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International Journal of... 2013Many oral surgeons in their daily practice have the problem of controlling postoperative bleeding. In surgical, oral and maxillofacial practice, standard... (Review)
Review
Many oral surgeons in their daily practice have the problem of controlling postoperative bleeding. In surgical, oral and maxillofacial practice, standard anti-hemorrhagic protocols, especially in high risk patients, are obviously required and need to be continuously updated. The purpose of this review is to give a rational insight into the management of bleeding in oral and dental practice through modern drugs and medical devices such as lysine analogues and serine protease inhibitors, desmopressin, fibrin sealants, cyanoacrylates, gelatins, collagen and foams, protein concentrates, recombinant factors, complementary and alternative medicine and other compounds.
Topics: Complementary Therapies; Deamino Arginine Vasopressin; Fibrin Tissue Adhesive; Gelatin Sponge, Absorbable; Humans; Oral Surgical Procedures; Postoperative Hemorrhage; Serine Proteinase Inhibitors
PubMed: 24355219
DOI: 10.1177/039463201302600402 -
Revista Da Associacao Medica Brasileira... 2012
Topics: Diaphragm; Foreign Bodies; Humans; Male; Medical Errors; Middle Aged; Radiography; Stomach Neoplasms; Surgical Sponges
PubMed: 23250088
DOI: No ID Found -
Ugeskrift For Laeger Jan 2017Haemostasis is of fundamental significance in neurosurgery, and insufficient control of bleeding is associated with morbidity and mortality. Topical haemostatic agents... (Review)
Review
Haemostasis is of fundamental significance in neurosurgery, and insufficient control of bleeding is associated with morbidity and mortality. Topical haemostatic agents play an important role, as the characteristics of neuronal tissue limit the use of classical surgical haemostasis techniques. Appropriate choice of agent depends on the location and type of bleeding, but also on knowledge of the products' mechanisms of action, indications, price and accessibility. Biological products are superior to the mechanical in efficacy but require more preparation and are significantly more cost-intensive.
Topics: Blood Loss, Surgical; Cellulose, Oxidized; Collagen; Fibrin; Hemostasis; Hemostatics; Humans; Hydrogen Peroxide; Neurosurgical Procedures; Palmitates; Sodium Chloride; Surgical Sponges; Thrombin; Waxes
PubMed: 28397668
DOI: No ID Found -
Nature Communications Aug 2021Developing an anti-infective shape-memory hemostatic sponge able to guide in situ tissue regeneration for noncompressible hemorrhages in civilian and battlefield...
Developing an anti-infective shape-memory hemostatic sponge able to guide in situ tissue regeneration for noncompressible hemorrhages in civilian and battlefield settings remains a challenge. Here we engineer hemostatic chitosan sponges with highly interconnective microchannels by combining 3D printed microfiber leaching, freeze-drying, and superficial active modification. We demonstrate that the microchannelled alkylated chitosan sponge (MACS) exhibits the capacity for water and blood absorption, as well as rapid shape recovery. We show that compared to clinically used gauze, gelatin sponge, CELOX™, and CELOX™-gauze, the MACS provides higher pro-coagulant and hemostatic capacities in lethally normal and heparinized rat and pig liver perforation wound models. We demonstrate its anti-infective activity against S. aureus and E. coli and its promotion of liver parenchymal cell infiltration, vascularization, and tissue integration in a rat liver defect model. Overall, the MACS demonstrates promising clinical translational potential in treating lethal noncompressible hemorrhage and facilitating wound healing.
Topics: Alkylation; Animals; Bacterial Infections; Blood Coagulation; Chitosan; Hemorrhage; Hemostatic Techniques; Liver; Liver Diseases; Liver Regeneration; Male; Materials Testing; Microscopy, Electron, Scanning; Porosity; Rats; Surgical Sponges; Swine; Swine, Miniature; Wound Healing
PubMed: 34354068
DOI: 10.1038/s41467-021-24972-2 -
The American Journal of Case Reports Sep 2020BACKGROUND During any surgical procedure, there are several factors that may lead to morbidity and mortality. One of those factors is a retained cotton or gauze surgical...
BACKGROUND During any surgical procedure, there are several factors that may lead to morbidity and mortality. One of those factors is a retained cotton or gauze surgical sponge inadvertently left in the body during an operation, known as gossypiboma. This clinical oversight may cause serious postoperative complications and increase the risk of mortality, particularly if left undiscovered. Furthermore, this issue adds to the economic burden on healthcare systems by increasing the rate of reoperation and rehospitalization. The length of postoperative gossypiboma diagnosis varies greatly, as patients may either present acutely with symptoms such as a palpable mass, pain, nausea, and vomiting, or remain asymptomatic for several years. CASE REPORT We report the case of a 48-year-old man who underwent a thoracotomy after a road traffic accident. The resulting empyema led to the intraoperative discovery of an intrathoracic gossypiboma, which was initially interpreted radiologically as a part of the previous surgical staple line. The causative agent was discovered by the team's nurses during the postsurgical count of instruments and sponges, and who were alerted to a recovered sponge differing in appearance from the sponges used for that procedure. CONCLUSIONS In general, proper counting and adherence to the World Health Organization 'Surgical Safety Checklist' can greatly improve the outcome of any surgery. The diagnosis of gossypiboma is often late or missed entirely and leads to additional interventions that can be avoided or detected early when the material contains a radiopaque marker. In cases under suspicion of any mistakenly left object, the use of intraoperative radiology before skin closure is highly recommended to prevent postoperative complications for the patient and organization.
Topics: Foreign Bodies; Humans; Male; Middle Aged; Postoperative Complications; Reoperation; Surgical Sponges; Thoracotomy
PubMed: 32893262
DOI: 10.12659/AJCR.923992 -
Asian Journal of Surgery Apr 2005Retained surgical sponges are seldom reported due to medicolegal implications. Awareness of this problem among surgeons and radiologists is essential to avoid... (Review)
Review
OBJECTIVE
Retained surgical sponges are seldom reported due to medicolegal implications. Awareness of this problem among surgeons and radiologists is essential to avoid unnecessary morbidity. We present our experience with this entity and review the related literature.
METHODS
The medical records of 11 patients who were diagnosed as having retained surgical sponges from 1990 to 2003 were reviewed.
RESULTS
The incidence was 1:5,027 inpatient operations. There were four males and seven females with a median age of 45 years. The original operations were gynaecological (n=4), general (n=4), urological (n=2) and laminectomy (n=1). In seven cases, the original operation was performed on an emergency basis. Five patients were obese. A presumed correct sponge count was documented in eight cases. The median time between the original procedure and diagnosis of retained sponges was 12 months. The tentative diagnosis was intestinal obstruction (4 patients), urinary tract infection (1 patient), Crohn's disease (1 patient) and tumour recurrence (1 patient). The correct diagnosis was suggested in the remaining four patients. Surgical removal of the retained sponges was carried out in all cases except one, in which the patient passed the sponge spontaneously through the rectum.
CONCLUSION
Retained sponges are more common in obese patients and after emergency surgery. A high degree of suspicion is important for preoperative diagnosis. Despite the use of radio-opaque sponges and thorough sponge counting, this moribund mishap still occurs. Although human errors cannot be completely abolished, continuous medical training and strict adherence to regulations should reduce the incidence to a minimum.
Topics: Adult; Female; Foreign Bodies; Humans; Incidence; Jordan; Male; Medical Errors; Middle Aged; Obesity; Postoperative Complications; Radiography; Retrospective Studies; Risk Factors; Surgical Sponges
PubMed: 15851364
DOI: 10.1016/s1015-9584(09)60273-6 -
Medicina 2013
Topics: Cysts; Female; Foreign Bodies; Humans; Middle Aged; Surgical Sponges
PubMed: 23732206
DOI: No ID Found -
International Journal of Biological... Dec 2020Silk fibroin (SF) is derived from Bombyx mori silkworm cocoons and has been used in textiles and as a suture material for decades. More recently, SF has been used for... (Comparative Study)
Comparative Study Review
Silk fibroin (SF) is derived from Bombyx mori silkworm cocoons and has been used in textiles and as a suture material for decades. More recently, SF has been used for various new biomedical applications, including as a wound dressing, owing to its excellent biological and mechanical properties. Specifically, the mechanical stiffness, versatility, biocompatibility, biodegradability, water vapour permeability and slight bactericidal properties make SF an excellent candidate biomaterial for wound dressing applications. The effectiveness of SF as a wound dressing has been tested and well-documented in vitro as well as in-vivo, as described here. Dressings based on SF are currently used for treating a wide variety of chronic and acute (e.g. burn) wounds. SF and its derivatives prepared as biomaterials are available as sponges, hydrogels, nanofibrous matrices, scaffolds, micro/nanoparticles, and films. The present review discusses the potential role of SF in wound dressing and its modulation for wound dressing applications. The comparison of SF based dressings with other natural polymers understands the readers, the scope and limitation of the subject in-depth.
Topics: Animals; Bandages; Bandages, Hydrocolloid; Biocompatible Materials; Biopolymers; Chemical Phenomena; Fibroins; Humans; Hydrogels; Manufactured Materials; Materials Testing; Nanostructures; Polyvinyl Alcohol; Rats; Rats, Sprague-Dawley; Silk; Surgical Sponges; Wound Healing; Zinc Oxide
PubMed: 32814099
DOI: 10.1016/j.ijbiomac.2020.08.041 -
Annals of the Royal College of Surgeons... Mar 2014
Topics: Foreign Bodies; Humans; Medical Errors; Needles; Surgical Instruments; Surgical Sponges
PubMed: 24895764
DOI: 10.1308/rcsann.2014.175 -
Anesthesia Progress 1990
Review
Topics: Administration, Topical; Age Factors; Anti-Inflammatory Agents; Contraceptives, Oral; Drug Combinations; Dry Socket; Gelatin Sponge, Absorbable; Humans; Hydrocortisone; Least-Squares Analysis; Lincomycin; Molar, Third; Oxytetracycline; Tooth Extraction
PubMed: 2077984
DOI: No ID Found