Showing posts with label gloves change. Show all posts
Showing posts with label gloves change. Show all posts

Friday, December 22, 2017

A year in review: Best of 2017


We are already round the corner to 2018, here are the top 10 most read articles from 2017.

News from ACOG 2017: Changing gloves before abdominal closure brings down the rate of wound infection by almost 50% in Cesarean Section

Results of a randomized controlled trial presented at the ACOG 2017 showed that changing the outer gloves before closing the abdomen decreases the wound complication of infection, cellulitis and dehiscence.

Clinical review: Updates on Cesarean Section
Here is a roundup of the latest research on Cesarean Section.

The American Heart Association updates BP guidelines in 14 years: now 130 is the new 140
The American Heart Association (AHA)  and The American College of Cardiology (ACC) has changed the definition of hypertension for the first time in 14 years, moving the number from the old standard of 140/90 to the newly revised 130/80.

According to the new definition, 130 to 139 mm Hg systolic and or 80 to 89 mm Hg will be labelled as stage 1 hypertension.

First US baby born after uterine transplant delivered in Texas
The first birth as a result of a uterine transplant in the United States took place on Friday in Texas at the Baylor University Medical Center in Dallas. The women had undergone a live donor transplant and have received her uterus from Taylor Siler, 36, a registered nurse in the Dallas area.

New use of old drug: Sildenafil Citrate (Viagra) improves amniotic fluid index in oligohydramnios.
Sildenafil Citrate (Viagra) improves amniotic fluid index in pregnancies complicated by oligohydramnios according to a new study published ahead of print on March 6,2017 in Journal of Obstetrics and Gynecology.

WHO updates its guidance on Tranexamic Acid for the Treatment of Postpartum Hemorrhage

WHO has recently updated their guidelines for use of Tranexamic acid for treatment of Postpartum Hemorrhage: TXA should now be included in the treatment regimen for PPH along with other drugs, irrespective of the cause of hemorrhage.  

CDC releases ‘long awaited’ guidelines for preventing surgical site infections.
The Center for Disease Control released its much-awaited update to its 1999 guidelines for the prevention of surgical site infections (SSIs). The guidelines were published online May 3, 2017 in JAMA.

Finally, an oral drug found effective in treatment of Uterine Fibroids following successful phase-3 trial

Relugolix successfully reduced heavy menstrual blood loss among Japanese women in a Multicenter, Randomized, Double-Blind, Parallel-Group, Phase 3 Study to Evaluate the Efficacy and Safety of Oral relugolix 40 mg as compared with injectable leuprolide in the Treatment of Uterine Fibroids.

Now ‘Switch’ the way you suture: Reinventing suturing technique with the new device
Mellon Medical, a Dutch MedTech developer has reinvented suturing by developing a device which enables the surgeon to suture with only one hand, the other hand remaining free to use as needed. The product is named Switch®, a single use precision instrument that allows the surgeon to suture tubular structures or skin with twice the speed of conventional suturing.

A simple, novel solution to identify and protect ureter during surgery

AllotropeMedical, a Houston based medical startup has devised StimSite, a novel, hand-held, single use device that precisely identifies ureter during surgery; thus, eliminating the need for ureteral stenting.


Thursday, May 11, 2017

News from ACOG 2017: Changing gloves before abdominal closure brings down the rate of wound infection by almost 50% in Cesarean Section.


Results of a randomized controlled trial presented at the ACOG 2017 showed that changing the outer gloves before closing the abdomen decreases the wound complication of infection, cellulitis and dehiscence.

Wound infection after a cesarean section (CS) is a major cause of maternal morbidity, lengthy hospital stay and increased medical cost. The rate of surgical site infection after cesarean section range from 3% to 15%.

The nature of the procedure is such that surgeon’s and assistant’s gloves are contaminated by lower genital tract bacteria and seed an otherwise sterile operative field. Previous studies have not shown that a change of gloves decreases the rate of post-operative wound infection.   

The study was led by Dr. Buvana Reddy from Woodbury, Minnesota but the results were presented at the conference by coauthor Jonathan Scrafford, MD from University of Minnesota–Minneapolis.

A review of literature showed that only one small similar study of 92 patients was published in 2004 in Journal of Reproductive Medicine in 2004. The study concluded that “Obstetricians may decrease the number of postcesarean wound infections by having the entire team change surgical gloves after delivery of the placenta.” But, the study lacked power and the timing of change of gloves after the delivery of placenta was not very practical during the course of surgery.

The present study is larger, and focuses on a composite wound outcome score instead of just evaluating the surgical site infection and the timing of change of gloves was at the time of abdominal closure.

This single center study recruited 553 women who had a planned cesarean section at the center across a period of 15 months. Out of this cohort, data is available for a total of 250 patients in the control arm and 236 patients in the study arm who received the glove-changing intervention.

The patients were matched on demographics, total surgical time and the amount of blood loss. After statistical analysis 15 patients in the study arm suffered from wound infection as compared to 34 patients in the control group (P = .008). Statistical significant difference was also observed in wound dehiscence in the two group (5 in glove changing arm vs 14 in the control arm; P = .01)

Pre-operative vaginal preparation with antiseptic solution did not alter the results of the study.

The number need to treat for achieving the benefit of gloves changing was 14 and the added cost per procedure was just $5.