BACKGROUND Surgical site infections are a major cause of morbidity and mortality following orthopedic surgery.Recent efforts to identify sources of contamination in the operating rooms have implicated mobile phones.AI...BACKGROUND Surgical site infections are a major cause of morbidity and mortality following orthopedic surgery.Recent efforts to identify sources of contamination in the operating rooms have implicated mobile phones.AIM To investigate microbial colonization on the mobile phones of health care professionals in the orthopedic operating room.METHODS We conducted a cross-sectional study involving culture and sensitivity analysis of swabs taken from the mobile phones of orthopedic and anesthesia attendings,residents,technicians and nurses working in the orthopedic operating rooms over a period of two months.Demographic and cell phone related factors were recorded using a questionnaire and the factors associated with contamination were analyzed.RESULTS Ninety-three of 100 mobile phones were contaminated.Species isolated were Coagulase-negative Staphylococcus(62%),Micrococcus(41%)and Bacillus(26%).The risk of contamination was increased with mobile covers and cracked screens and decreased by cell phone cleaning.CONCLUSION Mobile phones belonging to health care workers are frequently contaminated with pathogenic bacteria with the potential of transferring drug resistance to nosocomial pathogens.Studies investigating the relationship to surgical site infections need to be conducted.The concept of"mobile hygiene"involving the change of mobile covers,replacement of cracked screens or even wiping the phone with an alcohol swab could yield the cost-effective balance that contaminated cell phones deserve until they are established as a direct cause of surgical site infections.展开更多
Objective： To evaluate the effectiveness ofJudet＇s quadricepsplasty for treatment of knee contractures and to identify the effect of local infiltration of epinephrine on blood loss associated with this procedure. Me...Objective： To evaluate the effectiveness ofJudet＇s quadricepsplasty for treatment of knee contractures and to identify the effect of local infiltration of epinephrine on blood loss associated with this procedure. Methods： A retrospective cohort study was conducted in which all cases of knee contractures managed with Judet＇s quadricepsplasty from 1st January 2009 to 31st December 2013 were included and were divided into two groups. The epinephrine group included patients who were infiltrated with diluted epinephrine （1：400,000） along with xylocaine, around the operative field 15 min prior to the incision time, while the control group did not receive any infiltration. Judet＇s outcome, blood loss, drop in he- moglobin and required blood transfusion were noted for all patients and compared between both groups. Results： Most common preceding pathology identified for the development of knee contractures was periarticular fracture while ilizarov application was the most common etiology. Both groups were found similar in all preoperative characteristics except preoperative flexion contracture （p = 0.02）. All func- tional outcome measures including Judet＇s outcome were similar in both groups. In contrast, duration of surgery （p = 0.01）, blood loss （p = 0.02）, drop in hemoglobin （p = 0.01） and number of transfusions （p = 0.03） were significantly reduced in epinephrine group. Conclusion： Judet＇s quadricepsplasty is a useful procedure to increase the range of motion of rigid knees and local infiltration of epinephrine is effective in decreasing the amount of subsequent blood loss and transfusion requirements.展开更多
文摘BACKGROUND Surgical site infections are a major cause of morbidity and mortality following orthopedic surgery.Recent efforts to identify sources of contamination in the operating rooms have implicated mobile phones.AIM To investigate microbial colonization on the mobile phones of health care professionals in the orthopedic operating room.METHODS We conducted a cross-sectional study involving culture and sensitivity analysis of swabs taken from the mobile phones of orthopedic and anesthesia attendings,residents,technicians and nurses working in the orthopedic operating rooms over a period of two months.Demographic and cell phone related factors were recorded using a questionnaire and the factors associated with contamination were analyzed.RESULTS Ninety-three of 100 mobile phones were contaminated.Species isolated were Coagulase-negative Staphylococcus(62%),Micrococcus(41%)and Bacillus(26%).The risk of contamination was increased with mobile covers and cracked screens and decreased by cell phone cleaning.CONCLUSION Mobile phones belonging to health care workers are frequently contaminated with pathogenic bacteria with the potential of transferring drug resistance to nosocomial pathogens.Studies investigating the relationship to surgical site infections need to be conducted.The concept of"mobile hygiene"involving the change of mobile covers,replacement of cracked screens or even wiping the phone with an alcohol swab could yield the cost-effective balance that contaminated cell phones deserve until they are established as a direct cause of surgical site infections.
文摘Objective： To evaluate the effectiveness ofJudet＇s quadricepsplasty for treatment of knee contractures and to identify the effect of local infiltration of epinephrine on blood loss associated with this procedure. Methods： A retrospective cohort study was conducted in which all cases of knee contractures managed with Judet＇s quadricepsplasty from 1st January 2009 to 31st December 2013 were included and were divided into two groups. The epinephrine group included patients who were infiltrated with diluted epinephrine （1：400,000） along with xylocaine, around the operative field 15 min prior to the incision time, while the control group did not receive any infiltration. Judet＇s outcome, blood loss, drop in he- moglobin and required blood transfusion were noted for all patients and compared between both groups. Results： Most common preceding pathology identified for the development of knee contractures was periarticular fracture while ilizarov application was the most common etiology. Both groups were found similar in all preoperative characteristics except preoperative flexion contracture （p = 0.02）. All func- tional outcome measures including Judet＇s outcome were similar in both groups. In contrast, duration of surgery （p = 0.01）, blood loss （p = 0.02）, drop in hemoglobin （p = 0.01） and number of transfusions （p = 0.03） were significantly reduced in epinephrine group. Conclusion： Judet＇s quadricepsplasty is a useful procedure to increase the range of motion of rigid knees and local infiltration of epinephrine is effective in decreasing the amount of subsequent blood loss and transfusion requirements.
