Design and application of fistula gauze packing drainage device / 中国中西医结合急救杂志

Gauze packing and drainage is a routine treatment for various types of fistula and sinus pressure ulcers. Because the external orifice of pressure ulcer or fistula is relatively small and the sinus deep, the conventional gauze packing has many drawbacks. Under the situation the operator is not skillful enough and no appropriate tools, it is necessary to pull the external orifice by tweezers to dilate the sinus and perform gauze packing and drainage, which brings great pain to patients, possibly leading to wound enlargement and delayed healing. At present, there is lack of auxiliary tools to improve gauze packing. Therefore, we developed and designed a gauze filler for packing and drainage of various kinds of fistula and sinus pressure ulcers, the device has the following advantages: good drainage effect, simple operation, low cost, safety and effectiveness. It not only improves the comfort of patients, reduces the number of dressing changes, reduce the number of dressing changes, shorten the hospitalization time and pay expense, but also reduces the burden of medical workers thus it is worthwhile to popularize and apply the newly designed gauze filler in clinical practice.

Therapeutic effects of early open decompression drainage on acute pulpitis / 中华老年医学杂志

Objective To investigate the clinical effects of open decompression drainage on acute pulpitis.Methods Totally 180 acute pulpitis patients hospitalized during January 2012 to September 2014 in our department were selected and randomly divided into control group and observation group (n=80 each).The control group was treated with pulp inactivating agent and the observation group was given open decompression drainage.The clinical effects,analgesia efficiencies at 7d after treatment,treatment course and the complications were compared between the 2 groups.Results There was significant difference in the effective rate between control and observation groups after treatment [61.3％ (49/80 cases) vs.86.3％ (69/80 cases),P＜0.05].The analgesia efficiencies at 7d after treatment was 46.3％ (37/80 cases) in control group and 73.8％ (59/80 cases)in observation group (P＜0.05).There was no significant difference in treatment course between two groups [(7.7±1.4) times vvs.(6.1± 1.2) times,P＞0.05]].6 patients developed periapical periodontitis in control group,and only 4 cases in the observation group (P＞0.05).Conclusions Early open decompression drainage has good clinical effects and analgesia efficiencies in treatment of acute pulpitis,which is worthy of clinical application.

Effects of open drainage ditch design on bacterial and fungal communities of cold waterlogged paddy soils

A field experiment established in 1980 was conducted to evaluate the effects of open drainage ditch applied for water removal on bacterial and fungal communities of cold waterlogged paddy soils in 2011. In this experiment, traditional plate counting and temperature gradient gel electrophoresis were employed to characterize the abundance and diversity of soil bacterial and fungal communities. Four different distances from the open drainage ditch, 5, 15, 25 and 75 m with different degrees of drainage were designed for this study. Maximum populations of culturable aerobic bacteria and fungi were at 15-m distance while minimum populations were at 75-m distance. Significant differences (p < 0.05) in fungal populations were observed at all distances from open drainage ditch. The highest diversity of the bacterial community was found at a distance of 25 m, while that of the fungal community was observed at a distance of 5 m. Sequencing of excised TGGE bands indicated that the dominant bacteria at 75-m distance belonged to anaerobic or microaerobic bacteria. Relationships between microbial characteristics and soil physicochemical properties indicated that soil pH and available nitrogen contents were key factors controlling the abundance of culturable aerobic bacteria and fungi, while soil water capacity also affected the diversity of fungal community. These findings can provide the references for better design and advanced management of the drainage ditches in cold waterlogged paddy soils.

A comparative study between active closed drainage and passive open drainage systems in urologic surgery

OBJECTIVE: To compare the clinical efficacy/significance and incidence of exposure to body fluids between the active closed drainage system and passive open drainage system in patients who underwent urologic surgeryMATERIALS AND METHODS: Patients who underwent elective and emergency open urologic surgery that required wound drainage were included. A daily data collection completed by the medical and the nursing staff was performed. Patients with dirty wounds were excludedRESULTS: Sixty-four patients were entered in the study. After exclusion, 56 patients [Group I (Passive drainage) = 27; Group 2 (Active drainage) = 29)] were evaluated for the performance of wound drainage systems. The drain-related complications of group 1 and group 2 were 26 percent and 10 percent, respectively [P 0.5 (NS)]. Change of dressing was more frequent in group 1 than in group 2 patients [P .000 (S)]. There were 567 (group 1CONCLUSION: The clinical efficacy of passive open drain and active closed drain systems were comparable. The risk of exposure of healthcare personnel to potentially harmful body fluids was less when closed suction drain was used in patients who underwent urologic surgery. (Author)

Results of Treatments for Pyogenic Liver Abscesses

Pyogenic liver abscess has been a life-threatening disease with a uniformly fatal outcome if left untreated. Changes in the etiology, clinical manifestations, methods of diagnosis, treatment and prognosis of pyogenic liver abscess have occurred slowly, but continuously, over the past century. Modern imaging techniques, improved drainage procedures, and appropriate antibiotic therapy have substantially reduced the mortality and the morbidity. A review of 103 patients with pyogenic liver abscess who were treated at Masan Samsung Hospital over a 5-year period from January 1992 to December 1996 was undertaken to characterize recent trends in diagnosis and management. There were 60 males and 43 females whose ages ranged from 11 to 85 years (mean 62.3 years). The peak age was in the 6th decade. Pyogenic liver abscess more often involved the right lobe (65.1%) than the left lobe (26.2%), and a single abscess was encountered more often than multiple abscesses in a 2.2:1 ratio. Upper abdominal pain, fever, and chills were the most common symptoms, and upper abdominal tenderness was the most common physical finding. An elevated serum alkaline phosphatase was seen in 73.8% of all patients and was the most common biochemical abnormality. Biliary tract disease was the most frequent underlying disorder. In the bacteriological study, we obtained positive cultures in 89.3% of the cases:65.0% were Gram-negative organism, 17.5% were Gram-positive organism, and 6.8% were anaerobes. E. coli was the most frequently cultured organism (31.5%). Ultrasonography and/or CT scanning was employed in the diagnosis and the follow up of all patients. Surgical open drainage was performed in 52 cases (50.5%) and percutaneous closed drainage in 51 cases (49.5%). The outcome of surgical open drainage was similar to that of percutaneous closed drainage, except for the mortality rate. Post-treatment complications occurred in 26 cases (25.2%), and the most frequent complication was a pulmonary problem (8.7%). The mortality rate due to pyogenic liver abscess was 7.8%, and the most common cause of death was sepsis.

Surgical Treatment of Acute Necrotizing Pancreatitis

Acute necrotizing pancreatitis (ANP) is a disease with high morbidity and mortality despite the progress made in intensive medical care. This study was conducted to clarify the strategy and the prognostic factors in its surgical management.We reviewed retrospectively 26 patients who had operative treatment for ANP from March 1990 to February 1995 at Wallace Memorial Baptist Hospital. The results were as follows:1) The most common cause of the ANP was alcohol (38.5%) and the next most common cause was gallstone (23.1%). 2) The operative indications were an acute surgical abdomen (15 cases), sepsis (6 cases), organ failure (3 cases), and shock (2 cases). 3) The culture results for the specimens which were obtained from the necrotic lesions or from fluid collections showed bacterially positive patients in 78.9% of the cases and polymicrobial infection in 31.6% of the cases. 4) Of the operative methods, a necrosectomy with open drainage and delayed lavage was applied to 17 cases (65.4%), and the mortality of this procedure was 23.5%. 5) During the postoperative course, reoperation was required in 3 cases (11.5%) and diabetes was seen in 6 cases of 22 cases (27.3%). 6) We analyzed prognostic factors like the Ranson score, infection, inadequate necrosectomy with drainage, and preoperative organ failure with statistical methods (Student's t-test and Chi-square test). The Ranson score and infection showed little correlation with the postoperative mortality, but an inadequate necrosectomy with drainage and preoperative organ failure showed a statistically significant correlation (p=0.006, p=0.009, respectively). In conclusion, we applied a necrosectomy with open drainage and delayed lavage to most of the ANP patients. An inadequate necrosectomy with drainage and preoperative organ failure had important meanings as prognostic factors and affected the postoperative mortality. Hence we think that necrotic lesions and fluid collections require early radical debridement and wide drainage, especially in infected necrotizing pancrectitis, and that multiple, well-positioned drains are important for decreased morbidity and mortality.

The Treatment of Infected Nonunited Fractures of Long Bone / 대한정형외과학회잡지

Many difficult problems are encountered in the treatrnent of infected nonunion of long bone. To solve these difficult fractures, authors adopted an active approach-thorough debridement of the infected and necrotic soft tissue and bone, rigid internal fixation with autogenous cancellous bone graft and opening of the wound to ensure continuous drainage until union of the fracture. Authors treated 28 cases of infected nonunions with this method from Mar. 1980 to Feb. 1989, and the results are as follows ;1. Femur(54%) and tibia(43%) were most frequently involved sites. 2. Most of the cases(86%) were treated by rigid internal fixation and cancellous bone graft. 3. In most cases(64%), infection was controlled spontaneously by the time of bony union, but in 5 cases which showed persistent drainage, implant removal controlled the problem, and residual soft tissue and bony defect were solved by Papineau's technique or musculocutaneous flap. 4. Revision was required in 5 cases(18%) because of insercure fixation. 5. Union could be obtained in average 4.8 months, and infection could be controlled in all except 1 case.

The Treatment of Infected Nonunited Fractures of Long Bones / 대한정형외과학회잡지

Treatment of infected nonunions of long bone is confronted with various difficult problem, e.g. eradication of infection and osseous union even in the presence of devastating infection. To solve this problem various method were proved including exerternal fixation, electrical stimulation and functional casting method with some success. Intreating these difficult infected nonunions, we adopted another program which includes through debridment of the infected and necrotic soft tissue and bone, autogenous bone graft, rigid internal fixation of fragments and ope.n drainage of the wound until union of the fracture. We treated 8 cases of infected nonunions with this method from march, 1980 to september 1983 and results are as follows: 1. Satisfactory union was obtained within average 5 months. 2. In some cases pus drainage continued even after osseous union but it was easily controlled after removal of fixation devices. 3. After bone union and removal of internal fixation devices, some kind of protective measures, e.g. crutches and braces were used for about 6 montes to prevent refracture. 4. In conclusion our method is considered to be an effctive means is treating infected nonunion of fractures.