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At least 721 records · Page 40Linked to original sources
PubMed1985

Endothelial cell repopulation after intracameral acetic acid irrigation.

A significant, but transient corneal edema followed inadvertent intracameral irrigation of acetic acid in two patients. Since postsurgical corneal edema generally indicates corneal endothelial dysfunction, the effects of acetic acid on corneal endothelium were studied in the cat where the endothelial regenerative capacity is thought to be comparable to that of humans. The anterior chambers of feline eyes were irrigated with 0.25% acetic acid or balanced salt solution in a double-masked manner. Marked corneal opacification and thickening were evident following exposure to the acetic acid but did not occur following irrigation with balanced salt solution alone. Following intracameral acetic acid irrigation, a few endothelial cells were found in the anterior chamber angle but could not be found on Descemet's membrane. Over an 8-week period gradual repopulation of Descemet's membrane by endothelial cells occurred, first in the periphery and later in the central cornea, coincident with resolution of corneal edema.

Acetates↗
PubMed1997

Effects of distilled water and mixture of sorbitol-mannitol irrigation fluids on fluid-electrolyte balance in patients undergoing transurethral prostatectomy.

This study aimed to compare two various irrigation fluids used in transurethral prostatectomy (TURP) with respect to changes in fluid-electrolyte balance and to evaluate the blood loss during TURP. TURP was performed in 50 patients using distilled water and in 42 patients using a mixture of sorbitol and mannitol solution (2.7% sorbitol and 0.54% mannitol) as irrigation fluid. Fluid-electrolyte changes and blood loss were evaluated. None of the patients had transurethral resection syndrome. Decline in serum sodium level was more significant in patients who were operated on with the sorbitol plus mannitol irrigation fluid in contrast to its clinical insignificance (p < 0.05). Decrease in serum sodium concentration in patients with more than 15 g of tissue resected was greater than in patients with less than 15 g of tissue resected (p < 0.05). Blood loss was greater in the distilled water group (p < 0.05). Blood loss was 145.5 +/- 3.4 ml in patients given a blood transfusion. In conclusion, a fluid containing mainly sorbitol must be the irrigation fluid preferred over distilled water because of its non-haemolytic nature, but although not important clinically, it can cause hyponatraemia more than distilled water. Furthermore, it is useful to determine blood loss during TURP before deciding to give a blood transfusion.

Aged↗
PubMed1988

An assessment of colostomy irrigation.

One hundred patients with permanent sigmoid colostomies were surveyed to determine their satisfaction and success with the "irrigation" technique of colostomy management. Most patients who irrigate their colostomies achieve continence. Odors and skin irritation are minimized. The irrigation method is economical, time efficient, and allows a reasonably liberal diet. It avoids bulky appliances and is safe. In appropriately selected patients, the irrigation technique is the method of choice for management of an end-sigmoid colostomy.

Adult↗
PubMed1989

Immediate detection of irrigant absorption during transurethral prostatectomy: case report.

A transurethral prostatic resection is described in which immediate detection of a rapid massive irrigant absorption could be made by the use of ethanol-tagged irrigating fluid and repeated measurements of the ethanol concentration in the patient's expired breath. This monitoring enabled the surgeon to prevent further absorption by concluding the operation before symptoms resulted. Furosemide was given immediately to promote renal excretion of the absorbed irrigant, and the intravenous infusions were temporarily restricted to limit the intravascular fluid load. In retrospect, volumetric measurement showed that a total of 2410 ml of irrigant had been absorbed.

Absorption↗
PubMed1997

Sorbitol 2.5% mannitol 0.54% irrigation solution for hysteroscopic endometrial ablation surgery.

PURPOSE: To determine if systemic absorption of sorbitol 2.5%/mannitol 0.54% irrigation solution (165 mosm.L-1) during hysteroscopic endometrial ablation with diathermy is associated with hyponatraemia and hypoosmolality. METHODS: In 35 day surgery patients in a university hospital we measured baseline preoperative variables: serum sodium and creatinine concentrations and osmolality, haematocrit, haemoglobin, urine osmolality and sodium concentration, and weight. Fractional excretion of sodium (FENa) was calculated. The same observations were obtained postoperatively before discharge (one hour post resection). Volumes of intraoperative fluid irrigation intravasation and perioperative intravenous fluid absorption (lactated Ringer's solution) were estimated clinically (volumetric). RESULTS: The mean (+/-SD) serum sodium concentration preoperatively was 140.3 +/- 2.4 mmol.L-1; and postoperatively, 139.7 +/- 2.2 mmol.L-1 (P = NS). The serum osmolality decreased from 285.4 +/- 4.5 to 282.6 +/- 4.1 mmol.kg-1 (P < 0.001). The mean volume of intravasated irrigation fluid was 26.4 ml (range 0-300). During the same time, the FENa increased from 0.57% to 0.79% (P < 0.001). CONCLUSION: In these patients, closely and continuously observed for imbalance between infused and collected irrigation fluid, these was no clinical evidence for hyponatraemic hypoosmolality. However, there was a small 1% +/- 1.5% (mean +/- SD; range -3.4 to 3.6%) decrease in plasma osmolality despite adequate blood volumes as shown by urinary sodium indices.

Adult↗
PubMed2000

Syringe pressure irrigation of subdermic tissue after appendectomy to decrease the incidence of postoperative wound infection.

To evaluate syringe pressure irrigation of the surgical wound to decrease its infection after appendectomy, we designed a randomized control trial at the Emergency Department of Mexico City General Hospital, including 350 patients with acute abdomen suggestive of appendicitis, without any other infection clinically evident. The trial was randomized into 2 groups. Group I patients received prophylactic systemic antibiotics before surgery. Group II patients received the same prophylactic systemic antibiotics plus syringe pressure irrigation of the surgical wound with 300 ml of saline solution using a 20-ml syringe with 19-gauge intravenous (IV) catheter to measure the incidence of postoperative wound infection. In our results, 283 patients had appendicitis. Of these, 188 were uncomplicated (66.4%) and 95 (33.6%) were complicated. Of the complicated cases, 40 were assigned to group I, and of these, 29 (72. 5%) developed wound infection. In group II there were 55 patients and only 9 (16.3%) developed wound infection after syringe pressure irrigation [p = 0.000001; 95% confidence interval (CI) = 0.02-0.22]. We conclude that syringe pressure irrigation of the surgical wound after appendectomy contributes significantly to decrease the incidence of postoperative wound infection in complicated cases. It is a cheap, safe, and accessible method in any surgical room.

Adolescent↗
PubMed1998

Intraoperative bowel irrigation improves anastomotic collagen metabolism in the left-sided colonic obstruction but not covering colostomy.

This study investigated the effects of intraoperative colonic irrigation and proximal diverting end colostomy after segmental bowel resection in experimental left-colonic obstruction on anastomotic healing. Simple obstruction of descending colon was performed in male Sprague-Dawley rats. After 24 h we performed segmental colonic resection and anastomosis in the control group (n = 15); resection, anastomosis, and covering colostomy in the colostomy group (n = 14); resection and anastomosis after antegrade colonic lavage through cecum by using isotonic saline solution in the irrigation group (n = 13). In rats that were killed 7 days later anastomotic dehiscence and bursting pressure and tissue hydroxyproline concentration at the anastomosis were measured. No significant differences were observed between groups in terms of anastomotic dehiscence, bursting site, or pressure. The hydroxyproline concentration was significantly higher in the irrigation group than the control group (P = 0.025) and the colostomy group (P = 0.029), but no difference was noted between the control group and the colostomy group. These findings suggest that intraoperative antegrade colonic irrigation in the acute left-sided colonic obstruction positively affects collagen metabolism at the anastomotic site; if the anastomosis is performed without bowel cleansing, covering colostomy does not improve collagen metabolism.

Anastomosis, Surgical↗
PubMed2000

[Bipolar irrigation forceps. Initial experiences with a new device in high frequency surgery].

PROBLEM: During most surgeries, tissues are coagulated by a high-frequency current in order to stop the bleeding. Usually, bipolar forceps are used for this procedure. Until now it could not be avoided, however, that the biotissue would adhere to the forceps ends making hemostasis more difficult to achieve. Can this negative effect possibly be avoided? MATERIAL AND METHOD: A newly developed bipolar irrigation forceps spilling out a 0.9% sodium chloride solution during the coagulation process has been designed to avoid this disadvantage. The irrigation forceps has been tested and evaluated experimentally in surgery as well as clinically. RESULTS: The irrigation liquid selected is a 0.9% sodium chloride solution. Thermal imaging during biotissue coagulation has shown that the tissue heats up more and faster with flushed coagulation, and that the tip of the forceps heats up less than with unirrigated coagulation. In both experimental-surgical as well as in clinical tests it was possible to stop the biotissue sticking to the ends of the forceps. This effect was also confirmed histologically. CONCLUSION: Since other methods of avoiding the sticking effect during tissue coagulation by a high-frequency current have not been successful until now, the bipolar irrigation electrode is a promising new development. It helps the surgeon to work more efficiently and safely without having to adapt to big changes, and, at the same time, it reduces the risk of complications.

Animals↗
PubMed2003

Joint irrigation as treatment for osteoarthritis.

Irrigation is necessary to achieve distension and visualization of the joint during arthroscopy. Clinical improvement observed after diagnostic arthroscopy has been attributed to irrigation, and this is supported by sound pathophysiologic rationales. Studies have been performed using various irrigation techniques with and without concomitant arthroscopy. Unblinded studies have generally yielded favorable results, although recent blinded studies have demonstrated a substantial and durable placebo effect, but little support for the benefit of the irrigation procedure.

Arthroscopy↗
PubMed1983

Reduction of post-cesarean section infectious morbidity by means of antibiotic irrigation.

The effectiveness of antibiotic irrigation in reducing post-cesarean section infectious morbidity was studied in a prospective, randomized, double-blind trial. One hundred twenty-eight patients were divided into three groups and irrigated with either cefoxitin solution, cephapirin solution, or saline. Following delivery of the placenta, the uterine cavity and incision, bladder flap, pelvic gutters, and subcutaneous tissue of the patients were irrigated. There was a significant reduction in total infectious morbidity (p less than 0.02) and wound infection (p less than 0.04) when antibiotic use was compared to the saline control. No statistical difference in the effectiveness of the two antibiotics could be demonstrated. No adverse effects were noted. Antibiotic irrigation is a safe and effective method in reducing infectious morbidity of the parturient patient.

Bacterial Infections↗
PubMed1995

Changes in amino acids, ammonium, and coagulation factors after transcervical resection of the endometrium with a glycine solution used for uterine irrigation.

OBJECTIVE: Transcervical resection of the endometrium with the use of 1.5% glycine for irrigation is associated with postoperative nausea in some patients. This could be because of hyponatremia or toxic effects of glycine and its metabolites. Moreover, 1.5% glycine is hypoosmolar, and hemolysis and fibrinolysis are possible. Changes in plasma factors related to these potential complications of transcervical resection of the endometrium were measured. STUDY DESIGN: In 101 patients undergoing transcervical resection of the endometrium sodium, ammonium, and coagulation factors were measured preoperatively and postoperatively at intervals. In the initial 30 patients glycine and 28 other amino acids were measured at the same intervals. The results were correlated with the patients' clinical status and operative parameters. RESULTS: Glycine and nine other amino acids and ammonia showed increased postoperative plasma levels; these changes were correlated with the absorption of the irrigating glycine solution and the development of hyponatremia. Minor activation of fibrinolysis and hemolysis was also seen. CONCLUSION: Nausea after transcervical resection of the endometrium with 1.5% glycine for irrigation may be partly explained by toxic effects of glycine and its secondary metabolites in addition to the effects of water intoxication and hyponatremia. Minor, clinically insignificant changes in the coagulation system may also occur. Studies on alternatives to glycine for creation of near-isotonic irrigating solutions are encouraged.

Adult↗
PubMed1980

Comparison of three methods of whole bowel irrigation.

Sixty-two patients undergoing colorectal surgery or colonoscopy were prepared by three methods of whole bowel irrigation: nasogastric saline solution alone, nasogastric saline irrigation with oral mannitol, and oral mannitol solution without saline. The additional of mannitol to saline irrigation reduced the risk of sodium and water retention, which was eliminated by oral mannitol alone. The best mechanical preparation was achieved by adding mannitol to saline irrigation, but oral mannitol alone was judged more acceptable by the patients and less demanding by the nursing staff and was the preparation of choice for colonoscopy.

Colon↗
PubMed1995

First-trimester endocervical irrigation: feasibility of obtaining trophoblast cells for prenatal diagnosis.

We sought to determine the feasibility of obtaining trophoblast cells for first-trimester prenatal diagnosis using endocervical irrigation. We studied 20 pregnant patients between 7-10.5 weeks' gestation who presented for elective pregnancy termination. Under ultrasound guidance, a specially designed plastic catheter was advanced to the level of the internal cervical os. Gentle flushing and aspiration was performed with 3 mL of normal saline. The material obtained was fixed and stained. A placental pathologist identified trophoblast cells using light microscopy. In another five cases, we attempted to culture the endocervical washings. Trophoblast cells were identified by microscopy after staining the cultured material with an anti-alpha-hCG-antibody bound stain. In ten of 20 cases (50%), trophoblast material was retrieved on irrigation. Of the five additional cases on which culture was attempted, trophoblast was successfully cultured in one, the results were equivocal in two, and culture was unsuccessful in the other two. Trophoblast cells for prenatal diagnosis can be obtained in a significant percentage of cases by first-trimester endocervical irrigation. The advantages of irrigation include technical simplicity, brief duration (less than 3 minutes), and suitability to first-trimester diagnosis. Further testing is necessary to determine the risks.

Cells, Cultured↗
PubMed1979

Scanning electron microscope study of a new irrigation method in endodontic treatment.

The effectiveness of a newly developed perforated endodontic irrigation needle, with its distal aperture sealed, was compared to conventional endodontic irrigation procedures. In all instances 5 percent sodium hypochlorite was used since the delivery system, rather than the irrigant, was being evaluated. A base line group in which all soft tissue was described was also included. The results indicate that the perforated endodontic irrigation needle is a very effective instrument for the cleansing of instrumented root canals.

Dental Instruments↗
PubMed1982

Forces and efficacy in endodontic irrigation systems.

Measurements of the pressure necessary to activate three commercially available types of endodontic irrigation systems were obtained from an in vitro testing procedure. In addition, the irrigation process was observed in simulated 1 mm. diameter root canals prepared in clear acrylic. Except for one patented system, the force necessary to depress the plunger of an irrigation syringe was found to increase as the size of the needle decreased. the most effective irrigation was observed when the larger needles of a blunted, open-end design were inserted to the full length of the preparation.

Dental Pulp Cavity↗
PubMed1981

Evaluation of povidone-iodine as vesical irrigant for treatment and prevention of urinary tract infections.

This is a preliminary study evaluating diluted solutions of povidone-iodine (PVP-I) as urinary bladder irrigants for the treatment and prevention of urinary tract infection. Diluted povidone-iodine solutions were used as indwelling catheter irrigants and as instillations into the urinary bladder following intermittent catheterization. The diluted PVP-I solutions had no efficacy in either the treatment or prevention of urinary tract infections when used as indwelling urethral or suprapubic catheter irrigants. There was a suggestion of a slight decrease in the incidence of urinary tract infections during the use of PVP-I in the intermittent catheterization group in this uncontrolled study, but the percentage of positive urine cultures was greater than desired. The absence of any unfavorable data has led us to conclude that the diluted PVP-I caused no undesirable side effects in any of the patients treated with this agent, PVP-I bladder irrigation warrants further investigation in special cases such as lower urinary tract fungal infections.

Catheterization↗
PubMed1985

Comparison of epsilon aminocaproic acid and normal saline for postoperative bladder irrigation following transurethral resection of prostate.

A prospective, randomized, double-blind trial of bladder irrigation with a 0.5% solution of epsilon aminocaproic acid (EACA) versus normal saline plus placebo was undertaken in 75 patients undergoing transurethral resection of the prostate for benign or malignant disease. Systemic absorption after irrigation with EACA was not detectable. No significant advantage, however, was demonstrated for the EACA solution over normal saline irrigation in measured postoperative blood loss, irrigant volume, hours of catheterization, or length of hospital stay.

Aminocaproates↗
PubMed1991

Absorption of irrigating fluid during transurethral prostatic resection as measured by ethanol, radioisotopes, and regular-interval monitoring.

Ethanol monitoring is a novel noninvasive method for immediate detection of absorption of irrigating fluid during transurethral prostatic resection. Its accuracy was evaluated during thirteen resections using 5% mannitol +2% ethanol as the irrigating fluid. The ethanol concentration in the expired breath correlated strongly with the degree of absorption of intravascular irrigating fluid as determined by a radioisotope technique, and fluid volume measurements, and with the changes in the serum sodium concentration. Extravascular absorption of the irrigating fluid resulted in prolonged elevation of the ethanol concentration and gave smaller changes in the serum sodium concentration.

Absorption↗