Clinical outcome and cost comparison of carpal tunnel wound closure with monocryl and ethilon: a prospective study.

This prospective non-randomised two-cohort study compares the use of an absorbable suture (Poliglecrapone [Monocryl]: Group A) and a non-absorbable suture (Polyamide [Ethilon]: Group B) in wound closure after elective carpal tunnel decompression. The primary outcome was scar cosmesis as assessed by the Stonybrook Scar Evaluation Scale (SBSES); the financial cost of wound closure was compared as a secondary outocome. All fifty patients completed follow-up. At six weeks, there was no significant difference in the two groups regarding scar tenderness (p = 0.5), although residual swelling was more evident in the absorbable group (p = 0.2). The mean SBSES score at six weeks was 4.72 in Group A, and 4.8 in Group B (p = 0.3). The unit cost per closed wound of Monocryl was three times than Ethilon (p < 0.05). Ethilon is thus cost-effective without compromising the cosmetic outcome, and we recommend using this as the preferred suture for closure of carpal tunnel wounds.

Angulated locking plate in periprosthetic proximal femur fractures: biomechanical testing of a new prototype plate.

INTRODUCTION: To improve proximal plate fixation of periprosthetic femur fractures, a prototype locking plate with proximal posterior angulated screw positioning was developed and biomechanically tested. METHODS: Twelve fresh frozen, bone mineral density matched human femora, instrumented with cemented hip endoprosthesis were osteotomized simulating a Vancouver B1 fracture. Specimens were fixed proximally with monocortical (LCP) or angulated bicortical (A-LCP) head-locking screws. Biomechanical testing comprised quasi-static axial bending and torsion and cyclic axial loading until catastrophic failure with motion tracking. RESULTS: Axial bending and torsional stiffness of the A-LCP construct were (1,633 N/mm ± 548 standard deviation (SD); 0.75 Nm/deg ± 0.23 SD) at the beginning and (1,368 N/mm ± 650 SD; 0.67 Nm/deg ± 0.25 SD) after 10,000 cycles compared to the LCP construct (1,402 N/mm ± 272 SD; 0.54 Nm/deg ± 0.19 SD) at the beginning and (1,029 N/mm ± 387 SD; 0.45 Nm/deg ± 0.15) after 10,000 cycles. Relative movements for medial bending and axial translation differed significantly between the constructs after 5,000 cycles (A-LCP 2.09° ± 0.57 SD; LCP 5.02° ± 4.04 SD; p = 0.02; A-LCP 1.25 mm ± 0.33 SD; LCP 2.81 mm ± 2.32 SD; p = 0.02) and after 15,000 cycles (A-LCP 2.96° ± 0.70; LCP 6.52° ± 2.31; p = 0.01; A-LCP 1.68 mm ± 0.32; LCP 3.14 mm ± 0.68; p = 0.01). Cycles to failure (criterion 2 mm axial translation) differed significantly between A-LCP (15,500 ± 2,828 SD) and LCP construct (5,417 ± 7,236 SD), p = 0.03. CONCLUSION: Bicortical angulated screw positioning showed less interfragmentary osteotomy movement and improves osteosynthesis in periprosthetic fractures.

Efectos del anestésico local con vasoconstrictor en los valores de signos vitales de pacientes sometidos a cirugía de la cavidad bucal en la Facultad de Odontología de la Universidad de El Salvador / Effects of local anesthetic with vasoconstrictor on vital sign values of patients undergoing oral cavity surgery at the Faculty of Dentistry of the University of El Salvador

Esta investigación se basa principalmente en la cuantificación de los signos vitales en pacientes sometidos a cirugía oral con el objetivo de determinar el grado de variación de estos mismos al infiltrar anestésico local al 2% con vasoconstrictor, además de regirse por criterios de inclusión dentro de los cuales podemos mencionar el rango de edad entre 16 a 40 años, pacientes sin enfermedad sistémica conocida o diagnosticada; es indispensable para los profesionales de la odontología dar el manejo más adecuado a los pacientes que serán sometidos a procesos quirúrgicos dentro de lo cual podemos incluir la toma de signos vitales, ya que todo procedimiento quirúrgico conlleva el riesgo de sufrir complicaciones esta es una forma efectiva de prevenir accidentes quirúrgicos como crisis hipertensivas, sincope vasovagal, hipoglucemias, ataques de ansiedad entre otros. Este estudio se realizó en pacientes que asistieron a la consulta del área de cirugía de la Facultad de Odontología de la Universidad de El Salvador entre los meses de Septiembre a Noviembre del año 2008. El estudio se realizó mediante la toma de valores de signos vitales en todos los pacientes; la primera toma se realizó antes de comenzar el procedimiento, la segunda toma a los 10 minutos después de infiltrar el anestésico local con vasoconstrictor, y la tercera toma al finalizar la cirugía. La presente investigación es de tipo descriptivo y se limita a establecer la relación que hay entre los vasoconstrictores y el mantenimiento de los valores de signos vitales. Los resultados que arroja la investigación es que el valor de los signos vitales se modifican levemente por la administración de anestésico local con vasoconstrictor pero se aumentan aun más por el estrés que causa en algunos pacientes el procedimiento quirúrgico.

This research is mainly based on the quantification of vital signs in patients undergoing oral surgery in order to determine the degree of variation of these when infiltrating 2% local anesthetic with vasoconstrictor, in addition to being governed by inclusion criteria within the Which we can mention the age range between 16 to 40 years, patients without known or diagnosed systemic disease; It is essential for dental professionals to give the most appropriate management to patients who will undergo surgical processes, within which we can include taking vital signs, since every surgical procedure carries the risk of complications this is an effective way to prevent surgical accidents such as hypertensive crisis, vasovagal syncope, hypoglycemia, anxiety attacks among others. This study was carried out in patients who attended the surgery area of ​​the Faculty of Dentistry of the University of El Salvador between the months of September to November 2008. The study was carried out by taking vital sign values ​​in all patients; the first intake was made before starting the procedure, the second intake 10 minutes after infiltrating the local anesthetic with vasoconstrictor, and the third intake at the end of the surgery. The present investigation is descriptive and is limited to establishing the relationship between vasoconstrictors and the maintenance of vital sign values. The results of the research are that the value of vital signs are slightly modified by the administration of local anesthetic with vasoconstrictor but are increased even more by the stress caused in some patients by the surgical proced