Wound closure after knee and hip replacement (TKA and THA): Survey results on the clinical practice in Spain. / Cierre de herida en cirugía protésica de rodilla y cadera (PTR y PTC): Resultados de una encuesta sobre la práctica clínica en España.

BACKGROUND AND OBJECTIVE: In orthopedic surgery, it is clear that an optimal standardized closure technique has not yet been developed. Locally, there are no objective data describing the standard surgical practice in wound closure. The aim of this study is to analyze the clinical practice of surgical wound closure in orthopedic surgery by means of a survey of a representative local sample and thus obtain information on the context of closure in Spain. METHOD: an ad hoc group of specialists in orthopedic surgery and traumatology was formed. The group of experts, after analyzing the literature, developed a questionnaire of 32 closed multiple-choice questions divided into the following blocks: hemostasis, surgical wound closure (deep, superficial, and cutaneous), and dressings. RESULTS: A total of 471 surgeons responded to the survey completely and with sufficient information to perform the descriptive analysis. 79% believe that ATX can influence the decrease in surgical site infection rate. 96% believe that the type of deep closure at the level of the arthrotomy could influence outcomes and complications after hip and/or knee replacements. 85% believe that the type of shallow closure at the subcutaneous level may influence outcomes and complications after hip and/or knee replacement. 64% of surgeons use single-use incisional negative pressure therapy for the treatment of surgical wound complications (seroma, prolonged drainage, dehiscence). CONCLUSIONS: There is a high level of variability in wound closure in our setting and a low level of training on the subject. The authors recommend that the different scientific societies invest resources to improve training in this field and reduce the percentage of surgeons who are considered inadequately trained, as well as adapting closure techniques to those considered gold standard according to the evidence.

[Translated article] Wound closure after knee and hip replacement (TKA and THA): Survey results on the clinical practice in Spain.

BACKGROUND AND OBJECTIVE: In orthopaedic surgery, it is clear that an optimal standardised closure technique has not yet been developed. Locally, there are no objective data describing the standard surgical practice in wound closure. The aim of this study is to analyse the clinical practice of surgical wound closure in orthopaedic surgery by means of a survey of a representative local sample and thus obtain information on the context of closure in Spain. MATERIAL AND METHOD: An ad hoc group of specialists in orthopaedic surgery and traumatology was formed. The group of experts, after analyzing the literature, developed a questionnaire of 32 closed multiple-choice questions divided into the following blocks: hemostasis, surgical wound closure (deep, superficial, and cutaneous), and dressings. RESULTS: A total of 471 surgeons responded to the survey completely and with sufficient information to perform the descriptive analysis. 79% believe that ATX can influence the decrease in surgical site infection rate. 96% believe that the type of deep closure at the level of the arthrotomy could influence outcomes and complications after hip and/or knee replacements. 85% believe that the type of shallow closure at the subcutaneous level may influence outcomes and complications after hip and/or knee replacement. 64% of surgeons use single-use incisional negative pressure therapy for the treatment of surgical wound complications (seroma, prolonged drainage, dehiscence). CONCLUSIONS: There is a high level of variability in wound closure in our setting and a low level of training on the subject. The authors recommend that the different scientific societies invest resources to improve training in this field and reduce the percentage of surgeons who are considered inadequately trained, as well as adapting closure techniques to those considered gold standard according to the evidence.

Embolismo gaseoso tras el uso del sistema de lavado CarboJet® durante la hemiartroplastía de cadera: Caso clínico y revisión de la literatura / Gas embolism after the use of the CarboJet® lavage system during hip hemiarthroplasty: Clinical case and literature review

Presentamos el caso de una paciente de 89 años de edad que sufrió paro cardiorrespiratorio durante la realización de hemiartroplastía de cadera cementada que precisó resucitación cardiopulmonar. Esta complicación ocurrió inmediatamente después de usar el sistema de lavado mediante dióxido de carbono CarboJet®, y se atribuyó a embolismo gaseoso, tras descartar otras entidades. Se discuten los posibles factores que pueden contribuir a esta complicación quirúrgica.

Case report of an 89 year-old patient who had cardiorespiratory arrest during cemented hip hemiarthroplasty and required cardiopulmonary resuscitation. This complication occurred immediately after using the carbon dioxide-based lavage system known as CarboJet® and was attributed to gas embolism once other entities were ruled out. The possible factors that may contribute to this surgical complication are discussed.

[Gas embolism after the use of the CarboJet lavage system during hip hemiarthroplasty. Clinical case and literature review]. / Embolismo gaseoso tras el uso del sistema de lavado CarboJet durante la hemiartroplastía de cadera. Caso clinico y revisión de la literature.

Case report of an 89-year-old patient who had cardiorespiratory arrest during cemented hip hemiarthroplasty and required cardiopulmonary resuscitation. This complication occurred immediately after using the carbon dioxide-based lavage system known as CarboJet and was attributed to gas embolism once other entities were ruled out. The possible factors that may contribute to this surgical complication are discussed.

[Large intraosseous ganglion in the femoral condyle treated with resorbable cement: clinical case and differential diagnosis]. / Ganglión intraóseo de gran tamaño en cóndilo femoral tratado con cemento reabsorbible: caso clínico y diagnóstico diferencial.

We report a case of a very large intraosseous ganglion in a patient with Down's syndrome. The lesion was located in the medial femoral condyle and was diagnosed with imaging techniques (X-rays, CAT scan, bone scan and magnetic resonance imaging) that allowed measuring it. Treatment consisted of curettage and filling of the defect with the skeletal repair system carbonated apatite resorbable cement which allowed for immediate early weight bearing during the postoperative period in a non-cooperative patient. We think the location and size of the lesion are of interest, as well as the peculiarities of the patient, which may help understand the pathophysiology of this entity. As far as we know, the use of resorbable cement to treat this kind of lesions has not been reported.