scholarly journals Effect of intersphincteric fistula tract ligation versus anal fistulectomy on pain scores and serum levels of vascular endothelial growth factor and interleukin-2 in patients with simple anal fistulas

2020 ◽  
Vol 48 (9) ◽  
pp. 030006052094907
Author(s):  
Xin Dong ◽  
Zhanbo Jia ◽  
Bianfang Yu ◽  
Xuebin Zhang ◽  
Fagang Xu ◽  
...  
Keyword(s):  
Wound Healing ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Serum Levels ◽  
Fistula Tract ◽  
Control Group ◽  
Anal Continence ◽  
Anal Fistulas ◽  
Operation Conditions ◽  
Pain Scores

Objective This study was performed to explore the effects of ligation of the intersphincteric fistula tract (LIFT) on pain scores and serum levels of vascular endothelial growth factor (VEGF) and interleukin (IL)-2 in patients with simple anal fistulas. Methods Ninety patients with simple anal fistulas were evenly randomized into a study group (treated with LIFT) and a control group (treated with traditional anal fistulectomy) according to a random number table. The surgical outcomes, basic operation conditions (operation time, hospital stay, and anal continence), and postoperative wound healing rates were compared between the two groups. Results The study group had significantly better operation conditions (better anal continence and shorter length of hospital stay), a higher postoperative wound healing rate, lower pain scores, higher VEGF and IL-2 levels, and higher overall efficacy rate than the control group. However, the incidence of postoperative complications was not significantly different between the two groups. Conclusions Patients who underwent LIFT had better surgical outcomes, higher wound healing rates, better anal continence, a shorter length of hospital stay, and less severe postoperative pain than those who underwent simple anal fistulectomy. Increased levels of VEGF and IL-2 after surgery may promote wound healing.

scholarly journals Muscle-sparing pedicled transverse rectus abdominis myocutaneous flaps for breast reconstruction: Combining benefits of both worlds

2018 ◽  
Vol 28 (1) ◽  
pp. 6-9
Author(s):  
Yijun Wu ◽  
Samuel Yew Ming Ho
Keyword(s):  
Breast Reconstruction ◽  
Hospital Stay ◽  
Operative Time ◽  
Length Of Hospital Stay ◽  
Rectus Abdominis ◽  
Control Group ◽  
Tram Flap ◽  
Transverse Rectus Abdominis Myocutaneous ◽  
Pain Scores ◽  
Muscle Sparing

Background: Breast reconstruction plays a vital role in the restoration of form post-mastectomy. Autologous breast reconstructions using both free as well as pedicled flaps form the bulk of the breast reconstruction in our centre. Objective: This study seeks to evaluate the muscle-sparing modification of the pedicled transverse rectus abdominis myocutaneous (MS-TRAM) flaps against conventional transverse rectus abdominis myocutaneous (TRAM) flaps, in an attempt to marry the benefits of both and minimise the drawbacks of each technique. Patients and methods: A retrospective analysis of 20 women, 10 of whom had undergone unilateral immediate breast reconstruction with pedicled MS-TRAM flaps after skin-sparing mastectomy (MS group), and 10 who had undergone the conventional pedicled TRAM flap (control group) by the same surgeon (S. Ho) over a two-year period from 2013 to 2015 was performed. Patients’ records were reviewed, assessing patient demographics including age, smoking status and evaluating the operative time, time to ambulation, length of hospital stay, pain scores and abdominal bulge rates. Results: Mean operative time was not significantly longer in the MS group. Pain scores were lower in the MS group. The length of hospital stay was not significantly different between the two groups. Abdominal bulge rates at 24 months postoperatively were 0% in the MS group patients and 10% in the control group. Conclusion The pedicled MS-TRAM flap is an excellent breast reconstruction option that is comparable to the conventional TRAM flap. It preserves innervated muscle in the donor site that reduces time to ambulation and postoperative pain. It does not add significantly to surgical time and does not require microvascular anastomosis.

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

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.

Stereotactic Electroencephalography Is Associated With Reduced Pain and Opioid Use When Compared with Subdural Grids: A Case Series

2021 ◽  
Author(s):  
Jonathan P Scoville ◽  
Evan Joyce ◽  
Joshua Hunsaker ◽  
Jared Reese ◽  
Herschel Wilde ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Chart Review ◽  
Statistical Tests ◽  
Case Series ◽  
Length Of Hospital Stay ◽  
Retrospective Chart Review ◽  
Opioid Use ◽  
Pain Scores ◽  
Surgical Methods ◽  
Significant Difference

Abstract BACKGROUND Minimally invasive surgery (MIS) has been shown to decrease length of hospital stay and opioid use. OBJECTIVE To identify whether surgery for epilepsy mapping via MIS stereotactically placed electroencephalography (SEEG) electrodes decreased overall opioid use when compared with craniotomy for EEG grid placement (ECoG). METHODS Patients who underwent surgery for epilepsy mapping, either SEEG or ECoG, were identified through retrospective chart review from 2015 through 2018. The hospital stay was separated into specific time periods to distinguish opioid use immediately postoperatively, throughout the rest of the stay and at discharge. The total amount of opioids consumed during each period was calculated by transforming all types of opioids into their morphine equivalents (ME). Pain scores were also collected using a modification of the Clinically Aligned Pain Assessment (CAPA) scale. The 2 surgical groups were compared using appropriate statistical tests. RESULTS The study identified 43 patients who met the inclusion criteria: 36 underwent SEEG placement and 17 underwent craniotomy grid placement. There was a statistically significant difference in median opioid consumption per hospital stay between the ECoG and the SEEG placement groups, 307.8 vs 71.5 ME, respectively (P = .0011). There was also a significant difference in CAPA scales between the 2 groups (P = .0117). CONCLUSION Opioid use is significantly lower in patients who undergo MIS epilepsy mapping via SEEG compared with those who undergo the more invasive ECoG procedure. As part of efforts to decrease the overall opioid burden, these results should be considered by patients and surgeons when deciding on surgical methods.

Does laryngopharyngeal reflux affect healing and recovery after tonsillectomy?

2007 ◽  
Vol 122 (6) ◽  
pp. 603-608 ◽  
Author(s):  
S Elwany ◽  
Y A Nour ◽  
E A Magdy
Keyword(s):  
Wound Healing ◽  
Laryngopharyngeal Reflux ◽  
Ph Monitoring ◽  
Control Group ◽  
Study Group ◽  
Pain Scores ◽  
Blinded Study ◽  
Group A ◽  
Group B ◽  
Control Group Group

AbstractIntroduction:Laryngopharyngeal reflux is increasingly being implicated in several otolaryngological disorders.Aims:To study a potential correlation between pre-operative laryngopharyngeal reflux and wound healing and recovery after tonsillectomy, based on subjective and objective findings.Materials and methods:A prospective, blinded study was undertaken, including 60 patients scheduled for tonsillectomy, divided into two equal groups: a study group (group A) with pre-operative laryngopharyngeal reflux documented using ambulatory 24-hour pH monitoring; and a control group (group B) without laryngopharyngeal reflux.Results:Group A had significantly higher pain scores on the seventh and 14th post-operative days (p = 0.022 and p = 0.000, respectively) and took a significantly longer time to return to normal eating (p = 0.013), compared with group B. Group A also showed significantly slower healing on the seventh and 14th post-operative days, as estimated by assessing the grade of post-operative slough formation (p = 0.016 and p = 0.029, respectively). A significant correlation between the number of pharyngeal reflux episodes and the degree of post-operative slough was also found.Conclusions:Laryngopharyngeal reflux can significantly decrease wound healing following tonsillectomy. Therefore, pre-operative recognition and management of this condition is desirable in order to eliminate its negative post-operative effect.

RNA Sequencing Reveals the Wound Repair Mechanism of Cuyuxunxi Prescription in Surgical Patients with Anal Fistulas

2021 ◽  
Vol 24 ◽  
Author(s):  
Yin Qu ◽  
Zhijun Zhang ◽  
Yafeng Lu ◽  
De Zheng ◽  
Wei Yang
Keyword(s):  
Wound Healing ◽  
Treatment Group ◽  
Rna Sequencing ◽  
Anal Fistula ◽  
Wound Repair ◽  
Inflammatory Responses ◽  
Control Group ◽  
Surgical Wound ◽  
Anal Fistulas ◽  
Skin Development

Background: Anal fistula is one of the most common colorectal and perirectal diseases in the world. Cuyuxunxi (CYXX) prescription is an efficient herbal fumigant used to promote the surgical wound healing of anal fistulas. Objective: This study aimed to explore the underlying molecular mechanism of CYXX prescription on surgical wound healing of anal fistulas. Methods: Ten patients with anal fistula were randomized into a control group or treatment group. The wound surface of patients in the control group was rinsed by normal saline, while that in the treatment group was rinsed by CYXX prescription. The wound tissues of patients with anal fistulas seven days after the surgery were collected for hematoxylin-eosin (HE) staining and RNA sequencing. The expressions of differentially expressed genes (DEGs) were validated by real-time quantitative PCR (RT-qPCR). Results: HE staining showed that CYXX treatment reduced the infiltration of inflammatory cells. A total of 472 DEGs, including 141 up-regulated genes and 331 down-regulated genes, were identified. These genes were significantly related to skin development, xenobiotic stimulus, and inflammation. In addition, the consistency rate of RT-qPCR and sequencing results was 83.33%, which showed a high relative reliability of the sequencing results. Conclusion: CYXX prescription could improve epidermis repair and reduce inflammatory responses.

Comparison of topical honey and povidone iodine-based dressings for wound healing: a systematic review and meta-analysis

2021 ◽  
Vol 30 (Sup4) ◽  
pp. S28-S36
Author(s):  
Fujie Zhang ◽  
Zongnan Chen ◽  
Feng Su ◽  
Taijuan Zhang
Keyword(s):  
Wound Healing ◽  
Hospital Stay ◽  
Analogue Scale ◽  
Povidone Iodine ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Beneficial Effects ◽  
Vas Score ◽  
Wound Recovery ◽  
Hospital Stay Duration

Objectives: In this review and meta-analysis, we analyse the evidence to compare the efficacy of honey and povidone iodine-based dressings on the outcome of wound healing. Method: A systematic literature search was performed using PRISMA guidelines in academic databases including MEDLINE, Scopus, Embase and CENTRAL. A meta-analysis was carried out to assess the effect of honey and povidone iodine-based dressings on mean healing duration, mean hospital stay duration and visual analogue scale (VAS) score of pain. Results: From the search, 12 manuscripts with a total of 1236 participants (mean age: 40.7±11.7 years) were included. The honey-based dressings demonstrated a medium-to-large effect in reduction of mean healing duration (Hedge's g: –0.81), length of hospital stay (–3.1) and VAS score (–1.2) as compared with the povidone iodine-based dressings. We present evidence (level 1b) in favour of using honey for improvement of wound recovery as compared with povidone iodine. Conclusion: This review and meta-analysis demonstrate beneficial effects of honey-based dressings over povidone iodine-based dressings for wound recovery.

The Association between Prolonged Antibiotic Use in Culture Negative Infants and Length of Hospital Stay and Total Hospital Costs

2021 ◽  
Author(s):  
Wesam Sourour ◽  
Valeria Sanchez ◽  
Michel Sourour ◽  
Jordan Burdine ◽  
Elizabeth Rodriguez Lien ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Blood Culture ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Antibiotic Use ◽  
Hospital Length Of Stay ◽  
Control Group ◽  
Multivariate Linear Regression Analysis ◽  
Negative Blood Culture ◽  
Total Cost

Objective This study aimed to determine if prolonged antibiotic use at birth in neonates with a negative blood culture increases the total cost of hospital stay. Study design This was a retrospective study performed at a 60-bed level IV neonatal intensive care unit. Neonates born <30 weeks of gestation or <1,500 g between 2016 and 2018 who received antibiotics were included. A multivariate linear regression analysis was conducted to determine if clinical factors contributed to increased hospital cost or length of stay. Results In total, 190 patients met inclusion criteria with 94 infants in the prolonged antibiotic group and 96 in the control group. Prolonged antibiotic use was associated with an increase length of hospital stay of approximately 31.87 days, resulting in a $69,946 increase in total cost of hospitalization. Conclusion Prolonged antibiotics in neonates with negative blood culture were associated with significantly longer hospital length of stay and increased total cost of hospitalization. Key Points

scholarly journals A Retrospective Study Evaluating the Effectiveness of an Asthma Clinical Pathway in Pediatric Inpatient Practice

2008 ◽  
Vol 13 (4) ◽  
pp. 233-241
Author(s):  
Elisa Edwards ◽  
Kristie Fox
Keyword(s):  
Drug Therapy ◽  
Hospital Stay ◽  
Clinical Pathway ◽  
Length Of Hospital Stay ◽  
Control Group ◽  
Readmission Rates ◽  
Asthma Education ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Pediatric Inpatient

OBJECTIVE To determine if the asthma clinical pathway implemented at Wolfson Children's Hospital reduces the length of hospital stay. To determine if pathway use affected the use of asthma education, the use of appropriate discharge medications based on asthma classification, and readmission rates. METHODS A list of patients aged 2 to 18 years discharged from Wolfson Children's Hospital between September 1, 2004 and August 31, 2006 with the diagnosis of asthma was generated. Medical records of eligible patients were reviewed for demographic information, asthma pathway use, duration of hospital stay in days, readmission rates, receipt of asthma education, and medications prescribed upon discharge. Patients placed on the asthma clinical pathway were compared to a control group with asthma who were matched based on age and discharge date. Length of stay was averaged for each group. Asthma education, discharge medications, and readmission rates were compared between the two groups. RESULTS Forty-three patients placed on the asthma clinical pathway were compared to a 43 patients in the control group that were matched for age and discharge date. Use of the asthma clinical pathway reduced hospital stay by 0.372 days (P = .0373). Receipt of asthma education (P = .3864), the use of appropriate drug therapy prescribed upon discharge (P = .1398), and readmission rates (P = .5486) were unaffected by pathway use. CONCLUSIONS The asthma clinical pathway used at Wolfson Children's Hospital reduces length of hospital stay, but has no bearing on receipt of asthma education, use of appropriate drug therapy upon discharge, or readmission rates.

scholarly journals Optimization of Esophageal Ultrasound under Artificial Fish Swarm Algorithm and Its Adoption in Treatment of Ventricular Septal Defect

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Zhi Li ◽  
Guihe Chen ◽  
Feng Wang
Keyword(s):  
Ventricular Septal Defect ◽  
Hospital Stay ◽  
Septal Defect ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Control Group ◽  
Artificial Fish Swarm Algorithm ◽  
Artificial Fish Swarm ◽  
Swarm Algorithm ◽  
Experimental Group

This work was aimed at exploring the adoption value of the optimized and upgraded esophageal ultrasound in the treatment of patients with ventricular septal defect (VSD) by artificial fish swarm algorithm. A model was built based on artificial fish swarm algorithm. A random ultrasonic optical signal in the database was decomposed several times and sparsity was optimized to complete partial optimization, which was then extended to global optimization. A total of 100 patients with ventricular septal defect were divided into control group who underwent cardiopulmonary bypass under the guidance of three-dimensional thoracic ultrasound and experimental group of ventricular septal defect occlusion under the guidance of esophageal ultrasound based on artificial fish swarm algorithm. The results showed that the number of successful cases in the experimental group was 12 cases of perimembranous type, 10 cases of septal type, 7 cases of simple membranous type, 13 cases of muscular type, 4 cases of subdry type, and 2 cases of ridge type. The average length of operation after surgery was 70.65 minutes, the average length of ventilator ventilation was 125.8 minutes, and the average length of intensive care unit was 377.9 minutes. The average length of hospital stay after surgery was 5.6 days, and the average total length of hospital stay was 8.2 days, which were better than the control group in many aspects, with statistical significance ( P < 0.05 ). In short, the artificial fish swarm algorithm for esophageal ultrasound-guided ventricular septal defect closure had short operation time and good postoperative effect, which was of high application value in the clinical treatment of patients with ventricular septal defect.

Effect of Colostomy on Treatment Outcome in Fournier Gangrene: A Prospective Comparative Study

2021 ◽  
pp. 229255032110247
Author(s):  
Barakat Abdelreheem Mahmood ◽  
Emad Hussein ElSayed ◽  
Sherif Abdalla Ali
Keyword(s):  
Wound Healing ◽  
Comparative Study ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Wound Dehiscence ◽  
Inhospital Mortality ◽  
Perianal Region ◽  
Fournier Gangrene ◽  
Prospective Comparative Study ◽  
The Difference

Background and Aim: Value of colostomy in management of Fournier gangrene (FG) is a debatable issue. Almost all relevant studies are retrospective and included heterogeneous patients’ groups. The present prospective study aimed to evaluate the role of colostomy in management of FG affecting the perianal region in 2 well-matched FG groups. Patients and Methods: The present prospective comparative study included 30 patients with FG associated with extensive involvement of the perianal region. They comprised 15 patients subjected to colostomy and other 15 patients who refused to perform the procedure. Colostomy was performed after the first debridement. Outcome parameters in the present study included time to wound healing, length of hospital stay, and inhospital mortality. Results: Comparison between the studied groups regarding the preoperative characteristics revealed no statistically significant differences. Postoperatively, patients in the colostomy group had significantly fewer number of debridements (1.3 ± 0.5 vs 2.7 ± 1.2, P < .001), shorter hospital stay (9.5 ± 3.3 vs 29.9 ± 6.2 days, P < .001), and significantly shorter time to wound healing (16.5 ± 3.9 vs 42.9 ± 6.9 days, P < .001). Also, patients in the colostomy group had significantly lower rate of wound dehiscence, wound infection, and flap ischemia. However, the difference wasn’t statistically significant. Conclusions: Aggressive treatment of FG aided by colostomy after first debridement would result in better clinical outcome.

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