New approach to surgical care aims to improve recovery and reduce length of hospital stay

Abstract Context: The outbreak of the Coronavirus disease 2019 (Covid-19) has posed new challenges to surgical care throughout the world. Laparoscopic guidelines were revised to address the theoretical risks associated with transmission of viral droplets and many elective surgeries were suspended.Aims: We aimed to describe strategies that lowered viral transmission risks such as alternative anaesthetic techniques and low-cost infection control and prevention practices for laparoscopic surgeries.Settings and Design: Seventy two patients who presented to hospital as acute surgical emergencies between April and July 2020 and analyzed clinical data of 50 patients who underwent laparoscopic surgeries. This was a prospective observational study.Methods and Material: Procedures were performed under spinal anaesthesia utilizing alternate electrosurgical units and simple smoke evacuation systems.Statistical analysis used: Continuous variables were summarized as mean and standard deviation (SD) or median and range. Discrete variables were summarized as frequencies and percentages. Univariate testing was performed using t test or Mann-Whitney U test. ANOVA or Kruskal-Wallis test was used for categorical data.Results: Of the 50 operated patients, the median age was 23 years with 54% females. The most frequently performed procedure was laparoscopic cholecystectomy, the overall median theatre time was 47 minutes, and 40% patients were managed as day cases with reduced hospital stay.Conclusions: Use of spinal anaesthesia, a simple smoke evacuator and some additional measures during laparoscopic surgeries reduce theatre time and length of hospital stay. These strategies could address and minimize the risks associated with Covid-19 transmission in surgical settings in low-resource countries.

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MANAGEMENT OF POST-SURGICAL INFLAMMATION WITH PROTEOLYTIC ENZYME-BIOFLAVONOID COMBINATION

10.36106/ijsr/0603723 ◽

2021 ◽

pp. 34-37

Author(s):

Rajesh Dhadiwal ◽

Shashank Tiwari ◽

Ramendra Kumar Jauhari

Keyword(s):

Wound Healing ◽

Hospital Stay ◽

Clinical Studies ◽

Proteolytic Enzyme ◽

Surgical Care ◽

Length Of Hospital Stay ◽

Enzyme Therapy ◽

Surgical Wound ◽

Delayed Wound Healing ◽

Infective Complications

Surgical care is an integral component of health systems, and so is the appropriate management of the surgical wound. Excessive inammation and edema, in the post-surgical period, can result in delayed wound healing, infective complications and increased length of hospital stay, among other complications. Systemic enzyme therapy (SET) with trypsin and bromelain, in combination with the bioavonoid rutoside, has been extensively investigated as alternatives to conventional therapies for pain and swelling associated with many inammatory conditions. The multi-pronged pharmacodynamic action of these ingredients on different inammatory processes has been highlighted in this review. Additionally, clinical studies demonstrating the benecial effects of SET in multiple surgical settings, including general surgical, dental, orthopaedic, cosmetic surgeries, are also discussed

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Institutional Review of Laparoscopic Surgery during Coronavirus Disease - 2019: Recommendations for Developing Countries

10.21203/rs.3.rs-101190/v2 ◽

2020 ◽

Author(s):

Md Jafrul Hannan ◽

Mosammat Kohinoor Parveen ◽

Alak Nady ◽

Md Samiul Hasan

Keyword(s):

Hospital Stay ◽

Spinal Anaesthesia ◽

Low Cost ◽

Surgical Care ◽

Length Of Hospital Stay ◽

Anaesthetic Techniques ◽

Continuous Variables ◽

Institutional Review ◽

Surgical Emergencies ◽

Control And Prevention

Abstract Context: The outbreak of the Coronavirus disease 2019 (Covid-19) has posed new challenges to surgical care throughout the world. Laparoscopic guidelines were revised to address the theoretical risks associated with transmission of viral droplets and many elective surgeries were suspended.Aims: We aimed to describe strategies that lowered viral transmission risks such as alternative anaesthetic techniques and low-cost infection control and prevention practices for laparoscopic surgeries.Settings and Design: Seventy two patients who presented to hospital as acute surgical emergencies between April and July 2020 and analyzed clinical data of 50 patients who underwent laparoscopic surgeries. This was a prospective observational study.Methods and Material: Procedures were performed under spinal anaesthesia utilizing alternate electrosurgical units and simple smoke evacuation systems.Statistical analysis used: Continuous variables were summarized as mean and standard deviation (SD) or median and range. Discrete variables were summarized as frequencies and percentages. Univariate testing was performed using t test or Mann-Whitney U test. ANOVA or Kruskal-Wallis test was used for categorical data.Results: Of the 50 operated patients, the median age was 23 years with 54% females. The most frequently performed procedure was laparoscopic cholecystectomy, the overall median theatre time was 47 minutes, and 40% patients were managed as day cases with reduced hospital stay.Conclusions: Use of spinal anaesthesia, a simple smoke evacuator and some additional measures during laparoscopic surgeries reduce theatre time and length of hospital stay. These strategies could address and minimize the risks associated with Covid-19 transmission in surgical settings in low-resource countries.

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Pilonidal Sinus: How to Choose Between Excision and Open Granulation Versus Excision and Primary Closure?

Swiss Surgery ◽

10.1024/1023-9332.8.6.255 ◽

2002 ◽

Vol 8 (6) ◽

pp. 255-258 ◽

Cited By ~ 28

Author(s):

Perruchoud ◽

Vuilleumier ◽

Givel

Keyword(s):

Hospital Stay ◽

Pilonidal Sinus ◽

Primary Closure ◽

Average Length ◽

Length Of Hospital Stay ◽

Healing Time ◽

Incision And Drainage ◽

The Mean ◽

Primary Healing

Aims: The purpose of this study was to evaluate excision and open granulation versus excision and primary closure as treatments for pilonidal sinus. Subjects and methods: We evaluated a group of 141 patients operated on for a pilonidal sinus between 1991 and 1995. Ninety patients were treated by excision and open granulation, 34 patients by excision and primary closure and 17 patients by incision and drainage, as a unique treatment of an infected pilonidal sinus. Results: The first group, receiving treatment of excision and open granulation, experienced the following outcomes: average length of hospital stay, four days; average healing time; 72 days; average number of post-operative ambulatory visits, 40; average off-work delay, 38 days; and average follow-up time, 43 months. There were five recurrences (6%) in this group during the follow-up period. For the second group treated by excision and primary closure, the corresponding outcome measurements were as follows: average length of hospital stay, four days; average healing time, 23 days; primary healing failure rate, 9%; average number of post-operative ambulatory visits, 6; average off-work delay, 21 days. The average follow-up time was 34 months, and two recurrences (6%) were observed during the follow-up period. In the third group, seventeen patients benefited from an incision and drainage as unique treatment. The mean follow-up was 37 months. Five recurrences (29%) were noticed, requiring a new operation in all the cases. Discussion and conclusion: This series of 141 patients is too limited to permit final conclusions to be drawn concerning significant advantages of one form of treatment compared to the other. Nevertheless, primary closure offers the advantages of quicker healing time, fewer post-operative visits and shorter time off work. When a primary closure can be carried out, it should be routinely considered for socio-economical and comfort reasons.

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Length of Hospital Stay in Infants Treated for Neonatal Abstinence Syndrome in Peninsula Regional Medical Center

PEDIATRICS ◽

10.1542/peds.137.supplement_3.483a ◽

2016 ◽

Vol 137 (Supplement 3) ◽

pp. 483A-483A

Author(s):

Nahid Rostami ◽

Diane Hitchens

Keyword(s):

Hospital Stay ◽

Medical Center ◽

Length Of Hospital Stay ◽

Neonatal Abstinence Syndrome ◽

Abstinence Syndrome ◽

Regional Medical ◽

Regional Medical Center

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Indications and practice of enteral nutrition

Orvosi Hetilap ◽

10.1556/oh.2014.30066 ◽

2014 ◽

Vol 155 (51) ◽

pp. 2028-2033 ◽

Cited By ~ 1

Author(s):

Judit Hallay ◽

Dániel Nagy ◽

Béla Fülesdi

Keyword(s):

Risk Factors ◽

Treatment Outcome ◽

Enteral Nutrition ◽

Hospital Stay ◽

Length Of Hospital Stay ◽

Nutrition Therapy ◽

Present Review ◽

Hospitalised Patients ◽

Impact On Treatment ◽

Efficacy Of Treatment

Malnutrition in hospitalised patients has a significant and disadvantageous impact on treatment outcome. If possible, enteral nutrition with an energy/protein-balanced nutrient should be preferred depending on the patient’s condition, type of illness and risk factors. The aim of the nutrition therapy is to increase the efficacy of treatment and shorten the length of hospital stay in order to ensure rapid rehabilitation. In the present review the authors summarize the most important clinical and practical aspects of enteral nutrition therapy. Orv. Hetil., 2014, 155(51), 2028–2033.

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Effect of Chewing Gum on Bowel Motility in Women Undergoing Post-Operative Cesarean Section

International Journal of Innovative Research in Medical Science ◽

10.23958/ijirms/vol03-i06/04 ◽

2018 ◽

Vol 3 (06) ◽

Author(s):

Dr.Randa Mohammed AboBaker

Keyword(s):

Cesarean Section ◽

Hospital Stay ◽

Demographic Data ◽

Length Of Hospital Stay ◽

Chewing Gum ◽

Control Group ◽

Controlled Clinical Trial ◽

Bowel Motility ◽

Gum Chewing ◽

Significant Difference

Postoperative Ileus (POI) is one of the most common problems after obstetrics, gynecologic and abdominal surgeries. Sham feeding, such as gum chewing, accelerates the return of bowel function and the length of hospital stay. The present study aims to evaluate the effect of chewing gum on bowel motility in women undergoing post-operative cesarean section. Intervention study was used at the Postpartum Department of Maternity and Children Hospital, KSA. A randomized controlled clinical trial research design. Through a convenience technique, 80 post Caesarian Section (CS) women were included in the study. Data were collected through three tools: Tool (I): Socio-demographic data and reproductive history interview schedule. Tool (II): Postoperative Assessment Sheet. Tool (III): Outcomes of gum chewing and the length of hospital stay. Method: subjects were assigned randomly into two groups of (40) the experimental and (40) the control. Subjects in the study group were asked to chew two pieces of sugarless gum for 30 min/three times daily in the morning, noon, and evening immediately after recovery from anesthesia and in Postpartum Department; while subjects in the control group followed the hospital routine care. Each woman in both groups was tested abdominally using a stethoscope to auscultate the bowel sounds and asked to report immediately the time of either passing flatus or stool. Results: illustrated that a highly statistically significant difference was observed between the two groups concerning their gum chewing outcomes. Where, P = 0.000. The study concluded that gum chewing is safe, well tolerated and appears to be effective in reducing the incidence and consequences of POI following CS.

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