Injury
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We set out to examine the implications of seasonal variation in hip fracture for trauma services and for the frail older people who typically suffer this injury. Since 2007 the National Hip Fracture Database (NHFD) has been reporting data for all over-60 year old patients presenting in England, Wales and Northern Ireland. We analysed published NHFD data for the 450,764 people who presented during the seven years from April 2011 to March 2018. ⋯ An 8% increase in hip fracture numbers during the winter would equate with 1250 additional fractures during these months each year. Patients average over 20 days in hospital, so these additional cases will compound the stresses on hospital services over the Christmas and New Year holiday period. Such factors must be taken into consideration when organising trauma services if we are to try and avoid the additional 325 deaths that we found to occur each winter.
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Infections after internal fixation of fractures remain a challenge. Silver is known for its antimicrobial activity, including activity against multi-resistant strains. The aim of the current study was to analyze the biocompatibility and potential influence on the osteotomy healing process of a silver-coating technology for locking plates compared to silver-free locking plates in an established rabbit model. ⋯ Silver in the blood was only found in 3 animals within the first two weeks and all animals were free of silver afterwards. There were no detectable silver concentrations in the brain, liver, spleen, axillary lymph nodes and kidney. This study shows undisturbed osteotomy healing of the presented antimicrobial silver surface coating and a good biocompatibility in this rabbit model.
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Poincianella pluviosa has already been described as capable of healing skin wounds. In an attempt to prolong contact of the drug with the wound, it was proposed in this study to evaluate wound healing using a crude extract (CE) of P. pluviosa incorporated in carboxymethylcellulose polymer films. The chromatographic profile of the semipurified fraction of P. pluviosa was evaluated by ultra-high performance liquid chromatography (UHPLC), confirming the compounds gallic acid, geraniin, and ellagic acid. ⋯ The CE of the film permeated the skin, reaching the dermis and was able to influence re-epithelisation, cell proliferation, and collagen formation. Satisfactory results were observed against S. aureus strains, particularly coagulase negative. Films with CE of P. pluviosa can be an alternative in the wound healing, protecting against opportunistic infections and giving comfort to the patient.