Most prognostic factor related to development of traumatic osteonecrosis of femoral head following hip dislocation. Time to relocation or severity of injury?

Femoral head osteonecrosis following hip dislocations has been reported to be directly related to the timing of reduction. Reduction within six hours of injury was reported to lower the risk to 10%. Most previous reports concluded no good results were achieved if reduction is delayed beyond twenty-four hours. In this study, factors which are implicated in the development of traumatic osteonecrosis of femoral head were evaluated. Thirty-eight patients with simple posterior hip dislocation admitted to a single tertiary centre were evaluated. All patients were treated with closed manual reduction. Plain radiograph of the hip was done to screen for occurrence of osteonecrosis of the femoral head. The duration of injury until the last x-ray done must be more than four months post injury. The mean age was 25 years (range 14 to 48 years). Majorities were males (92.1%) and motorcyclists (71.0%). 15.7% had associated femoral head fracture, while 31.6% had posterior acetabular fracture. Time to relocation for 42.1% of cases was less than six hours, with 28.9% of cases were reduced after twelve hours. Mean duration from the onset of injury until last x-ray done was 41 months (range 4 to 99 months). No case of avascular necrosis of the femoral head was reported. All of the hips had good to excellent functional and radiographic outcome. The findings were not consistent with previous reports concluding no good results achieved if reduction is delayed beyond 24 hours. This supports the claim that the severity of injury sustained rather than delay in treatment is the more important factor influencing the occurrence of femoral head osteonecrosis

A comparative study of Tualang honey spray versus film spray (OPSITE®) as post-long bone fracture fixation wound dressing

Introduction: Honey-based dressings have a potential benefit in treating wounds in implant-related surgery due to its anti-microbial activities and healing potentials. The aim of the study is to compare Tualang honey spray with film spray (Opsite®) as an alternative dressing material following long bone fracture fixations. This is a preliminary study in Malaysia that involves human subjects. Methodology: This is a randomized, controlled trial involving patients with closed diaphyseal fracture of tibia or femur treated with open reduction and internal fixation (plates or intramedullary devices) at a single tertiary centre. Forty patients were randomly divided into three groups according to the dressing material used; film spray (Opsite®) dressing (n=16), Tualang honey spray (n=13), and control group (n=11). Each group used a same wound protocol except for the control group in which involve application of non-adhesive film (Mepore) only. Dressing materials were applied immediately after surgery and on day three post-surgery. Wound assessment was done on day 14 and day 42 post-surgery. Outcomes evaluated include wound complications, and the effects on skin commensals. On day 42, infection rate (wound dehiscence) and scar formation were also evaluated. Results: There was a case of superficial surgical site infection from the Opsite® spray group. Acinobacter species was isolated from one of the patients under the control group. There was no statistically significant association between dressing methods used and wound healing. All wounds healed without any infection at the end of the study. Tualang honey spray have a significant influence in reducing the risk of hypertrophic scar formation and has similar wound outcomes as compared to Opsite® spray. Conclusion: Tualang honey spray is comparable to the widely used Opsite* spray as a safe alternative for dressing material. Contradict to some previous studies; it promotes good wound healing with a low risk of hypertrophic scar formation

Tualang honey spray versus film spray (Opsite®) as post-long bone fracture fixation wound dressing: a comparative study

Background of Study: Honey-based dressings have a potential benefit in treating wounds in implant-related surgery due to its anti-microbial activities and healing potentials. The study aims to compare Tualang honey spray with film spray (Opsite®) as an alternative dressing material following long bone fracture fixations. This is a preliminary study in Malaysia on human subjects. Materials and Methods: This is a randomized, controlled trial involving trauma patients with closed fracture diaphysis of tibia or femur internally stabilized with either plates or intramedullary devices. Forty patients were randomly divided into three groups according to the dressing material used; film spray (Opsite®) dressing (n=16), Tualang honey spray (n=13), and control group (n=11). Each group used a same wound protocol except for the control group in which involve application of non-adhesive film (Mepore) only. Dressing materials were applied immediately following surgery and on day three post-surgery after wound inspection. Assessment of wound performed on day 14 and day 42 post-surgery. Outcomes measured include wound complications, and the effects on skin commensals. On day 42, infection rate and scar formation were also evaluated. Results: A patient from the Opsite® spray group had surgical site infection. Acinobacter was isolated from one of the patients under the control group. There was no statistically significant association between wound healing and dressing methods used. All wounds healed without any evidence of infection at the end of the study. Tualang honey spray have a significant influence in reducing the risk of hypertrophic scar formation. Wound outcomes were also similar compared to Opsite® spray. Conclusion: Tualang honey spray is a safe alternative for wound dressing material comparable to the widely used Opsite* spray. It promotes good wound healing with a low risk of hypertrophic scar formation

Tualang honey spray versus film spray (Opsite*) as post-long bone fracture fixation wound dressing: a comparative study

Introduction: Tualang honey spray is a new dressing agent with potential wound healing quality and outcome compared to other products. The aim of the study is to compare the advantages of Tualang honey versus spray film (Opsite*) as dressing materials following long bone fracture fixations. This is a preliminary study in Malaysia that involve human as subjects. Methodology: This is a prospective randomized controlled trial involving patients with closed fracture mid-shaft of tibia or femur treated with open reduction and internal fixation (plates or intramedullary devices) at a single tertiary centre. Forty patients fulfilling the criteria of the study were involved. It was a three-arm study that consist of film spray (Opsite*) dressing (n=16), Tualang honey spray (n=13), and control group (n = 11). Each group had a same wound protocol except for the control group that involve only application of non-adhesive film (Mepore). Dressing materials were applied on wounds of the other two groups accordingly, immediately after surgery and on day three following surgery. Wound assessment were done on day 14 and day 42 following surgery. Outcomes evaluated include wound complications and the effects on skin commensals. On the final evaluation on day 42, infection rate and scar formation were also evaluated. Results: A case of superficial surgical site infection was observed from the Opsite* spray group. Acinobacter species was isolated from one of the patients under the control group. There was no association between dressing methods used and wound healing. All wounds healed without any infection at the end of the study. Tualang honey spray was shown to have significant influence in reducing the risk of hypertrophic scar formation and has similar wound outcome as compared to Opsite* spray. Some of the results obtained were comparable to other previous studies on type of dressing and surgical wound healing. Conclusion: Tualang honey spray is a safe alternative for dressing material and was shown comparable to Opsite* spray. Contradict to some of the data available in the literature; its usage is able to promote a good wound healing with a low risk of hypertrophic scar formation