Hand Hygiene among Anesthesiologists and Microorganisms Contamination in Anesthesia Environments: A Single-Center Observational Study.

Objective: To investigate the baseline levels of microorganisms' growth on the hands of anesthesiologists and in the anesthesia environment at a cancer hospital. Methods: This study performed in nine operating rooms and among 25 anesthesiologists at a cancer hospital. Sampling of the hands of anesthesiologists and the anesthesia environment was performed at a ready-to-use operating room before patient contact began and after decontamination. Results: Microorganisms' growth results showed that 20% (5/25) of anesthesiologists' hands carried microorganisms (> 10 CFU/cm 2) before patient contact began. Female anesthesiologists performed hand hygiene better than did their male counterparts, with fewer CFUs ( P = 0.0069) and fewer species ( P = 0.0202). Our study also found that 55.6% (5/9) of ready-to-use operating rooms carried microorganisms (> 5 CFU/cm 2). Microorganisms regrowth began quickly (1 hour) after disinfection, and increased gradually over time, reaching the threshold at 4 hours after disinfection. Staphylococcus aureus was isolated from the hands of 20% (5/25) of anesthesiologists and 33.3% (3/9) of operating rooms. Conclusion: Our study indicates that male anesthesiologists need to pay more attention to the standard operating procedures and effect evaluation of hand hygiene, daily cleaning rate of the operating room may be insufficient, and we would suggest that there should be a repeat cleaning every four hours.

Treatment of tibiofibular diastasis without ankle fracture with endobutton device / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the clinical effects of Endobutton device in the treatment of tibiofibular diastasis without ankle fracture.</p><p><b>METHODS</b>From January 2009 to January 2011, a total of 8 patients with tibiofibular diastasis without ankle fracture were treated with Endobutton device. There were 6 males and 2 females with an average age of 34 years (ranged, 25 to 44 years). All the patients with ankle injured history and ankle pain, swelling, ecchy-mosis were diagnosed by radiology and then operated with Endobutton device. The clinical effects were evaluated according to Baird-Jackson scoring system and radiological evaluated parameters comprised of tibiofibular overlap,total clear space and medial clear space.</p><p><b>RESULTS</b>All the patients were followed up, and the duration ranged from 6 to 24 months,with an average of 12 months. Radiographic results were detailed as follows: tibiofibular overlap averaged (3.83 +/- 0.37) mm in preoperative and (7.46 +/- 0.14) mm in postoperative; mean total clear space (7.90 +/- 0.22) mm in preoperative and (3.39 +/- 0.07) mm in postoperative; medial clear space averaged (5.08 +/- 0.34) mm in preoperative and (3.16 +/- 0.07) mm in postoperative. There was significant difference above data between preoperative and postoperative one. The lastest Baird-Jackson score results: 6 cases obtained an excellent result, 1 good and 1 fair. The main score was (94.63 +/- 3.66).</p><p><b>CONCLUSION</b>Endobutton device for the treatment of tibiofibular diastasis without ankle fracture has advantages such as simple and minimally invasive, no need of second operation for implant removal, recover the ankle function better and less complications, which should be popularized and applied to clinical widely.</p>

Application of elastic intramedullary nail in treating bilateral femoral shaft fractures in children / 中国骨伤

<p><b>OBJECTIVE</b>To explore the curative effects and complications of elastic intramedullary nail in treating children's bilateral femoral shaft fractures.</p><p><b>METHODS</b>Form February 2005 to March 2008, 7 patients with bilateral femoral shaft fractures were treated by closed reduction and internal fixation with elastic intramedullary nail. There were 5 males and 2 females. The age ranged from 3 to 13 years with the mean of 8.3 years. Six injuries caused by road accident and 1 injury caused by fall from high. Two cases associated with pulmonary contusion, 3 cases brain injuries, 1 case fracture of calcaneus and 1 case bladder injuries. All the cases were closed fractures without nerve and blood vessel injury. A cast external fixation had been used after operation for a month in two cases.</p><p><b>RESULTS</b>All the patients were followed up for 21-37 months with an average of 30.3 months. No infecton of incisional wound, displacement fracture, internal fixation fail, delayedunion and malunion were found. All fracture obtained healing for 7-12 weeks with an average of 8.7 weeks. Inequality of lower limb was found in 1 case (length differences was 5 mm). According to Flynn scoring,all fractures were excellent.</p><p><b>CONCLUSION</b>Treatment of femoral shaft fractures in children with elastic intramedullary nail according with biological principle. The method has little trauma, less complication, outstanding effect and it is a good way to treat bilateral femoral shaft fractures result from high-energy injuries.</p>