Continuous Wound Irrigation in the Pig

It was demonstrated in the pig that full-thickness wounds in the skin can be continuously treated by irrigation for several days. Irrigation was accomplished through a porous, occlusively applied dressing having two ports, one for supply and one for drainage. The fluid, delivered by means of an iv set, was sucked through the inert dressing, leaving it partially saturated, and with fluid spread evenly through its pores. Particulate matter was removed along narrow paths converging on the outlet, not showing any significant diversion. The apparatus for fluid supply and drainage was arranged to move with the animal, thus eliminating the risk of obstruction of the tubes as a result oft wisting. The fluid was eliminated by one suction line, and the vacuum in the dressing maintained by another. This allowed the suction to be adjusted to a level near the atmospheric pressure.     

An approach for developing quantitative risk-based microbial standards for fresh produce

A key objective of the Good Agricultural Practices (GAP) program is to reduce the potential for produce to become contaminated with microbial pathogens, such as through irrigation water. Without microbial standards, however, it is impractical to decide whether there is a need to disinfect, a need to institute watershed protection programs, or a need to institute post-harvest disinfection regimes. To develop such standards, quantitative microbial risk assessments can be performed using pathogen monitoring data for produce. This paper presents an approach which can be used towards the application of a risk assessment framework to developing microbial standards for fresh produce. Risks of infection are estimated using typical monitoring data of Salmonella detected on carrots and assuming various scenarios of the likelihood of an individual consuming a contaminated serving of carrots in a given year. Estimated annual risks of infection range from 2.20 × 10^-5 to 2.16 × 10^-3, assuming 1% and 100% of an individual's carrot servings are contaminated, respectively. In addition, critical factors are identified which need to be incorporated in such a risk assessment approach as well as their impact on risk estimates to provide growers with benchmarks which may be targeted to reduce health risks.     

The effect of sodium hypochlorite and ethylenediaminetetraacetic acid irrigation, individually and in alternation, on tooth surface strain

Aim  To evaluate the effect of irrigation regimens on tooth surface strain using saline, sodium hypochlorite (3% and 5% NaOCl) and ethylenediaminetetraacetic acid (17% EDTA), individually and in alternating combinations.
Methodology  Single-rooted premolar teeth with single canals prepared to standardized dimensions were grouped by anatomical features and randomly distributed amongst six experimental groups ( n  = 12 each). The six groups were: (1) saline; (2) 5% NaOCl; (3) 3% NaOCl; (4) 17% EDTA; (5) 3% NaOCl and 17% EDTA; (6) 5% NaOCl and 17% EDTA. All groups underwent four (group 1) or five (groups 2, 3, 4, 5, 6) sequential 30-min irrigation periods following each of which the tooth was subjected to a standard regime of cyclic, nondestructive, occlusal loading. Tooth surface strain was measured during each loading cycle using electrical strain gauges mounted cervico-proximally. The data were analysed by Hierarchical anova and post hoc multiple comparisons.
Results  Irrigation with 5% NaOCl alone or alternating with 17% EDTA significantly ( P  < 0.001) increased the peak strain values for each of the irrigation periods compared with that of saline (group 1). The data for the other groups revealed no significant differences compared with those of saline. The strain increase after the fourth irrigation cycle was significantly higher for group 6 than for group 2. The measured canal morphology and dentine thickness parameters did not prove to have a significant effect on tooth surface strain.
Conclusions  Irrigation with 5% NaOCl acting alone or alternated with 17% EDTA (used in 30 min cycles), significantly increased tooth surface strain. The alternated regimen showed significantly greater changes in tooth surface strain than NaOCl alone. Irrigation with 3% NaOCl and 17% EDTA individually or in combination did not significantly alter the tooth surface strain.     

Effects of irrigation temperature on heat control in vitro at different drilling depths

Purpose: Thermal injury during implant bed preparation has a major influence on implant osseointegration and survival. This study investigated the effectiveness of the temperature of the saline solution used for heat control during drilling.
Material and methods: Fresh frozen edentulous segments of bovine mandibles were sectioned into 12 × 6 cm pieces. Thermoresistors were placed 0.5 mm from the drilling cavity walls, at depths of 3, 7, and 12 mm. Signals from the three thermoresistors were analyzed using ORIGIN 5.0 software.
Results: The maximum temperatures during drilling without irrigation were 50.9, 47.4, and 38.1°C at depths of 3, 7, and 12 mm, respectively. With irrigation using saline at 25 and 10°C, the maximum temperatures at a depth of 12 mm were 37.4 and 36.3°C, respectively. All other measurements with both 25 and 10°C saline were below body temperature.
Discussion and conclusion: This experimental in vitro study showed that more heat was generated in the superficial part of the drilling cavity than at the bottom. Therefore, external irrigation at room temperature can provide sufficient cooling during drilling. Lower temperature saline was more effective in cooling the bone, and irrigation of the site should be continued between the drilling steps.     

输血器巧制Y型接头在膀胱冲洗中应用

膀胱冲洗是利用导尿管将溶液灌入至膀胱内,再用虹吸原理将灌入的液体引流出的方法[1]。是临床护理中一项常用护理技术,曾被传统护理作为对长期留置尿管患者预防尿管伴随性感染(CAU-TI)发生的重要措施。普通科室为患者留置尿管时一般常用双腔单囊导尿管,当需要执行膀胱冲洗     

Catheter Ablation of Recurrent Scar-Related Ventricular Tachycardia Using Electroanatomical Mapping and Irrigated Ablation Technology: Results of the Prospective Multicenter Euro-VT-Study

Catheter Ablation of Ventricular Tachycardia.   Introduction: Ventricular tachycardia (VT) late after myocardial infarction is an important contributor to morbidity and mortality. This prospective multicenter study assessed the efficacy and safety of electroanatomical mapping in combination with open-saline irrigated ablation technology for ablation of chronic recurrent mappable and unmappable VT in remote myocardial infarction.
Methods and Results: In 8 European institutions, 63 patients (89% males) were enrolled in the study. All patients had remote myocardial infarction and presented with a median number of 17 (range 1–380) VTs in the preceding 6 months. Incessant VT was present in 14 patients (22%). Left ventricular ejection fraction measured 30 ± 13%. A mean of 3 VTs were targeted per patient and 22% of all patients had only unmappable VT. The mean follow-up period was 12 ± 3 months. A total of 164 VTs were targeted during catheter ablation. Ablation was acutely successful in 51 patients (81%). One patient (1.5%) experienced a major complication with degeneration of VT into ventricular fibrillation necessitating cardiopulmonary resuscitation maneuvers. However, no death occurred acutely or within the first 30 days after catheter ablation. During the follow-up, 19 of the initially successful ablated patients (37%) and 31 of all ablated patients (49%) developed some type of VT recurrence.
Conclusions: The results of this multicenter study demonstrate the high acute success rate and a low complication rate of irrigated tip catheter ablation of all clinical relevant VTs in remote myocardial infarction. However, during the follow-up a relevant number of recurrences occurred. (J Cardiovasc Electrophysiol, Vol. 21, pp. 47–53, January 2010)     

The effect of various in-vitro and ex-vivo parameters on irrigant flow and apical pressure using manual syringe needle irrigation: Systematic review

BackgroundFluid dynamics is a majorly neglected aspect to be studied in root canal irrigation. The fundamental rule to understand mechanics is to observe patterns of flow during the process. Thus, this work is conducted to do a systemic assessment of the in-vitro and ex-vivo based studies to evaluate the effect of various parameters on the irrigant flow and apical pressure on using a manual syringe needle for root canal irrigation.MethodsThe literature search was conducted through libraries such as PubMed (Medline), CINAHL, Embase, Scopus and other hand literature from Google Scholar, the British medical library etc. The systematic review was reported following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. As they include studies that were in-vitro and ex-vivo based, the risk of bias of the selected articles was assessed using a customized tool based on the previous literature and parameters evaluated in the studies included.ResultsThe literature search resulted in 101 items of which 19 records were included in this review. Results reported that multiple factors and parameters were assessed to evaluate the flow and apical pressures on using manual syringe needle irrigation.ConclusionsPresent systematic review gives insights in-depth about the irrigation dynamics of manual syringe needle irrigation. Besides, it is inconclusive to compile a single factor or a single parameter contributing to the enhanced irrigant flow and least apical pressures.     

术中肠道灌洗在梗阻性左半结肠癌根治术中的应用

目的探讨术中肠道灌洗在梗阻性左半结肠癌根治术中肠道一期切除吻合的应用价值和安全性评价。方法回顾性分析60例左半结肠癌并急性梗阻患者的术中处理。结果60例中治疗组50例行术中肠道灌洗一期切除吻合,47例恢复顺利,无并发症发生,2例出现吻合口瘘,1例出现腹腔脓肿,2例死亡;对照组8例行一期肠切除吻合而未行术中肠道灌洗,4例出现吻合口瘘,其中2例出现感染性休克,死于多器官功能衰竭;二期手术组2例行结肠造口,二期吻合。统计显示术中肠道灌洗一期肠切除吻合组并发症发生率和死亡率明显低于未行结肠灌洗组,差异有统计学意义。结论左半结肠癌性梗阻术中肠道灌洗一期切除吻合对提高病人生存率,减少并发症发生有重要意义。     

膀胱癌术后膀胱灌注患者的心理状况调查及护理干预

目的掌握膀胱癌术后膀胱灌注患者的心理动态,及时给予护理干预,提高患者的生活质量。方法填写《癌症患者心理反应状况量表》进行心理测试,评估患者的心理状况,进行护理干预,干预前后进行心理状况比较。结果干预前后患者的心理状况有明显差别(P<0.01)。结论及时给予有效的护理干预,能改善患者的不良心理,增强战胜疾病的信心,提高患者的遵医行为,按时定期灌注,降低复发率,提高患者的生活质量。