Aims: Evaluating more fully the forms of daytime consulting department and give some recommends to improve this model. Settings: 6 hospitals at central, provincial and district level. Method: Prospective description and assessment. Subjects: Hospital and department leaders and patients. Results: Daytime treatment department should be expanded and strengthen base on close relationship with in-patient departments, patient selection to reduce the patient load at in-patient department and apply to every level and professional departments. For daytime in-patient bed: in-patient departments should be arranged into special area with simple and flexible organization and management. It should require minimal material facilities and budget and appropriate to patients who live near from the hospital, reduce the nighttime in-patient load and apply to every level and speciality
Beds ; Equipment and Supplies, Hospital

COVID-19/therapy* ; Equipment and Supplies ; Female ; Humans ; Infant, Newborn ; N95 Respirators ; Patient Isolators ; Personal Protective Equipment ; Practice Guidelines as Topic ; Pregnancy ; Pregnancy Complications, Infectious ; Respiratory Protective Devices ; Resuscitation/methods* ; SARS-CoV-2 ; Singapore

This study was conducted with whole home care nurses nationwide to provide secondary analyzed data to understand on their usage of medical equipments and their need of them for a month. This study found that treatments given by home care nurses were nelaton catheterization, bladder washing/urethral washing, newborn care, exchange and care for nasogastric tube and suction in that order of frequency. Second, instruments and equipments used for home care were reported to be stethoscope, patient monitor, blood pressure measuring equipment, air flotation mattresses, beds for patients, mattresses, suctioning device sets, enteral feeding equipment and dressing set in that oder of frequency. Moreover, need assessment of medical instruments and equipments showed renal dialysis was most needed and patient monitor, blood pressure measuring equipment, enteral feeding equipment, solution and other supplies for renal dialysis and beds for patient were necessary in that order. In conclusion, the results of this study investigating special treatments and medical instruments and equipments used for home care patients and analyzing patients' need, were expected to be useful for expansion of application of long-term care insurance for the elderly and health insurance as well as for quality control of home care and development of medial instruments and equipments used at home.
Aged ; Bandages ; Beds ; Blood Pressure Monitors ; Catheterization ; Catheters ; Enteral Nutrition ; Equipment and Supplies ; Home Care Services* ; Home Nursing* ; Humans ; Infant, Newborn ; Insurance, Health ; Insurance, Long-Term Care ; Quality Control ; Renal Dialysis ; Stethoscopes ; Suction ; Urinary Bladder

PURPOSE: When choosing dressing method to treat skin defect by second degree or higher burn, we have to consider method of rapid epithelization and minimization of pain during the treatment. In this study, we used biologic dressing with cultured allogenic keratinocytes for skin defect due to burn. We followed up the degree of epithelization, the degree of pain, and patient satisfaction. METHODS: From June 2003 to June 2006, among the patients with skin defect due to burn, 31 cases with second degree burn(moderate to severe) were selected and biological dressing with cultured allogenic keratinocytes were done. 21 cases did not use cultured allogenic keratinocytes. Most of the patients had second degree burn. We applied cultured allogenic keratinocyte by Kaloderm. For wounds that were not deep enough to effect the dermis, escharectomy was done before applying Kaloderm. After the operation, moist wound site was maintained by dressing with saline gauze for 5-7 days. We compared the condition of the wound site before and after applying Keloderm by grading epithelization by standardized percentage scoring scale(1-5), and degree of pain and patient satisfaction by visual analogue scale(0-10). RESULTS: When cultured allogenic keratinocytes were applied for the same period of time, the mean score of epithelization were 3.29+/-0.529(mean+/-S.D.). Without the application, the mean score of epithelization were 2.86+/-0.655(mean+/-S.D.). The degree of pain was 7.71+/-1.419(mean+/-S.D.) and 2.35+/-0.950(mean+/-S.D.) before and after the application, respectively. The patients' satisfaction score was 6.45+/-0.850(mean+/-S.D.) and 8.45+/-0.961(mean+/-S.D.) before and after the application, respectively. CONCLUSION: Applying biological dressing with cultured allogenic keratinocyte to skin defect due to second degree burn showed satisfactory results in the degree of the epithelization, degree of pain and patients' satisfaction.
Bandages ; Biological Dressings ; Burns ; Dermis ; Humans ; Keratinocytes ; Patient Satisfaction ; Skin

To broadly understand the new direction of biological evaluation for medical devices, we introduced both domestic and international progress of biological evaluation and focused on illustrating the key points on full life-cycle biological evaluation, toxicological risk evaluation, evaluation endpoints and package material evaluation concern as well as how to use the update vision of ISO 10993-1:2018 scientifically and reasonably in order to provide us better services on performing biological evaluation for medical devices.
Equipment and Supplies

The purpose of UDI-PI and related international regulations/guidelines is analyzed. The application practice for the registrant/filing applicant to determine the composition of UDI is given. The article provides reference for the related stakeholders to implement UDI system.
Equipment and Supplies

IMDRF revised the
Equipment Safety ; Equipment and Supplies

OBJECTIVE: To explore the design points of a three-dimensional (3D) printed customized cementless intercalary endoprosthesis with an intra-neck curved stem and to evaluate the key points and mid-term effectiveness of its application in the reconstruction of ultrashort bone segments in the proximal femur. METHODS: Between October 2015 and January 2021, 17 patients underwent reconstruction with a 3D printed-customized cementless intercalary endoprosthesis with an intra-neck curved stem. There were 11 males and 6 females, the age ranged from 10 to 76 years, with an average of 30.1 years. There were 9 cases of osteosarcoma, 4 cases of Ewing sarcoma, 2 cases of chondrosarcoma, 1 case of liposarcoma, and 1 case of myofibroblastoma. The disease duration was 5-14 months, with an average of 9.5 months. Enneking staging included 16 cases of stage ⅡB and 1 case of stage ⅢB. The distances from the center of the femoral head to the body midline and the acetabular apex were measured preoperatively on X-ray images. Additionally, the distances from the tip of the intra-neck curved stem to the body midline and the acetabular apex were measured at immediate postoperatively and last follow-up. The neck-shaft angle was also measured preoperatively, at immediate postoperatively, and at last follow-up. The status of osseointegration at the bone-prosthesis interface and bone growth into the prosthesis surface were assessed by X-ray films, CT, and Tomosynthesis-Shimadzu metal artefact reduction technology (T-SMART). The survival status of the patients, presence of local recurrence or distant metastasis, and occurrence of postoperative complications were assessed. The recovery of lower limb function was evaluated pre- and post-operatively using the Musculoskeletal Tumor Society (MSTS) scoring system, and pain relief was evaluated using the visual analogue scale (VAS) scores. RESULTS: The patient's femoral resection length was (163.1±57.5) mm, the remaining proximal femoral length was (69.6±9.3) mm, and the percentage of femoral resection length/total femoral length was 38.7%±14.6%. All 17 patients were followed up 25-86 months with an average of 58.1 months. During the follow-up, 1 patient died of lung metastasis at 46 months postoperatively, and the remaining 16 patients survived tumor-free. There was no complication such as periprosthetic infection, delayed incision healing, aseptic loosening, prosthesis fracture, or periprosthetic fracture. No evidence of micromotion or wear around the implanted stem of the prosthesis was detected in X-ray and T-SMART evaluations. There was no significant radiolucent lines, and radiographic evidence of bone ingrowth into the bone-prosthesis interface was observed in all stems. There was no significant difference in the distance from the tip of the curved stem to the body midline and the apex of the acetabulum at immediate postoperatively and last follow-up compared with the distance from the center of the femoral head to the body midline and the apex of the acetabulum before operation, respectively (P>0.05), and there was no significant difference in the above indexes between immediate postoperatively and last follow-up (P>0.05). The differences in the neck-shaft angle at various time points before and after operation were also not significant (P>0.05). At last follow-up, the MSTS score was 26.1±1.2 and the VAS score was 0.1±0.5, which were significantly improved when compared with those before operation [19.4±2.1 and 5.7±1.0, respectively] (t=14.735, P<0.001; t=21.301, P<0.001). At last follow-up, none of the patients walked with the aid of crutches or other walkers. CONCLUSION The 3D printed customized cementless intercalary endoprosthesis with an intra-neck curved stem is an effective method for reconstructing ultrashort bone segments in the proximal femur following malignant tumor resection. The operation is reliable, the postoperative lower limb function is satisfactory, and the incidence of complications is low.
Female ; Male ; Humans ; Child ; Adolescent ; Young Adult ; Adult ; Middle Aged ; Aged ; Femur/surgery* ; Lower Extremity ; Bone-Implant Interface ; Femur Head ; Artificial Limbs

Background: In a low resource setting, strategies to optimize Personal Protective Equipment (PPE) supplies are being observed. Alternative protective measures were identified to protect health care personnel during delivery of care Objective: To provide list of recommendations on alternative protective equipment during this Coronavirus Disease 2019 (COVID-19) pandemic Methodology: Articles available on the various research databases were reviewed, appraised and evaluated for its quality and relevance. Discrepancies were rechecked and consensus was achieved by discussion. Recommendations: The use of engineering control such as barriers in the reception areas minimize the risk of healthcare personnel. Personal protective equipment needed are face shields or googles, N95 respirators, impermeable gown and gloves. If supplies are limited, the use of N95 respirators are prioritized in performing aerosol-generating procedures, otherwise, surgical masks are acceptable alternative. Cloth masks do not give adequate protection, but can be considered if it is used with face shield. Fluid-resistance, impermeable gown and non-sterile disposable gloves are recommended when attending to patients suspected or confirmed COVID-19. Used, soiled or damaged PPE should be carefully removed and properly discarded. Extended use of PPE can be considered, while re-use is only an option if supplies run low. Reusable equipment should be cleaned and disinfected every after use Conclusion In supplies shortage, personal protective equipment was optimized by extended use and reuse following observance of standard respiratory infection control procedures such as avoid touching the face and handwashing. The addition of physical barriers in ambulatory and triage areas add another layer of protection
Personal Protective Equipment ; Triage

PURPOSE: With the advances of knowledge in wound healing process and technology in various fields, dressing material of the split thickness skin graft (STSG) donor site was improved. Recently, biologic dressing materials attracted attention and these are used for wound management. The aim of the study was to compare the efficacy of Xe-derma® (porcine acellular dermal matrix) with Kaloderm® (cultured epithelial autografts) for treatment of the donor site. METHODS: From July 2015 to January 2016, 20 patients who had undergone STSG were enrolled. The grafts harvested with a same manner and the donor sites were managed with Xe-derma® or Kaloderm®. We compared days for re-epithelization, number of dressings, ease of application, ease of wound monitoring, pain level and complications. RESULTS: All patients managed by these dressing materials were well healed without any complications. There is no statistically difference (P=0.830) between the days for re-epithelization of Xe-derma® (11.10±0.944) and Kaloderm® (11.00±1.054). Number of dressings of Xe-derma® (1.2±0.421) was lower than Kaloderm® (2.3±0.483). Ease of application of Kaloderm® (7.40±0.516) was easier than Xe-derma® (6.36±0.343). Ease of wound monitoring of Xe-derma® (7.77±0.856) was easier than Kaloderm® (6.25±0.720). Xe-derma® was more painless in 1 day and 3 days after operation than Kaloderm®. CONCLUSION: Advantageous properties of Xe-derma® are improving wound healing, reducing pain by contact to the wound immediately after application and easy of wound monitoring due to its transparency. Therefore, we expected Xe-derma® can be used for management of various wound.
Bandages ; Biological Dressings* ; Humans ; Skin* ; Tissue Donors* ; Transplants* ; Wound Healing ; Wounds and Injuries