Discussion on the Relevant Factors of General Surgery Incision Infection and Prevention Methods

There are many reasons that can lead to incision infection of general surgical patients. The main reasons include weight, age, body albumin level, surgical time, observation ward, etc. This paper analyzes the clinic data of patients with incision infection after general surgery based on clinic practice and study on the reasons that have impact on general surgical incision infection and gives relevant prevention countermeasures

Tissue-Engineered Solutions in Plastic and Reconstructive Surgery: Principles and Practice

Recent advances in microsurgery, imaging, and transplantation have led to significant refinements in autologous reconstructive options; however, the morbidity of donor sites remains. This would be eliminated by successful clinical translation of tissue-engineered solutions into surgical practice. Plastic surgeons are uniquely placed to be intrinsically involved in the research and development of laboratory engineered tissues and their subsequent use. In this article, we present an overview of the field of tissue engineering, with the practicing plastic surgeon in mind. The Medical Research Council states that regenerative medicine and tissue engineering "holds the promise of revolutionizing patient care in the twenty-first century." The UK government highlighted regenerative medicine as one of the key eight great technologies in their industrial strategy worthy of significant investment. The long-term aim of successful biomanufacture to repair composite defects depends on interdisciplinary collaboration between cell biologists, material scientists, engineers, and associated medical specialties; however currently, there is a current lack of coordination in the field as a whole. Barriers to translation are deep rooted at the basic science level, manifested by a lack of consensus on the ideal cell source, scaffold, molecular cues, and environment and manufacturing strategy. There is also insufficient understanding of the long-term safety and durability of tissue-engineered constructs. This review aims to highlight that individualized approaches to the field are not adequate, and research collaboratives will be essential to bring together differing areas of expertise to expedite future clinical translation. The use of tissue engineering in reconstructive surgery would result in a paradigm shift but it is important to maintain realistic expectations. It is generally accepted that it takes 20-30 years from the start of basic science research to clinical utility, demonstrated by contemporary treatments such as bone marrow transplantation. Although great advances have been made in the tissue engineering field, we highlight the barriers that need to be overcome before we see the routine use of tissue-engineered solutions

Cathodic voltage-controlled electrical stimulation and betadine decontaminate nosocomial pathogens from implant surfaces

ABSTRACTPeriprosthetic joint infection (PJI) after total joint arthroplasty is a major concern requiring multiple surgeries and antibiotic interventions. Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli are the predominant causes of these infections. Due to biofilm formation, antibiotic treatment for patients with PJI can prolong resistance, further complicating the use of current treatments. Previous research has shown that cathodic voltage-controlled electrical stimulation (CVCES) is an effective technique to prevent/treat implant-associated biofilm infections on titanium (Ti) surfaces. This study thus evaluated the efficacy of CVCES via the use of 10% betadine alone and in combination with CVCES to eradicate lab-grown biofilms on cemented and cementless cobalt–chromium (CoCr) and Ti surfaces. CVCES treatment alone for 24 hours demonstrated no detectable CFU for E. coli and P. aeruginosa biofilms on cementless CoCr implants. In the presence of cement, E. coli biofilms had 106 CFUs/implant remaining after CVCES treatment alone; however, P. aeruginosa biofilms on cemented implants were reduced to below detectable limits. The use of 10% betadine treatment for 3 minutes followed by 24-hour CVCES treatment brought CFU levels to below detectable limits in E. coli and P. aeruginosa. The same was true for S. aureus biofilms on cementless patellofemoral implants as well as femoral and tibial implants. These treatment methods were not sufficient for eradication of S. aureus biofilms on cemented implants. These results suggest that CVCES alone and CVCES with 10% betadine are effective approaches to treating biofilms formed by certain bacterial species potentially leading to the treatment of PJI.IMPORTANCEPeriprosthetic joint infections (PJIs) are problematic due to requiring multiple surgeries and antibiotic therapies that are responsible for increased patient morbidity and healthcare costs. These infections become resistant to antibiotic treatment due to the formation of biofilms on the orthopedic surfaces. Cathodic voltage-controlled electrical stimulation (CVCES) has previously been shown to be an effective technique to prevent and treat biofilm infections on different surfaces. This study shows that CVCES can increase the efficacy of 10% betadine irrigation used in debridement, antibiotics, and implant retention by 99.9% and clear infection to below detection limits. PJI treatments are at times limited, and CVCES could be a promising technology to improve patient outcomes

The introduction of robotic-arm assisted Total Hip Arthroplasty: Learning curve and effect on theatre utilization.

Background: The objective of this study was to report on the learning curve associated with the introduction of robotic-arm assisted Total Hip Arthroplasty with a focus on operating theatre utilization. Methods: A total of 339 primary THA cases (225 robotic-arm assisted, 114 conventional) were eligible for inclusion in this retrospective observational study. All patients underwent hybrid THA by a single surgeon using a posterolateral approach. The anaesthetic, intraoperative, and postoperative protocols remained unchanged during the study. Total case time was defined as the interval from arrival to the operating theatre complex to entering the recovery area. Results: 281 cases were included in the theatre utilization analysis. There were no differences in the demographics between the robotic-arm assisted and conventional THA cases in terms of age (p=0.463) or gender (p=0.953). Total case time for conventional THA was 100 minutes (95% CI: 98.04 to 102.06) and 127.6 minutes (95% CI: 125.5 to 129.63) for robotic-arm assisted. Robotic-arm assisted THA (n=188) cases were analysed in sequential groups of 50 (Groups A to D). Robotic arm THA total case time decreased by 16 minutes between Group A (mean 135.44, 95%CI:131.21 to 139.6) and Group D (mean 119.45, 95%CI: 115.88 to 123.01). Robotic THA cases were associated with a 35% increase in total case time in the early phase which reduced to a 19% increase after 150 cases. Conclusion: Operating theatre utilization analysis revealed increased total case time in robotic-arm assisted cases which gradually improved over the duration of the study