orabase and Abscess

Topics: Abscess; Adipose Tissue; Adolescent; Anti-Bacterial Agents; Carboxymethylcellulose Sodium; Combined Modality Therapy; Drainage; Female; Humans; Injections, Intralesional; Laryngoscopy; Lipectomy; Surveys and Questionnaires; Transplantation, Autologous; Vocal Cord Paralysis; Voice Disorders; Voice Quality

Intra-peritoneal adhesions are frequent following abdominal surgery and are the most common cause of small bowel obstructions. A hyaluronic acid/carboxymethylcellulose (HA/CMC) film adhesion barrier has been shown to reduce adhesion formation in abdominal surgery. An HA/CMC powder formulation was developed for application during laparoscopic procedures.. This was an exploratory, prospective, randomised, single-blind, parallel-group, Phase IIIb, multicentre study conducted at 15 hospitals in France to assess the safety of HA/CMC powder versus no adhesion barrier following laparoscopic colorectal surgery. Subjects ≥18 years of age who were scheduled for colorectal laparoscopy (Mangram contamination class I‒III) within 8 weeks of selection were eligible, regardless of aetiology. Participants were randomised 1:1 to the HA/CMC powder or no adhesion barrier group using a centralised randomisation list. Patients assigned to HA/CMC powder received a single application of 1 to 10 g on adhesion-prone areas. In the no adhesion barrier group, no adhesion barrier or placebo was applied. The primary safety assessments were the incidence of adverse events, serious adverse events, and surgical site infections (SSIs) for 30 days following surgery. Between-group comparisons were made using Fisher's exact test.. Of those randomised to the HA/CMC powder (n = 105) or no adhesion barrier (n = 104) groups, one patient in each group discontinued prior to the study end (one death in each group). Adverse events were more frequent in the HA/CMC powder group versus the no adhesion barrier group (63% vs. 39%; P <0.001), as were serious adverse events (28% vs. 11%; P <0.001). There were no statistically significant differences between the HA/CMC powder group and the no adhesion barrier group in SSIs (21% vs. 14%; P = 0.216) and serious SSIs (12% vs. 9%; P = 0.38), or in the most frequent serious SSIs of pelvic abscess (5% and 2%; significance not tested), anastomotic fistula (3% and 4%), and peritonitis (2% and 3%).. This exploratory study found significantly higher rates of adverse events and serious adverse events in the HA/CMC powder group compared with the no adhesion barrier group in laparoscopic colorectal resection.. ClinicalTrials.gov NCT00813397. Registered 19 December 2008.

Topics: Abscess; Adult; Aged; Carboxymethylcellulose Sodium; Colon; Female; Fistula; France; Humans; Hyaluronic Acid; Laparoscopy; Male; Middle Aged; Peritoneal Diseases; Peritonitis; Powders; Prospective Studies; Rectum; Risk Assessment; Risk Factors; Single-Blind Method; Surgical Wound Infection; Time Factors; Tissue Adhesions; Treatment Outcome

The objective of this study was to investigate whether the use of a silver-containing hydrofiber dressing to pack abscess cavity after incision and drainage (I & D) leads to faster wound healing and less pain.. Patients 18 years or older visiting the emergency department with cutaneous abscesses, requiring I & D, were randomly assigned to the intervention (Aquacel Ag; ConvaTec, Skillman, New Jersey) or standard care (iodoform) group between April 2008 and May 2009. Patients were followed up 48 to 72 hours and 10 to 14 days after the initial visit. Primary outcomes were the proportion of patients with greater than 30% reduction in surface area of abscess or cellulitis at first follow-up.. Ninety-two patients were enrolled prospectively and randomly assigned to the Aquacel Ag or the iodoform groups; mean age was 38.0 (SD, 12.0) years; 49 patients were in the Aquacel Ag and 43 were in iodoform groups, respectively. There were no differences in demographic and clinical characteristics between groups. Logistic regression analysis showed that the intervention (Aquacel Ag) was independently associated with greater than 30% reduction in surface area of abscess (P = .002) but not in cellulitis at first follow-up. There was also significant decrease in pain intensity perceived by patients in the Aquacel Ag group based on the mean change in Facial Pain Scale scores between the initial visit and first follow-up.. In patients with cutaneous abscesses, use of an antimicrobial hydrofiber ribbon dressing for packing was associated with faster wound healing and reduction in perceived pain in comparison with use of iodoform dressing.

Topics: Abscess; Adult; Anti-Infective Agents; Bandages; Carboxymethylcellulose Sodium; Drainage; Drug Carriers; Emergency Service, Hospital; Female; Humans; Male; Middle Aged; Silver Compounds; Skin Diseases

This study assessed the potential of topical Calendula officinalis extract on the healing of oral mucositis induced by 5-fluorouracil (5-FU) in hamsters.. Oral mucositis was induced in 60 male hamsters by 5-FU (60 mg/kg) on days 0, 5, and 10 of the study. The cheek pouch was scratched with a sterile needle on days 1 and 2. On days 12-17, 5% and 10% C. officinalis gel and gel base groups were treated and then compared with a control group. Macroscopic and microscopic scores and weights were evaluated.. Microscopic and macroscopic scores of mucositis were lower in the 5% and 10% C. officinalis gel groups than in the gel base and control groups (P < .05). Weight gain was noted in the treatment groups compared with the gel base and control groups (P < .05).. Calendula officinalis extract accelerated the healing of oral mucositis in hamsters.

Topics: Abscess; Animals; Antimetabolites, Antineoplastic; Calendula; Carboxymethylcellulose Sodium; Cricetinae; Drug Carriers; Erythema; Fluorouracil; Gels; Hyperemia; Injections, Intraperitoneal; Male; Mesocricetus; Mouth Diseases; Mouth Mucosa; Oral Hemorrhage; Oral Ulcer; Phytotherapy; Plant Extracts; Re-Epithelialization; Single-Blind Method; Stomatitis; Time Factors; Weight Gain; Wound Healing

A survey of community nurses identified that a wide range of dressings, and in some cases unethical practices, are being used for this simple postoperative condition. Communication between hospital, community staff and patients was poor.

Topics: Abscess; Alginates; Bandages; Carboxymethylcellulose Sodium; Community Health Nursing; Disease Management; Drainage; England; Health Care Surveys; Humans; Occlusive Dressings; Rectal Diseases; Surveys and Questionnaires

Polysaccharides isolated from fungi, Phellinus spp. is well-known material with anti-tumor and anti-inflammatory properties. We have assessed the adhesion- and abscess-reducing capacity of carboxymethylcellulose (CMC) and polysaccharides from Phellinus spp. combination in a rat peritonitis model. In 72 Sprague-Dawley rats, experimental peritonitis was induced by means of the cecal ligation and puncture model (CLP). After 24 hr, the abdomen was reopened and the ligated cecum was resected. Peritoneal fluid samples were taken for microbiological examination. Rats were randomly assigned to 6 groups: ringer lactate solution (RL group), polysaccharides from Phellinus gilvus (PG group) and Phellinus linteus (PL group), carboxymethylcellulose (CMC group), and their combinations (PG+CMC and PL+CMC groups). Adhesions and abscesses were noted at day 7 after CLP. RT-PCR assay for urokinase-type plasminogen activator (uPA), its cellular receptor (uPAR), and tumor necrosis factor (TNF)-alpha was performed to assess the cecal tissue. Microbiological examination showed polymicrobial bacterial peritonitis. Adhesion formation was significantly reduced in PG+CMC and PL+CMC groups (P<0.05). The incidence of abscesses was reduced in all treated groups except the RL group (P<0.05). uPA, uPAR, and TNF-alpha mRNA were highly expressed in the PG+CMC and PL+CMC groups, as compared to the RL group. We concluded that the combination of polysaccharides and CMC had significant adhesion- and abscess-reducing effects compared with their single treatment and the effects may act by modifying the fibrinolytic capacity of uPA, uPAR and TNF-alpha produced from activated macrophages in a rat peritonitis model.

Topics: Abscess; Animals; Basidiomycota; Carboxymethylcellulose Sodium; Cecum; DNA Primers; Drug Therapy, Combination; Male; Peritonitis; Polysaccharides; Rats; Rats, Sprague-Dawley; Receptors, Cell Surface; Receptors, Urokinase Plasminogen Activator; Reverse Transcriptase Polymerase Chain Reaction; Tissue Adhesions; Tumor Necrosis Factor-alpha; Urokinase-Type Plasminogen Activator

Intra-abdominal infection is complicated by adhesion and abscess formation. We have assessed the adhesion- and abscess-reducing capacity of various solution volumes and concentrations of two polyanionic polysaccharides, hyaluronan (HA) and carboxymethylcellulose (CMC), in a rat peritonitis model.. In 192 male Wistar rats a bacterial peritonitis was induced using cecal ligation and puncture. After 24 h the abdomen was reopened and the ligated cecum resected. Animals were randomized into three control groups, nine groups treated with various solution volumes (1 to 8 ml) containing different HA concentrations, and four groups treated with 1.7% CMC solution. Rats were killed at day 7, postoperatively, and adhesions were scored at five abdominal sites on a scale from 0 to 4. The presence and size of intra-abdominal abscesses were noted.. Fifty-four rats (28%) prematurely died. There was no significant difference in mortality between treatment groups and controls. Treatment with CMC (P < 0.001) and low (0.2 and 0.4%) concentrations of HA (P < 0.005) significantly reduced intra-abdominal adhesion formation. High volumes of 0.2 and 0.4% HA were most effective (P = 0.01). The effect of CMC was volume independent. The incidence of abdominal abscesses was also significantly reduced by treatment with either CMC (P < 0.001) or low concentrations of HA (P < 0.001). With regard to abscess formation the effect was independent of the volume administered for HA, while low volumes of CMC were most effective (P < 0.005).. Intraperitoneal treatment with either CMC or low-viscosity HA solution reduced intra-abdominal adhesion and abscess formation in a rat peritonitis model. The volume-induced reduction in adhesion formation suggests a hydroflotation effect of HA solution.

Topics: Abscess; Animals; Carboxymethylcellulose Sodium; Disease Models, Animal; Hyaluronic Acid; Male; Peritonitis; Rats; Rats, Wistar; Tissue Adhesions

Postoperative intra-abdominal adhesions are a major source of postsurgical morbidity. Pelvic irradiation increases the likelihood of adhesion development. The purpose of this study was to evaluate the effects of hyaluronic acid-carboxymethylcellulose film, which was designed as a barrier to prevent adhesions, on the healing of ileal anastomoses performed on irradiated rat bowel.. Sixty-eight female Sprague-Dawley rats underwent whole pelvic irradiation with a single fraction of 1700 cGy. Twenty weeks later the rats underwent exploratory laparotomy with segmental ileal resection and reanastomosis. Eighteen of the anastomoses were wrapped in hyaluronic acid-carboxymethylcellulose film. Fifty anastomoses were not treated with any adhesion-inhibiting barrier. On the fifth postoperative day the animals underwent another laparotomy for evaluation of the anastomotic sites.. At the second laparotomy 93% of the rats treated with hyaluronic acid-carboxymethylcellulose film were found to have perianastomotic abscesses. In the non-hyaluronic acid-carboxymethylcellulose film group the perianastomotic abscess rate was 24% (P <.0001).. Among previously irradiated rats undergoing small-bowel resection and anastomosis, hyaluronic acid-carboxymethylcellulose film was associated with a markedly increased rate of abscess formation at the operative site.

Topics: Abscess; Anastomosis, Surgical; Animals; Biocompatible Materials; Carboxymethylcellulose Sodium; Disease Models, Animal; Female; Hyaluronic Acid; Ileum; Membranes, Artificial; Radiation Injuries, Experimental; Rats; Rats, Sprague-Dawley; Tissue Adhesions; Wound Healing