Orthopedic Infectious Diseases Online Library

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  • Intra-operative incidental contamination of surgical wounds is not rare. Povidone-iodine solution can be used to disinfect surgical wounds. Although povidone-iodine is a good broad-spectrum disinfecting agent, it has occasionally been reported to have a negative effect on wound healing and bone union. Therefore, its safety in a spinal surgery is unclear. A prospective, single-blinded, randomized study was accordingly conducted to evaluate the safety of povidone-iodine solution in spinal surgeries. Ascertained herein was the effect of wound irrigation with diluted povidone-iodine solution on wound healing, infection rate, fusion status and clinical outcome of spinal surgeries. Materials and methods: From January 2002 to August 2003, 244 consecutive cases undergoing primary instrumented lumbosacral posterolateral fusion due to degenerative spinal disorder with segmental instability had been collected and randomly divided into two groups: the study group (120 cases, 212 fusion levels) and the control group (124 cases, 223 fusion levels). Excluded were those patients with a prior spinal surgery, spinal trauma, malignant tumor, infectious spondylitis, rheumatoid arthritis, ankylosing spondylitis, metabolic bone disease, skeletal immaturity or with an immunosuppressive treatment. In the former group, wounds were irrigated with 0.35% povidone-iodine solution followed by normal saline solution just before the bone-grafting and instrumentation procedure. However, only with normal saline solution in the latter. All the operations were done by the same surgeon with a standard technique. All the patients were treated in the same postoperative fashion as well. Later on, wound healing, infection rate, spinal bone fusion and clinical outcome were evaluated in both groups. Results: A significant improvement of back and leg pain scores, modified Japanese Orthopedic Association function scores (JOA) and ambulatory capacity have been observed in both groups. One hundred and seven patients in the study group and one hundred and nine in the control group achieved solid union. There was no infection in the study group but six deep infections in the control group. Wound dehiscence was noted in one group 1 and two group 2 patients. A subsequent statistical analysis revealed higher infection rate in the control group (P<0.05), but no significant difference in fusion rate, wound healing, improvement of pain score, function score and ambulatory capacity between the two groups. Conclusion: Diluted povidone-iodine solution can be used safely in spinal surgeries, and it will not influence wound healing, bone union and clinical outcome.

  • The Jupiter orbiting spacecraft Galileo has provided evidence that the Jovian magnetotail is subject to a periodic process with a typical timescale of several days by which the Jovian system is presumably releasing its excess iogenic mass. This process is analyzed using data returned from the Energetic Particles Detector (EPD), the magnetometer and plasma wave experiment on Galileo. The mass release process resembles a terrestrial substorm in the sense of a global reconfiguration of the magnetotail. During the initial "loading" phase the plasma convection is at a moderate speed in the corotational direction, and the Jovian plasma sheet appears to be in a stable configuration. In the release phase reconnection through a thinned current sheet leads to radially inward and outward plasma flows and the ejection of plasmoids. The striking difference from terrestrial substorms is the periodical appearance of the reconfiguration events. Such an intrinsic periodic behavior cannot readily be explained by a solar wind driven process. Therefore the role of the solar wind as energy source is of less importance than for terrestrial substorms. Instead, ion mass-loading from internal plasma sources and fast planetary rotation causes stretching of magnetotail field lines. The resulting magnetotail configuration favors magnetic reconnection. This leads to the formation and release of plasmoids. Continued mass-loading then again leads to stretching of tail field lines. Thus assuming that this quasi-periodical process is internally driven, a simple conceptual model to estimate the time period of the periodic reconfiguration process is constructed. The model shows that the suggested intrinsic mechanism can explain the observed several days periodicities of Jovian substorm-like processes.

Last update from database: 2/11/25, 9:08 PM (UTC)