Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “IRRIGATION”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 793 records · Page 44Linked to original sources
PubMed1996

Indications for cisternal irrigation with urokinase in postoperative patients with aneurysmal subarachnoid haemorrhage.

The use of cisternal drainage can lead to complications such as shunt-dependent hydrocephalus and meningitis. We assessed the indications for cisternal irrigation with urokinase in postoperative patients with aneurysmal subarachnoid haemorrhage (SAH). The SAH scores by CT on admission and on the day after surgery were used to evaluate two parameters: the total amount of subarachnoid blood on admission and the clearance rate of subarachnoid blood by surgery. In patients whose parameters values belonged to the range where the total SAH score on admission exceeded 10 points and the surgical clearance rate was less than 50%, the possibility of cerebral infarction was significantly higher in patients without than in those with irrigation (p < 0.05). However, there was no difference between patients with and without irrigation for parameter values outside of the range. Therefore, this range may be useful in providing stricter indications for irrigation therapy with urokinase and thus avoiding the complications of cisternal drainage.

Adult↗
PubMed2004

Iron bezoar retained in colon despite 3 days of whole bowel irrigation.

Concretion formation is a documented complication of large iron ingestions. The generally accepted treatment is supportive care, whole bowel irrigation, and intravenous deferoxamine for systemic toxicity. Laparotomy and gastrotomy have also been used in patients with a high iron burden and bezoar formation. Though experiments suggest that iron is poorly absorbed in the colon, there are no case reports of iron overdose without systemic toxicity, despite a retained colonic bezoar. We report the case of a 16-month-old who presented to an Emergency Department 19 h after an iron ingestion. Initial laboratory studies revealed an anion gap of 14 mEq/L, and a 20 h serum iron concentration of 429 mcg/dL. An abdominal radiograph revealed multiple pills throughout the stomach and small bowel; whole bowel irrigation was initiated. Deferoxamine was administered at 10 mg/kg/h and then stopped when the serum iron level reached 27 mcg/dL, 36 h later. At this time, the abdominal radiograph showed an iron bezoar remaining in the ascending colon despite a clear rectal effluent from whole bowel irrigation. Despite whole bowel irrigation over the next 36 h, the iron bezoar was not removed and actually migrated proximally in the colon. Treatment was stopped on the third day and a normal diet was instituted with prompt passage of the bezoar.

Antidotes↗
PubMed2006

Colonic irrigations: a review of the historical controversy and the potential for adverse effects.

Colonic irrigations enjoy widespread popularity among alternative medicine practitioners, although they are viewed with considerable skepticism by the conventional medical community. Although proponents make claims of substantial health benefits, skeptics cite the lack of evidence for health benefits and emphasize the potential for adverse effects. Yet historically, there are clinical reports of effectiveness and virtually no research refuting these reports. Instead there was a campaign against exaggerated claims by nonmedical practitioners that resulted in a movement away from this form of therapy without any scientific study of efficacy. Given the current popularity of colonic irrigations, it is important that such research be performed, which will require a quantitative estimate of the potential for adverse effects. Although there is little specific literature on colonic irrigations, a review of the literature on related procedures such as enemas and sigmoidoscopies suggests that the risk of serious adverse effects is very low when the irrigations are performed by trained personnel using appropriate equipment.

Constipation↗
PubMed2006

Alteration in irrigant flow and deflection of flexible ureteroscopes with nitinol baskets.

BACKGROUND AND PURPOSE: Introduction of an instrument into the working channel of ureteroscopes adversely affects flow and deflection. We evaluated the alterations in ureteroscope channel flow and deflection caused by available Nitinol(R) baskets. MATERIALS AND METHODS: We compared the effects of 11 Nitinol baskets on irrigation flow and deflection of three flexible ureteroscopes (Olympus P3, ACMI DUR8, and ACMI DUR8 Elite). ANOVA was used to compare the loss of flow and deflection for each basket, with P values adjusted for multiple comparisons by the Tukey method. RESULTS: Ureteroscope flow and deflection were progressively adversely affected by all baskets as their diameter increased. The average baseline irrigant flow (46.6 mL/min) was decreased significantly: by 78.5% (to 9.9 mL/min), with the smaller baskets (Microvasive 1.9F and Cook 2.2F) and by 99.1% (to 0.4 mL/min) with the larger baskets (ACMI 3.0F and Microvasive 3.0F). Similarly, the mean baseline upward deflection (162 degrees) decreased by 2 degrees (1.2%) for the Cook 2.4F N-Compass and by 20 degrees (12.3%) for the ACMI 3.0F. Loss of downward deflection from baseline (170 degrees) ranged from 6 degrees (3.5%) for the Microvasive 1.9F to 17 degrees (10%) for the Microvasive 2.6F grasping forceps. The least deterioration in flow and deflection occurred with the two smallest baskets (Microvasive 1.9F and Cook 2.2F). CONCLUSION: Ureteroscope irrigation flow and deflection deteriorate progressively with larger-caliber Nitinol baskets. The Microvasive 1.9F and Cook 2.2F baskets resulted in the least deterioration of irrigation and deflection metrics. However, basket size is not the only factor responsible for changes in flow and ureteroscope deflection.

Alloys↗
PubMed1986

A dressing system providing fluid supply and suction drainage used for continuous or intermittent irrigation.

In this article a dressing system is described that is capable of providing continuous or intermittent wound irrigation. It is based on a felt dressing provided with an adhesive cover and ports for fluid supply and suction drainage. At continuous irrigation (approximate rate, 70 ml/h), a 1-L fluid bag and a siphon about 30 cm in height are used; at intermittent irrigation (approximate rate, 60 ml/min), a 60-ml fluid bag and a suction balloon are used. In an experimental set-up it was shown that the supplied fluid diffused throughout the dressing felt and that the felt was partly saturated both during continuous and after intermittent irrigation, the effect of gravity being counteracted by capillary force and suction. The suction pressure at the drainage port and within the occlusively applied felt showed a linear relationship. The drainage of particles, while relatively impeded at low flow rates, was satisfactory at rates recommended for clinical use. The dressing felt was inert to adherence of bacteria and white blood cells. This dressing system would seem to provide access to the whole wound surface for active therapy through fluid supply and suction drainage.

Bandages↗
PubMed1998

Endoscopic management of subcutaneous gunshot wound with irrigation technique.

The application of the endoscope to the treatment of gunshot wounds has never been reported to our knowledge, with the exception of the laparoscope and the sigmoidscope in abdominal gunshot wounds. We report a patient with a subcutaneous gunshot wound who was treated endoscopically using the irrigation technique. The patient was a 25-year-old man who had been shot in the upper arm. The bullet was found near the thoracic spine via radiograph. At surgery the endoscope was inserted into the wound and irrigation was started. Excellent views could be obtained by irrigation, and the endoscope was advanced along the path of the bullet. The bullet and several fragments were removed with two additional small incisions. The method described herein seems beneficial in that (1) it is less invasive than conventional surgical debridement with a long incision, (2) it may provide information helpful in diagnosing the condition and the location of the bullet and its path, and (3) saline irrigation may have a cleansing effect.

Adult↗
PubMed2002

Obturation of accessory canals after four different final irrigation regimes.

The aim of this study was to evaluate accessory canal obturation after four different final irrigation regimes. Sixty-four extracted human lower premolars were instrumented, divided randomly into four groups, and finally irrigated as follows: no irrigation (NO), distilled water (WA), sodium hypochlorite ([SH] 6%, 20 ml for 15 min), and EDTA (15%, 8 ml for 3 min) combined with the SH regimen (ES). The System B and the Obtura II were used to fill the canals. The teeth were cleared and observed under a digital microscope. Obturation material penetration rates in length into the accessory canals were measured and the following values were obtained: 22.3% in group NO, 21.8% in group WA, 53.5% and 68.1% in groups SH and ES, respectively. Statistically significant differences were found when comparing each of the first two groups (NO and WA) with SH and ES groups (p < 0.05). The use of sodium hypochlorite alone or in combination with EDTA in final irrigation flushes may enhance a better obturation material penetration into the accessory canals.

Bicuspid↗
PubMed2003

The effect of chlorhexidine gluconate as an endodontic irrigant on the apical seal: long-term results.

The purpose of this study was to determine whether chlorhexidine gluconate (0.12%), used as an endodontic irrigating solution, would affect the apical seal of three root canal cements. One hundred, extracted, human, single-canal teeth were divided into 9 experimental groups of 10 teeth each, in addition to a positive and negative control group of 5 teeth each. The teeth were decoronated at the level of the CEJ, accessed, instrumented to a Master apical file #50, irrigated with either sterile saline, 5.25% NaOCl, or 0.12% chlorhexidine gluconate, and dried using paper points. Obturation was accomplished using lateral condensation and one of three endodontic sealers: Roth's 811, AH 26, or Sealapex. Postobturation apical leakage was measured at 270- and 360-day observation periods using the fluid filtration method. Using the mixed-model repeated-measures ANOVA test with Tukey's honest significance difference multiple comparison procedure, the results showed the saline-Sealapex combination had significantly more leakage (p < 0.05) than either the Peridex-Sealapex or saline-Roth's combinations at 270 days. No other significant differences were noted between any sealer-irrigant combination at 270 days. The saline-Sealapex combination had significantly more leakage than the saline-Roth's combination at 360 days. No other significant differences were noted at 360 days. Under the conditions of this study, chlorhexidine gluconate irrigant did not adversely affect the apical seal of three root canal cements at 270 and 360 days.

Analysis of Variance↗
PubMed2003

The effect of passive ultrasonic activation of 2% chlorhexidine or 5.25% sodium hypochlorite irrigant on residual antimicrobial activity in root canals.

Ninety-four single-canal roots were prepared using the step-down technique. Forty-two canals were irrigated with 2% chlorhexidine, 42 canals with 5.25% sodium hypochlorite (NaOCl), and 10 control canals with phosphate-buffered saline (PBS). The chlorhexidine and NaOCl groups were each then equally divided into a final irrigation group and a 1-min passive ultrasonic irrigation group. Canals were enlarged with a Parapost drill. The apical 3-5 mm was covered with nail polish. Canals were rinsed with PBS, dried, refilled with PBS, and stored. At 6 h, 20 microl of fluid was pipetted from each canal and placed into wells on agar plates, which were inoculated with Streptococcus sanguinis. The plates were incubated, and zones of inhibition were measured. Sampling was repeated at 24, 48, 72, 96, 120, 144, and 168 h. Residual antimicrobial activity with 2% chlorhexidine was statistically significantly superior to 5.25% NaOCl with irrigation alone and with final passive ultrasonic activation (p < 0.001). Chlorhexidine experimental groups demonstrated residual antimicrobial activity for as long as 168 h.

Anti-Infective Agents, Local↗
PubMedDate not supplied

Benzalkonium chloride: a potential disinfecting irrigation solution.

OBJECTIVE: To determine the disinfecting properties of benzalkonium chloride as an irrigation agent. DESIGN: Comparison was made between irrigation of contaminated muscle strips with benzalkonium chloride and normal saline (control). SUMMARY OF BACKGROUND DATA: Benzalkonium chloride is a cationic disinfectant, which has questionable efficacy in an organic environment. However, no previous study has attempted to use high volumes of this cationic solution to overcome the neutralizing effect of organic tissue and thus maintain this detergent's germicidal properties. METHODS: 2.5 cm x 0.5 cm x 0.5 cm pieces of bovine muscle were aseptically cut from the center of freshly harvested beef muscle and incubated with 1.0 x 10(7) colony forming units of bacteria for 15 minutes. The muscle strips were then irrigated with either 100 mL, 1 L, or 10 L of benzalkonium chloride at a 1:2000 concentration in normal saline. Normal saline was used as the control. The muscle strips were sonicated to remove adherent bacteria; the number of living organisms was determined by quantitatively culturing the sonicate. RESULTS: In vitro, benzalkonium chloride was superior to normal saline at disinfecting bovine muscle (p < or = 0.001). When 10 L of benzalkonium chloride irrigation was used, no living bacteria could be recovered (p < or = 0.012). CONCLUSION: In this experimental setting benzalkonium chloride was an effective disinfection agent, with enhanced activity at large volumes.

Animals↗
PubMed2000

Effectiveness of electrolyzed oxidized water irrigation in a burn-wound infection model.

OBJECTIVE: The purpose of the study was to determine whether electrolyzed oxidized water (EOW) functions as a bactericide in burn injury with Pseudomonas aeruginosa infection in a rat burn-wound model. METHODS: Anesthetized Sprague-Dawley rats (n = 31) were subjected to third-degree burns to 30% of total body surface area. Two days after injury, all rats were infected with P. aeruginosa using 1 mL of a suspension containing 1 x 10(8) colony-forming units. Rats were assigned to one of three groups: no irrigation (group I), irrigation with physiologic saline (group II), or irrigation with EOW (group III). Blood culture, endotoxin levels, and survival rates were determined. RESULTS: Survival rate was significantly higher in group III than in groups I or II (p < 0.0001). Serum endotoxin levels on day 3 after infection in group III were significantly lower than the levels in group I (p < 0.01) and group II (p < 0.01). There were significant differences between the three groups in the culture of P. aeruginosa (p < 0.05). CONCLUSION: Irrigation and disinfection with EOW may become useful in preventing burn-wound sepsis.

Animals↗
PubMed1996

A continuous microneurosurgical irrigation and suction system: technical note.

OBJECTIVE: We describe a continuous microneurosurgical irrigation and suction technique. This technique automatically clears the operative field, frees the surgeon to perform microdissection with both hands, and actually aids in dissection of the arachnoid layer. TECHNIQUE: The suction catheter (MicroVac; P.M.T., Inc., Hopkins, MN) described by Spetzler and Iverson and an additional continuous microirrigation technique are discussed. The catheter design has a sump effect and is secured in a dependent position in the operative field to continuously remove blood, irrigate the area, and reduce cerebrospinal fluid accumulation. The irrigation system consists of standard intravenous tubing with an angiocatheter used to direct a precise stream into the operative field. RESULTS AND CONCLUSION: The irrigation and suction system, when properly adjusted, continuously clears the operative site of minute amounts of blood that may obscure the surgeon's view and assists in dissection of the arachnoid layer. It has been used since 1991 with excellent success and satisfaction.

Arachnoid↗
PubMed1999

Experimental prophylaxis of Staphylococcus aureus endophthalmitis after vitrectomy: the use of antibiotics in irrigating solution.

PURPOSE: To test the efficacy of clindamycin and gentamicin in irrigating solution during vitrectomy to prevent experimental Staphylococcus aureus endophthalmitis. MATERIALS AND METHODS: Thirty-six New Zealand white rabbits were divided into six groups. Vitrectomy using two different irrigating solutions was followed by intravitreal injection of S. aureus: Group 1, balanced salt solution (BSS) followed by 1,000 colony-forming units (CFU) S. aureus; Group 2, BSS fortified with clindamycin, 10 microg/mL, and gentamicin, 8 microg/mL (CGBSS), followed by intravitreal injection of 1,000 CFU S. aureus; Group 3, BSS followed by 2,000 CFU S. aureus; Group 4, CGBSS followed by 2,000 CFU S. aureus; Group 5, BSS followed by 4,000 CFU S. aureus; and Group 6, CGBSS followed by 4,000 CFU S. aureus. The eyes were examined clinically after surgery. Vitreous samples were cultured and histologic studies were performed. RESULTS: Severe endophthalmitis developed in all eyes in Groups 1, 3, and 5 (not given antibiotics). No endophthalmitis developed in Group 2. In Group 4, five of the six eyes were normal and one eye had endophthalmitis. In Group 6, one eye had clear vitreous and fundus, three eyes had moderate vitreous haze, and the other four eyes demonstrated severe endophthalmitis. Bacterial growth in Groups 1, 2, 3, 4, 5, and 6 were 4/4, 0/4, 6/6, 1/6, 4/6, and 2/8 eyes, respectively. CONCLUSION: When 1,000 to 2,000 CFU S. aureus were injected after vitrectomy, clindamycin and gentamicin in the irrigating solution significantly diminished the intraocular inflammation and the rate of positive bacterial culture. Clindamycin and gentamicin in the irrigating solution were not significantly effective when 4,000 CFU bacteria was injected; however, the degree of inflammation was less severe than in the control group.

Acetates↗
PubMed2005

Removal of retinal indocyanine green dye by autologous serum irrigation in macular hole surgery.

PURPOSE: To investigate the efficacy of autologous serum irrigation for removal of retinal indocyanine green (ICG) dye used to visualize the internal limiting membrane (ILM) in macular hole surgery. METHODS: Eighteen consecutive eyes of 16 patients with macular holes underwent vitrectomy and ILM peeling using ICG solution. Nine of 18 eyes underwent intravitreal autologous serum irrigation before completion of the surgery to remove residual ICG dye in the retina. The main outcome measures were postoperative visual acuity, macular hole status, retinal pigment epithelial changes, and time course of ICG dye fading from the retina with or without intravitreal autologous serum irrigation. RESULTS: No significant difference was noted in the improvement of visual acuity between the two groups. An abnormal pigment epithelial change was seen in one eye without serum application. ICG dye disappeared from the retina within an average of 6.1 months after surgery without serum and 2.4 months after surgery with serum (P < 0.01). CONCLUSIONS: Autologous serum irrigated in the vitreous cavity just before completion of macular hole surgery can help remove ICG dye used in surgery. The application was simple and safe and significantly shortened the period of residual retinal ICG staining.

Adult↗
PubMed2004

Bradycardia and sinus arrest following saline irrigation of the brain during epilepsy surgery.

Adverse cardiac events during the intraoperative period are life-threatening. The authors report three episodes of severe bradycardia and sinus arrest that occurred in a patient undergoing anterior temporal lobectomy and amygdalo-hippocampectomy for the treatment of epilepsy. The first episode occurred during resection of the amygdala; the other two episodes were observed during subsequent irrigation of the exposed brain structures, most likely the brain stem structures, because of a rent that the surgeon had deliberately made into the basilar cistern for better anatomic appreciation of the structures to be excised. The patient responded well to treatment with no adverse outcomes. The probable mechanisms leading to this event are discussed; the authors excluded insular cortex stimulation, the effects of the anesthetic drugs used, and venous air embolism as a cause of bradycardia and sinus arrest. The amygdala resection was the most likely cause of the first episode of bradycardia; the second episode of bradycardia and sinus arrest occurred because of inadvertent stimulation of brain structures by the high temperature (42 degree C) of the saline used for irrigation. To counter its effects, saline irrigation at room temperature (20 degree C) was started, and this caused the third episode of bradycardia, most likely because of "temperature shock" of the exposed brain. Prompt communication with the surgical team and vigilance are crucial for the appropriate management of such an incident, which may pose a threat to life. Avoiding irrigation of the exposed brain with high-temperature saline may prevent such an incident.

Adolescent↗
PubMed2005

Efficacy of dilute betadine solution irrigation in the prevention of postoperative infection of spinal surgery.

STUDY DESIGN: Prospective, single-blinded, randomized study. OBJECTIVES: To evaluate the efficacy of dilute betadine irrigation of spinal surgical wounds in prevention of postoperative wound infection. SUMMARY AND BACKGROUND: Deep wound infection is a serious complication of spinal surgery that can jeopardize patient outcomes and increase costs. Povidoneiodine is a widely used antiseptic with bactericidal activity against a wide spectrum of pathogens, including methicillin-resistant Staphylococcus aureus. The aim of this study was to evaluate the efficacy of dilute betadine solution in the prevention of wound infection after spinal surgery. METHODS: Four hundred and fourteen patients undergoing spinal surgery were randomly assigned to two groups. In group 1 (208 patients), surgical wounds were irrigated with dilute betadine solution (3.5% betadine) before wound closure. Betadine irrigation was not used in group 2 (206 patients). Otherwise, perioperative management was the same for both groups. RESULTS: Mean length of follow-up was 15.5 months in both groups (range, 6-24 months). No wound infection occurred in group 1. One superficial infection (0.5%) and six deep infections (2.9%) occurred in group 2. The differences between the deep infection rate (P = 0.0146) and total infection rate (P = 0.0072) were significant between the two groups. CONCLUSIONS: Our report is the first prospective, single-blinded, randomized study to evaluate the clinical effectiveness of dilute betadine solution irrigation for prevention of wound infection following spinal surgery. We recommended this simple and inexpensive measure following spinal surgery, particularly in patients with accidental wound contamination, risk factors for wound infection, or undergoing surgery in the absence of routine ultraviolet light, laminar flow, and isolation suits.

Adult↗
PubMed2006

A randomized, prospective, double-blind study on the efficacy of dead sea salt nasal irrigations.

OBJECTIVE: The objective of this randomized, prospective, double-blind study was to compare nasal irrigation using hypertonic Dead Sea salt (DSS) solution with hypertonic saline in the treatment of chronic rhinosinusitis and improvement of quality of life (QOL). METHODS: With Institutional Review Board approval, 42 adults seeking treatment for chronic rhinosinusitis in a tertiary university-affiliated medical center were studied. After history and endonasal examination, computed tomography imaging, and QOL survey (Standardized Rhinoconjunctivitis Quality of Life Questionnaire [RQLQ(S)]), patients were randomized to self-administered hypertonic saline spray and irrigation twice daily or hypertonic DSS spray and irrigation. Patients were reassessed weekly and at 1 month. RESULTS: Both groups had similar symptoms and RQLQ(S) scores before treatment and had significant improvement after treatment. However, the DSS patients had significantly better symptom relief and only the DSS group showed improved RQLQ(S) scores. CONCLUSIONS: We present a short-term study providing level I evidence on the superiority of DSS over saline nasal irrigation for treatment of chronic rhinosinusitis.

Adolescent↗
PubMed2005

A pitfall of FDG-PET image interpretation: accumulation of FDG in the dependent area of the urinary bladder after bladder irrigation--the usefulness of the prone position.

In F-18 FDG PET studies, retrograde irrigation of the urinary bladder is usually used to reduce the interference with physiological urinary accumulation of F-18 FDG in patients with possible pelvic lesions. A 34-year-old female who had recently been diagnosed with cervical cancer had an F-18 FDG-PET scan performed for whole-body evaluation. The bladder was irrigated with physiological saline and filled with 200 mL of irrigation fluid through a 3-way balloon catheter inserted before the scan. Two areas with high FDG accumulation were noted in the posterior pelvis. Tumor invasion or metastasis could not be ruled out. Additional focal imaging of the pelvis was performed with the patient in the prone position. The lesion on the left side of the patient was still noted, whereas the lesion on the right had disappeared, which proved that it was a false-positive lesion. Great caution is required when assessing imaging results to avoid misdiagnosis in patients after bladder irrigation.

Adult↗