Clinical Healing Time Research Articles

The Effect of Age on Fracture Healing Time in Metacarpal Fractures.

Background: Older patients are treated for fracture with increasing frequency. Although studies on animals suggest that older mice and rats heal fractures more slowly, the clinical implications remain unclear. A better understanding of differences in healing with age can help customize fracture treatment. Our purpose was to retrospectively evaluate metacarpal fractures for healing time looking specifically at age-related differences. Methods: A retrospective review of patients treated for metacarpal fractures was conducted. Patients with incomplete charts or inadequate follow-up were excluded. One hundred ninety-eight charts were analyzed. Demographic and other patient factors were documented. Fracture characteristics and treatment type were documented. Fracture healing was determined clinically. Plain radiographs and examination were used in decision making. Results: Age was not associated with fracture healing time as a continuous variable (P = .09). Patients above 75 years were not associated with increased healing time (P = .58). Fracture characteristics were related to healing time: minimally displaced and comminuted fractures healed faster than oblique fractures, spiral fractures, or transverse fractures (P = .048). Patients undergoing surgery healed faster than those without surgery (P = .046). Renal failure negatively affected fracture healing time (P = .03). Diabetes, hypothyroidism, and gender were not associated with healing time. Complications were not associated with age or other patient or fracture-related factors. Conclusions: Age does not affect clinical fracture healing time in adult. Therefore, older patients do not require disparate treatment. Other fracture-related factors and considerations such as functional demand and support systems might influence treatment decisions in fracture care.

Effect of microsurgical clearance combined with vacuum sealing drainage for chronic osteomyelitis

Objective To explore the clinical effect of microsurgical clearance combined with vacuum sealing drainage(VSD) for chronic osteomyelitis, and to analyze its complications. Methods 80 patients with chronic osteomyelitis in the People's Hospital of Xuecheng District from January 2014 to January 2015 were selected and randomly divided into two groups according to the digital table, with 40 cases in each group.The observation group was treated with microsurgical clearance combined with VSD, the control group was given microsurgical clearance treatment.The changes of inflammatory factors were compared at 1 week after treatment, and the number of wound dressing, the percentage of wound healing and the time of clinical healing were analyzed. Results After treatment for 1 week, the levels of tumor necrosis factor-α(TNF-α), interleukin-1(IL-1) and high-sensitivity C-reactive protein(hs-CRP) in the observation group were (12.0±0.1)μg/L, (0.6±0.1)μg/L, (10.7±1.0)mg/L, respectively, which were significantly lower than those in the control group [(18.5±0.6) μg/L, (0.9±0.2)μg/L, (31.2±2.0) mg/L](t=67.584, 9.899, 57.983, all P<0.05). The number of dressing in the observation group was less than that in the control group[(7.4±1.2) times vs.(7.3±1.2) times, t=16.499, P<0.05)]. The recovery rate of the wound in the observation group was higher than that in the control group[(47.4±2.9)% vs.(16.4±1.2)%, t=62.470, P<0.05]. The clinical healing time in the observation group was shorter than that in the control group[(25.3±1.8)d vs.(33.2±2.7)d, t=15.397, P<0.05)]. The incidence rate of complications such as infection, hematoma and wound unhealing in the observation group was 7.5%, which was lower than 35.0% in the control group (χ2=7.470, P<0.05). Conclusion Microsurgical treatment combined with VSD in the treatment of patients with chronic osteomyelitis can effectively reduce the inflammatory reaction, so it can promote wound healing and reduce related complications. Key words: Osteomyelitis; Microsurgery; Drainage; Negative-pressure wound therapy

The Use of Integra® Dermal Regeneration Template for the Orbital Exenteration Socket: A Novel Technique.

Integra® dermal regeneration template is a bilayer membrane system that acts as a scaffold for regenerating dermal skin cells. It is used for wound reconstruction following burns, extensive injuries, and a large tumor excision in multiple parts of the body. The dermal layer is made of porous matrix of bovine tendon collagen and glycosaminoglycan. The epidermal layer is made of polysiloxane layer. In this study, the authors evaluated the use of Integra® dermal regeneration template for the immediate reconstruction of the orbital exenteration socket. Five patients who underwent exenteration and immediate reconstruction of the socket with Integra® dermal regeneration template were included in this study. Demographic and clinical features, healing time, complications, and follow-up time were recorded. The study included 4 male patients and 1 female patient with a mean age of 74 years (range, 49-87 years). The primary diagnoses were orbital extension of conjunctival melanoma in 2 patients, squamous cell carcinoma in 1 patient, and uveal melanoma in 1 patient, and aggressive orbital Wegener granulomatosis in 1 patient. There was no postoperative infection, necrosis, hematoma, or fluid accumulation in any patients. The mean postoperative follow-up period was 20 months (range, 11-42 months). The sockets were completely granulated by 4 weeks, and epithelized, getting ready for the prosthesis in 8 weeks. Integra® dermal regeneration template can be used for the immediate reconstruction of the socket following exenteration. It is easy to use, and provides a short healing time without any need for any additional reconstructive procedures.

Effectiveness analysis of Ilizarov external fixation and ankle arthrodesis in treatment of late traumatic ankle arthritis

To evaluate the effectiveness of Ilizarov external fixation and ankle arthrodesis in the treatment of late traumatic ankle arthritis. Between June 2013 and June 2015, 27 patients with late traumatic ankle arthritis were treated with Ilizarov external fixation technique. There were 16 males and 11 females with an age of 27-69 years (mean, 45.7 years). Sixteen cases were on the left side, 11 on the right side. All the patients suffered from traumatic ankle fractures or ligament damages caused by initial traumas. After 6 months of standard conservative treatment, the results was invalid and all patients had ankle joint pain and movement disorders. The disease duration was 3-39 years (mean, 11.5 years). According to Takakura ankle arthritis staging, there were 16 cases in stage 3 and 11 cases in stage 4. The tibial-talar angle before operation was (102.55±4.02) ° measured on conventional double-feet loading anteroposterior and lateral X-ray films. The American Orthopaedic Foot and Ankle Society (AOFAS) ankle and foot joint score was 45.72±6.45, and the visual analogue scale (VAS) score was 8.61±1.96. All the patients were followed up 15-42 months (mean, 28.1 months). All ankles achieved bony fusion, the clinical healing time was 12.9 weeks on average (range, 11-18 weeks). No persistent bleeding in the incisions and needle tract occurred during the follow-up. There were 4 cases of mild needle infection, 2 cases of anterior dislocation of talus, and 3 cases with different degree of limited activity. No traumatic bone defect, bone disconnection, and false joint formation was observed. At 12 months after operation, the AOFAS ankle and foot joint score, VAS score, and tibial-talar angle were 80.53±9.14, 2.77±0.82, and (94.36±2.48)°, respectively, which were significantly improved when compared with preoperative ones ( t=16.17, P=0.00; t=14.28, P=0.00; t=9.01, P=0.00). The effectivenss was excellent in 9 cases, good in 13 cases, and fair in 5 cases, with an excellent and good rate of 81.5%. Satisfactory effectiveness can be obtained through Ilizarov external fixation and ankle arthrodesis in the treatment of traumatic ankle arthritis, showing certain application prospect, while long-term effectiveness should be comfirmed by large sample randomized controlled trials.

Clinical effects of mini-locking plate with vertical or parallel technology for treatment of Dubberley type B capitellar fractures

Objective To investigate the clinical effects of mini-locking plate with vertical or parallel technology in the treatment of Dubberley type B capitellar fractures. Methods A case series study was done on clinical data of 17 cases of Dubberley type B capitellar fractures treated through operation with vertical or parallel mini-locking plate. There were 12 males and 5 females, with age range of 23-77 years (mean 56.4 years). The fractures were classified according to the Dubberley system, including type ⅠB in 2 cases, ⅡB in 6 and type ⅢB in 9. The operations were conducted through the Kocher approach at posterior-lateral rear elbow joint and the fractured bone was fixed firstly with Kirschner wire and mini screws after resetting and then with vertical or parallel mini locking plate. The surgery time and bleeding volume during the surgery were recorded. The position of fracture, healing, avascular necrosis of capitellum, heterotopic ossification, and traumatic arthritis were evaluated. At the final follow-up, the Mayo elbow performance score (MEPS) was used to evaluate the function of elbow, and flexion and extension of the elbow, swing of the forearm and inner stability of the elbow joint were evaluated. Results The surgery time was 50-90 minutes (mean 60 minutes). The bleeding volume during surgery was 40-120 ml (mean 60 ml). All patients were followed up for 12-24 months (mean 12.1 months). Anatomical reduction was seen in 12 cases and almost anatomical reduction in 5. None had vessel or nerve wound, and the wound was healed at phase Ⅰ within 10-12 days after operation. The clinical fracture healing time was 8-12 weeks (mean 11.4 weeks). At the final follow-up, the fractures were well healed without complications like fracture reduction loss, ischemic necrosis of the humerus, traumatic arthritis or heterotopic ossification of the elbow joint. MEPS in all cases was 60-100 points (mean 87.6 points). MEPS assessment result was excellent in 13 cases, good in 3 and fair in 1, with the excellent rate of 94%. At the final follow-up, the average activity of the elbow was 6 ° (0°-10°) for extension and 118° (90°-130°) for flexion, the average forearm pronation was 70° (60°-90°), the average forearm supination was 82°(70°-90°), and the inner stress test showed no instability. Conclusion Vertical or parallel mini-locking plate in the treatment of Dubberley type B capitellar fractures is associated with few complications, early functional exercise after operation, and satisfactory short-term outcome. Key words: Humeral fractures; Fracture fixation, internal; Mini-locking plate

Cancellous bone wrapping grafting for segmental defects of long bone

Objective To investigate the principles and effects of cancellous bone wrapping grafting for treatment of segmental defects of long bone. Methods From January 2008 to December 2015, 50 patients with segmental long bone defect were treated by various wrapping grafting with rich autogenous can-cellous bone. They were 31 males and 19 females, aged from 13 to 69 years (average, 34.6 years). The cancellous bone was wrapped by titanium mesh in 8 cases, by wire mesh in 10, by line binding in 13, and by induced membrane in 19. The bone defect was located at tibia in 22 cases, at radius in 10, at humerus in 8, at ulna in 7 and at femur in 3. The length of bone defect ranged from 3 to 9 cm, averaging 5.9 cm. Bone healing, complications and functionary recovery of adjacent joint were recorded. The bone defect healing and functionary recovery of adjacent joint were evaluated according to the Paley criteria. Results The inci-sions healed by the first intention in 48 cases and by the second in 2. All were followed up for 12 to 48 months (average, 19.1 months). All the bone defects healed by the first intention but one treated by induced membrane wrapping which was healed 15 months later by the secondary grafting due to nonunion at ends. The total clinical healing time ranged from 3 to 16 months (average, 6.1 months). The last follow-ups showed that all the affected limbs resumed weight-bearing activities. The healing of bone defects was graded as excellent in all but one in the group of induced membrane wrapping. Totally, the functionary recovery of adjacent joint was excellent in 18, good in 22, fair in 7 and poor in 3 cases (an excellent and good rate of 80.0%). Conclusions Cancellous bone wrapping grafting can avoid or significantly reduce loosening and absorption of cancellous bone graft after tradi-tional bone grafting. Although it is effective for treatment of large segmental bone defect, its methods should vary according to the specific conditions of the patient. Key words: Bones; Fractures, ununited; Free bone graft; Wrapping bone graft

Percutaneous cannulated screw fixation for pediatric epiphyseal ankle fractures.

BackgroundAnkle injuries are among the most common injuries in children. The aim of this study was to compare the efficacies of two percutaneous fixation methods after closed reduction in physeal ankle fractures.MethodsWe reviewed the cases of 24 patients with a mean age of 12.29 years; 16 were male, and 8 were female. Only patients with fractures of Salter-Harris types 2, 3, and 4 with displacements greater than 2 mm were included in the study. Patients were treated with closed reduction manipulation and percutaneous screw fixation. For each patient, either cannulated or headless full threaded compressive screws were used for percutaneous fixation. Radiological and clinical healing time, range of motion (ROM), American Orthopaedic Foot and Ankle Society (AOFAS) score and physeal arrest were then measured.ResultsThe mean follow-up time was 13 months. The mean time until cast removal was 3.5 weeks (range 2–5). A full ROM was achieved at an average of 5.7 weeks postoperatively (range 4–8). The radiologic healing time was 6.1 weeks (range 4–7). The patients’ clinical healing time averaged 6.8 weeks (range 5–8). Differences in radiologic healing time (p = 0.487), clinical healing time (p = 0.192), AOFAS score (p = 0.467), and complication rate (p = 0.519) between patients who received the headless compressive screw and those who received the cannulated screw for fixation were not statistically significant.ConclusionsWe demonstrate good clinical results with closed reduction and the percutaneous screw fixation method. Both cannulated and headless compressive screws can be used safely as a treatment method in physeal ankle fractures.

Analysis of therapeutic effect of induced membrane technique for treatment of bone defect

Objective To investigate the influencing factors and technical points of induced membrane technique for treatment of bone defect. Methods All of 20 patients of bone defect were treated by induced membrane technique in our hospital from January 2008 to November 2014,including 15 males and 5 females; aged 13-69, average 38.5; infectious bone defect in 16 cases and non-infectious bone defect in 4 cases. Record the complications, evaluate the healing of bone defect and functional recovery of adjacent joints by Paley method, respectively, and grade the range of movement (ROM) of adjacent joints by authors’s method. Results In the first stage of surgery, 1 case needed a second operation as the wound gradually spitted and bone cement contaminated after tighten closure of the skin flap, while others had no infection or recurrence of infection. In the second stage of surgery, 3 cases had induced membrane damage and defect. All were followed-up from 12 to 50 months (average 19.7 months); all the bone defects healed, the clinical healing time was 3.0 to 7.0 months (average 4.7 months). The healing time in the 3 cases with induced membrane damage and defect (average 6.0 months) was longer than that in patients without induced membrane damage and defect(average 4.6 months). 1 case of infectious bone defect with induced membrane damage and defect had local infection in 6 months after the second stage of surgery, for whom the conservative treatment was invalid but got controlled after second operation while 1 case of infectious bone defect without induced membrane damage and defect had local infection in 12 months after second stage of surgery, in whom the infection was controlled by the conservative treatment, the others had no infection or recurrence of infection, no broken of fixators noted; at the last follow-up, all the bone defect healing graded excellent, the functional recovery of the adjacent joints graded: excellent in 8 cases, good in 10 cases, and fair in 2 cases (the excellent and good rate was 90%), the ROM of the adjacent joints graded: excellent and good in 8 cases, respectively, fair and poor in 2 cases, respectively (the excellent and good rate was 80%). Conclusion Induced membrane technique has advantages of simple surgery, faster healing of bone defect, no correlation between the healing time and the length of bone defect, fewer complications, etc, but in clinical application, the operators must understand the therapy principle and pay attention to the influencing factors and technical points so as to avoid operation errors, reduce complications and improve therapeutic effect. Key words: Extremities; Wounds and injuries; Infection; Bone Cements

Comparison of clinical effect betweem reconstructing femoral calcar and proximal femoral antirotation nail for the treatment of unstable femoral intertrochanteric fracture in elderly patients

To compare the clinical effects of two methods of internal fixation in treating unstable femoral intertrochanteric fractures in elderly patients. From August 2009 to August 2014, 68 elderly patients with unstable femoral intertrochanteric fracture treated with locking proximal femur plate and auxiliary short reconstructed plate (reconstructing calcar group) and proximal femoral nail antirotation (PFNA group) with clinical course from 1 to 3 days were retrospectively analyzed. In reconstructing calcar group, there were 30 patients including 8 males and 22 females, aged from 63 to 85 years old with an average of (73.41±5.12) years old, the fractures were classified to type AO 31-A2.2 in 12 cases, A2.3 in 11 cases, A3.3 in 7 cases according to AO/ASIF classification. In PFNA group, there were 38 patients including 10 males and 28 females, aged from 65 to 90 years old with an average of (74.26±4.53) years old, the fractures were classified to type AO 31-A2.2 in 15 cases, A2.3 in 13 cases, A3.3 in 10 cases. All fracture were caused by injury, leading pain and swelling. Femoral intertrochanteric fracture was confirmed by X ray films. The data of each group were collected for statistical analysis on the following aspects: the incision length, operation time, blood loss volume, postoperative partial weight bearing standing time, clinical healing time of fracture, postoperative complications, and hip functional score of Harris. All incisions were healed at stage I. In the aspect of postoperative complications, there were 1 case of screw blade cutting and 1 case of deep venous thrombosis in PFNA group; there was 1 case of deep venous thrombosis in the reconstructing calcar group (χ²=0.000, P=1.000). Patients were followed up from 20 to 24 months with an average of 22.5 months. There were no significant in postoperative partial weight bearing standing time, postoperative complications, hip functional score of Harris between two group. There were significant in the incision length, operation time, blood loss volume, clinical healing time of fracture. In the incision length, operation time, blood loss volume, clinical healing time of fracture, the PFNA group was significantly differently less than that of the reconstructing calcar group (P<0.001). In the clinical healing time of fracture, the PFNA group was significantly differently less than that of the reconstructing calcar group (P<0.05). For the treatment of unstable femoral intertrochanteric fractures in elderly patients, reconstructing calcar and PFNA are both effective, and proximal femoral intramedullary nails may be the best choice, which can be simpler operation, smaller incision and less healing time.

Repair of bony defective nonunion of humeral condyle using autologous platelet-rich-plasma combined with iliac autograft

Objective To investigate the clinical effectiveness of autologous platelet-rich-plasma(PRP)combined with iliac autograft in reconstruction of bony defective nonunion of humeral condyle. Methods The 27 patients who had been admitted to our department from January 2004 to June 2015 for bony defective nonunion of humeral condyle were analyzed retrospectively. Of them, 15 underwent recon-struction with PRP combined with iliac autograft(experimental group)and 12 reconstruction with only iliac autograft(control group). The preoperative demographic data of the 2 groups were not significantly different(P> 0. 05). The 2 groups were compared in terms of operation time, hospital stay, bony union time, range of motion of the elbow, and modified Cassebaum scoring. Results The patients were followed up for 12to 90 months(average, 24. 6 months). No such complications were observed as displacement of bone blocks, loosening or breakage of implants, re-nonunion, malunion, delayed ulnar neuritis, or olecranon nonunion. There were no statistic differences between the 2 groups regarding operation time, hospital stay, range of motion of the elbow and modified Cassebaum scoring(P> 0. 05). The clinical healing time(4. 2 ± 1. 3months)and bony healing time(4. 8 ± 1. 4 months)for the experimental group were significantly shorter than for the control group(6. 0 ± 1. 1 months and 6. 2 ± 1. 0 months, respectively)(P< 0. 05). Conclusion Autologous PRP combined with iliac autograft can speed up the healing of bony defective nonunion of humeral condyle, promoting functional recovery of the elbow. Key words: Humeral fractures; Fractures, ununited; Platelet-rich-plasma; Bone transplantation

The role of platelet rich plasma in management of fracture neck femur: new insights.

The aim of this study is evaluation of the efficacy of the use of platelet rich plasma (PRP) in management of femoral neck fractures. This is a prospective study that was conducted between February 2010 and March 2013. A total of 60 patients were included in this study, categorized randomly into two groups. Group A included fracture neck femur treated by closed reduction and internal fixation with three cannulated screws and group B by addition of PRP to internal fixation. We planned to compare time of healing, need for revision and incidence of complications between the two groups. Union occurred in 53 patients (88.33%) in both groups, 25 cases (83.3%) in group A and 28 cases (93.3%) in group B, including three cases (5%) with avascular necrosis (AVN): two in group A (6.7%) and one case in group B (3.3%).Revision surgery was done for six cases (20%) in group A and for two cases (6.7%) in group B. In both groups, all united cases had good to excellent clinical outcome as regards Harris hip score (HHS) at the end of the follow up. Despite advances in surgical techniques and medical care, the risk of nonunion and avascular necrosis (AVN) after treatment of femoral neck fractures have not been changed appreciably in the last 50years. Results of this study generally showed that both the median clinical and radiographic healing time were lower in group B compared to group A.

Ultrasound treatment for accelerating fracture healing of the distal radius. A control study.

To investigate the accelerating effects of low-intensity pulse ultrasound stimulation (LIPUS) on the fracture healing of distal radius. A total of 81 patients with distal radius fracture were randomly divided into two groups: the ultrasound treatment group and the control group. Patients in the ultrasound treatment group were immobilized in a below-elbow cast and received LIPUS treatment 15 min/day, while the control group were immobilized by a plaster support and cast. The patients were followed up every week and took X-ray films. The initial and healed X-ray films and the gray value of fracture site were analyzed by Photoshop software. The effect of reposition was evaluated based upon Steward recommended by Dienst, combining with Aro's measuring method. Clinical fracture healing time in ultrasound group was significantly shorter than that in the control group (32.04 ± 2.58d vs. 40.75 ± 5.12d, p <0.01). In addition, the grey value changes of fracture sites of the ultrasound group were much higher than that of the control group. The reposition effects of fracture healing had no difference between the two groups (p >0.05). Low-intensity pulse ultrasound stimulation could accelerate fracture healing of the distal radius and promote local bone formation.

Clinical research on treating fracture of middle and lower 1/3 of tibiofibula by electroacupuncture

ObjectiveTo observe the differences in efficacy on treatment of fractures of the middle and lower 1/3 of the tibiofibula between cribriform splints plus electroacupuncture, warming needle and moxibustion only, and external fixation with traditional splints plus the administration of an herbal formula. Clinical efficacy and the effects on serum bone morphogenic protein −7 (BMP-7) and endothelin −1 (ET-1) were both measured. Method600 patients with fractures of the middle and lower 1/3 of the tibiofibula were randomly divided into three groups according to andome number table: splint with electroacupuncture (group A), warm needling moxibustion group (group B) and splint with traditional Chinese medicine herb (Group C). Cribriform splints with electroacupuncture were used in group A, warming needling therapy were adopted in group B, and traditional splints with external fixation were used along with oral administration of musk bone capsules (▪) in group C. Clinical results for the three groups were compared, and ELISA method was used to detect the serum BMP-7 and ET-1 of patients in the three groups before and after treatment. ResultsGroup A was better than group B and group C in terms of clinical healing days and delayed healing status (P<0.05). After treatment, group A was also better than the other two groups in the improvement of BMP-7 and ET-1 (P<0.05). ConclusionElectroacupuncture treatment with cribriform splints for fractures of the middle and lower 1/3 of the tibiofibula resulted in significantly shorter clinical healing time, and lower incidence of delayed healing compared to warm needling or splints with a traditional Chinese herbal formula. Its mechanism may be associated with greater regulation of serum BMP-7 and ET-1 through electroacupuncture.

Epidemiology and variables involved in dental abscess: survey of dental emergency unit in Trieste

The objective of this epidemiologic study was to estimate the healing time of acute dental abscesses and to evaluate the main variables involved in the healing process itself. Among a sample of over 24000 patients visited at the emergency dental unit, 688 subjects were diagnosed with dental abscess and enrolled in the study. Case histories of all patients were collected to investigate the clinical course and healing time of dental abscess according to anamnestic and diagnostic data and therapeutic management. A multiple logistic regression model was performed to evaluate the association of each variable with the healing time required for dental abscess. Variables associated with increased healing time were spring seasonality at admission, pyretic state, trismus, involvement of multiple anatomic spaces, and spontaneous drainage. Moreover, administration of some, but not all, classes of antibiotics was also associated with an increased healing time. The knowledge of variables involved in healing time for dental abscess is crucial in the optimization of managing such infections in terms of cost-benefit ratio. This would represent a valuable way to ensure a shortened and more effective healing.

The influence of stress hyperglycemia on fracture healing of patients with fracture of shaft of femur pro-operation

Objective To investigate the influence of stress hyperglycemia on fracture healing of patients with fracture of shaft of femur pro-operation.Methods To retrospectively analyze the clinical data of 65 patients with fracture of shaft of femur.Then according to the blood sugar level of the initial admission,all patients were divided into high glucose group 41 cases and no high glucose group 24 cases.The difference of fracture healing time was compared between both groups.Results The mean clinical fracture healing time in high glucose group was ( 11.5 ± 1.3 ) weeks.Conclusion Our study found that there was relationship between blood glucose level and fracture healing in patients with fracture of shaft of femur pro-operation,patients with stress hyperglycemia pre-operation seemed to have longer fracture healing time than the ones without. Key words: Stress hyperglycemia; Fracture femur

Nursing and effect of honeysuckle lotion on the patients taking sorafenib with the complication of hand and foot blisters

Objective To explore the effect of honeysuckle lotion on the primary hepatic cancer patients taking sorafenib with the complication of hand and foot blisters.Methods Totals of 45 patients who took sorafenib and complicated with the hand and foot blisters were randomly divided into experimental group ( n =23 ) and control group( n =22).The experimental group were soaked in honeysuckle lotion accompany with topical urea ointment,while control group received topical urea ointment.Then,the clinical effective and healing time of two groups were observed.Results There was no significant difference detected in age,lesion and general between two groups.The clinical treatment effective rate of experimental group was 91.3％ significantly better than 59.1％ that of control group ( x2 =8.494,P ＜ 0.05 ).The healing time of experimental group was (8.5 ± 4.2)d and that of control group was (11.8 ± 6.3 )d,and the difference was statistically significant (t =2.92,P ＜ 0.05 ).Conclusions The honeysuckle lotion application can promote wound healing for primary hepatic cancer patients taking sorafenib with the complication of hand and foot blisters.And it is worthy for clinical application. Key words: Nursing; Hand and foot blisters; Honeysuckle lotion; Sorafebin

Rap System of Stress Stimulation Can Promote Bone Union after Lower Tibial Bone Fracture: A Clinical Research

Background Lower tibial bone fracture may easily cause bone delayed union or nonunion because of lacking of dynamic mechanical load.Objective Research Group would design a new instrument as Rap System of Stress Stimulation (RSSS) to provide dynamic mechanical load which would promote lower tibial bone union postoperatively.Methods This clinical research was conducted from January 2008 to December 2010, 92 patients(male 61/female 31, age 16-70years, mean 36.3years) who suffered lower tibial bone closed fracture were given intramedullary nail fixation and randomly averagely separated into experimental group and control group(according to the successively order when patients went for the admission procedure). Then researchers analysed the clinical healing time, full weight bearing time, VAS (Visual Analogue Scales) score and callus growth score of Lane-Sandhu in 3,6,12 months postoperatively. The delayed union and nonunion rates were compared at 6 and 12 months separately.Results All the 92 patients had been followed up (mean 14 months). Clinical bone healing time in experimental group was 88.78±8.80 days but control group was 107.91±9.03days. Full weight bearing time in experimental group was 94.07±9.81 days but control group was 113.24±13.37 days respectively (P<0.05). The delayed union rate in 6 months was 4.3% in experimental group but 10.9% in control group(P<0.05). The nonunion rate in 12 months was 6.5% in experimental group but 19.6% in control group(P<0.05). In 3, 6, 12 months postoperatively, VAS score and Lane-Sandhu score in experimental group had more significantly difference than them in control group.Conclusions RSSS can intermittently provide dynamic mechanical load and stimulate callus formation, promote lower tibial bone union, reduce bone delayed union or nonunion rate. It is an adjuvant therapy for promoting bone union after lower tibial bone fracture.

Genetic characterization indicates that a specific subpopulation of Pseudomonas aeruginosa is associated with keratitis infections.

Pseudomonas aeruginosa is a common opportunistic bacterial pathogen that causes a variety of infections in humans. Populations of P. aeruginosa are dominated by common clones that can be isolated from diverse clinical and environmental sources. To determine whether specific clones are associated with corneal infection, we used a portable genotyping microarray system to analyze a set of 63 P. aeruginosa isolates from patients with corneal ulcers (keratitis). We then used population analysis to compare the keratitis isolates to a wider collection of P. aeruginosa from various nonocular sources. We identified various markers in a subpopulation of P. aeruginosa associated with keratitis that were in strong disequilibrium with the wider P. aeruginosa population, including oriC, exoU, katN, unmodified flagellin, and the carriage of common genomic islands. The genome sequencing of a keratitis isolate (39016; representing the dominant serotype O11), which was associated with a prolonged clinical healing time, revealed several genomic islands and prophages within the accessory genome. The PCR amplification screening of all 63 keratitis isolates, however, provided little evidence for the shared carriage of specific prophages or genomic islands between serotypes. P. aeruginosa twitching motility, due to type IV pili, is implicated in corneal virulence. We demonstrated that 46% of the O11 keratitis isolates, including 39016, carry a distinctive pilA, encoding the pilin of type IV pili. Thus, the keratitis isolates were associated with specific characteristics, indicating that a subpopulation of P. aeruginosa is adapted to cause corneal infection.

Preliminary experience of a modified Maquet technique for repair of cranial cruciate ligament rupture in dogs

The modified Maquet technique (MMT) uses the same principle as the tibial tuberosity advancement (TTA) for stabilization of the cranial cruciate ligament-deficient stifle in the dog. In the MMT, the tibial tuberosity is advanced in a similar manner to that used in the TTA, however the means by which the tibial crest is stabilized differs. The plate and fork originally described by Montavon et al. are not used (7). The MMT was first described by Maquet for use on humans; it leaves intact a distal bony attachment to the tibial shaft, and the tuberosity is either reinforced or not by a figure-of-eight wire. In this paper, we describe the MMT, and we report the results of our first 20 canine patients with cranial cruciate ligament rupture that were treated by the MMT. Mean clinical bone healing time was 6.8 weeks (range 4 to 12 weeks). The evidence provided by this clinical communication suggests that it is technically possible to achieve an advancement of the tibial tuberosity without the need for a plate. The MMT deserves consideration as a primary treatment option for cranial cruciate ligament rupture in dogs, and further evaluation in large clinical studies. Long-term follow-up and force plate analysis would be necessary to compare the MMT to both the TTA and the tibial plateau levelling osteotomy.

Comprehensive care for bedsore infections diabetes in aged patients

Objective To observe the clinical effect of comprehensive care for aged diabetes patients infected the 3rd or 4th period of pressure ulcer.Methods 100 aged patients with diabetes and infected bedsore were divided into two groups randomly. To all the patients, normal series of conventional diabetes care was offered and, hydrogen peroxide solution was used to wash the raw surface while changing dressing. For 50 cases in Control Group, Iodophors and furacillin solution were used as disinfectant. But for the rest 50 cases in Experimental Group, after disinfection with amikacin, Jianshuneng was sprayed on the raw surface Control group(50cases) the introduction of 2.5% Jianshuneng solution disinfection. Infrared radiation was applied in both groups. Clinical effect and clinical healing time were measured. Results The efficient tale of Experimental Group was 100% while that of Control group was 82.0%; Clinical Healing time for the Experimental Group was (14.12+3.27)d, which was obviously shorter thanthat (24.37+3.87)d in Control Group. There was significant difference between two groups in both efficient tare and clinical healing time (P<0.05). Conclusions comprehensive diabetes care for the aged diabetes patients infected bedsore had excellent clinical efficacy, it is safe, effective and worth the clinical practice and should be spreaded. Key words: Diabetes; Bedsore; Amikacin; Jianshuneng; Infrared Radiation; Comprehensive Care