Electrolytes ; Therapeutic Irrigation ; methods

Lateral epicondylopathy represents pain in the lateral (radial aspect) of the elbow caused by degeneration in the common extensor tendon. Calcium deposit frequently developes in lateral epicondylopathy, with the prevalence up to 46%. There are considerable debates on its treatment protocols for lateral epicondylopathy so far, likewise, the effective treatment method for calcific lateral epicondylopathy has not been established. We report here a case of chronic intractable calcific lateral epicondylopathy treated with ultrasound-guided barbotage and focused type extracorporeal shock wave therapy (ESWT). To our knowledge, this is the first report of calcific lateral epicondylopathy treated by ultrasound-guided barbotage combined with ESWT.
Calcium ; Clinical Protocols ; Elbow ; Methods ; Prevalence ; Shock ; Tendons ; Therapeutic Irrigation

OBJECTIVETo establish the technical specifications of transbronchoscope whole lung lavage (TBWLL) and to compare the clinical efficacy between TBWLL and bronchoalveolar lavage (BAL) or whole lung lavage (WLL).

METHODSA total of 133 patients with pneumoconiosis admitted to Hunan Prevention and Treatment Institute for Occupational Diseases from 2009 to 2014 were divided into TBWLL group (n=43), BAL group (n=45), and WLL group (n=45). Patients in the TBWLL group received conventional BAL of both lungs under a fiber bronchoscope, as well as sedation and anesthesia; lavage was performed twice in each course. TBWLL was compared with the BAL and WLL in terms of lavage volume. The clinical symptoms, pulmonary function, and blood gas before and after treatment and the safety were evaluated.

RESULTSThe TBWLL group had significantly relieved cough and limitation of activity after lavage (P<0.05). Compared with the BAL group, the TBWLL group had significantly increased single lavage volumes and total lavage volume and a significantly shortened length of hospital stay (P<0.05). The three groups showed no significant short-term changes in clinical symptoms and pulmonary function after lavage. The TBWLL and WLL groups had a significantly lower incidence of postoperative complications than the BAL group (P<0.05).

CONCLUSIONTBWLL has good clinical efficacy, with the advantages of BAL and WLL, and is highly feasible, safe, and effective.

Bronchoalveolar Lavage ; Bronchoscopes ; Humans ; Lung ; physiopathology ; Pneumoconiosis ; therapy ; Therapeutic Irrigation ; methods

The principles of open fracture management are to manage the overall injury and specifically prevent primary contamination becoming frank infection. The surgical management of these complex injuries includes debridement & lavage of the open wound with combined bony and soft tissue reconstruction. Good results depend on early high quality definitive surgery usually with early stable internal fixation and associated soft tissue repair. While all elements of the surgical principles are very important and depend on each other for overall success the most critical element appears to be achieving very early healthy soft tissue cover. As the injuries become more complex this involves progressively more complex soft tissue reconstruction and may even requiring urgent free tissue transfer requiring close co-operative care between orthopaedic and plastic surgeons. Data suggests that the best results are obtained when the whole surgical reconstruction is completed within 48-72 h.
Debridement ; Fractures, Open ; surgery ; Humans ; Reconstructive Surgical Procedures ; methods ; Surgical Wound Infection ; prevention & control ; Therapeutic Irrigation

Following a post-traumatic incident, orthopaedic surgeons often struggle to look for an abundant source of alternative bone graft because the bone defect is too big or when nonunion is refractory to treatment. We present two cases where the patients' bone grafts were harvested from the healthy femur. This process involved the use of a new intramedullary reamer, which allowed the bone graft to be harvested simultaneously during the reaming process.
Adult ; Bone Transplantation ; instrumentation ; methods ; Equipment Design ; Femur ; pathology ; Humans ; Male ; Middle Aged ; Therapeutic Irrigation ; Tissue and Organ Harvesting ; instrumentation ; methods

OBJECTIVETo study the efficacy of endotracheal lavage in neonatal ventilator-associated pneumonia (VAP).

METHODSFifty-eight neonates with VAP between January 2002 and December 2008 were randomly assigned to two groups: lavage and control (n=29 each). After withdrawal from ventilator, both groups received sensitive antibiotics therapy according to sputum culture results as well as supportive treatment. The lavage group was additionally treated with endotracheal lavage (2-3 times daily). The therapeutic effects were compared between the two groups.

RESULTSThere were no significant differences in the average time of mechanical ventilation between the lavage and the control groups. The effective rate in the lavage group (93%) was significantly higher than that in the control group (69%; p<0.05). Three percent of patients in the lavage group required twice or more mechanical ventilation compared with 24% in the control group (p<0.05). Blood gas analysis results were obviously improved in the lavage group 2 hrs after treatment (p<0.01).

CONCLUSIONSEndotracheal lavage can decrease the number in mechanical ventilation and improve therapeutic effects in neonates with VAP.

Female ; Humans ; Incidence ; Infant, Newborn ; Male ; Pneumonia, Ventilator-Associated ; epidemiology ; therapy ; Respiration, Artificial ; statistics & numerical data ; Therapeutic Irrigation ; methods ; Trachea

Adolescent ; Adult ; Bone Transplantation ; Chronic Disease ; Drainage ; methods ; Female ; Humans ; Male ; Middle Aged ; Osteomyelitis ; surgery ; Therapeutic Irrigation

OBJECTIVETo investigate the volume of pulse lavage sufficient for removal of intraoperative bone and polymethyl methacrylate (PMMA) particles.

METHODSFrom 2007.11 to 2008.11, 18 patients with osteoarthritis underwent cemented TKA. Among the patients, 6 patients were male and 12 patients were female, ranging in age from 54 to 77 years, with an average of 61.5 years. The course of disease ranged from 3 to 9 years, mean 6.7 years. Pulse lavage with 1 L of sterile saline was performed for 8 times using a pulsatile irrigator after prothesis fixed. During pulse lavage, aspirated fluid was collected in a 1 L aliquot, and the weight of bone and PMMA particles in each fluid were measured.

RESULTSThe weight of particles peaked in the first 1 L lavage fluid and gradually decreased until the 8th lavage fluid. Significant differences were found between the first vs second, second vs third, and third vs fourth lavage. However, no significant differences were found beyond the fourth lavage.

CONCLUSIONThe results of this study indicates that 4 L of pulse lavage is effective for removing the bone and PMMA particles during cemented TKA.

Aged ; Arthroplasty, Replacement, Knee ; methods ; Female ; Humans ; Male ; Middle Aged ; Polymethyl Methacrylate ; Sodium Chloride ; administration & dosage ; Therapeutic Irrigation

PURPOSE: To compare surgical results between conventional intraocular lens (IOL) implantation using an ophthalmic viscosurgical device (OVD) and IOL implantation using a balanced salt solution (BSS) after irrigation/aspiration (I/A) of the lens cortex. METHODS: A randomized prospective study was conducted on 62 patients who underwent cataract surgery. Following completion of conventional I/A of the lens cortex, we divided patients into two groups according to whether or not BSS was used. In group A (n = 31), the anterior chamber and the capsular bag were completely filled with an OVD before IOL implantation. On the other hand, in group B (n = 31), BSS was irrigated into the anterior chamber through a previous side port during IOL implantation. Surgical results were compared between the two groups. RESULTS: In both groups, IOP peaked six hours after surgery. The occurrence of an IOP spike by postoperative day one was observed in six cases (6 / 31) in group A and in no cases (0 / 31) in group B, a difference that was statistically significant (p = 0.024). The values of endothelial cell density, central corneal thickness, anterior chamber inflammation, myopic shift, and posterior capsule opacification were not significantly different between the two groups. CONCLUSIONS: Compared with the use of OVD for IOL implantation, use of BSS during IOL implantation resulted in reductions in postoperative IOP spike and OVD removal time.
Aged ; Anterior Chamber/*surgery ; Cataract Extraction ; Device Removal ; Humans ; Intraocular Pressure ; Lens Implantation, Intraocular/*methods ; Middle Aged ; Phacoemulsification/*instrumentation/*methods ; Prospective Studies ; Therapeutic Irrigation/*methods

OBJECTIVETo investigate the effect of closed vacuum drainage combined with heparin irrigation in the treatment of scald burns with seawater immersion in rabbits.

METHODSTwenty New Zealand rabbits were subjected to deep partial-thickness scald burns in 4 regions on the bilateral skin of the spine. The wounds were managed with common dressing (group A), common dressing after seawater immersion (group B), closed vacuum drainage after seawater immersion (group C), or closed vacuum drainage combined with heparin irrigation after seawater immersion (group D). Wound effusion and tissue necrosis were observed at 1, 3, 5 and 7 days after the burns. Tissue samples were collected from the wounds for HE staining and immunohistochemistry for VEGF and CD31, and the changes of capillary endothelial cells in the wound were observed using electron microscopy. The water content in the wound tissues was determined, and the wound healing rate was calculated after the injury.

RESULTSSea water immersion of the wound results in earlier onset of edema and more extensive tissue necrosis in the scalded rabbits. The mean necrotic area in groups C and D was smaller than that in group B early after the burns, and vacuum drainage promoted necrotic tissue elimination and accelerated wound healing. Early after the burns, water content in the tissues increased with time in all the groups and reached the highest level at 3 days, and was significantly lower in groups C and D than in group B. Pathologically, vascular endothelial cell damage at the wound site was worsened after seawater immersion. In group D, the basement membrane damage was milder and the endothelial cell membrane remained intact at the wound site, where new blood vessels occurred at 3 days after the burns, a time earlier than that in the other 3 groups with also the highest vascular density.

CONCLUSIONSClosed vacuum drainage combined with heparin irrigation can relieve edema at the scald wound with seawater immersion, improve microcirculation, accelerate the removal of necrotic tissue, and promote the growth of new blood vessels.

Animals ; Burns ; therapy ; Drainage ; methods ; Edema ; Endothelial Cells ; cytology ; Heparin ; therapeutic use ; Rabbits ; Seawater ; Skin ; injuries ; Therapeutic Irrigation ; Vacuum ; Wound Healing