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2.
Khirurgiia (Mosk) ; (1): 34-41, 2021.
Artigo em Russo | MEDLINE | ID: mdl-33395510

RESUMO

OBJECTIVE: To compare early and long-term results of various mesh prosthesis fixation methods in laparoscopic inguinal hernia repair. MATERIAL AND METHODS: It is a prospective clinical non-randomized trial. The study included 212 patients. Conventional stapler fixation (112 patients), self-gripping mesh implants (48 patients) and n-butyl cyanoacrylate adhesive fixation (52 patients) were compared. We estimated surgery time, pain syndrome severity in early and long-term postoperative period, postoperative morbidity and recurrence rate were evaluated. RESULTS: Early postoperative morbidity, activation of patients and hospital-stay were similar in all groups. Pain syndrome within 6 postoperative hours in the first group exceeded the same parameter in the second group by 1.23 times (95% CI 1.15-1.31, p<0.05) and by 1.19 times in the third group (95% CI 1.12-1.26, p<0.05). Within 12 hours, pain syndrome in the first group was 1.27 times more severe compared to the third group (95% CI 1.20-1.34, p<0.05). Pain syndrome in long-term period was similar in all groups. In the first group, one recurrence was detected (0.9%). CONCLUSION: There were no significant between-group differences. However, we found the correlation of postoperative pain syndrome with mesh implant fixation technique.


Assuntos
Hérnia Inguinal , Herniorrafia , Laparoscopia , Implantação de Prótese , Telas Cirúrgicas , Cianoacrilatos/administração & dosagem , Cianoacrilatos/efeitos adversos , Hérnia Inguinal/cirurgia , Herniorrafia/efeitos adversos , Humanos , Dor Pós-Operatória/etiologia , Estudos Prospectivos , Implantação de Prótese/efeitos adversos , Implantação de Prótese/métodos , Telas Cirúrgicas/efeitos adversos , Técnicas de Sutura/efeitos adversos , Procedimentos Cirúrgicos sem Sutura/efeitos adversos , Procedimentos Cirúrgicos sem Sutura/métodos , Fatores de Tempo , Adesivos Teciduais/administração & dosagem , Adesivos Teciduais/efeitos adversos , Resultado do Tratamento
4.
Eur J Vasc Endovasc Surg ; 60(3): 469-478, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32620348

RESUMO

OBJECTIVE: In vascular and cardiac surgery, the ability to maintain haemostasis and seal haemorrhagic tissues is key. Fibrin and thrombin based sealants were introduced as a means to prevent or halt bleeding during surgery. Whether fibrin and thrombin sealants affect surgical outcomes is poorly established. A systematic review and meta-analysis was performed to examine the impact of fibrin or thrombin sealants on patient outcomes in vascular and cardiac surgery. DATA SOURCES: Cochrane CENTRAL, Embase, and MEDLINE, as well as trial registries, conference abstracts, and reference lists of included articles were searched from inception to December 2019. REVIEW METHODS: Studies comparing the use of fibrin or thrombin sealant with either an active (other haemostatic methods) or standard surgical haemostatic control in vascular and cardiac surgery were searched for. The Cochrane risk of bias tool and the ROBINS-I tool (Risk Of Bias In Non-randomised Studies - of Interventions) were used to assess the risk of bias of the included randomised and non-randomised studies; quality of evidence was assessed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. Two reviewers screened studies, assessed risk of bias, and extracted data independently and in duplicate. Data from included trials were pooled using a random effects model. RESULTS: Twenty-one studies (n = 7 622 patients) were included: 13 randomised controlled trials (RCTs), five retrospective, and three prospective cohort studies. Meta-analysis of the RCTs showed a statistically significant decrease in the volume of blood lost (mean difference 120.7 mL, in favour of sealant use [95% confidence interval {CI} -150.6 - -90.7; p < .001], moderate quality). Time to haemostasis was also shown to be reduced in patients receiving sealant (mean difference -2.5 minutes [95% CI -4.0 - -1.1; p < .001], low quality). Post-operative blood transfusions, re-operation due to bleeding, and 30 day mortality were not significantly different for either RCTs or observational data. CONCLUSION: The use of fibrin and thrombin sealants confers a statistically significant but clinically small reduction in blood loss and time to haemostasis; it does not reduce blood transfusion. These Results may support selective rather than routine use of fibrin and thrombin sealants in vascular and cardiac surgery.


Assuntos
Perda Sanguínea Cirúrgica/prevenção & controle , Procedimentos Cirúrgicos Cardíacos , Adesivo Tecidual de Fibrina/administração & dosagem , Hemostasia , Hemostáticos/administração & dosagem , Hemorragia Pós-Operatória/prevenção & controle , Trombina/administração & dosagem , Adesivos Teciduais/administração & dosagem , Procedimentos Cirúrgicos Vasculares , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Adesivo Tecidual de Fibrina/efeitos adversos , Hemostáticos/efeitos adversos , Humanos , Hemorragia Pós-Operatória/etiologia , Fatores de Risco , Trombina/efeitos adversos , Fatores de Tempo , Adesivos Teciduais/efeitos adversos , Resultado do Tratamento , Procedimentos Cirúrgicos Vasculares/efeitos adversos
5.
Br J Nurs ; 29(8): S20-S27, 2020 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-32324453

RESUMO

Vascular access device insertion is a common procedure in healthcare, and complications associated with vascular access can be serious and cause considerable patient harm. The use of care bundles to reduce the risks of these complications is well documented. However, the removal of devices, especially those associated with medical adhesive, can cause significant skin injuries, which often could be avoided if this aspect is included in the care bundle and the risk factors are better understood in healthcare. Appeel Sterile is an effective sterile silicone-based medical adhesive remover that is available in a variety of formats. It is the only sterile medical adhesive remover available, which makes it the safest choice for use with vascular access devices.


Assuntos
Cateterismo Periférico/enfermagem , Silicones/uso terapêutico , Higiene da Pele/enfermagem , Ferimentos e Lesões/prevenção & controle , Humanos , Risco , Pele/lesões , Higiene da Pele/métodos , Adesivos Teciduais/efeitos adversos , Ferimentos e Lesões/etiologia
7.
Emerg Med J ; 37(4): 212-216, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31919233

RESUMO

OBJECTIVE: The use of tissue adhesives has become a popular option for closure of wounds in the ED. There have been a growing number of reports of inadvertent tissue adhesive injuries including closure of the eyelids. We aim to identify and compare various removal methods of tissue adhesives described in the literature in an exploratory trial. METHODS: A review was first conducted to establish all published methods for the removal of medical-grade tissue adhesives as well as commercial cyanoacrylates. This search was conducted on PubMed, Google Scholar and Google. All articles that reported attempts at removal of cyanoacrylate glues were included. These methods were then tested on a porcine model in an exploratory trial. Incisions were made on pigskin and closed with Histoacryl, a tissue adhesive. Three removal methods were tested-gentle rubbing with test compound after 45 or 90 s, as well as soaking in test compound. Removal methods that were successful underwent repeat testing. RESULTS: A total of 37 sources were reviewed with 13 different removal methods suggested. Based on the information, we tested 24 different compounds. Soaking of Histoacryl-closed wounds in Polydexa ear/eye drops displayed consistent success in achieving complete separation of incision edges after 2 hours. Several other soapy substances and antibiotic ointments showed potential but were not as consistent. CONCLUSION: In conclusion, in our trial of removal methods of Histoacryl, soaking in Polydexa antibiotic drops consistently facilitated removal after 2 hours. This approach can be attempted after inadvertent Histoacryl injury.


Assuntos
Dexametasona/uso terapêutico , Pálpebras/anormalidades , Neomicina/uso terapêutico , Polimixina B/uso terapêutico , Aderências Teciduais/complicações , Aderências Teciduais/tratamento farmacológico , Adesivos Teciduais/efeitos adversos , Animais , Dexametasona/normas , Combinação de Medicamentos , Embucrilato , Pálpebras/efeitos dos fármacos , Pálpebras/fisiopatologia , Humanos , Neomicina/normas , Polimixina B/normas , Suínos , Adesivos Teciduais/uso terapêutico
9.
Vasc Endovascular Surg ; 54(1): 47-50, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31581906

RESUMO

OBJECTIVES: Cyanoacrylate glue is injected for incompetent great saphenous vein (GSV) treatment 5 cm distal to the saphenofemoral junction (SFJ). Although a few reports have investigated the postprocedural remnant stump length, none have focused on the factors affecting glue extension length and the consequent remnant stump length. METHODS: Seventy-nine patients undergoing cyanoacrylate closure using the VenaSeal system at our clinic between August 2018 and November 2018 were investigated. The GSV diameter was measured just before treatment in the supine position 3 cm distal to the SFJ. Cyanoacrylate glue was injected 5 cm distal to the SFJ. RESULTS: The mean glue extension length was 1.13 ± 1.12 cm. The GSV diameter and glue extension length exhibited a significant inversely proportional relationship (P < .001). More specifically, patients with a GSV diameter ≥0.7 cm had a longer remnant stump length than those with a smaller GSV diameter (P < .001). CONCLUSIONS: An increased GSV diameter is likely associated with a decreased glue extension length and, consequently, a longer remnant stump.


Assuntos
Cianoacrilatos/administração & dosagem , Veia Safena , Adesivos Teciduais/administração & dosagem , Varizes/terapia , Adulto , Cianoacrilatos/efeitos adversos , Feminino , Humanos , Injeções Intravenosas , Masculino , Pessoa de Meia-Idade , Veia Safena/diagnóstico por imagem , Veia Safena/fisiopatologia , Adesivos Teciduais/efeitos adversos , Resultado do Tratamento , Ultrassonografia de Intervenção , Varizes/diagnóstico por imagem , Varizes/fisiopatologia
11.
J Vasc Access ; 21(1): 33-38, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31159638

RESUMO

The Infusional Services Team at a large cancer centre in Belfast, Northern Ireland, performed a cross-sectional analysis of two catheter securement technologies to address an area of frequent, but underestimated concern - peripherally inserted central catheter migration and dislodgement. Healthcare practitioner and patient feedback, along with economic impact, were assessed. The costs associated with catheter replacement during the adhesive device group study period were calculated using an average cost per insertion, based on material costs required for the procedure. Other factors were the replacement cost of the adhesive engineered securement device with each dressing change. In the subcutaneous securement group, the material costs were adjusted for use of the subcutaneous device as it remained in situ for the duration of the catheters' dwell time. This review found that subcutaneous securement offers both patient and facilities a safe, effective and economical alternative for device securement with patients who are unable to tolerate or have successful securement with adhesive securement devices. The use of subcutaneous devices provided for reduced risks for peripherally inserted central catheters in terms of dislodgement, migration or malposition, alleviating the potential risks to develop catheter-related thrombosis and device-related infection.


Assuntos
Cateterismo Venoso Central/instrumentação , Cateterismo Periférico/instrumentação , Cateteres de Demora , Cateteres Venosos Centrais , Migração de Corpo Estranho/prevenção & controle , Adesivos Teciduais/uso terapêutico , Cateterismo Venoso Central/efeitos adversos , Cateterismo Venoso Central/economia , Cateterismo Periférico/efeitos adversos , Cateterismo Periférico/economia , Cateteres de Demora/economia , Cateteres Venosos Centrais/economia , Pesquisa Comparativa da Efetividade , Análise Custo-Benefício , Estudos Transversais , Desenho de Equipamento , Migração de Corpo Estranho/economia , Migração de Corpo Estranho/etiologia , Custos de Cuidados de Saúde , Humanos , Irlanda do Norte , Fatores de Tempo , Adesivos Teciduais/efeitos adversos , Adesivos Teciduais/economia , Resultado do Tratamento
12.
Plast Reconstr Surg ; 145(1): 32-37, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31881600

RESUMO

Skin adhesives have become standard in wound closure as alternatives to traditional sutures or as sterile occlusive dressings after surgery of all types. The literature is replete with case reports of contact dermatitis following exposure to cyanoacrylate-based adhesives, such as 2-octyl cyanoacrylate. Nonetheless, it has been the impression of the senior author and others that the incidence of allergic and/or contact dermatitis is much higher than commonly considered. The authors prospectively studied 102 consecutive patients who underwent breast surgery performed by the senior author with 2-octyl cyanoacrylate placed over incisions as an occlusive dressing. Two patients with a known glue allergy did not receive cyanoacrylate at surgery but were scratch tested to confirm the diagnosis. All patients were followed postoperatively. Twelve patients went on to develop significant dermatitis postoperatively after glue placement. Cyanoacrylate was confirmed as the cause of all rashes by allergy scratch testing for a total incidence of 14 percent (14 patients). Given the popularity of cyanoacrylate products across emergency rooms, clinics, and operating rooms, awareness of the true incidence of these reactions may caution against their use in the future. CLINICAL QUESTION/LEVEL OF EVIDENCE:: Therapeutic, IV.


Assuntos
Cianoacrilatos/efeitos adversos , Dermatite de Contato/epidemiologia , Mamoplastia/métodos , Adesivos Teciduais/efeitos adversos , Técnicas de Fechamento de Ferimentos/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Dermatite de Contato/etiologia , Feminino , Humanos , Incidência , Pessoa de Meia-Idade , Estudos Prospectivos , Virginia/epidemiologia , Adulto Jovem
13.
Am J Surg Pathol ; 44(4): 490-494, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31577551

RESUMO

Patients undergoing transthoracic needle core lung biopsy (TTNB) are at risk for biopsy-related pneumothorax. Instilling pleural sealant at the pleural puncture site reduces this risk. The impact of histologic changes associated with pleural sealant on assessing the histologic type and pathologic stage in lung cancer resection specimens has not been previously evaluated. All lung cancer resection specimens from 2015 to 2018 in which polyethylene glycol hydrogel pleural sealant was instilled during TTNB were reviewed. Thirty-three cases were identified. TTNB preceded lobectomy by an average of 35 days. Amphophilic, weakly polarizable, crinkled pleural sealant material was associated with tumor in 11 cases (33%), including 8 adenocarcinomas, 2 squamous cell carcinomas, and 1 pleomorphic carcinoma that averaged 1.7 cm in greatest dimension. Surrounding the sealant material was a 0.25 to 1.0 cm in greatest dimension pseudocystic space with a thin granulomatous rim of macrophages and multinucleated giant cells that occupied on average 17% of the tumoral area. Pleural sealant could have impaired assessment of pathologic stage in 1 case by obscuring the visceral pleural elastic layer, but definitive visceral pleural invasion was present nearby. Although hydrogel pleural sealant instilled during TTNB has the potential to obscure important histologic features, in practice, it appears to have little or no adverse impact on the assessment of histologic type and pathologic stage in subsequent lung cancer resection specimens. Recognition of the histologic appearance of hydrogel pleural sealant and its associated tissue response is important for avoiding diagnostic misinterpretation.


Assuntos
Migração de Corpo Estranho/patologia , Neoplasias Pulmonares/patologia , Polietilenoglicóis/efeitos adversos , Adesivos Teciduais/efeitos adversos , Biópsia com Agulha de Grande Calibre , Erros de Diagnóstico , Migração de Corpo Estranho/induzido quimicamente , Humanos , Hidrogéis , Neoplasias Pulmonares/cirurgia , Estadiamento de Neoplasias , Pneumonectomia , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Estudos Retrospectivos
14.
J Wound Ostomy Continence Nurs ; 46(6): 491-496, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31738304

RESUMO

PURPOSE: The purpose of this study was to identify the purpose, type, and site of medical adhesives (MAs) used for patient care and to measure the incidence of medical adhesive-related skin injury (MARSI) among patients in a pediatric intensive care unit (PICU). DESIGN: A prospective observational study. SUBJECTS AND SETTING: The sample comprised 60 children hospitalized at a 13-bed PICU in a university-affiliated tertiary care hospital in Yangsan (southeastern Korea) from August 2 to October 25, 2017. The median age was 2.9 months, and the composition of male and female was 34 (56.7%) and 26 (43.3%), respectively. METHODS: The skin of all participants was examined by first-line staff nurses every shift and occurrences of MARSI were confirmed by a wound care specialist. Characteristics of MA use were analyzed with descriptive statistics, and incidence rates of MARSI were calculated using 3 methods: (1) rate per 100 patients, (2) rate per 100 MAs, and (3) rate per 1000 days of MA use. Chi-squared (χ) tests were conducted to analyze associations between MARSI and sex, age group, and primary service type (medical vs surgical). RESULTS: The total number of MAs used was 414 and the total day of use of MAs was 1424.8. Medical adhesives most frequently used were endotracheal tube fixation devices (55/414) and fixation devices for the face (167/414). The number of MARSI occurrences was 35 cases in 23 patients; skin stripping was the most common form of MARSI (26/35). The incidence rate was 58.3 MARSIs per 100 patients, 8.5 MARSIs per 100 MAs, and 24.6 MARSIs per 1000 days of MA use. The MARSI incidence rate was significantly different based on age group (P = .014). CONCLUSION: We observed a frequent occurrence of MARSI among patients in the PICU, especially in patients requiring long-term use of MAs such as central line dressings or in MAs placed in high-moisture areas such as near an endotracheal tube. We highlight the importance of regular skin inspection and frequent but gentle replacement of MAs for prolonged use of MAs in critically ill children.


Assuntos
Pele/lesões , Adesivos Teciduais/normas , Feminino , Humanos , Lactente , Unidades de Terapia Intensiva Pediátrica/organização & administração , Unidades de Terapia Intensiva Pediátrica/estatística & dados numéricos , Masculino , Estudos Prospectivos , República da Coreia , Pele/fisiopatologia , Adesivos Teciduais/efeitos adversos , Adesivos Teciduais/uso terapêutico
15.
Indian J Ophthalmol ; 67(10): 1610-1616, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31546491

RESUMO

Purpose: To evaluate the visual outcome and complication profile after glued intraocular lens (IOL) in post uveitic eyes. Methods: Patients with history of uveitis who had glued IOL with 3 months antecedent quiet anterior chamber (AC) were included in this prospective observational case series. Visual acuity, slit-lamp examination, fundus evaluation, optical coherence tomography, intraocular pressure, specular count and AC inflammation were analyzed before and after glued IOL procedure. Glued IOL eyes were also compared with their fellow normal capsular bag IOL. Results: Overall 17 eyes (50.7 ± 16.1 years) were analyzed. It included 41.8%, 23.5%, and 35.29% anterior, posterior, and pan uveitis, respectively. The etiologies were tuberculosis (23.53%), toxoplasmosis (11.77%), Fuch's heterochromic cyclitis (5.88%), HLA B27 (11.77%), psoriatic arthritis (5.88%), Rheumatoid arthritis (5.8%), sarcoidosis (11.77%), herpetic kerato-uveitis (5.88%), and idiopathic (17.65%). Cataractous subluxated lens (35.3%), aphakia (23.5%), decentered IOL (23.5%) and intraoperative capsular rupture (17.6%) were the surgical indications. A significant improvement in the mean uncorrected and best corrected visual acuity (P < 0.001) was recorded. The complications were IOL pigment dispersion (47%), macular edema (41%), and epiretinal membrane (24%). There was significant rise in AC reaction on day 1 (P < 0.001) and normal AC was attained by 88.2% eyes at 6 months. AC inflammation reactivation was noted in 11.7% of eyes. Though inflammatory reactivation was similar to the normal IOL, macular edema was higher in glued IOL. Conclusion: Glued IOL can cause inflammation in uveitis eyes which can be managed medically with minimal complications.


Assuntos
Adesivo Tecidual de Fibrina/efeitos adversos , Cápsula do Cristalino/patologia , Doenças do Cristalino/complicações , Adesivos Teciduais/efeitos adversos , Uveíte/induzido quimicamente , Uveíte/complicações , Acuidade Visual/fisiologia , Adulto , Idoso , Feminino , Adesivo Tecidual de Fibrina/uso terapêutico , Humanos , Inflamação/induzido quimicamente , Pressão Intraocular , Complicações Intraoperatórias , Implante de Lente Intraocular/métodos , Masculino , Pessoa de Meia-Idade , Facoemulsificação , Estudos Prospectivos , Microscopia com Lâmpada de Fenda , Adesivos Teciduais/uso terapêutico , Tomografia de Coerência Óptica
16.
Dermatitis ; 30(5): 314-322, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31517667

RESUMO

BACKGROUND: Cyanoacrylates are strong adhesives used for a variety of medical, industrial, and cosmetic applications and have been implicated as a cause of allergic contact dermatitis. OBJECTIVE: The aim of the study was to review our experience in patch testing with cyanoacrylates. METHODS: We reviewed patch test results of 38 patients with a clinical history of contact dermatitis due to a cyanoacrylate-containing adhesive (mostly Dermabond). Testing used cyanoacrylates of >99% purity diluted to 10% to 30% in petrolatum (pet.), undiluted octyl cyanoacrylate, and/or Dermabond Mini or Advanced "as is." Patch tests were also performed with methacrylates, formaldehyde (a cyanoacrylate impurity), benzalkonium chloride, and cyanoacrylate polymerization inhibitors. Three patients were also tested with Dermabond Mini on abraded skin. RESULTS: Commercial cyanoacrylate patch testing material (ethyl cyanoacrylate 10% pet.) detected 29% of Dermabond-allergic patients, whereas patch testing with octyl cyanoacrylate 10% pet. increased detection to 50%. Testing with higher concentrations and/or on abraded skin further increased yield. Thirteen (37%) of our 35 cyanoacrylate-allergic patients were also allergic to methacrylates or acrylates. CONCLUSIONS: Octyl cyanoacrylate is the usual allergenic ingredient in Dermabond. Patch testing with high concentrations is often required. Testing Dermabond on abraded skin further improves diagnostic sensitivity by more closely simulating clinical use.


Assuntos
Cianoacrilatos/efeitos adversos , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/etiologia , Testes do Emplastro , Adesivos Teciduais/efeitos adversos , Humanos , Metacrilatos/efeitos adversos , Testes do Emplastro/métodos
17.
Br J Nurs ; 28(15): S26-S32, 2019 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-31393764

RESUMO

The skin is the largest and one of the most important organs of the body and as such it is essential that skin integrity is maintained to preserve normal body functions as much as possible at all times. Health professionals must endeavour to minimise any pain and trauma likely to be encountered by their patients through the use of a variety of medical products and devices that are designed to adhere to the skin, especially as the use of dermatological and wound-management products in particular, that incorporate adhesives to help keep them secure and in place, has grown in line with the increasingly ageing population and changing demographics throughout the UK. This article reviews the literature related to the causes of medical-adhesive-related skin injuries (MARSIs) and the reported patient effects, in particular pain and skin trauma and highlight some 'at-risk' patient groups and potential actions to minimise risk. A sterile silicone medical adhesive remover-Appeel Sterile-is introduced and the clinical benefits highlighted through the discussion of clinical evidence and case studies undertaken on a range of patients with varied aetiologies.


Assuntos
Dor/prevenção & controle , Higiene da Pele/enfermagem , Adesivos Teciduais/efeitos adversos , Ferimentos e Lesões/prevenção & controle , Humanos , Dor/etiologia , Pele/lesões , Populações Vulneráveis , Ferimentos e Lesões/etiologia
18.
Ann Ital Chir ; 90: 100-105, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31182696

RESUMO

INTRODUCTION: The routinely use of drains in thyroid surgery is a traditional and well-defined method, even if there is no clear evidence of significant improvement in patients outcomes. Aim of our study is to define the feasibility, safety and cost- effectiveness of fibrin sealant in total thyroidectomy in order to overcome the use of drains. MATERIALS AND METHODS: We enrolled 262 patients (45 men and 217 women, mean age 54.7 yrs) undergone total thyroidectomy in University Hospital of Palermo (Italy), between July 2015 and October 2017. We randomized patients into group A (drain) and group B (no drain, fibrin sealant application). RESULTS: We registered statistical difference between the two groups in mean operative time, visual analogue scale of pain, post-operative stay, incidence of seromas and/or deep and superficial hematomas, re-operation and wound infection (reduced in the fibrin sealant group). No significant difference have been found in intraoperative blood loss, postoperative cough, post-operative use of analgesic and in incidence of hypoparathyroidism or recurrent palsy. CONCLUSIONS: Our study demonstrates that there is no evidence that the use of suction drains improves patients outcome and that routinely use of fibrin sealant can be advocated in thyroid surgery as an adjunct to a good surgical procedure. KEY WORDS: Complication, Drainage, Fibrin Sealant, Thyroidectomy.


Assuntos
Drenagem , Adesivo Tecidual de Fibrina , Tireoidectomia/métodos , Adesivos Teciduais , Análise Custo-Benefício , Estudos de Viabilidade , Feminino , Adesivo Tecidual de Fibrina/efeitos adversos , Adesivo Tecidual de Fibrina/economia , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Adesivos Teciduais/efeitos adversos , Adesivos Teciduais/economia , Resultado do Tratamento
19.
Ann Vasc Surg ; 60: 463-467, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31200058

RESUMO

Surgical site infections (SSIs) are a common source of morbidity with vascular surgery incisions, especially in the groin. Single institution case series have widely varying, but high incidences of groin wound infection after open lower extremity revascularization. Optimally, a dressing that did not require changes, had low cost, and was water resistant would be optimal in these patients. We developed and validate a new dressing utilizing Dermabond (Ethibond™) and Tegaderm™ for vascular surgery incisions that could simplify and reduce postoperative SSIs. In this initial experience, we reviewed 94 patients. Of the 94 patients, 0 had signs of infection superficial or deep, dehiscence, or evidence of nonhealing. Gluing a Tegaderm to an incision using Dermabond is a novel and easy way to perform dressing that reduces wound infection, increases patient comfort, avoids dressing changes, and allows visualization of the wound.


Assuntos
Bandagens , Cianoacrilatos/uso terapêutico , Infecção da Ferida Cirúrgica/prevenção & controle , Adesivos Teciduais/uso terapêutico , Procedimentos Cirúrgicos Vasculares , Cicatrização , Adulto , Idoso , Idoso de 80 Anos ou mais , Bandagens/efeitos adversos , Cianoacrilatos/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Tempo , Adesivos Teciduais/efeitos adversos , Resultado do Tratamento , Procedimentos Cirúrgicos Vasculares/efeitos adversos
20.
J Gastroenterol Hepatol ; 34(9): 1486-1491, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31245885

RESUMO

BACKGROUND: Tissue adhesive injection is the first-line treatment for gastric varices rebleeding. Available studies are focused on antibiotic usage in emergency endoscopy, while the use of antibiotics in selective endoscopic tissue adhesive treatment remains controversial. METHODS: This is a randomized controlled study conducted in a tertiary referral hospital. Consecutive patients were enrolled from February 16, 2016, to November 19, 2016, and blindly randomized into two treatment groups. Patients in the prophylactic group received 2 g of cefotiam during endoscopic injection of tissue adhesive. All the subjects were observed for rebleeding, fever, and changes in laboratory indicators in hospital and post-discharge. RESULT: One hundred and seven patients who received endoscopic therapy for gastroesophageal varices were included. Fifty-three patients were allocated to the antibiotic prophylactic group and 54 patients to the on-demand group. The two groups had similar baseline characteristics. The incidence of fever in hospital was 2/53 (3.8%) vs 9/54 (16.7%) (P = 0.028). Perioperative and postoperative clinical events were significantly lower in the antibiotic prophylactic group (5.7% vs 24.1%, P = 0.018; 7.5% vs 20.4%, P = 0.050). Inflammation indices were elevated on the first day after endoscopic therapy; however, no significant difference was observed between the two groups. The cumulative rebleeding free rate within 2 months was lower in the antibiotic prophylactic group (1.9% vs 9.3%, P = 0.100). CONCLUSION: Our study illustrated that prophylactic use of antibiotics in selective endoscopic injection of tissue adhesive reduced the incidence of the total clinical events in perioperative period and had a trend towards lower rebleeding in 2 months.


Assuntos
Antibacterianos/administração & dosagem , Antibioticoprofilaxia , Cefotiam/administração & dosagem , Endoscopia Gastrointestinal , Varizes Esofágicas e Gástricas/terapia , Hemorragia Gastrointestinal/terapia , Hemostase Endoscópica , Adesivos Teciduais/administração & dosagem , Adulto , Idoso , Antibacterianos/efeitos adversos , Antibioticoprofilaxia/efeitos adversos , Cefotiam/efeitos adversos , China , Endoscopia Gastrointestinal/efeitos adversos , Feminino , Febre/etiologia , Hemostase Endoscópica/efeitos adversos , Humanos , Injeções , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Recidiva , Fatores de Tempo , Adesivos Teciduais/efeitos adversos , Resultado do Tratamento
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