Gauze Swabs Research Articles

Who bit the boat? New DNA collection and genomic methods enable species identification in suspected shark-related incidents

Species identification following shark-related incidents is critical for effective incident management and for collecting data to inform shark-bite mitigation strategies. Witness statements are not always reliable, and species identification is often ambiguous or missing. Alternative methods for species identification include morphological assessments of bite marks, analysis of collected teeth at the scene of the incident, and genetic approaches. However, access to appropriate collection media and robust genetic assays have limited the use of genetic technologies. Here, we present a case study that facilitated a unique opportunity to compare the effectiveness of medical gauze readily available in first-aid kits, and forensic-grade swabs in collecting genetic material for shark-species identification. Sterile medical gauze and forensic-grade swabs were used to collect transfer DNA from the bite margins on a bitten surf ski which were compared to a piece of shark tissue embedded along the bite margin. Witness accounts and the characteristics of the bite mark impressions inferred the involvement of a Carcharodon carcharias (white shark). The morphology of a tooth found on the boat that picked up the surf ski, however, suggested it belonged to an Orectolobus spp. (wobbegong). Genetic analysis of DNA transferred from the shark to the surf ski included the application of a broad-target nested PCR assay followed by Sanger sequencing, with white shark contribution to the ‘total sample DNA’ determined with a species-specific qPCR assay. The results of the genetic analyses were congruent between sampling methods with respect to species identification and the level of activity inferred by the donor-specific DNA contribution. These data also supported the inferences drawn from the bite mark morphology. DNA from the recovered tooth was PCR amplified with a wobbegong-specific primer pair designed for this study to corroborate the tooth’s morphological identification. Following the confirmation of gauze used for sampling in the case study event, two additional isolated incidents occurred and were sampled in situ using gauze, as typically found in a first-aid kit, by external personnel. DNA extracted from these gauze samples resulted in the identification of a white shark as the donor of the DNA collected from the bite marks in both instances. This study, involving three incidents separated by time and location, represents the seminal application of gauze as a sampling media after critical human-shark interactions and strongly supports the practical implementation of these methods in the field.

Canine olfactory detection and its relevance for the medical identification of patients with COVID-19

Introduction The assessment of Volatile Organic Compounds (VOCs) in exhaled breath or sweat represents a potential non-invasive and rapid diagnostic tool for respiratory diseases. Objective To determine if trained dogs can reliably identify the odour associated with COVID19. Methods This is a monocentric prospective study carried out in the Emergency Department (ED) of a university hospital fromJulyto November 2021.Axillary sweat samples from all patients were collected bytwo trained health care professionals. The samples were collected in the form of sterile gauze swabs placed under the armpits for at least 4 h for each patient.Then, Tubes wereshiftedto the double-blind dog training centre for VOC detection by two individuals. Results Dogs were tested using a total of 129 axillary sweat samples; 69 of the 107 patients who tested positive for COVID-19 based on their odours had a positive PCR/Antigen test and 19 of the 22 patients who were tested negative for COVID-19 by the dogs had a negative PCR test. The sniffer dog infection detection method had a sensitivity of 95.83% and a specificity of 33.33%. The PPV was 64.49% and the NPVwas 86.36%. The measurement of the intensity of the connection between the two variables (disease/sign) was very strong (Q = 0.84). This link is statistically significant (X2 = 19.13) with a probability p ≤ 0.001. Conclusion Overall, the use of trained detection dogs as a screening method for SARS-CoV-2 is an interesting avenue of research that warrants further exploration and validation.

PRESSURE ULCERS (BEDSORES, DECUBITUS ULCERS): STRATEGY OF COMPLEX TREATMENT IN A PALLIATIVE CARE DEPARTMENT, AUTHOR'S VIEWS FROM THE STANDPOINT OF CLINICAL EXPERIENCE

Introduction. Weakened, immobile, bedridden patients who occupy a passive position in bed often develop local changes of dystrophic and ulcerative-necrotic changes, decubitus ulcers, which are determined by trophycal disturbances of the skin and underlying tissues. Significant risk factors include diabetes mellitus, conditions after cerebrovascular diseases, Parkinson's disease and other neurological pathologies, and exhaustion in patients with insufficient or inadequate care. Modern scientific research is mainly aimed at developing strategies and methods for the treatment of pressure ulcers that have already formed, which is a local purulent-necrotic process. There is no clear consensus on the criteria for readiness of bedsores (which affects the outcome of surgery) for surgical treatment, which ultimately determines the length of the hospital care of palliative patients.
 Objective. To investigate the possibilities and optimize the complex management (surgical treatment, etc.) of decubitus ulcers (pressure ulcers) especially stage III-IV in some rehabilitation medical centres, in particular in the palliative care department.
 Materials and methods. Some cases of decubitus ulcers (pressure ulcers, especially stage III-IV) from palliative care department are being investigated. The total sample of the retro- and prospective analysis included the results of the complex treatment of 412 patients aged 40-93 years: 174 males and 238 females with soft tissue pressure ulcers.
 Results and discussion. Stage I and II pressure ulcers were treated conservatively. In the presence of purulent complications, complex surgical sanation was performed. Clinical plans and treatment included adequate nutritional support, decompression of the area, and sanation of pressure ulcers with antiseptics, including surgical intervention if necessary, adequate local and systemic infection control, and correction of background comorbidities. Based on author's clinical classification and the DOMINATE strategy, we created a simplified strategy, pathogenetically based, and adapted for the treatment of pressure ulcers in a palliative care department with an adequate sequence of care and complex therapy. Under visual and tactile control, purulent area were diagnosed, opened, and revised intraoperative in stages with precise stepwise necro-, and in 7% of patients – with sequestro necrectomy; the formed cavity was washed with a solution of hydrogen peroxide, chlorhexidine, and aqueous povidone-iodine solution, which also achieved complete evacuation of pus and the necrotic detritus. If necessary, we applied counter-perforations. Some purulent cavities were drained with rubber drains, filled with hydrophilic liniment, and swabs soaked in povidone-iodine. The main wound was filled with sterile gauze swabs with hydrophilic liniment. If it was impossible to simultaneously remove necrotic masses from the standpoint of monitoring the patient's general condition or additional/repeated necrosis formation, we used strategies of complex treatment according to standard clinical protocols, tactics of repeated, programmed resanitations/renecrectomies, and antibacterial therapy. Our proposed clinical classification criteria and adapted NODITE clinical strategy are simple and easy to use. Significant reduction of pain, signs of purulent necrotic inflammation, and effective secondary prevention of complications constitute a set of criteria for effectiveness and economic feasibility, which, in our opinion, determines the possibility of introducing into clinical practice. Using the NODITE strategy, we found complete healing of complicated pressure ulcers within 45-60 days in half of the patients in the main group, while in the control group; this figure was only 35.7%. It has been shown that adequate local restriction and sanation of the problem area and the use of special anti-decubitus mattresses in palliative care departments contribute to the regression of the pathological process, granulation and marginal wound epithelialization.
 Conclusion. The strategy for the prevention, care and treatment of complicated bedsores includes N (Nutrition) – adequate nutritional support; O (Offloading) – offloading, decompression – external pressure reduction on the bedsores area by the use of special care products and orthopedic devices, which contributes to the proliferative phase of the wound process; D (Debridement) – opening, removal of pus and necrosis from the wound with precise step-by-step necro- and (if necessary) sequestro necrectomy, with drainage of purulent cavity; I (Infection) – the most appropriate combination of general antibiotic therapy and topical application of antiseptics and antibiotics; T (Tissue management) – creating an appropriate environment in the wound, care, and stimulation of marginal epithelisation; E (Education) – providing appropriate care, monitoring the dynamics of the pressure ulcer wound process and correcting local venous and/or lymphatic stasis.

Food and Environmental Virology: Use of Passive Sampling to Characterize the Presence of SARS-CoV-2 and Other Viruses in Wastewater.

Fecal shedding of SARS-CoV-2 leads to a renaissance of wastewater-based epidemiology (WBE) as additional tool to follow epidemiological trends in the catchment of treatment plants. As alternative to the most commonly used composite samples in surveillance programs, passive sampling is increasingly studied. However, the many sorbent materials in different reports hamper the comparison of results and a standardization of the approach is necessary. Here, we compared different cost-effective sorption materials (cheesecloths, gauze swabs, electronegative filters, glass wool, and tampons) in torpedo-style housings with composite samples. Despite a remarkable variability of the concentration of SARS-CoV-2-specific gene copies, analysis of parallel-deposited passive samplers in the sewer demonstrated highest rate of positive samples and highest number of copies by using cheesecloths. Using this sorption material, monitoring of wastewater of three small catchments in the City of Dresden resulted in a rate of positive samples of 50% in comparison with composite samples (98%). During the investigation period, incidence of reported cases of SARS-CoV-2 in the catchments ranged between 16 and 170 per 100,000 persons and showed no correlation with the measured concentrations of E gene in wastewater. In contrast, constantly higher numbers of gene copies in passive vs. composite samples were found for human adenovirus and crAssphage indicating strong differences of efficacy of methods concerning the species investigated. Influenza virus A and B were sporadically detected allowing no comparison of results. The study contributes to the further understanding of possibilities and limits of passive sampling approaches in WBE.

Effectiveness of bismuth subgallate for preventing bleeding following adenotonsillectomy: A multicentre study

BackgroundTonsillectomy and adenotonsillectomy are surgical procedures routinely performed worldwide, with various complications, including postoperative bleeding (PTH). Among haemostatic agents, bismuth subgallate (BS) has been employed in the past decades, but its use is controversial in children. ObjectiveThis retrospective, multicentre study aims to evaluate the effectiveness and safety of BS in preventing PTH following tonsillectomy and adenotonsillectomy. Materials and methodsTwo cohorts of children between 0 and 18 years of age were compared in two different hospitals. The first (active) group of patients included children who underwent tonsillectomy/adenotonsillectomy performed using BS added to gauze swabs, whereas this agent was not administered to the second (control) group. The following variables were analysed: age, gender, degree of tonsillar hyperplasia, length of hospital stay, acute complications (including bleeding and infection), further admissions to the Paediatric Emergency Department (PED), and further hospital admissions in the 30 days postoperatively. ResultsFour-thousand- seven hundred forty-four children were included in the study, 2598 in the active group and 2146 in the control group. The cases included in the active treatment group displayed a significantly reduced PTH prevalence, 1.4 versus 2.6 % (p < 0.05). No cases of neurological complications or aspiration pneumonia were detected. ConclusionsThis study supports BS as a safe and reliable option for preventing severe PTH following tonsillectomy/adenotonsillectomy.

Diurnal changes in pathogenic and indicator virus concentrations in wastewater

Wastewater-based epidemiology (WBE) has been commonly used for monitoring SARS-CoV-2 outbreaks. As sampling times and methods (i.e. grab vs composite) may vary, diurnal changes of viral concentrations in sewage should be better understood. In this study, we collected untreated wastewater samples hourly for 4 days at two wastewater treatment plants in Wales to establish diurnal patterns in virus concentrations and the physico-chemical properties of the water. Simultaneously, we also trialled three absorbent materials as passive samples as a simple and cost-efficient alternative for the collection of composite samples. Ninety-six percent of all liquid samples (n = 74) and 88% of the passive samplers (n = 59) were positive for SARS-CoV-2, whereas 87% and 97% of the liquid and passive samples were positive for the faecal indicator virus crAssphage, respectively. We found no significant daily variations in the concentration of the target viruses, ammonium and orthophosphate, and the pH and electrical conductivity levels were also stable. Weak positive correlations were found between some physico-chemical properties and viral concentrations. More variation was observed in samples taken from the influent stream as opposed to those taken from the influent tank. Of the absorbent materials trialled as passive samples, we found that tampons provided higher viral recoveries than electronegative filter paper and cotton gauze swabs. For all materials tested, viral recovery was dependent on the virus type. Our results indicate that grab samples may provide representative alternatives to 24-h composite samples if taken from the influent tank, hence reducing the costs of sampling for WBE programmes. Tampons are also viable alternatives for cost-efficient sampling; however, viral recovery should be optimised prior to use.

THE ROLE OF ENDONASAL ELECTROPHORESIS WITH DEXAMETHASONE IN THERAPY OF UVEITIS UNDER CONCOMITANT ANKYLOSING SPONDYLITIS

Uveitis is a severe clinical manifestation of ankylosing spondylitis, leading to the loss of vision, particularly among young and working-able individuals. This study aims at evaluating the outcomes of integrated treatment for uveitis in Bekhterev's disease using endonasal electrophoresis with dexamethasone. Materials and Methods. The study included 22 patients (23 eyes) with uveitis and underlying ankylosing spondylitis who received inpatient treatment at Acad. Z. Aliyeva National Centre of Ophthalmology between 2017 and 2022. The average age of the patients was 34 ± 8.7 years, including 5 female and 17 male patients. In the main group, consisting of 12 patients (12 eyes), endonasal electrophoresis with dexamethasone was performed in addition to general and local steroid therapy. The control group comprised 10 patients (11 eyes) who received treatment without physiotherapy. Endonasal electrophoresis was conducted using the "Potok-1" apparatus, with gauze swabs soaked in a 0.4% dexamethasone solution and inserted into the middle nasal passages. The active electrode was secured to the free ends, and the drug was administered from the cathode. A total of 10 procedures were performed, starting from 10 minutes and gradually increasing to 15 minutes. The patients received inpatient treatment for two to three weeks. Results: The patients from main and control groups demonstrated positive dynamics in terms of increased visual acuity and expanded visual fields. Inflammation signs subsided within 4-5 days since the beginning of the treatment in the main group and within 6-7 days in the control group. Clinical improvement was evident in both groups, characterized by hypopion resorption, reduced cell count in the anterior chamber, and decreased opacities in the vitreous body. In the posterior segment, perivascular infiltration, chorioretinal foci, and macular oedema also showed signs of improvement. Conclusion: The use of dexamethasone endonasal electrophoresis as part of the complex therapy for uveitis in ankylosing spondylitis demonstrated more pronounced clinical effects compared to traditional treatments. Positive dynamics were observed in clinical, functional, perimetric, and electrophysiological indicators. Dexamethasone endonasal electrophoresis proved to be well-tolerated by patients and economically viable, making it a valuable addition to the complex therapy of uveitis in ankylosing spondylitis in both inpatient and outpatient settings.

Vancomycin Concentrations in Synovial Fluid Do Not Reach Chondrotoxic Thresholds After Anterior Cruciate Ligament Reconstruction With Vancomycin-Soaked Autologous Soft Tissue Grafts: An In Vivo Prospective Observational Study in Humans

Background: Studies have revealed that vancomycin soaking of the anterior cruciate ligament (ACL) graft can drastically reduce the incidence of postoperative infections after ACL reconstruction. However, it remains unknown whether the chondrotoxic threshold of vancomycin in synovial fluid is exceeded during this process. Several studies investigated the chondrotoxic properties of vancomycin in in vitro experiments and described a concentration of 1000 µg/mL as the critical threshold. Purpose/Hypothesis: The purpose of the study was to measure the vancomycin concentration in synovial fluid after ACL reconstruction with vancomycin-soaked autografts. It was hypothesized that intra-articular vancomycin concentrations in the synovial fluid would not reach the chondrotoxic threshold of 1000 µg/mL after vancomycin soaking of autologous semitendinosus tendon and soft tissue quadriceps tendon grafts for ACL reconstruction. Study Design: Cohort study; Level of evidence, 3. Methods: The study enrolled 10 patients undergoing ACL reconstruction using 4-strand semitendinosus tendon autografts and 10 patients undergoing ACL reconstruction using soft tissue quadriceps tendon autografts. Before implantation, each harvested graft was intraoperatively wrapped in gauze swabs that had been soaked in a 5-mg/mL vancomycin solution. After wound closure, an aspirate of 5 mL of synovial fluid was taken from each patient. The vancomycin concentration of the aspirate was analyzed using high-performance liquid chromatography–tandem mass spectrometry. Spearman rho correlation coefficients were used to identify relationships between the parameters, and the t test was used to test for differences between graft types. A P value of <.05 was considered statistically significant. Results: The study included 20 patients (14 women and 6 men; age, 29.35 ± 11.3 years). The mean vancomycin concentration measured in the synovial fluid was 23.23 ± 21.68 µg/mL, with a minimum concentration of 2.32 µg/mL and a maximum concentration of 71.56 µg/mL. No significant difference was found between the 2 graft types (P = .911). Significant positive correlation (r = 0.644; P < .05) was observed only between the vancomycin concentration and the mean duration from initiation of vancomycin soaking of semitendinosus tendon grafts to implantation (13.4 ± 6 minutes). No correlations were observed between the vancomycin concentration and the duration from implantation to fluid aspiration or between the vancomycin concentration and the graft diameter (median, 8.5 mm; range, 6.0-10.0 mm) for both graft types. Conclusion: Chondrotoxic vancomycin concentrations ≥1000 µg/mL were not reached in any aspiration of synovial fluid after ACL reconstruction using soft tissue autografts that were intraoperatively soaked in a 5-mg/mL vancomycin solution. Against the backdrop of multiple studies that showed significantly reduced infection rates after ACL reconstruction when vancomycin soaking was used, this study suggests that the chondrotoxic properties of this method are negligible because of its submarginal intra-articular concentrations.

Oral hygiene practices in nurseries (0-3 years) in the cities of Pavia and Vigevano.

This study was conducted to evaluate attention to and knowledge of oral care in children aged 0-3 years, on the basis of data collected from early years educators working with this age group. Information was also collected about the oral hygiene practices adopted in nurseries and the types of food provided, with the aim of increasing knowledge and raising awareness of this topic. A questionnaire was created using the "Google Forms" program and sent to all the 47 nurseries in the city of Pavia and Vigevano. Twenty establishments agreed to take part in the research. Assessment of knowledge and of awareness of oral care among early years educators caring for children in the age range 0-3 years revealed variability and some confusion. The results showed a general lack of attention to oral care in the period before the milk teeth appear, as well as limited use of gauze swabs. There was generally some use of educational play focusing on this issue, albeit not daily across all the nurseries participating in the survey. Nurseries rarely had the support of a professional dental hygienist to raise awareness among early years educators and parents. The findings obtained through this study indicate that, in the area surveyed, there is a lack of widespread knowledge and awareness of oral prevention in young children, and of the oral hygiene maintenance techniques to use in this age group. This suggests a need to develop preventive protocols to improve knowledge and awareness of children's oral health among the adults who care for them.

Hygiene Indicators and Salmonellae on Surfaces of Swine Carcasses from Two Slaughterhouses in Northern Portugal

The monitoring of carcass surface contamination along the slaughter line enables verification of slaughter operation hygiene and the use of good manufacturing practices. Pork meat is a common source of human nontyphoidal salmonellosis, one of the most frequently reported foodborne illnesses worldwide. This study was conducted to gather data on microbial loads before and after evisceration on the surfaces of swine carcasses in two slaughterhouses. The presence of Salmonella enterica was evaluated only after evisceration on carcass surfaces and in livers and floor drains (environmental samples) because pigs are common carriers of this pathogen. The contamination of carcass surfaces was evaluated by delimitation of surface area with sterilized templates (100 cm2), and surface samples were collected with gauze swabs. Total aerobic mesophilic bacteria, Enterobacteriaceae, and Escherichia coli were enumerated. Significant differences (P < 0.05) in counts of mesophilic bacteria, Enterobacteriaceae, and E. coli were found on the external carcass surfaces, with higher counts after evisceration. The neck and abdominal areas had higher levels of mesophilic bacteria, Enterobacteriaceae, and E. coli and a high prevalence of Salmonella. Salmonella was detected in only one of the studied slaughterhouses; 19 (7.3%) of 259 analyzed carcass samples were positive for Salmonella, and Salmonella was detected in two livers and two floor drains. A total of 52 Salmonella isolates (44 from carcasses, 5 from livers, and 3 from drains) were recovered. Three Salmonella serovars (Typhimurium 4,5:i- , Wernigerone, and Derby) were identified, and 53.8% of the 52 isolates were multidrug resistant. The results reveal the need for continuous improvement of slaughtering operations and implementation of good manufacturing practices to ensure the safety of pork produced in Portugal.

PetSavers research

Rebecca Verhoven BSc (Hons) RVN, and lecturer Kat Hart, report on their PetSavers-funded research undertaken while Rebecca was a student vet nurse – Cotton wool versus non-woven gauze swabs: comparatively, which is more efficacious for minimizing the preoperative microbial load on the ovariohysterectomy surgical site in bitches?

Optimisation of Processes by Recommending Cost Reduction Strategies in Central Sterile Supply Department (CSSD) in a Tertiary Care Hospital

Background Cost analysis in central sterile supply department (CSSD) helps to achieve financial sustainability and improved efficiency for optimal field operations. This research intends to propose strategies to reduce re-sterilization of CSSD items and formulate alternatives for direct purchase of consumable items by suggesting in-house manufacture of these items. Methods An observational prospective study using cost analysis tools such as activity-based costing and cost–benefit analysis was conducted in a tertiary care corporate hospital. Primary data collection was done with the help of semi-structured interview questions and checklist. Results The analysed data indicated that on an average 150 sets per month were sent back for steam re-sterilisation which incurred the cost for re-packing, re-sterilisation and re-storage. Additionally, crucial study findings indicate that gauze swabs and dressing pads (consumable items) have been consumed in large quantities per month (20,000 Qty) leading to profligacy. Conclusion In-house preparation of dressing pads and gauze swabs has amassed sufficient amount of savings of about ₹70,377 and ₹24,104 per month on an average with the available resources. Moreover, techniques to avoid re-sterilization will help decrease resource consumption that includes electricity and exhaustive use of manpower.

Is Blood Transfusion Justified During Soft Tissue Surgery in Noma Patients? A One-Year Appraisal at Noma Children Hospital, Sokoto, Nigeria.

Background:Non-utilization of blood and inappropriate blood transfusion are common in surgical operations. Some surgical procedures are associated with minimal bleeding that does not warrant blood transfusion. No previous study has looked at the pattern of blood loss in noma defect repair to determine the possible need for blood transfusion.Aim/Objectives:This study aimed to determine the total amount of blood loss, the number of units of blood transfused, and the correlation between estimated blood loss and total operating time in patients who had surgical correction of noma defects.Materials and Methods:This is a hospital-based cross-sectional study of 35 patients who underwent surgical correction of noma defects. Age, sex, pre- and post-operative haemoglobin (Hb), number of requested blood units, total operating time, and total estimated blood loss were recorded. The methods used for the blood loss estimation were gauze swabs, Abdo-packs, drapes, and suction bottles.Results:Comparison of the mean pre- and post-operative Hb did not yield any statistically significant difference. The total estimated blood loss in these surgeries was in the range of 65–209 mL, with a mean of 117.20 ± 35.88 mL. No correlation between estimated blood loss and total operating time was noted (P = 0.940). No blood was transfused in any of the subjects.Conclusion:This study observed minimal blood loss in surgical corrections of the soft tissue noma defect. Apart from blood grouping, there may be no need for routine cross-matching of blood pre-operatively for surgical repair of noma defect. However, more studies are needed to buttress this finding.

Influence of patient-related factors on intraoperative blood loss during double opposing Z-plasty Furlow palatoplasty and buccal fat pad coverage: A prospective study.

BackgroundSurgical procedures including palatoplasty have a risk for complications. The aim of this study was to investigate the intraoperative and early postoperative blood loss using the buccal fat pad (BFP) during cleft lip and/or cleft palate (CL/P) surgery. Material and MethodsThis prospective study included a total of 109 patients with cleft palate (CP) during a three-month period of treatment at Hasanuddin University Dental Hospital (permanent center) and charity trips in rural parts of Eastern Indonesia. All patients were treated with DOZ Furlow technique combined with BFP graft. Before and after surgery, the total amount of intraoperative blood loss was calculated by measuring the weight differences of the gauze swabs that were used to control the surgical bleeding followed by a complete blood count at three days postoperatively. ResultsThe difference in the amount of blood loss based on age categories in charity groups was found to be significant (P<0.05). Overall, we found that high body weight and operation time significantly contributed to increased blood loss (P<0.05). Conclusions Weight and operative time can contribute to more blood loss during palatoplasty. Key words:Buccal fat pad, complication, cleft lip, cleft palate, palatoplasty.

Substantiation of the method of manufacturing gauze swabs depending on the purpose of use

Annotation. Gauze remains the main dressing. It is used to make swabs for drying wounds and dissecting tissues. The purpose of the work is to establish the optimal density of the swab for drainage of the wound and preparation of tissues. Swabs made of 10x12 cm gauze fragments were investigated. The gauze fragments were weighed before and after immersion in water and the absorption capacity per unit dry weight was calculated. The dissecting properties of the swabs were investigated on plasticine blocks, the surface of which was pressed with a force of 12 N. The formed depressions were filled with gypsum. The volume and weight of the casts were determined. To determine the reliability of the difference between the two mean values used the reliability criterion t (Student’s test). It was found that loose swabs absorbed 913.5±43.9% of water, medium density – 766.3±55.2%, dense – 682.9±70.1 (p˂0.05). This is due to the fact that loose swabs have the largest in radius and length of the capillaries. When studying the recesses formed by embossing the swab on the surface of the block, it was found that when using loose swabs formed a deep conical recess, which indicated the risk of injury. When embossed with dry swabs of medium density received molds weighing 0.034±0.0000011 g, wet – 0.033±0.0000011 g (p&gt;0.05). When using dense swabs – 0.037±0.0000011 g and 0.034±0.0000011 g, respectively (p˂0.05). Dense swabs showed the best dissecting properties. When wet, they are slightly but significantly reduced. Medium density swabs have slightly worse dissecting properties. When wet, they did not change significantly. We attribute the decrease in dissecting properties to the displacement of water from the gauze when pressed. Thus, loose swabs (∆M=913.5%±43.9%) absorb fluid best, which determines their predominant use for wound drying. Dense swabs are characterized by the lowest absorption capacity (682.9±70.1%), the best dissecting properties.

Retained Negative Pressure Wound Therapy Foams as a Cause of Infection Persistence.

Significance: Negative pressure wound therapy (NPWT) has become a valuable adjunct in the treatment of acute and chronic wounds in several surgical disciplines. Retained foams are among its side effects, and they pose a rare but devastating complication at the site of this therapy, which might be associated with wound-healing complications, infection persistence, repeated surgical revisions, and prolonged antibiotic courses. Recent Advances: In the past 15 years, an increasing number of studies have identified this potential problem. Although the exact incidence remains unknown, initial studies have indicated rates of up to 10% in large collectives being treated by NPWT. Critical Issues: The lack of radiopaque markers does not allow for the visual control of retained foams using plain radiographs. Further imaging methods (e.g., CT and MRI) also do not help in adequate differential diagnosis. The lack of routine documentation of the number, type, and localization of the inserted foam(s) and unplanned surgery with a different surgical team pose risk factors for foam retainment. Future Directions: Introducing new documentation records for wounds treated with NPWT is recommended. At foam removal, all dressing materials should be examined for integrity. The development of foams with radiopaque markers by the industry, such as those routinely used in surgical gauze swabs, might also be a useful step to minimize the risk of foam retainment within wounds.

Endovascular treatment of splenic artery aneurysm rupture

A case of successful clinical endovascular treatment for rupture of a splenic artery aneurysm with intraperitoneal bleeding is presented. An emergency open surgery, urgent endovascular aneurysm embolization and planned relaparotomy with the removal of gauze swabs and drains were performed. The staging of surgical treatment was determined by the location of the patient at the time of the complication and the equipment of medical institutions that provided medical care. Regarding the dangerous condition with rupture of the splenic artery aneurysm minimally invasive high-tech surgical care is possible only under certain conditions and depends on the qualifications of doctors, a multidisciplinary approach and the level of equipment of a medical institution. Endovascular embolization of the splenic artery aneurysm when it ruptures is a modern, highly effective and reliable minimally invasive surgical method.

THE EFFECT OF 10 % LIDOCAINE SPRAYED TO NASAL PACKS ON PAIN AFTER ELECTIVE SEPTOPLASTY.

Aim To study analgesic effect of lidocaine10 % sprayed to 10 cm х 10 cm gauze swabs with neomycin and bacitracin ointment nasal packing using visual analog scale (VAS) in postoperative period for patients underwent septoplasty operation. Materials and methods 100 patients aged between 17 and 50 years and divided into two equal groups. Group L lidocaine 10% was sprayed to gauze swabs with neomycin and bacitracin ointment nasal packing and group S control group 0.9% NaCl applied to same nasal packing. Postoperatively, VAS scale, side effects and analgesic requirements were recorded. Results There were no differences between the number of female and male patients. Postoperative pain was less in group L than group S, there was a statistically significant difference between L group and S group (p &lt;0.05). The patient in the S group needs more rescue drug. L group had significantly better pain score versus S group at all intervals (2, 6, 12, 18, and 24) postoperative period. Conclusion Lidocaine 10% sprayed to 10 cm х 10 cm gauze swabs with neomycin and bacitracin ointment nasal pack provide better analgesic effect and reduced needs to analgesic requirement after septoplasty surgery.

350 Effects of swab type on detection of PEDV from feed manufacturing surfaces

Abstract As pathogens become more prevalent within the swine industry, the demand for methods to monitor and detect them has increased. Using environmental swabbing to detect pathogens in the feed supply chain may allow for a greater likelihood of detection than product sampling. The objective of this experiment was to identify the swab that detects porcine epidemic diarrhea virus (PEDV) from feed manufacturing surfaces at the dose most similar to that included in an ingredient. The experiment was arranged as a 2×2×4 factorial with two doses of PEDV (low: 10^3 or high: 10^5 TCID50), two surface types (stainless steel or polyethylene tote), and four swab types (1: sponge-tip swab packaged with neutralizing buffer; 2: Dacron-tip swab packaged in Dey-Engley neutralizing broth; 3: dry dust-mop; or 4: cotton gauze soaked in phosphate-buffered saline). Soybean meal (SBM) was inoculated with levels of PEDV and placed onto stainless steel for 15 min, then the polyethylene tote. The SBM was removed, surfaces were swabbed with one of four types. Samples of inoculum, SBM, and swabs were analyzed for PEDV via qRT-PCR with three replicates per treatment. Data were analyzed via the GLIMMIX procedure of SAS. There was a dose×surface type×swab type interaction (P &lt; 0.0001; SEM=0.967; Table 1). In stock virus and SBM, increased dose resulted in lower (P &lt; 0.05) detectable PEDV. However, no virus was detected in sponge-tip swabs used on stainless steel surfaces. Dacron-tip and cotton gauze swabs yielded the most detectable PEDV from surfaces, but was still 1.2 to 5.1 Cycle threshold (Ct) higher than SBM. Detectable PEDV in SBM was approximately 11 Ct higher than in stock virus. In summary, environmental swabbing can easily detect PEDV, but at higher Ct than product samples. Of the swabs tested, Dacron-tip and cotton gauze are superior for PEDV environmental analysis than dry mops. Sponge-tip swabs should not be used for environmental monitoring of PEDV.

Comparative effectiveness of complex treatment schemes for rabbits with pasalurosis and psoroptosis

Psoroptosis and pasalurosis in rabbits for their maintenance in unsanitary conditions often becomes massive. To increase the effectiveness of treatment of rabbits it is expedient to use combined drugs based on active substances with different mechanisms of action on parasites. Rabbits of the first experimental group applied spray treatment with acaricidal properties of kerosene + glycerol (1:1) three times with an interval of 5 days. Spraying the inner surface of the ears was carried out after mechanical cleaning with gauze swabs soaked in iodine solution + glycerin (1:4). To destroy the helminths, brovadasol plus (5 g/10 kg body weight), orally with food, was administered once. For animals of the second experimental group, the "brovermectin 2%" helminthoacaricide was chosen, it was orally administered at a dose of 1 ml/50 kg body weight, divided into 5 days of regular use. Mechanical treatment of ear with chlorhexidine bigluconate was carried out analogously to rabbits of the first group twice a day for 10 days. On the day of treatment with the rabbits in the second group, Dexacel 0.2 % (KELAN.V., Belgium) was injected intramuscularly with a dose of 0.1/1 kg of body weight, in order to improve the general animal's stanchion. For combined infestations (scabies and nematodes) it is advisable to use preparations based on ivermectin (in our study, "Brovermectin 2%" at a dose of 1 ml/50 kg, which was divided into 5 parts and daily diluted one part in 1/2 of the daily water) In the case of the need to treat only psoroptosis, one can use a kerosene solution in glycerol (1:1) in the form of a spray. A prerequisite for the effective treatment of psoropathy is the regular mechanical cleaning of the affected ears from the purulent parasitic exudate or iodine solution + glycerol (1:4) or Chlorhexidine bigluconate 0,05%. It is appropriate to use "Dexacel 02" (one time, non-inflammatory y dose of 0.1/1 kg body weight) in order to improve the general animal's condition. The use of "Brovadazole plus" (once, with food, at a dose of 5 g/10 kg body weight) did not ensure 100% destruction of Passalurus ambiquus, but due to the short carencia period (only 7 days), if necessary, can be applied to fattening rabbits in the last 2 weeks before slaughter. In contrast to the period of carencia, "Brovermectin 2%" is at least 24 days. Key words: rabbit, psoroptosis, pasalurosis, brovermectin, acaricidal efficacy, Dexacel 02.