Architectural analysis of subconjunctival oblique limbus incision techniques in manual cataract extraction surgery by optical coherence tomography imaging

The purpose was to assess the profile of subconjunctival oblique limbus incision (SCOLI) design by using anterior-segment optical coherence tomography (AS-OCT) and try to emphasize the proper technique of wound construction. The structural dimensions and integrity of the wound were acquired from the patients, who had undergone manual small-incision cataract surgery with SCOLI techniques, using a Canon OCT anterior-segment imaging system on the first postoperative day. The use of AS-OCT allowed for an in vivo evaluation of SCOLI in high definition. The radial OCT scan image showed three staggered incisions, including conjunctiva incision, scleral entrance, and inner corneal lip. A tangential scan demonstrated that the internal lip is parallel to the curvature of the peripheral cornea. The en face image showed an asymmetric 4 arc-shaped configuration rather than a symmetrical one. In conclusion, AS-OCT could be used to analyze SCOLI to determine optimal wound construction and geometry. The results of this study indicated that an asymmetric 4 arc-shaped limbus tunnel incision was superior to the conventional linear equivalent in stability and nucleus delivery.

Study of changes in pre-existing against-the-rule astigmatism after temporal manual small-incision cataract surgery using frown, straight, and smile incisions

Purpose: To assess the change in the amount of astigmatism caused by frown, straight, and smile incision in patients with pre?existing against?the?rule (ATR) astigmatism of more than and equal to 1 diopter Methods: This is a prospective, comparative study conducted over 18 months on 60 patients. Twenty patients were allocated to each incision using simple random sampling. Demographic details, best?corrected visual acuity (BCVA), intraocular pressure (IOP), anterior and posterior segment evaluation, and A?scan were done. An average of three measurements of K horizontal (Khavg), K vertical (Kvavg), and difference between the two (Khavg ? Kvavg) were taken using manual keratometry. All surgeries were performed by a single surgeon. All the data analyses were performed by using IBM Statistical Package for the Social Sciences (SPSS) version 20 software. Frequency distribution and cross tabulation were performed to prepare the tables. Results: In frown incision, Khavg ? Kvavg was significantly decreased on day 45 from the preoperative value (P < 0.001), followed by straight incision (P < 0.001), and smile incision (P < 0.001). Maximum decrease was observed in frown incision (49.15%) followed by straight (37.75%) and smile (28.57%) incisions. Conclusion: Our results are consistent with reduction of pre?existing ATR astigmatism with temporal incisions, and frown incision seems to be the best approach.

Comparison of clinical efficacy and safety of microwave therapy versus suction-curettage through small incisions in the treatment of axillary osmidrosis / 中华皮肤科杂志

Objective@#To compare clinical efficacy and safety of microwave therapy versus suction-curettage through small incisions in the treatment of axillary osmidrosis.@*Methods@#Totally, 60 patients with axillary osmidrosis were enrolled from Department of Dermatology, Xijing Hospital, Fourth Military Medical University from January 2017 to February 2018. Every patient received miraDry microwave therapy on the left axillary (microwave therapy group) and suction-curettage through small incisions on the right axillary (suction-curettage group) , and operation duration was recorded. After follow-up of half a year, clinical efficacy and complications were compared between the two groups.@*Results@#After 6-month follow-up, no significant differences were observed in the response rate or recurrence rate between the microwave therapy group (93.33%[56/60], 6.67%[4/60] respectively) and suction-curettage group (96.67% [58/60], 3.33% [2/60] respectively; both P > 0.05) . However, the incidence rate of postoperative complications was significantly lower in the microwave therapy group (0) than in the suction-curettage group (6.67% [4/60], χ2 = 4.138, P = 0.042) .@*Conclusion@#Compared with suction-curettage through small incisions, microwave therapy has advantages of being non-invasive and less postoperative complications.

Comparison of clinical efficacy and safety of microwave therapy versus suction-curettage through small incisions in the treatment of axillary osmidrosis / 中华皮肤科杂志

Objective To compare clinical efficacy and safety of microwave therapy versus suction -curettage through small incisions in the treatment of axillary osmidrosis.Methods Totally,60 patients with axillary osmidrosis were enrolled from Department of Dermatology,Xijing Hospital,Fourth Military Medical University from January 2017 to February 2018.Every patient received miraDry microwave therapy on the left axillary (microwave therapy group) and suction-curettage through small incisions on the right axillary (suction-curettage group),and operation duration was recorded.After follow-up of half a year,clinical efficacy and complications were compared between the two groups.Results After 6-month follow-up,no significant differences were observed in the response rate or recurrence rate between the microwave therapy group (93.33％[56/60],6.67％[4/60] respectively) and suction-curettage group (96.67％ [58/60],3.33％ [2/60] respectively;both P ＞ 0.05).However,the incidence rate of postoperative complications was significantly lower in the microwave therapy group (0) than in the suction-curettage group (6.67％ [4/60],x2 =4.138,P =0.042).Conclusion Compared with suction-curettage through small incisions,microwave therapy has advantages of being non-invasive and less postoperative complications.

Cirugía de estrabismo mínimamente invasiva / Minimally invasive strabismus surgery

RESUMEN La cirugía con incisiones de pequeño tamaño comienza a ser una norma en la medicina actual, la cual ha ganado popularidad en muchos campos, entre ellos el de la Oftalmología. Una muestra de esto son las pequeñas incisiones para la facoemulsificación, la vitrectomía sin sutura 25 G y los pequeños dispositivos de drenaje de glaucoma. Algo similar ocurre con la cirugía de estrabismo mínimamente invasiva (minimally invasive strabismus surgery) al permitir alcanzar iguales resultados motores y sensoriales que con la técnica de abordaje de los músculos extraoculares a nivel del limbo. Esta revisión bibliográfica ofrece nuevos conocimientos teóricos sobre una técnica mínimamente invasiva para el abordaje del estrabismo, que originará mejores resultados estéticos y la satisfacción de los pacientes con esta afección, así como su rápida reincorporación a las distintas ocupaciones laborales, a las escuelas y a las tareas habituales(AU)

ABSTRACT Surgery based on small size incisions is gradually becoming standard practice in health care, gaining popularity in many specialties, among them ophthalmology. Evidence of this are the small incisions made for phacoemulsification, sutureless 25-G vitrectomy, and the small glaucoma drainage devices. Something similar occurs in minimally invasive strabismus surgery, where the same motor and sensory results are achieved as with limbal approach of the extraocular muscles. The present bibliographic review provides new theoretical information about a minimally invasive strabismus surgery technique leading to better esthetic results and greater satisfaction by patients suffering from this disorder, as well as their quick reincorporation to their work, school and regular daily activities(AU)

A Randomized Control Trial Comparing the Efficacy of Polydiaxanone II and Polypropylene Suture Material for Midline Vertical Abdominal Incision Using Interrupted X Sutures in Prevention of Burst Abdomen

Background: Abdominal wound dehiscence is a commoncomplication of emergency laparotomy. Its prevention inimportant to reduce postoperative morbidity and mortality. Theaim of this study to compare the incidence and risk of burstabdomen, wound infection and sinus formation withPolydiaxanone (PDS II) versus Polypropylene (PPL) in midlinelaparotomy wounds.Materials and Methods: 60 patients undergoing laparotomythrough a midline vertical incision were randomized afterinformed consent, to either a Polydiaxanone (PDS II) versusPolypropylene (PPL) suture material. The incidence andrelative risk (RR) of burst abdomen, wound infection and sinusformation using Polypropylene (PPL) group as the referencecategory were calculated.Results: There was 1 burst abdomen (out of 30 cases, 3.3%)in Polypropylene (PPL) group and none (out of 30) inPolydiaxanone (PDS II). The RR of burst could not becalculated because of 0 in one arm. The incidence of woundinfection was 16.6% in Polypropylene (PPL) (5 out of 30 cases)compared to 10% (3 out of 30 cases) in Polydiaxanone (PDSII). The relative risk (RR) of wound infection was 0.60. Theincidence of suture sinus was 10% (3 out of 30 cases) inPolypropylene (PPL) as compared to 3.3% in Polydiaxanone(PDSII) group.Conclusion: The risk of burst abdomen, wound infection &suture sinuses is less with the use of Polydiaxanone (PDS II).

Vector analysis and comparison of surgically induced astigmatism after coaxial phacoemulsification with 2.2-and 2.8-mm clear corneal incisions / 眼科新进展

Objective To evaluate the surgically induced astigmatism (SIA)caused by coaxial phacoemuisification and intraocular lens (IOL) implantation with different clear corneal incision.Methods Clinical data of 97 patients 97 eyes underwent phacoemulsification and IOL implantation with 2.2 mm (2.2 mm group,44 eyes) or 2.8mm (2.8 mm group,53 eyes) clear corneal incisions were retrospectively reviewed.The corneal curvature were measured before and four weeks after the surgery.Then SIA were calculated,followed by analysis of the differences in mean SIA and centroid SIA between the 2.2 mm and 2.8 mm groups.Results At 4 weeks after surgery,the centroid and mean SIA of the 2.8 mm group was (0.234 ± 0.423) D@105° and (0.552 ±0.349) D,respectively;the corresponding data was (0.174 ± 0.464) D@104° and (0.582 ±0.392) D in the right eyes,and (0.272 ±0.382)D@106° and (0.545 ±0.300) D in the left eyes,respectively.At 4 weeks after surgery,the centroid and mean SIA of the 2.2 mm group was (0.108 ±0.417)D@98°and (0.506 ±0.362) D,respectively;the corresponding data was (0.145 ±0.404)D@81° and (0.5182 ±0.332)D in the right eyes,and (0.127 ± 0.418) D@120° and (0.516 ± 0.418) D in the left eyes,respectively.There was no significant difference in centroid SIA and mean SIA,centroid SIA and mean SIA of the right and left eyes,as well as both eyes between the two groups (all P＞0.05);Atotal of 47 patients (48.5％) had SIA greater than 0.5 D,and 28 patients (52.8％) were in the 2.8 mm groups,including 12 patients (22.6％) in the right eyes and 16 patients (20.5％) in the left eyes;as well as 19 patients (43.2％) in the 2.2 mm group,including 10 patients (22.7％) in the right eyes and 9 patients (20.5％) in the left eyes.There was no significant difference in the proportion of SIA greater than 0.5 D and the proportion of SIA between the left and right eyes greater than 0.5 D between the two groups (all P ＞ 0.05).Conclusion The mean SIA and centroid SIA are not statistically different in the 2.2 mm group than in the 2.8 mm group,but SIA were more stable in the 2.2 mm group than in the 2.8 mm group.The axis of the SIA were closely related to the position of the incisions,which were the vertical direction of the incisions.

Comparison of single incision and double incision triple surgery for angle closure glaucoma with cataract / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To study and analyze the clinical effect of single incision and double incision phacoemulsification,foldable intraocular lens implantation combined with trabeculectomy triple surgery in the treatment of glaucoma with cataract.METHODS:The study was from January 2016 to February 2017 in our hospital including 68 patients (79 eyes) with glaucoma and cataract.All patients were divided into two groups (observation group and control group);the control group only take single incision surgery;the observation group was taken two incision triple operation method for treatment.The follicular formation,intraocular pressure (lOP) changes,visual acuity changes,anterior chamber depth and anterior chamber open degree were compared between the two groups.RESULTS:At 1mo after the surgery,functional follicular formation rate was 98％ in observation group,higher than the control group (71％) with significant difference (P＜0.05).The control group and the observation group the mean preoperative lOP,best corrected visual acuity,uncorrected visual acuity had no significant difference (P＞ 0.05).In observation group,postoperative mean lOP,best corrected visual acuity,uncorrected visual acuity was 12.45+3.01mmHg,0.17±0.03,0.19±0.02,significantly different compared control group (P＜ 0.05).Anterior chamber depth and anterior chamber open degree increased in the two groups at 1mo after operation.The changes of observation group were more than control groups (P＜0.05).In control group,there were 5 eyes with corneal edema,4 eyes with transient shallow anterior chamber,3 eyes with transient high lOP,3 eyes with inflammatory exudation.In observation group,there were 4 eyes with corneal edema,3 eyes with transient shallow anterior chamber,3 eyes with transient high lOP,2 eyes with inflammatory exudation.After one-week treatment,those side reaction recovered,without hyphema,pupillary capture or other severe complications.CONCLUSION:The two incision triple surgery in the treatment of glaucoma with cataract patients get better results,effectively reduce intraocular pressure,improve the patients' best corrected visual acuity and uncorrected visual acuity,more formation rate of function follicular,increase the anterior chamber depth,it is safe and reliable.

Diagnóstico y control del astigmatismo en la cirugía del cristalino / Diagnosis and control of astigmatism in the crystalline surgery

Se realizó una revisión bibliográfica con el objetivo de conocer las opciones quirúrgicas para la corrección del astigmatismo preoperatorio y posoperatorio en la cirugía de catarata. Fueron abordados tópicos como los estudios preoperatorios detallados que nos permiten realizar una planificación quirúrgica personalizada, así como las diferentes soluciones quirúrgicas actuales, tanto las incisiones anastigmáticas en la facoemulsificación, como las incisiones relajantes limbares combinadas o no con las lentes intraoculares tóricas y los procederes con excímer láser. Se consultaron investigaciones que abarcan varios años hasta el presente para conocer los diferentes resultados de la utilización de estos procederes quirúrgicos hasta llegar a técnicas más novedosas en estudio como el láser femtosecond y las lentes intraoculares ajustables con la luz. Todo esto puede maximizar la corrección refractiva total y lograr en el paciente una óptima calidad visual y una mejor calidad de vida. La corrección refractiva total no es fácil de lograr; no obstante, es posible y debe ser la meta de cada cirujano de catarata(AU)

The present literature review was aimed at finding out the surgical options for the preoperative and postoperative correction of astigmatism in the cataract surgery. The addressed topics were detailed preoperative studies that allow customized surgical planning as well as several current solutions including anartigmatic incisions in phacoemulsification and relaxing limbal incisions either combined or not and Excimer laser procedures. Several research studies comprising various years up to the present were consulted to learn about different results from the use of these surgical methods as well as the most state-of-the-art techniques under study such as fentosecond laser and light-adjustable intraocular lenses. All this may maximize the total refractive correction and achieve optimal visual quality and better quality of life for the patient. It is not easy to reach complete refractive correction but it is possible and should be the goal to be accomplished by every cataract surgeon(AU)

Platelet-Rich Fibrin a Second Generation Autologous Platelet Concentrate for the Treatment of Inadequate Width of Attached Gingiva.

Along with the better understanding of the pathogenesis of periodontal diseases, the treatment modalities for various periodontal diseases have also gone a step ahead. One of the most important and currently unsolved problems in clinical periodontics is the predictable successful treatment of inadequate width of attached gingiva. Recently, importance has been given to the use of platelet-rich fibrin (PRF) for predictably treating periodontal diseases. PRF is an intimate assembly of glycan chains, glycoproteins, and cytokines. These are enmeshed in a slowly polymerized fibrin network which has the potential to accelerate soft and hard tissue healing. This article presents the clinical results of treatment of inadequate width of attached gingiva with PRF.

Ritidoplastia mini-invasiva, um procedimento efetivo através de pequenas incisões / Mini-invasive facelift, an effective procedure through small incisions

Introdução: Os procedimentos aplicados nos problemas de envelhecimento facial devem ficar restritos aos tecidos brandos e às relações com o volume prévio do esqueleto. Eles podem ser realizados mediante diversas técnicas: dissecção ampla e aberta, endoscópica e mini-invasiva. O objetivo é apresentar nossa concepção de ritidoplastias mini-invasivas e ritidoplastias completas através de mini-incisões, após 18 anos de experiência. Métodos: A ritidoplastia mini-invasiva é realizada através de mini-incisões localizadas na linha do cabelo da região frontal, região temporal, na fossa triangular da orelha, no sulco submentoniano e nas pálpebras. Ampla dissecção é realizada para liberar a fáscia parietal do arco zigomático para elevar em continuidade com o SMAS e o platisma num único plano. Essas estruturas são seletivamente fixadas em posições mais elevadas, restaurando a posição dos tecidos brandos e o contorno da face. Resultados: Nossa experiência se apoia em 672 pacientes, operados durante 19 anos, com mínimo de complicações a serem registradas, tendo sido evitadas as incisões pré-auriculares em 89% dos pacientes. Estão registrados os detalhes e táticas de como realizar cirurgias com segurança e a qualidade dos resultados. Conclusões: Diferentes procedimentos são descritos para mostrar como realizamos as ritidoplastias com minivias de acesso, de acordo com as regiões tratadas e sem cicatrizes pré-auriculares em 89% dos casos operados.

Introduction: A restoring procedure of the ageing process of the face should consider the conditions of the soft tissues and the relationship between them and the existing skeletal volume. This could be done through different approaches: open, endoscopic or mini-invasive. To present our concept of mini-invasive facelift, a full facelift through minimal incisions, product of eighteen years of experience. Methods: The mini-invasive facelift is done through minimal incisions located on the frontal hairline, temporal area, triangular fossae of the auricle, submentalis sulcus and eyelids. A wide dissection is performed to liberate the parieto-temporal fascia from the zigomatic arch, to pull it up in continuity with the SMAS and the platysma as one continuous layer or composite flap. These structures are selectively fixed to a higher position restoring the location of the soft tissues and the contour of the face. Results: We have done this procedure to 672 patients, along 19 years, with minimal complications (described also), and avoiding the pre-auricular incisions in 89% of our patients. In this paper details and tips to perform this procedure in a safer way and to get the most natural results are presented. Conclusions: Different approaches are described to perform a face lift with specific mini access views according to the regions to be treated , without periauricular scar round 89% of the operated cases.

The Clinical Study on Double-plate Method for Complex Tibia Plateau Fracture / 浙江中医药大学学报

[Objective] To investigate and analyze the clinical effect of double-plate method on complex tibia plateau fracture. [Methods] A total of 62 pa-tients that had complex tibia plateau fracture from October 2010 to December 2012 in our hospital, were divided into the experimental group and the control group randomly, 31 patients per group. Patients of the experimental group received double steel plate internal fixation with double incision, and patients of the control group received locking plate internal fixation, and the clinical efficacy of two groups were compared. [Results] The excel ent rate of the experimental group was better than that of the control group(87.1% vs 64.5% χ2=4.309 P=0.038), and the difference of complications rate of two groups had no statistical significance(3.2%vs 6.5% χ2=0.350 P=0.554). [Conclusion] The clinical effect of double-plate method for complex tibia plateau fracture is good, and the complications rate is low, worthy of clinical promotion.

Astigmatismo posquirúrgico en la facoemulsificación según el lugar de la incisión / Postsurgical astigmatism in phacoemulsification according to the surgical site

Objetivo: Determinar el astigmatismo inducido por la técnica de facoemulsificación según el lugar de la incisión en los pacientes operados de catarata en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer" de enero a diciembre de 2010. Métodos: Se realizó un estudio descriptivo, longitudinal y retrospectivo en 2 510 pacientes operados de catarata mediante la técnica de faco chop por diferentes zonas de abordaje de la incisión principal (superior, oblicua, temporal) y extracción extracapsular del cristalino por incisiones tunelizadas. Se analizó la mejor agudeza visual corregida y sin corregir, la dureza del cristalino, el lugar de la incisión, el equivalente esférico, la queratometría y el astigmatismo inducido. Resultados: La media del astigmatismo queratométrico inducido fue de 0,45 dioptrías por facoemulsificación y 1,30 dioptrías por vía tunelizada. Al relacionarlo con la dureza del cristalino fue de 0,44 dioptrías en los núcleos de 2 cruces de dureza. Se indujo 0,03 dioptrías de astigmatismo con incisión temporal menor o igual a 3 mm. La mejor agudeza visual promedio sin corregir antes de la cirugía fue de 0,12 y después de 0,31; mientras que la corregida fue de 0,50 antes, a 0,77 después de la cirugía. Estos valores fueron mejores en la incisión temporal con cuatro líneas de ganancia de visión sin corregir y cinco líneas con corrección. El mejor equivalente esférico se obtuvo en la incisión temporal con 0,73 dioptrías. Conclusiones: La facoemulsificación con incisión por el lado temporal induce un menor astigmatismo. Esto logra una ganancia visual mejor y satisfactoria para el paciente.

Objective: To determine the astigmatism induced by the phacoemulsification technique, according to the surgical site in the patients operated on from cataract in "Ramón Pando Ferrer" Cuban Institute of Ophthalmology in the period of January to December 2010. Methods: A retrospective, longitudinal and descriptive study was conducted to evaluate the behaviour of post surgery astigmatism in 2510 patients operated on from cataract by means of phacoemulsification technique (Phaco Chop) for different approach areas of main incision (upper, oblique, temporal) and extracapsulary cataract extraction with tunnelized incisions. Variables such as best corrected and non-corrected visual acuity, hardness of the crystalline lens, site of incision, spheral equivalent, keratometry, and induced astigmatism were all analyzed. Results: The mean induced astigmatism in phacoemulsification was 0.45 D, and for the extracapsulary cataract extraction technique was 1.30 D. When relating to the crystalline hardness, the induced astigmatism was 0, 44 D in the nuclei of 2 hardness crossings. The induced astigmatism was 0.03 D with temporal incisions or smaller than or similar to 3mm. The best non-corrected average visual acuity before surgery was 0.12 and after surgery was 0.31, whereas the preoperative corrected acuity was 0.50 and the postoperative value was 0.77. These values were better in temporal incisions with four lines of visual gain without correction and five lines with correction. The best spheral equivalent was 0.73 D in the temporal incision. Conclusion: The phacoemulsification on the temporary side induces smaller postoperative astigmatism with better satisfactory visual gain for the patient.

Neurotrophic Corneal Ulcer Development Following Cataract Surgery with a Limbal Relaxing Incision

A 60-year-old man with bilateral corneal opacity underwent cataract extraction surgery involving the use of a limbal relaxing incision in his left eye. He had lower lid ectropion and lagophthalmos in both eyes. Eleven days after the surgery, a slit-lamp examination revealed a neurotrophic corneal ulcer with a punch-out epithelial defect and rolled edges at the center of the pre-existing corneal opacity. The patient was treated with sodium hyaluronate, autologous serum, and oral doxycycline. Six weeks after the surgery an improvement in corneal sensation was observed and the neurotrophic corneal ulcer subsequently healed over the course of one year. In this report, we present a case of neurotrophic keratitis that occurred after performing cataract surgery concurrent with a limbal relaxing incision. As such, we suggest that limbal relaxing incisions should be performed cautiously in patients with causative risk factors for corneal hypesthesia.

Comparison of cutaneous incisions to approach the infraorbital rim and orbital floor

Aim: The aim of this article was to retrospectively analyze and compare the esthetic outcomes achieved after the use of 20 subciliary incisions, 22 subtarsal incisions and 16 infraorbital incisions to approach the infraorbital rim and orbital floor in orbital fractures. Methods: The sample consisted of 58 patients (37 males and 21 females) with orbital trauma (floor and infraorbital rim) treated with open reduction and internal rigid fixation in the Department of Oral and Maxillofacial Surgery at “Hospital de Base do Distrito Federal”, Brazil, between September 1996 and August 2003. The following aspects were evaluated: (1) the average distance of the scars measured from the ciliary margin caudally, (2) the esthetic appearance of the scars, (3) chronic lid edema, (4) scleral show, (5) ectropion. Results: Subciliary incision demonstrated better surgical results when compared to the non-subciliary incisions. No statistically significant difference in chronic lid edema rates was found between the three groups of incisions (Fisher, p>0.217 in all cases). There was no statistically significant difference in ectropion, scleral show and chronic edema rates between the three groups of incisions. Conclusions: The subciliary and subtarsal incisions offer better esthetic results than the infraorbital incision.

Rhytidectomy of W-shaped incisions combined with multiple suspension in temporal hair line / 中华医学美学美容杂志

Objective To study the advantages of rhytidectomy of W-shaped incisions combined with multiple suspension in temporal hair line. Methods 40 patients were divided into two groups: 16 cases in group A were treated by rhytidectomy of W-shaped incisions combined with multiple suspcnsion in temporal hair line;24 cases in group B were treatcd by traditional rhytidectomy. Results The inci-sions in group A, with an excellent repair under scar formation, healed well and some hairs on the timpo-ral hair line grew. Fishtail lines were obviously reduced, with nasolabial fold lifting the masseter area skin on parotid. Compared with group B, the difference was statistically significant (P<0.05). Conclusions This approach is simple but convenient, safe and efficient. Therefore, it is valuable and applicable clinical-ly.

Clinical study of long-acting antibacterial material JUC for prevention of incision infection in circumcision / 重庆医科大学学报

0.05).Conclusion:Compared with traditional dressing,JUC has similar effects on circumcisions in the aspects of isolating operative incisions,long-acting antisepsis and preventing infection of incisional wound.

Antibacterial Use in Department of Orthopedics: An Investigation and Analysis / 中华医院感染学杂志

OBJECTIVE To investigate the reasonable use of antibacterial in department of orthopedics.METHODS The patients in our department were registered according to the inventory of antibacterial use made by the hospital infection monitoring network of Medical Administration Bureau,Ministry of Health of the People′s Republic of China,the(operative) incision was classified according to Clinical Surgery.The data of reasonable use of antibacterial were(obtained) after evaluation and(analysis).RESULTS Of the 257 patients in our study,79.37% of them were used antibacterial,20.62% were not used antibacterial,24.50% were used antibacterial for therapy,75.49% were used antibacterial for infection(prevention);95.09% were used systematically;74.50% were reasonable(usage,) 25.49% were unreasonable usage;of the 204 patients who were used antibacterial,only 34 patients were tested by drug sensitivity trial,and the others were used by experience.CONCLUSIONS In order to use antibacterial reasonably,we suggest two points,one is that the medicine management department should workout a feasible antibacterial use institution and mass(evaluation) criterion,take mass examination regurally,and connect the bonus to the examination result;the other is that we should enhance the management of antibacterial market,avoid the improper competition,rise the morality view of the doctor,and suggest them to use antibacterial reasonably(according) to the scientific theory.

The Effect of Nonincisional Double Fold Formation Using Three Small Incisions, Two-stitch Method

PURPOSE: The aim of this study was to analyze the effects of using the nonincisional, double fold formation method with three small incisions and two-stitches. METHODS: This study included 39 patients who underwent double eyelid operation by a nonincisional technique and who were followed up for more than 6 months. On the desired double eyelid line, three points 6 mm apart were marked and three stab incisions made. A small amount of subcutaneous tissue was removed through the incisions, and orbital fat was removed through the lateral wound site-if necessary. Using double-armed 7-0 nylon or prolene, two buried sutures of 6 mm width were made. Sixteen patients also underwent surgery for epiblepharon, and three patients with unilateral double eyelid due to trauma had a contralateral eyelid operation for asymmetry correction. Five patients also had epicanthoplasty. RESULTS: Two patients lost their folds completely and reoperations were performed. Two patients showed cysts due to suture material and so the suture knots were removed; the double fold remained afterwards, so no other procedures were needed. In one case, the suture was seen subcutaneously, so suture removal and reoperation were performed. CONCLUSIONS: To minimize double fold loss, which is a disadvantage of the nonincisional double fold formation technique, we removed a portion of pretarsal tissue, muscle, and/or orbital fat and made two wide slings. Also, we corrected asymmetry due to traumatic unilateral double eyelid and epicanthal fold. In conclusion, we expect that our method could extend the applicability of nonincisional double fold formation.