Wound Drainage Research Articles

Predicting Prolonged Wound Drainage after Hemiarthroplasty for Hip Fractures: A Stacked Machine Learning Study.

Prolonged wound drainage (PWD) is one of the most important reasons that increase the risk of early periprosthetic joint infection after arthroplasty. It is very important to evaluate the risk factors for PWD in the surgical field after arthroplasty surgery. This can be accomplished using machine learning or artificial intelligence methods. Our aim in this study was to compare machine learning methods in predicting possible PWD. The study was carried out on clinical, laboratory, and radiological data of 313 patients who underwent hemiarthroplasty (HA) for proximal femur fractures. We preprocessed the dataset and trained and tested machine learning methods using cross validation. We compared various machine learning algorithms (linear discriminant analysis, decision tree, k-nearest neighbors, gradient boosting machine, and logistic regression [LR]) based on performance measures. We also combined the most successful algorithms with a metaclassifier. To help understand the relationship between risk factors, we provided a risk factor severity ranking. To estimate the risk of PWD, classification was performed with first-level classifiers and then integrated as a LR-based meta-learner stacking method. More performance improvements were achieved with the stacking method. We found that the stacking method was superior to other methods in PWD classification. We determined that the volume of fluid collected from the drain, morbid obesity class, blood transfusion, and body mass index score were the four most important risk factors according to stacking.

Removal of the wound drain at the right time after total joint arthroplasty

Introduction: The principle of wound treatment after joint arthroplasty, closed suction drainage, is well established. The effectiveness of this method has recently come under scrutiny. The use of closed suction drains is currently regarded as debatable.There isn't much information available to help the surgeon determine how long the drain should stay in place. Typically, this has only ever included directions.This has typically just included directives like

The Impact of Closed Suction Wound Drain on Immediate and Persistent Pain in Adolescents Undergoing Posterior Spinal Fusion for Idiopathic Scoliosis. A randomized clinical trial

The Impact of Closed Suction Wound Drain on Immediate and Persistent Pain in Adolescents Undergoing Posterior Spinal Fusion for Idiopathic Scoliosis. A randomized clinical trial

Association between duration of anticoagulant thromboprophylaxis and revision rate in primary total hip arthroplasty: a Danish and Norwegian nationwide cohort study.

There are concerns that bleeding following primary total hip arthroplasty (THA) contributes to prolonged wound drainage and prosthetic joint infection (PJI). We examined whether short (1-5 days), medium (6-14 days), and extended (≥ 15 days) duration of thromboprophylaxis is associated with the 5-year revision rate after THA due to osteoarthritis. We performed a cohort study based on data from hip arthroplasty and administrative registries in Denmark and Norway (2008-2014). The outcome was revision surgery due to PJI, aseptic loosening or any cause, and patient mortality. Adjusted cause-specific hazard ratios (HRs) were analyzed with Cox regression analyses. Among 50,482 THA patients, 8,333 received short, 17,009 received medium, and 25,140 received extended thromboprophylaxis. The HRs for revision due to PJI within 5 years were 1.0 (95%CI 0.7-1.3) and 1.1 (CI 0.9-1.3) for short and extended vs. medium treatment, whereas HR for extended vs. medium prophylaxis was 1.5 (CI 1.2-2.0) within 3 months. The HRs for revision due to aseptic loosening within 5 years were 1.0 (CI 0.7-1.4) and 1.1 (CI 0.9-1.4) for short and extended vs. medium treatment. The HRs for any revision within 5 years were 0.9 (CI 0.8-1.1) and 0.9 (CI 0.8-1.0) for short and extended vs. medium treatment. Extended vs. medium prophylaxis was associated with a decreased 0-3 month mortality. The absolute differences at 5 years were ≤ 1%. Our data suggests no association between duration of anticoagulant thromboprophylaxis and revision rate within 5 years of primary THA. The extended thromboprophylaxis might be associated with early increased revision rate due to PJI but also with lower mortality; however, the clinical relevance of this finding requires further research.

Biomimetic three-layer hierarchical scaffolds for efficient water management and cell recruitment

Taking inspiration from the structures of roots, stems and leaves of trees in nature, a biomimetic three-layered scaffold was designed for efficient water management and cell recruitment. Using polycaprolactone (PCL) and polyacrylonitrile (PAN) as raw materials, radially oriented nanofiber films and multistage adjustable nanofiber films were prepared through electrospinning technology as the base skin-friendly layer (roots) and middle unidirectional moisture conductive material (stems), the porous polyurethane foam was integrated as the outer moisturizing layer (leaves). Among which, radially oriented nanofiber films could promote the directional migration of fibroblasts and induce cell morphological changes. For the spatially hierarchically nanofiber films, the unidirectional transport of liquid was effectively realized. While the porous polyurethane foam membrane could absorb 9 times its weight in biofluid and retain moisture for up to 10 h. As a result, the biomimetic three-layered scaffolds with different structures can promote wound epithelization and drain biofluid while avoiding wound inflammation caused by excessive biofluid, which is expected to be applied in the field of skin wounds.

Administration of Prophylactic Enoxaparin on the Morning of Surgery Does Not Increase Risk of Blood Transfusion or Wound Drainage Following Internal Fixation of Geriatric Femur Fractures.

Despite standard use of chemoprophylaxis, 30-day incidence of venous thromboembolism after geriatric, those older than 60 years, femur fracture surgery is reported to be up to 10%. Missing one dose of enoxaparin has been proven to increase the risk of developing venous thromboembolism. It is commonplace to hold preoperative chemoprophylaxis the morning of surgery because of concern for intraoperative bleeding or wound drainage. We sought to determine whether administration of prophylactic enoxaparin the morning of surgery resulted in an increased rate of blood transfusion or wound drainage in geriatric patients undergoing femur fracture treatment. We retrospectively reviewed patients older than 60 years who underwent internal fixation of an isolated femur fracture, including femoral neck, intertrochanteric, subtrochanteric, femoral shaft, and distal femur fractures, at a Level 1 trauma center. Medical records, hospital billing data, and radiographs were reviewed to determine patient characteristics such as Charlson Comorbidity Index, enoxaparin dosing, packed red blood cell transfusion, and persistent wound drainage, defined as any drainage requiring utilization of closed incision negative pressure wound therapy. Thirty-day mortality served as the secondary outcome measure. Five hundred seven patients were included. One hundred sixty-four (32%) received enoxaparin on the morning of surgery, whereas 343 (68%) did not. 27% of patients received PRBC transfusion, and this did not differ between groups (27% vs. 28%, P = 0.72). Subgroup analysis of fixation strategies revealed no difference in the frequency of blood transfusion for any fixation type as related to the timing of enoxaparin dosage. Utilization of closed incision negative pressure wound therapy for the treatment of postoperative wound drainage did not differ between dosing groups. No difference was observed in thirty-day mortality between groups (2.4% vs. 2.7%, P = 0.9). Administration of a prophylactic dose of enoxaparin on the morning of surgery does not seem to increase the rate of postoperative blood transfusion or wound drainage after fixation of geriatric femur fracture. Level III, therapeutic.

Wound drain in lumbar arthrodesis for degenerative disease: an experimental, multicenter, randomized controlled trial

INTRODUCTIONDrains for surgical wound management are frequently used in spine surgery. They are often used to decrease the incidence of postoperative hematoma and decrease wound tension. No conclusive evidence in the literature supports using drains to avoid complications in degenerative lumbar spine surgery. PURPOSEWe aimed to evaluate wound drains in patients with lumbar arthrodesis for degenerative disorders based on clinical outcomes, complications, hematocrit, and length of stay. STUDY DESIGNA multicenter randomized prospective controlled clinical trial. PATIENT SAMPLEWe enrolled surgical candidates for posterior lumbar decompression and fusion surgery for degenerative disorders from October 2019 to August 2021. Patients were randomized into the drain or nondrain group at nine hospitals. The inclusion criteria were as follows: patients aged 40 to 80 years with lumbar and radicular pain, lumbar degenerative disorder, and primary surgery up to three levels. The exclusion criteria were bleeding abnormalities, bleeding >2,500 mL and dural tears. OUTCOME MEASURESPreoperative data including Oswestry disability index (ODI), SF-36, lumbar and lower extremity visual analog scale (VAS), body mass index (BMI), hematocrit, and temperature were recorded. Surgical parameters, including surgical time, complications, estimated blood loss (EBL), postoperative temperature and hematocrit (days 1 and 4), dressing saturation, and length of hospital stay (LOS), were registered. METHODSThe two groups were assessed preoperatively, perioperatively and at the 1-month follow-up. A REDCap database was used for registration. Data analysis was performed using classical statistics. RESULTSOne hundred one patients were enrolled using the Redcap database, and 93 patients were evaluated at the final follow-up. Forty-five patients were randomized to the drain group, and 48 were randomized to the nondrain group. The preoperative characteristics were equivalent in both groups: demographic aspects, pain, ODI, SF-36, BMI, hematocrit, and spine pathology. Surgical time, EBL and complications were similar, with no difference between the groups. No difference was found between BMI and complications. No difference was observed in dressing saturation or postoperative temperature between the groups. The postoperative day 4 hematocrit was higher in the nondrain group [36.4% (32–39)] than in the drain group [34% (29.7–37.6)] without statistically differences (p=.054). The LOS was higher in the drain group [4 (3–5) days] than in the nondrain group [3 (2–4) days] (p=.007). The quality-of-life score, SF-36, was higher in the nondrain group [67.9 (53.6–79.2)] than in the drain group [56.7 (49.1–66)] (p=.043). CONCLUSIONSNondrain patients presented shorter LOS and better outcomes, with similar complication rates. No difference was found between BMI and complications. Based on this study, in patients undergoing primary posterior spinal decompression and fusion up to three levels for degenerative lumbar disorders, we do not recommend the use of postoperative drains.

Complications associated to wound drainages in tumor spine surgery: a multicenter surveillance study from the German Spine Registry (DWG-Register)

There is an ongoing debate whether a surgical drainage is beneficial to prevent local accumulation of hematoma and to reduce the rate of wound infections, and neurological deficits. Data from the German Spine Society (DWG) registry were filtered for surgically treated spine tumor cases between 2017 and 2021. Cases were categorized into with (Group I) and without (Group II) placement of a surgical drainage. Subgroups were compared for demographic data, type of surgery, experience of the surgeon and postoperative surgical complications. 10,029 cases were included into final analysis (Group I: 3007; Group II: 7022). There was no significant difference between both groups regarding age or gender distribution. Average morbidity of patients was significantly elevated in Group I (p < 0.05) and the rates of invasive surgery were significantly increased in this group (p < 0.001). Overall complication rates were reported with 12.0% (Group I) and 8.5% (Group II). There were significantly more epidural hematoma (p < 0.001) and motor dysfunction (p = 0.049) as well as deep wound infections (p < 0.001) and implant failures (p = 0.02) in Group I. A surgical wound drainage cannot prevent epidural hematoma.

What's New in Adult Reconstructive Knee Surgery.

What's New in Adult Reconstructive Knee Surgery.

The effect of subcutaneous drain insertion after median sternotomy on surgical site infection in obese patients

Background: Sternal wound infection after cardiac surgery is associated with high morbidity and mortality. This study aimed to assess the effect of subcutaneous wound drainage on surgical site infection in overweight patients undergoing cardiac surgery via median sternotomy.&#x0D; Methods: This prospective study was conducted on 100 obese patients undergoing sternotomy as a part of cardiac surgery from March 2021 to June 2022. The study included two groups. Group 1 (n= 45) had prophylactic subcutaneous drainage after surgery, and Group 2 (n= 55) did not have prophylactic subcutaneous drainage.&#x0D; Results: Hospital stay (7.8±1.9 vs. 8.65±1.38 days; P= 0.013) were higher in patients without drains. Deep sternal wound infection [2 (4.44%) vs. 9 (16.4%); P= 0.105], superficial wound infection [2 (4.44%) vs. 7 (12.7%); P= 0.18] and debridement with secondary suture [1 (2.2%) vs. 6 (10.9%); P= 0.125] were non-significantly lower in patients with subcutaneous drains.&#x0D; Conclusion: Obese cases who received prophylactic subcutaneous wound drainage after sternotomy wound closure could have a lower incidence of wound complications. A larger randomized trial is recommended.

Comparative study of two elastic fixation systems in single-segment lumbar disc herniation surgery for nucleus pulposus extraction

To investigate the clinical application of two elastic pedicle internal fixation systems in single-segment lumbar disc herniation fenestration. A retrospective analysis of 64 patients with lumbar intervertebral disc herniation treated by surgery from June 2019 to March 2021. According to the different elastic fixation systems placed during the operation, the patients were divided into ordinary pedicle screw elastic rod link group (elastic rod group) and a special elastic pedicle screw rigid rod fixed connection group (elastic screw group). There were 33 cases in the elastic rod group, including 18 males and 15 females, aged from 30 to 69 years old with an average of(49.18±10.23) years old;and 31 cases in the elastic screw group, including 16 males and 15 females, aged from 32 to 68 with an average of (49.81±9.24) years old. The operation time, intraoperative blood loss, postoperative wound drainage, and postoperative landing time of the two groups were recorded separately. The visual analogue scale (VAS), Japanese Orthopaedic Association (JOA) score, and Oswestry Disability Index (ODI) were compared before and 3, 12 months after operation. The height of the adjacent vertebral space on the lateral DR film before and 12 months after the operation was measured. The clinical efficacy was evaluated by Macnab standard. All the patients successfully completed the operation, and were followed up. The operation time, intraoperative blood loss, postoperative wound drainage and postoperative landing time in the elastic rod group were(63.73±12.01) min, (89.55±16.07) ml, (81.67±16.00) ml, (3.45±0.75) d , while in the elastic nail group was (62.96±11.54) min, (88.35±17.14) ml, (82.29±15.40) ml, (3.29±0.78) d, the difference was not statistically significant. The symptoms of low back pain and lower extremity numbness were significantly improved in all patients after operation. There was no significant difference in VAS, JOA score and ODI between the two groups before and after surgery (P>0.05). At 12 months after operation, there was no significant difference in the height of the adjacent vertebral space between the upper adjacent vertebral body and the same segment before operation(P>0.05), and there was no significant difference between the groups before and after the operation. According to Macnab criteria, the elastic rod group was excellent in 30 cases, good in 2 cases, fair in 1 case, while the elastic nail group was excellent in 29 cases, good in 2 cases, fair in 0 cases, and there was no significant difference(Z=-0.42, P=0.68). In fenestrated nucleus pulposus extraction for lumbar disc herniation, the two elastic pedicle internal fixation systems are equally effective and can be used. The elastic screw internal fixation system has certain advantages when the distance between the two vertebral bodies is short, and the elastic rod cannot be placed or is difficult to be placed, and it is more widely used.

Impact of negative pressure wound drainage compared with natural wound drainage after thyroid tumour surgery: A meta-analysis.

We conducted a meta-analysis to compare the effectiveness of negative pressure wound drainage to that of spontaneous wound drainage after thyroid tumour surgery. A thorough analysis of the literature up to July 2022 revealed that, of the 1234 patients who used surgery for thyroid tumours, 615 used negative pressure wound drainage and 619 used natural wound drainage. To measure the influence of negative pressure wound drainage in comparison to natural wound drainage following thyroid tumour surgery, mean difference (MD) and odds ratio (OR) with 95% confidence intervals (CIs) were measured using the contentious and dichotomous approaches with a random or fixed-effect model. Subjects who used negative pressure wound drainage had significantly higher averages for drained material (OR, 12.52; 95% CI, 6.78-18.26, P= 0.001), shorter drain placement times (MD, -1.06; 95% CI, 1.57 to -0.55, P= .001), lower rates of infection at the surgical site (OR, 0.17; 95% CI, 0.05-0.60, P= .006), higher rates of wound healing (OR, 5.91; 95% CI, 1.56-22.34, P= .009), and lower rate of wound seroma (OR, 0.21; 95% CI, 0.10-0.42, P< .001) in subjects after thyroid tumour surgery in comparison to subjects who used natural wound drainage after thyroid tumour surgery. Those who used negative pressure wound drainage had significantly higher averages of drained material, shorter drain placement times, lower rates of wound infection at the surgical site, higher rates of wound healing, and lower rates of wound seroma. Care must be used when analysing the results because of the small sample size of 7 of the 13 studies included in the meta-analysis and the lack of studies in several comparisons.

Comparison of the Effect of Intra-Articular, Periarticular, and Combined Injection of Analgesic on Pain Following Total Knee Arthroplasty: A Double-Blinded Randomized Clinical Trial.

Background:The aim of this study was to compare the efficacy of 3 methods of intraoperative analgesic cocktail injection during total knee arthroplasty (TKA)—intra-articular (IA), periarticular (PA), and combined intra-articular and periarticular (IA+PA)—on controlling early postoperative pain.Methods:This was a prospective double-blinded parallel randomized clinical trial. A total of 153 patients scheduled for TKA were allocated to IA, PA, or IA+PA (51 patients each) by block randomization. The primary outcome was morphine consumption. Secondary outcomes were visual analogue scale (VAS) pain, knee flexion, straight leg raising, Knee Society Score (KSS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).Results:The morphine consumption was lowest in the PA group (median = 0, interquartile range [IQR] = 5) and highest in the IA group (median = 10, IQR = 5). The PA group had significantly lower VAS pain at rest than either IA (mean difference = −0.70; 95% confidence interval [CI] = −0.93 to −0.46; p < 0.001) or PA+IA (mean difference = −0.41; 95% CI = −0.65 to −0.18; p < 0.001). The PA group had also lower VAS pain during activity compared with IA (mean difference = −0.63; 95% CI = −0.85 to −0.40; p < 0.001) and IA+PA (mean difference = −0.38; 95% CI = −0.61 to −0.16; p < 0.001). The PA group had significantly greater active knee flexion compared with IA (mean difference = 9.68°; 95% CI = 5.50° to 13.86°; p < 0.001) and IA+PA (mean difference = 5.13°; 95% CI = 0.95° to 9.31°; p = 0.010). Passive knee flexion was greater for PA than IA (mean difference = 7.85°; 95% CI = 4.25° to 11.44°; p < 0.001). Other outcome variables were not significantly different among the 3 groups. The only complications were wound drainage (1 each in the IA and IA+PA groups) and deep venous thrombosis (1 in the IA group).Conclusions:PA was associated with less early postoperative pain and greater active knee flexion compared with the other 2 analgesic methods.Level of Evidence:Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Using Drain-Free Flap Fixation Techniques Versus Traditional Wound Closure With Drain Placement to Prevent Seroma Formation and Its Complications in Breast Cancer Patients Undergoing Mastectomy: A Systematic Review and Meta-analysis.

During the past decade, there has been some controversy related to using flap fixation techniques instead of conventional wound closure methods and drain placement during mastectomy procedures. The purpose of our study was to address this controversy using a systematic review and meta-analysis of current published literature. Nineteen studies met our inclusion criteria. Our sample population consisted of 2,956 participants divided into two groups. The study group (SG) consisted of 1,418 individuals and the control group (CG) consisted of 1,538 participants. We found there was a significant reduction in the incidence of seroma formation (odds ratio [OR] = 0.35; 95% confidence interval, CI [0.3, 0.42]; p < .000) and surgical site infection (OR = 0.65; 95% CI [0.48, 0.88]; p = .006) in the SG compared with the CG. The length of hospital stay was also significantly reduced in the SG (0.59 days; 95% CI [0.73, 0.46]; χ 2 [6, N = 502] = 52.88; p < .000) compared with the CG. The results of our study show that using a flap fixation technique after mastectomy can decrease the patient's risk for seroma formation and surgical site infection while reducing their length of hospital stay. Further studies with longer follow-up periods are warranted to evaluate long-term complications associated with using a flap fixation technique compared with using conventional wound closure techniques and drain placement.

The Medical Needs and Characteristics of Cancer and Progressive Neurologic Disease Patients Who Use Home-Based Medical Care in Korea: A Retrospective Study for 2011-2020.

To investigate the needs and characteristics of patients with cancer and neurologic disorders requiring home-based medical care (HBMC). Retrospective observational study. Patients receiving HBMC on discharge from a tertiary hospital in Korea during 2011-2020. Patients were classified into 3 disease groups: cancer, progressive neurologic disorders (NR), and others. Characteristics and medical needs were assessed in each disease group. Medical needs were categorized based on functional items requiring support or management at the time of registration: respiratory, feeding, urinary system, drain tube, central catheter, wound, medication, and other. Patients with multiple medical needs were assigned to multiple categories. Patients who used HBMC for more than 3months were defined as long-term users; their characteristics were evaluated in the same way. Of the total 655 patients, 47.0% (308) had cancer and 17.3% (113) were NR patients. Among all patients, 78.8% were partially dependent (44.0%) or completely dependent (34.8%) in daily activities, and there were more dependent patients in the NR group (80.5%) than cancer (26.6%). Patients with cancer needed central catheter management the most (43.5%), followed by wound care (36.7%), feeding support (35.1%), and drain tube management (22.1%). NR patients required feeding support the most (80.5%), followed by respiratory support (43.4%), wound care (41.6%), and urinary system support (19.5%). Of all patients, 30.2% (198) were long-term users (NR, 37.9%; cancer, 35.4%). Long-term users were common among patients who needed respiratory support (59.4%), feeding support (48.75), and urinary system support (34.6%). Homebound patients with cancer and progressive neurologic disorders need medical services at home after discharge. Patients who need feeding and respiratory support usually use HBMC for more than 3months. Further studies are needed to design an optimal HBMC that continuously provides medical services to patients with serious illnesses living at home.

Comparison of the Outcome of Gentamycin Lavage Versus Normal Saline Lavage for Axillary Dissection in Modified Radical Mastectomy

Aim: To compare the gentamycin lavage with normal saline lavage after axillary dissection in modified radical mastectomy in terms of mean postoperative wound drainage was the objective of this study. Material: This Randomized controlled trial was conducted at Department of Surgery, Jinnah Hospital Lahore form July, 2018 to June, 2019. Total 100 female patients with 30 to 60 years of age, who underwent modified radical mastectomy for breast cancer. The patients were divided into two groups; group A (operative wound washed with 500ml normal saline) and B (wound washed with 500ml of gentamycin solution (240mg) in addition to the 500ml of normal saline). Results: Mean age and BMI of patients were 49.60±5.83 vs. 49.50±6.723 years (p=0.937) and 27.02±2.90 vs. 27.12±3.33 kg/m2 (p=0.873), in group A and B, respectively. Mean wound drainage were 356.46 ± 59.11 vs. 317.42 ± 51.92 ml (p=0.001), in group A and B, respectively. Conclusions: Gentamycin lavage reduces the postoperative axillary wound drainage after modified radical mastectomy as compared to normal saline lavage. Keywords: Gentamycin Lavage; Axillary Dissection; Modified Radical Mastectomy

Systemic inflammatory response in rats with explosive wound

Aim. To evaluate the temporal changes in circulating cytokines rallying systemic inflammatory response after a blast injury.Material and Methods. Experiments were performed on 60 male Wistar rats (50 rats with blast-related soft tissue injury of the thigh and 10 intact rats). Blast injury was modeled under general anaesthesia using grater firecrackers stuffed with a pyrotechnic mixture. After 3, 7, 14 and 28 days post injury, we carried out a gross examination of the wound and its drainage, measured wound area, assessed local oedema severity, and evaluated serum potassium, myoglobin TNF-α, IL-1β, IL-6, and IL-10.Results. Three to seven days post injury, therewas abundant serous and purulent exudate and pronounced local edema without considerable changes in the wound area. Serum myoglobin and potassium were raised 2.2-2.6-fold and 1.3-fold, respectively (p &lt; 0.05); in addition, we documented the elevation of a major pro-inflammatory cytokine IL-1β. Fourteen days post injury, wound area reduced by 24%, (p &lt; 0.05) along with the decreased wound drainage and local edema of the injured area. Although the levels of serum myoglobin and pro-inflammatory cytokines (in particularIL-6) lowered, they were still significantly higher as compared with the intact rats. Twenty eight days post injury, fibrosis has been completed, epithelialization occurred and only a small scab remained on the wound surface. Yet, serum IL-1β still was 1.3-fold higher than in the intact animals (p &lt; 0.05), albeit IL-6 and TNF-α returned to the reference values. The concentration of anti-inflammatory cytokine IL-10 reached its maximum values relative to the control (3.9-fold, p &lt; 0.05) to the 14th day post injury that was followed by a considerable reduction (though not reaching the reference values) by the period of scar formation.Conclusion. Blast injury in rats is accompanied by a dysregulated balance between pro-inflammatory and anti-inflammatory cytokines throughout all regeneration phases.

ISOLATION AND CHARACTERISTICS OF BACTERIA CITROBACTER SP. SR35 FROM A COAL MINE WASTE DUMP

SummaryBacteria of the genus Citrobacter are found in soil, water, the intestinal tract of animals, human clinical samples (urine, sputum, blood, wound drainage, etc.), also in wastewaters and waste dumps of mines. Gram-negative bacteria SR35, capable of reducing sulfur and sulfate ions, were isolated from the waste dump of the Nadiya coal mine, Chervonograd Mining and Industrial district (Lviv region, Ukraine). The work aimed to identify and study morphological, physical and chemical properties (cell shape, size, Gram staining, sporulation, motility, oxygen requirements, ability to form H2S, utilization of carbon sources, catalase activity, oxidase activity) of isolate SR35. Methods. We used standard microbiological and biochemical research methods (microbial culture, microscopy methods, determination of amilase, lipase activity). Chromosomal DNA was isolated by the method of soft lysis. The 16S rRNA gene was amplified using universal primers 27F and 1492R. It was sequenced by the Sanger method. Phylogenetic reconstruction was performed using the MEGA X program. Identification of isolates was carried out based on both the sequence of the 16S rRNA gene and physiological and biochemical properties. Results. The studied bacteria are rods (0.5–0.8×1.5–2.0μm), which form chains and are capable of reducing nitrate and sulfate ions and assimilating several carbon sources. Glucose, lactose, mannose, mannitol, and inositol are fermented with the formation of acid. Motile. Catalase positive, oxidase negative. Form H2S during growth in Kligler’s medium. According to the results of pairwise alignment of the isolate’s 16S rRNA gene sequence, the highest percentage of identity with representatives of the genus Citrobacter was established (99.23–99.86% identity, coverage 98%) and it was confirmed by phylogenetic reconstruction. Citrobacter sp. SR35 is resistant to 2 μM cadmium (II), 5 mM iron (II), 0.25 mM cobalt (II), 10 mM manganese (II), 0.5 mM copper (II), and 0.1 mM chromium (VI). Conclusions. According to the results of sequencing of the 16S rRNA (accession number GenBank OP279754) gene, and physiological, and biochemical characteristics (oxidase, catalase, metabolism of carbon sources, production of H2S, etc.), it was established that isolate SR35 belongs to the genus Citrobacter.

The Revolutionary Gustav Adolf Neuber: A Tribute to the Father of Aseptic Surgery.

Gustav Adolf Neuber was a celebrated multifaceted German surgeon, who significantly contributed to the establishment of modern surgical Antisepsis techniques as well as the modification and questioning of the use of wound drainage systems. In addition, he reformed architectural and structural concepts regrading operating rooms. In the field of plastic surgery, Gustav Adolf Neuber established a procedure for autologous fat-grafting. The lack and inadequacy of literature sources regarding Neuber´s contribution to common surgical practices and antisepsis vastly disregards the importance of his work. Aim of the current work is not only to restore his reputation as the Father of Antisepsis and autologous fat-grafting but also to make amends for the lack of relevant sources in the current literature. To the best of our knowledge there is no concrete and adequate biographical work regarding G.A. Neuber´s immense contribution in the outstanding English literature. References can only be found in writings or speeches of German Surgeons originating in the mid of the 20th century. The current work is mainly based on the opening speech delivered by Professor Dr Konjentzny (1880-1957) in a sitting ceremony of the "Deutsche Gesellschaft der Chirurgie" on the first of June in 1950 which was dedicated to commemorating Neuber as a tribute for his 100th Birthday and a historical article entitled: "Neuber und die Asepsis".

Results of minimally invasive technology in thyroid surgery

This article analyzes the results of examination and surgical treatment of 572 patients with surgical thyroid gland diseases who were operated on using open and minimally invasive techniques. All patients were divided into several groups depending on the chosen surgical technique. The results of surgical treatment of patients with thyroid diseases in each group were assessed according to the following parameters: duration of surgery, intraoperative blood loss, drainage of a postoperative wound, pain intensity in the postoperative period, complications, length of hospital stay in the postoperative period, cosmetic effect. A decrease in the number of intra- and postoperative complications during minimally invasive surgical interventions has been reliably established.