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PubMed1982

The pharmacokinetics of prophylactic antibiotics administered by intraoperative irrigation at the time of cesarean section.

Thirty patients at term undergoing cesarean section received intraoperative irrigation with either cefamandole, cephalothin, or ampicillin to prevent postoperative infection. Serum drug levels were measured at 15, 60 and 120 minutes after completion of irrigation. Serum levels at each sampling interval were highest for cefamandole and lowest for cephalothin. Les than 2% of the total drug dose was excreted in the urine during the first 2 postoperative hours. In most patients, maximum serum antibiotic concentrations exceeded minimal inhibitory concentrations for several recognized pelvic pathogens. It is concluded that the mechanism of action of intraoperative irrigation may in part be due to systemic absorption of antibiotic and not simply to a local effect on the endometrium. Moreover, the degree of systemic absorption may be sufficient to cause allergic drug reactions and to exert selective pressures for the emergence of drug-resistant microorganisms.

Adult↗

PubMed1980

Ineffectiveness of povidone-iodine irrigation of abdominal incisions.

Two to four percent of uncontaminated surgical wounds become infected; the incidence is increased in contaminated cases. The present study was designed to determine the efficacy of wound irrigation with povidone-iodine in patients not receiving prophylactic antibiotics who were undergoing gynecologic operations. The results revealed no significant difference in the relatively high occurrence of wound infections, morbidity, and elevated fever indices between the povidone-iodine wound irrigation group of patients and the control group. From a review of previous studies of topical antibiotics and antiseptics in contaminated cases as well as from the present findings, providone-iodine wound irrigation without assocaited use of prophylactic antibiotics does not appear to reduce significantly the incidence of wound infections in patients with potential vaginal contamination.

Abdomen↗

PubMed1980

[The ethmoiditis of the child and the irrigation treatments by Proetz in short general anaesthesia (author's transl)].

From the anatomy of the sinuses in children and the follow-up of inflammatory diseases one can assume that in most cases the infection develops primarily in the ethmoid. We therefore believe that the diagnosis of chronic maxillary sinusitis in children is mostly wrong as well as the decision to operate upon the maxillary sinus before sanation of the ethmoid sinuses. The term pyosinus should be reintroduced to facilitate the differential diagnosis from sinusitis. Analogous to irrigation treatment of the maxillary sinus the displacement-method by Proetz is the only possible irrigation for the ethmoid sinus. The technique of Proetz-irrigation in short general anaesthesia is described and recommended. Prompt and effective treatment of ethmoiditis will avoid extension over the maxillary sinus. Thus surgery on the maxilla - very problematic in view of its growth - can be ommited in most of the cases.

Child↗

PubMed1995

[The effect of subgingival irrigation with acetylsalicylate on the polymorphonuclear leukocyte count in periodontal pockets of medium depth].

Considering the role played by arachidonic acid metabolites in the pathogenesis of periodontal disease and the possible beneficial effects exerted by non steroidal anti inflammatory drugs on periodontal damage, the aim of the present study was to assess the capability of a 1% acetylsalicylate solution, delivered by subgingival irrigation, in reducing the number of polymorphonuclear leukocytes (PMN) in periodontal pockets of patients affected by periodontitis. Ten patients systemically healthy, in the age between 36 and 64, participated in the study. After supragingival scaling in each patient test and two control sites were chosen among those exhibiting a pocket depth between 5 and 7 mm. The number of periodontal pocket PMN was evaluated after subgingival washing by the technique of Skapski & Lenher and Gingival Bleeding Index (GBI) score was recorded in each experimental site. Test sites then received subgingival subgingival washing by 0.5 ml of a 1% acetylsalicylate solution three times a week whereas control sites were irrigated by physiologic solution. After treatment the number of PMN and GBI scores from each test and control site was re-evaluated. Results showed that test sites exhibited a decrease in the number of pocket-PMN respect to control sites although not statistically significant (p > 0.5). At contrary GBI score did not modify through the study. In conclusion subgingival irrigation by acetylsalicylate demonstrated to be able to reduce subclinical inflammation in periodontal pockets evaluated by the number of PMN in gingival fluid.

Adult↗

PubMed1995

Total colonic mobilization and exteriorization facilitates intra-operative colonic irrigation.

Intraoperative colonic irrigation has become an accepted procedure in the management of left-sided bowel obstruction, making it possible to perform a safe primary anastomosis after resection. However, many surgeons raise objections to the technique because it is a complex procedure to perform on an acutely ill patient and, furthermore, the procedure is time consuming. A modification of the technique initially described by Dudley and his colleagues has already been reported from our hospital and utilizes an irrigation needle and a one-piece disposal sack. During irrigation, the colon requires to be manipulated to encourage the onward flow of faecal contents. Difficulty may be experienced because of the sharp angulation and fixity of the colon at both the hepatic and splenic flexures. Mobilization and exteriorization of the whole colon eliminates this problem.

Colon↗

PubMed1994

[Intraoperative colonic irrigation in the emergency treatment of occlusive lesions of the left colon].

This study reports the use of an intraoperative antegrade colonic irrigation in the management of left-sided large bowel obstruction requiring emergency surgery. 35 consecutive patients had primary bowel resection with immediate anastomosis (without colostomy) after intraoperative antegrade colonic irrigation. The cause of the obstruction was large bowel carcinoma in 26, diverticulitis in seven and volvulus in two cases. There were two post-operative deaths (5.7%). No digestive fistula was observed. The results of this study suggest that intraoperative colonic irrigation is an effective method, enabling the surgeon to perform a primary anastomosis with reasonable safety after emergency resection of selected distal colonic lesions.

Aged↗

PubMed1994

[Arthroscopic distension irrigation in acute postoperative infection of the knee joint--long-term follow-up].

Between 1983 and 1993, 26 patients, 12 patients from our clinic and 14 referred patients, had to be treated because of a septic knee joint following open ligament repair or subsequent arthroscopic surgery. Immediately after arthrocentesis for synovial-fluid analysis a distension-irrigation system was established under arthroscopic control as described by R.W. Jackson. Three tubes were placed into the knee joint cavity. One was used for inflow and the other two for outflow. Distension was performed by open inflow and closed outflow tubes each second hour for 10 to 15 min. Systemic antibiotics were administered. In 22 aspirated materials the cultures revealed bacteria: mostly staphylococcus aureus (65%). In two cases in which irrigation of the knee-joint infection was performed later than the 10th postoperative day a relapse of the infection occurred and required a complete debridement and synovectomy. During follow-up period three patients underwent second look arthroscopy due to meniscus tear, rupture of an ACL reconstruction and synovial proliferation. 7 +/- 3 (2-13) years after treatment, 24 patients were re-examined, all had x-rays and 11 patients had a MRI of the knee joint additionally. 19 patients showed excellent or good results: no complaints, full ROM, no signs of osteoarthritis on x-rays and nearly normal participation in sports 4 out of 11 patients had signs of cartilage lesion and synovial proliferation. This retrospective study indicates that the distension-irrigation system is successful only in early acute cases of knee-joint infections of postoperative origins.

Adult↗

PubMed1994

[Brain abscess ruptured into the lateral ventricle: the usefulness of treatment by intraventricular irrigation with antibiotics. A case report].

A case is reported of a brain abscess, which ruptured into the lateral ventricle and was treated using intraventricular irrigation with antibiotics. A 37-year-old man was suffering from a headache and high fever. Precontrast CT scan revealed a heterogeneous low density area in the left temporal lobe, and postcontrast CT scan showed a multilobular ring-like enhanced mass. Diagnosed as a brain abscess, intravenous administration of antibiotics was performed. On the sixth day the patient suddenly became drowsy. Postcontrast CT scan revealed an enhanced effect in the left lateral ventricular wall. Drowsiness was attributed to increased intracranial pressure and severe ventriculitis. Bilateral continuous ventricular drainage via the anterior horn of the lateral ventricle was performed. The drainage fluid from the left lateral ventricle was just like pus. Intraventricular irrigation with antibiotics between the bilateral anterior horns of the lateral ventricle, was performed in order to save the patient. The infusion fluid, Lactate Ringer's solution containing Cefazolin sodium, was infused into the right ventricle and CSF-like pus was drained from the left ventricle. The CSF reading gradually improved, and on the 14th day postoperatively irrigation was terminated. The postoperative course was uneventful. The diagnosis, treatment, and prognosis of patients with brain abscesses have improved dramatically as a result of more reliable methods of identifying infecting organisms, more effective antibiotic regimens, the development of microsurgical techniques and CT scan. However, despite these advances, the prognosis for brain abscess ruptured into the ventricle is usually very pessimistic.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1994

[Effect of intraocular irrigating solution on flicker electroretinogram during cataract surgery in humans].

We studied the effects of intraocular irrigating solutions on the 30Hz flicker electroretinogram (ERG) during extracapsular cataract surgery in 45 eyes of 35 patients. The effects of two commercially available irrigating solutions. S-MA2 (Opeguard MA) and DE-057 (BSS Plus) were compared. After irrigation and aspiration (I/A) of the residual cortex with S-MA2, ERG amplitude increased to 111.2 +/- 5.8% of the pre-I/A amplitude. It significantly increased to 116.9 +/- 7.0% at the end of operation (p < 0.05) compared with before I/A. After I/A with DE-057, ERG amplitude increased to 109.5 +/- 5.3% of the pre-I/A amplitude. It significantly increased to 115.7 +/- 6.5% at the end of operation (p < 0.05) compared with before I/A. After I/A with S-MA2, ERG peak time was significantly prolonged to 103.9 +/- 0.8% of the pre-I/A peak time (p < 0.01). It was significantly shortened to 101.5 +/- 0.9% at the end of the operation (p < 0.001) compared with after I/A. After with DE-057, ERG peak time was significantly prolonged to 104.2 +/- 1.2% of the pre-I/A peak time (p < 0.01). It was significantly shortened to 101.3 +/- 1.22% at the end of the operation (p < 0.05). There were no statistical differences between changes of amplitude and peak time with S-MA2 and those with DE-057. We speculated that a drop in the retinal temperature during I/A in the anterior chamber and an increment of the photopic ERG amplitude during light adaptation with the operating microscope caused these ERG changes.

Adolescent↗

PubMedDate not supplied

Effects of subgingival irrigation with chlorhexidine on the periodontal status of patients with HA-coated integral dental implants.

The purpose of this study was to examine the effect of chlorhexidine irrigation on the periodontal status of patients with HA-coated dental implants as measured by clinical, microbiological, and immunological measures. Thirty non-adjacent implants were randomly assigned to receive a one-time irrigation with either 0.12% chlorhexidine or sterile saline, or no irrigation. All parameters were measured at baseline, 2, 5, and 8 weeks. Results showed no significant differences between any treatment modalities at any time interval. A statistically significant decrease in probing depth (P < .05) occurred within the chlorhexidine and no-treatment groups at all time intervals compared to baseline.

Analysis of Variance↗

PubMed1993

Cooling effect from absorption of prewarmed irrigating fluid in transurethral prostatic resection.

Thirty patients were studied over 10-min periods in the course of transurethral prostatic resection with measurements of rectal temperature and fluid absorption. Glycine with or without ethanol was used as the irrigant. The changes in the body temperature as reflected in oesophageal and rectal measurements in 5 of the patients were almost identical. Seven of the 30 patients became hyponatraemic and absorbed an average of 1328 ml of glycine solution. They had a significantly greater drop in rectal temperature than patients with little or no fluid absorption. This cooling effect occurred despite prewarming of the irrigant medium to 37 degrees C, which can be explained by a decrease in fluid temperature when the bag is being emptied. It was concluded that absorption of irrigating fluid is a mechanism that promotes heat loss during transurethral operations.

Absorption↗

PubMed1993

[Effect of intraocular irrigating solution on electroretinogram during pars plana vitrectomy].

The effects of intraocular irrigating solutions on the human retina are not known. We recorded 30 Hz-flicker electroretinograms (ERGs) during vitrectomy, and examined the effects of perfusate S-MA2 and DE-057 on the human ERG. The amplitude of the 30 Hz-flicker ERGs were not significantly different for the two irrigating solutions. The peak latency of the 30 Hz-flicker ERG was increased 14 +/- 4.4% (mean +/- SE) during irrigation with S-MA2, compared with the preoperative peak latency. Replacement of S-MA2 by DE-057 increased the peak latency by 37 +/- 5.8% (p < 0.01). Since the peak latency of the 30 Hz-flicker ERG became shorter after replacement of DE-057 by S-MA2, these effects were reversible (p < 0.01).

Aged↗

PubMed1996

[Epinephrine stability in solutions for intra-ocular irrigations].

PURPOSE: Epinephrine may be used for ocular irrigation during ophthalmic surgery when diluted in balanced saline solutions. In aqueous solution, epinephrine breakdown depends on pH, light, temperature, oxidating agents and increases with time. METHODS: The stability of epinephrine in plastic bags prepared in low concentrations (1 mg/L) was studied by HPLC analysis with UV detection, completed with pH determinations, performed after storage (protected from light) in various conditions: at room temperature (+25 degrees C), at +4 degrees C (in a refrigerator), at -20 degrees C (in a freezer). Spontaneous defreezing at room temperature was compared to accelerated thawing in a microwave oven. RESULTS: Epinephrine diluted in ocular irrigation solutions (1 mg/L) was stable for 2 days at room temperature, 14 days at +4 degrees C and 35 days at -20 degrees C. Microwave thawing did not alter the stability of epinephrine. CONCLUSION: The preparation of epinephrine solutions for intra-ocular irrigation may be centralized if the bags are stored less than two weeks in a refrigerator and less than one month in a freezer.

Drug Stability↗

PubMed1998

[Treatment of mediastinal infection by continuous closed irrigation with an antibiotic solution in a new bone baby].

The patient was a three-week-old girl. Four days after thoracic surgery, mild fever developed, and turbid fluid was drained from the incision. Culture of the discharge showed Pseudomonas aeruginosa and Serratia marcescens. Débridement was immediately performed and continuous closed irrigation with an antibiotic solution started and maintained for 17 days. During this period, the upper half of the body was elevated. Ten days after irrigation started culture of the drainage fluid became negative. We emphasize early diagnosis, and the usefulness of continuous closed irrigation with an antibiotic solution in neonates.

Drug Therapy, Combination↗

PubMed1976

Side-effects of high pressure irrigation.

This study was undertaken to identify side-effects of high pressure irrigation. Standardized surgical wounds made in Yorkshire pigs were subjected to high pressure syringe and pulsatile irrigation. As a result of these treatments, fluids were disseminated into the adjacent tissue of the wound, predominantly in a lateral direction. Bacteria did not accompany this disseminated fluid and apparently were filtered out by the surface tissues. This treatment results in a tissue injury which impairs its defenses, making the wound more susceptible to infection. However, the remarkable cleansing capacity of high pressure irrigation appears to outweigh this side-effect, since heavily contaminated wounds subjected to this treatment heal per primum without infection.

Animals↗

PubMed1985

Viability of tumor cells in the irrigation fluid of the Cavitron Ultrasonic Surgical Aspirator (CUSA) after tumor fragmentation.

The Cavitron Ultrasonic Surgical Aspirator (CUSA) (Cooper Medical, Stamford, CT) is a relatively new surgical modality. The risk of tumor seeding during tumor surgery has not been studied until now. Hanks balanced salt solution, normal saline, distilled water, and Dakin's solution were used as irrigation fluids during CUSA fragmentation of Lewis lung carcinoma in C57B1/10 female mice, using the machine at 40% of its maximal output. All four irrigation fluids contained viable tumor cells--growing in vitro as well as in vivo--after tumor aspiration. Normal saline was also used when the machine was operating at its maximal output. Under these conditions, the irrigation fluid contained viable tumor cells as well.

Animals↗

PubMed1993

Morphological study of the effects of intranasal zinc sulfate irrigation on the mouse olfactory epithelium and olfactory bulb.

The effects of intranasal zinc sulfate (ZnSO4) irrigation on the morphology of the olfactory epithelium and olfactory bulb were studied in mice with short survival times (as early as 1 day) and with long survival times (up to 593 days) after the irrigation procedure. As in several previous studies, the olfactory epithelium was completely destroyed within a few days after the ZnSO4 treatment. Within 2-4 days, the septum and turbinates were covered by a new, cuboidal epithelium, the cells of which differed significantly from any cells normally seen in the olfactory epithelium. Slowly, over several months, small areas of the olfactory epithelium regenerated in many of the animals. The ultrastructural changes occurring in the olfactory bulb from 1 to 25 days (the reactive stage) were characterized by degenerating olfactory axons and axon terminals, hypertrophy of astroglial cell processes, and proliferation of or extravasation by phagocytic cells. By 25 days after intranasal ZnSO4 irrigation, the number of reactive glial processes and phagocytic cells returned to normal. In some mice with survival times of 150 days or longer, there was reinnervation of small areas of the olfactory bulb by regenerated olfactory axons. These new olfactory axons innervated only superficial glomeruli or the outer portions of deeper glomeruli, but they formed synaptic contacts with mitral/tufted cells and periglomerular cells that did not differ from control animals. These findings were supported by tract-tracing experiments with 3H-amino acids and by behavioral analysis. In summary, the ultrastructural changes observed in the olfactory bulb in this study were not significantly different from those observed after surgical lesions of the olfactory epithelium or nerve.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Intranasal↗

PubMed2005

The potential efficiency of irrigation management and propargyl bromide in controlling three soil pests: Tylenchulus semipenetrans, Fusarium oxysporum and Echinochloa crus-galli.

Propargyl bromide (3-bromopropyne, 3BP) is a potential alternative for methyl bromide. Little information is available about its efficiency in controlling pests. The purpose of this paper is to estimate the 3BP dose required for killing three pests and to compare the efficiency of water management approaches to that of fumigation. The pests, Fusarium oxysporum Schlecht (fungus), Echinochloa crus-galli (L) Beauv (grass) and Tylenchulus semipenetrans Cobb (nematode) were exposed to different 3BP concentrations in a sandy loam at 30 degrees C in a closed system. The lethal dose for killing 90% of the population (LD90) was calculated from the total applied mass, and varied from 0.3 microg g(-1) soil for the nematode, 3 microg g(-1) for the grass, and 9 microg g(-1) for the fungus. The concentration-time index for killing 90% of the population (CT90) was 11 microg g(-1) h for the nematode, 112 microg g(-1) h for the grass and 345 microg g(-1) h for the fungus. 3BP seems as efficient as other fumigant alternatives in controlling these pests. Using an open system, it was shown that the volume of soil in which the pests were controlled varied for different irrigation managements. Even 96 h after fumigation (with a concentration 10 times higher than would potentially be applied in the field), more than 20% of the soil volume had not reached the fungus and grass CT90 of the non-irrigated soil. The soil underneath the furrow and the bed reached CT90 only slowly in all irrigated treatments even though techniques for increasing efficiency were used (tarping, surface sealing with water and high application rate).

Agriculture↗