Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Mar 2014
Silver negative pressure dressing with vacuum-assisted closure of massive pelvic and extremity wounds.
Massive soft tissue loss involving the pelvis and extremities from trauma, infections, and tumors remains a challenging and debilitating problem. Although vacuum-assisted closure (VAC) technology is effective in the management of soft tissue loss, the adjunct of a silver dressing in the setting of massive wounds has not been as well tested. ⋯ Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Mar 2014
Review Meta AnalysisDoes obesity affect the surgical outcome and complication rates of spinal surgery? A meta-analysis.
As obesity becomes more prevalent, it becomes more common among patients considering orthopaedic surgery, including spinal surgery. However, there is some controversy regarding whether obesity is associated with complications, failed reconstructions, or reoperations after spinal surgery. ⋯ Obesity seemed to be associated with higher risk of surgical site infection and venous thromboembolism, more blood loss, and longer surgical time. Future prospective studies are needed to confirm the relationship between obesity and the outcome of spinal surgery.
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Clin. Orthop. Relat. Res. · Mar 2014
Comparative StudyIndustrially prefabricated cement spacers: do vancomycin- and gentamicin-impregnated spacers offer any advantage?
Industrially preformed antibiotic-loaded cement spacers are useful to facilitate the second stage of two-stage exchange arthroplasty for infected THAs and TKAs. However, whether gentamicin alone or a combination of antibiotics (such as vancomycin and gentamicin) is more effective is not known. ⋯ Level III, therapeutic study. See the Instructions for Authors for a complete description of levels of evidence.