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At least 1,171 records · Page 65Linked to original sources
PubMed1991

Effect of Ringer's lactate irrigation on the formation of postoperative abdominal adhesions.

Intraabdominal adhesions continue to pose a potentially serious postoperative clinical problem. Reported here is an experiment designed to study any effect that balanced Ringer's lactate (RL) solution may have on intraabdominal adhesion formation. Surgical trauma was induced in mice by controlled gauze abrasion of one side of the abdominal wall; the opposite side was used as a control. RL irrigation was compared with no irrigation. Adhesions were scored on the basis of incidence (%) and severity (on a 0-10 scale). The abraded right peritoneum exhibited 100% adhesions for both the RL group and the nonirrigated group. However, on the side that was not abraded, the nonirrigated group showed only 30% incidence of adhesions and 1.7 +/- 3.3 severity as compared with 100% adhesions and 7.7 +/- 2.2 severity for the RL group. These results suggest the need for further studies to establish the extent to which irrigation with solutions such as Ringer's lactate or saline may enhance formation of postoperative adhesions.

Abdomen↗
PubMed1991

Theophylline desorption from activated charcoal caused by whole bowel irrigation solution.

Whole bowel irrigation with polyethylene glycol electrolyte lavage solution has been recommended as an adjunct to traditional overdose management. Although combined activated charcoal and whole bowel irrigation could enhance the efficacy of both modalities, this improvement remains largely speculative. An in vitro experiment was designed to determine whether polyethylene glycol electrolyte lavage solution alters the adsorption of theophylline to activated charcoal. Theophylline was agitated with activated charcoal in either water or polyethylene glycol electrolyte lavage solution, at each of three activated charcoal:theophylline ratios; 1:1, 3:1, and 10:1. The concentration in the supernatant was determined by high pressure liquid chromatography, and the maximal adsorptive capacity of activated charcoal for theophylline was calculated from the Langmuir equation. The percent of theophylline adsorbed by activated charcoal in water was 16 +/- 4%, 67 +/- 5%, and 97 +/- 3% for the 1:1, 3:1, and 10:1 ratios, respectively. This was decreased to 17 +/- 5%, 37 +/- 3%, and 62 +/- 2% when polyethylene glycol electrolyte lavage solution was added. A statistical difference (p less than 0.05) occurred at the 3:1 and 10:1 activated charcoal:theophylline ratios. Similarly the maximal adsorptive capacity was decreased 23% from 264 mg/g to 203 mg/g when polyethylene glycol electrolyte lavage solution was added to activated charcoal prior to theophylline. Polyethylene glycol electrolyte lavage solution significantly decreases adsorption of theophylline to activated charcoal in vitro. In vivo studies are required to confirm these findings. If activated charcoal is to be used clinically for theophylline toxicity, the authors suggest the possibility of larger quantities of activated charcoal, and administering activated charcoal in a slurry of water before the initiation of whole bowel irrigation.

Adsorption↗
PubMed2005

The use of closed-suction irrigation systems to manage spinal infections.

OBJECT: Management of infection in the hardware system-fixated spine has proven to be problematic. In many cases, instrumentation is required to provide stability or to maintain correction of deformity, and removal could be hazardous. The authors describe the use of closed continuous irrigation to treat spinal wound infections in patients with fixation systems; irrigation can be used in all parts of the spine with excellent results. METHODS: The authors conducted a retrospective chart-based review of cases in which spinal instrumentation procedures were performed consecutively during a 10-year period. Infection developed in 36 patients. The infections involved the cervical, thoracic or thoracolumbar, and lumbar regions. Anterior and posterior drains were placed in one patient. In one patient refractory infections responded to replacement of the dual-inflow port drainage system. In all cases the wound infection completely resolved. There were no cases that required the removal of the fusion mass or instrumentation. In all cases progression to solid fusion was achieved. CONCLUSIONS: Closed irrigation systems can be used effectively to manage anterior or posterior cervical, thoracic, and lumbar wound infections. These systems preclude the explantation of the instrumentation and allow spinal stability to be preserved. The authors noted no evidence of recurrent infection or failed fusion.

Adult↗
PubMed2006

Percutaneous drainage and continuous irrigation in patients with severe pyogenic spondylitis, abscess formation, and marked bone destruction.

OBJECT: The use of percutaneous suction aspiration has recently become viewed as an effective management strategy for pyogenic spondylitis unresponsive to conservative treatment. What remains unclear is whether it can be effective for severe pyogenic spondylitis in which abscess formation or marked bone destruction is present. The authors undertook a study to clarify answers to this question. METHODS: The authors evaluated clinical and radiographic/neuroimaging data obtained in five patients with severe pyogenic spondylitis, extensive abscesses, and marked bone destruction. These patients had undergone percutaneous drainage and continuous irrigation because open surgery was considered contraindicated in light of their poor general health. The mean period during which continuous irrigation was applied was 9 days (range 7-11 days), and the mean period during which the drainage tube was in place was 19 days (range 13-38 days). All patients suffered from back pain, which was relieved by the percutaneous technique in four patients after a mean of 8 days. The abscesses and inflammation resolved in all patients. Progressive osseous destruction was not observed, and open surgery was performed in only one patient in whom back pain persisted as a result of spinal instability. CONCLUSIONS: After an unsuccessful course of conservative treatment, severe pyogenic spondylitis with abscess formation or marked bone destruction was successfully treated using percutaneous drainage and continuous irrigation. Based on their results, the authors believe that this procedure can be used in patients with severe pyogenic spondylitis that was unresponsive to conservative treatment, particularly in those whose general health is poor.

Aged↗
PubMed1987

The effects of pulsed fluid irrigation on bony ingrowth in porous polyethylene implants.

Twelve adult dogs were used to evaluate the effect of pulsed isotonic saline irrigation on bony ingrowth. The distal supracondylar ridge of the knee was transected. Six dogs had the area irrigated with a pulsed lavage system for 15 sec and six dogs did not. A porous piece of polyethylene was then stapled to the cancellous surface. Three of each were evaluated histologically at 3 weeks and 6 weeks. The pulsed irrigation significantly decreased the depth of bone penetration into the sections of polyethylene.

Animals↗
PubMed1993

[Early detection of absorption of irrigating fluid during transurethral resection of the prostate with alcohol gas detector tube].

Nineteen patients (mean age, 70 years; range, 58-80 years) undergoing elective transurethral resection of benign hypertrophy of the prostate (mean weight of resectate, 25 g; range 10-59 g; mean resection time, 61 min; range 45-80 min) under spinal anesthesia were studied for early detection of absorption of irrigating solution by means of expired breath alcohol analysis. The irrigating fluid used in all resections was tenfold diluted Urigal solution containing 1% ethanol. Expired breath was collected into a rubber bag every 10 min during the surgery, and the concentration of ethanol was analyzed using a gas detector tube (GASTEC LTD.). Hemodynamic parameters including central venous pressure were routinely measured at the same intervals. The volumetric fluid balance was measured every 20 min. Blood was collected preoperatively, at the same 20-min intervals during the resection, and 4-6 hours after the end of the operation. Serum electrolytes, hemoglobin and total plasma protein concentration were measured, and blood gas tension was analyzed. Mean arterial pressure, central venous pressure, blood gas tension showed no significant changes at these observed time intervals. Heart rate decreased 120 min after the start of the operation. Ethanol was detected in the expired breath 10 min after the start of the surgery, and showed progressive increase in concentration until the end of the surgery. Serum electrolyte concentrations and hemoglobin content showed gradual decrease proportional to the increase in irrigating fluid volume. The ethanol concentration in the expired breath was significantly correlated with the change in serum sodium concentration.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorption↗
PubMed1999

[Treatments for post-pneumonectomy pyothorax without broncho-pleural fistula: irrigation of the post-pneumonectomy space].

Between January 1986 and December 1997 pneumonectomy was performed in 58 patients. Of the 58 patients, four had pyothorax without broncho-pleural fistula. Four patients underwent chest tube drainage and irrigation of the post-pneumonectomy space, and one of which died of lung cancer during treatment for pyothorax. Two had no evidence of recurrent infection, and one had a chest wall fistula after about one year and a fistulectomy was performed. These observations suggest that draining and irrigating of the post-pneumonectomy space are effective and non-invasive methods for treating post-pneumonectomy pyothorax without broncho-pleural fistula. However we were not able to investigate specific methods, fluid types, or irrigation time frames.

Empyema, Pleural↗
PubMed1999

The use of fluconazole as a local irrigant for nephrostomy tubes.

OBJECTIVES: Few data exist concerning the combined use of fluconazole systemically and as an irrigant for nephrostomy tubes in a patient with renal candidiasis. The patient described here presented with renal fungal balls obstructing the drainage of urine from her nephrostomy tubes. METHODS: Twelve months after chemoradiation for a stage IIB squamous cell carcinoma of the uterine cervix, a 35-year-old woman presented with renal obstruction necessitating insertion of ureteral stents. After 6 months of chemotherapy, the patient developed uremia. After nephrostomy tubes were placed, renal candidiasis was noted, and fluconazole was begun systemically. When the renal candidiasis failed to clear, nephrostomy tube irrigations were begun. RESULTS: Fourteen days of therapy with fluconazole resulted in the resolution of the uremia. The patient died 6 months later with her nephrostomy tubes in situ and without evidence of candidiasis in her urinary tract. CONCLUSIONS: The patient described was successfully treated without having to remove her nephrostomy tubes. Two other authors have reported the successful use of fluconazole irrigation to treat candidiasis in nephrostomy tubes that was unresponsive to systemic fluconazole. Before the appearance of these reports, the best results were obtained with removal of the catheter in renal candidiasis.

Adult↗
PubMed1999

[Transnasal microsurgery using a micro-pressure-suction-irrigation system for pituitary adenomas].

Micro-pressure-suction-irrigation system (MPSIS), introduced by Luedecke et al, is an instrumentation for the direct transnasal pituitary procedure. We improved this system for use in Japan. The irrigation system can effectively clean the operating field by one-hand manipulation and dissect tumor tissue by its rapid flow. The pressure of suction and irrigation can be adjusted respectively by a device in the handpiece. The MPSIS is applicable to different stages of intervention because it is equipped with separate tips of various diameters, lengths and angles. This system is especially useful in combination with a micromirror or an endoscopy for direct inspection of the eccentric tumor sites such as the cavernous sinus, the upper part of the planum sphenoidale, or the posterior suprasellar regions. The use of the MPSIS helps to avoid injury to normal tissue structures, and prevents tiny soft microadenoma from being lost during preparation. We have proved the suitability and usefulness of the MPSIS in 23 surgical interventions for transnasal microsurgery of pituitary adenomas.

Adenoma↗
PubMed1999

Sequential irrigation with common detergents: a promising new method for decontaminating orthopedic wounds.

This investigation sought to determine the capacity of irrigation solutions in decontaminating orthopedic wounds challenged with a polymicrobial inoculum. Rats were divided into two groups, a control group and a treatment group. After creation of a dorsolumbar incision and placement of a wire through the spinous process, rats were inoculated with Staphylococcus aureus and Pseudomonas aeruginosa. Wounds were irrigated with control or treated solutions. At 2 weeks, cultures were obtained. There were statistically significant differences between groups regarding total number of culture positive sites (P < 0.001), culture-positive animals (P = 0.02), and quantitative cultures (P < 0.02). Sequential irrigation with surfactants lowers bacteria counts recovered from polymicrobial wounds.

Analysis of Variance↗
PubMedDate not supplied

A new machine for irrigation-aspiration.

This new irrigation-aspiration system (Fig 9) demonstrates application of basic physical principles to a particular medical problem, maintaining the integrity of the anterior chamber during aspiration of cataractous material. This system is readily incorporated into the standard procedure of irrigation-aspiration of soft cataractous material at relatively low cost. The surgical procedure and the operation of this system with irrigation-aspiration and "prevent-collapse" components are under direct control of the physician.

Anterior Chamber↗
PubMed1999

Water as an irrigant in transurethral resection of the prostate: a cost-effective alternative.

The safety of water as an irrigant solution in transurethral resection of the prostate (TURP) has been a controversial issue. Although it has been mostly abandoned in more affluent countries, it is still widely used in developing countries simply because of financial reasons. With this study, we attempted to show in a representative number of cases that this method can be applied without major fluid absorption, as would be indicated by changes in sodium (Na), creatinine (Crea), blood urea nitrogen (BUN), and free haemoglobin (fHb) levels in serum. Prospectively, we assessed the occurrence of clinical symptoms of TUR-syndrome, as well as changes in serum parameters in 60 patients irrigated during TURP with sterile water. Values of patients with some degree of resorption, as indicated by a drop in serum sodium, were compared to patients without any resorption. There was no TUR-syndrome in our patients, and serum levels of all parameters did not change significantly after TURP with water. Patients with a drop in sodium post-TURP did not have significant changes in Crea, BUN or fHb. The average saving was 162.60 USD per treatment. In our study population, water was a safe irrigation solution. Even with some degree of resorption, there were no significant haemolysis or metabolic imbalances. Saving for the patient are considerable and render the treatment affordable.

Aged↗
PubMed1998

The effect of intra-articular irrigation injection therapy on osteoarthrosis of the temporomandibular joint.

OBJECTIVE: To investigate the effect of intra-articular irrigation-injection therapy in treating osteoarthrosis of the temporomandibular joint. MATERIALS AND METHODS: Thirty-seven patients (the test group) received intra-articular irrigation injection; 26 patients (the control group) received intra-articular injection of steroid. The synovial fluid, aspirated from five subjects of the test group before and after the therapy, was assayed to determine the tumor necrosis factor. RESULTS: Clinical evaluations were performed 3 months after the therapy. Thirteen subjects in the test group fell into the "excellent" category, 19 into the "good" category, and five into the "no effect" category; in the control group, eight subjects fell into the "excellent" category; nine into the "good" category, and nine into the "no effect" category. The category difference in total effectiveness between the test group and the control group is statistically significant (X2 = 3.9340 P < 0.05). TNF in synovial fluid also showed statistically significant differences before and after treatment (T = 2.8825, P < 0.05). CONCLUSIONS: Intra-articular irrigation injection is an effective therapy method for treating osteoarthrosis and is superior to intra-articular injection of steroid.

Adult↗
PubMed1999

[Evaluation of endothelial cells after the usage of gentamycin in irrigation-aspiration fluid during extracapsular cataract extraction].

PURPOSE: Assessment of the density of endothelial cells after usage of gentamicin in irrigation-aspiration fluid. MATERIAL AND METHODS: 60 patients subjected to extracapsular cataract extraction with intraocular lens implantation. In 30 eyes irrigation was performed with Ringer fluid (group I) and in 30 eyes Ringer fluid with gentamicin (group II) 4 mg gentamicin were added to 500 ml of Ringer fluid obtaining the concentration 8 micrograms/ml. Evaluation of endothelial cells density was carried before operation, 1 month and 6 months after. RESULTS: Percentage endothelial cells loss in group I was 7.8% 1 month postoperatively and 14.5% 6 months after operation and in group II 8.5% and 14.87%, respectively. CONCLUSION: Gentamicin added to irrigation-aspiration fluid doesn't cause enhanced endothelial cells loss during extracapsular cataract extraction.

Aged↗
PubMed2000

[Programmed irrigation and drainage in the treatment of patients with a local soft-tissue suppurative infection].

Treatment of 92 patients aged from 18 to 69 years with abscesses and phlegmons of soft tissues included programmed irrigation and drainage. Apparatuses with two-level programs were used. It was shown that programmed irrigation and drainage allowed microbial dissemination by wash liquid to be decreased to 10 colony-forming units per 1 ml during 3 days. This term can be shortened to 1 day when using the program of intensive irrigation and drainage (more than 200 cycles during the first days after operation) and when intraoperative treatment with a beating jet of liquid is used in combination with curettage and vacuuming.

Abscess↗
PubMed2000

[Programmed irrigation and drainage in the treatment of patients with suppurative arthritis and intramedullary phlegmons].

Programmed irrigation and drainage were used in the process of treatment of 17 patients with purulent arthritis of the knee joint and talocrural articulation and of 13 patients with intramedullary phlegmons of the femoral, tibial and humeral bones. The programmed irrigation and drainage were proved to decrease the microbial dissemination of the wash liquid to 10 colony-forming units per 1 ml during 1-3 days. The method allowed to avoid synovectomy and resection of the joint in patients with purulent gonitis, to decrease the risk of appearance of secondary infections. The programmed irrigation and drainage for intramedullary phlegmons provide complete sanitation of the purulent focus during 7-10 days, create favorable conditions for consolidation of fractures and prevent the development of chronic osteomyelitis.

Adolescent↗
PubMed1975

Functional recovery from spinal cord trauma following normothermic irrigation in dogs.

The spinal cords of 16 normal dogs were exposed via dorsal laminectomies and damaged with a known impact force. In eight dogs the injured portions of the spinal cords were irrigated, without durotomy, for 2 h with normothermic saline. The remaining eight dogs were used as controls and were not irrigated. The results showed that normothemic irrigation of damaged spinal cords, immediately after impact trauma, had a significant beneficial effect on the functional recovery of the spinal cords.

Animals↗
PubMed2000

[Continent colostomy and colon irrigation].

The authors have studied a functional activity of a continent colostomy at 20 patients, undergone an abdomeno-perineal extirpation of rectum and carried out periodic colonirrigations, during a period of 6 months. A conus type, closed irrigating system has been used. The degree of an incontinency at patients has been compared before and after the beginning of the colonirrigations. The irrigating procedures have reduced spontaneous defications at patients during a week 28 times and have improved the quality of life significantly. The application of colostomy bags has been restricted in 8 (40%) patients. An intraluminal ultrasonographic investigation has been done at 12 (60%) patients at the end of 6 month irrigating period. No changes of the ultrasonographic image of the precolostomic segment of colon has been observed.

Adult↗