scholarly journals Open Abdomen Management and Candida Infections: A Very Likely Link

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Savino Occhionorelli ◽  
Monica Zese ◽  
Rosario Cultrera ◽  
Domenico Lacavalla ◽  
Marco Albanese ◽  
...  
Keyword(s):  
Antifungal Therapy ◽  
Open Abdomen ◽  
Case Series ◽  
Abdominal Sepsis ◽  
Temporary Abdominal Closure ◽  
Retrospective Case ◽  
Abdominal Closure ◽  
Closure Duration ◽  
Abdominal Hypertension ◽  
Significant Difference

Objective. Laparostomy can be applied in trauma, abdominal sepsis, intra-abdominal hypertension, or compartment syndrome. Systemic infections, especially if complicated by Candida, are associated with a high risk of mortality. Methods. This is a single-centre retrospective case series of 47 cases admitted to our Department, which required laparostomy procedure; we analyzed the type of surgery, temporary abdominal closure, duration of open abdomen, complications, SOFA score, mortality with Candida infections, and empirical or targeted antifungal therapy. Results. We found that patients with Candida infection were related with a statistically significant difference (p<0.05) with a complication after OA closure, total complications, time elapsed after OA application, time spent on the first surgical OA application, type of temporary abdominal closure that is used, and duration of the open abdomen. The use of empirical and targeted antifungal therapy is related to the duration of open abdomen too. Conclusions. Management of the OA is often burdened by sepsis or septic shock, especially when complicated by Candida infection. Candida score is a validated tool to identify patients who can be treated empirically, but every situation must be considered on an individual basis.

scholarly journals Overview on Temporary Abdominal Closure Techniques: A Review

2021 ◽  
pp. 68-74
Author(s):  
Hashem Bark Awadh Abood ◽  
Sadeel Fahad Daghistani ◽  
Nouf Hashem Koshak ◽  
Yazid Ali Alghamdi ◽  
Sahad sami Ghamri ◽  
...  
Keyword(s):  
Open Abdomen ◽  
Fascial Closure ◽  
Temporary Abdominal Closure ◽  
Advantages And Disadvantages ◽  
Abdominal Closure ◽  
Abdominal Hypertension ◽  
Fluid Regulation ◽  
Abdominal Compartment ◽  
Emergency Abdominal Surgery ◽  
The Ideal

Open abdomen (OA) is becoming more common, primarily to prevent intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) following emergency abdominal surgery. The purpose of temporary abdominal closure (TAC) techniques is no longer just abdomen coverage; fluid regulation and early fascial closure are now important considerations. TAC techniques for leaving the abdomen open are numerous. The ideal one should be simple to apply and remove, allow for quick access to a surgical second opinion, drain secretions, ease primary closure with acceptable morbidity and mortality, allow for easy nursing, and, finally, be readily available and inexpensive. Over the years, several TAC methods have been proposed. In this review, we overview different techniques for temporary abdominal closure and its advantages and disadvantages.

scholarly journals Ologen Implantation versus Conjunctival Autograft Transplantation for Treatment of Pterygium

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Xiuping Chen ◽  
Fei Yuan
Keyword(s):  
Operative Time ◽  
Case Series ◽  
Retrospective Case ◽  
Short Operative Time ◽  
Conjunctival Autograft ◽  
Primary Surgery ◽  
Significant Difference ◽  
Autograft Group ◽  
Group 1 ◽  
Primary Pterygium

Purpose. To evaluate the effectiveness and safety of Ologen implantation versus conjunctival autograft transplantation for primary pterygium. Methods. A retrospective case-series analysis. Thirty-one eyes of 29 patients were included in the Ologen group and 42 eyes of 35 patients in the autograft group. The patients were followed up for 1 year and evaluated for slit-lamp biomicroscopy, intraocular pressure, and adverse events. Recurrence rate, complications, and final appearance of the cases were evaluated prospectively. Result. At 1 year after operation, 2 eyes recurred (6.5%) in the Ologen group and 4 eyes recurred (9.52%) in the autograft group. There was no statistically significant difference between both groups (P=0.157, χ2 = 3.781). There was no occurrence of serious complications. Two eyes among the 31 eyes of the Ologen group were conjunctivitis; the incidence of complications was 6.45% (2 eyes). There was conjunctivitis in 3 eyes of the autograft group, 1 eye complicated with symblepharon, and 1 eye with conjunctival granuloma; the incidence of complications was 11.90% (5 eyes), and there was no statistically significant difference between both groups (P=0.094). The conjuntiva was less vascular and inflamed at 1 month postoperatively in the Ologen group than in the autograft group. Conclusions. Ologen transplantation was technically easier, provided short operative time compared with conjunctival autograft transplantation, and preserved healthy conjunctiva with less complication and less recurrence; it may be a new, safe, and effective alternative for improving the short-term success rate of primary surgery.

Efficacy and safety of misoprostol vaginal insert vs. oral misoprostol for induction of labor

2019 ◽  
Vol 47 (2) ◽  
pp. 176-182 ◽  
Author(s):  
Katharina Redling ◽  
Sabine Schaedelin ◽  
Evelyn Annegret Huhn ◽  
Irene Hoesli
Keyword(s):  
Mode Of Delivery ◽  
Case Series ◽  
Neonatal Outcomes ◽  
Efficacy And Safety ◽  
Retrospective Case ◽  
Application Form ◽  
Oral Misoprostol ◽  
Vaginal Deliveries ◽  
Significant Difference ◽  
Time To Delivery

Abstract Objectives To compare the oral application form of misoprostol with the misoprostol vaginal insert (MVI) in a Swiss cohort with special regards to the efficacy and safety. Methods We performed a retrospective case series including a historical group induced with oral misoprostol (MO, n=101) and an MVI group (n=101). The primary outcome was time to delivery. Secondary outcomes were mode of delivery, occurrence of tachysystole, use of analgesia and neonatal adverse outcome. Results A total of 202 women were included in the analysis (101 in the MVI as well as in the MO group). Time from start of induction to delivery was significantly shorter in the MVI group compared to the MO group (15.91 h vs. 37.68 h, P<0.001). Within the first 24 h, 78.2% of the women in the MVI group had given birth compared to 28.7% in the MO group (P<0.001). Tachysystole occurred more often in the MVI group (22.8% vs. 5.0%, P<0.001). Women in the MVI group more often needed opioid analgesia during the induction before onset of active labor (31.7% vs. 2.0%, P<0.001). There was no significant difference between neonatal outcomes in the two groups. Conclusion Time to delivery was significantly shorter in the MVI group with a higher rate of vaginal deliveries within the first 24 h. However, patients needed more opioids for pain relief during induction with MVI. There was no difference in neonatal outcomes.

scholarly journals Temporary abdominal closure for trauma and intra-abdominal sepsis

2017 ◽  
Vol 82 (2) ◽  
pp. 345-350 ◽  
Author(s):  
Tyler J. Loftus ◽  
Janeen R. Jordan ◽  
Chasen A. Croft ◽  
R. Stephen Smith ◽  
Philip A. Efron ◽  
...  
Keyword(s):  
Abdominal Sepsis ◽  
Temporary Abdominal Closure ◽  
Abdominal Closure

In Vitro Comparison of Intra-Abdominal Hypertension Development After Different Temporary Abdominal Closure Techniques

2008 ◽  
Vol 144 (1) ◽  
pp. 102-106 ◽  
Author(s):  
Emanuel Benninger ◽  
Ludwig Labler ◽  
Burkhardt Seifert ◽  
Otmar Trentz ◽  
Michael D. Menger ◽  
...  
Keyword(s):  
Temporary Abdominal Closure ◽  
Abdominal Closure ◽  
Abdominal Hypertension ◽  
Hypertension Development ◽  
In Vitro Comparison

Evaluation of the Safety of Early Compared to Late Enteral Nutrition in Canine Septic Peritonitis

2017 ◽  
Vol 53 (2) ◽  
pp. 90-95 ◽  
Author(s):  
Jamie Elizabeth Hoffberg ◽  
Amy Koenigshof
Keyword(s):  
Enteral Nutrition ◽  
Case Series ◽  
Early Enteral Nutrition ◽  
Retrospective Case ◽  
Gastrointestinal Complications ◽  
Additional Risk ◽  
Significant Difference ◽  
Septic Peritonitis ◽  
Potential Benefits ◽  
Postoperative Feeding

ABSTRACT Septic peritonitis is a relatively common condition in the veterinary intensive care unit, with a classically high mortality rate. Early enteral nutrition (EEN) in critically ill humans can lead to improved outcome. This study was performed to determine the safety of early postoperative feeding in canine septic peritonitis. In this retrospective case series, 56 dogs were identified. Sixteen dogs received EEN, defined as nutrition within 24 hr of surgery; 27 received late enteral nutrition (LEN) defined as nutrition more than 24 hours following surgery; and 13 dogs had no enteral nutrition in hospital (NEN). Signalment, physical examination findings, and occurrence of pre-admission vomiting, regurgitation, and length of anorexia were the same amongst all groups. There was no significant difference in the number of gastrointestinal complications postoperatively between the EEN, LEN, and NEN groups or in the occurrence of vomiting/regurgitation postoperatively compared to preoperatively. There was no difference in the length of hospitalization between any group, although fewer dogs in the NEN group survived compared to the EEN/LEN combined group (46% [6/13] versus 81% [37/40]). This study indicates it is safe to initiate EEN without additional risk of gastrointestinal complications. Prospective studies are needed to evaluate the potential benefits of EEN in dogs with septic peritonitis.

scholarly journals The Association between Preoperative Dry Eye Symptoms and Postoperative Discomfort in Patients Underwent Photorefractive Keratectomy

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Gilad Rabina ◽  
Ingibjorg Iris Boguslavsky ◽  
Michael Mimouni ◽  
Igor Kaiserman
Keyword(s):  
Postoperative Pain ◽  
Dry Eye ◽  
Subjective Evaluation ◽  
Case Series ◽  
Photorefractive Keratectomy ◽  
Ocular Surface Disease Index ◽  
Retrospective Case ◽  
Significant Difference ◽  
Eye Symptoms ◽  
Dry Eye Symptoms

Purpose. To investigate the association between preoperative dry eye symptoms on postoperative pain and discomfort after photorefractive keratectomy (PRK). Methods. A retrospective case series of 151 consecutive patients, who underwent myopic PRK in both eyes between 5/2016 and 5/2017. Patients with positive dry eye disease (DED) signs on clinical examination or with known DED were excluded. Patients underwent a subjective evaluation for dry eye symptoms using ocular surface disease index (OSDI) and modified standard patient evaluation of eye dryness (SPEED) questionnaires. One day postoperatively, the patients were evaluated again by a questionnaire of pain, discomfort, photophobia, foreign body sensation, satisfaction with vision, and frequency of usage of anesthetic drops. Results. Fifty-two patients had any preoperative dry eye symptoms (OSDI score > 0) compared to 99 nonsymptomatic patients (OSDI score of 0). Postoperatively, the symptomatic dry eye patients suffered significantly more pain than the nondry eye patients (p=0.02). Thirteen patients had a cumulated modified SPEED score >4 (moderate to severe) in comparison to 138 patients with score of 0–4 (non to mild). Patients with moderate to severe preoperative symptoms suffered more pain (p=0.006), photophobia (p=0.005), and epiphora (p=0.03). No statistically significant difference was seen in postoperative subjective visual quality (p=0.82) between the two groups. Conclusion. Preoperative dry eye symptoms may be associated with postoperative pain, epiphora, and photophobia and thus influence negatively on patient satisfaction with this procedure.

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