scholarly journals A STUDY OF PORT SITE INFECTION AFTER LAPAROSCOPIC CHOLECYSTECTOMY

2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Mahesh Joshi ◽  
Prama Dubey
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Quality Of Healthcare ◽  
Port Site ◽  
Site Infection ◽  
Proper Selection ◽  
Basic Principles ◽  
Elective Laparoscopic Cholecystectomy ◽  
Selection Of Patients ◽  
Selection Of

Background: Port site infections though rare, shall be evaluated and studied so as to improve the quality of healthcare. Materials and Methods: This prospective study was conducted on100 patients of all age group and both sexes with symptomatic cholelithiasis undergoing laparoscopic cholecystectomy were analysed for port site infection. Result:   Out of 100 patients studied only 3 patients presented with port site infection. Conclusion: It is concluded that port site infection are rare in elective laparoscopic cholecystectomy and can be further reduced by proper selection of patients, and strictly following basic principles of laparoscopic cholecystectomy Keywords: Port site infection, laparoscopic, Cholecystectomy

scholarly journals A STUDY OF PORT SITE COMPLICATIONS AFTER LAPAROSCOPIC CHOLECYSTECTOMIES AT TERTIARY CARE HOSPITAL IN WESTERN RAJASTHAN

2019 ◽  
Vol 3 (7) ◽  
Author(s):  
Surendra Saini ◽  
Manish Kumar Saini
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Tertiary Care ◽  
Quality Of Healthcare ◽  
Port Site ◽  
Care Hospital ◽  
Medical College ◽  
Port Site Hernia ◽  
Elective Laparoscopic Cholecystectomy

Background: Port site complications though rare, shall be evaluated and studied so as to improve the quality of healthcare. Materials and Methods: This prospective study was conducted in the Department of General Surgery, Sardar Patel Medical College & P.B.M. Hospital, Bikaner, Rajasthan. 200 patients of all age group and both sexes with symptomatic cholelithiasis undergoing laparoscopic cholecystectomy. Result: Out of 200 patients studied only 1 patient presented with port site hernia in the follow up and 13 patients presented with port site infection. No other complication was detected   after laparoscopic cholecystectomies. Conclusion:  It is concluded that port site complications are rare in elective laparoscopic cholecystectomy and can be further reduced by proper selection of patients, and strictly following basic principles of laparoscopic cholecystectomy. Keywords: Laparoscopic surgeries, Port site infections, Complications

scholarly journals Why are we still using antibiotic prophylaxis in elective laparoscopic cholecystectomy for the low-risk groups? a review of literature

2021 ◽  
Vol 8 (2) ◽  
pp. 760
Author(s):  
Devajit Chowlek Shyam ◽  
Ranjit Chowlek Shyam ◽  
Donkupar Khongwar ◽  
Dathiadiam Tongper
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Surgical Site Infection ◽  
Antibiotic Prophylaxis ◽  
Open Cholecystectomy ◽  
Gallstone Disease ◽  
Port Site ◽  
Low Risk ◽  
Site Infection ◽  
Skin Preparation ◽  
Elective Laparoscopic Cholecystectomy

Gallstone disease is one of the most common gastrointestinal conditions requiring surgery and more than 90% of cholecystectomies are done laparoscopically. The major complications of laparoscopic cholecystectomy are major bleeding, Bile duct injury, and wound infection or surgical site infection. The incidence of Surgical site infection in laparoscopic cholecystectomy (0.4-1.13%) is significantly low compared to open cholecystectomy (3-47%) and the probable reasons are the smaller incision and the use of trocar along with almost nil to minimal wound contamination as compared to open cholecystectomy. Port site infection is a type of surgical site infection (1.8%) and the Umbilical port site is the most common site followed by the epigastric port site. In spite of the low-risk of surgical site infection, many surgeons still practice antibiotic prophylaxis in elective laparoscopic cholecystectomy for low-risk patients. Antibiotic prophylaxis is a debatable topic in the low-risk group undergoing elective laparoscopic cholecystectomy.Meticulous preoperative skin preparation is one of the established local factors to prevent the occurrence of SSI.

Catheter-directed thrombolysis for deep vein thrombosis: 2021 update

2021 ◽  
pp. 1358863X2110429
Author(s):  
Samuel Z Goldhaber ◽  
Elizabeth A Magnuson ◽  
Khaja M Chinnakondepalli ◽  
David J Cohen ◽  
Suresh Vedantham
Keyword(s):  
Deep Vein Thrombosis ◽  
Vein Thrombosis ◽  
Catheter Directed Thrombolysis ◽  
Related Quality ◽  
Health Related ◽  
Deep Vein ◽  
Major Reduction ◽  
Selection Of Patients ◽  
Selection Of

Catheter-directed thrombolysis (CDT) has been utilized as an adjunct to anticoagulant therapy in selected patients with deep vein thrombosis (DVT) for approximately 30 years. CDT used to be limited to patients with DVT causing acute limb threat and those exhibiting failure of initial anticoagulation, but has expanded over time. Randomized trials evaluating the first-line use of CDT for proximal DVT have demonstrated that CDT does not produce a major reduction in the occurrence of post-thrombotic syndrome (PTS) and that it is poorly suited for elderly patients and those with limited thrombus extent or major risk factors for bleeding. However, CDT does offer selected patients with acute iliofemoral DVT improvement in reducing early DVT symptoms, in achieving reduction in PTS severity, and in producing an improvement in health-related quality of life (QOL). Clinical practice guidelines from medical and surgical societies are now largely aligned with the randomized trial results. This review offers the reader an update on the results of recently completed clinical trials, and additional guidance on appropriate selection of patients with DVT for catheter-directed thrombolytic therapy.

Frequency of port site infection following gall bladder removal through Epigastric vs Umbilical port.

2021 ◽  
Vol 28 (03) ◽  
pp. 277-281
Author(s):  
Bushra Shaikh ◽  
Imamuddin Baloch ◽  
Azhar Ali Shah ◽  
Abdul Sami Mirani ◽  
Parkash Lal Lund ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Wound Infection ◽  
Port Site ◽  
Site Infection ◽  
College Hospital ◽  
Medical College ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

Objective: To compare the frequency of port site wound infection following gall bladder removal through umbilical and epigastric port in laparoscopic cholecystectomy. Study Design: Randomized Control Trial. Setting: Surgical Unit 2, Ghulam Muhammad Mahar Medical College, hospital Sukkur. Period: 1st November 2019 to 30th October 2020. Material & Methods: All cases who underwent four port laparoscopic cholecystectomy were enrolled in two groups. All procedures were performed under general anesthesia. As the last event of surgery gall bladder was retrieved in a glove bag through umbilical port in group A and through epigastric port in group B, both under direct camera vision. Wound infection was considered if there was 3 to 5 grade of wound according to Southampton wound grading system (Figure-1) on 5th postoperative day. All demographics and outcome variables were recorded. Results: Age ranged from 20 to 60 years with mean age of 38.875±8.11 years, BMI 29.973±5.12 Kg/m2, duration of surgery 50.656±8.41 mins and Southampton score was 1.044±1.07 in Group A and mean age of 38.560±6.23 years, BMI 27.437±5.04 Kg/m2, duration of surgery 48.920±8.67 mins and Southampton score was 0.856±0.92 in Group B. In group A, 18 (5.7%)patients developed port site wound infection in contrast to 5 (1.6%) patients in group B (P= 0.006). Conclusion: We conclude that epigastric port retrieval of gall bladder following laparoscopic cholecystectomy results in less port site infection.

scholarly journals Review. Anticoagulant Therapy in Sepsis. The Importance of Timing

2017 ◽  
Vol 3 (2) ◽  
pp. 63-69 ◽  
Author(s):  
Ecaterina Scarlatescu ◽  
Dana Tomescu ◽  
Sorin Stefan Arama
Keyword(s):  
Anticoagulant Therapy ◽  
Coagulation Activation ◽  
Proper Selection ◽  
Beneficial Effects ◽  
Patient Heterogeneity ◽  
The Difference ◽  
The Right ◽  
Harmful Effects ◽  
Selection Of Patients ◽  
Selection Of

Abstract Sepsis associated coagulopathy is due to the inflammation-induced activation of coagulation pathways concomitant with dysfunction of anticoagulant and fibrinolytic systems, leading to different degrees of haemostasis dysregulation. This response is initially beneficial, contributing to antimicrobial defence, but when control is lost coagulation activation leads to widespread microvascular thrombosis and subsequent organ failure. Large clinical trials of sepsis-related anticoagulant therapies failed to show survival benefits, but posthoc analysis of databases and several smaller studies showed beneficial effects of anticoagulants in subgroups of patients with early sepsis-induced disseminated intravascular coagulation. A reasonable explanation could be the difference in timing of anticoagulant therapy and patient heterogeneity associated with large trials. Proper selection of patients and adequate timing are required for treatment to be successful. The time when coagulation activation changes from advantageous to detrimental represents the right moment for the administration of coagulation-targeted therapy. In this way, the defence function of the haemostatic system is preserved, and the harmful effects of overwhelming coagulation activation are avoided.

SEGMENT CRACKS AND ALIGNMENT ISSUES FOR TUNNELING CONSTRUCTION

2014 ◽  
Vol 1 (1) ◽  
Author(s):  
Arulampalam Paul Suyanthiran
Keyword(s):  
Tunnel Boring Machine ◽  
Shield Tunnel ◽  
Proper Selection ◽  
Tunnel Boring ◽  
Twin Tunnel ◽  
Shield Tunnelling ◽  
Tunnel Alignment ◽  
Selection Of ◽  
Left Lead

This study describes the causes of shield tunnel segment cracks and alignment issues during shield tunnelling. The study was conducted in Down Town Line 3 (DTL3) contracts 926 and 927 twin tunnel projects in Singapore. It is revealed that these issues arose when Tunnel Boring Machine (TBM) shoving on curve alignment though TBM is designed with articulation, which allows the machines to handle tight curves with ease. The study focused on how construction methodology affects the quality of tunnelling in terms of alignment and segment cracks. It was found that the clearance between the tail shield and tunnel lining was not maintained during mining. As a result, the tail shield exerts stress on the segments and causes cracks. In addition, the tunnel alignment deviated from pre-designed alignment, which directly affects the safety and durability of the shield tunnel. This study concludes that a proper selection of ring type “right lead” or “left lead” and the appropriate key selection, along with the skill of the workers, significantly solve segment cracks and alignment issues.

Cardioversion of Atrial Fibrillation: How Important is a Long Arrhythmia Duration?

1994 ◽  
Vol 39 (3) ◽  
pp. 78-79
Author(s):  
G.Y.H. Lip ◽  
K.J. Hogg
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Successful Outcome ◽  
Proper Selection ◽  
Long Duration ◽  
Selection Of Patients ◽  
Selection Of

A long duration of atrial fibrillation is usually considered as an adverse feature for successful cardioversion of atrial fibrillation and the maintenance of sinus rhythm. This often leads to the exclusion of such patients from being considered for this procedure. We report three patients in whom atrial fibrillation was present for a long duration (one for 2 years, two for 10 years), and successful cardioversion to sinus rhythm was achieved. Proper selection of patients with atrial fibrillation with an understanding of all features predicting a successful outcome will often allow a good result.

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