Observation on cleaning and curative effect of ultrasonic debridement machine in cleaning the postoperative surface of wound of perianal abscess / 中国医学装备

Objective:To investigate the effect of ultrasonic debridement machine for postoperative cleaning of perianal abscess.Methods:77 patients with perianal abscess were enrolled in this study.They were divided into control group (38 cases) and observation group (39 cases) by random sampling.The control group was implemented routine treatment post operation and the observation group was implemented routine dressing combined with ultrasonic cleaning machine to clean the crissum.And the visual analogue scale (VAS) was adopted to analyze the pain level of postoperative wound.And the postoperative clearance rate of bacteria, wound healing time, controlled time of infection and cleaning effect of wound between two groups were compared.Results:The VAS score of the observation group on the 1st, 3rd, 5th and 9th day after operation were significantly lower than those of control group (t=8.031, ■on wound of observation group was significantly higher than that of control group while the length stay in hospital of■healing time and controlled time of infection of observation group were significantly lower than those of control group■machine to clean wounds after perianal abscess surgery can effectively remove bacteria of wound, and improve cleaning effect, alleviate pain level of wound, and promote the rapid repair of wounds.

Hepatectomy for pyogenic liver abscess treatment: exception approach? / Hepatectomia para o tratamento do abscesso hepático piogênico: abordagem de exceção?

ABSTRACT Background: Percutaneous drainage for pyogenic liver abscess has been considered the gold-standard approach for the treatment on almost of the cases. However, when percutaneous drainage fails or even in some especial situations, as multiloculate abscess, lobe or segment surgical resection can solve infectious clinical condition. Aim: To report a series of patients who underwent hepatectomy for pyogenic liver abscess performed by a single surgical team. Methods: Eleven patients were operated with ages ranging from 45-73 years (mean and median 66 years). There were eight men and three women. The etiologies were: idiopathic (n=4), biliary (n=2), radiofrequency (n=2), direct extension (n=1), portal (n=1), and arterial (n=1). The mean lesion diameter was 9.27 cm (6-20 cm). Results: The mean operation length was 180 min (120-300). The mean intra-operative blood loss was 448 ml (50-1500). Surgical approaches were: right hepatectomy (n=4), left hepatectomy (n=3), left lateral sectioniectomy (n=1), right posterior sectioniectomy (n=2), resection of S8 (n=1), and S1 (n=1). Postoperative morbidity rate was 30%, while mortality was null. Median hospital stay was 18 days (5-45). The median follow-up period was 49 months (13-78). There was single lesion recurrence. Conclusion: Hepatectomy can be done as exception approach for pyogenic hepatic abscess treatment; it is a good therapeutic option in special situations.

RESUMO Racional: A drenagem percutânea do abscesso hepático piogênico tem sido considerada padrão-ouro para o tratamento na maioria dos casos. Mais raramente, quando essa abordagem falha ou em casos de abscessos multiloculados, a ressecção daquele segmento ou lobo destruído pode resolver o contexto infeccioso. Objetivo: Relatar uma série de doentes com abscesso hepático que foram submetidos a hepatectomia. Método: Onze doentes foram operados. A idade variou de 45-73 anos (média e mediana 66). Foram oito homens e três mulheres. As causas foram: idiopática (n=4), biliar (n=2), radiofrequência (n=2), portal (n=1), arterial (n=1), e extensão direta (n=1). A média do tamanho das lesões foi 9,27 cm (6-20). Resultados A média de tempo cirúrgico foi de 180 min (120-300). A média de sangramento intra-operatório foi de 448 ml (50-1500 ml). Os procedimentos cirúrgicos foram: hepatectomia D (n=4), hepatectomia E (n=3), setorectomia lateral E (n=1), setorectomia posterior D (n=2), ressecção do S8 (n=1) e S1 (n=1). A morbidade pós-operatória foi 30%, enquanto a mortalidade foi nula. Mediana de internação foi de 18 dias (5-45). A mediana de seguimento foi 49 meses (13-78). Houve uma única recidiva de lesão. Conclusão: Embora a hepatectomia possa ser considerada conduta de exceção para tratamento do abscesso hepático piogênico, ela deve ser boa opção terapêutica em situações especiais.

Therapeutic Observation of Moxa Smoke Fumigation in Healing Wounds and Releasing Pain After Perianal Abscess Surgery / 上海针灸杂志

Objective To observe the therapeutic efficacy of moxa smoke fumigation in promoting the wounds healing and improving the pain at dressing changes after perianal abscess surgery.Method A hundred eligible patients with perianal abscess were divided into a treatment group and a control group by the random number table, 50 cases in each group. The subjects all received dressing change from nurses of the Anorectal Department. In addition, the treatment group received moxa smoke fumigation at wounds for 30 min and the control group received microwave radiation at wounds for 30 min, both after dressing change, for a total of 14 times. The wounds-healed time, Visual Analogue Scale (VAS) scores on the day 1, 2, 3, 7, and 14 after the surgery, and Verbal Rating Scale (VRS) scores of the two groups were observed.ResultPatients in the treatment group took significantly shorter time to heal the wounds compared to those in the control group (P0.05), while the scores in the treatment group on day 2, 3, 7 and 14 were significantly lower than those in the control group (P<0.05); the VRS scores on day 1, 2, 3, 7, and 14 in the treatmentgroup were significantly lower than those in the control group (P<0.05).Conclusion Moxa smoke fumigation can promote the healing of the wounds after perianal abscess surgery, reduce the pain brought by dressing change, and this analgesic effect is consistent.

Minimally invasive approach of tubo-ovarian abscesses / Tratamento minimamente invasivo dos abcessos tubo-ováricos

PURPOSE: To evaluate the treatment outcome of tubo-ovarian abscesses managed by transvaginal ultrasound-guided aspiration. METHODS: Descriptive analysis of all patients with tubo-ovarian abscesses treated with a minimally invasive procedure, ultrasound-guided drainage, at the Department of Gynecology, Centro Hospitalar Vila Nova de Gaia/Espinho, during a period of 5 years (from June 2009 to June 2014). RESULTS: Twenty-six cases were included in the study. The mean age of the study group was 42.8 years. All patients were submitted to transvaginal ultrasound-guided aspiration and sclerosis with iodated solution, as well as received broad-spectrum intravenous antibiotics. The mean time from admission to drainage was 2.5 days. Cultures for aerobic and anaerobic pathogens were positive in 14 of the 26 cases. A complete response was noted in 23 of the 26 cases. No complications or morbidity were noted as a consequence of the drainage procedures. CONCLUSION: Minimally invasive treatment of tubo-ovarian abscesses by transvaginal ultrasound-guided drainage is an effective and safe approach. .

OBJETIVO: Avaliar os resultados da aspiração transvaginal ecoguiada no tratamento dos abcessos tubo-ováricos. MÉTODOS: Análise descritiva de todas as pacientes com diagnóstico de abcesso tubo-ovárico tratadas com um procedimento minimamente invasivo, drenagem ecoguiada, no Serviço de Ginecologia do Centro Hospitalar Vila Nova de Gaia/Espinho, durante um período de 5 anos (junho de 2009 a junho de 2014). RESULTADOS: Vinte e seis casos foram incluídos neste estudo, com média de idade de 42,8 anos. Todas as pacientes foram submetidas a punção aspirativa transvaginal ecoguiada e esclerose com solução iodada, associada a antibioterapia endovenosa de largo espectro de ação. O tempo médio desde a admissão até o procedimento de drenagem foi de 2,5 dias. Os exames culturais para micro-organismos aeróbicos e anaeróbicos foram positivos em 14/26 casos. Resposta completa com o tratamento instituído ocorreu em 23 dos 26 casos. Não houve registro de complicações ou morbilidade com os procedimentos de drenagem realizados. CONCLUSÃO: O tratamento minimamente invasivo dos abcessos tubo-ováricos, com drenagem transvaginal ecoguiada, constitui uma abordagem terapêutica eficaz e segura. .

Brain abscess surgical treatment

A retrospective study was carried out on 120 patients with brain abscess treated at Cho Ray Hospital from Oct 2000 to Feb 2003. 91% patients were hospitalized on emergency. The patients were diagnosed easily and quickly brain abscess by CT. 80 patients (70.8%) underwent emergency surgeries and the commonest applied technique (73.3%) was punction and pus drainage. Antibiotic were indicated suitably for patients, corticoids were prescribed for 31.6% patients with severe brain edema, antiepileptic drugs were given for patients with convulsions. Twelve patients (10%) died because of too late hospitalizations with general complications and/or brain hernia. Patients with brain abscess were commonly arrived late; the majority of them were admitted on emergency. Although having CT for accurate diagnosis and surgery and new antibiotic generations, the mortality rate is still high