Psychological influences on wound healing

2019 ◽  
Vol 98 (8) ◽  
pp. 312-314
Keyword(s):  
Wound Healing ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Wound Complications ◽  
State Of Mind ◽  
Life Threatening ◽  
Psychological Influences ◽  
Fear And Anxiety ◽  
Care Costs

Surgical wound complications remain a major cause of morbidity; although usually not life threatening, they reduce the quality of life. They are also associated with excessive health care costs. Wound healing is affected by many factors – wound characteristics, infection, comorbidities and nutritional status of the patient. In addition, though, psychological stress and depression may decrease the inflammatory response required for bacterial clearance and so delay wound healing, as well. Although the patient´s state of mind can be influenced only to a certain extent, we should nevertheless stick to ERAS (Enhanced Recovery After Surgery) guidelines and try to diminish fear and anxiety by providing enough information preoperatively, pay due attention to postoperative analgesia and seek to provide an agreeable environment.

scholarly journals Creation of an Enhanced Recovery After Surgery (ERAS) Guideline for neonatal intestinal surgery patients: a knowledge synthesis and consensus generation approach and protocol study

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e023651 ◽  
Author(s):  
Ashleigh C N Gibb ◽  
Megan A Crosby ◽  
Caraline McDiarmid ◽  
Denisa Urban ◽  
Jennifer Y K Lam ◽  
...  
Keyword(s):  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Rapid Review ◽  
Second Phase ◽  
Intestinal Surgery ◽  
Quality Of Evidence ◽  
Modified Delphi ◽  
Human Ethics ◽  
Eras Protocol

IntroductionEnhanced Recovery After Surgery (ERAS) guidelines integrate evidence-based practices into multimodal care pathways designed to optimise patient recovery following surgery. The objective of this project is to create an ERAS protocol for neonatal abdominal surgery. The protocol will identify and attempt to bridge the gaps between current practices and best evidence. Our study is the first paediatric ERAS protocol endorsed by the International ERAS Society.MethodsA research team consisting of international clinical and family stakeholders as well as methodological experts have iteratively defined the scope of the protocol in addition to individual topic areas. A modified Delphi method was used to reach consensus. The second phase will include a series of knowledge syntheses involving a rapid review coupled with expert opinion. Potential protocol elements supported by synthesised evidence will be identified. The Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) system will be used to determine strength of recommendations and the quality of evidence. The third phase will involve creation of the protocol using a modified RAND/UCLA Appropriateness Method. Group consensus will be used to rate each element in relation to the quality of evidence supporting the recommendation and the appropriateness for guideline inclusion. This protocol will form the basis of a future implementation study.Ethics and disseminationThis study has been registered with the ERAS Society. Human ethics approval (REB 18–0579) is in place to engage patient families within protocol development. This research is to be published in peer-reviewed journals and will form the care standard for neonatal intestinal surgery.

The Application of Enhanced Recovery After Surgery and Negative-Pressure Wound Therapy in The Perioperative Period of Elderly Patients With Colorectal Cancer

2020 ◽  
Author(s):  
Hanrong Liu ◽  
Ping Yang ◽  
Song Han ◽  
Yu Zhang ◽  
Hui-ying Zhu
Keyword(s):  
Colorectal Cancer ◽  
Wound Healing ◽  
Negative Pressure ◽  
Wound Dressing ◽  
Readmission Rate ◽  
Negative Pressure Wound Therapy ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Perioperative Period ◽  
Wound Therapy

Abstract Objective: To Explore the perioperative application of enhanced recovery after surgery (ERAS) and negative-pressure wound therapy in the elderly patients with colorectal cancer. Methods: A retrospective clinical data were studied in the patients with colorectal cancer in Department of General Surgery in Shanghai Forth People,s Hospital (from March, 2017 to March, 2019), One hundred and fifty patients with undergoing radical surgery for colorectal cancer were divided into two groups: ERAS group(n=76 cases, accepting ERAS management) and Conventional treatment(CT) group(n=74 cases, accepting traditional treatment),Bleeding in operation, the time of postoperative anal flatus ,number of wound dressing changing, time of wound healing, the length of postoperative hospital stay, readmission rate, postoperative complication, were compared between the two groups. Results: ERAS was associated with less bleeding in operation, less Wound fat liquefaction, less wound dressing changing, less time of wound healing，less time of postoperative anal flatus compare to CT group（P<0.05）; anastomotic fistula、readmission rate is similar in two groups（P>0.05）. Conclusion: The modified ERAS can be safely applied to the perioperative period of elderly colorectal cancer patients and promote recovery; negative-pressure wound therapy is helpful for wound healing and promoting rehabilitation.

scholarly journals Safety of early discharge with a chest tube after pulmonary segmentectomy

2020 ◽  
Vol 58 (3) ◽  
pp. 613-618
Author(s):  
Feichao Bao ◽  
Natasha Toleska Dimitrovska ◽  
Shoujun Hu ◽  
Xiao Chu ◽  
Wentao Li
Keyword(s):  
Chest Tube ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Early Discharge ◽  
Air Leak ◽  
Tube Removal ◽  
Prolonged Air Leak ◽  
Life Threatening ◽  
Chest Tube Removal ◽  
Hospital Days

Abstract OBJECTIVES Early removal of chest tube is an important step in enhanced recovery after surgery protocols. However, after pulmonary resection with a wide dissection plane, such as pulmonary segmentectomy, prolonged air leak, a large volume of pleural drainage and the risk of developing empyema in patients can delay chest tube removal and result in a low rate of completion of the enhanced recovery after surgery protocol. In this study, we aimed to assess the safety of discharging patients with a chest tube after pulmonary segmentectomy. METHODS We retrospectively reviewed a single surgeon’s experience of pulmonary segmentectomy from May 2019 to September 2019. Patients who fulfilled the criteria for discharging with a chest tube were discharged and provided written instructions. They returned for chest tube removal after satisfactory resolution of air leak or fluid drainage. RESULTS In total, 126 patients underwent pulmonary segmentectomy. Ninety-five (75%) patients were discharged with a chest tube postoperatively. The mean time to chest tube removal after discharge was 5.6 (range 2–32) days, potentially saving 532 inpatient hospital days. Overall, 90 (95%) patients experienced uneventful and successful outpatient chest tube management. No life-threatening complications were observed. No patient experienced complications resulting from chest tube malfunction. Five (5%) patients experienced minor complications. Overall, all patients reported good-to-excellent mobility with a chest tube. CONCLUSIONS Successful postoperative outpatient chest tube management after pulmonary segmentectomy can be accomplished in selected patients without a major increase in morbidity or mortality.

scholarly journals Effectiveness and Safety of Preoperative Oral Carbohydrates in Enhanced Recovery after Surgery Protocols for Patients with Diabetes Mellitus: A Systematic Review

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Li-Na Ge ◽  
Lin Wang ◽  
Feng Wang
Keyword(s):  
Diabetes Mellitus ◽  
Randomized Controlled Trials ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Biomedical Literature ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Patients With Diabetes

To evaluate the necessity and safety of preoperative oral carbohydrates in enhanced recovery after surgery (ERAS) protocols for diabetes mellitus patients. We searched PubMed, EMBASE, the Cochrane Library, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, and WANFANG databases for articles published through September 2018. We used the Cochrane risk-of-bias tool to assess the methodological quality of included studies. Literature screening, data extraction, and quality evaluation were performed independently by two investigators. Of the 6328 retrieved articles, five eligible randomized controlled trials were included. Two were from China and three were from Germany, Sweden, and Canada. Preoperative oral carbohydrates may facilitate control of preoperative blood glucose, improve postoperative insulin resistance in diabetes patients, and decrease the occurrence of adverse reactions. However, the overall quality of the included studies was low. The available evidence shows that preoperative oral carbohydrates are probably beneficial for patients with diabetes mellitus. High-quality, large randomized controlled trials are needed to verify our findings and provide quantitative results.

scholarly journals Smartband use during enhanced recovery after surgery facilitates inpatient recuperation following minimally invasive colorectal surgery

2020 ◽  
Author(s):  
Tzu-Chieh Yin ◽  
Ching-Wen Huang ◽  
Hsiang-Lin Tsai ◽  
Wei-Chih Su ◽  
Cheng-Jen Ma ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Minimally Invasive ◽  
Perioperative Care ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Early Mobilization ◽  
Quality Of Recovery ◽  
Hospital Stays ◽  
Minimally Invasive Colorectal Surgery

Abstract Background Enhanced recovery after surgery (ERAS) is valuable in perioperative care for its ability to improve short-term surgical outcomes and facilitate patient recuperation after major surgery. Early postoperative mobilization is a vital component of the integrated care pathway and is a factor strongly associated with successful outcomes. However, early mobilization still has various definitions and lacks specific strategies. Methods Patients who underwent minimally invasive surgery for colorectal cancer followed our perioperative ERAS program, including mobilization from the first postoperative day. After perioperative care skills were improved in our well-established program, compliance, inpatient surgical outcomes, and complications associated with adding smartband use were evaluated and compared with the outcomes for standard protocol. Quality of recovery was evaluated using patient-rated QoR-40 questionnaires the day before surgery, on postoperative day 1 and 3, and on the day of discharge. Results Smartband use after minimally invasive colorectal surgery failed to increase compliance with early mobilization or reduce the occurrence of postoperative complications significantly compared with standard ERAS protocol. However, when smartbands were utilized, quality of recovery was optimized and patients returned to their preoperative status earlier, at postoperative day 3. The duration of theoretical hospital stays and hospital stays of uncomplicated patients wearing smartbands was also reduced by 1.1 and 0.9 days, respectively ( P = 0.0091 and 0.049). Conclusions Smartbands enable enhanced communication between patients and surgical teams and strengthen self-management in patients undergoing minimally invasive colorectal resection surgery. Accelerated recovery to preoperative functional status can be facilitated by integrating smartbands into the process of early mobilization during ERAS.

scholarly journals The application of enhanced recovery after surgery and negative-pressure wound therapy in the perioperative period of elderly patients with colorectal cancer

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Han-rong Liu ◽  
Ping Yang ◽  
Song Han ◽  
Yu Zhang ◽  
Hui-yin Zhu
Keyword(s):  
Colorectal Cancer ◽  
Wound Healing ◽  
Negative Pressure ◽  
Wound Dressing ◽  
Readmission Rate ◽  
Negative Pressure Wound Therapy ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Perioperative Period ◽  
Wound Therapy

Abstract Objective To Explore the perioperative application of enhanced recovery after surgery (ERAS) and negative-pressure wound therapy in the elderly patients with colorectal cancer. Methods A retrospective clinical data were studied in the patients with colorectal cancer in Department of General Surgery in Shanghai Fourth People,s Hospital (from March, 2017 to March, 2019), One hundred and fifty patients with undergoing radical surgery for colorectal cancer were divided into two groups: ERAS group (n = 76 cases, accepting ERAS management) and Conventional treatment(CT) group (n = 74 cases, accepting traditional treatment), Bleeding in operation, the time of postoperative anal flatus, number of wound dressing changing, time of wound healing, the length of postoperative hospital stay, readmission rate, postoperative complication, were compared between the two groups. Results ERAS was associated with less bleeding in operation, less Wound fat liquefaction, less wound dressing changing, less time of wound healing, less time of postoperative anal flatus compare to CT group (P < 0.05); anastomotic fistula, readmission rate is similar in two groups (P > 0.05). Conclusion The modified ERAS can be safely applied to the perioperative period of elderly colorectal cancer patients and promote recovery; negative-pressure wound therapy is helpful for wound healing and promoting rehabilitation.

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