233 research outputs found
Evidence update on prevention of surgical site infection
No full textPurpose of review: surgical site infection (SSI) is a common health care associated infection and complicates up to 10-20% of operations with considerable health care resources. Apart from the widely adopted use of appropriate hair removal, antibiotic prophylaxis, avoidance of hypothermia and peri-operative glycaemic control to reduce SSIs this review has considered new research and systematic reviews, and whether their findings should be included in guidelines.
Recent findings: The efficacy of preoperative bathing/showering, antibiotic prophylaxis for clean surgery and perioperative oxygen supplementation to reduce the risk of SSI is still in doubt. By contrast, the use of 2% chlorhexidine in alcohol skin preparation, postoperative negative pressure wound therapy and antiseptic surgical dressings do show promise. Antimicrobial sutures in independent meta-analyses were found to reduce the risk of SSI after all classes of surgery (except dirty) whereas the use of wound guards, or diathermy skin incision (compared with scalpel incision), did not.
Summary: The incidence of SSI after surgery is not falling. Based on this review of published trials and evidence-based systematic reviews some advances might be included into these care bundles. More research is needed together with improved compliance with care bundles
Improving everyday life experiences for young children with cancer
No full textChildren with cancer regularly have long term central line catheters inserted in the chest to deliver medication. Often termed ‘Hickman Lines’, they result in tubing protruding from the chest, which can result in medical issues including infections, but also discomfort for the child, particularly when sleeping. A team of researchers, led by Dr Jess Power, including Professor David Leaper and Joanne Marie Harris, has been investigating the design and development of a product to contain these external lines, providing greater comfort and safety for the child whilst also meeting the needs of the medical communit
Photogrammetric video tracks of Antarctic blue whale movements recorded during the 2013 Antarctic Blue Whale Voyage
No full textProgress Code: completedDuring the 2013 Antarctic Blue Whale Voyage of the Southern Ocean Research Partnership a photogrammetric video tracking system was used to collect precise surfacing locations during encounters with some Antarctic blue whales. The photogrammetric video tracking system is described by Leaper and Gordon 2001, and enables determination of the range and bearing to tracked objects relative to the ship. <br/><br/>During the voyage, 32 tracking sessions yielded 553 precise photogrammetric locations comprising a total of 27 tracks of blue whales.<br/><br/>Leaper, R. and Gordon, J. 2001. Application of photogrammetric methods for locating and tracking cetacean movements at sea. Journal of Cetacean Research and Management, 3: 131-141
Growth factor profiles in intraperitoneal drainage fluid following colorectal surgery: relationship to wound healing and surgery
No full textCytokines and growth factors are important at each stage of wound healing. This study aims to determine the changing profiles of these factors in intraperitoneal drainage, acute wound fluid, following colorectal surgery, and to correlate levels to wound healing and surgical outcomes. Acute wound fluid samples (n = 52 patients) were collected daily from postoperative day 1 until drain removal. Levels of cytokines (interleukins-6 and -1? and tumor necrosis factor-?) and epidermal growth factor, platelet-derived growth factor, vascular endothelial derived growth factor, basic fibroblast growth factor, and transforming growth factor-?1 were determined by enzyme-linked immunosorbent assay. A significant negative correlation emerged between the levels of interleukin-6, epidermal growth factor, platelet-derived growth factor, and basic fibroblast growth factor and the postoperative day, e.g., basic fibroblast growth factor : day 1, 695, median (29–2,806, range) pg/ml; day 2, 249 (1–1,784); day 3, 94 (0–722); day 7, 22 (0–326) (p < 0.05, Spearman's correlation). Levels appeared to relate to the stage of wound healing. Several factors, in particular interleukin-1? and tumor necrosis factor-? levels, correlated with surgical outcomes such as the need for a defunctioning stoma and/or postoperative complications. Cytokines and growth factors are involved in normal wound healing, and their levels in acute wound fluid may act as markers of wound healing and surgical outcome
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Preventing and managing surgical site infections (Editorial 2008)
No full textHealth-care-associated infections are a public health challenge and a considerable media and public concern. In a UK prevalence survey, surgical site infections accounted for 14% of health-care-associated infections; almost 5% of patients having surgery developed a surgical site infection (Smyth et al, 2008). Surgical site infections may affect the superficial tissues of the incision, the deep fascial and muscle layers, or an organ or body space encountered during the operation. They are associated with increased morbidity, mortality and costs of care, and doubling of the length of hospital stay (Leaper et al, 2004; Coello et al, 2005)
Photogrammetric video tracks of whale movements recorded during the 2019 ENRICH Voyage (IN2019_V01)
No full textProgress Code: completedStatement: Data are good quality, with no known issues or problems.<b>Purpose</b><br/>Photogrammetric video tracking was conducted in order to obtain data on baseline surface behaviour and fine-scale movements of Antarctic blue whales, and to enable investigation of relationships among vocal activity, behaviour, and movement.During the 2019 ENRICH Voyage of the CSIRO vessel, RV Investigator (IN2019_V01), a digital photogrammetric video tracking system was used to collect precise surfacing locations during encounters with mainly Antarctic blue whales, but also some fin whales. The photogrammetric video tracking system is a modern digital video version based on the same operating principle as the that described by Leaper and Gordon 2001, and enables determination of the range and bearing to tracked objects relative to the ship.<br/><br/>Video tracking was conducted on 24 occasions for a total of 18 hours. Focal follows were aborted when it was no longer possible to follow the focal animal due to ice or when the presence of other animals meant it was no longer possible to be sure which was the focal animal. <br/><br/>Leaper, R. and Gordon, J. 2001. Application of photogrammetric methods for locating and tracking cetacean movements at sea. Journal of Cetacean Research and Management, 3: 131-141
Group in a St. Germain sleigh
No full textLeft to right: Raymond Davis, Rosie (Henry) Wandke, Pete David, possibly Chuck Rodgers, Billy Watt, Fred McMullan, Leaper
Cost-Effective Use of Silver Dressings for the Treatment of Hard-to-Heal Chronic Venous Leg Ulcers
No full textAim
To estimate the cost-effectiveness of silver dressings using a health economic model based on time-to-wound-healing in hard-to-heal chronic venous leg ulcers (VLUs).
Background
Chronic venous ulceration affects 1–3% of the adult population and typically has a protracted course of healing, resulting in considerable costs to the healthcare system. The pathogenesis of VLUs includes excessive and prolonged inflammation which is often related to critical colonisation and early infection. The use of silver dressings to control this bioburden and improve wound healing rates remains controversial.
Methods
A decision tree was constructed to evaluate the cost-effectiveness of treatment with silver compared with non-silver dressings for four weeks in a primary care setting. The outcomes: ‘Healed ulcer’, ‘Healing ulcer’ or ‘No improvement’ were developed, reflecting the relative reduction in ulcer area from baseline to four weeks of treatment. A data set from a recent meta-analysis, based on four RCTs, was applied to the model.
Results
Treatment with silver dressings for an initial four weeks was found to give a total cost saving (£141.57) compared with treatment with non-silver dressings. In addition, patients treated with silver dressings had a faster wound closure compared with those who had been treated with non-silver dressings.
Conclusion
The use of silver dressings improves healing time and can lead to overall cost savings. These results can be used to guide healthcare decision makers in evaluating the economic aspects of treatment with silver dressings in hard-to-heal chronic VLUs
Bacterial Growth Kinetics under a Novel Flexible Methacrylate Dressing Serving as a Drug Delivery Vehicle for Antiseptics
No full textA flexible methacrylate powder dressing (Altrazeal®) transforms into a wound contour conforming matrix once in contact with wound exudate. We hypothesised that it may also serve as a drug delivery vehicle for antiseptics. The antimicrobial efficacy and influence on bacterial growth kinetics in combination with three antiseptics was investigated in an in vitro porcine wound model. Standardized in vitro wounds were contaminated with Staphylococcus aureus (MRSA; ATCC 33591) and divided into six groups: no dressing (negative control), methacrylate dressing alone, and combinations with application of 0.02% Polyhexamethylene Biguanide (PHMB), 0.4% PHMB, 0.1% PHMB + 0.1% betaine, 7.7 mg/mL Povidone-iodine (PVP-iodine), and 0.1% Octenidine-dihydrochloride (OCT) + 2% phenoxyethanol. Bacterial load per gram tissue was measured over five days. The highest reduction was observed with PVP-iodine at 24 h to log10 1.43 cfu/g, followed by OCT at 48 h to log10 2.41 cfu/g. Whilst 0.02% PHMB resulted in a stable bacterial load over 120 h to log10 4.00 cfu/g over 120 h, 0.1% PHMB + 0.1% betaine inhibited growth during the first 48 h, with slightly increasing bacterial numbers up to log10 5.38 cfu/g at 120 h. These results indicate that this flexible methacrylate dressing can be loaded with various antiseptics serving as drug delivery system. Depending on the selected combination, an individually shaped and controlled antibacterial effect may be achieved using the same type of wound dressing
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