ObjectiveTo introduce a new medical heat preservation device, and to explore the application value and effectiveness in replantation of severed fingers. MethodsThe medical heat preservation device was design, water was used as the heating medium, and temperature was set and controlled by microcomputer. Between November 2010 and January 2014, 421 cases undergoing replantation of severed fingers were divided into 2 groups. Within 9 days after operation, the medical heat preservation device was used in 210 cases (experimental group), and the conventional heat lamp was used in 211 cases (control group). There was no significant difference in gender, age, injury cause, the interval between injury and admission, injury finger side, and operation time between 2 groups (P>0.05). The vascular crisis rate, success rate of replantation of severed fingers, comfort, sleep quality, and the influence on roommates were compared. ResultsThe comfort and the influence on roommates were good in 188 cases (89.52%) and 201 cases (95.71%) in the experimental group, which were significantly higher than those in the control group (25/211, 11.85%; 145/211, 68.72%). According to Pittsburgh sleep quality index (PSQI) for sleep quality, the results were good in 105 cases, fair in 85 cases, and poor in 20 cases in the experimental group; the results were good in 45 cases, fair in 95 cases, and poor in 71 cases in the control group. Blood vessel crisis occurred in 35 cases (16.67%) of the experimental group, which was significantly lower than that in the control group (76/211, 36.02%) (P<0.05). The survival rate of replantation in the experimental group (196/210, 93.3%) was significantly higher than that in the control group (181/211, 85.78%) (P<0.05). Significant differences were found between 2 groups (P<0.05) in above indexs. ConclusionMedical heat preservation device for replantation of severed fingers can improve the comfortable degree of patients and the quality of sleep, increase the survival rate of finger replantation, and reduce the occurrence of vascular crisis after operation.
Objective To systematically review the efficacy of maternal body temperature preservation during caesarean section. Methods Databases including PubMed, EMbase, The Cochrane Library (Issue 2, 2015), WanFang Data, CBM and CNKI were searched from inception to July 2015 to collect randomized controlled trials (RCTs) of body temperature preservation in patients with caesarean delivery. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan5.3 software. Results A total of 15 RCTs involving 1 331 patients were included. The results of meta-analysis showed that patients in the temperature preservation group had a smaller body temperature variation (MD= –0.22, 95%CI –0.32 to –0.13, P < 0.000 01) and a lower incidence of shivering (RR=0.53, 95%CI 0.42 to 0.67, P < 0.000 01) than patients in the control group. There were no statistical differences between the two groups in blood loss (MD= –13.77, 95%CI –33.95 to 6.42, P=0.18) and newborn Apgar score (MD=0.12, 95%CI –0.37 to 0.6, P=0.64). Conclusions Current evidence shows that body temperature preservation measures can better protect patients with caesarean delivery. Specifically, body temperature preservation measures could reduce patients’ body temperature variation and incidence of shivering but had no effect on blood loss and newborn Apgar score. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
ObjectiveTo investigate the impact of comprehensive interventions on the prevention of the incidence of surgical site infection (SSI) after hip or knee arthroplasty.MethodsPatients who underwent total hip and knee arthroplasty for the first time in orthopedics department of Chengdu Fifth People’s Hospital from January 2016 to March 2018 were selected. The patients were observed after surgery for 1 year, and divided into the control group and the treatment group according to the odd or even hospitalization number. Basic precautions were taken in the control group, while further comprehensive preventive measures (preoperative chlorhexidine bath, intraoperative body temperature maintenance, using antibacterial film over surgery area without shearing, health and education after discharge from hospital) were taken in the treatment group. The incidence of SSI of the two groups was compared to evaluate the effects of comprehensive interventions.ResultsA total of 341 patients were included, including 174 in the control group and 167 in the treatment group. No one failed to be followed up. Among the 341 patients undergoing surgery, 13 had SSI, including 11 (6.3%) in the control group and 2 (1.2%) in the treatment group. The incidence of SSI in the treatment group was lower than that in the control group (χ2=6.102, P=0.014). Single factor analysis showed that sex (χ2=10.933, P=0.001), preoperative chlorhexidine sponge bath (χ2=8.837, P=0.003), intraoperative thermal insulation (χ2=13.917, P<0.001), health education (χ2=12.671, P<0.001), skin preparation methods (χ2=6.102, P=0.014), perioperative blood glucose control (χ2=17.512, P=0.003), and surgical type (χ2=8.360,factor P=0.004) were the effect factors of occurrence of SSI. Logistic regression analysis showed that surgical type [odds ratio (OR)=0.129, 95% confidence interval (CI)(0.026, 0.640), P=0.012] and strict blood glucose control [OR=9.868, 95%CI (2.158, 45.131), P=0.003] were the independent factors affecting the occurrence of SSI.ConclusionsComprehensive intervention measures can effectively reduce the occurrence of SSI after hip and knee arthroplasty. It is not confirmed that preoperative chlorhexidine bath can reduce the occurrence of SSI. But choosing selective operation and controlling the perioperative blood glucose below 200 mg/dL can reduce the risk of SSI.