Standardized osteochondral fractures in the left femoral condyle in 19 adult mongrel dogs were fixed with either fibrin sealant or Kirschner wire. Adaptation and mechanical strength after 4, 7 or 8, and 14 days were compared with an in vitro study of the initial strength of the fibrin sealant in osteochondral fractures. After 4 days, the maximum tensile strength was increased in the fibrin sealed group, whereas no difference in energy absorption at failure was found. Although the initial strength of the fibrin bond was low, the tendency to displacement was less in this group. Our results suggest that fibrin sealant can be used for fixation of small osteochondral fragments, provided that immobilisation is sufficient.

BackgroundNecrotizing soft tissue infection is the most serious of all soft tissue infections. The patient’s life is dependent on prompt diagnosis and aggressive treatment. Diagnostic delays are related to increased morbidity and mortality, and the risk of under- or missed diagnosis is high due to the rarity of the condition. There is a paucity of knowledge regarding early indications of disease. The aim of the study has thus been to explore patients’ and families’ experiences of early signs and symptoms and to describe their initial contact with the healthcare system.MethodsA qualitative explorative design was used to gain more knowledge about the experience of early signs and symptoms. Fifty-three participants from three study sites were interviewed. The framework method was used for data analysis.ResultsMost of the participants experienced treatment delay and contacted healthcare several times before receiving correct treatment. The experience of illness varied among the participants depending on the duration of antecedent signs and symptoms. Other important findings included the description of three stages of early disease progression with increase in symptom intensity. Pain experienced in necrotizing soft tissue infections is particularly excruciating and unresponsive to pain medication. Other common symptoms were dyspnea, shivering, muscle weakness, gastrointestinal problems, anxiety, and fear.ConclusionOur study adds to the understanding of the lived experience of NSTI by providing in-depth description of antecedent signs and symptoms precipitating NSTI-diagnosis. We have described diagnostic delay as patient-related, primary care related, or hospital related and recommend that patient and family narratives should be considered when diagnosing NSTI to decrease diagnostic delay.

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