ABSTRACT
ABSTRACT Introduction: Good wound closure is an important step in management of distal femur fracture to prevent infection and faster rehabilitation. Knotless barbed sutures can save time and distribute wound tension evenly. However, its role in terms of functional outcome, closure time, and postoperative complications has not been studied in a distal femur fracture. Material and methods: A total of 47 patients aged more than 18 years of distal femur fracture treated with distal femur locking plate were randomized either into either barbed or traditional suture groups. in the barbed group, capsular wound closure was carried out with 2-0 bidirectional barbed knotless sutures (Quill SRS® PDO, Angiotech, Vancouver, BC, Canada). In patients assigned to group B, capsular closure was done with 1-0 Vicryl® (Ethicon inc. Somerville, NJ) and 5-0 Ethibond® alternatively. Results: The mean flexion at the knee joint was 105.7±15.6 degrees in the study group while it was 110.4±13.7 in the control group (p= 0.2133). Mean estimated closure time was significantly shorter in the study group as compared to the control group (p<0.05). Cases of needle prick injury were higher in traditional suture group. Patients developed stitch abscess and superficial infection in both groups. However, the difference in incidence between the two was not statistically significant Conclusion: Barbed suture is an efficient method of wound closure. It reduces wound closure time with similar complication rate as with use of conventional sutures. Evidence Level II; Randomized Clinical Trial.
RESUMO Introdução: O fechamento adequado da ferida é um passo importante no manejo da fratura distal do fêmur a fim de evitar infecção e permitir uma rápida reabilitação. Suturas farpadas sem nós podem poupar tempo e distribuir uniformemente a tensão da ferida. Entretanto, seu papel em termos de resultado funcional, tempo de fechamento e complicações pós-operatórias não tem sido analisado em casos de fratura distal do fêmur. Material e métodos: Um total de 47 pacientes com mais de 18 anos de idade com fratura distal do fêmur tratados com placa de fixação distal do fêmur foram aleatorizados em grupos de sutura farpada ou tradicional. No grupo de farpados, o fechamento da ferida capsular foi feito com suturas sem nós farpados bidirecionais 2-0 (Quill SRS® PDO, Angiotech, Vancouver, BC, Canadá). Em pacientes designados para o grupo B, o fechamento capsular foi feito com Vicryl®1-0 (Ethicon inc. Somerville, NJ) e Ethibond® 5-0 respectivamente. Resultados: A flexão média na articulação do joelho foi de 105,7±15,6 graus no grupo de estudo e 110,4±13,7 no grupo controle (p= 0,2133). O tempo médio estimado de fechamento foi significativamente menor no grupo de estudo em comparação com o grupo controle (p<0,05). Os casos de ferimento por perfuração da agulha foram maiores no grupo de sutura tradicional. Os pacientes desenvolveram abscesso de pontos e infecção superficial em ambos os grupos. Entretanto, a diferença na incidência entre os dois não foi estatisticamente significative Conclusão: A sutura farpada é um método eficiente para o fechamento de feridas. Ele reduz o tempo de fechamento das feridas com uma taxa de complicação semelhante à utilização de suturas convencionais. Evidência Nível II; Ensaio Clínico Randomizado.
ABSTRACT
The long term success of periodontal therapy depends less on the manner in which the case was treated than on vigorous follow-up of the wound healing process immediately after therapy and on how well the case is maintained in subsequent recall (Rosling et al 1976, Nyman et al 1977, Knowles et al 1979, Ramfjord et al 1982, West felt et al 1985) SPT has gone by many names, including recall and maintenance, but the name was changed at the 1989 World Workshop in Clinical Periodontics to reflect the fact that the long-term treatment provided for patients during supportive periodontal treatment is of critical importance to the survival of the dentition. In most cases, this form of therapy is used following the completion of active periodontal therapy, but it can be used in other phases of treatment as well.1
ABSTRACT
Background: With the addition of adjuvants to local anaesthetics the onset, duration and quality of brachial plexus block improves to a marked extent. The intent of this study was to compare onset, duration of sensory and motor block along with duration of analgesia when an ?-2 agonist dexmedetomidine or a steroid dexamethasone was added to a mixture of 2% lignocaine with adrenaline and 0.5% bupivacaine.Methods: 100 patients belonging to ASAI and ASAII were included in the study scheduled for upper limb surgeries after taking informed consent. These patients were divided in to two groups having 50 patients in each group. Group D received 20ml of 2% lignocaine with adrenaline plus 18ml of 0.5% bupivacaine plus 50?g of dexmedetomidine and group X received 20ml of 2% lignocaine with adrenaline plus 18ml of 0.5% bupivacaine plus 8mg of dexamethasone. Onset of sensory and motor block, duration of block, quality of intraoperative analgesia and duration of analgesia were recorded.Results: Our study revealed similar onset of sensory block in group D and X. Group D showed early onset and longer duration of motor block compared to group X. Intraoperative haemodynamics were similar in both groups.Conclusions: Our study concludes that using dexmedetomidine as adjuvant prolongs the duration of block and postoperative analgesia compared to dexamethasone with minimal or negligible adverse events.