The Efficacy of an Octenidine Decolonisation Protocol in Reducing Staphylococcus Aureus Carriage in Patients Undergoing Total Joint Arthroplasty
Tristan Symonds,
Hannah Brien,
Benjamin Parkinson,
Andrea Grant,
Kenji Doma
Issue:
Volume 8, Issue 3, June 2020
Pages:
81-85
Received:
7 April 2020
Accepted:
26 April 2020
Published:
19 May 2020
Abstract: Prosthetic joint infections are responsible for a high morbidity and economic cost in patients undergoing total joint arthroplasty. Staphylococcus aureus (S Aureus) is a key modifiable risk factor in the reduction of surgical site infections (SSI). Evidence suggests that decolonization of S aureus carriers reduces the risk of SSI. Octenidine is an antiseptic active against gram-positive and gram-negative bacteria. The aim of this study is to establish the eradication rate of S aureus in patients undergoing total joint arthroplasty using an Octenidine decolonisation protocol prior to surgery. This was a prospective case series performed at the Cairns Private Hospital during a five month trial period of using Octenidine wash and nasal gel in patients undergoing elective TJA. Patients undergoing total joint arthroplasty during a five-month trial period had pre-operative nasal swabs to screen for S aureus pre and post Octenidine treatment. All patients underwent a body wash and nasal gel protocol for five days using Octenidine. The primary outcome was to determine decolonisation rates in patients following the protocol. A total of 183 patients met inclusion criteria into this study. At the first swab 151 (82.5%) patients had normal regional flora and 32 (17.5%) were positive for S aureus. Of these 32 patients 30 (93.75%) were negative for MRSA and 2 (6.25%) had non-multiresistant MRSA. The decolonization rate for patients with S aureus was 76.6%. It was unsuccessful in clearing the two patients with nmMRSA. Octenidine is effective in reducing S aureus colonisation in patients undergoing total joint arthroplasty. Further studies are required to compare this agent to traditional mupirocin based protocols to determine its efficacy as an alternative for use in pre-operative staphylococcal decolonisation.
Abstract: Prosthetic joint infections are responsible for a high morbidity and economic cost in patients undergoing total joint arthroplasty. Staphylococcus aureus (S Aureus) is a key modifiable risk factor in the reduction of surgical site infections (SSI). Evidence suggests that decolonization of S aureus carriers reduces the risk of SSI. Octenidine is an ...
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Experience on the Vascular Approaches for Hemodialysis in the EL ABBADI Mohamed Saâd Clinic in Casablanca
Balde Oumar Taibata,
Camara Soriba Naby,
Balde Abdoulaye Korse,
Diallo Amadou Djoulde,
Camara Fode Lansana,
Balde Habiboulaye,
Barry Madiou,
Soumaoro Labile Togba,
Fofana Husseine,
Soumah Aboubacar Fode Momo,
Diakite Sandaly,
Camara Mariame,
Camara Mohamed,
Diallo Asmaou,
Yombouno Ives,
Biro Diallo
Issue:
Volume 8, Issue 3, June 2020
Pages:
86-89
Received:
20 April 2020
Accepted:
21 May 2020
Published:
4 June 2020
Abstract: The arteriovenous fistula (AVF) for hemodialysis, consists of surgically creating an anastomosis between an artery and a superficial vein in the arm. This study aims to mark our contribution to the study of arteriovenous fistulas for hemodialysis during our internship in Morocco Methodology: We carried out a six years retrospective study from January 1st, 1994, to December 31st, 1999, inclusively. The study involved 1,531 arteriovenous fistulas performed during our studying period on 2,361 consultations. All the adequate files were included in our study. The other inadequate files were excluded. Results: The study involved 833, that is 44.8% of men and 698, or 37.6% of women. Sex ratio 1.19. Thus, we counted right radial FAV 388 cases; Ulnar FAV 5 cases; FAV of the elbow crease 137 cases. In the left upper limb, 1,321 procedures, or 71.1%, distributed as follows: Left radial FAV 1,080 cases Cubital FAV 7 cases Elbow fold AVF 234 cases. According to the Vascular Seats (arteries and veins), the anastomoses were performed between Arteries and radial veins 388 or 20.9% Left radial arteries and veins 1080 cases or 58.1%, Humero-basilica 194 or 10.4%, Humero-cephalic 154 cases or 8.2%. Anastomoses on ulnar and other arteries 2, 5% straight 388 or 20.9% Left radial arteries and veins Conclusion: For patients with end-stage chronic kidney disease, arteriovenous fistulas are the last hope for their survival.
Abstract: The arteriovenous fistula (AVF) for hemodialysis, consists of surgically creating an anastomosis between an artery and a superficial vein in the arm. This study aims to mark our contribution to the study of arteriovenous fistulas for hemodialysis during our internship in Morocco Methodology: We carried out a six years retrospective study from Janua...
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Performing Central Neck Dissection in Patients with Papillary Thyroid Carcinoma with Clinically Node Negative, Benefits and Drawbacks: A Comparative Study
Ibtsam Shehta Harera,
Gamal Osman,
Rehab Hemeda,
Shady Emad Shaker,
Mohamed Abdallah Zaitoun
Issue:
Volume 8, Issue 3, June 2020
Pages:
90-96
Received:
28 April 2020
Accepted:
20 May 2020
Published:
4 June 2020
Abstract: Context: central neck dissection in addition to total thyroidectomy as a management procedure of patients with papillary carcinoma of the thyroid [PTC] was previously found to decrease the incidence of lymph node recurrence and allow and accurate PTC surgical staging that allow making a better decision regarding adjuvant radioactive iodine (RAI) ablation. But recently, central neck dissection in patients with clinical and radiological evidences of negative cervical lymph nodes was found to have many post-operative complications. Aim: to assess benefits, complications and drawbacks of performing central neck dissection by in PTC patients. Patients and methods: This is a prospective randomized study which included 70 PTC patients who was subjected to total thyroidectomy with or without neck dissection; all included patients have clinically negative cervical lymph nodes, 40 (60%) underwent total thyroidectomy in addition to central neck dissection and 30 (40%) patients were subjected to only total thyroidectomy without central neck dissection. We followed our patients for five years to detect recurrence, RFS and OS rates. Results: We found that operative time was longer in patients underwent central block dissection (p=0.049). Recurrence free survival and overall survival rates were not significantly different among both included groups, which denoted that central block neck dissection has no survival benefits in PTC patients. Conclusions: We have concluded that performing central neck dissection in PTC with clinically and radiologically negative lymph nodes has no benefits in increasing patients’ survival or decreasing recurrence rate and might lead to prolongation of operation time, increasing post-operative morbidity.
Abstract: Context: central neck dissection in addition to total thyroidectomy as a management procedure of patients with papillary carcinoma of the thyroid [PTC] was previously found to decrease the incidence of lymph node recurrence and allow and accurate PTC surgical staging that allow making a better decision regarding adjuvant radioactive iodine (RAI) ab...
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Pediatric Orthopaedics in Precarious Environment Possibilities and Limits of Humanitarian Surgery
Issue:
Volume 8, Issue 3, June 2020
Pages:
97-103
Received:
8 May 2020
Accepted:
25 May 2020
Published:
4 June 2020
Abstract: This is a retrospective study concerning a 35 years experience of pediatric orthopedic humanitarian surgery performed in precarious situation. This account may be useful to share with younger surgeons considering initiating such a surgery in developing countries. The data of 80 surgical missions held between 1983 and 2018 in Central African Republic have been collected and analyzed. The missions were planned with authorization of the local ministry of health. Their duration was usually two weeks, one week in the capital and one week in about fifteen villages in the country having small rehabilitation centers created when poliomyelitis was devastating. Surgery was performed in the local health center or hospital, with cooperation of the local medical team, sometimes without electricity, usually without radiograph, allowing only clinical diagnosis and not aggressive surgery. Postoperative care was given in the rehabilitation center. All in all 7500 children were seen in out-patients clinics and 2 200 underwent surgery. Sequelae of poliomyelitis which included 66% of out-patients between 1983 and 2000 turned down and became very rare, replaced by a more varied pathology with predominantly congenital malformations and sequelae of intramuscular injections, as well as sequelae of burns and sequelae of neurologic suffering (cerebral palsy, neuromalaria, sequelae of poisoning by toxic cassava). These pathologies are analyzed and the therapeutic options are discussed considering the local facilities. The families often neglected the given appointments, and due to this poor cooperation 25% only out of the operated patients were reviewed, making ineffective any statistical analysis. Nevertheless numerous pieces of information concerning the postoperative result and the late follow-up could be obtained from the local teams, allowing a global evaluation of the validity of this kind of humanitarian surgery.
Abstract: This is a retrospective study concerning a 35 years experience of pediatric orthopedic humanitarian surgery performed in precarious situation. This account may be useful to share with younger surgeons considering initiating such a surgery in developing countries. The data of 80 surgical missions held between 1983 and 2018 in Central African Republi...
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