentially fatal complication of anesthesia, and several different cognitive aids designed to facilitate a timely and accurate response to this crisis currently exist. Eye tracking technology can measure voluntary and involuntary eye movements, gaze fixation within an area of interest, and speed of visual response and has been used to a limited extent in anesthesiology. METHODS: With eye tracking technology, we compared the accessibility of five malignant hyperthermia cognitive aids by collecting gaze data from twelve volunteer participants. Recordings were reviewed and annotated to measure the time required for participants to locate objects on the cognitive aid to provide an answer; cumulative time to answer was the primary outcome. RESULTS: For the primary outcome, there were differences detected between cumulative time to answer survival curves (P < 0.001). Participants demonstrated the shortest cumulative time to answer when viewing the Society for Pediatric Anesthesia (SPA) cognitive aid compared to four other publicly available cognitive aids for malignant hyperthermia, and this outcome was not influenced by the anesthesiologists’ years of experience. CONCLUSIONS: This is the first study to utilize eye tracking technology in a comparative evaluation of cognitive aid design, and our experience suggests that there may be additional applications of eye tracking technology in healthcare and medical education. Potentially advantageous design features of the SPA cognitive aid include a single page, linear layout, and simple typescript with minimal use of single color blocking.

Cat striate cortex: monocular and interocular comparisons of spatial-frequency selectivity

Spatial frequency and bandwith characteristics were determined for neurones in cat striate cortex. Responses to drifting sin-wave gratings, optimized for orientation, direction and velocity, were determined over a range of spatial frequencies. Comparative measurements of spatial frequency tuning at constant velocity and at constant temporal drift frequency revealed that, overall, tuning derived by either method was similar. Results were evaluated in relation to neuronal class (simple or complex); cell subclass (standard, intermediate or special), defined by length summation, directionality; and velocity selectivity. Distributions of optimal spatial frequency for simple and complex neurones were comparable. By contrast, bandwidths of simple neurones were markedly narrower than for complex neurones, Standard complex neurones, in turn, had narrower vandwidths than special or intermediate complex neurones. Optimal spaties frequency correlated inversely with optimal velocity, directly with orientation selectivity. Thus, neurones tuned to high spatial frequencies tended to respond optimally to low velocities, and were more sharply orientation selective, than neurones tuned to low spatial frequencies. In binocular nurones, spatial frequency tuning characteristics of the two monocular imputs were compared. For either eye, spatial frequency tuning curves were reproducible over time. In a minority of neurones, spatial frequency characteristics were matched for the two eyes . A Majority showed mismatch in spatial frequency characteristics between the eyes. Individual neurones were tuned to different bands of spatial frequencies through either eye; more sharply spatial-frequency selective through one eye than the other; or had both dissimilar bandwidth and spatial frequency. Changing imput spatial-frequency resulted in profound, systematic shifts in ocular dominance. These were progressive in the case of spatial-frequncy mismatch. In cases of bandwidth, or bandwidth an spatial-frequency mismatch, the eye associated with more sharply-tuned imput exerted relatively greater influence at centre frequencies, the other eye relatively greater influence at extreme frequencies...