In using short-term antibiotic prophylaxis in clean orthopedic procedures we can avoid side effects and also it is more cost-effective. Background: Antibiotic therapy prevents postoperative infections after orthopedic procedures, but the method and prescribed dose of this therapy are debated. Short-term prophylaxis and long-term prophylaxis are 2 accepted methods after orthopedic procedures. Objectives: In this prospective observational study, we compared the results of shortterm and long-term prophylaxis after elective orthopedic procedures at 2 hospitals of Jundishapur University of Medical Sciences. Patients and Methods: We divided patients who underwent uneventful orthopedic operations into 2 groups, administered short-and long-term prophylactic antibiotic therapy, respectively, and observed the patients for signs and symptoms of superficial and deep infections. We compared and analyzed the results with SPSS, considering P values of less than 0.001 to indicate a significant difference. Results: There was no significant difference regarding superficial and deep infections between short-and long-term prophylaxis groups; thus, both methods can be used for prophylaxis after elective orthopedic surgeries, effecting equal rates of success. Conclusions: Short-term prophylaxis can be used for clean orthopedic procedures with equivalent results as long-term therapy.
Objectives: The purpose of this study was to evaluate the effect of intra-articular injection of fibrinogen on postoperative bleeding following total knee arthroplasty. Methods: A double-blind randomized clinical trial was conducted on 40 patients aged 40 - 70 years under spinal anesthesia candidate for total knee arthroplasty in Golestan hospital, Ahwaz, Iran, in 2017-2018. Patients were divided into fibrinogen intra-articular injection (n = 20) and control (n = 20) groups. The amounts of blood loss and blood transfusion requirement were recorded. Hemoglobin (Hb), hematocrit (HCT), international normalized ratio (INR), platelet (PLT), prothrombin time (PT), and partial thromboplastin time (PTT) were recorded before and after the surgery. Results: There was no significant difference in the average amount of intraoperative blood loss between the groups (P > 0.05). The average amount of blood loss 24 hours after the surgery was significantly lower in the fibrinogen group than in the control group (fibrinogen group 350.61 ± 120.32 cc; control group 540.00 ± 170.21 cc; P = 0.0002). There were significant differences in transfusion between the groups (fibrinogen group 250 ± 20 cc; control group 350 ± 50 cc; P < 0.0001). There was a significant difference between the two groups in 24 h postoperative Hb and HCT (P < 0.001). Conclusions: Intra-articular fibrinogen administration may reduce acute bleeding and can be used as an effective intervention to prevent further bleeding and the need for transfusion in patients undergoing total knee arthroplasty.
Background:The majority of the cases of coccydynia occur in conjunction with either subluxated or hypermobile coccyx, and it has been proposed that this pathologic instability may cause chronic inflammatory changes. Objectives: This study was done to evaluate the effect of coccygectomy in patients with resistant coccydynia after initial conservative therapy failure. Patients and Methods: Between October 2010 and December 2013, 13 patients with coccydynia underwent coccygectomy in the hospitals of Ahvaz city after a failed conservative therapy for at least 4 -6 months. In order to evaluate the results, a questionnaire was obtained, including the extent of relief in the painful area, improvement in quality of life, intensity of pain in the sitting position, pain during daily activities, and the need for analgesics, according to the criteria described by Bayne. Results: The patients were followed up for an average of 25.7 months. The results were good in 11 patients, excellent in 1, and fair in only 1 patient. The excellent and good rates amounted to 92.2%. No major complication was seen. Conclusions: Coccygectomy is a successful treatment in patients unresponsive to conservative treatments for coccydynia.
Background:The majority of the cases of coccydynia occur in conjunction with either subluxated or hypermobile coccyx, and it has been proposed that this pathologic instability may cause chronic inflammatory changes. Objectives: This study was done to evaluate the effect of coccygectomy in patients with resistant coccydynia after initial conservative therapy failure. Patients and Methods: Between October 2010 and December 2013, 13 patients with coccydynia underwent coccygectomy in the hospitals of Ahvaz city after a failed conservative therapy for at least 4 -6 months. In order to evaluate the results, a questionnaire was obtained, including the extent of relief in the painful area, improvement in quality of life, intensity of pain in the sitting position, pain during daily activities, and the need for analgesics, according to the criteria described by Bayne. Results: The patients were followed up for an average of 25.7 months. The results were good in 11 patients, excellent in 1, and fair in only 1 patient. The excellent and good rates amounted to 92.2%. No major complication was seen. Conclusions: Coccygectomy is a successful treatment in patients unresponsive to conservative treatments for coccydynia.
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