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At least 1,333 records · Page 74Linked to original sources
PubMed1984

Treatment of the perineal wound after proctectomy by intermittent irrigation.

Between 1977 and 1983, 43 patients underwent proctectomy (40 patients for carcinoma, three for ulcerative colitis). The subsequent perineal wound received primary closure and the pelvic space was treated with intermittent irrigation and suction drainage using a double-lumen catheter. Primary healing of the perineal wound occurred in 56.4% of cases and in 89.7% of cases the perineal wound had healed completely by the sixth postoperative week. The relationships between perineal wound healing and the age and sex of the patient, the stage of the tumor, and the tumor distance from the anal verge were assessed. The period of hospitalization was significantly reduced when the perineal wound underwent primary healing. The results obtained in terms of wound healing are comparable with the best published results using continuous irrigation. Our method is advantageous in that it does not necessitate immobilization of the patient.

Aged↗
PubMed1998

Induction of cell division in olfactory basal epithelium following intranasal irrigation with wheat germ agglutinin-horseradish peroxidase.

The lectin, wheatgerm agglutinin (WGA) conjugated to horseradish peroxidase (HRP), previously was shown to be transported into the central nervous system following application by intranasal irrigation. The current study investigated the hypothesis that uptake of molecules, such as the lectin-conjugate, by olfactory receptor cells would mimic internalization of other substances including odorants. This process would result in both premature death of receptor cells and increased turnover of their precursors, globose basal cells. Tetramethylbenzidine histochemical analysis showed the presence of significant amounts of the lectin-conjugate in both the receptor epithelium and olfactory bulb until at least 2 weeks postintranasal application. Neither supporting nor globose basal cells contained WGA-HRP, suggesting that uptake was primarily into olfactory receptor cells. Cell turnover, assessed by tritiated-thymidine (thymidine) autoradiography, increased both 1 and 2 weeks, but not 3 and 4 weeks, following intranasal irrigation with WGA-HRP. Most of the cells containing thymidine labelling appeared to be globose basal cells, although supporting cells also occasionally exhibited labelling. Survival of either mature or immature receptor cells in the epithelium, indicated by epithelial thickness and cell density of the septal epithelium, also declined following treatment. These data suggest that uptake of substances may result in cell loss from the olfactory epithelium and increased mitotic activity of basal cells.

Administration, Intranasal↗
PubMed1989

Ethanol fixation of bladder irrigation specimens for flow cytometric analysis. A multiinstitutional study from the bladder cancer flow cytometry network.

Ethanol preservation of voided and catheterized urine has long been the standard for urinary cytologic study. In this report ethanol preservation of bladder irrigation specimens was evaluated for flow cytometric analysis in a multiinstitutional study requiring specimen transport. Specimens from ten patients obtained at one center were preserved for varying periods of time in 50% ethanol, then distributed by express mail to four other participating centers, up to 3000 miles distant. On receipt, from 1 to 3 weeks after collection, the samples were processed and examined by flow cytometric study using propidium iodide as the fluorochrome. Forty-six of the 50 (92%) analyzed specimens gave satisfactory histograms. In 41 of the 46 adequate samples (89%), an aneuploid peak in the alcohol preserved (propidium iodide stained) specimen correlated well with the fresh (acridine orange stained) specimen. However, there was variable loss of DNA stainability with a broadening of the coefficient of variation in some alcohol-preserved specimens and an increase in cellular debris so that measurements of DNA index and percent hyperdiploid cells were considered unreliable. The authors conclude that ethanol preservation of bladder irrigation specimens for short periods of time may be a feasible alternative when flow cytometric analysis cannot be carried out on fresh specimens, but that this is not optimal fixation for specimens that must be transported and further studies of other fixatives are recommended.

Aneuploidy↗
PubMed2002

Tidal irrigation as treatment for knee osteoarthritis: a sham-controlled, randomized, double-blinded evaluation.

OBJECTIVE: To evaluate the effectiveness of tidal irrigation (TI) in comparison with a well-matched sham irrigation (SI) procedure as a treatment for knee osteoarthritis (OA). METHODS: One hundred eighty subjects with knee OA were randomized to receive TI or SI, with clinical followup over the ensuing 12 months. The primary outcomes of interest were change in pain and function, as measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Subjects and the nurse assessor were blinded, and success of blinding was assessed. RESULTS: Although the study groups were otherwise comparable, the baseline WOMAC pain and physical functioning scores were higher (worse) in the SI group. After adjustment for baseline, there were no differences between the effects of

Aged↗
PubMed1978

The bacteriology of primary wound sepsis in potentially contaminated abdominal operations: the effect of irrigation, povidone-iodine and cephaloridine on the sepsis rate assessed in a clinical trial.

Two hundred and nine potentially contaminated abdominal operations were randomly allocated to prophylaxis with a single dose of 1 g cephaloridine intraincisionally, irrigation of the wound at the end of the operation with saline or spraying of the wound with povidone-iodine. In high risk operations (ileocolorectal or those in obese patients) the rate of major wound sepsis in those protected by cephaloridine was 3.8% compared with 13.2% in the irrigation and 16.7% in the povidone-iodine groups. In low risk operations no significant differences in sepsis rates were found. Bacteriological studies of incised organs, subcutaneous fat and pus showed that the majority of wound infections arose from endogenous sources. The outstanding problem remains that of prevention of contamination of the abdominal wall during surgery.

Abdomen↗
PubMed1984

Colostomy irrigation with prostaglandin E2 and bisacodyl. A double-blind cross-over study.

The emptying of the colon and the side-effects after intraluminal application of prostaglandin E2 and of bisacodyl in 14 patients was studied by employing colostomy irrigation. The design was double-blind with cross-over, the irrigation was one litre of tap water to which was added in randomized sequence placebo, prostaglandin *2 (350, 700 and 1400 micrograms) or bisacodyl (1.25, 2.5 and 5 mg). Neither prostaglandin E2 nor bisacodyl had any significant effect.

Adult↗
PubMed1985

Intra-operative colonic irrigation in the management of left-sided large bowel emergencies.

In a consecutive series of 93 patients who required emergency surgery for distal colonic lesions, 61 had primary bowel resection with immediate anastomosis after intra-operative antegrade colonic irrigation. The operative mortality was 8 per cent, anastomotic leakage rate 7 per cent and superficial wound infection occurred in 3 per cent of patients. The mean hospital stay was 13 days. Of the remaining 32 patients, 3 did not have a resection and 29 had a primary resection and end colostomy without anastomosis: bowel continuity was later restored in 17 of 28 survivors (61 per cent) but 11 (39 per cent) were left with a permanent colostomy. The hospital mortality in this group was 6 per cent, superficial wound infection rate 14 per cent and the mean hospital stay 26 days. The results of this study suggest that intra-operative 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.

Adolescent↗
PubMed1989

Debridement and closed cavity irrigation for the treatment of pancreatic necrosis.

Pancreatic and peripancreatic debridement combined with a closed cavity system of drainage was used to manage necrotic sequelae of severe acute pancreatitis in 14 patients. Intravenous contrast-enhanced computed tomography, or latterly incremental dynamic computed tomographic angiography, accurately detected and localized necrotic tissue. Operation was delayed where possible to permit demarcation of the necrotic area and the development of a 'capsule' of inflammatory tissue. A retrocolic route of access to the necrotic area was used in nine cases, and purpose-made silicone elastomer tubes with an outside diameter of 20 mm were positioned so that drainage was assisted by gravity when the patient was supine. The cavity was irrigated with saline (initially 2 litres daily), and in the last seven patients Trasylol was included in the irrigation fluid (5 x 10(6) kallidinogenase inactivator (KI) units/litre) for the first postoperative week. Three elderly patients died (mean age 72 years) but all patients aged less than 68 years survived. Planned reoperation was carried out in two patients, but further reoperations were not required in the remaining 11. Drainage tubes were removed when contrast studies showed the cavity to be small and superficial; the median duration of drainage was 28 days. Although sinograms demonstrated fistulae between cavity and small bowel (n = 4) or small bowel and colon (n = 2), no clinical problems resulted and all closed spontaneously. Closed drainage may be as effective as techniques of marsupialization, but avoids the need for frequent relaparotomy.

Acute Disease↗
PubMed1995

Response of olfactory Schwann cells to intranasal zinc sulfate irrigation.

The response of olfactory Schwann cells was assessed at 2, 4, and 7 days following intranasal zinc sulfate irrigation in 1-month-old mice. Ultrastructural and immunohistochemical observations showed dramatic differences between experimental and control mice which had been washed with saline intranasally. Two days after zinc sulfate treatment, many olfactory nerve bundles contained patchy areas of axonal degeneration, while the cell bodies of the olfactory Schwann cells appeared to have increased in electron density and to have shifted peripherally. Some of the cell bodies protruded from the surface of the axon fascicle, suggesting that the olfactory Schwann cells were in the initial process of migrating away. On the fourth day when most of the olfactory axons had degenerated, some olfactory Schwann cells were aligned immediately beneath the basal lamina of the olfactory epithelium. These cells were immunopositive for the S-100 protein and possessed an expanded perinuclear space. Many olfactory Schwann cells were present in the region beneath the cribriform plate, while some appeared to have passed through the gaps between the bony plates to reach the olfactory bulb. Hence, the results showed that many olfactory Schwann cells migrated towards the olfactory bulb following loss of axonal contact. Furthermore, on the seventh day following zinc sulfate treatment, some olfactory Schwann cells in the vicinity of the olfactory bulb appeared phagocytic, as indicated by their extension of processes around fragments of cell debris and the presence of lysosome-like organelles in the perikaryon. The control mice which had been intranasally irrigated with saline did not demonstrate massive olfactory axonal degeneration, and the morphology of the nasal cavity region was similar to that of normal mice.

Animals↗
PubMed1989

Intraoperative antegrade irrigation in complicated left-sided colonic cancer.

Emergency one-stage surgery for acute, complicated, left-sided colonic cancer can be performed because of intraoperative antegrade irrigation of the large intestine. This procedure was performed in 17 patients: 15 patients with an obstructive, left-sided cancer and two patients with a perforated carcinoma. The age distribution ranged between 57 and 92 years. There were two postoperative septic complications: a small wound abscess and a partial abdominal wall dehiscence. One patient died because of massive upper gastrointestinal bleeding. This method permits the creation of a primary anastomosis in the left colon, obviating the necessity of a coeco- or colostomy, preternatural anus, or an extensive right-sided hemicolectomy. Several surgical interventions are avoided, resulting in a decrease of mortality, morbidity, duration of hospital stay, and costs. Moreover, intraoperative irrigation could be an attractive alternative for the usual preoperative mechanical bowel preparation, which is especially burdensome in elderly patients.

Aged↗
PubMed2026

The Statistical Fragility of Saline Nasal Irrigation for Rhinosinusitis: A Systematic Review.

OBJECTIVE: To assess the statistical fragility of randomized controlled trials (RCTs) evaluating high-volume saline nasal irrigation (SNI) for rhinosinusitis using fragility analysis. DATA SOURCES: PubMed, MEDLINE, and Embase were searched for RCTs published between May 1976 and January 2026. REVIEW METHODS: This study was reported as per PRISMA guidelines. RCTs that compared high-volume SNI to non-irrigation standard care for acute, recurrent, or chronic rhinosinusitis, and reported ≥ 1 dichotomous outcome, were included. Fragility index (FI), the minimum number of event reversals needed to alter statistical significance, and fragility quotient (FQ), FI normalized to sample size, were calculated for statistically significant dichotomous outcomes. Reverse FI (rFI) and reverse FQ (rFQ) were calculated for non-significant outcomes. RESULTS: Eight RCTs were included, yielding 38 dichotomous outcomes. Eight outcomes (21.1%) were statistically significant. The overall combined median FI was 5 (FQ 0.062), with similar FI values between significant and non-significant outcomes. In over one-fifth of outcomes, loss to follow-up exceeded FI. Analysis of principal dichotomous outcomes from studies demonstrated a median FI of 6 (FQ 0.092), with five of eight (62.5%) outcomes non-significant. CONCLUSION: RCTs evaluating SNI for rhinosinusitis exhibit moderate-to-high statistical fragility, with small outcome changes capable of reversing study conclusions. Because fragility analysis was limited to dichotomous outcomes while many primary endpoints were continuous, our findings should be interpreted as complementary rather than comprehensive appraisals of RCTs. Future RCTs with larger sample sizes, reduced bias, and pre-specified fragility considerations are needed to better define the clinical role of SNI.

Rhinosinusitis↗
PubMed1995

Effect of phosphate concentration in buffered irrigating solutions on arterial thrombosis.

The concentration of phosphate in buffered saline irrigation solutions was evaluated for its effect upon the incidence of arterial thrombosis. A rabbit thrombosis model of combined intimal abrasion and twisted pedicle in the rabbit central ear artery was used. Higher concentrations of phosphate (20 mM) in normal saline yielded a lower thrombosis rate at 7 days postoperatively (50%) in comparison to 5 mM phosphate (89% thrombosis rate; P < 0.05). A standard phosphate-buffered salt solution (Dulbecco's; 9.5 mM phosphate with potassium, calcium, and magnesium salts) also had a high thrombosis rate (91%). This study demonstrates that subtle variations in the irrigation solution can have profound effects upon arterial thrombosis.

Animals↗
PubMed1996

Endothelial toxicity of ceftazidime in anterior chamber irrigation solution.

Due to the high toxicity of aminoglycoside antibiotics, many authors prefer to use third generation cephalosporines in the prophylaxis and treatment of intraocular infections. The aim of the present study was to determine safe ceftazidime levels in anterior chamber irrigation solution. Twenty-two eyes of 12 white New Zealand rabbits were divided into six groups of two animals each. Double paracentesis was performed in both eyes, irrigating the right eye with 250 ml of BSS-Plus (BSS+) solution, and the left eye with 250 ml of BSS+ solution with increasing concentrations of ceftazidime (2, 3, 4, 6 and 8 mg ml-1). Each rabbit was killed at the end of surgery, except the last group, which received BSS+ and BSS+ with 8 mg ml-1 of ceftazidime, respectively, in one eye, and were then killed 24 hr later. Endothelial lesions were assessed by silver nitrate staining. We considered lesions endothelial silver affinity ranging from minimal (1-2+) to intense (3-4+). 1-2+ silver affinity was found in 4 +/- 1.35% of endothelial cells in the controls; this percentage in turn increased with antibiotic concentration (6.1 +/- 1.13%, 6.7 +/- 0.4%, 7.2 +/- 1.36%, 7.3 +/- 1.93% and 7.5 +/- 1.83%, respectively). The percentage of 3-4+ silver affinity was 0.18 +/- 0.17% in the controls, and likewise increased with antibiotic concentration (0.22 +/- 0.11%, 0.37 +/- 0.09%, 2.8 +/- 0.63% and 3.1 +/- 0.46%, respectively). The increase in affinity was greatest up to the 4 mg ml-1 concentration. In the last group there were zones of endothelial alterations in morphology and size, with signs of attempted repair in the eye treated with antibiotic, but none in the case treated only with BSS+. Ceftazidime concentrations above 3 mg ml-1 in intraocular infusions induce endothelial cell toxicity.

Animals↗
PubMed2001

High-dose intravenous infusion of irrigating fluids containing glycine and mannitol in the pig.

BACKGROUND: Large-scale absorption of electrolyte-free irrigating fluid during endoscopic surgery may result in a "transurethral resection syndrome." The severity of the syndrome can probably be modified by using mannitol 5% instead of the most widely used glycine 1.5%. METHODS: Seventeen pigs with a mean body weight of 22 (range 19-26) kg received an intravenous infusion of 100 mL kg(-1) h(-1) of either glycine 1.5% or mannitol 5% over 90 min. Central hemodynamics, whole-body and brain oxygen consumption, intracranial pressure, blood hemoglobin, and the sodium concentrations in serum and urine were monitored for 120 min. Selected measurements were made on 6 other pigs given mannitol 3% and in 2 controls not given any fluid. Morphological examinations of the hearts were conducted. RESULTS: Both glycine 1.5% and mannitol 5% transiently increased cardiac output, the aortic blood flow rate, and arterial pressures, but all of these parameters fell to below baseline after the infusions were ended. The intracranial pressure was lower (P < 0.05) and the oxygen consumption in the brain decreased (P < 0.001) during the infusion of mannitol 5%. Glycine 1.5% expanded the intracellular volume more than mannitol did (P < 0.002). Signs of myocardial damage were graded glycine 1.5% > mannitol 5% > mannitol 3%. CONCLUSIONS: Massive infusion of glycine 1.5% and mannitol 5% left the pigs in a hypokinetic hypotensive state. Glycine 1.5% increased the intracranial pressure and injured the myocardium more than mannitol 5%, which then seems to be a more appropriate irrigating fluid to use during endoscopic surgery.

Animals↗
PubMed1988

Changes in intravesical pressure during irrigating fluid absorption in transurethral prostatic surgery.

Continuous recording of intravesical pressure (IVP) and incremental volumetric measurements of irrigating fluid absorption were performed during 37 transurethral resections of the prostate (TUR). Absorption which resulted in concomitant dilutional changes in peripheral blood, indicating intravascular absorption, was associated with prolongation of the time required to increase the IVP. There was an inverse relation between the change in maximum IVP and the rate of irrigating fluid absorption. Absorption that did not result in concomitant dilutional changes in peripheral blood, indicating extravascular absorption, was associated with similar changes in IVP parameters but the critical pressure for absorption was lower.

Absorption↗
PubMed1989

Comparison of isotonic saline, distilled water and boiled water in irrigation of open fractures.

A prospective randomised study was carried out on 86 patients with first, second and third degree open fractures in order to compare the effect of isotonic saline, distilled water and boiled water as irrigating fluids. The standard management consisted of emergency surgical toilet, use of broad spectrum antibiotics and fracture immobilization. The results show that the outcome was not affected by the type of irrigating fluid used.

Amputation, Surgical↗
PubMed1993

The advantage of primary resection and anastomosis with intraoperative bowel irrigation for obstructing left-sided colorectal carcinoma.

Of a total 712 patients with left-sided colorectal cancer, 79 (11%) required emergency surgery due to severe obstruction by tumors. Of these 79 patients, 55 underwent tumor resection and anastomosis. Primary resection and anastomosis with intraoperative bowel irrigation was performed in 44 patients (primary group), while staged resection and anastomosis was performed in only 11 (staged group). In comparing the two groups, there was no significant difference in the rates of curative resection, being 76% versus 90%. However, the primary group demonstrated significantly lower rates of postoperative wound infection (P < 0.001), anastomotic dehiscence (P not equal to 0.05), and postoperative mortality, at 2% versus 18% (P < 0.05). The cumulative survival curve was also better in the primary group (P < 0.05). These favorable results of the primary group were confirmed by analyses which established that no bias of therapeutic backgrounds existed in either of the two groups. Thus, it was concluded that for left-sided obstructing colorectal carcinoma, intraoperative bowel irrigation, followed by primary resection and anastomosis, produces more advantageous results.

Adult↗
PubMed1979

Antibiotic irrigation-perfusion treatment for chronic osteomyelitis.

This paper reports 125 antibiotic irrigation-perfusion treatments of chronic osteomyelitic patients. The localisation of the osteomyelitic process, the duration of the disease, the duration of the treatment, the age distributions of the patients, and the results of the treatment are noted. The study revealed that only one third of the patients healed after the irrigation-perfusion treatment. This rate falls short of the results reported in the literature. The possible causes are discussed and emphasis is given to the technical problems. On the basis of this survey the author is of the opinion that this method is to be employed only in exceptional cases of bone infections. The indication and contraindications are precisely defined.

Adolescent↗