Saline Irrigation Group Research Articles

Effect of saline irrigation temperature difference on postoperative acute pain and hypothermia during biportal endoscopic spine surgery.

Recently, enhanced recovery after surgery (ERAS) protocols have attracted attention; they emphasize on avoiding intraoperative hypothermia while performing lumbar fusion surgery. However, none of the studies have reported the protocol for determining the temperature of saline irrigation during biportal endoscopic spine surgery (BESS) procedure. This study evaluated the effectiveness of warm saline irrigation during BESS in acute postoperative pain and inflammatory reactions. Fifty-five patients who underwent BESS procedure were retrospectively analyzed for the incidence of perioperative hypothermia (< 36oC), postoperative inflammatory factors (white blood cells (WBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), interleukin-6 (IL-6), serum amyloid A (SAA)), and clinical outcomes (back visual analog scale (VAS) score, postoperative shivering). The patients were divided into the warm and cold saline irrigation groups. Hemoglobin, WBC, ESR, creatine kinase, and creatine kinase-muscle brain levels did not significantly differ between the warm and cold saline groups. The mean CRP, IL-6, and SAA levels were significantly higher in the cold saline group than in the warm saline group (p = 0.0058, 0.0028, and 0.0246, respectively); back VAS scores were also higher with a statistically significant difference until two days postoperatively (p < 0.001). During the entire procedure, the body temperature was significantly lower in the cold saline irrigation group, but the hypothermia incidence rate significantly differed 30min after the operation was started. Using warm saline irrigation during BESS is beneficial for early recovery after surgery, as it is associated with reduced postoperative pain and complication rates.

Efficacy of Dexamethasone Diluted Saline Irrigant on Postoperative Sequelae in Patients Undergoing Lower Third Molar Surgery: A Prospective Clinical Study.

Background Third molar impaction surgery is one of the most commonyet challenging procedures done as a part of minor oral surgery. Years of research and improvisation of techniques have been done, yet there are still a lot of postoperative sequelae after surgical removal of the impacted tooth. In our study, we have compared the efficacy of dexamethasone diluted saline solution over plain saline solutionused as an irrigant in the reduction of postoperative sequelae for lower third molar surgery. Aim The aim of the study was to evaluate the efficacy of dexamethasone dilutedsaline solution over plain saline solutionin the reduction of postoperative sequelae for lower third molar surgery. Materials and methods The research was conducted atSaveetha Dental College and Hospitalin the Department of Oral and Maxillofacial Surgery. The study consisted of 48 individuals, 24 of whom haddexamethasone saline as an irrigant (8 mg of dexamethasone was diluted in 100 ml of plain saline) (Group 1), and 24 inwhom plain saline was used as an irrigant (Group 2) in the lower third molar surgery. Patients were evaluated postoperatively for pain and swelling. The postoperative swelling was measured on postoperative day two and day seven.Postoperative pain was measured onday two, day four, and day seven after surgery using a visual analog scale. Data were analyzed using SPSS (IBM Corp., Armonk, NY) with P-values less than 0.05 considered statisticallysignificant. The statistical test used to compare the outcomes between the two groups was the independent samples t-test. Results It was found that study participants in the dexamethasone saline irrigation group reported statistically significantly lesser pain than participants receiving plain saline irrigation on day two (P = 0.001), day four (P = 0.001), and day seven (P = 0.001), respectively. Also, there was a reduction in swelling among participants in the dexamethasone saline irrigation group when compared to the normal saline irrigation group, which was statistically significant (P = 0.001) on day two, while the postoperative swelling was not statistically significant onday seven (P = 0.08) between the two study groups. Conclusion Based on the results obtained, it can be concluded thatdexamethasone saline solution (8 mg/100 mL) was more effective as an irrigantin reducing the postoperative sequelaethan regular saline solution in the lower third molar surgery.

Efficacy of Continuous Saline Irrigation Therapy for Descending Necrotizing Mediastinitis.

Objectives Descending necrotizing mediastinitis (DNM) is a poor prognosis disease. This study aims to examine the patient background and treatment of DNM and to identify more effective treatments for DNM. Methods The patient background and treatment of 11 patients who underwent surgery for DNM between November 2010 and June 2021 were studied. The patients were divided into six patients who underwent continuous saline irrigation (group I) and five patients who did not (group N). The differences in the drainage duration and length of hospital stay between the two groups were retrospectively investigated. Results Eleven patients were treated for DNM: six male and five female, with a median age of 61 years (35-79). Comorbidities included diabetes mellitus in three cases; one patient was administered steroids. The pathways of occurrence were anterior tracheal gap/vascular visceral gap/posterior visceral gap in group I (2/1/2) and group N (0/2/4). Progression was I/IIA/IIB according to Endo's classification in group I (1/1/4) and group N (3/1/1). The mean duration of irrigation was 9.0 ± 3.7 days, and the drainage duration in group I was 17.5 ± 8.2 days, which was significantly shorter than 31 ± 13.6 days in group N ( p < 0.048). The hospital stays in group I was 29.3 ± 8.4 days, which was significantly shorter than that in group N (68 ± 27.1 days; p < 0.015). Conclusions Irrigation therapy significantly shortened the drainage duration and hospital stay. Irrigation is a useful treatment for DNM.

Combined use of a 980‑nm diode laser and preoperative intravesical instillation of pirarubicin for the prevention of short‑term recurrence of non‑muscle invasive bladder cancer: A pilot study.

At present, transurethral resection of bladder tumors (TURBT) is the main surgical method for treating non-muscle invasive bladder cancer (NMIBC), but its postoperative recurrence needs to be prevented. The aim of the present study was to investigate the efficacy of a 980-nm diode laser combined with preoperative intravesical instillation of pirarubicin (THP) for the prevention of NMIBC recurrence. The data of 120 patients with NMIBC who underwent transurethral resection between May 2021 and July 2022 were retrospectively collected, and these patients were followed up. The patients were divided into four groups based on the surgical method used and preoperative intravesical instillation of THP as follows: i) 980-nm diode laser with THP (LaT); ii) 980-nm diode laser alone (La); iii) TURBT with THP (TUT); and iv) TURBT alone (TU). Clinicopathological variables, postoperative complications and short-term outcomes among the aforementioned groups were analyzed. The blood loss volume and the incidence of perforation and delayed bleeding were significantly lower in the LaT and La groups compared with those in the TUT and TU groups. The days of bladder irrigation, catheter extubation and postoperative hospitalization were significantly shorter in the LaT and La groups compared with the TUT and TU groups. The detection rate of suspicious lesions was significantly higher in the THP irrigation groups (LaT and TUT) compared with that in the saline irrigation groups (La and TU). Tumor diameter and number, 980-nm laser and THP irrigation were shown to be independent risk factors in the Cox regression analysis. In addition, the recurrence-free survival (RFS) rate of the LaT group was significantly higher than that of the other three groups. In conclusion, a 980-nm diode laser can effectively reduce intraoperative blood loss and the incidence of perforation, and accelerate postoperative recovery. Preoperative intravesical instillation of THP is conducive to identifying suspicious lesions. The combination of a 980-nm laser with preoperative THP intravesical instillation can significantly prolong RFS time.

Saline irrigation for reducing the recurrence of common bile duct stones after lithotripsy: a randomized controlled trial.

Mechanical lithotripsy produces stone fragments that are not easily detected by cholangiography and is a potential cause of recurrence of common bile duct stones (CBDS). This study aims to clarify whether 100ml saline irrigation after mechanical lithotripsy reduces the recurrent rate of CBDS. In this randomized controlled trial performed at the Surgical Endoscopy Center, the First Hospital of Lanzhou University between May 10, 2019, and Dec 31, 2020, patients undergoing endoscopic mechanical lithotripsy were randomly assigned to receive saline irrigation (study group) or no irrigation (control group). The saline irrigation was given 100ml saline pulse irrigation after cholangiography showed no residual stones. Patients were followed up for at least 24 months after endoscopic stone removal to assess the recurrence of CBDS. This study was registered with ClinicalTrials.gov (NCT03937037). During the median follow-up period of 35.6 months (interquartile range, 26.0-40.7), 43 of the 180 patients had stone recurrence (24%). The frequency of recurrence of CBD stones was 12.22% in the saline irrigation group and 35.56% in the control group, with a difference of 23.33% between the two groups (95% confidence interval [CI], 11.35%-35.32%, p<0.001). Multivariable Cox proportional hazards analyses showed that constipation (hazard risk [HR] 2.42; 95% CI, 1.22-4.80, p=0.012), periampullary diverticulum (PAD) (HR 3.06; 95% CI, 1.62-5.79, p<0.001), and total to direct bilirubin ratio (HR 1.48; 95% CI, 1.21-1.81, p<0.001) were independent risk factors for the recurrence of CBDS. Saline irrigation was the only preventive factor for the recurrence of CBDS (HR 0.22; 95% CI, 0.11-0.44, p<0.001). For patients with CBDS requiring mechanical lithotripsy, 100ml saline irrigation effectively reduces the recurrent rate of CBDS after endoscopic stone removal. This work was supported by National Natural Science Foundation of China (32160255); Natural Science Foundation of Gansu Province (22JR5RA898, 20JR10RA676); Science and Technology Planning Project of Chengguan District in Lanzhou (2020JSCX0043).

Comparison of the efficacy of hot saline irrigation and tranexamic acid on Boezaart score, intraoperative blood loss, and duration of surgery in functional endoscopic sinus surgery: a systematic review and meta-analysis

Link of Video Abstract: https://youtu.be/wEp6PioGVqw Background: Hot saline irrigation and tranexamic acid are techniques used to control bleeding during functional endoscopic sinus surgery (FESS). Hot saline irrigation and tranexamic acid can help control bleeding originating from microvascular located in the nasal cavity and paranasal sinuses. This study aims to compare the efficacy of these two techniques on Boezaart score, intraoperative blood loss, and duration of surgery in functional endoscopic sinus surgery. Methods: This study is an intervention meta-analysis, the research formulated based on the population, intervention, comparison, outcome, and study design (PICOS). Articles were searched from five databases, including PubMed Central and publisher websites, Cochrane Library, ResearchGate, SAGE Journals, and Web of Science. There were no publication year or publication status restrictions on the selected research articles, and the date of the last search was up to February 2023. The efficacy of hot saline irrigation as a bleeding control method compared to tranexamic acid was assessed based on Boezaart surgical field score, intraoperative bleeding, and duration of surgery in functional endoscopic sinus surgery (FESS). Results: A total of 532 research articles were identified, and fifteen articles that met the inclusion and exclusion criteria were selected. Hot saline irrigation p-value p=0.0002 and for tranexamic acid p=&lt;0.00001 based on Boezaart score. Hot saline irrigation p= 0.0001 and tranexamic acid had a p= 0.0002 based on the Intraoperative blood loss, but the standardized mean difference in the hot saline irrigation group was smaller compared to the tranexamic acid topical group. Hot saline irrigation p=0.06 and tranexamic acid p=0.13 for duration of surgery. Conclusion: This meta-analysis showed that the administration of tranexamic acid or hot saline irrigation could significantly reduce duration of surgery, intraoperative blood loss and improved surgical feld quality compared with room temperature saline irrigation. There is no statistically significant difference between tranexamic acid topical and hot saline irrigation.

Low-concentration Povidone-iodine and Normal Saline as Irrigant on Reducing Postoperative Complications after the Third-molar Surgery: A Comparative Study

This study was conducted to compare the efficacy of using 0.5 mg/mL povidone-iodine solution as an irrigant and coolant in reducing postoperative sequelae like swelling, trismus, and pain with the conventional normal saline irrigation during the surgical removal of the impacted lower third molar. The research was conducted out toward the MES Dental College in Perinthalmanna, Kerala, in the Department of Oral and Maxillofacial Surgery. After mandibular third-molar surgical removal, researchers studied 60 individuals, 30 of whom had normal saline irrigation (group I), and 30 of whom received 0.05% povidone-iodine irrigation (group II). The postoperative discomforts were measured on the second and seventh days after surgery, respectively. After that, the data were analyzed using SPSS. The data analysis considered p-values less than 0.05 to be significant. At the second postoperative visit, patients in the povidone-iodine group reported much less pain, swelling, and reduced mouth opening than those in the normal saline group. But on the seventh postoperative day, there was not much difference between either group. Following the surgical removal of teeth, it was revealed that povidone-iodine solution (0.5 mg/mL) was more effective as irrigation and cooling aid than regular saline solution. Low-concentrated povidone-iodine is a better option in dentistry as irrigant.

Hot saline irrigation for haemostasis in functional endoscopic sinus surgery: a systematic review and meta-analysis.

The aim of this study was to perform a systematic review and meta-analysis of existing evidence on the role of hot saline irrigation in patients undergoing functional endoscopic sinus surgery and its impact on the visibility of the surgical field. A search of PubMed, Cochrane, Ovid databases and Google Scholar was performed. Three randomised controlled trials were included. Pooled meta-analysis demonstrated a statistically significant better visibility of the surgical field, and a reduction in total blood loss and operating time during functional endoscopic sinus surgery in the hot saline irrigation group compared with the room temperature irrigation group. Subgroup analysis of studies that did not use vasoconstrictors showed a significant reduction in total blood loss and operating time. This is the first systematic review that addresses hot saline irrigation for haemostasis in functional endoscopic sinus surgery. The results suggest that hot saline irrigation in functional endoscopic sinus surgery for chronic rhinosinusitis may significantly improve visibility of the surgical field, reduce total blood loss by 20 per cent and decrease operating time by 9 minutes. However, there are limitations of the study because of the significant heterogeneity of the methods, quality and size of the studies.

Efficacy of Povidone-Iodine Nasal Irrigation Solution After Sinonasal Surgery: A Randomized Controlled Study.

To evaluate the efficacy of postoperative nasal irrigation with povidone-iodine (PVP-I) solution in patients undergoing sinonasal surgery. Single-blind, randomized controlled study. This is a prospective, single-blind, randomized controlled study. Patients with chronic rhinosinusitis (CRS) and hypertrophic inferior turbinates who underwent endoscopic sinus surgery (ESS) and inferior turbinate reduction were enrolled in the study. Patients were evaluated using the Taiwanese version of the 22-item Sino-Nasal Outcome Test (TWSNOT-22), rhinomanometry, endoscopic examination, and bacterial cultures. One week after the operation, patients were randomly assigned to either a 0.1% PVP-I nasal irrigation group or a control (normal saline) irrigation group. We then compared the two groups' results to illustrate the effects of nasal irrigation with PVP-I solution following sinonasal surgery. Of the 55 patients that completed the study, 27 patients were in the PVP-I group and 28 were in the control group. In both groups, the TWSNOT-22 scores, Lund-Kennedy endoscopic scores, and total nasal resistance (TNR) all revealed significant improvements at 3 months postoperatively compared with preoperative measurements (all, P < .05). However, there were no significant differences between the two groups in TWSNOT-22, endoscopic, or TNR scores 3 months after the operation (all, P > .05). A dilute 0.1% PVP-I nasal irrigation as a postoperative care modality after sinonasal surgery did not provide additional benefit compared with normal saline irrigation. 2 Laryngoscope, 132:1148-1152, 2022.

English

BACKGROUND The objective of this study was to test as to whether daily saline nasal irrigation improved sinus symptoms in adult subjects with chronic rhino sinusitis, and also study the safety of saline irrigation, incidence of any complication and improvement in quality of life in these patients. METHODS This was a prospective observational study conducted between two groups of patients at Government TD Medical College, Alappuzha. Patients who satisfied the criteria for diagnosing chronic rhino sinusitis were included in the study. The first group was given saline nasal irrigation with oral drug therapy while the second group was put on oral drugs alone. Each subject was given a pretested, structured questionnaire. Along with socio-demographic information, the questionnaire also contained queries of quality of life measure, compliance of nasal irrigation and adverse effects following its use. RESULTS The pre-treatment scores and post treatment scores were analysed and the results were statistically significant with P values of &lt; 0.001 in all. 77 % of the patients in the saline irrigation group were strictly using saline nasal irrigation which meant a satisfactory compliance and the improvement in post treatment scores was statistically highly significant with a P value of &lt; 0.001. Also there was a statistically significant difference between the mean pre-test and post test scores of the two groups with P value of &lt; 0.001 and t value of 51.942 using the paired t test. CONCLUSIONS Chronic rhinosinusitis has a major negative impact on the healthcare and economy of not only the patients but also of the society. Saline nasal irrigation is an effective yet easy method of therapy in alleviating the symptoms of chronic rhinosinusitis and improving the quality of life in these chronic sufferers. KEY WORDS Chronic Rhinosinusitis, Saline Nasal Irrigation, Quality of Life, Economic Burden

Streptokinase irrigation through a percutaneous catheter helps decrease the need for necrosectomy and reduces mortality in necrotizing pancreatitis as part of a step-up approach

BackgroundPercutaneous catheter drainage in pancreatic necrosis with a predominant solid component has a reduced success rate. To improve the efficacy of percutaneous catheter drainage, we used streptokinase in the irrigation fluid in the present study. MethodsIn this retrospective analysis of 4 prospective randomized studies performed at our center from 2014 to 2019, 108 patients were evaluated. We assessed the safety, feasibility, and efficacy of streptokinase irrigation compared to saline irrigation. Data were also analyzed between 50,000 IU and 150,000 IU streptokinase. ResultsThere were 53 patients in the streptokinase irrigation group and 55 in the saline irrigation group, and both groups were comparable in terms of age, sex, etiology, APACHE II score, and percutaneous catheter drainage characteristics. The modified computerised tomography severity index and modified Marshall score at the onset of pain were significantly higher in the streptokinase group. Sepsis reversal was significantly higher in the streptokinase group (75% vs 36%), and the need for necrosectomy (34% vs 54%) was also lower in the streptokinase group. Mortality was lower in the streptokinase group than in the saline group (32% vs 40%). The incidence of bleeding in the streptokinase group was lower than that in the saline group (7% vs 18%). A higher dose of streptokinase (150,000 IU) resulted in lower rates of necrosectomy, bleeding, and mortality compared to those with 50,000 IU streptokinase. ConclusionSignificant reductions in the need for surgery and sepsis reversal were noted in the streptokinase group. The results using 150,000 IU streptokinase were superior to those using 50,000 IU streptokinase.

The role of saline irrigation of subcutaneous tissue in preventing surgical site complications during cesarean section: A prospective randomized controlled trial

Aim: Following cesarean section, wound complications develop in 3 to 30% of the patients. The purpose of this study is to evaluate the effect of subcutaneous saline irrigation during caesarean section on postoperative surgical site complications. Methods: This prospective randomized controlled study was conducted between November 17, 2020 and December 16, 2020 at Medipol University, Private Nisa Hospital. A total of 230 women undergoing elective cesarean delivery were divided into 2 groups. The subcutaneous tissue was irrigated with saline solution in group 1 (n=115), and not irrigated in the control group (n=115). On the 7th postoperative day, the surgical site was evaluated for hematoma, seroma, wound dehiscence, and superficial surgical site infection. Results: The incidences of seroma (7% vs. 15.7%, P=0.013), hematoma (6.1% vs. 15.7%, P=0.024) and superficial surgical site infection (4.3% vs. 11.3%, P=0.035) were significantly lower in the saline irrigation group, while the groups were similar in terms of wound dehiscence (P=0.176). Conclusion: Saline irrigation of the subcutaneous tissue during cesarean section decreased the rates of seroma, hematoma, and superficial surgical site infections significantly.

Estimation of percent wound area reduction over a period of four weeks among diabetic foot ulcers

Foot ulcers are the most commonly experienced,fearful complications of diabetes which can frequently be life or limb-threatening.Several factors can lead to the occurrence of foot ulcers in diabetics.Prevention and proper management of DFUs are the prime most important in the care of patients with diabetes. It is essential to predictthe wound healingtime in managing the diabetic foot ulcers.The main objective of the study is to examine the reduction in wound area over four weeks in achieving more than 50 % Percentage Area Reduction (PAR) as a clinical outcome.Twowound irrigation methods were used for irrigating the wounds. Assessment of the wound area was done and comparedon achieving more than 50 % reduction in ulcer area at the end of four weeks. The studyused a descriptive comparative design with a control group. DiabeticFoot ulcerpatients (N = 160) from a private hospital were randomly allocated into 80 in each group (Neem solutionirrigation and Normal saline irrigation groups). In both groupsSurface area of the wound was measured using a disposable wound ruler with standard calibrations at baseline and then at the end of each week till four weeks are completed. Data were analyzed in SPSS20 software while considering p&lt; .05 as statistically significant.The mean Wound surface area of the Normal saline group was 18.41 at the end of the first week and 14.04 after four weeks verses 19.84. The above-quoted scores in the Neem solution irrigation group were 14.68 and 6.92, respectively, against 17.13(p &lt; .05).At the end of 4 weeks, the mean per cent reduction in area from baseline of DFUs irrigated with Neem solution was 72.4 % and with Normal saline was 48.7 %. Ulcers irrigated with neem solution had a 28.7 % greater mean reduction in area from baseline when compared with the normal saline control group at the end four weeks (p&lt;.05).

Hot nasal packing with hot saline irrigation for hemostasis after adenoidectomy: A prospective randomized controlled study

ObjectiveThis study aimed to investigate the efficacy of hot posterior nasal packing and hot saline irrigation in bleeding control after adenoidectomy. MethodsA total of 130 patients scheduled for adenoidectomy were included in the study, and randomized into two groups at the beginning of the surgical operation. After adenoidectomy, saline impregnated tampon, and saline irrigation at room temperature (22 °C) was applied to the patients in one group while 50 °C saline impregnated tampon and saline irrigation at the same temperature were applied to the patients in the other group. We recorded hemostasis for up to 3 min after tamponade for bleeding control, and the amount of bleeding into the nasopharynx. ResultsThe age of the patients ranged from 1.5 to 13 years (mean ± SD: 6.07 ± 3.08 years, and 5.33 ± 2.55 years, 22 °C and 50 °C saline irrigation groups, respectively). There were 37 males and 28 females in the 22 °C saline group, while 34 males and 31 females in the 50 °C saline group. When comparing the two groups, there was no statistically significant difference in terms of duration of hemostasis (p = 0.64). However, bleeding scores at 2 nd min after the tamponade were significantly lower in the 50 °C saline group (p = 0.007). The amount of bleeding in the 50 °C saline group was also significantly lower than the 22 °C saline group (p = 0.015). ConclusionIn this study, application of 50 °C saline impregnated tampon, and hot saline irrigation was found to be more effective in the control of bleeding after adenoidectomy by reducing the amount of bleeding compared to 22 °C saline impregnated tampon application and saline irrigation at 22 °C. However, hot nasal packing and hot saline irrigation did not affect duration of hemostasis and cauterization.

Comparison of antibiotics and saline irrigation with tube drainage in the treatment of postoperative abdominal and pelvic infectious effusion

Objective: To compare the efficiency of saline irrigation, antibiotics irrigation and high-concentration antibiotics perfusion with tube drainage in the treatment of infectious effusion. Methods: Clinical and sonographic features of abdominal and pelvic infectious effusion of 64 patients with malignant tumor collected from September 2013 to September 2017 were retrospectively analyzed. The changes of effusion size and temperature, catheterization time were evaluated in saline irrigation group and antibiotics irrigation group. The catheterization time was compared between antibiotics irrigation group and high-concentration antibiotics perfusion group. Results: The effective rates of the saline irrigation group and the antibiotics irrigation group were 68.6% and 86.8%, respectively, and the times of catheterization were 11.9±8.4 days and 7.8±4.8 days, respectively, with significantly statistical difference (both P<0.05). However, the effective rates of the antibiotics irrigation group and the high concentration antibiotic perfusion group were 86.8% and 100.0%, respectively (P=0.067), while the times of catheterization were 7.8±4.8 days and 3.6±3.1 days, respectively (P<0.001). Conclusion: The antibiotic irrigation with tube drainage, especially the high concentration perfusion is more effective than saline in the treatment of abdominal and pelvic infection effusion.

Magnetic resonance imaging evaluation of the distribution of spray and irrigation devices within the sinonasal cavities.

Optimizing intranasal distribution and retention of nasal sprays is essential in the management of patients with chronic rhinosinusitis (CRS), including those that have had functional endoscopic sinus surgery (FESS). Despite multiple existing distribution studies, there remains a need for a technique that allows regionalization of particle deposition within a patient's unique 3-dimensional (3D) geometry without exposing the patient to radiation. Seven participants delivered normal saline containing a gadolinium-based contrast agent (GBCA) by either saline irrigation or nasal sprays on 1 side of the nasal cavity. The saline irrigation group included 2 participants (both healthy) while the nasal spray group included 5 participants (2 healthy, 2 post-FESS patients, 1 CRS patient without any sinus surgery). The distribution of new signal enhancement was assessed on each participant using magnetic resonance imaging (MRI). Serial scans were performed over an interval of 4 minutes in the nasal spray group to assess changes in intranasal distribution over time. Signal enhancement was widespread within the nasal cavities and maxillary sinuses of participants (both healthy) that underwent sinus irrigation. For the nasal spray participants, the hotspots for signal enhancement were similar regardless of disease status or previous history of surgery. These included the internal nasal valve, anterior septum, inferior surface of the inferior turbinate, nasal floor, and nasopharynx. No signal enhancement was detected with nasal sprays in either unoperated or operated paranasal sinuses. A technique has been developed using MRI evaluation of radioopaque contrast to characterize the temporospatial distribution of topical drug delivery within the sinonasal cavities.

The association of Leptospermum honey with cytokine expression in the sinonasal epithelium of chronic rhinosinusitis patients.

ObjectiveTo identify the differences in cytokine expression between sinonasal tissue from patients treated with Leptospermum (Manuka) honey (LH) irrigation versus normal saline irrigation twice-daily for twelve weeks following sinus surgery (FESS).MethodsForty-six CRS patients were recruited. Sinus tissue biopsies were collected during FESS and then at 5 and 12 weeks postoperatively during the course of treatment. A multi-plex cytokine assay quantified the abundance of 17 cytokines in biopsied tissue. Cytokine expression fold-change was analyzed between each time point using a robust linear regression model and compared between the two treatment groups.ResultsCompared to the saline irrigation group, five cytokines were differently expressed (CI = 95%) in sinonasal tissue obtained from subjects in the LH irrigation group during the 12-week treatment period. Cytokines IL-6 (P = 0.0400), IL-8 (P = 0.0398), MCP-1 (P = 0.0284), and MIP-1β (P = 0.016) were significantly increased in the LH irrigation group compared to the saline irrigation group. IL-13 was significantly increased in the saline irrigation group compared to the LH group (P = 0.0086).ConclusionLH may potentially act to modulate the expression of IL-6, IL-8, IL-13, MCP-1 and MIP-1β in sinonasal tissue.

Effect of Postoperative Xylitol Nasal Irrigation on Patients with Sinonasal Diseases.

To examine the effect of xylitol nasal irrigation in a large sample size of patients who had undergone nasal surgery. Double-blinded randomized controlled crossover study. Tertiary referral center. The study included 100 patients with sinonasal disease who underwent endoscopic sinus surgery (ESS), septoplasty, or both concurrently. To identify patients with allergic sensitization, serum-specific immunoglobulin E levels were measured. Nasal symptoms were evaluated with the NOSE (Nasal Obstruction Symptoms Evaluation) and SNOT-20 (Sino-Nasal Outcome Test-20) and via visual analog scale (VAS) scores. In the ESS group (n = 34), the general nasal symptom score evaluated by the SNOT-20 showed significantly greater improvement in the xylitol group versus the saline group ( P = .022). VAS symptom scores for sneezing ( P = .003), headache ( P = .02), and facial pain ( P = .037) were also more improved in the xylitol group. In the septoplasty group (n = 39), the VAS score for nasal stuffiness showed a significantly greater improvement in the xylitol group when compared with the saline irrigation group ( P = .001). Among the patients with allergic sensitization (n = 31), rhinorrhea symptoms improved significantly more in the xylitol group than in the saline group ( P = .024). The preference survey showed that more than half of the patients in each surgical group preferred xylitol irrigation. We found that xylitol nasal irrigation was useful in postoperative ESS and septoplasty care. For patients with allergic sensitization, rhinorrhea showed greater improvement in the xylitol group than in the saline group.

The impact of subcutaneous irrigation on wound complications after cesarean sections: A prospective randomised study

ObjectiveTo assess the effectiveness of subcutaneous saline irrigation in preventing wound complications after cesarean sections. Study designPatients undergoing primary cesarean sections were randomly assigned to either the subcutaneous saline irrigation group or the control group. The participants were asked to come to the hospital for routine inspection of the skin incision on day 7 and day 30 postoperatively. The wounds were inspected for hematoma, seroma, separation and signs of superficial infection. The prime outcome was the comparison of the superficial surgical site infection (SSI) rates among the groups. Additionally, factors associated with wound complications were also analyzed using logistic regression. ResultsA total of 204 women undergoing primary cesarean sections were randomized, and 185 were included in the final analysis. There was no significant difference in terms of SSI rates among the groups (14.3% in the saline group vs 12.8% in the control group, p = 0.76). However, the existences of hematoma and seroma were significantly lower in the saline irrigation group compared to the control group. ConclusionIrrigation of subcutaneous tissue decreases the occurrences of both postoperative hematoma and seroma in women undergoing primary cesarean sections.

Overnight continuous saline irrigation after transurethral resection for non-muscle-invasive bladder cancer is helpful in prevention of early recurrence

It has been reported that many methods prevent recurrence after transurethral resection of bladder tumour (TURBT) for non-muscle-invasive bladder cancer (NMIBC), but it has rarely been reported that overnight continuous saline irrigation is effective in preventing recurrence. The purpose of this study was to evaluate the efficacy of overnight continuous saline irrigation in preventing recurrence after TURBT. We retrospectively studied patients with NMIBC who underwent TURBT from January 2010 to May 2015 at our institution. Patients who underwent cystoscopy every 12 weeks during the first year after surgery were included. Patients with cancer stage ≥pT2, lymph node metastasis, or distant metastasis were excluded. The overnight continuous saline irrigation (OCSI) group and the no irrigation group were compared and analyzed. A total of 332 patients were included in the study. There were no differences in the basic characteristics of the patients between the two groups. In the OCSI group, the recurrence-free survival rate was higher than that in the no irrigation group, indicating that there was a significant difference between the two groups (p=0.032). After TURBT surgery, OCSI may help prevent early recurrence of NMIBC.