Use Of Long-term Indwelling Catheters Research Articles

Treatment of sternoclavicular joint osteomyelitis with debridement and delayed resection with muscle flap coverage improves outcomes.

The objective of this study was to evaluate the efficacy of various treatment options for sternoclavicular joint osteomyelitis. We evaluated patients with a diagnosis of sternoclavicular joint osteomyelitis, treated at our hospital from 2002 to 2012. Four treatment options were compared. Three out of twelve patients were successfully cured with antibiotics alone (25%). Debridement with or without negative pressure therapy was successful for one of three patients (33%). Simultaneous debridement, bone resection, and muscle flap coverage of the acquired defect successfully treated one of two patients (50%). Debridement with delayed bone resection and muscle flap coverage was successful in five of five patients (100%). Osteomyelitis of the sternoclavicular joint is a rare disease that has become more prevalent in recent years and can be associated with increasing use of long-term indwelling catheters. Initial debridement with delayed bone resection and pectoralis major muscle flap coverage can effectively treat sternoclavicular joint osteomyelitis.

Preventing infection with long-term indwelling urinary catheters

This article sets out to inform readers on the care and management of indwelling catheters. The reason for urinary catheter insertion is discussed and the decision to use a long-term indwelling urinary catheter is explained. This article focuses on the risk of urinary tract infections (UTI) associated with the use of long-term indwelling catheters and how these may be avoided. Examples of current products are detailed and how the selection of the right product may be achieved is also outlined.

Urine bladder catheters in nursing home patients: A one-day point prevalence study in a Swedish county

The aim of this study was to register the use of long-term indwelling catheters in nursing homes in a defined geographical region, and present the indications for and duration of catheterization, catheter material and size, the time between the regular catheter changes and the number of patients with regular catheter rinses. On 16 February 2009, the 78 nursing homes in a county in western Sweden with 260 000 inhabitants reported the required information to the study centre. Of the 2625 nursing home patients (1781 women and 844 men), 50 (3%) of the women (mean age 88 years) and 135 (16%) of the men (mean age 85 years) had indwelling catheters. Urine retention and high residual urine were the most common indications (79%). Incontinence (6%) was rarely the reason. The men had been catheterized much longer (mean ± SD 32 ± 29 months) than the women (20 ± 19 months). Regular bladder catheter rinses were used in 51 patients (28%). Seven per cent of nursing home patients in the region had an indwelling catheter, the men five times more often than the women. The main indication for both genders was insufficient bladder emptying, and rarely incontinence. The men had been catheterized for much longer periods than the women and more often arrived at the nursing home with a long-term indwelling catheter.

Diagnosis and management of deep vein thrombosis of the upper extremity: a review.

Deep vein thrombosis of the upper extremity is an increasing clinical problem due to the use of long-term indwelling catheters for chemotherapy or long-term feeding. The clinical diagnosis is difficult to make, and various imaging modalities have been used for this purpose. The use of (interventional) radiological procedures has been advancing in recent years. This review describes the clinical background, the imaging modalities that may be employed, treatment options and outcome of patients with upper extremity thrombosis.

Staphylococcus epidermidis: An Increasing Cause of Infection in Patients with Granulocytopenia

Staphylococcus epidermidis, a major component of the skin flora, is usually considered a contaminant when recovered from diagnostic cultures. Since 1974 infections caused by gram-negative bacilli and S. aureus occurring among patients with granulocytopenic cancer have remained constant; infections due to S. epidermidis occurring before 1977 at a rate of 2.0 per 1000 days of hospitalization of patients with acute leukemia, increased to 14.6 per 1000 days in 1979. All S. epidermidis infections before 1977 originated from skin sites; since 1977 the respiratory tract and alimentary canal have become the predominant sites of origin. Predisposing factors for infection were profound granulocytopenia (less than 100/microL), a diagnosis of acute leukemia, and an oral nonabsorbable antibiotic regimen lacking vancomycin. The increased incidence of infection was not related to a nosocomial source or the more frequent use of long-term indwelling catheters. Methicillin resistance among isolates was common (40%). Intravenous vancomycin therapy provided the best therapeutic results. Diagnostic cultures positive for S. epidermidis in the setting of infection and profound granulocytopenia warrant appropriate antibiotic therapy.