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At least 865 records · Page 48Linked to original sources
PubMed2002

Efficacy of daily hypertonic saline nasal irrigation among patients with sinusitis: a randomized controlled trial.

OBJECTIVES: To test whether daily hypertonic saline nasal irrigation improves sinus symptoms and quality of life and decreases medication use in adult subjects with a history of sinusitis. STUDY DESIGN: Randomized controlled trial. Experimental subjects used nasal irrigation daily for 6 months. POPULATION: Seventy-six subjects from primary care (n=70) and otolaryngology (n=6) clinics with histories of frequent sinusitis were randomized to experimental (n=52) and control (n=24) groups. OUTCOMES MEASURED: Primary outcome measures included the Medical Outcomes Survey Short Form (SF-12), the Rhinosinusitis Disability Index (RSDI), and a Single-Item Sinus-Symptom Severity Assessment (SIA); all 3 were completed at baseline, 1.5, 3, and 6 months. Secondary outcomes included daily assessment of compliance and biweekly assessment of symptoms and medication use. At 6 months, subjects reported on side effects, satisfaction with nasal irrigation, and the percentage of change in their sinus-related quality of life. RESULTS: No significant baseline differences existed between the 2 groups. Sixty-nine subjects (90.8%) completed the study. Compliance averaged 87%. Experimental group RSDI scores improved from 58.4 -/+ 2.0 to 72.8 -/+ 2.2 (P < or =.05) compared with those of the control group (from 59.6 -/+ 3.0 to 60.4 -/+ 1.1); experimental group SIA scores improved from 3.9 -/+ 0.1 to 2.4 -/+ 0.1 (P < or =.05) compared with those of the control group (from 4.08 -/+ 0.15 to 4.07 -/+ 0.27). The number needed to treat to achieve 10% improvement on RSDI at 6 months was 2.0. Experimental subjects reported fewer 2-week periods with sinus-related symptoms (P <.05), used less antibiotics (P <.05), and used less nasal spray (P =.06). On the exit questionnaire 93% of experimental subjects reported overall improvement of sinus-related quality of life, and none reported worsening (P <.001); on average, experimental subjects reported 57 -/+ 4.5% improvement. Side effects were minor and infrequent. Satisfaction was high. We found no statistically significant improvement on the SF-12. CONCLUSIONS: Daily hypertonic saline nasal irrigation improves sinus-related quality of life, decreases symptoms, and decreases medication use in patients with frequent sinusitis. Primary care physicians can feel comfortable recommending this therapy.

Adolescent↗
PubMed2000

High and low pressure irrigation in contaminated wounds with exposed bone.

BACKGROUND: Irrigation and debridement are essential in the initial management of traumatic wounds. The relative efficicacy of low pressure irrigation compared with high pressure irrigation remains unclear. AIMS: The purpose of this study was to examine the time dependent efficacy of both high and low pressure lavage in removing adherent bacteria from traumatic wounds with exposed bone. METHODS: Using an in-vivo model, we created bilateral Staphylococcus aureus contaminated femoral wounds in 30 mice. The wounds were incubated for 1 to 10 hours and lavaged with either high (70 psi) or low pressure lavage (1-2 psi). The mean colony forming units of bacteria were compared between groups at each time point. RESULTS: High and low pressure lavage were effective in removing adherent bacteria from contaminated wounds up to 8 hours and 4 hours, respectively. High pressure lavage was more effective than low pressure at every time point. CONCLUSION: The efficacy of low pressure lavage in wounds with exposed bone is questionable when irrigation is delayed beyond 4 hours.

Animals↗
PubMedDate not supplied

NaOCl and EDTA irrigating solutions for endodontics: SEM findings.

Premolars roots of humans were manually instrumented with K-type files and irrigated with different solutions to evaluate the rate of cleaning of endodontic surface. Root canals irrigated with 0.9% saline solution or H2O2 (10 volumes) showed the presence of predentin and amorphous smear layer. Thick smear layer was always present on endodontic walls rinsed with 5% solution of NaOCl. Specimens treated with 0.2% solution of EDTA showed partially clean dentinal tubules orifices and remnants of a thin smear layer. Occasional uninstrumented areas of the same roots presented smear layer remnants and predentin with calcified bacteria. The root canals irrigated with NaOCl and EDTA solutions alternated after each instrument showed at the dentin surface thick smear layer: only few dentinal tubules orifices were visible. Endodontic surface of root canals irrigated with NaOCl during instrumentation and finally rinsed with EDTA solutions showed the most homogeneous ultrastructural pictures: partially clean dentinal orifices were detectable in the whole canals.

Bicuspid↗
PubMed2003

How I do it: a technique for oral wound irrigation following maxillectomy and mandibulectomy.

BACKGROUND: Numerous devices have been recommended for ensuring appropriate hygiene and care of wounds resulting from maxillectomy and mandibulectomy. This article describes an irrigation device for use in the oral cavity after these procedures. METHODS: The system consists of: a prepackaged, disposable, 50-cc piston syringe; a nonconductive connecting tube; and, a saliva ejector that can be assembled for oral irrigation. RESULTS: The modified piston syringe allows physicians, nurses, and patients to efficiently irrigate mucosal wounds, maxillary or mandibular defects, and oropharyngeal or oral and pharyngeal wounds. CONCLUSION: This system is efficacious, more adaptable, and less expensive than other self-irrigating gravimetic instruments and is thus recommended for use in patients who have undergone maxillectomy or other ablative procedures in the oral cavity.

Humans↗
PubMed2003

Irrigated bipolar radiofrequency ablation with transmurality feedback for the surgical Cox-Maze procedure.

BACKGROUND: Nonirrigated radiofrequency ablation (RFA) has been used to replicate the surgical scars of the Cox-Maze procedure. This study aimed to demonstrate that an irrigated, bipolar RFA energy source could also effectively replicate Cox-Maze lesions with impedance monitoring to predict the transmurality of ablated tissue. METHODS: A complete Cox-Maze lesion pattern was created ex vivo on fresh porcine atria using an irrigated, bipolar RFA system. Tissues were clamped between opposing electrodes with steady pressure to ensure an intimate tissue-electrode interface during ablation. A proprietary feedback and control algorithm monitored tissue impedance and terminated ablation when lesions were deemed transmural by a plateau in impedance decline. Ablation time and power, lesion width and length, and tissue thickness were recorded. Lesions were stained with 1% triphenyltetrazolium chloride and sectioned for gross assessment of transmurality. RESULTS: One hundred thirty-seven lesions were created on 11 porcine hearts. The total ablation time per lesion was 14.8 +/- 1.2 seconds (range, 10.0-19.0 seconds). Lesions averaged 4.2 +/- 1.3 mm (range, 1.3-10.2 mm) in width. Average tissue thickness was 3.0 +/- 1.7 mm (range, 0.5-9.9 mm). Crosssectional examination revealed that 100% of lesions were transmural (n = 718), and no tissue defects were observed. CONCLUSIONS: These results indicate that irrigated bipolar RFA energy can produce transmural Cox-Maze lesions ex vivo on intact porcine atria and that impedance monitoring is a reliable predictor of lesion transmurality. Additional in vivo studies are under way to further demonstrate the efficacy and safety of irrigated, bipolar RFA technology.

Animals↗
PubMed2005

Effect of endodontic irrigants on microleakage of coronal restorations.

PURPOSE: To evaluate the effect of endodontic irrigants on the sealing ability of resin composite coronal restorations bonded with two different bonding systems, Clearfil SE Bond and PQ1. METHODS: The specially designed coronal preparations with distal margins on dentin and mesial margins on enamel were performed on 100 single-rooted teeth. They were initially divided into five groups. Irrigants used during the root canal preparation in each group were as follows: sodium hypochlorite, hydrogen peroxide, Tubulicid Plus, Cetrexidin and saline (control). After root canal filling, each irrigation group was divided into two bonding groups. Following the placement of the composite restorations, the specimens were immersed in India ink and cleared to allow visualization of the leakage. RESULTS: The differences among the irrigation groups were statistically significant only at margins remaining on dentin structures for both of the bonding resins (P< 0.05). Sodium hypochlorite, hydrogen peroxide groups demonstrated higher leakage scores than the controls (P< 0.005). Leakage patterns of Cetrexidin and Tubulicid Plus groups did not differ significantly from the controls (P> 0.005). Cetrexidin allowed better sealing than Tubulicid Plus in PQ1 bonded restorations, but did not in Clearfil SE Bond samples.

Acrylic Resins↗
PubMed1992

Changes in serum electrolytes after transcervical resection of endometrium and submucous fibroids with use of glycine 1.5% for uterine irrigation.

OBJECTIVE: We evaluated the postoperative changes in serum electrolytes in relation to the amount of irrigating fluid absorption and the occurrence of nausea and vomiting after transcervical resection of endometrium and submucous fibroids. METHODS: From May 1989 to October 1991, 101 consecutive patients were operated on for menometrorrhagia with transcervical resection of endometrium and submucous fibroids using glycine 1.5% for uterine irrigation. The deficit of glycine was assessed during and at the end of the operation. During the postoperative course, attention was paid to the occurrence of cerebral confusion, nausea (defined by at least one incident of vomiting), and dyspnea. The serum levels of sodium, potassium, and chloride were assessed before the operation, at the end of the procedure, and after 4, 8, and 12 hours. RESULTS: No marked water intoxication or signs of volume overload were seen, but 33% of the patients had nausea and vomiting in the postoperative period. These patients showed a more pronounced postoperative decrease in serum sodium (P = .0001) and a larger glycine deficit (P = .004) than did patients without nausea. The postoperative decrease in serum sodium correlated significantly to the glycine deficit (R2 = 0.83, P less than .001). CONCLUSION: Postoperative hyponatremia after transcervical resection of the endometrium correlated with the deficit of irrigant fluid but not with the operation time or the total amount of irrigant fluid used. We recommend that serum sodium be controlled and corrected if necessary postoperatively in patients with nausea and vomiting.

Absorption↗
PubMed1992

[The addition of ethyl alcohol to the irrigating fluid. Monitoring fluid absorption during transurethral resection of the prostate].

The absorption of irrigation solution during transurethral prostatic resection may lead to the life-threatening condition of the so-called TUR syndrome. For a long time no early recognition procedure was easily and routinely available. This study was set up to investigate the effectiveness of ethanol as an early indicator of beginning absorption, as described by Hulten. Ethanol was therefore added to the irrigating fluid as a marker, and alcohol concentrations were measured in the exhaled breath. METHODS. For measurement of alcohol an Alcotest monitor 7110, Drägerwerk (Lübeck, FRG) was used. In preliminary experiments with 13 healthy volunteers the lowest amount of measurable i.v.-administered 2% Ringer-ethanol solution was found to be about 200 ml. The irrigating fluid used was a 2% ethanol-mannitol/sorbitol solution. RESULTS. The control of breath and blood alcohol levels in 10 patients undergoing transurethral bladder surgery showed that there was no absorption of alcohol across the internal bladder lining. Of 52 patients, who had to undergo transurethral prostatic resection, 23 had positive breath alcohol values of up to 0.81/1000. In 6 patients the blood alcohol levels only were elevated (max. 0.18/1000). In 23 other patients no increased blood or breath alcohol levels were detectable. The negative breath alcohol levels in 6 patients were most probably attributable to low breath volumes due to lack of cooperation caused by pre- and/or intraoperative sedation. There were no significant changes in central venous pressure, mean arterial pressure or heart rate even at the time of maximal alcohol levels, compared with initial values. These parameters thus cannot be used for the early recognition of beginning absorption. Simultaneous monitoring of serum sodium concentrations revealed significant decreases at the time of maximal breath alcohol levels. Yet, the first indication of beginning absorption was always a positive alcohol level. Serum sodium changes followed later with increasing alcohol levels. Sodium concentration did not drop before a positive alcohol level was measured in any of these cases. CONCLUSION. It was thus proven that the addition of ethanol to the irrigating fluid and monitoring of the patient's exhaled breath with the Alco-testmonitor is a simple, non-invasive system that can be routinely used for early detection of absorption during transurethral prostatic resection. Adequate adjustment of the further course of the operation was possible. The dreaded TUR syndrome did not develop in any of the patients monitored in this way.

Aged↗
PubMed2006

Realistic irrigation visualization in a surgical wound debridement simulator.

Wound debridement refers to the removal of necrotic, devitalized, or contaminated tissue and/or foreign material to promote wound healing. Surgical debridement uses sharp instruments to cut dead tissue from a wound and it is the quickest and most efficient method of debridement. A wound debridement simulator can ensure that a medical trainee is competent prior to performing a procedure on a genuine patient. Irrigation is performed at different stages of debridement in order to remove debris and reduce the bacteria count through rinsing the wound. This paper presents a novel approach for realistic irrigation visualization based on texture representations of debris. This approach applies image processing techniques to a series of images, which model the cleanliness of the wound. The active texture is generated and updated dynamically based on the irrigation state, location, and range. Presented results demonstrate that texture mapping and image processing techniques can provide effective and efficient solutions for irrigation visualization in the wound debridement simulator.

Algorithms↗
PubMedDate not supplied

The effects of subgingival irrigation with chlorhexidine and stannous fluoride. A preliminary investigation.

This pilot study compared the effectiveness of subgingival irrigation with 0.12% chlorhexidine, 1.64% stannous fluoride, and sterile saline, in addition to scaling and root planing, on levels of Bacteroides porphyromonas and the clinical parameters bleeding tendency, probing depth, and attachment level. A convenience sample of eight patients, exhibiting 32 sites with moderate periodontal disease, was randomly assigned to receive all treatments according to a four-quadrant treatment design. Subgingival irrigation was performed at 0, 1, 2, and 3 weeks following scaling and root planing. Clinical and microbial assessments were measured at baseline, 4, 8, and 12 weeks. Data were analyzed using a two-factor repeated measure analysis of variance, and the Newman-Keuls sequential range test or Friedman test and Kruskal-Wallis test revealed statistically significant (p less than .01) improvements in probing depths, attachment levels, and Bacteroides porphyromonas for all groups at 12 weeks when compared to baseline values. No statistically significant differences occurred between any of the treatment groups at any time period. Based on the findings of this investigation, it has been concluded that four weekly irrigations with 0.12% chlorhexidine, 1.64% stannous fluoride, or saline irrigation did not enhance the beneficial effects of scaling and root planing alone.

Chlorhexidine↗
PubMed2006

[A simple-irrigating system for endoscopic sinus surgery].

INTRODUCTION: The most troublesome problem during endoscopic surgery is fouling of the endoscope lens (tip) with blood. Irrigating systems are available on the market but they are relatively very expensive. We present our own simple irrigating system, very effective and inexpensive. MATERIAL AND METHODS: The system consists of: polyethylene catheter No 6, sterile intravenous line with interposed stopcock, 500 ml saline solution, endoscope. The catheter is fixed to the endoscope with sterile sticks and connected to the bottle of saline solution with intravenous line. During the operation the irrigant solution flow is controlled with interposed stopcock. CONCLUSIONS: A simple irrigating system allows cleaning of blood from the endoscope obviating the need for frequent removal of the endoscope from the nose. This allows more rapid and safer endoscopic surgery. It is very simple and cheap.

Endoscopes↗
PubMed1991

Periprosthetic knee sepsis. The role of irrigation and debridement.

Thirty-three infected total knee arthroplasties were treated by irrigation, debridement, and intravenous antibiotics. These cases were retrospectively reviewed with an average follow-up period of 4.5 years. There were 12 revisions and 21 primary arthroplasties in the series. Thirty-two knees were openly irrigated and debrided, and one was arthroscopically treated. In 20 of 33 knees, infection recurred--a reinfection rate of 61%. The authors attempted to identify factors influencing success and failure of infection eradication. There was a statistically significant improvement in the success rate of knees irrigated and debrided within four weeks of index surgery (p less than .05). No statistically significant correlation was found between success and failure with regard to gender, age, preoperative diagnosis, previous surgery, length of intravenous antibiotics, or time from clinical symptoms to debridement. The authors believe that irrigation and debridement have a role in the immediate postoperative period. Caution should be used in periprosthetic knee infection appearing greater than four weeks from index surgery.

Adult↗
PubMed1991

Bladder irrigation does not prevent haemorrhagic cystitis in bone marrow transplant recipients.

Thirty-four patients receiving allogeneic bone marrow transplants as treatment for haematological malignancy were prospectively randomized to receive or not to receive bladder irrigation by indwelling urinary catheter during preparation for transplant. Twenty-two patients received busulphan and cyclophosphamide, four received busulphan, cyclophosphamide and irradiation, and eight received cyclophosphamide and total body irradiation. The actuarial incidence of haemorrhagic cystitis in those randomized to receive bladder irrigation was 48% for the whole group and 52% in those receiving busulphan and cyclophosphamide only. In those randomized not to receive bladder irrigation the incidence of haemorrhagic cystitis was 29% for the overall group and 38% in those receiving busulphan and cyclophosphamide. There was no statistically significant difference between the two groups. We conclude that bladder irrigation does not minimize the risk of haemorrhagic cystitis in this patient population.

Adolescent↗
PubMed1990

Subgingival irrigation in the maintenance phase of periodontal therapy.

The purpose of this study was to evaluate the effect of subgingival scaling versus subgingival pocket irrigation with 0.1% chlorhexidine or saline controls on the repopulation of subgingival periodontal sites with disease-associated micro-organisms following a single procedure of scaling and root planing. Additionally, pertinent clinical parameters (attachment level, plaque index, bleeding on probing) were also recorded. 375 sites in 30 individuals with previously untreated periodontal disease were thoroughly scaled and subsequently either rescaled, irrigated, or not treated at all for the following 6 months at 1-month intervals. The results show that the initial scaling and root planing procedure led to significant clinical and microbiological improvements in all experimental groups. These improvements were maintained in all but the untreated sites. Based on the observed clinical and microbiological changes, subgingival irrigation of periodontal pockets at 1-month intervals was equally effective as scaling and root planing performed at the same pace. 0.1% chlorhexidine however, being used as test irrigant, was not more effective than saline controls.

Adult↗
PubMed1990

A simple irrigator-aspirator cannula for laparoscopy: the Stewart system.

An irrigator-aspirator cannula (Stewart system) that may be assembled from common operating room supplies is described for use during operative laparoscopy. The unit consists of a disposable three-way stopcock inserted into a standard 5-mm suction probe. One stopcock port is connected to an irrigation fluid source and pressurized with an inflatable cuff; the other stopcock port is attached to wall suction. Flow rates were determined comparing two types of influx tubing, two different heights of the fluid source, and a range of inflatable cuff pressures. The flow rate of this system with urologic irrigation tubing at pressures of 150 mmHg was comparable to that of a commercially available irrigator-aspirator system. The instrument has been used in 15 routine and emergency operative laparoscopy cases and provides adequate aquadissection, rapid and easy maintenance of a clean operative field, smoke evacuation during laser vaporization, and atraumatic suction traction of tissues.

Female↗
PubMedDate not supplied

Water irrigating devices for the orthodontic patient.

Fixed orthodontic appliances increase the number of retention areas, resulting in increased possibilities for the accumulation of dental plaque. In addition, there is a risk of direct mechanical irritation. In spite of good toothcleaning most orthodontic patients develop generalized moderate gingivitis or an edematous type within one to two months after the placement of the fixed orthodontic appliances. Since the gingival changes represent a reaction to the bacterial plaque products rather than to the orthodontic forces; the only way to control them is by effective oral hygiene. Braces and banded teeth have many tiny recesses that a toothbrush and other cleaning aids have difficulty reaching. For good oral hygiene, these should be kept free of food debris. Water irrigating devices irrigates these hard-to-clean areas to remove food and other debris. Pulsating jets of water very gently lift the free gingiva to rinse out crevices. The water irrigator also pulses into areas between teeth and gums to flush out trapped food and debris. Water irrigating devices cannot by any means be regarded as substitutes for more effective plaque-removing methods, such as tooth-brushing and flossing; rather, they should be considered as an adjunct to the total oral hygiene program.

Dental Devices, Home Care↗
PubMedDate not supplied

Scanning and light microscopic study of irrigated and nonirrigated joints following burr surgery performed through a small incision.

Research was conducted on young, adult male rabbits where osseous burr surgery was performed through a small incision using two methods of joint debris extrusion. Surgical joint debris was found in all specimens at 1 week following surgery. Also, 1 week postoperatively, the surgically untouched chondral and subchondral joint aspects were intact in both irrigated and nonirrigated specimens. There was, however, subchondral bone inflammation in all specimens but the nonirrigated population had a greater inflammatory subchondral infiltrate. The synovium was more inflamed in the nonirrigated group. Bone particles, observed with scanning electron microscopy, generally appeared to be only slightly more evident in the nonirrigated group. Metal particles were observed in several specimens. By 28 weeks, joint debris was practically undetectable. In the irrigated specimens the chondral and subchondral portions presented with occasional degenerative focal loss of the chondral and subchondral layers. In comparison, the nonirrigated group demonstrated not only occasional but moderate-to-frequent focal loss with fissuring in the chondral and subchondral layers in addition to extrinsic repair of the cartilage surface. Subchondral bone inflammation was also more severe in the nonirrigated group. Observations from this project confirm that joint debris is removed through intrinsic joint processes and further suggests that the postoperative course of inflammation is not a totally abrasion-related phenomenon. The findings support the use of intraoperative irrigation as opposed to debris extrusion without irrigation in order to reduce both immediate and chronic postsurgical inflammation.

Animals↗
PubMed1990

Intraoperative dexamethasone irrigation in lumbar microdiskectomy.

In 45 lumbar hemilaminectomy/microdiskectomy patients, a control group of 23 patients had the standard operative procedure. The remaining 22 patients were treated with intraoperative irrigation of long-acting dexamethasone before incision closure. Age, weight, gender ratio, mean postoperative hospital stay, mean in-hospital narcotics usage, and incidence of perioperative complications among the two groups were compared. Age and gender ratios were comparable, although the control group was significantly heavier in body weight than the steroid-irrigated group. The steroid-irrigated group had a significant reduction in hospitalization and a marked reduction in narcotics usage compared with the control group. Postoperative fever occurred in one patient in the steroid group. The control group had three postoperative complications. These preliminary observations suggest that dexamethasone irrigation during lumbar diskectomy is a safe and effective adjunct to surgical management.

Adult↗