Journal of surgical orthopaedic advances
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Comparative Study
Late postoperative infection following spinal instrumentation: stainless steel versus titanium implants.
Late postoperative infection following instrumented spinal surgery is a clinical entity that has emerged in recent years. The extended surface of the spinal instrumentation in combination with hematogenous seeding or intraoperative inoculation is the main predisposing factor. In order to investigate the contribution of the instrumentation material (stainless steel versus titanium implants) and mechanical loosening, two groups of patients are presented. ⋯ Common intraoperative findings were excessive inflammatory tissue and some degree of instrumentation loosening and corrosion (stainless steel). Removal of instrumentation in combination with appropriate antibiotics was an effective treatment. Further study with long-term follow-up is necessary in order to understand the exact incidence and pathology of such infections.
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Multicenter Study Comparative Study
The influence of arterial flow on capillary refill in pediatric lower extremity.
This study assesses the relationship between capillary refill time (CRT) and arterial blood flow (ABF) in the lower extremities of pediatric patients to determine if a correlation exists that would demonstrate CRT as an accurate means of monitoring tissue perfusion. The ABF and CRT were evaluated in 20 pediatric patients at four different pressures (0, (1/2) systolic blood pressure [SBP], SBP, and 1(1/2) SBP) using Doppler ultrasound and a stop-frame digital camera. ⋯ Thus, at significantly decreased rates of blood flow, a possible inverse relationship exist between ABF and CRT in the lower extremities of this pediatric population. However, the change in CRT correlating to the decrease in ABF is too small to be considered practically useful for clinically monitoring tissue perfusion.