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Objective To study operative treatment of severe tibial pilon fracture.Methods Between March 2010 and September 2016,29 patients with severe pilon fracture received operative treatment and complete follow-up at Department of Orthopaedic Surgery,Maternal and Child Care Service Centre of Guangzhou Nansha District.They were 24 men and 5 women,aged from 23 to 62 years (average,40.3 years).According to AO/OTA classification,9 cases were type C1,12 type C2 and 8 type C3.There were 6 open and 23 closed fractures.Of them,27 were complicated with fibular fracture.Open reduction and intenal fixation was conducted in 22 cases and limited internal fixation combined with external fixation in 7.Results This cohort was followed up for an average of 15 months (from 12 to 25 mouths).All the fractures obtained union after an average of 16 weeks (from 8 to 28 weeks),but the union in 5 cases was delayed.According to American Orthopaedic Foot and Ankle Society (AOFAS) criteria for ankle and hind foot,16 cases were rated as excellent,9 as good,3 as fair,one as poor,yielding an excellent to good rate of 86.2％.The main complications included superficial necrosis of wound skin in 3 cases,which were cured by skin flap repair after wound treatment,and superficial and deep infection both in 2 cases,which were cured by dressing change.Conclusions Severe tibial pilon fractures should be treated according to their different types and severities of soft tissue injury,using different operative methods and timing.
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Objective To realize the incidence of healthcare-associated infection(HAI)in patients after receiving extracorporeal membrane oxygenation(ECMO)procedure,and to evaluate the related factors for HAI.Methods Clinical data of patients receiving ECMO from January 2003 to December 2012 were collected and analyzed retro-spectively.Results Of 43 patients receiving ECMO,15 (34.88% )developed 24 times(55.81% )of HAI. The main HAI site was lower respiratory tract(n= 12,50.00% ),followed by blood stream(n= 6,25.00% ),skin and soft tis-sue(n= 5,20.83% ).A total of 28 isolates of pathogens were detected,gram-negative bacilli were 19(67.86% )iso-lates,gram-positive cocci 7(25.00% ),and fungi 2(7.14% );pathogens were mainly isolated from specimens of sputum(n= 12,42.86% ),blood (n= 9,32.14% )and wound secretion(n= 6,21 .43% ). The incidence of postopera-tive HAI in ECMO patients was related with patients’age,duration of ECMO,complication,mechanical ventila-tion,tracheal intubation or tracheotomy,and indwelling urinary catheter.Conclusion HAI in patients receiving EC-MO is high,hospital should take corresponding prevention and control measures targeting to the related risk factors of infection,so as to reduce the incidence of HAI after the ECMO.
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OBJECTIVE To establish and apply the hospital infection information system,and study the risk factors and occurrence pattern hospital infection,to control the incidence of hospital infection.METHODS The hospital infection management software was developed by the hospital with the Hope-Bridge Technology Company of Guangzhou.RESULTS This system can joint with the hospital information system(HIS) seamlessly,as a subsystem of HIS,and be utilized in the real-time monitoring for all inpatients.It has the function of inquiry,statistics and analysis,it can monitor correctly and comprehensively on infection case,hospital environmental hygiene,usage of antibiotics and intervening operations.CONCLUSIONS The hospital infection management software is convenient and easy to operate,which can enhance the efficiency and effect of the management of hospital infection.