scholarly journals P104 POSTOPERATIVE OUTCOME AND COMPLICATIONS AFTER STOMA REVERSAL SURGERY WITH CICATRIAL HERNIA HERNIA PROPHYLAXIS BY MESH AUGMENTATION IN SUBLAY TECHNIQUE USING GORE® BIO A® MESH

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Marsela Ceno ◽  
Dietmar NV Paul ◽  
Dieter Berger
Keyword(s):  
Wound Closure ◽  
Postoperative Outcome ◽  
Synthetic Mesh ◽  
Wound Infection Rate ◽  
Stoma Reversal ◽  
Primary Wound Closure ◽  
Mesh Augmentation ◽  
Sublay Technique ◽  
A Prospective Study

Abstract Aim At the surgery hospital of Klinikum Mittelbaden in Baden-Baden (Prof. Dr. Dieter Berger) stoma reversal surgery was performed on 127 patients in the time from Nov. 15, 2010 to Mar. 11, 2015. All 127 patients were treated with a resorbable synthetic mesh (GORE® BIO-A® mesh) in sublay technique to close abdominal wall incisions. Primary wound closure was carried out in all cases. In order to evaluate the rate of postoperative hernias, which literature reports to be over 30 percent and a common complication, all 127 patients were included in a prospective study. Material and Methods In total, 104 of the included patients (n = 127) took part in the follow-up examinations. 72 patients underwent clinical examinations and imaging diagnostics, 21 were surveyed on the telephone whenever their presentation at a follow-up exam was impossible, whereas 11 patients deceased during the follow-up period. These cases were analyzed on the basis of the previous examinations which had been part of the respective health records. The follow-up examination took place after a median time span of 87 weeks (8 -218 weeks). Results The total herniation rate of 7.7 percent (n = 8/104) in the examined patient population was thus much lower than described in the literature. Conclusions According to our own prospective analysis, we were able to register a very low herniation rate compared to the literature when the resorbable synthetic mesh (GORE® BIO-A®) was applied in sublay technique for stoma reversal. One disadvantage could lie in the increased perioperative wound infection rate. 5/8 hernias were observed after the occurrence of perioperative wound infections.

Osteotomy and primary wound closure in bisphosphonate-associated osteonecrosis of the jaw: a prospective clinical study with 12 months follow-up

2009 ◽  
Vol 18 (4) ◽  
pp. 449-460 ◽  
Author(s):  
Philipp Stockmann ◽  
Eleftherios Vairaktaris ◽  
Falk Wehrhan ◽  
Martin Seiss ◽  
Stephan Schwarz ◽  
...  
Keyword(s):  
Clinical Study ◽  
Wound Closure ◽  
Osteonecrosis Of The Jaw ◽  
Prospective Clinical Study ◽  
Primary Wound Closure

The association between intraoperative correction of Dupuytren’s disease and residual postoperative contracture

2009 ◽  
Vol 35 (3) ◽  
pp. 220-223 ◽  
Author(s):  
O. W. Donaldson ◽  
D. Pearson ◽  
R. Reynolds ◽  
R. K. Bhatia
Keyword(s):  
Prospective Study ◽  
Postoperative Outcome ◽  
Surgical Correction ◽  
Dupuytren’S Disease ◽  
Dupuytren's Disease ◽  
Full Correction ◽  
A Prospective Study ◽  
Preoperative Deformity

The purpose of this study was to determine whether preoperative contracture and the amount of intraoperative correction can be used to predict the postoperative outcome of fasciectomy for Dupuytren’s disease. A prospective study of 52 patients undergoing primary fasciectomy during an 18 month period was undertaken. The contracture of each joint was measured preoperatively, after fasciectomy during the operation and 6 months after surgery. Forty-two metacarpophalangeal (MCPJ) and 58 proximal interphalangeal (PIPJ) joints were treated surgically. Full intraoperative correction was achieved in 41 MCPJs. Thirty-seven had full correction at follow-up. Full intraoperative correction was obtained in 35 PIPJs and 13 had complete correction at follow-up. The extent of the preoperative deformity was a significant predictor of complete intraoperative correction. The extent of both preoperative deformity and intraoperative correction were significant predictors of loss of surgical correction after operation.

scholarly journals A study of the wound performance following subcutaneous infiltration and topical instillation of ceftriaxone before primary closure of skin in laparotomy for peritonitis due to non-traumatic perforation of small intestine

2017 ◽  
Vol 4 (12) ◽  
pp. 3956
Author(s):  
Sudhir S. ◽  
Kanmani G. Telkar
Keyword(s):  
Wound Infection ◽  
Primary Closure ◽  
Wound Closure ◽  
Postoperative Morbidity ◽  
Study Groups ◽  
Wound Infection Rate ◽  
Control Group ◽  
Study Group ◽  
Distilled Water ◽  
A Prospective Study

Background: Surgical site infection (SSI) continues to be a baffling problem since time immemorial. It is one of the major causes for postoperative morbidity and mortality. Many methods have been evolved to combat wound infection, but the rate of wound infection has been more or less static over past few years. The search for alternative modes of management is going on and one of the methods is intra incisional subcutaneous infiltration of antibiotics.Methods: This is a prospective study comprising of control and study groups of 25 patients each. Control group patients did not receive subcutaneous infiltration of 1gm (diluted with 10 cc of distilled water) of ceftriaxone whereas study group received the infiltration. Precise examination of wound was done from post-operative day 3 up to day 10 for the presence of pus discharge or any subcutaneous collection.Results: Wound infection rate was 48% in control group and 32% in study group that is 12 out of 25 patients wound were infected in control and 8 out of 25 were infected in study group and 13 out of 25 had no infection in control and 17 out of 25 had no wound infection in study group.Conclusions: The incidence of SSI in the group which received subcutaneous infiltration of antibiotic was less than the group of patients, which did not receive ceftriaxone, showing that the use of subcutaneous infiltration of ceftriaxone injection at the time of wound closure may be more effective in reducing SSI.

scholarly journals Anticoagulation after VA-ECMO decannulation, providing new insights

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
A Maestro-Benedicto ◽  
A Duran-Cambra ◽  
M Vila-Perales ◽  
J Sans-Rosello ◽  
J Carreras-Mora ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Cardiogenic Shock ◽  
Anticoagulation Therapy ◽  
Thromboembolic Events ◽  
Bleeding Events ◽  
Membrane Oxygenation ◽  
Funding Sources ◽  
Va Ecmo ◽  
A Prospective Study

Abstract Funding Acknowledgements Type of funding sources: None. INTRODUCTION Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is an essential tool for the management of refractory cardiogenic shock. Little is known about the incidence of thromboembolic events after V-A ECMO decannulation, although some studies report a high incidence of cannula-related venous thrombosis after venovenous extracorporeal membrane oxygenation (VV-ECMO). Due to this fact, in our institution anticoagulation therapy is systematically prescribed for at least 3 months after VA-ECMO per protocol.  AIM The main objective of this study was to explore the feasibility of 3-month anticoagulation therapy after VA-ECMO decannulation. METHODS We performed a prospective study that included 27 consecutive patients who were successfully treated with VA-ECMO in a medical ICU between 2016 and 2019 and were prescribed 3-month anticoagulation therapy per protocol after decannulation. Exclusion criteria was dying on ECMO or while on the ICU. Data analysis included demographics, mean days on ECMO, 3-month survival, and thromboembolic and bleeding events (excluding immediate post-decannulation bleeding, since anticoagulation was prescribed 24h after). RESULTS Our cohort consisted mainly of men (N = 21, 78%), with a mean age of 60 ± 11 years and a mean time on VA-ECMO of 8 ± 3 days, who primarily suffered from post-cardiotomy cardiogenic shock (N = 9, 34%) or acute myocardial infarction (N = 6, 23%). 5 patients (18%) received a heart transplant. Regarding anticoagulation, 15 patients (60%) had other indications apart from the protocol, like incidental thrombus diagnosis (N = 7, 26%) or valve surgery (N = 5, 18%). Anticoagulation therapy was not feasible in 1 patient (4%) with severe thrombopenia. No patients had severe or life-threatening bleeding events in the follow-up, although 8 patients (30%) had bleeding events, mainly gastrointestinal bleeding (N = 4, 15%), requiring withdrawal of anticoagulation in 1 patient. The incidence of thromboembolic events was 7%; two patients with low-risk pulmonary embolisms. During the 3-month follow-up survival rate was 95%. CONCLUSIONS This is the only study to date addressing the strategy of 3-month anticoagulation therapy after VAECMO, showing it is feasible and safe and may be helpful in reducing or ameliorate thromboembolic complications in the follow-up, although it is not exempt of complications. Abstract Figure. Kaplan-Meier survival analysis

scholarly journals Colorectal resection in endometriosis patients: correlation between histopathological findings and postoperative outcome

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Peter Tschann ◽  
Nikola Vitlarov ◽  
Martin Hufschmidt ◽  
Daniel Lechner ◽  
Paolo N. C. Girotti ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Colorectal Resection ◽  
Postoperative Outcome ◽  
Resection Margins ◽  
Pain Level ◽  
Histopathological Findings ◽  
Vas Score ◽  
Reduction Of Pain

Abstract Introduction Endometriosis is associated with a high number of chronic pelvic pain and reduced quality of life. Colorectal resections in case of bowel involvement of endometriosis are associated with an unneglectable morbidity in young and healthy patients. There is no linear correlation established between the degree of symptoms and stage of endometriosis. The aim of this study was to correlate the histological findings to preoperative pain scores in colorectal resected patients with endometriosis. Methods Twenty-five patients who underwent laparoscopic colorectal resection for endometriosis between 2014 and 2019 were included in this retrospective study. Pain level was assessed preoperatively and postoperatively via phone call in May 2020. Histopathology was correlated to preoperative symptoms and postoperative outcome. Results Average follow-up time was 38.68 months (± 19.92). Preoperative VAS-score was 8.32 (± 1.70). We observed a significant reduction of pain level in all patients after surgery (p ≤ 0.005). Pain levels were equal regarding the presence of satellite spots and various degrees of infiltration depth. The resection margins were clear in all patients. Postoperative complications occurred in 6 cases (24%) and anastomotic leakage was observed in 3 patients (12%). Average VAS-score at time of follow-up was 1.70 (± 2.54). Conclusion Our data demonstrate that adequate colorectal resection leads to reduction of pain and an increase of quality of life irrespective of histopathological findings. An experienced team is necessary to improve intraoperative outcome and to reduce postoperative morbidity in case of complication.

scholarly journals Sulcus-Deepening Trochleoplasty for Trochlear Dysplasia

2021 ◽  
Vol 1 (3) ◽  
pp. 263502542110111
Author(s):  
Anthony J. Ignozzi ◽  
Zane Hyde ◽  
Scott E. Dart ◽  
David R. Diduch
Keyword(s):  
Patient Satisfaction ◽  
Trochlear Dysplasia ◽  
Recurrent Dislocation ◽  
Trochlear Groove ◽  
Thick Shell ◽  
Absorbable Sutures ◽  
Postoperative Dislocation ◽  
A Prospective Study ◽  
Patellar Stability

Background: Patients who are refractory to initial management of trochlear dysplasia, which consists of bracing and physical therapy, may be candidates for trochleoplasty. Indications: Indications for trochleoplasty include Dejour classification type B or D trochlear dysplasia, supratrochlear spur height ≥7 mm, and a positive J sign on examination. Technique Description: The thick shell sulcus-deepening trochleoplasty technique involves removing the supratrochlear spur by creating a 5-mm–thick osteochondral shell with underlying cavity, dividing the thick shell into medial and lateral leaflets, and securing the leaflets with absorbable sutures. This establishes a new trochlear groove that is flush with the anterior cortex of the femur. Results: A review of 21 studies with length of follow-up from 8.8 months to 15 years found postoperative dislocation was present in 0% to 15% of patients and the patient satisfaction ranged from 81.0% to 94.4%. A prospective study with a minimum 2-year follow-up found no cases of recurrent dislocation, no progression of radiographic arthritis, 84.8% of patients returned to sport, and the patient satisfaction was a 9.1/10. Discussion/Conclusion: Sulcus-deepening trochleoplasty for trochlear dysplasia provides patellar stability and excellent patient satisfaction.

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