scholarly journals Quality of life and scar evolution after negative pressure or conventional therapy for wound dehiscence following post-bariatric abdominoplasty

2017 ◽  
Vol 14 (6) ◽  
pp. 960-966 ◽  
Author(s):  
Paolo Limongelli ◽  
Giuseppina Casalino ◽  
Salvatore Tolone ◽  
Luigi Brusciano ◽  
Giovanni Docimo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Negative Pressure ◽  
Conventional Therapy ◽  
Wound Dehiscence

scholarly journals Negative-pressure wound therapy compared with standard dressings following surgical treatment of major trauma to the lower limb: the WHiST RCT

2020 ◽  
Vol 24 (38) ◽  
pp. 1-86
Author(s):  
Matthew L Costa ◽  
Juul Achten ◽  
Ruth Knight ◽  
May Ee Png ◽  
Julie Bruce ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Site Infection ◽  
Negative Pressure ◽  
Lower Limb ◽  
Negative Pressure Wound Therapy ◽  
Major Trauma ◽  
Site Infection ◽  
Wound Therapy ◽  
Deep Surgical Site Infection

Background Major trauma is the leading cause of death in people aged < 45 years. Patients with major trauma usually have lower-limb fractures. Surgery to fix the fractures is complicated and the risk of infection may be as high as 27%. The type of dressing applied after surgery could potentially reduce the risk of infection. Objectives To assess the deep surgical site infection rate, disability, quality of life, patient assessment of the surgical scar and resource use in patients with surgical incisions associated with fractures following major trauma to the lower limbs treated with incisional negative-pressure wound therapy versus standard dressings. Design A pragmatic, multicentre, randomised controlled trial. Setting Twenty-four specialist trauma hospitals representing the UK Major Trauma Network. Participants A total of 1548 adult patients were randomised from September 2016 to April 2018. Exclusion criteria included presentation > 72 hours after injury and inability to complete questionnaires. Interventions Incisional negative-pressure wound therapy (n = 785), in which a non-adherent absorbent dressing covered with a semipermeable membrane is connected to a pump to create a partial vacuum over the wound, versus standard dressings not involving negative pressure (n = 763). Trial participants and the treating surgeon could not be blinded to treatment allocation. Main outcome measures Deep surgical site infection at 30 days was the primary outcome measure. Secondary outcomes were deep infection at 90 days, the results of the Disability Rating Index, health-related quality of life, the results of the Patient and Observer Scar Assessment Scale and resource use collected at 3 and 6 months post surgery. Results A total of 98% of participants provided primary outcome data. There was no evidence of a difference in the rate of deep surgical site infection at 30 days. The infection rate was 6.7% (50/749) in the standard dressing group and 5.8% (45/770) in the incisional negative-pressure wound therapy group (intention-to-treat odds ratio 0.87; 95% confidence interval 0.57 to 1.33; p = 0.52). There was no difference in the deep surgical site infection rate at 90 days: 13.2% in the standard dressing group and 11.4% in the incisional negative-pressure wound therapy group (odds ratio 0.84, 95% confidence interval 0.59 to 1.19; p = 0.32). There was no difference between the two groups in disability, quality of life or scar appearance at 3 or 6 months. Incisional negative-pressure wound therapy did not reduce the cost of treatment and was associated with a low probability of cost-effectiveness. Limitations Owing to the emergency nature of the surgery, we anticipated that some patients who were randomised would subsequently be unable or unwilling to participate. However, the majority of the patients (85%) agreed to participate. Therefore, participants were representative of the population with lower-limb fractures associated with major trauma. Conclusions The findings of this study do not support the use of negative-pressure wound therapy in patients having surgery for major trauma to the lower limbs. Future work Our work suggests that the use of incisional negative-pressure wound therapy dressings in other at-risk surgical wounds requires further investigation. Future research may also investigate different approaches to reduce postoperative infections, for example the use of topical antibiotic preparations in surgical wounds and the role of orthopaedic implants with antimicrobial coatings when fixing the associated fracture. Trial registration Current Controlled Trials ISRCTN12702354 and UK Clinical Research Network Portfolio ID20416. Funding This project was funded by the National Institute for Health Research Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 38. See the NIHR Journals Library for further project information.

scholarly journals Mirtazapine for the Treatment of Chronic Pruritus

Medicines ◽  
2019 ◽  
Vol 6 (3) ◽  
pp. 73 ◽  
Author(s):  
Raveena Khanna ◽  
Emily Boozalis ◽  
Micah Belzberg ◽  
John G. Zampella ◽  
Shawn G. Kwatra
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Conventional Therapy ◽  
Sleep Disturbances ◽  
English Language ◽  
First Line ◽  
Chronic Itch ◽  
Wide Range ◽  
Chronic Pruritus

Background: Chronic pruritus is a debilitating condition associated with a wide range of dermatologic, systemic and psychogenic etiologies. In patients with chronic pruritus that is refractory to conventional therapy, symptoms can significantly decrease quality of life by contributing to anxiety, sleep disturbances, and in many cases depression. Recent studies have demonstrated the effectiveness of mirtazapine in relieving chronic itch that is refractory to standard first-line therapies. Methods: We searched PubMed for English-language articles containing the words (“pruritus” or “itch”) AND “antidepressant” and then conducted a systematic review of the current literature to summarize the efficacy of mirtazapine in treating chronic itch. Results: All studies reported a reduction in itch intensity following the administration of mirtazapine. Conclusion: Collectively, these studies suggest the potential for mirtazapine to relieve chronic itch attributed to dermatological causes and malignancies. As, such mirtazapine may be an option for patients with chronic pruritus that is refractory to typical first-line treatments.

Results of surgical treatment of pilonidal sinus in 50 patients operated by the Bascom 2 method – prospective study

2019 ◽  
Vol 91 (5) ◽  
pp. 1-5
Author(s):  
Paweł Dutkiewicz ◽  
Przemysław Ciesielski ◽  
Małgorzata Kołodziejczak
Keyword(s):  
Quality Of Life ◽  
Wound Healing ◽  
Pilonidal Sinus ◽  
Surgical Care ◽  
Wound Dehiscence ◽  
Healing Time ◽  
Physical And Mental Health ◽  
The World ◽  
Wound Healing Time

Introduction: Treatment of the pilonidal sinus, due to the various surgery method, remains the current topic of discussion during surgeon meetings around the world. The newest methods of treatment consist in the excision and simultaneous closure of the wound with the cleft lift techniques. One of such methods is the Bascom 2 technique widely used in the world and less popular in Poland. Aim of the study: To evaluate the results of treatment of pilonidal cysts using the Bascom 2 method performed by one operator. Material and method: 50 patients (40 men, 10 women), Avg. 30.6 years of age, All patients treated with the Bascom 2 method in one surgical ward by one operator (resident during specialization training) with the use of a uniform surgical care for all operational protocols. The following were assessed: BMI, average hospitalization time, pain, post-operative complications, wound healing time, patient's quality of life, and the percentage of recurrences after surgery. The follow-up period ranged from 12 to 52 months. Results: Average BMI 27.13 kg / m2. Avg. time of hospitalization 2.95 days. Postoperative pain in the first 24 hours was on average 4.55 points. (+/- 2.24 points); on the 10th day of. 2.04 points (+/- 1.58 points); in the 30th day of the 0.76 points (+/- 1.1 points). Pain after healing 0.14 points (+/- 0.40 points). Postoperative complications occurred in 28.57% of patients (partial wound dehiscence (16.32%), serum leak (10.2%), hematoma (6.12%), total wound dehiscence (0%), wound infection (0%). The average time of full healing was 2.94 weeks. The recurrence occurred in one patient (2.04%). Conclusions: Bascom 2 method is characterized by low recurrence rate and short wound healing time. It is a safe, effective and patient-accepted treatment method. Statistically significantly improves the patient's quality of life one year after surgery in terms of both physical and mental health.

Negative pressure wound therapy versus standard wound care on quality of life: a systematic review

2016 ◽  
Vol 25 (3) ◽  
pp. 154-159 ◽  
Author(s):  
A.H.J. Janssen ◽  
E.H.H. Mommers ◽  
J. Notter ◽  
T.S. de Vries Reilingh ◽  
J.A. Wegdam
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Wound Care ◽  
Wound Therapy

scholarly journals Effects of variable frequencies of kinesthesia, balance and agility exercise program in adults with knee osteoarthritis: study protocol for a randomized controlled trial

2020 ◽  
Author(s):  
Aysha I. Adhama ◽  
Mukadas O. Akindele ◽  
Aminu A. Ibrahim
Keyword(s):  
Quality Of Life ◽  
Randomized Controlled Trial ◽  
Knee Osteoarthritis ◽  
Conventional Therapy ◽  
Controlled Trial ◽  
Hip Osteoarthritis ◽  
Life Questionnaire ◽  
Knee Oa ◽  
Randomized Controlled

Abstract Background: Knee osteoarthritis (OA) is a common painful and disabling condition that affects older individuals. Proprioceptive training programs in the form of kinesthesia, balance and agility (KBA) exercises have been reported to be beneficial for individuals with knee OA. However, the most optimal treatment dosage of KBA exercise is still unclear. The aim of this study is to determine the effects of different frequencies of KBA treatment (i.e. twice-weekly or thrice-weekly) in adults with knee OA.Methods: A single (assessor) blind, three-arm parallel, multi-center randomized controlled trial will be conducted. Eighty-four adults with knee OA will be recruited from four tertiary hospitals in Northwestern Nigeria and randomly assigned into one of three intervention groups; twice-weekly KBA (n = 28), thrice-weekly KBA (n = 28), and conventional physiotherapy or control (n = 28) in the ratio of 1:1:1. Participants in the conventional therapy group will receive two sessions of brief patient education, and 16 sessions of ultrasound therapy, stretching and strengthening exercises for 8 weeks. Participants in the two different KBA groups will receive KBA exercise according to the designed sessions for 8 weeks in addition to the conventional therapy. All groups will be assessed pre-intervention, immediately post-intervention and at 8 weeks, 3-month, 4-month, and 6-month post-randomization. The primary outcome will be physical function (Ibadan Knee and Hip Osteoarthritis Outcome Measure) while the secondary outcomes will be pain (Visual Analogue Scale for pain), knee stability (Knee Outcome Survey-Activities of Daily Living Scale), proprioception (electronic goniometer), and quality of life (Osteoarthritis Knee and Hip Quality of Life Questionnaire).Discussion: Findings of this study may provide evidence on the effectiveness of KBA exercise and the ideal number of sessions needed to achieve the highest effectiveness in adults with knee OA.Trial registration: Pan African Clinical Trials Registry, (PACTR201810713260138), Retrospectively registered on 28 November 2017.

scholarly journals Quality of life and costs of conventional therapy in patients treated by catheter ablation for atrial fibrillation

Cor et Vasa ◽  
2012 ◽  
Vol 54 (11-12) ◽  
pp. e421-e427
Author(s):  
Veronika Bulková ◽  
Martin Fiala ◽  
Dan Wichterle ◽  
Luděk Haman ◽  
Jan Chovančík ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Conventional Therapy

Long-Term Outcome Study in Patients with Abdominal Wound Dehiscence: a Comparative Study on Quality of Life, Body Image, and Incisional Hernia

2013 ◽  
Vol 17 (8) ◽  
pp. 1477-1484 ◽  
Author(s):  
Gabrielle H. van Ramshorst ◽  
Hasan H. Eker ◽  
Jan A. van der Voet ◽  
Johannes Jeekel ◽  
Johan F. Lange
Keyword(s):  
Quality Of Life ◽  
Body Image ◽  
Wound Dehiscence ◽  
Outcome Study ◽  
Abdominal Wound ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Abdominal Wound Dehiscence
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