Incision Healing Time Research Articles

Discussion on clinical application and nursing experience of percutaneous dilational tracheostomy in critical patients of ICU

Objective To explore the clinical effect and nursing methods of percutaneous dilational tracheostomy in critical patients of ICU. Methods A total of 76 cases of critical patients of ICU from January 2014 to January 2015 were randomly collected as the research objects.All of the patients were divided into two groups according to the surgical methods, 38 patients underwent traditional open tracheotomy were as the control group, while 38 patients underwent percutaneous dilational tracheostomy were as the observation group.The patients of the two groups all received appropriate nursing measures throughout the perioperative period.The operation effect indexes included operative time, peri-operative bleeding, length of incision, wound healing time, etc.of the two groups were observed and compared, and the postoperative complications were compared. Results The operative time, peri-operative bleeding, length of incision and wound healing time of the observation group were significantly better than that of the control group, and the differences were statistical significance (P<0.05). The postoperative complication rate of the observation group (5.26%) was significantly lower than that of the control group, and the difference was statistical significance (P<0.05). Conclusions Percutaneous dilational tracheostomy for the treatment of critical patients of ICU can significantly shorten the operation time, and when combined with careful and meticulous nursing can reduce the intraoperative blood loss and promote the wound healing, and has good security, it is worthy of clinical application. Key words: ICU; Critical patients; Percutaneous dilational tracheotomy; Nursing strategy

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.

Clinical application of disposable circumcision suture device (DCSD) versus ShangRing circumcision in male circumcision

Objectives To compare the efficacy and safety of disposable circumcision suture device (DCSD) and ShangRing circumcision in the tratment of patients with redundant prepuce or phimosis. Methods 180 patients with redundant prepuce or phimosis were randomly divided into two groups: the DCSD group (n=93) and the ShangRing group (n=87). Factors concerning efficacy and safety were compared. Results DCSD showed obvious advantages over the ShangRing in operating time [(6.36±1.09)min vs. (7.23±1.10) min], postoperative 24h pain score (1.94±1.08) vs.(2.89±0.98), postoperative 7d pain score (2.08±0.89) vs. (3.74±1.01), wound healing time [(18.44±3.58)d vs. (21.66±3.65)d], the incidence of wound dehiscence (2.2% vs. 11.5%), and overall satisfactory rate (86.0% vs. 73.6%). There was significant difference in above results (P 0.05). Conclusions DCSD has advantages of shorter operation and incision healing time, reduced postoperative pain score, and high appearance satisfaction. It should be widely used in clinical practice. Key words: Circumcision, Male; Surgical Staplers

Application of subtalar joint distractor in operative treatment for comminuted calcaneal fracture

Objective To evaluate the method and clinical effect of subtalar joint distractor assisted open reduction and internal fixation of comminuted intra-articular calcaneal fracture. Methods Twenty-two patients with fresh closed calcaneal fracture treated with open reduction and internal fixation from May 2011 to July 2013 were included in the study. According to the modes of operation, the patients were randomly divided into two groups (n=11 in each): in group A patients underwent fracture reduction assisted by subtalar joint distractor and in group B patients underwent Steinmann pin traction and poking reduction. All were fixed using the lateral calcaneal plate. Operation time, Bohler angle, Gissanes angle, calcaneus height, incision healing time and complications of the two groups were investigated for evaluating the effect of operation. Clinical effect was evaluated using the American Orthopedic Foot & Ankle Society (AOFAS) score before the removal of internal fixation. Results Period of follow-up was (14.3±0.8)months (range, 12 to 18 months). Two patients in group B had delayed wound healing, and were treated with regular wound care. At the final follow-up, no infection, nonunion, malunion and internal fixation failure were observed. Bohler angle, operation time and calcaneus height observed in group A were superior to those in group B (P 0.05). Compared to the preoperative data, Bohler angle, Gissanes angle and calcaneus height were significantly improved in both groups (P<0.01). AOFAS score was (83.6±1.4) points in group A and (81.7±1.5) points in group B. Conclusion Subtalar joint distractor assisted open reduction and internal fixation is effective to shorten operation time, improve fracture reduction, reduce wound complications and increase the operative effect for comminuted intra-articular calcaneal fracture. Key words: Calcaneus; Fractures, comminuted; Subtalar joint; Distractor

Effect of open and laparoscopic cholecystectomy on postoperative intestinal adhesions

Objective To explore the impact of open and laparoscopic cholecystectomy of different operation methods on postoperative intestinal adhesions. Methods 128 patients with acute cholecystitis were randomly divided into the observation group (64 cases) and control group (64 cases). The control group was treated with open cholecystectomy, the observation group was treated with laparoscopic cholecystectomy.The postoperative intestinal function, complications and intestinal adhesion were compared between the two groups. Results The bleeding amount, incision size, operation time of the observation group were (132.29±27.28)mL, (3.9±0.2)cm, (102.1±20.9)min, which were significantly better than those of the control group [(197.44±31.21)mL, (15.4±2.3)cm, (129.5±30.6)min], the differences were statistically significant(t=12.574, 38.850, 5.915, P<0.05). The incision healing time, bowel sounds recovery time, exhaust time of the observation group were (8.65±0.75)h, (23.63±5.14)h, (31.65±10.71)h, which were significantly shorter than those of the control group [(13.27±1.18)h, (36.17±7.14)h, (46.35±13.36)h], the differences were statistically significant (t=26.434, 11.403, 6.868, all P<0.05). The length of hospital stay and hospitalization expenses of the observation group were (3.9±1.6)d, (9 830±840)RMB, which were significantly less than those of the control group [(5.7±2.4)d, (1 2876±703)RMB] (t=4.992, 22.247, all P<0.05). Conclusion Laparoscopic cholecystectomy can not only reduce intraoperative bleeding volume and operation time, promote postoperative intestinal function recovery, but also can save the cost of hospitalization, reduce complications and the incidence of intestinal viscosity.Security is good, it is recommended. Key words: Cholecystectomy; Cholecystectomy, laparoscopic; Postoperation complications; Ankylenteron

Effects of silicon dressing on incision healing after dermatologic surgery

Objective To evaluate the effects of silicon dressing on incision healing after dermatologic surgery. Methods Total 68 patients after dermatologic surgery in our hospital from October 2013 to July 2014 were divided into treatment group and control group. The control group including 35 patients was treated with regular dressing, and the treatment group including 33 patients was treated with silicon dressing at the foundation of regular dressing. Incision healing time, class-A healing rate and scar formation rate were evaluated in the two groups, respectively. Results Incision healing time [(5.09±1.22) d], class-A healing rate (32 cases, 99.7%) and scar formation rate (0 cases, 0.0%) in treatment group were significantly better than those (7.00±0.87) d, 88.6% (31 cases) and 11.4% (4 cases) in control group. The results showed a statistically significant difference between the two groups (P<0.05]. Conclusions Silicon dressing can be used to improve the incision healing after dermatologic surgery. Key words: Incision healing; Silicon dressing; Dermatologic surgery

Disposable circumcision suture device: clinical effect and patient satisfaction.

In our experience patients undergoing circumcision are mostly concerned about pain and penile appearances. We conducted a prospective randomized trial to assess the benefits of a new disposable circumcision suture device (DCSD). A total of 942 patients were equally divided into three groups (conventional circumcision, Shang ring and disposable suture device group). Patients in the DCSD group were anesthetized with compound 5% lidocaine cream, the others with a 2% lidocaine penile block. Operation time, intra-operative blood loss, incision healing time, intra-operative and post-operative pain, the penile appearance and overall satisfaction degree were measured. Operation time and intra-operative blood loss were significantly lower in the Shang ring and suture device groups compared to the conventional group (P < 0.001). Intra-operative pain was less in the suture device group compared with the other two groups (P < 0.001); whereas post-operative pain was higher in the conventional group compared to the other two groups (P < 0.001). Patients in the suture device (80.57%) and Shang ring (73.57%) groups were more satisfied with penile appearances compared with the conventional circumcision group (20.06%, P < 0.05). Patients in suture device group also healed markedly faster than the conventional group (P < 0.01). The overall satisfaction rate was better in the suture device group (78.66%) compared with the conventional (47.13%) and Shang ring (50.00%) groups (P < 0.05). The combination of DCSD and lidocaine cream resulted in shorter operation and incision healing times, reduced intra-operative and post-operative pain and improved patient satisfaction with the cosmetic appearances.

Effect of surgical technique for unilateral orchiectomy on subsequent testicular function in Miniature Horse stallions

Management decisions on unilateral orchiectomy are often influenced by the potential for post operative return to successful breeding. The effects of 2 surgical methods (first intention [FI] vs. second intention [SI] incision healing) for unilateral orchiectomy on resulting semen quality and scrotal temperature were evaluated. To evaluate the effects of 2 surgical unilateral orchiectomy techniques on scrotal healing, size of the remaining testis and post operative sperm quality. Unilateral orchiectomy was performed on mature Miniature Horse stallions. Semen was collected prior to and up to 60 days after, unilateral orchiectomy. Semen parameters, scrotal and body temperatures, testis volume and days to incision healing were evaluated. There was no effect of treatment or time on percent total sperm motility. Total sperm numbers were higher (P < 0.05) 60 days after unilateral orchiectomy compared with 14 and 30 days. Percent viable sperm were higher (P < 0.05) 30 and 60 days compared with pre- and 14 day post unilateral orchiectomy. Scrotal temperatures were lower after unilateral orchiectomy compared with preoperative values ( < or = 0.003). Higher scrotal temperatures were recorded in Group IF, as compared with Group IS, during recoveryfrom anaesthesia and at 1 and 2 h after surgery (P = 0.02). Mean time to incision healing was less in Group II (10.0 days) than in Group II (21.5 days; P = 0.05). In this study, total sperm motility was maintained and size of the remaining testis, total sperm numbers and percent viable sperm increased after unilateral orchiectomy. Incision healing time was shorter in Group II; however, surgical technique did not have an effect on semen quality at 30 and 60 days post unilateral orchiectomy. These data suggest that surgical technique for unilateral orchiectomy may not dramatically influence function of the remaining testis.

Tunnel thread-drawing therapy in treating patients with horseshoe-shaped low-position perianal abscess: a randomized controlled trial

Tunnel thread-drawing therapy is an effective treatment for complex anal fistula, and this therapy may be used for horseshoe-shaped low-position perianal abscess. To analyze the therapeutic effects of tunnel thread-drawing therapy in treatment of horseshoe-shaped low-position perianal abscess. A total of 68 patients with horseshoe-shaped low-position perianal abscess were from Department of Anorectal Surgery, Shanghai Tianshan Traditional Chinese Medicine Hospital, and were randomly divided into treatment group and control group. There were 34 cases in each group. The patients in the treatment group received thread-drawing therapy and the patients in the control group received multiple incisions and drainage. Lasting time of postoperative pain, healing time of incision, average area of the wound scar, anal function and postoperative recurrence were observed in the two groups. Late postoperative follow-up was from half a year to three years. The lasting time of postoperative pain and healing time of incision in the treatment group were shortened as compared with those in the control group (P<0.01). There was no significant difference in postoperative recurrence rate between the two groups (P>0.05). There is a significant curative effect of tunnel thread-drawing therapy in treatment of horseshoe-shaped low-position perianal abscess.

Child cleft palate surgery to relax the application of high frequency electric knife incision of the Clinical Observation

Objective Electric knife for plastic surgery to repair cleft palate in child care during the application of the effect of relaxation incision summarize. Methods 70 cases of unilateral complete cleft palate children were randomly divided into two groups to carry out ab reconstructive surgery, One of a group of plastic repair of cleft palate in the bilateral relaxing incisions are ordinary scalpel incision,b bilateral relaxation incision group used high-frequency electric cut open, Observed in each group operation time, amount of bleeding, wound healing time for relaxation,visco-periosteal flap survived, and were compared. Results b group operative time was significantly shorter than a group (P 0.05), two sets of flap survival sticky situation well, without necrosis. Conclusion High-frequency electric knife in the plastic repair of cleft palate children relaxation incision and application of the ordinary compared to scalpel incision, incision healing time of relaxation,visco-periosteal flap survival no significant difference in the situation,but with a shor-ter operation time,blood loss less advantages, improve surgical safety, is worth popularizing. Key words: High-frequency electric knife; Cleft palate; Pplastic prosthetics; Relaxation incision

Management Strategy for Dirty Abdominal Incisions: Primary or Delayed Primary Closure? A Randomized Trial

It is still a matter of debate whether delayed primary closure (DPC) of dirty abdominal incisions reduces surgical site infections (SSIs) compared with primary closure (PC). Our objective was to determine whether DPC of dirty abdominal incisions reduces SSIs. A controlled randomized study was conducted at an academic tertiary care 1,500-bed university hospital in Western India involving 81 consecutive patients with dirty abdominal incisions. Only 77 patients (DPC = 37, PC = 40) were evaluable because of the deaths of four patients. A total of 52 patients had peptic or typhoid perforations, whereas the rest had appendicular perforations/abscesses, penetrating or blunt abdominal injuries with gastrointestinal perforation, or intra-peritoneal abscesses. Patients were randomized to have their surgical incisions (skin and subcutaneous tissue) either closed primarily (PC) or left open with saline-soaked gauze dressings for DPC on the 3(rd) postoperative day or later if the incision conditions were inappropriate for closure. The main outcome measure was the incidence of postoperative SSI. In the entire series, SSI developed after incision closure in 23% of the patients. Infections were significantly more common in the PC group (42.5% vs. 2.7% for DPC; p = 0.0000375). There also were significantly more cases of abdominal dehiscence in the PC group (DPC 1 [2.7%] vs. PC 10 [25%]; p = 0.005). The mean complete incision healing (CIH) time and length of hospital stay (LOS) were longer after PC (18.52 days) than DPC (13.86 days), resulting in a significant difference in the end point of healing and LOS (p = 0.0207). Short-term cosmetic results for PC incisions were significantly inferior to those for DPC (p = 0.03349). Delayed primary closure is a sound incision management technique that should be utilized for dirty abdominal incisions. It significantly lowers the rate of superficial SSI as well as fascial dehiscence and reduces the mean CIH time and hospitalization. The short-term cosmetic appearance is superior.

S215 – The Effects of Topical Halofuginon on Myringotomy in Rats

Objectives 1) To investigate the role of halofuginone hydrobromide on myringotomy incision healing time. 2) To investigate the role of halofuginone hydrobromide on formation of myringosclerosis. Methods 40 rats with normal eardrums were involved in this study to determine if topical halofuginone application had an impact on prolonging the time for healing of myringotomy incision and its histopathological consequences. The study group and control group consisted of 30 and 10 rats, respectively. A posterior incision 1 mm in diameter was made on randomly selected healty eardrums of the rats. After making incision in the study group, gelfoam soaked in halofuginone hydrobromide of 30 mg/dl was applied on the perforation, while gelfoam dipped in isotonic saline was introduced to perforation in the control group. On days 1, 3,7,10,14,18,21, 24, 27 and 30, otoendoscopic evaluation of eardrums under general anesthesia was conducted and perforations were screened. On control days, one randomly selected rat from each group was sacrified and temporal bones were dissected in order to evaluate the tympanic membranes histopathologically. Results The average times for patency of perforation in study and control groups were 21.43 and 7.50 days, respectively. The difference was found to be statistically significant (p&lt;0.05). Conclusions Histopathological evaluation revealed that halofuginone seems to result in low hyalinization and fibrosis on eardrum compared to the control group.

A minimally invasive approach in the treatment of complicated anal fistula through spatium intermuscular of anal sphincter

To investigate the optimal operative approach for the complicated anal fistula. One hundred and ninety-two cases with complicated anal fistula were randomly divided into minimally invasive operation group (through spatium intermuscular of anal sphincter) and fistula resection group. The operation time, bleeding time during and after operation, pain lasting time, healing time of incision, area of anal scar, anal malformation and function and post operative recurrence were observed and compared between the two groups. Compared to those of fistula resection group, the operative time was (36.5+/- 15.3)min, bleeding time during and after operation (2.0+/- 0.5)d, postoperative pain lasting time (1.5+/- 0.5)d, healing time of incision (18.5+/- 5.5)d in minimally invasive operation group. All were shortened (P< 0.05), and the incidence of anal malformation (5.2%, P< 0.01) and partial anal incontinence (2.1%, P< 0.01) was lower. There was no significant difference in postoperative recurrence between the two groups. The minimally invasive operation through spatium in termuscular of anal sphincter is superior to fistula resection on the management of complicated fistula.