Influence of articular arthroscopy-like washout on fracture healing of intra-articular fractures; animal experiment

Aim: To examine whether the application of intra-articular lavage during arthroscopic joint fracture surgery can disturb fracture union and cartilage healing. Metods: Twenty New Zealand rabbits were then randomly divided into 3 groups; these groups consisted of 2 surgical groups including eight rabbits and a control group consisting of 4 rabbits. After both rear limbs exposed with a medial parapatellar incision, medial femoral condyle was fractured. Four groups were created by doing anatomic reduction or non-anatomic reduction and making irrigation or no irrigation. (Group 1: Fixed by creating a gap and no Irrigation; Group 2: Fixed by creating a gap and irrigation; Group 3: Fixed with complete reduction and no irrigation; Group 4: Fixed with complete reduction and irrigation) X-rays of both knees of all rabbits were taken at the end of the second week and at the end of the eighth week. The operated knees were collected for histopathological analysis. Results: Radiological data show a significant difference in the level of ossification between the groups in the 2nd week; however, this difference was lost in the 8th week. Histopathologically, at the end of week 8, it was observed that the subchondral bone tissue was incompletely renewed in all the groups. The cartilage tissue of the joint surface was not fully formed and renewed and that it did not completely coalesce with the old cartilage tissue in all of the groups. Compared with the other groups, the group that fracture was anatomically reducted with no irrigation (Group 1), the cartilaginous tissue layer formed was thicker while the surface of the tissue was flatter. Conclusion: There were no adverse effects of intra-articular lavage on fracture union and cartilage healing in an in vivo environment. Nonetheless, the findings of this study should be confirmed with a larger sample size

A simple concept for covering pressure sores : wound edge-based propeller perforator flap

We present a new surgical modification to allow propeller perforator flaps to cover pressure sores at various locations. We used a propeller perforator flap concept based on the detection of newly formed perforator vessels located 1 cm from the wound margin and stimulated by the chronic inflammation process. Between January 2009 and January 2017, 33 wound edge-based propeller perforator flaps were used to cover pressure sores at various locations in 28 patients. In four cases more than one flap was used on the same patient. The patients comprised 18 males and 10 females with a mean age of 4125 (range, 16-70) years. All patients underwent follow-up for 0-12 months. The mean follow-up duration was 503 months. Venous congestion was observed in three flaps that were rotated by 180 degrees (91%). However, there was a significant difference between flaps rotated by 90 degrees and 180 degrees according to the complication rate (P = 0034). Out of 33 flaps, 29 flaps healed uneventfully. Patients were able to sit and lie on their flaps three weeks after surgery. In our study, we were able to obtain satisfying final results using these novel flaps

Preventing infective complications following leech therapy: Is practice keeping pace with current research?

Background: Despite several publications strongly advocating prophylactic antibiotics during leech therapy, and recent primary articles shedding new light on the microbiota of leeches, many units either do not use antibiotic prophylaxis, or are continuing to use ineffective agents. Methods: A 5-year follow-up of plastic surgery units in the United Kingdom and the Republic of Ireland was conducted in 2007 to ascertain current practice regarding the use of prophylactic antibiotics with leech therapy. A comprehensive literature search investigated primary research articles regarding the microbiota of leeches to update the reconstructive surgery community. Results: Despite published evidence to support the use of prophylactic antibiotics during leech therapy, 24% of units do not use antibiotic prophylaxis and 57% of those using antibiotics are using potentially ineffective agents. Advanced molecular genetic techniques, which allow accurate characterization of both culturable and nonculturable microbiota of the leech digestive tract, show a wider diversity than at first thought, with variable antiobiotic resistance profiles. Conclusions: Despite infection due to leech therapy being a well known and relatively common complication, many units are not using appropriate antibiotic prophylaxis. © 2009 Wiley-Liss, Inc. Microsurgery 2009

Are you afraid to travel during COVID-19?

COVID-19, which is a new type of coronavirus disease, has affected the whole world in a very short time, hundreds of thousands of people to die and the physical and mental health of billions of people to deteriorate. It was determined that people\u27s understanding of the holiday has been changed significantly during the pandemic period. Under normal conditions, the economic and social preferences of consumers are in the forefront in making travel decisions, whereas it is understood that psychological preferences became more evident in pandemic periods. It is aimed to reveal the relationship between tourists\u27 travel concerns and intentions to travel during the COVID-19 pandemic period. In order to test the hypotheses of the study, quantitative research method was used in the field research. The application was made online due to pandemic conditions and it reached 410 people. Frequency, percentage, standard deviation, factor analysis, correlation and regression analyze were used in the study. According to the results of this study, it has been found that there are significant relationships between fear of COVID-19, travel anxiety and travel intention. Furthermore, as a result of the regression analysis, it was determined that travel anxiety has an effect on travel intention