A Randomized Clinical Trial on the Use of Antiseptic Solutions for the Pin-Site Care of External Fixators: Chlorhexidine-Alcohol Versus Povidone-Iodine.

Pin-site infections remain a common clinical complication in patients with external fixators. Pin-site care is commonly performed with either chlorhexidine-alcohol solution or povidone-iodine solution. This study aimed to investigate the superiority of chlorhexidine-alcohol solution versus povidone-iodine solution for external fixator pin-site care in pin-site infection. This prospective randomized clinical trial using an open, parallel-group design was conducted in a single Spanish hospital. Eligible consenting patients from November 2018 to May 2019 who underwent placement of an external fixator were included. Patients were randomly assigned to receive pin-site care using either a 2% chlorhexidine-alcohol solution or a 10% povidone-iodine solution. The primary endpoint was the development of a pin-site infection. In total, 568 pins were analyzed (128 patients, with a mean of 4.3 pins per patient). No significant differences were found between groups. However, statistically significant differences were found regarding time and infection variables. The longer the person had the fixator, the higher the risk of infection, t(x) = 5.49, p = .002. Both chlorhexidine-alcohol and povidone-iodine solutions are equally effective antiseptic agents for the prevention of infections in external fixators.

Assessment of the Pneumatic Ischemia Technique Using the Limb Occlusion Pressure During Upper Limb Surgery.

PURPOSE: The purpose of our study was to evaluate effective ischemia and its associated complications using the limb occlusion pressure technique versus standard pneumatic ischemia technique. DESIGN: Single-centered randomized, controlled clinical trial. METHODS: One hundred sixty participants were randomized into two equal and parallel groups: (1) intervention group-LOP technique, and (2) control group-standard pneumatic ischemia technique. FINDINGS: Anesthetic incidences (need to administer analgesics for pain and/or hypnotics for anxiety) were similar in both groups. Statistically significant differences were observed for pain, hyperemia, and hospitalization, with higher values in the control group. Patients in the intervention group had, at 95% confidence, a 2.9 times greater chance of having optimal ischemia (assessed as 9 on the analog scale) than patients in the control group (odds ratio, 2.9; 95% confidence interval, 1.4 to 6.1). CONCLUSIONS: Intervention group patients had lower indexes of hyperemia, pain, and hospital stay.

Prevalencia de úlceras por presión en pacientes sometidos a artrodesis de columna / Prevalence of pressure ulcers in patients undergoing an arthrodesis spine

Objetivos: Identificar la incidencia de úlceras por presión (UPP) en el quirófano en pacientes sometidos a artrodesis de columna realizadas en el intervalo de 2 años. Material y métodos: Diseño descriptivo, trasversal retrospectivo. Revisión de historias clínicas. Resultados: Se valoraron 269 pacientes, 52% mujeres, de una media de edad de 58,7 años. Las posiciones más frecuentes fueron decúbito supino y decúbito prono (34% ambas). La prevalencia de UPP fue del 14%, con un 51,4% de grado II, y la localización más frecuente fue tórax y frente. La mayor frecuencia de aparición fue a partir de las 4 horas de intervención, pero no hallamos relaciones significativas entre la aparición de úlceras por presión y otras variables. Conclusiones: Es necesario llevar a cabo estudios de intervención para prevenir UPP en el área quirúrgica, debido a que existe poca bibliografía al respecto. Por otro lado, la alta incidencia hallada nos hace plantearnos la necesidad de aumentar las medidas preventivas por parte de enfermería

Objectives: Identify the incidence of pressure ulcers (PU) in surgery in patients undergoing spinal fusion performed in the range of 2 years. Material and methods: Descriptive, transversal and retrospective design. Review of medical histories. Results: 269 patients were evaluated, 52% were women and the average age of 58.7 years. The most frequent were supine and prone positions (34% both). PU prevalence was 14%, with 51.4% grade II, the most frequent location was chest and forehead. The highest frequency of occurrence was from 4 hours intervention, but we have not significant relationships between pressure ulcers and other variables. Conclusions: It is necessary to carry out intervention studies to prevent PU in the surgical area, because there is little literature. On the other hand the high incidence found begs the need to increase preventive measures by nurses