The impact of water mattresses on incidence of PUs in patients with spinal cord injuries in Nigeria.

OBJECTIVE: To evaluate the impact of water mattresses on the incidence of pressure ulcers and length of hospitalisation in patients with spinal cord injuries in Nigeria. METHOD: A retrospective review was conducted of all patients who presented and were managed for complete traumatic spinal cord injury between January 2005 and December 2008. This period included 2 years prior to, and 2 years following, the introduction of water mattresses to the ward; patients from these periods were grouped as A and B, respectively. Information collated from the medical records included demographic data, wound aetiology, time to presentation, level of injury, complications, treatment, and duration of hospitalisation and follow-up. Outcome measures were presence or absence of pressure ulcers and length of hospital stay. RESULTS: In total, 201 patients were treated within the study period. Of these, 99 patients met the inclusion criteria; 35 patients (19 paraplegics and 16 tetraplegics) were managed between 2005 and 2006 (group A), while 64 patients (28 paraplegics and 36 tetraplegics) were managed in 2007 and 2008 (group B). The age range of the included patients was 9-76 years (39.0 ± 4.6 years and 41.5 ± 3.2 years for groups A and B, respectively) and all were male. Patient characteristics were similar for the two groups; however, there was a significant difference between the two groups in terms of presence of pressure ulcers, deteriorating of existing ulcers and condition of the patient on discharge (p < 0.05). CONCLUSION: The majority of pressure ulcers are preventable and a simple support surface, such as water mattresses, can reduce the incidence and magnitude of pressure ulceration, thus reducing hospital stay. DECLARATION OF INTEREST: The authors do not have any financial relationship with any organisation that manufactures water mattresses, either locally or overseas. There were no external sources of funding for this study.

Oucome of management of non-gonococcal septic arethritis at National Orthopaedic Hospital, Enugu, Nigeria.

BACKGROUND: Septic arthritis is an accute bacterial infection of a synovial joint. It is an orthopaedic emergency that can lead to morbidity or mortality if not properly treated. the fundamental issues in the management of septic arthritis include the duration of antibiotic therapy, the mode of joint drainage and the role of physiotherapy. There is a paucity of local data on septic arthritis in Nigeria. The study wa carried out at the National Orthopoedic Hospital, Enugu; a regional trauma and orthopaedic center with wide catchments area covering at least three geopolitical zones of Nigeria. The objective of the study is to describe the pattern and distribution of non-gonococcal septic arthritis, the causative organisms, and the outcome of management of this condition at Enugu, Nigeria and make recommendations on the antibiotic therapy. METHOD: A retrospective study of all the patients that presented at the National Orthopaedic Hospital Enugu with Non-gonococcal septic arthritis between January 1997 and December, 2006 was done. The patient's case notes were retrieved from the Medical Record Department. Information extracted and analyzed included demographic data, joints affected, cultured organisms, antibiotic sensitivity pattern, duration of parenteral and oral antibiotics therapy, complications and follow-up period. Patients with incomplete records, immune-compromised patients and those with subjacent osteomyelitis were excluded from the study. RESULT: Forty-three patients were seen within the period and 40 had analyzable data. The age range was 1 month to 39 years, with a mean age of 10.2 years. Twenty-one patients (52.5%) were males and 19 (47.5%) were females. The hip joint was the most commonly affected (47.5%). Staphylococcus aureus was the most common organism (50%), followed by Coliformn (42.5%). Most patients (75%) had parenteral antibiotics for 3-5 days, while 77.5% of patients received oral antibiotics for 2-4 weeks. All the patients had arthrotomy and joint irrigation within 48 hours of admission. Complicatins were recorded in 11 patients (27.5%). Fixed flexion deformity was the commonest complication (17.5%). No mortality was recorded. CONCLUSION: Septic arthritis is an orthopaedic emergency. Early diagnosis and prompt treatment with appropriate ontibiiotics and surgical drainage are the keys to a successful outcome. In our environment (Enugu), the coliforms ore competing favourably with stophylococcus oaureus as causative agents of septic arthritis. Short term parenteral antibiotics of 3-5 days seems to be as effective as the 1-2 weeks therapy in the non-immune compromised patients and in cases not complicated by juxtarticular osteomyehlitis or presence of prosthetic implants.

Outcome of Management of Non-Gonococcal Septic Arthritis at National Orthopaedic Hospital; Enugu; Nigeria

Septic arthritis is an acute bacterial infection of a synovial joint. It is an orthopaedic emergency that can lead to morbidity or mortality if not properly treated. The fundamental issues in the management of septic arthritis include the duration of antibiotic therapy; the mode of joint drainage and the role of physiotherapy. There is paucity of local data on septic arthritis in Nigeria. The study was carried out at the National Orthopaedic Hospital; Enugu; a regional trauma and orthopaedic center with wide catchments area covering at least three geopolitical zones of Nigeria.The objective of the study is to describe the pattern and distribution of non-gonococcal septic arthritis; the causative organisms; and the outcome of management of this condition at Enugu; Nigeria and make recommendations on the antibiotic therapy. A retrospective study of all the patients that presented at the National Orthopaedic Hospital Enugu with Non-gonococcal septic arthritis between January 1997 and December; 2006 was done. The patient's case notes were retrieved from the Medical Record Department. Information extracted and analyzed included demographic data; joints affected; cultured organisms; antibiotic sensitivity pattern; duration of parenteral and oral antibiotics therapy; complications and follow-up period. Patients with incomplete records; immunecompromised patients and those with subjacent osteomyelitis were excluded from the study. Forty-three patients were seen within the period and 40 had analyzable data. The age range was 1 month to 39 years; with a mean age of 10.2 years. Twenty-one patients (52.5) were males and 19 (47.5) were females. The hip joint was the most commonly affected (47.5). Staphylococcus aureus was the most common organism (50); followed by Coliforms (42.5). Most patients (75) had parenteral antibiotics for 3-5 days; while 77.5of patients received oral antibiotics for 2-4 weeks. All the patients had arthrotomy and joint irrigation within 48 hours of admission. Complications were recorded in 11 patients (27.5). Fixed flexion deformity was the commonest complication (17.5). No mortality was recorded. Septic arthritis is an orthopaedic emergency. Early diagnosis and prompt treatment with appropriate antibiotics and surgical drainage are the keys to a successful outcome. In our environment (Enugu); the coliforms are competing favourably with staphylococcus aureus as causative agents of septic arthritis. Short term parenteral antibiotics of 3 - 5 days seems to be as effective as the 1 - 2 weeks therapy in the non-immune compromised patients and in cases not complicated by juxtarticular osteomyelitis or presence of prosthetic implants