The Experts below are selected from a list of 276 Experts worldwide ranked by ideXlab platform
A. Lyons - One of the best experts on this subject based on the ideXlab platform.
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The use of a Negative Pressure wound management System in perineal wound closure after extralevator abdominoperineal excision (ELAPE) for low rectal cancer
Techniques in Coloproctology, 2016Co-Authors: H. Sumrien, P. Newman, C. Burt, K. Mccarthy, A. Dixon, A. Pullyblank, A. LyonsAbstract:Background Perineal wound healing is a significant challenge after extralevator abdominoperineal excision (ELAPE) due to a high rate of wound breakdown. Negative Pressure therapy has proven benefits in open wounds, and recently a Negative Pressure System has been developed for use on closed wounds at high risk of breakdown, such as apronectomy and hysterectomy. The aim of the present study was to determine whether Negative Pressure therapy applied to closed perineal wounds after ELAPE improved wound healing and compare outcomes to the published literature and outcomes from a historical cohort of patients who had undergone ‘standard’ abdominoperineal resection (APR) and primary closure of the perineal wounds. Methods Prospective data on consecutive patients having ELAPE in the period from November 2012 to April 2015 were collected. The pelvic floor defect was reconstructed with biologic mesh. The adipose tissue layer was closed with vicryl sutures, a suction drain was left in the deep layer, the subcuticular layer and skin were closed, and the Negative Pressure System was applied. Any wound breakdown within the first 30 days postoperatively was recorded. Results Of the 32 consecutive ELAPE patients whose perineal wounds were closed within 30 days with the use of the Negative Pressure System, there was 1 patient with major perineal wound breakdown and 2 patients with a 1 cm superficial wound defect, which needed no further treatment. In the remaining 29 (90 %) patients, the perineal wounds healed fully without complications. Twenty-five patients underwent standard APR in 2010–2011 with primary closure of their perineal wounds. Ten out of 25(40 %) of patients who had undergone standard APR and primary closure of perineal wounds had major wound complications ( p = 0.01). Conclusions Our results suggest that after ELAPE the application of a Negative Pressure System to the perineal wound closed with biologic mesh may reduce perineal wound complications and may reduce the need for major perineal reconstruction.
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the use of a Negative Pressure wound management System in perineal wound closure after extralevator abdominoperineal excision elape for low rectal cancer
Techniques in Coloproctology, 2016Co-Authors: H. Sumrien, P. Newman, C. Burt, K. Mccarthy, A. Dixon, A. Pullyblank, A. LyonsAbstract:Background Perineal wound healing is a significant challenge after extralevator abdominoperineal excision (ELAPE) due to a high rate of wound breakdown. Negative Pressure therapy has proven benefits in open wounds, and recently a Negative Pressure System has been developed for use on closed wounds at high risk of breakdown, such as apronectomy and hysterectomy. The aim of the present study was to determine whether Negative Pressure therapy applied to closed perineal wounds after ELAPE improved wound healing and compare outcomes to the published literature and outcomes from a historical cohort of patients who had undergone ‘standard’ abdominoperineal resection (APR) and primary closure of the perineal wounds.
Carlos G. Adorno - One of the best experts on this subject based on the ideXlab platform.
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Comparison of the Volume of Root Canal Irrigant Collected by 2 Negative Pressure Needles at Different Flow Rates of Delivery.
Journal of Endodontics, 2018Co-Authors: Diana Moreno, Antonio J. Conde, Gaizka Loroño, Carlos G. Adorno, Roberto Estevez, Rafael CisnerosAbstract:INTRODUCTION: A greater irrigant volume improves the effectiveness of root canal irrigation. The purpose of this study was to compare 2 Negative Pressure Systems regarding the volume of irrigant collected from the apical area in moderately curved canals at 3 different flow rates of delivery in vitro. METHODS: The mesiobuccal canals of 30 molars with a curvature between 20° and 40° were prepared to size #40.04 taper. A closed System was created. The canals were irrigated at 3, 6, and 12 mL/min for 30 seconds using EndoVac (SybronEndo, Orange, CA) and the INP needle (Mixnus Fine Engineering Co Ltd, Nagano, Japan) (both independent variables). A recovery trap was used to collect the irrigant aspirated by the Negative Pressure needles. Irrigant volume (dependent variable) was measured in milliliters. Data were analyzed using mixed analysis of variance. RESULTS: There was a statistically significant interaction between the Negative Pressure System and the irrigant volume collected (P
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A comparison between two Negative Pressure irrigation techniques in simulated immature tooth: an ex vivo study
Clinical Oral Investigations, 2016Co-Authors: Ahmed Jamleh, Yasue Fukumoto, Yoshioka Takatomo, Chihiro Kobayashi, Hideaki Suda, Carlos G. AdornoAbstract:Objectives This ex vivo study evaluated the irrigation efficacy of a new apical Negative Pressure System (ANP) in canals with simulated immature teeth, by comparing it to EndoVac (EV) System in terms of smear layer (SL) removal and irrigation extrusion. Materials and methods Three millimetres of the root end of 40 single canalled lower incisors were resected and decoronated to standardize root canal length. After instrumentation, the specimens were embedded in warm normal saline agar coloured with 1 % acid red and randomly divided into four groups; one control group and three experimental groups. Except in the control group where distilled water was used as irrigant using positive Pressure irrigation needle, the canals were irrigated with 6 % NaOCl and 17 % EDTA using the intracanal Negative Pressure needle (iNP) System, the EV System or 27G open-ended needle under positive Pressure (PP). NaOCl extrusion was determined by observing a discolouration of the agar surrounding the root. The SL was evaluated by observing scanning electron microscope images based on a four-level scoring System. Results Two specimens with irrigant extrusion were observed in the iNP group, which was significantly different (logistic regression, p 0.05) among the experimental groups in terms of SL removal, but all were significantly different to the control group. Conclusions Irrigation with the iNP could be a viable alternative to EV as an apical Negative Pressure irrigation technique especially while treating immature teeth. Clinical relevance ANP in canal cleanliness is recommended to be utilized in treating immature teeth where periapical tissues should be saved and stimulated. The iNP System might have the potential to avoid irrigant extrusion while cleaning the canal till the apical end.
G. Versier - One of the best experts on this subject based on the ideXlab platform.
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Vacuum-assisted closure: a low-cost Negative Pressure System for wound management
European Journal of Orthopaedic Surgery & Traumatology, 2009Co-Authors: Didier Ollat, A. Bouchard, B. Tramond, F. Nuzzaci, O. Barbier, G. VersierAbstract:Negative Pressure dressings are helpful for humanitarian surgery for healing infected and late-treated large wounds and also wounds with large loss of skin. However, specific commercial device has high costs that are prohibitive for precarious surgery with limited funds and an austere environment. Our idea is to make a Negative Pressure dressing using only low-cost and non-specific surgical devices. We describe a technical device of Negative Pressure in which only low-cost disposable medical equipments were used. The vacuum comes from a surgical room electric pump or from a single-use suction canister. Our successful experience suggests that this low-cost alternative method of Negative Pressure dressing can be safely used in countries with limited health care Systems.
H. Sumrien - One of the best experts on this subject based on the ideXlab platform.
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The use of a Negative Pressure wound management System in perineal wound closure after extralevator abdominoperineal excision (ELAPE) for low rectal cancer
Techniques in Coloproctology, 2016Co-Authors: H. Sumrien, P. Newman, C. Burt, K. Mccarthy, A. Dixon, A. Pullyblank, A. LyonsAbstract:Background Perineal wound healing is a significant challenge after extralevator abdominoperineal excision (ELAPE) due to a high rate of wound breakdown. Negative Pressure therapy has proven benefits in open wounds, and recently a Negative Pressure System has been developed for use on closed wounds at high risk of breakdown, such as apronectomy and hysterectomy. The aim of the present study was to determine whether Negative Pressure therapy applied to closed perineal wounds after ELAPE improved wound healing and compare outcomes to the published literature and outcomes from a historical cohort of patients who had undergone ‘standard’ abdominoperineal resection (APR) and primary closure of the perineal wounds. Methods Prospective data on consecutive patients having ELAPE in the period from November 2012 to April 2015 were collected. The pelvic floor defect was reconstructed with biologic mesh. The adipose tissue layer was closed with vicryl sutures, a suction drain was left in the deep layer, the subcuticular layer and skin were closed, and the Negative Pressure System was applied. Any wound breakdown within the first 30 days postoperatively was recorded. Results Of the 32 consecutive ELAPE patients whose perineal wounds were closed within 30 days with the use of the Negative Pressure System, there was 1 patient with major perineal wound breakdown and 2 patients with a 1 cm superficial wound defect, which needed no further treatment. In the remaining 29 (90 %) patients, the perineal wounds healed fully without complications. Twenty-five patients underwent standard APR in 2010–2011 with primary closure of their perineal wounds. Ten out of 25(40 %) of patients who had undergone standard APR and primary closure of perineal wounds had major wound complications ( p = 0.01). Conclusions Our results suggest that after ELAPE the application of a Negative Pressure System to the perineal wound closed with biologic mesh may reduce perineal wound complications and may reduce the need for major perineal reconstruction.
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the use of a Negative Pressure wound management System in perineal wound closure after extralevator abdominoperineal excision elape for low rectal cancer
Techniques in Coloproctology, 2016Co-Authors: H. Sumrien, P. Newman, C. Burt, K. Mccarthy, A. Dixon, A. Pullyblank, A. LyonsAbstract:Background Perineal wound healing is a significant challenge after extralevator abdominoperineal excision (ELAPE) due to a high rate of wound breakdown. Negative Pressure therapy has proven benefits in open wounds, and recently a Negative Pressure System has been developed for use on closed wounds at high risk of breakdown, such as apronectomy and hysterectomy. The aim of the present study was to determine whether Negative Pressure therapy applied to closed perineal wounds after ELAPE improved wound healing and compare outcomes to the published literature and outcomes from a historical cohort of patients who had undergone ‘standard’ abdominoperineal resection (APR) and primary closure of the perineal wounds.
A. Hindmarsh - One of the best experts on this subject based on the ideXlab platform.
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Endoluminal Vacuum Therapy (E-Vac): A Treatment Option in Oesophagogastric Surgery
World Journal of Surgery, 2018Co-Authors: D. J. Pournaras, R. H. Hardwick, P. M. Safranek, V. Sujendran, J. Bennett, G. D. Macaulay, A. HindmarshAbstract:Background Leaks from the upper gastrointestinal tract often pose a management challenge, particularly when surgical treatment has failed or is impossible. Vacuum therapy has revolutionised the treatment of wounds, and its role in enabling and accelerating healing is now explored in oesophagogastric surgery. Methods A piece of open cell foam is sutured around the distal end of a nasogastric tube using a silk suture. Under general anaesthetic, the foam covered tip is placed endoscopically through the perforation and into any extra-luminal cavity. Continuous Negative Pressure (125 mmHg) is then applied. Re-evaluation with change of the Negative Pressure System is performed every 48–72 h depending on the clinical condition. Patients are fed enterally and treated with broad-spectrum antibiotics and anti-fungal medication until healing, assessed endoscopically and/or radiologically, is complete. Results Since April 2011, twenty one patients have been treated. The cause of the leak was postoperative/iatrogenic complications (14 patients) and ischaemic/spontaneous perforation (seven patients). Twenty patients (95%) completed treatment successfully with healing of the defect and/or resolution of the cavity and were subsequently discharged from our care. One patient died from sepsis related to an oesophageal leak after withdrawing consent for further intervention following a single endoluminal vacuum (E-Vac) treatment. In addition, two patients who were successfully treated with E-Vac for their leak subsequently died within 90 days of E-Vac treatment from complications that were not associated with the E-Vac procedure. In two patients, E-Vac treatment was complicated by bleeding. The median number of E-Vac changes was 7 (range 3–12), and the median length of hospital stay was 35 days (range 23–152). Conclusions E-Vac therapy is a safe and effective treatment for upper gastrointestinal leaks and should be considered alongside more established therapies. Further research is now needed to understand the mechanism of action and to improve the ease with which E-Vac therapy can be delivered.
