Modified kloen approach treatment for acetabular fractures.

To evaluate the feasibility and efficacy of modified Kloen approach for the treatment of ace tabular fractures through lateral window exposure beneath fascia iliaca with superior ramus of pubis exposure by internal small incision. Matta radiological criteria was employed to evaluate the post operation recovery, and modified D'Aubigne-Postel evaluation system was adopted for demonstration of hip joint function condition. There is no incision infection, neurovascular trauma or postoperative lymphorrhagia. 42 patients cooperated with the following up of 11.2 months. The average bone healing time was 13 weeks. Matta radiological criteria was to evaluate the postoperative fracture quality, 18 case with excellent recovery, 16 cases with good recovery, 4 cases with normal recovery and 1 case with bad recovery. Modified D'Aubigne-Postel evaluation was taken 6 months after surgery, 17 cases with excellent recovery, 22 cases with good recovery, 2 cases with normal recovery and 1 case with bad recovery. There was no internal fixation loosening, breakage or inguinal hernia. The modified Kloen approach can improve iliofemoral vascular activity, expense exposure range for restoration and fixation. Besides, the exposure of articular surface could ensure the condition of restoration quality, and avoid the incidence of postoperative hernia.

Preliminary Experience of Nontransecting Urethroplasty for Pelvic Fracture-related Urethral Injury.

OBJECTIVE: To evaluate the urinary outcomes and preservation of erectile function in patients with pelvic fracture-related urethral injury (PFUI) after nontransecting spongiosum anastomotic urethroplasty (NTSAU). MATERIALS AND METHODS: Fifty-nine male patients with PFUI following traumatic pelvic fracture underwent NTSAU. Inclusion criteria were age 18-60 years, posterior urethral stenosis <2.5 cm without previous urethroplasty, and intact erectile function. Exclusion criteria were history of open urethroplasty, long-segment posterior urethral stenosis (>2.5 cm), preoperative impotency, or age over 60 years. Pre- and postoperative outcome analyses were performed with a paired t test and chi-square test. RESULTS: Between January 2011 and August 2015, 59 patients with a mean age of 38.5 years (range, 21-59 years) and a mean stricture length of 2.0 cm (range, 1-2.5 cm) underwent simple NTSAU (group 1, n = 41) or NTSAU with inferior pubectomy (group 2, n = 18). Patients were followed for a mean 25 months (range, 12-60 months). The primary success rate was 96.6% (57 of 59), and stricture recurrence occurred in 2 (3.4%) patients. The secondary outcomes revealed no significant changes in number of events, tip rigidity, or duration of best episode between pre- and postoperative nocturnal penile tumescence test (on RigiScan) in group 1, but a slight decrease in group 2 (P <.05). The limitation was the small sample size and heterogeneous population. CONCLUSION: NTSAU is a safe, feasible, minimally invasive procedure for PFUI, optimizing erectile preservation.

Effect of Chahuang ointment on prevention of phlebitis from peripherally inserted central catheter: randomized clinical trial / Efeito da pomada Chahuang na prevenção de flebite de cateter central inserido perifericamente: ensaio clínico randomizado / Efecto de la pomada de Chahuang en la prevención de la flebitis por catéter central insertado periféricamente: ensayo clínico aleatorizado

ABSTRACT Objective: To assess the effect of Chahuang ointment, a Chinese herbal ointment, on the prevention of phlebitis in patients with peripherally inserted central catheters. Method: This was a multicenter randomized controlled trial, with 171 eligible patients randomly assigned into one of three groups: the Chahuang ointment group, the Mucopolysaccharide Polysulfate cream group, and the control group. The degrees of vein injuries at 72 hours after peripherally inserted central catheter insertion were the primary outcome. Secondary outcomes were the vascular wall thickness, tissue edema and microthrombus evaluated by Color Doppler Flow Imaging, the vascular endothelial growth factor, and endothelin-1 (ET-1) expression in vivo. Results: Compared with the control group, the Chahuang ointment group showed significantly lower incidence of postoperative phlebitis, tissue edema, and microthrombus at 72 hours after peripherally inserted central catheter insertion (all P<0.01). The VEGF and ET-1 expression were significantly inhibited in the Chahuang ointment group after 3 days of treatment (both P<0.01). There were no statistical differences in the degree of vein injuries, microthrombus, or tissue edema between the Chahuang ointment and mucopolysaccharide polysulfate groups (all P>0.05). Conclusion: Chahuang ointment was shown to provide effective prevention and protection against phlebitis after peripherally inserted central catheter insertion.

RESUMO Objetivo: Avaliar o efeito da pomada Chahuang, uma pomada à base de ervas chinesas, na prevenção de flebite em pacientes com cateter central de inserção periférica. Método: Este foi um estudo multicêntrico randomizado controlado, com 171 pacientes elegíveis aleatoriamente designados em um de três grupos: o grupo de pomada Chahuang, o grupo de creme de polissulfato de mucopolissacarídeo e o grupo de controle. Os graus de lesões das veias em 72 horas após a inserção do cateter central perifericamente inserido foram o resultado primário. Os desfechos secundários foram a espessura da parede vascular, edema tecidual e microtrombos avaliados por Color Doppler Flow Imaging, o fator de crescimento endotelial vascular e a expressão da endotelina-1 (ET-1) in vivo. Resultados: Comparado com o grupo controle, o grupo de pomada Chahuang apresentou incidência significativamente menor de flebite pós-operatória, edema de tecido e microtrombos 72 horas após a inserção do cateter central inserido perifericamente (todos P <0,01). A expressão de VEGF e ET-1 foi significativamente inibida no grupo de pomada Chahuang após 3 dias de tratamento (ambos P <0,01). Não houve diferenças estatísticas no grau de lesões das veias, microtrombos ou edema de tecido entre os grupos de pomada de Chahuang e polissulfato de mucopolissacarídeo (todos P> 0,05). Conclusão: A pomada Chahuang demonstrou fornecer prevenção e proteção eficazes contra flebite após a inserção do cateter central perifericamente inserido.

RESUMEN Objetivo: Evaluar el efecto de la pomada Chahuang, una pomada herbal china, sobre la prevención de la flebitis en pacientes con catéteres centrales insertados periféricamente. Método: Este fue un ensayo controlado aleatorio multicéntrico, con 171 pacientes elegibles asignados al azar en uno de tres grupos: el grupo de ungüento Chahuang, el grupo de crema de polisulfato de mucopolisacárido y el grupo de control. Los grados de lesiones de las venas a las 72 horas después de la inserción del catéter central insertado periféricamente fueron el resultado primario. Los resultados secundarios fueron el grosor de la pared vascular, el edema tisular y el microtrombo evaluados por imágenes de flujo con Doppler en color, el factor de crecimiento endotelial vascular y la expresión de endotelina-1 (ET-1) in vivo. Resultados: En comparación con el grupo de control, el grupo de ungüento Chahuang mostró una incidencia significativamente menor de flebitis posoperatoria, edema tisular y microtrombos a las 72 horas después de la inserción del catéter central insertado periféricamente (todos P <0,01). La expresión de VEGF y ET-1 se inhibió significativamente en el grupo de pomada de Chahuang después de 3 días de tratamiento (ambos P <0,01). No hubo diferencias estadísticas en el grado de lesiones venosas, microtrombos o edema tisular entre los grupos de pomada de Chahuang y polisulfato de mucopolisacárido (todos P> 0,05). Conclusión: Se demostró que la pomada de Chahuang proporciona una prevención y protección eficaces contra la flebitis después de la inserción de un catéter central insertado periféricamente.