Betadine Solution Research Articles

Analysis of adolescent idiopathic scoliosis population for Surgical Site Infection Risk Factors

ObjectiveThe incidence of surgical site infection (SSI) in adolescent idiopathic scoliosis (AIS) patients undergoing surgical correction varies but is commonly reported between 0.5 and 6.7 %. The identification of modifiable risk factors is crucial to preventing these infections in the AIS population. Some potential modifiable risk factors include the use of stainless-steel implants, a larger volume of instrumentation and an increased volume of blood products transfused. However, evidence in support of these factors and others representing true risk for the development of SSI is limited and often varies. We aimed to determine the incidence of SSI in AIS undergoing primary scoliosis fusion at our hospital, and explore demographic and clinical variables in the development of SSI in AIS. MethodsThis was a case control retrospective study. Patients aged 10-19 year-old that underwent posterior spinal fusion for initial correction of AIS at our hospital between the years 2012–2020 were eligible. Patients with any previous spine surgery or spine fracture were excluded. A descriptive analysis was then performed on the data. ResultsOf the 334 patients on which data was collected, one SSI was identified resulting in an incidence of infection of 0.3 %. The largest ethnicity represented was Caucasian with 254 patients. The average age was 14.3 years with averaged follow-up of 6.6 years. The majority of patients (252) received implants composed of titanium and cobalt chrome. The average operation duration was 5 h and 7.7 min, and the average hospital stay was 4.2 days. The average amount of blood loss was 553 ml. Chlorhexidine wipes or some other antimicrobial preparation was used on 197 patients and betadine solution was used on 321.185 patients were recorded to have received either antibiotic-loaded allograft or antibiotic powder and 326 patients were recorded to have received intraoperative antibiotics. ConclusionsThe long term clinical follow up of our study and low incidence of infection provide additional evidence for the benefit of antimicrobial techniques and risk factor mitigation previously suggested in the literature for the prevention of SSI in AIS. Level of evidenceLevel III.

Investigating the sterile surgical supply waste in laparotomy surgery

BackgroundOperating rooms contribute to over 40% of hospital expenses, with a portion attributed to waste from single-use, sterile surgical supplies (SUSSS). This research aimed to determine the amount of cost wastage due to not using SUSSS during laparotomy procedures.MethodsA descriptive-analytical investigation was conducted in two prominent teaching hospitals in Mashhad, Iran 2018. Seventy-seven laparotomy surgeries were scrutinized, documenting both used and unused disposable devices, with their respective costs being assessed. Data analysis was performed using SPSS version 16 software.ResultsThe study revealed that during surgery in the operating rooms, waste of SUSSS averaged 5.9%. Betadine solution and sterile Gauze types were the top two contributors to resource wastage. Sterile Gauze types incurred the highest cost loss. The study found a significant correlation between cost wastage and surgeon experience (r = 0.296, P < 0.001) as well as surgery duration (r = 0.439, P < 0.001).ConclusionInadequate management of available and commonly used disposable supplies leads to increased hospital expenses. Enhancing the surgical team’s knowledge of sterile surgical supplies usage and making thoughtful selections can play a vital role in curbing health costs by minimizing waste of SUSSS in the operating rooms.

HYDATID CYST IN CAUDATE LOBE OF LIVER- A THERAPEUTIC CHALLENGE

Background: Treatment of Echinococcal disease depends on the type, size, and location of the cyst, presence of complications, and the experience of the team. Treatment options include percutaneous treatments, surgery, anti-parasitic drugs, and follow-up without intervention. Objectives: To report a case of hydatid cyst located in caudate lobe of liver. Materials and Methods: A 32-year-female, presented with c/o of Pain in abdomen since 1 week localized to right hypochondrium. USG (A+P) was suggestive of hydatid cyst in caudate lobe of liver. MRI was suggestive of hydatid cyst of liver with abutment of left portal vein and IVC. Patient was first started on medical treatment for 6 weeks and then planned for laparoscopic hydatid cyst excision. Cyst was approached laproscopically and fluid aspirated followed by injection of 10% betadine solution (scolicidal) and then reaspirated. Endocyst was removed. The resultant cavity was plugged with omentum. Results: Patient was discharged on POD-3 on T. Albendazole 400 mg BD for 3 months and T. Praziquantal 600 mg once a week for 3 months. After 6 months, patient is symptomatically well and has no complaints or signs of recurrence at present. Conclusion: Minimally invasive laproscopic sugery has more or less replaced the conventional open surgical approach for cystic hydatidosis. Our case is unique due to its location in the caudate lobe of liver alongwith abutment and mild compression of IVC and portal vein which poses a therapeutic challenge to the surgeon. The caudate lobe of the liver is an anatomically complex liver segment. Its unique and intimate location with the hepatic hilum and inferior vena cava (IVC) coupled with its dual supply from both portal pedicles and direct venous drainage into the IVC make vascular control a particular challenge. Technically challenging cyst excision can be performed laparoscopically with its benefits of improved perioperative outcomes.

Evaluating the Efficacy of Topical Phenytoin in the Healing of Neuropathic Diabetic Foot Ulcers: A Comparative Study.

This study aims to observe the outcomes of topical phenytoin treatment in healing neuropathic diabetic foot ulcers with mild infection and compare these outcomes with those obtained from conventional dressing methods. A retrospective observational study was conducted by reviewing the medical records of patients with neuropathic diabetic foot ulcers treated at a tertiary care center from 2015 to 2020. Two groups were identified: (1) patients treated with topical phenytoin (for ulcers measuring less than 5 cm, a dosage of 100 mg was used; for ulcers measuring between 5 cm and 9 cm, a dosage of 150 mg was used; for ulcers measuring between 10 cm and 15 cm, a dosage of 200 mg was used; and for ulcers measuring greater than 15 cm, a dosage of 300 mg was used. The tablets were crushed and dispersed before administration) and (2) those were treated with conventional dressings (the conventional method includes wound wash with 0.9 normal saline and betadine solution with application of sterile gauze dressing). Data on wound healing rate, time to achieve complete healing, and recurrence rates were collected. The study included 120 patients, with 60 receiving topical phenytoin and 60 receiving conventional dressings. Preliminary findings indicated that the topical phenytoin group experienced a 27 (45%) reduction in ulcer size by week four, compared to a 15 (25%) reduction in the conventional group. The median time to complete healing was significantly shorter in the phenytoin group (eight weeks) compared to the conventional dressing group (12 weeks; p < 0.05). Additionally, granulation tissue appeared earlier in the phenytoin group, with an average onset of 10 days, compared to 18 days in the conventional group (p < 0.01). The incidence of ulcer recurrence was lower in the phenytoin group (6, 10%) compared to the conventional group (18, 30%; p < 0.05). Topical phenytoin demonstrated a promising enhancement in the healing of mildly infected neuropathic diabetic foot ulcers compared to conventional dressings. Further studies are recommended to substantiate these findings and explore the mechanisms underlying the observed benefits.

Comparative Analysis of Dilute Povidone Iodine (Betadine) versus Normal Saline in Bilateral Knee Joint Replacement Surgery: A Retrospective Cohort Study

Background: One of the proposed methods to reduce the risk of infection after joint replacement is the use of disinfectant solutions at the end of the surgery. Differing results have been reported regarding the effects of diluted povidone-iodine (betadine) washing solution and normal saline in reducing the risk of periprosthetic joint infection (PJI). The purpose of this retrospective cohort study is to compare the outcomes of diluted betadine solution with normal saline in bilateral knee replacement surgery.&#x0D; Methods: Patients who were referred to Ba’ath Hospital, Hamedan, Iran, from 2019 to 2021 for bilateral knee joint replacement were included. For each patient, one knee was washed with diluted betadine (35%), and the other with normal saline for 3 minutes before closing the wound. Demographic information, risk factors, and the rate of PJI three months after the surgery were collected and analyzed.&#x0D; Results: Out of 320 patients, 177 (55.3%) were women, and the most common underlying disease was type 2 diabetes with a frequency of 20.0%. Out of 640 operated knees, 17 cases (2.7%) of PJI occurred after surgery, of which 11 (4.3%) were washed with normal saline (P = 0.326). The multivariate regression analysis showed that being male (P = 0.028), diabetes (P = 0.030), high blood pressure (P = 0.019), and an increase in each body mass index (BMI) unit (P = 0.030) increased the chance of infection.&#x0D; Conclusion: Intraoperative irrigation with diluted betadine solution in bilateral knee replacement surgery can reduce the risk of infection, especially in patients with underlying diseases and obesity.

(045) Comparing Bacterial Presence with the Usage of 0.05% Chlorhexidine Gluconate (CHG) Lavage During Urologic Prosthesis Revision Surgery: Update on Results

Abstract Introduction An Inflatable Penile Prosthesis (IPP) is third line surgical therapy for refractory ED. An IPP uses a fluid-filled reservoir with a pump and valve system to activate inflation and deflation. Although penile implants achieve the highest success rates in ED treatment, the possible presence of bacteria on the device itself or bacteria exposure accumulated during the surgery increases the risk of progression into biofilm or infection. Biofilm complicates the bacteria eradication effort and can ultimately jeopardize the implant. Often, the only way to treat the post-op infection is with implant removal. Currently, many preventative measures, such as different perioperative irrigations, are being studied to reduce the number of penile implant infections. Research has shown that irrigation at the time of both infectious and noninfectious surgery lowers subsequent infection rates. Different solutions like saline, antibiotic, betadine, and hydrogen peroxide solutions have been considered. Recently, orthopedic literature has shown that 0.05% Chlorhexidine Gluconate (CHG) lavage has effectively reduced biofilm in artificial joint procedures. Objective The purpose of this study is to determine the effectiveness of CHG lavage on bacterial presence in IPP implant spaces. We hypothesize that CHG will lower bacterial presence after washing out implant spaces at time of replacement for infections and mechanical failure. Methods We aimed to investigate a series of patients who underwent revision IPP surgery while utilizing FDA-approved CHG lavage for irrigation and compared the bacterial presence before and after CHG washout. Additionally, Next Generation Sequencing (NGS), a DNA sequencing technology, was used to further identify the pathogens involved. Results Between 2021 to 2023, 48 patients underwent IPP revision surgery for either infectious or noninfectious reasons. During the operation, a section of the capsule tissue surrounding the implanted IPP pump was first taken and sent for cultures. NGS studies were also sent out. After the implant removal, all implant spaces were irrigated and washed out with CHG (two 450-mL bottles). A second tissue culture was then obtained post washout. Of the 48 patients, there were 4 positive bacterial cultures before washout and 13 positive NGS results. Results of the post CHG washout cultures were all negative. Conclusions It appears that irrigation with 0.05% Chlorhexidine Gluconate solution is an effective antiseptic that can decrease bacterial presence, and hopefully reduce IPP infections. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Microgen Dx, Irrisept.

Role of Octreotide and Instillation of Povidone-Iodine in the Treatment of Lymphorrhea in Renal Transplantation: A Comparative Study

Background: Lymphorrhea is a minor complication after kidney transplantation but may develop into a lymphocele and prolong hospital stay. Treatment is conservative based on percutaneous drainage until lymphatic leakage cessation. It has been reported that povidone iodine instillation and octreotide has beneficial effects to treat lymphorrhea after renal transplantation. Aims and Objectives: The aim of this study was to compare the povidone iodine instillation and octreotide treatment in lymphorrea after kidney transplantation. To evaluate the efficacy of povidone iodine and octreotide injection in comparison to control group for the treatment of lymphorrhea in renal transplant patient. Materials and Methods: It was comparative analytical study included 60 recipients of both cadaveric and live kidney allografts with posttransplant lymphorrhea including 20 treated with instillation of betadine solution, 20 with octreotide (0.1 mg three times a day subcutaneously), and 20 was control group (no betadine and octreotide was used). We reviewed the daily amount of fluid collection, duration of lymphorrhea, complications, lymphocele formation, rejection episodes, graft outcomes, and hospital stay. Results: The average duration of lymphorrhea was (8.85 ± 0.88) and (11.6 ± 0.94) and (16.15 ± 0.81) days for the betadine groups, the octreotide groups and control groups respectively. (P &lt; 0.05). No lymphoceles occurred among the betadine group, while three lymphoceles were found among patients treated with octreotide and five lymphocele were found among control groups. No differences were observed for wound infection, graft dysfunction episodes or renal function and death between the groups. No octreotide and povidone related adverse events were noted. Conclusion: The mean length of lymphorrhea was lower with povidone iodine instillation as compared to octreotide treatment. There was a shorter hospital stay and minor patient discomfort in betadine groups. In conclusion, lymphatic leakage after kidney transplantation may be successfully managed by betadine instillation as compared to octreotide and control groups.

Effect of Achillea vermicularis ointment on wound healing after episiotomy in primiparous women: a randomised clinical trial

IntroductionEpisiotomy may be followed by several maternal complications, such as postpartum infection, pain, discomfort, and prolonged wound healing. The present study was conducted to evaluate the effect of Achillea vermicularis on wound healing after episiotomy. MethodsWe performed a randomised clinical trial consisting of 100 participants aged on average 23.37 (±4.96) years, who underwent an episiotomy during normal vaginal delivery from June to December 2018. The mothers were randomly allocated to the treatment or control group. Those in the treatment group used the A. vermicularis 3% ointment, while those in the control group received routine treatment consisting of sitz baths with betadine solution. The primary outcome was wound healing, which was assessed using the redness, edema, ecchymosis, discharge, and approximation (REEDA) scale on baseline and days 7 and 10 after the intervention. ResultsThe episiotomy wound parameters did not differ significantly between groups on day 7, but there was a significant difference in redness (P = 0.02), discharge (P = 0.03), approximation of wound edges (P = 0.03), and wound healing (P < 0.001) between the two groups on day 10. DiscussionIt may be concluded that A. vermicularis ointment has a positive effect on wound healing after episiotomy on day 10 postpartum.

Beyond Traditional Approaches: A Pilot Study Exploring the Role of Injection Mitomycin C on the Surgical Resection Bed in Oral Cancer Treatment.

Background Oral cavity cancer ranks sixth among all cancers worldwide. India has the most oral cancer cases and accounts for one-third of the global oral cancer burden. Oral cavity cancer is known to be associated with an elevated likelihood of locoregional recurrences, which account for the bulk of post-surgery and radiotherapy treatment failures. Mitomycin C (MMC) is an antineoplastic and antibiotic agent that is administered topically rather than intravenously to treat bladder and intraperitoneal tumors to avoid recurrences. This study aimed to investigate the use of injection MMC as a local application on surgical resection beds for patients undergoing surgery for oral cancer and to assess its efficacy in preventing regional recurrences. Methodology In this prospective, interventional, pilot study, patients were assigned randomly to two groups using simple randomization. Group A involved the application of two gauze pieces soaked with MMC injection. Group B involved the application of two gauze pieces soaked with a 10% betadine solution. During the pectoralis major myocutaneous flap harvest procedure for reconstruction, two gauze pieces soaked with either injection MMC solution (20 mg MMC in 20 mL of 0.9% normal saline) or 10% betadine solution were placed on the surgical resection bed for a 45-minute contact period. Patients were evaluated daily in the postoperative period for local complications. Regular follow-up visits were scheduled for 15 months of follow-up. Results After exclusions at various phases, the final analysis included 50 patients in Group A and 50 patients in Group B. Minor complications, specifically blackening of the skin flap in the neck resulting in surgical site infections, were observed in 16% (eight patients) of the MMC group and in 6% (three patients) of the betadine group (p = 0.1997) patients. In the MMC group, two (4%)patients experienced locoregional recurrences at three months, four (8%) patients at six months, six (12%) patients at nine months, eight (16%) patients at 12 months, and 10 (20%)patients at 15 months of follow-up. In contrast, locoregional recurrences occurred in two (4%) patients in the betadine group at three months, six (12%)patients at six months, nine (18%) patients at nine months, 12 (24%) patients at 12 months, and 15 (30%) patients at 15 months. Although the difference in locoregional recurrences between the two groups was not statistically significant, there was a trend of decreasing locoregional recurrences in the MMC group relative to the betadine group as the duration of follow-up increased. In the subgroup analysis of patients with pathological extranodal extension (ENE), only 10 of 18 patients with ENE in Group A (55.55%) experienced a recurrence, whereas all 12 patients with ENE in Group B (100%) experienced a recurrence within the same time frame. This difference in locoregional recurrence rates between the two groups was statistically significant, with a p-value of 0.0100. Conclusions Our study demonstrated that the local administration of MMC on surgical resection beds may lower the risk of locoregional recurrences in patients with oral cancer, especially those with ENE. These findings contribute to the ongoing efforts to enhance treatment strategies and patient outcomes for this challenging malignancy.

Improving Surgical Safety in Living Donor Renal Transplantation With Antiseptic Skin Preparation, Bladder Irrigation, Corner-Saving Vascular Anastomosis, DJ Stenting, and Extravesical Ureteroneocystostomy Modifications: A Comprehensive Approach.

Introduction The antiseptic skin preparation, bladder irrigation, corner-saving vascular anastomosis, DJ stenting, and extravesical ureteroneocystostomy (ABCDE) approach encompasses a range of modifications applied during different stages of the surgical procedure in renal transplantation. These modifications include the following: A, antiseptic skin preparation sequentially with cetrimide 3.35%, chlorhexidine scrub 4%, spirit, and povidone-iodine 10%; B, bladder irrigation with amikacin and betadine solution;C, corner-saving end-to-side vascular anastomosis; D, DJ stenting with early postoperative removal within three weeks; and E, extravesical ureteroneocystostomy using our institute's modified Lich-Gregoir technique. Methods This prospective observational study was conducted at our institution between March 2021 and May 2023. Data were collected from the patients' medical records and analyzed using Statistical Package for the Social Sciences (SPSS) (IBM SPSS Statistics, Armonk, NY, USA). Statistical tests, including t-test, Mann-Whitney test, chi-square test, and Fisher's exact test, were used for analysis. The study assessed various recipient, donor, intraoperative, and post-transplant factors, as well as surgical complications and stent-related factors. Results Out of 72 renal transplantations, 12 (16.6%) had the followingsurgical complications: urinary(n= 4; 5.5%), wound-related (n= 3; 4.1%), andlymphocele(n= 5; 6.9%). The most common complications werelymphocele(n= 5; 6.9%) and urinary leak (n= 4; 5.5%). Surgical complications were more common in male recipients (91.6% versus 8.3%), as well as in recipients with longer dialysis duration (24 ± 17 versus 11.0 ± 7 months) and had extended hospitalization time (16.4 ± 8.6 versus 8.0 ± 2.9 days) (p < 0.05). Wound infectioncorrelated with longer surgeries (>300 minutes) and other complications. Lymphocele patients had higher drain output (>500 mL) on day 1 and longer hospital stays (>15 days). Urinary tract infections (UTIs) were linked to dialysis duration (>24 months), diabetes, and longer indwelling times of DJ stents and urinary catheters. Early DJ stent removal (<3 weeks) reduced UTI incidence and symptoms (p < 0.05). All complications were categorized as minor (3a or less), according to the Clavien-Dindo classification. Conclusion The modified ABCDE surgical approachin renal transplantation decreased the complications, showing favorable outcomes compared to those in the literature.

EFEKTIVITAS EKSTRAK DAUN BELIMBING WULUH (Averrhoa bilimbi L.) SECARA TOPIKAL TERHADAP PENYEMBUHAN LUKA PADA KELINCI (Oryctolagus cuniculus)

Wound healing is a repair process of damaged skin tissue caused by injury. The bilimbi (Averrhoa bilimbi L.) plant is widely known to have potential in wound healing and the plant part that is commonly used is the leaves. The purpose of this study was to determine the wound healing effects of bilimbi leaf extract (Averrhoa bilimbi L.) on rabbits (Oryctolagus cuniculus) topically. The wound healing test was conducted using the New Zealand strain rabbit test animal. The rabbit’s back skin was induced with 8 mm diameter wound and the induced wounds were grouped into 5 groups. The groups included a negative control group that was given with aqua dest solution; the positive control group was given with betadine solution; treatment groups were given with 3%; 6%; and 12% bilimbi leaves extract. The wounds that were treated with betadine solution and bilimbi leaves extract 3% healed on day 13th. The wounds that were treated with bilimbi leaves extract 6 and 12% were healed on day 12nd. The different results showed by the wounds that were treated with aqua destilata which were healed on day 14th. The results showed that bilimbi leaf extract was topically effective in wound healing on rabbit test animals. The most effective concentration of bilimbi leaves extract in wound healing was 6% and 12%.

The use of own stent construction as an alternative to partial cervical resection in the treatment of closed pyometra in mares

In this study, the author presents the results of effective treatment of closed pyometra in mares with cervical adhesions, using a stent of his own construction. A 17-year-old mare, breed S.P., was admitted to the hospital with a diagnosis of closed pyometra caused by cervical obstruction as a result of adhesions inside its lumen. After confirming the diagnosis, the cervical adhesions were manually separated and about 20 l of purulent discharge was leveraged from the uterus. In the following days, the uterus was treated for inflammation by rinsing it with 0.05% betadine solution. These treatments were repeated every other day, 4 times. On the last day of treatment, 500 mg of cefapyrin was administered intrauterine, and a stent constructed of two trimmed and appropriately connected Pezzer catheters was inserted into the cervix. The mare underwent a clinical check-up after 3 weeks and then at 3 and 8 months after stent insertion. During this period, the stent remained in place, and ultrasound showed only a scant amount of non-echoic discharge in the lumen of the uterus.

The effect of using various types of mouthwashes on wound healing and patient comfort following extractions in Taibah University patients

Objective: This study aimed to assess the effects of povidone-iodine, salt base water (Himalaya), and normal saline on soft tissue healing and pain alleviation as post-extraction mouthwashes in the dental clinic of Taibah Dental Hospital in Saudi Arabia. Methods: In the present study, the effects of various mouthwashes, including normal saline, Himalaya natural salt mouthwash, and diluted betadine solution was compared regarding the extraction socket healing and improved patient experience. The pain and edema were assessed using a visual analogue scale, and soft tissue healing was assessed using the Landry and Turnbull criteria. Results: On the first day, nearly all the study participants experienced the same level of discomfort, which then progressively subsided over five days. The wounds were examined for soft tissue healing on day three and seven following surgery and revealed no difference between the groups. Conclusion: Despite the fact that all mouthwash types produced equal beneficial effects, there was no statistically significant difference in the effect of using various types of mouthwash on the acceleration of soft tissue healing or the reduction of pain after uncomplicated exodontia.

An in vitro Study of Betadine's Ability to Eliminate Live Bacteria on the Eye: Should It Be Used for Protection against Endophthalmitis?

Povidone-iodide (Betadine) is an antiseptic that is applied topically and has many uses in the medical community, such as in wound care and pre- and post-operative surgical procedures. This study was done to measure the effectiveness of Betadine solutions in inhibiting the growth of Gram-negative and Gram-positive bacteria. The ability of 2.5 and 10% Betadine solutions to inhibit bacterial growth was measured against Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, and Acinetobacter baumannii. We grew the bacteria independently and together to simulate a hospital environment. All the bacteria showed zones of inhibition. However, discs were also tested for live bacteria using the colony-forming unit assay. Complete killing was only seen for S. aureus with the 10% Betadine solution. All other bacteria showed growth on the disc. This study showed several things. First, the zone of inhibition assay does not give an accurate assessment of antimicrobial properties when used alone and should be followed by a colony-forming unit assay. Second, 2.5% and 5% Betadine do not have effective antimicrobial properties against any of the bacteria tested, and 10% Betadine is only effective against S. aureus and not effective against the other bacteria tested.

Effect of Common Mouthwashes on Mechanical Properties of Suture Materials Used in Dental Surgeries: A Laboratory Experiment.

Background: Sutures play a pivotal role in promoting healing in any surgical procedure. However, the versatile nature of the oral environment entails additional properties in the suture materials to assure uneventful healing. A surgeon needs to understand these delicate intricacies in the immediate postoperative phase and needs some kind of algorithm in the selection of sutures that suits the different surgical scenarios. Therefore, a study was designed to observe the effect of four different types of mouthwash, viz. Avohex, Aloedent, Parodontax and Betadine, on the mechanical properties of Vicryl (polyglactin 910), PTFE (polytetrafluoroethylene), Prolene (polypropylene) and Mersilk. Methods: A total of 288 suture samples were divided in four equal groups (72 = each group) and used for the experiments. Tensile load, tensile strength as well as percentage elongation of the suture materials were evaluated in the various stated media at 3rd, 7th, 10th and 14th days, which were compared with the controls. The results were analyzed statistically and inferences were drawn. Results: Mersilk in (Avohex, Parodontax and Betadine) solutions showed a statistically significant decrease in tensile load over time. All the sutures had the highest tensile strength in Parodontax and had the lowest in Betadine solution. Vicryl and PTFE presented significant percentage elongation over time as compared to Prolene and Mersilk. Conclusion: The author has given certain recommendations but also states that there is no standard rule for the use of a particular suture material in all clinical situations. However, the selection of the suture material should be based on the type of surgery and preferences of the surgeon.

Phytochemical Screening and Antimicrobial Assay of Selected Plant Extracts with Ethnopharmacological Potential for Wound Healing

Bacteria usually colonize wounds, and their low level is beneficial to the wound healing process. Thus, antibacterial agents are usually applied to wounds. In the Philippines, many herbal plants are used to speed up the wound healing process. With their number, literature revealed no scientific study yet on which among these plants could well inhibit wound bacteria. Hence, this study focused on the phytochemical screening and antibacterial activity of the ethanolic extracts of six herbal plants, namely: Caesalpinia sappan Linn. (Sibukao), Jatropha curcas Linn. (Tuba-tuba), Lantana camara Linn. (Kantutay), Mimosa pudica Linn. (Makahiya), Moringa oleifera Lam. (Malunggay), and Psidium guajava Linn. (Guava). Betadine was used as the positive control. Qualitative phytochemical analysis and antimicrobial assay on wound bacteria using the agar well diffusion method were employed from the six extracts. Results revealed that phytochemicals, namely alkaloids, saponins, flavonoids, and tannins, were present in the plant extracts except for anthraquinones. Furthermore, the plant extracts showed antibacterial activity on wound bacteria, and P. guajava leaf extract exhibited the most significant antibacterial effect among the treatments and is greater than the positive control (Betadine solution). On the other hand, all the plant extracts have a lower antibiotic activity index when compared with Amikacin 30mcg and Erythromycin 15 mcg. However, except for Lantana camara extract, the five plant extracts have a remarkably higher antibiotic activity index when compared with Penicillin 10 U. It is concluded that the plants studied have varying levels of antibacterial activities that could promote wound healing.

The in vitro efficacy of betadine antiseptic solution and colloidal silver gel combination in inhibiting the growth of bacterial biofilms

Betadine (Povidone-Iodine) solution is a topically applied antiseptic, which has been used routinely used in wound care and general surgery to prevent skin and wound infections. However, several studies have documented the ineffectiveness of betadine. Other topical antimicrobial dressings, including those that contain silver, have been used in the management of infected wounds. The present study was undertaken to determine if the combination of 5% betadine solution and silver colloidal gel (Ag-gel) is more effective than either substance alone in inhibiting the growth gram-negative and gram-positive bacteria. The effectiveness of 5% betadine solution and Ag-gel as anti-microbial agents were assessed using both colony forming unit (CFU) assay and confocal laser scanning microscopy (CLSM). Ag-gel showed complete inhibition on all the bacteria species examined except the Klebsiella pneumoniae clinical isolate (CL) strain while 5% betadine concentrations did not completely kill any of the tested bacteria. In contrast, K. pneumoniae was completely eliminated in the presence of both 5% betadine solution and Ag-gel together. The CLSM showed similar findings to the CFU results examining the 5% betadine solution and Ag-gel combination. This study demonstrated that while the individual treatments using either 5% betadine solution and Ag-gel alone were infective antimicrobial agents, the combination of 5% betadine solution and Ag-gel was superior at eliminating all tested bacteria, including K. pneumoniae CL.

The effectiveness of prophylactic antibiotics and betadine skin preparation on cranial cutaneous Cutibacterium acnes – A prospective study

BackgroundCutibacterium acnes, formerly known as Propionibacterium acnes, is increasingly recognized as a cause of surgical site infection and implant failure despite the use of prophylactic antibiotics and antiseptic surgical preparations. The aim of this study was to investigate whether C. acnes persists in the dermal layer of the skin after standard perioperative antibiotics and skin prepping with alcoholic betadine solution in consecutive patients undergoing a craniotomy. MethodsA single centre prospective observational study was performed at Flinders Medical Centre. Adult patients undergoing a cranial neurosurgical intervention between October 2019 to March 2021 were eligible for inclusion. After administration of standard preoperative antibiotics (Cefazolin), three swabs were taken for each patient: one before prepping the skin with alcoholic betadine, one after prepping the skin and a dermal swab once the skin was incised. Results73 patients were included. Cutibacterium acnes cultures were positive in 61 patients of the “pre-prep” group (83.6%), 12 (16.4%) in the “post-prep” group, and 53 (72.6%) were from dermal swabs There was a significant reduction of positive cultures of the skin after surgical preparation was applied (p < 0.00001). There was a non-significant reduction of positive cultures in the dermal swabs after skin preparation (p = 0.068) ConclusionsCutibacterium acnes persists within the dermis of the scalp despite standard prophylactic measures using alcoholic betadine solution and cefazolin.

A Case Report on Acute Transient’s Psychotic Disorders

Background: Little is known about acute and transient psychotic disorders (ATPD), a diagnostic category introduced with ICD-10.&#x0D; Case Presentation: Acute transient psychotic disorder is a heterogeneous group of disorders characterised by the acute onset of psychotic symptoms such as delusion, hallucination and perceptual disturbances, and by the severe disruption of ordinary behaviour. Patient history: The Male patient 48 year old who was apparently admitted in AVBRH on date 08/05/2021 with chief complaint was Abnormal behaviour( taking clothes off in public ), irritability, aggressive, muttering and smiling to self from 10 days back. His parents once locked him in a room as they fear he might hurt him. He was taken to a faith healer in Pandarkawda twice by his parents. The Baba gave him some mysterious beats like bracelet to wear which eventually decreased his symptoms for 3 days but the symptoms persisted from the fourth day. This time, the Baba mixed a lemon juice, turmeric powder &amp; kumkuma (a powder made from dried turmeric with a bit of slaked lime) and applied all over him eyes which severely inflamed &amp; burnt his eyes. His eye injury elevated his psychotic symptoms which is why his parents took him to psychiatric OPD in AVBRH.&#x0D; Past History: Patient was apparently asymptomatic 2 yrs back. He was married to a woman of his parent’s choice. His marriage life was stressful and unhealthy. He was underestimated by his wife due to his low qualification and health problem.&#x0D; Clinical Finding: The patient has been undergone with various investigations like culture, blood tests, Physical examination and mental status examination symptomatically with antipsychotic agent and anticonvulsant such as Tab Olanzapine 10mg- HS, Tab Clonazepam 0.5mg – SOS.&#x0D; Medical Management: Antibiotic eye drop homatropine and eye ointment ciprofloxacin.&#x0D; Nursing Management: Administered fluid replacement i.e DNS and RL, eye care was done with betadine and Normal Saline solutions, eye care by administering eye drops and monitored all vital signs hourly.&#x0D; Conclusion: Patient was admitted to hospital with the chief complaint of muttering to self, irritability and eye injury, blisters, pus discharge from eyes and his condition was very critical and patient was admitted in AVBR Hospital ,immediate treatment was started by health team member and all possible treatment were given and now the patient condition is satisfactory.

Evaluating the Efficacy of Povidone-Iodine Solution Infection Prophylaxis in Immediate Tissue Expander-Based Breast Reconstruction: A Controlled Retrospective Analysis.

Background: There is currently no consensus among plastic surgeons regarding the optimal infection prophylaxis for immediate tissue expander placement following mastectomy. The goal of this study was to determine whether irrigation with 1 L of standard triple antibiotic solution (TAS) can achieve similar infection rates compared to a regimen of 180 mL of TAS with povidone-iodine solution (Betadine) painted on the field immediately prior to the placement of the expander. Methods: The 2 regimens were compared via retrospective propensity matching of all patients of the 2 senior authors who underwent bilateral tissue expander placement immediately following mastectomy with one of 3 mastectomy surgeons from January 2013 to December 2019 (n = 281). Groups were controlled for mastectomy surgeon, mastectomy type, mastectomy weight, age, race, body mass index, diabetes, hypertension, smoking, smoking status, prepectoral/subpectoral placement, use of acellular dermal matrix, operating room time, and duration of postoperative antibiotics. Results: Compared to the Betadine cohort (n = 65), the non-Betadine cohort (n = 65) experienced a similar rate of infections (13.8% vs 12.3%, P = 1.00), including major injections requiring intravenous antibiotic treatment (10.8% vs 9.2%, P = 1.00), after propensity matching. Infections in the non-Betadine cohort did not grow different bacteria on culture, require different antibiotic coverage, or result in prolonged duration of average antibiotic therapy (12.0 days vs 19.3 days, P = .19). Rates of subsequent expander washout and exchange (P = 1.00) and overall complications that required return to the operating room (P = .826) were similar between groups. Conclusion: The addition of Betadine solution to TAS added no benefit to infection prophylaxis or reduction of surgical complications in immediate tissue expander placement procedures.