Effect of an acrylic terpolymer barrier film beneath transparent catheter dressings on skin integrity, risk of dressing disruption, catheter colonisation and infection.

OBJECTIVES: We assessed the effect of a skin-protective terpolymer barrier film around the catheter insertion site on frequency of dressing disruptions and skin integrity issues (hyperaemia, skin irritation, residues of adhesives and moisture under the dressing). Secondary outcomes included colonisation of the central venous catheter (CVC) and rates of central line-associated bloodstream infection. RESEARCH METHODOLOGY: A monocentric, open-label, randomised controlled trial was performed comparing a control group receiving standard transparent catheter dressings without the skin-protecting barrier film and an intervention group receiving a transparent chlorhexidine-impregnated dressing with use of the skin-protective acrylic terpolymer barrier film (3M™ Cavilon™ No - Sting Barrier Film, 3 M Health Care, St. Paul, MN, USA). RESULTS: Sixty patients were enrolled and randomised in the study accounting for 60 central venous catheters and a total of 533 catheter days. Dressing disruptions occurred more frequently and at sooner time point in the control group. Skin integrity issues were significantly less observed in the intervention group. No differences in CVC colonisation or central line-associated bloodstream infection were observed. CONCLUSIONS: The application of a barrier film creating a skin-protective polymer layer beneath transparent catheter dressings is associated with less dressing disruptions and skin integrity issues without altering the risk of infectious complications if used in combination with a chlorhexidine-impregnated catheter dressing.

[Ormond's disease complicated by infectious endocarditis].

A case of retroperitoneal fibrosis (Ormond's disease) is reported. It is known to be usually diagnosed at the late stages of renal complications Urinary infection ended in infectious endocarditis caused by E. faecium showing multiple resistance to antibiotics. Moderate immunosuppressive and modern antibacterial (daptomycin) therapy ensured remission of both Ormond's diseases and endocarditis.

[Impact of a pneumonia prevention protocol on the results of treatment in patients in the acute period of stroke].

To evaluate the efficiency of introducing a local protocol for preventing pneumonia in the acute period of stroke, the authors analyzed the results of treating 52 intensive care unit patients who had a higher than 75% pneumonia risk. These patients were divided into 2 groups: a control group (before introduction of the protocol) (n = 25) and a study group (after introduction of the protocol (n = 27). A retrospective analysis showed a significant reduction in the total incidence of pneumonia (56 and 18.5%; p < 0.05), in the incidence of ventilator-associated pneumonia (65/1000 and 19/1000 days of artificial ventilation (AV); p < 0.05), total mortality (48.0 and 14.8%; p < 0.01) and mortality among patients on AV (78.6 and 21.1%; p < 0.005).

[Experience of surgical treatment of the patients with post-burn cicatricial gastric stenosis]. / Opyt khirurgicheskogo lecheniia bol'nykh s posleozhogovym rubtsovym stenozom zheludka.

Experience of surgical treatment of 48 patients with postburn cicatricial gastric stenosis was presented. In 28 of them the combined gastric and esophageal stricture were reveal. Gastric resection according to Billroth-I was performed in 26 patients, gastroduodenostomy according to Finney--in 4, gastric resection according to Hoffmeister-Finsterer--in 5, gastroenterostomy according to Belfler-Brown--in 10 and other operations--in 3. One patient died. For the treatment of combined stricture esophageal passability was restored using bougienage, optimally--along the ring-like thread-guide, conducted, while performing gastric operation, through the mouth, esophagus, stomach and brought out via microgastrostomy.