Simple Wound Irrigation in the Postoperative Treatment for Surgically Drained Spontaneous Soft Tissue Abscesses: A Prospective, Randomized Controlled Trial.

BACKGROUND: Soft tissue abscesses are among the most frequently encountered medical problems treated by different surgeons. Standard therapy remains incision and drainage with sterile saline irrigation during postoperative wound healing period. Aim of this prospective randomized controlled trial was to compare sterile irrigation versus nonsterile irrigation. STUDY DESIGN: A single center randomized controlled trial was performed to investigate postoperative wound irrigation. The control group used sterile irrigation, and the intervention group used nonsterile irrigation. Primary endpoints were reinfection and reintervention rates, assessed during follow-up controls for up to 2 years. Secondary endpoints were the duration of wound healing, inability to work, pain and quality of life. RESULTS: Between 04/2016 and 05/2017, 118 patients were randomized into two groups, with 61 allocated to the control- and 57 to the intervention group. Reinfection occurred in a total of 4 cases (6.6%) in the sterile protocol and 4 (7%) in the nonsterile protocol. Quality of life and pain values were comparable during the wound healing period, and patients treated according to the nonsterile irrigation protocol used significantly fewer wound care service teams. Despite equal wound persistence rates, a substantially shorter amount of time off from work was reported in the nonsterile protocol group (p value 0.086). CONCLUSION: This prospective, randomized trial indicates that a nonsterile irrigation protocol for patients operated on for soft tissue abscesses is not inferior to the standard sterile protocol. Moreover, a nonsterile irrigation protocol leads to a shorter period of inability to work with comparable pain and quality of life scores during the wound healing period.

[Ultrasound diagnosis in disorders of the neuromuscular knee joint system after cruciate ligament injuries]. / Die sonographische Diagnostik bei Störungen des neuromuskulären Systems Kniegelenk nach Kreuzbandverletzungen.

To verify neuromuscular disorders caused by joint alteration often technically measuring methods have to be applied which are complicated to discuss (isokinetic measuring methods, EMG etc.). Therefore the monitoring of limb circumference values has become established in practice. This study confronts the circumference measuring for the thigh following damages resp. injuries in the knee joint with direct methods to determine the muscular cross-sectional area. It is shown that circumference measures only up to a point can answer questions on muscular hypertonia and atrophy. The study presents standardized sonographic measuring methods that make possible an objective and reproducible verification of the state of individual muscles. Additionally the study shows that the m. vastus intermedius is to a much higher degree afflicted by neuromuscular disorders of knee joint damages resp. injuries than assumed until now.

[Studies of the neuromuscular system of the knee joint]. / Untersuchungen am neuromuskulären System Kniegelenk.

The paper analysis the therapeutic effects of isometric training and electromechanic therapy (EMT) of the quadriceps muscles on subjects. The effects of the training practised with the knee joint bent was to be compared with previous results of training with the knee joint stretched. 36 subjects were trained and the increase in strength was measured with the help of a strain gauge dynamometer. Again a marked superiority of the EMT over sole isometric training could be demonstrated. More over, the results showed that the increase of the isometric maximal strength following an EMT is not influenced by the position of the angle of the joint.