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Biomedical subjects

Richard F Edlich

Publications and source records attributed to Richard F Edlich.

11 recordsLinked to original sources
PubMed2003

Reducing accidental injuries during surgery.

Extensive clinical investigations have demonstrated that double-gloves and blunt-tipped surgical needles dramatically reduced the risk of accidental injuries during surgery. During the last decade, double-glove hole puncture indication systems have been developed that reduce the clinical risk of accidental needlestick injuries as well as detect the presence of glove hole puncture in the presence of fluids. When the outer glove is punctured, the colored underglove becomes apparent through the translucent outer glove, necessitating glove removal, hand washing, and donning of another double-glove hole puncture Indicator system. This article presents the first biomechanical performance study that documents the puncture resistance of blunt surgical needles in latex and nonlatex single gloves and double-glove hole puncture indication systems. The technique for measuring glove puncture resistance simulates the standard test for material resistance to puncture outlined by the American Society for Testing and Materials. The maximum puncture resistance force was measured by the compression load cell and recorded in grams with a strip chart recorder. Ten puncture resistance measurements for the taper point needle, blunt taper point needle, and blunt needle were taken from five samples of the Biogel Indicator underglove, Biogel Super-Sensitive glove, Biogel glove, Biogel Skinsense N Universal underglove, and Biogel Skinsense Polyisoprene glove; and the Biogel, Biogel Super-Sensitive, and Biogel Skinsense Polyisoprene double-glove hole puncture indication systems. The magnitude of puncture resistance forces recorded was influenced by several factors: glove material, number of glove layers, and type of surgical needle. For each type of curved surgical needle,the resistance to needle penetration by the nonlatex gloves was significantly greater than those encountered by the latex glove materials. The resistance to needle puncture of all three double-glove systems was significantly greater than that of either the nonlatex or latex underglove or outer glove. The taper point needle encountered the lowest puncture resistance forces in the five single gloves and the three double-glove systems. Blunting the sharp end of the taper point needle markedly increased its resistance to glove puncture in the five single gloves and five double-glove systems. The blunt-point surgical needle elicited the greatest needle penetration force in all of the single and double-glove systems.

Accidents, Occupational↗
PubMed2003

Latex allergy: a life-threatening epidemic for scientists, healthcare personnel, and their patients.

Latex allergy has become a global epidemic, affecting patients, healthcare workers, and scientific personnel. Today, the incidence of latex allergy in healthcare and scientific personnel varies from 17-36%, costing billions of dollars annually to treat. Consequently, it is the purpose of this special report to describe the etiology, immunology, diagnosis, management, prevention, and litigation of cases of latex allergy. The latex allergy epidemic has been attributed to the dramatic increase in glove usage following the establishment of Universal Precautions by the Centers for Disease Control and Prevention. Because of the latex allergy epidemic, every hospital and scientific research facility should institute a comprehensive emergency treatment program for latex allergic patients, latex-safe areas in their facilities, and a prevention program that includes the wide use of latex-free gloves and the absence of powdered gloves throughout these facilities.

Disease Outbreaks↗
PubMed2003

Revolutionary advances in adaptive seating systems for the elderly and persons with disabilities that assist sit-to-stand transfers.

The independence of elderly and arthritic patients as well as persons with disabilities is influenced considerably by their ability to stand from a chair. The presence of pain, reduced joint range of motion, stiffness, and muscle weakness often limit the ability to achieve a sit-to-stand position (STS). Realizing the enormous implications of STS performance, physicians, scientists, and industry have joined together to design and manufacture a wide variety of adaptive seating systems that facilitate therising process. These systems can be divided into three groups: those without mechanical devices, those with mechanical lifts, and those that can lift, tilt in space, recline, or rock. The design of mechanical seating systems without mechanical assists have been influenced by several factors, including chair height, armrest height, and foot position of the occupant. The evaluation of STS performance involves a variety of measurements to include joint angles and moments, speed of time to rise, functional reach and sway, and perception of patient stability (or perceived safety) in rising from a chair. These studies reported that chair seat height, use of armrest, and foot position had a major influence on the ability to do a STS movement. The use of higher chair seats resulted in lower moments at the knee and hip level. Investigators reported that lowering the chair height increased the need for momentum generation or repositioning of the feet to lower the needed moments. They found that the use of an armrest reduced the moments needed at the hip without altering the range of motion of the joints. These investigators found that repositioning of the feet influenced the strategy of STS movement, allowing lower mean extension moments at the hipwhen the foot position changed from anterior to posterior. Adaptive seating systems with lifts include the spring-booster chair spring-loaded flap seat, and ejector chair. Innovative investigators reported that increased seat height complemented by the mechanical lift enhanced STS transfers by persons with disabilities. The investigators noted that it was easier to perform STS transfer when using a mechanical lift than when rising unassisted or from a raised seat height. The latest adaptive seating system, the elevator chair, has the unique ability to assist the occupant to the STS position. The rear section of this chair remains in a fixed position to support the buttocks of the user during the mechanical lift. The front portion of the seat folds down incrementally as the chair rises to allow the feet of the user to be positioned firmly on the floor. Using an elevator chair, the height that the chair rises will vary with the length of the occupant's legs. When the user reaches a point when his/her legs are comfortably straight and the body is in an erect position, the occupant will walk unassisted from the chair. This elevator chair will soon be available with a tilt-in-space capability as well as a gently rocking motion. The elevator chairs are ideally suited for offices, waiting rooms, hospitals, long-term care facilities, and homes. While persons with disabilities appreciate the benefits of these adaptive seating systems, which allow them to achieve a STS position without assistance, healthcare personnel also value the benefits of these adaptive seating systems because they eliminate their need to lift the occupant to a standing position--an invitation for a potentially serious back injury.

Activities of Daily Living↗
PubMed2002

Functional electrical stimulation for a dropped foot.

The purpose of this collective review is to study the techniques, usage, methods, and clinical results of functional electrical stimulation applied to the peroneal nerve in the treatment of dropped foot. When stimulation is applied through surface electrodes, clinical reports have documented the therapeutic and orthotic benefits of functional electrical stimulation. Clinical trials are now being undertaken in which implantable electrodes are being used to stimulate the peroneal nerve in patients with dropped foot.

Aged↗
PubMed2002

Functional electrical stimulation cycle ergometer exercise for spinal cord injured patients.

The purpose of this collective review on functional electrical stimulation (FES) cycle ergometer training is to describe the pathologic effects of spinal cord injury (SCI) and the structure and function of the FES cycle ergometers, which reverse the devastating systemic and life-threatening effects of SCI. The pathophysiologic consequences of SCI include diminished cardiopulmonary and circulatory function as well as lower extremity muscle atrophy and bone mass reduction. Clinical studies have demonstrated that the two FES cycle ergometers offer promise in reversing these devastating consequences of SCI, which can shorten patients' lives. On the basis of this collective review, it is recommended that all patients with SCI have the benefits of this potentially life-sustaining clinical modality.

Cardiovascular Diseases↗
PubMed2002

Functional electrical stimulation in tetraplegic patients to restore hand function.

The purpose of this collective review is to describe a new form of functional electrical stimulation called neuroprosthesis. This unique technology has been devised to produce lateral pinch and palmar grasp in persons with C5 and C6 motor level spinal cord injuries. This neuroprosthesis includes external as well as implanted components. First, a receiver is surgically implanted into the patient's chest above a pectoralis major muscle. The receiver stimulator is then connected to 8 surgically implanted epimysial or intramuscular electrodes. Restoration of upper extremity function can greatly improve the lives of people affected with tetraplegia. When contralateral shoulder movements trigger an external transmitting coil, it sends a radio wave impulse to the stimulator inducing contraction of the muscles. Many tetraplegics are regaining hand function using implanted functional electrical stimulation. One major limitation is that the key muscles to be stimulated may have lower motor neuron damage, but this obstacle has been successfully overcome using surgical modifications of the biomechanics of the hand.

Activities of Daily Living↗
PubMed2002

Functional electrical stimulation of bladder and bowel in spinal cord injury.

The purpose of this collective review is to examine the use of functional electrical stimulation for incontinence. The Finetech-Brindley bladder system enhances voiding through stimulation via electrodes implanted around the ventral sacral roots. Detrusor hyperreflexia is eliminated through complete dorsal rhizotomy, which results in loss of reflex defecation and reflex erection/reflex lubrication. Consequently, a new system is being devised in which functional electrical stimulation for incontinence in spinal cord injury can be achieved without dorsal rhizotomy.

Electric Stimulation Therapy↗
PubMed2002

Functional electrical stimulation for ejaculation.

The purpose of this collective review is to discuss the technique and effectiveness of rectal probe electroejaculation in conjunction with various assistive reproductive modalities. The electroejaculation probe is positioned inside the anal ring with the electrodes placed against the prostate gland and seminal vesicles, after which electrostimulation is begun. Rectal probe electroejaculation must be always employed in a hospital setting to detect and prevent autonomic dysreflexia. This technology is considered the best approach in patients with spinal cord injury levels below T10 or in other patients in which penile vibratory stimulation fails.

Clinical Trials as Topic↗
PubMed2002

An innovative surgical suture and needle evaluation and selection program.

This report describes an innovative suture and needle clinical evaluation program jointly designed by hospital representatives of Consorta, Inc., a healthcare resource management and group purchasing organization, and United States Surgical/Davis & Geck Sutures (USS/D&G), manufacturer of surgical biomaterials. Nineteen Consorta shareholder hospitals enrolled 699 surgeons to participate in Phase I of this nonexperimental observational study of the clinical performance of surgical needles and sutures. Performance characteristics of the sutures and needles produced by USS/D&G, which were evaluated in 3407 surgical procedures, included packaging and ease of opening, needle strength and sharpness, tissue drag, knot security, tensile strength, and clinically acceptable and unacceptable determinations. In these 30-day studies, the surgeons concluded that the needles and sutures were clinically acceptable in 98.1% of the evaluations. The general, cardiothoracic, and orthopedic surgeons, who performed 73.8% of the product evaluations, reported that the suture and needle products were clinically acceptable in 97.2% of the evaluations. More than half (50.1%) of the evaluations involved the POLYSORB* braided synthetic sutures,which received a clinically acceptable rating in 98.4% of the evaluation. The next most frequently used sutures were the SOFSILK*, followed by the monofilament nylon suture. SOFSILK* was found to be clinically acceptable in 98.7% of the evaluations, whereas the monofilament nylon was noted to be clinically acceptable in 96.3% of the evaluations. Surgical needles made by USS/D&G had a 97.9% clinical acceptability rating.

Attitude of Health Personnel↗