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PubMed1985

Effects of intraocular irrigating solutions on the corneal endothelium after in vivo anterior chamber irrigation.

We used wide-field specular microscopy and corneal pachymetry to evaluate the effect of anterior chamber irrigation with BSS and BSS Plus on the corneal endothelium of cats. Endothelial changes were quantitated by computerized morphometric analysis of individual cells. After short-term (15 and 30 minutes) and long-term (one and two hours) irrigation, endothelial cell density remained unchanged. Corneal thickness increased significantly in the BSS group after one hour of irrigation. BSS Plus caused minimal changes in endothelial morphologic characteristics regardless of the irrigation time. By comparison, BSS caused a significant increase in the coefficient of variation of cell area (polymegethism) and a decrease in the percentage of hexagonal cells (pleomorphism). These changes were more prominent after prolonged irrigation. The morphologic changes caused by BSS irrigation are indicative of a stressed endothelial monolayer that may be more susceptible to additional surgical trauma.

Acetates↗
PubMed2004

Aural irrigation using the OtoClear Safe Irrigation System in children.

OBJECTIVE: To evaluate the safety and efficacy of the OtoClear Safe Irrigation System for removing cerumen from the external auditory canal in children. METHODS: Eligible subjects were 6 months-17 years of age with cerumen obstructing > or = 50% of the tympanic membrane (TM) from view (by otoscopy). Pneumatic otoscopy, tympanometry, and audiometry were performed followed by cleansing of the affected ear canal(s) with the OtoClear Safe Irrigation System and warm tap water. Otoscopy was performed after each wash of the canal. A curette or small alligator forceps was used to remove remaining cerumen if necessary. Tympanometry and audiometry were repeated after all procedures were completed. Telephone contact was made 1 week later regarding symptoms of acute otitis externa or any other problems. RESULTS: Eighteen children (28 ears) ages 1-10/12 to 11-2/12 years were entered. Four had previously had tympanostomy tubes. At entry, there was no visible TM in 19 ears, 5-10% visible TM in 5 ears, 20% in 1 ear, and 30-40% of the TM in 3 ears. The number of washes needed per ear was: 1 wash--16 ears, 2 washes--8 ears, 3 washes--1 ear, 4 washes--2 ears; washing was stopped in 1 ear because of pain. After irrigation, a curette or forceps was used in 6 ears. Following the procedures, > or = 95% of the TM was visible in 24 ears, and > or = 80% was visible in all ears. Six ears (4 children) with flat tympanograms at entry became normal after irrigation. On audiometry, a conductive loss in 2 ears at entry resolved after irrigation. The mean change in pure tone average (PTA) was -2.9 dB. Three subjects were noted to have hearing losses >5 dB at some frequencies which on review by audiologists were deemed non-significant. No perforations of the TM occurred. There were no reports of otitis externa or any other adverse events occurring after leaving the clinic. CONCLUSION: We found the OtoClear Safe Irrigation System to be safe and effective in our small sample of children. It was well tolerated in most and provided a non-traumatic method for the removal of obstructing cerumen.

Acoustic Impedance Tests↗
PubMed1985

Antimicrobial irrigation of deep pockets to supplement non-surgical periodontal therapy. II. Daily irrigation.

106 sites with probing pocket depths 7 mm or greater from 14 patients were treated with plaque control instruction and 1 episode of root planing. Sites in each patient were either irrigated with 2% chlorhexidine or left as non-irrigated controls. Irrigation immediately followed root planing and was repeated daily, by the patient, for 24 weeks. Clinical measurements were made at 12 and 24 weeks, as were gingival washings for determining the number and % of spirochetes. Results at 24 weeks demonstrated that bleeding scores decreased from 91% to 9%; the % of spirochetes dropped from approximately 9% to less than 1%; probing pocket depths decreased from 7.5 to 4.5 mm, and probing attachment levels gained 1.1 to 1.4 mm. The chlorhexidine irrigated experimental group and the non-irrigated control group did not differ significantly in any of the studied parameters. Thus, daily patient-administered chlorhexidine irrigation of deep pockets did not augment the effects of non-surgical periodontal therapy.

Adult↗
PubMed1997

Efficacy of sinus irrigation versus sinus irrigation followed by functional endoscopic sinus surgery.

Sinus irrigation is the traditional treatment for chronic maxillary sinusitis. Functional endoscopic sinus surgery (FESS) restores aeration and allows secretions to be removed from an infected sinus. This study compares the efficacy of sinus irrigation with that of sinus irrigation followed by FESS in 89 patients. We measured the effects by way of sinus radiographs, nasendoscopic findings, and patient complaints. When we analyzed the data in terms of intent to treat, we found significantly favorable results for sinus irrigation followed by FESS at the end point, though only for loss of smell and purulent rhinitis. Treatment consisting of sinus irrigation alone prevented surgery in 58% of all patients for 1 year. Both treatment methods were combined with a 10-day course of loracarbef, which might have contributed to the outcome. We conclude that a good option for treatment of chronic maxillary sinusitis seems to be sinus irrigation in combination with a broad-spectrum antibiotic followed by FESS.

Adult↗
PubMed1999

[Curative report of two cases with MRSA mediastinitis after cardiovascular surgery, treated by new irrigation technique (intermittent mass-irrigation technique)].

We experienced a 42-year-old patient who underwent aortic valve replacement and a 63-year-old patient who underwent coronary artery bypass grafting with mediastinitis caused by methicillin-resistant Staphylococcus aureus (MRSA). They were successfully treated with the intermittent mass-irrigation technique. The irrigation device consistent of a irrigation tube which placed in upper half of mediastinum and three suction tubes which placed in lower half. We dripped the wash composed of 0.03-0.05% of Povidone-Iodine with 1,000 ml of physiological saline, for 3 to 5 times a day by condition. After each wash, we cross clamped the drainage tubes and filled mediastinum with 0.5 grams of vancomycin hydrochloride dissolved in 100 ml of physiological saline, dripped from irrigation tube, for 30 minutes. After 9-day irrigation in the former case and 16-day irrigation in the latter case, the culture of drainage turned negative. We presumed that this new method is effective for mediastinitis after cardiovascular surgery.

Adult↗
PubMed2006

Single side hole irrigation--a simple method of catheter irrigation of the tendon sheath.

Treatment of septic flexor tenosynovitis at the hand requires significant hospital resources in terms of operative time and subsequent management of tendon irrigation. Delayed recovery or treatment failure may require re-irrigation and drainage. This may be due to failure to adequately irrigate the entire flexor sheath. We describe a method of closed tendon sheath irrigation which is simple to use and ensures that the complete tendon sheath is adequately irrigated. Unwieldy continuous irrigation is avoided and patient inconvenience is kept to a minimum.

Anti-Bacterial Agents↗
PubMed1985

Isotonic solutions of mannitol, sorbitol and glycine and distilled water as irrigating fluids during transurethral resection of the prostate and calculation of irrigating fluid influx.

The aim of the study was to evaluate the clinical properties of some irrigating fluids used in transurethral resection of the prostate, to study humoral changes and disposition of the various fluids and solutes on intravenous absorption and, finally, to draw conclusions concerning a suitable composition of irrigation fluid. 60 patients undergoing transurethral resection of the prostate were included in the study. Plasma concentrations of mannitol, sorbitol and glycine were determined (during and after operation) as indicators of intravenous irrigation fluid influx. The serum concentration of prostatic acid phosphatase and, in patients irrigated with distilled water, the postoperative increase in plasma haemoglobin and the serum lactate dehydrogenase increase were used as semiquantitative estimates of fluid influx. A wide-ranging series of biochemical analyses was performed on blood in all cases before, during and after the resection (inter alia, sodium, albumin, haptoglobin in serum). The half-lives in plasma were estimated for mannitol, sorbitol and glycine. Fluid absorption was calculated in several ways. Haemodilution occurred with all iso-osmolar solutions on absorption but not with distilled water. The dilution effect of glycine solution was the most pronounced. Calculation of absorbed fluid volumes gave values up to 3.0 litres. Plasma osmolality was unchanged with all irrigating fluids used. The half-life in plasma for sorbitol was about 30 min, for glycine about 90 min and for mannitol about 120 min. Glycine entered muscle cells and changed the amino acid pattern. There was an increase in the serine and ammonia concentrations in plasma postoperatively. On absorption of distilled water there was an increase in the concentration of plasma haemoglobin and in erythrocyte-derived enzymes. The immediate postoperative concentration of glycine, mannitol and sorbitol in plasma was used to calculate fluid absorption. These concentrations showed good correlation with the immediate postoperative decrease in serum sodium concentration. The serum sodium decrease can be used for calculations of the absorbed fluid volume. On absorption of large volumes of water with haemolysis products, kidney damage is possible. The osmotic diuretic effect of mannitol gives a tendency to low postoperative blood pressure if combined with an intravenous diuretic. Water as an irrigating fluid can be recommended for diagnostic purposes and for general bladder surgery.(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗
PubMed1998

Temperature-controlled irrigated tip radiofrequency catheter ablation: comparison of in vivo and in vitro lesion dimensions for standard catheter and irrigated tip catheter with minimal infusion rate.

INTRODUCTION: In patients with ventricular tachycardias due to structural heart disease, catheter ablation cures < 60% partly due to the limited lesion size after conventional radiofrequency ablation. Irrigated tip radiofrequency ablation using power control and high infusion rates enlarges lesion size, but has increased risk of cratering. The present study explores irrigated tip catheter ablation in temperature-controlled mode, target temperature 60 degrees C, using an irrigation rate of 1 mL/min, comparing this to conventional catheter technique, target temperature 80 degrees C. METHODS AND RESULTS: In vivo anesthetized pigs were ablated in the left ventricle. In vitro strips of porcine left ventricular myocardium were ablated in a tissue bath. Lesion volume was significantly larger after irrigated tip ablation both in vivo (544 +/- 218 vs 325 +/- 194 mm3, P < 0.01) and in vitro (286 +/- 113 vs 179 +/- 23 mm3, P < 0.001). The incidence of cratering was not significantly different between the two groups. In vivo, no coagulum formation on part of the catheter tip was seen after irrigated tip ablation as opposed to 52% of the applications with conventional ablation (P < 0.05). CONCLUSION: We conclude that temperature-controlled radiofrequency ablation with irrigated tip catheters using low target temperature and low infusion rate enlarges lesion size without increasing the incidence of cratering and reduces coagulum formation of the tip.

Animals↗
PubMed2005

Prevalence and intensity of Schistosomiasis mansoni in irrigation and non-irrigation areas of central Kenya.

OBJECTIVE: To compare the extent of intestinal schistosomiasis among school children attending school in an irrigation and non-irrigation area of Central Kenya. DESIGN: A cross sectional study. SETTING: Three separate parasitological surveys involving four primary schools in Mwea irrigation scheme, Kirinyaga District and two from a non-irrigation area in Machakos District. SUBJECTS: One thousand two hundred and twenty two children aged between five and nineteen years were examined for Schistostoma mansoni infection by Kato thick smear technique. RESULTS: High prevelances ranging from 73% to 94% were noted among children in all the participating schools. Overall 41% of the infected children had heavy infection (>400 eggs per gram), 27% had moderate infection (101-400 epg) and 32% had light infection (10-100epg). When data from the two areas were analysed seperately, peak eggs output were found in 5-9 year olds among children in Kirinyaga while this situation shifted to the 10-14 year olds in Machakos children. In Kirinyaga District, boys in the 10-14 years age group had a significantly higher output than girls (P<0.01), but this situation was reversed in the older children (P<0.05). Girls in Machakos District had consistently but non-significantly higher output than boys. CONCLUSION: Intestinal schistomiasis is more prevalent and with a higher intensity in the irrigated than in non-irrigated areas. There were also pronounced age and gender related differences in the pattern of infection between the two study areas.

Adolescent↗
PubMed2006

The influence of volume, type of irrigant and flushing method on removing artificially placed dentine debris from the apical root canal during passive ultrasonic irrigation.

AIM: To determine the influence of volume, irrigant and method of flushing on the removal of artificially-placed dentine debris from the apical part of root canals during passive ultrasonic irrigation. METHODOLOGY: Access cavities were prepared in 15 canine teeth and their root canals instrumented to size 20, 0.10 taper. Each root was split longitudinally, forming two halves. A groove was cut in the canal wall 2-6 mm from the apex in each half which was then filled with dentine debris prior to the roots being reassembled. All canals were ultrasonically irrigated, using a size 15, 0.02 taper smooth wire to a length of 21 mm that was placed in the canal to the apical foramen. In group 1 the canal was flushed with a continuous flow of 50 mL 2% sodium hypochlorite (NaOCl). In group 2 the continuous flow was not used but the canal was flushed with 12 mL 2% NaOCl, at a rate of 2 mL 30 s-1 using a syringe. Group 3 was treated in the same way as group 2 but the canal was flushed with 6 mL 2% NaOCl, at a rate of 2 mL min-1. Group 4 was treated in the same way as group 1 but water was used as the irrigant. Before and after irrigation, images of the grooves were captured and stored. The quantity of dentine debris in the groove was evaluated. The differences in debris scores between the experimental groups were analysed with the Kruskal-Wallis test and the Mann-Whitney U-test. The level of significance was set at P=0.05. RESULTS: The difference between all groups was statistically significant (K-W test P<0.001). Groups 1, 2 and 3 differed significantly from group 4 (P<0.001); there was no significant difference between groups 1, 2 and 3 (P=0.550). CONCLUSIONS: Syringe delivery of 2% NaOCl (6 and 12 mL) was as effective as a continuous flow of 2% NaOCl (50 mL). Water was not effective in removing dentine debris from grooves in the apical portion of root canals.

Cuspid↗
PubMed2004

A comparison of open irrigated and non-irrigated tip catheter ablation for pulmonary vein isolation.

AIMS: The relative efficacy and safety of open irrigated tip catheters compared with conventional non-irrigated catheters for pulmonary vein isolation (PVI) is unknown. METHODS: Forty-eight patients undergoing PVI using an open irrigated tip ablation catheter (Group 1) were compared with a group of 31 historical controls (Group 2). The control group underwent similar procedures using a standard, 4 mm tip, temperature controlled ablation catheter. Electrical mapping with a circular catheter was used to guide segmental radiofrequency ablation at the vein ostia. RESULTS: At follow-up (3.5+/-3.5 months) after a single procedure 35/48 (73%) patients in Group 1 and 14/31 (45%) in Group 2 were in sinus rhythm (p=0.03). Antiarrhythmic drug use was lower among those in Group 1 maintained in sinus rhythm (9/35 (26%) vs 8/14 (57%), p=0.002). Recurrent atrial fibrillation was more common in Group 2 (28/31 (90%) vs 28/48 (58%) p=0.004). Serious complications were uncommon in both groups. CONCLUSIONS: Compared with an historical control group, pulmonary vein isolation using open irrigated tip catheters was superior to ablation with conventional 4 mm tip catheters. Patients undergoing ablation with an irrigated tip catheter were less likely to experience symptomatic recurrences of atrial fibrillation or require further therapy for post-procedural arrhythmias.

Adult↗
PubMed2005

Closed chamber globe stabilization and needle capsulorhexis using irrigation hand piece of bimanual irrigation and aspiration system.

BACKGROUND: The prerequisites for a good capsulorhexis include a deep, well maintained anterior chamber, globe stabilization and globe manipulation. This helps to achieve a capsulorhexis of optimal size, shape and obtain the best possible position for a red glow under retroillumination. We report the use of irrigation handpiece of bimanual irrigation aspiration system to stabilize the globe, maintain a deep anterior chamber and manipulate the globe to a position of optimal red reflex during needle capsulorhexis in phacoemulsification. METHODS: Two side ports are made with 20 G MVR 'V' lance knife (Alcon, USA). The irrigation handpiece with irrigation on is introduced into the anterior chamber through one side port and the 26-G cystitome (made from 26-G needle) is introduced through the other. The capsolurhexis is completed with the needle. RESULTS: Needle capsulorhexis with this technique was used in 30 cases of uncomplicated immature senile cataracts. 10 cases were done under peribulbar anaesthesia and 20 under topical anaesthesia. A complete capsulorhexis was achieved in all cases. CONCLUSION: The irrigating handpiece maintains deep anterior chamber, stabilizes the globe, facilitates pupillary dilatation, and helps in maintaining the eye in the position with optimal red reflex during needle capsulorhexis. This technique is a safe and effective way to perform needle capsulorhexis.

Capsulorhexis↗
PubMed1993

Effect of calculus and irrigator tip design on depth of subgingival irrigation.

This study addressed three factors that may affect the penetration of medicaments into periodontal pockets: calculus, ejection site pressure, and irrigator tip design. Ejection site pressure for the Max-I-Probe, the Viadent and Water-Pik tips were determined with a variant of Bernoullis' equation. Depth of irrigant penetration was determined by delivering disclosing solution supragingivally and subgingivally. Following irrigation, assessed teeth were extracted and the percentage of pocket penetration by the dye was calculated. The Max-I-Probe and Viadent tips had significantly greater penetration than did the Water-Pik tip. Furthermore, calculus deposits reduced irrigation penetration in deep pockets (7 to 10 mm). Ejection site pressures of the three tips ranged from 0.10 to 4.80 psi. The ejection site pressure of the Max-I-Probe side-port delivery system was lower than that of the other two systems. Results indicated that subgingival calculus, irrigator tip design, and placement of the tip affect the depth to which drugs can be delivered subgingivally.

Anti-Infective Agents, Local↗
PubMed2005

Effect of petroleum-containing wastewater irrigation on bacterial diversities and enzymatic activities in a paddy soil irrigation area.

Effects of petroleum contamination on bacterial diversities and enzymatic activities in paddy soils were investigated in the Shenfu irrigation area, the largest area irrigated by oil-containing wastewater for more than 50 yr in northeastern China. Bacterial diversities were determined by conventional colony morphology typing techniques and 16S rDNA polymerase chain reaction (PCR)-denaturing gradient gel electrophoresis (DGGE). Dehydrogenase, hydrogen peroxidase, polyphenol oxidase, urease, and substrate-induced respiration (SIR) were measured to evaluate the effects of petroleum-containing wastewater irrigation on soil biochemical characteristics. Results showed that paddy soil total petroleum hydrocarbon (TPH) concentration in the irrigation area varied from 277.11 to 5213.37 mg kg(-1) dry soil. Soil TPH concentration declined along the gradient of the irrigation channel from up- to downstream. At the current pollution level, the paddy soil TPH concentration was positively correlated with the colony forming units (CFU) of aerobic heterotrophic bacteria (AHB) (r = 0.928, p < 0.001) and the genetic diversity based on DGGE profiles (r = 0.655, p < 0.05). The bacterial diversities in the soils based on colony morphotypes of AHB also increased with TPH concentration (r = 0.598), but not significant statistically (p = 0.052). Analysis of soil enzyme activities indicated a significant positive correlation between soil TPH concentration and activities of dehydrogenases (r = 0.974, p < 0.001), hydrogen peroxidases (r = 0.957, p < 0.001), polyphenol oxidases (r = 0.886, p < 0.001), and SIR (r = 0.916, p < 0.001). On the contrary, the urease activity showed a negative correlation with paddy soil TPH concentration (r = -0.814, p = 0.002), and could be used as a sensitive indicator of petroleum contamination.

Agriculture↗
PubMed2005

Entomological studies on malaria in irrigated and non-irrigated areas of Thar desert, Rajasthan, India.

BACKGROUND & OBJECTIVES: Malaria is the major health problem in western Rajasthan yet its vector fauna and transmission dynamics thereof is not understood properly. The present investigations report complete profile of qualitative and quantitative aspects of anopheline species occurring in different settings of desert ecosystem. METHODS: Area with irrigation through canal for more than 20 years (setting I), area with irrigation through canal for 10 years (setting II) and area without any irrigation (setting III) have been selected for studies. Species identification and their densities (per man hour) was made as per standard methods. RESULTS: In village of setting I, during rainy season, An. subpictus and An. stephensi were present while during winter season four species--An. subpictus, An. stephensi, An. culicifacies and An. annularis were collected. In all the villages of setting I, II and III no Anopheles mosquito was observed during summer season. In the villages of desert region without any irrigation facilities through any canal, the anopheline species were present only during rainy season. INTERPRETATION & CONCLUSION: An. stephensi is the major malaria vector of desert irrespective of whether the area is canal irrigated or not. During summer season absence of vector species in all the villages require further studies on micro-ecology of the species under desert conditions.

Agriculture↗
PubMed1989

Intraoperative angioscopy: principles of irrigation and description of a new dedicated irrigation pump.

The value of intraoperative angioscopy in the detection and immediate correction of technical errors and deficiencies during vascular surgery has been previously documented. The inability to see through blood remains the most significant limitation to the general application of angioscopy. Local irrigation with a balanced salt solution is the most commonly used method to clear the blood from a restricted field in a particular vessel. We have developed a new catheter irrigation pump system (maximum flow rate 340 ml/min) to establish and maintain visibility of the field during intraoperative angioscopy. Furthermore, we have demonstrated the safety of irrigating with high volume flows in the peripheral arteries and defined the basic principles of irrigation for angioscopy. The prototype pump tested in this study provides a wide range of flow rates and permits precise measurements of the fluid delivered. The instrument's display and its control with a single foot pedal makes its use relatively simple, obviating the need for additional support personnel while increasing the efficacy and safety of the angioscopic examination and increasing the number of situations where angioscopy may be very useful.

Animals↗
PubMed1993

A technique for prevention of sudden pressure loss on emptying of irrigation bags during arthroscopic surgery using gravity-fed irrigation systems.

Gravity-fed irrigation systems in arthroscopic surgery are safe and cheap, but visualization can be impaired by fluctuations in in-flow pressure, which leads to bleeding and temporary disruption of surgery. We describe a gravity-fed irrigation system using differential hydrostatic pressures in sequentially arranged irrigation bags that can be independently raised and lowered. This technique maintains a relatively steady flow and intra-articular pressure, thereby improving the quality of irrigation without having to resort to the more expensive pressure infusion systems, and minimizing the need for surgery under tourniquet.

Arthroplasty↗
PubMed2000

Effect of irrigating solution and irrigation temperature on the cornea and pupil during phacoemulsification.

PURPOSE: To evaluate the effect of irrigation solution and temperature on pupil diameter, corneal endothelium, and corneal pachymetry during and after phacoemulsification. SETTING: Klinik Dardenne, Bonn, Germany. METHODS: Eighty patients who had cataract surgery by phacoemulsification were assigned to 1 of 4 cross-classified groups and had intraoperative irrigation with room-temperature or refrigerated fortified balanced salt solution (BSS Plus) or modified Ringer's solution. Pupil diameters were recorded at different stages during the surgery. Epithelial cell counts and pachymetry were determined before and 1 day after surgery. RESULTS: The solution temperature did not affect any parameter. The type of solution did not influence endothelial cell loss; however, the solution had a significant effect on corneal pachymetry 1 day postoperatively. The corneas irrigated with BSS Plus were less swollen than the corneas irrigated with Ringer's solution. By day 14, corneal thickness was equal among all groups. CONCLUSION: Long-term results were equally favorable in all 4 groups. However BSS Plus induced less short-term corneal swelling than Ringer's solution. From these findings, it appears that BSS Plus may decrease corneal risk in cases with compromised corneas or prolonged surgery.

Adult↗