Total hip arthroplasty (THA) is the mainstay of treatment for advanced hip arthritis, but a number of postoperative wound complications may occur, such as wound dehiscence, bleeding and infection. Among them, wound infection is one of the serious complications after THA, which may lead to hip dysfunction or even disability, prolong hospital stay, increase readmission rate and significantly increase related medical expenses. Therefore, further understanding and action to change modifiable risk factors associated with wound infection will not only reduce medical expenses, but also improve the prevention, treatment and care. This article reviews the risk factors of surgical wound infection over the past 5 years, including patients factors (serum albumin, serum transferrin, blood transfusion, congestive heart failure, diabetes, overweight or obesity, smoking, and long-term use of hormone) and medical factors (previous surgery, surgical approach, length of surgery, and operating room environment).
Objective To investigate the mental status of medical staffs in the orthopedics department during the earthquake, providing evidence for psychological intervention. Methods Choosing 104 staffs in the orthopedics department as eligible subject with convenient sampling; the research tool was Symptom Checklist-90. The questionnaire was done by the participants with the same instruction from psychological professionals; analyze the results. Results The score in somatization, anxiety and phobic anxiety of staffs in the orthopedics department was significantly higher than the national norm. Conclusion There exists disorder in mental health of medical staffs in orthopedics department, it is necessary to implement mental intervention.
Enhanced recovery after surgery (ERAS) has been carried out in many surgical fields such as orthopedics, galactophore, cardiothoracic surgery, gastrointestinal surgery, and obstetrics due to its standardized perioperative management process to reduce surgical stress and reduce surgical complications. After more than a decade of development, ERAS has achieved initial results. However, in China, the development of ERAS in orthopedic is still in its infancy. Most of the researches focus on the multidisciplinary management path of perioperative period. How to break through the existing bottlenecks is the key to accelerate the further development of rehabilitation. Therefore, this paper introduces the origin and development of ERAS, analyzes the challenges and opportunities of orthopedic ERAS in clinical advancement, proposes the important measures to promote the accelerated development of orthopedics, and provides new ideas for promoting the in-depth development of orthopedics accelerated rehabilitation.
Objective To evaluate the safety and efficacy of intermittent pneumatic compression in prevention of deep venous thrombosis after major orthopedic operation. Methods We searched MEDLINE (1966 to January 2008), The Cochrane Library (Issue 2, 2008), CBM (1996 to January 2008), CNKI (1998 to January 2008), VIP (1998 to January 2008), and retrieved clinical controlled trials (CCTs) or randomized controlled trials (RCTs) in which IPC was used as an intervention to prevent DVT, and all the trials were published in English or Chinese. The methodological quality of the included studies was assessed according to the standard of Cochrane systematic review. RevMan 4.2 software was used for meta-analysis. Results Seven RCTs and 1 CCT were included. Their methodological quality was poor. The results of Meta–analyses showed: (1) The incidence of DVT in the IPC group was lower than that in the control group (RR=0.20, 95%CI 0.11 to 0.35, Plt;0.000 01); (2) There was no difference in the incidence of DVT between the IPC group and the LMWH group (RR=0.70, 95%CI 0.28 to 1.74, P=0.44); (3) The incidence of DVT in the IPC plus LMWH group was lower than that in the LMWH-alone group (RR=0.23, 95%CI 0.10 to 0.52, P=0.000 4). Furthermore, the incidence of DVT in the IPC plus LMWH group was lower than that in the GCS plus LMWH group (Plt;0.000 1). No severe adverse reaction of IPC in DVT prevention was reported. Conclusion IPC shows an effective tendency in DVT prevention, but because of the low quality and the small sample of the included studies, this conclusion needs to be verified by protocols of more samples and high quality.
摘要:目的: 探討脊髓動靜脈畸形患者科學的圍手術期護理方法。 方法 :對31例脊髓動靜脈畸形圍術期患者進行了科學的護理,即心理,術前、術后以及特殊癥狀護理,并分析護理效果。 結果 :31例患者中治愈27例,好轉4例。 結論 :脊髓動靜脈畸形手術難度大,危險性高,科學的圍手術期護理是促進治療效果的重要保證。Abstract: Objective: To discuss the effectiveness of scientific perioperative nursing for the patients with spinal arteriovenous malformations. Methods : 31 patients with spinal arteriovenous malformations had got nursing, such as psychology nursing and special perioperative symptoms. The nursing effective is analysed. Results : 27 cases are cured and the other 4 cases improved. Conclusion : Spinal arteriovenous malformations is difficult and dangerous for operation.The scientific perioperative nursing is important guarantee for advancing the cure effective.
Periwound skin, as an indicator of the wound healing monitoring process, is one of the most important components of wound management. Effective management of periwound skin is a major professional challenge. In practice, healthcare professionals usually focus on the wound site and pay little attention to the periwound skin. Inappropriate management of periwound skin will delay the wound healing process, increase the economic costs of the patients, and decrease the patients’ satisfaction with medical care. This article summarizes the clinical symptoms, assessment tools, and management strategies of periwound skin, aiming to provide new ideas and references for clinical wound management.
