The effects of lidocaine/prilocaine cream on wound healing were evaluated in this study. An incisional wound model on abdominal wall was performed on mice. A full thickness skin incision 2 cm in length was performed then it was sutured primarily with 4/0 polypropylene. In group I (n = 10) only suturing was done (control group), in group II (n = 10) lidocaine cream was applied after suturing on wound site and it was repeated for 6 days (twice in a day), in group III (n = 10) lidocaine/prilocaine cream was applied topically after suturing and repeated 6 days (twice in a day). At day 7, incisions were excised for evaluating tensile strength and 5-hydroxyproline (5-HP) values. Tensile strength values were lowest in control group and highest in lidocaine/prilocaine treatment group. 5-HP values were also expressed the same results. Both tensile strength and 5-HP values increased significantly in treatment groups in regard to the control (p < 0.05). It was concluded that lidocaine/prilocaine cream as topical anaesthetic agent had no adverse effect in an incisional wound model, furthermore it may have some beneficial effects on wound healing which remains to be evaluated and it can be used safely in day-to-day emergency practices.
Objectives: Hip fractures are one of the most serious causes of impairment and death in the elderly. The aim of this study is to identify the effects of different risk factors on mortality after a hip fracture in elderly Turkish patients.Patients and Methods: Two-hundred forty patients (>60 years; mean age 76.0±8.2 years) who were operated for fracture of the hip from 2001 to 2006 were investigated. Demographic data, preoperative length of hospital stay, anesthesia type and ASA physical status, albumin level at admission and comorbidities were recorded.Results: Mean albumin level was 3.45±0.62 g/dl. Onehundred eight (45%) had hypoalbuminemia. The difference between mortality rates of normo-and hypoalbuminemic patients were not significant at one and two-year. According to preoperative length of stay; one-year mortality was significantly higher in male patients (p=0.015) while two-year mortality was not. One-year mortality was related with high ASA physical status scores (p=0.002) while two-year mortality was not (p=0.169). According to gender; one-year mortality was found higher in men (p=0.001).Conclusion: Due to comorbidities, high ASA scores are common in elderly patients. Since the preoperative evaluation in high ASA physical status is longer, this may prolong the preoperative hospital stay. Delay after admission and high ASA physical status are important predictors of mortality for elderly hip fracture patients.Key words: Hip fracture; mortality; ASA; albumin.Amaç: Kalça kırıkları ileri yaşların fonksiyon kaybı ve ölüm ile sonuçlanabilen ciddi sağlık sorunlarındandır. Bu çalışmada amaç kalça kırığı sonrası yaşlı Türk hastalarda değişik risk faktörlerinin mortalite üzerine etkisini ortaya koymaktır. Bulgular: Geliş albumin seviyesi 3.45±0.62 g/dl olarak bulundu. Yüz sekiz hastada (%45) albumin düşüklüğü vardı. Albumin düzeyine göre bir ve iki yıl mortalite oranı anlamlı değildi. Ameliyat öncesi yatış süreleri incelendiğinde; birinci yıl mortalitesi erkek hastalarda istatistiksel anlamlı yüksek bulunurken (p=0.015), ikinci yıl mortalitesi bulunmadı. ASA fiziksel skorları yüksek olan hastaların birinci yıl mortaliteleri ile korelasyonunun istatistiksel olarak anlamlı olduğu (p=0.002), ikinci yılda ise olmadığı (p=0.169) saptandı. Cinsiyet incelendiğinde, birinci yıl mortalitesi erkekler için yüksek bulundu (p=0.001).Sonuç: Yüksek ASA skorlarına ek morbiditeler nedeniyle yaşlı hastalarda sık karşılaşılmaktadır. Preoperatif hazır-lık sürecinin ASA skoru yüksek olan hastalarda uzun olması nedeniyle ameliyat öncesi süre uzayabilmektedir. Kalça kırığı olan hastaların bir ve iki yıllık mortalite öngörüsünde ASA fiziksel durumu ve ameliyat öncesi gecikmenin önemli belirteçler olduğu görüşündeyiz.
The effects of burn trauma and granulocyte-colony stimulating factor (G-CSF) treatment on wound healing in a surgical incision model were studied. Sixty adult male mice were used in this study. Under general anesthesia hot water at 97°C was applied for 3 sec to the dorsum of the mice in order to achieve 20% burn wound. After burn trauma, full thickness midline skin incision 2 cm in length was performed on the abdominal wall and then were sutured primarily with 4/0 polypropylene. In Group I only skin incision was performed, group II had skin incision and burn, in group III G-CSF (0.03 BU/30 g) was applied intraperitoneally after burn and skin incision. Breaking strength and 5-hydroxyproline (5-HP) levels of the wounds were calculated 5 and 10 days after the procedure. 5-HP levels and breaking strength values showed statistical difference between groups II-III and I-II (p<0.05). 5-HP levels were lowest in incision and burn group (41.80 μ g/mg). Breaking strength levels were also lowest in the same group (0.12 kg) (p<0.05). These results suggest that third degree burn causes a significant impairment on incisional wound healing and G-CSF ameliorates this impairment.burn; wound; wound healing; G-CSF
It has been well known that some volatile anesthetic agents produce oxidative stress. Desflurane as a new volatile agent might have limited oxidative toxic effect because it is relatively a new short-acting anesthetic characterized by a short duration of action and a quick postanesthetic recovery. We investigated effect of desflurane on serum glutathione peroxidase (GSH-Px), lipid peroxidation (LP), vitamin E, and erythrocyte superoxide dismutase (SOD) values in patients. Fifteen adult patients are scheduled for elective surgery, ASA I or II physical status. Tidal volume and ventilation frequency were kept unchanged during the operation. Baseline values in venous blood samples were preoperatively taken and blood was also taken postoperatively at the 1st and the 12th hours of desflurane exposure. LP levels were significantly (p < 0.05) higher postoperatively at 1st hour than in preoperative values while alpha-tocopherol concentration was significantly (p < 0.001) lower in postoperative period at 1st hour than in preoperative period. Erythrocyte SOD and serum GSH-Px activities did not differ between pre- and postoperative periods. In conclusion, we observed that desflurane produced oxidative stress by decreasing alpha-tocopherol levels. Use of vitamin E may be possible to reduce the oxidative effect of desflurane.
We conclude that a prophylactic oral dose of ephedrine 50 mg is effective for minimizing and managing spinal anesthesia-induced hypotension during transurethral prostatectomy.
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