Full-scale Test on Emergency Repair Pavement under Airplane Loading

In order to reveal structural response law of emergency repair pavement under the airplane loading and verify the backfill material and structural applicability, two craters (Crater 1 composed of 2.4 m thick flying objects (FO) + 0.4 m thick graded crushed rocks (GCR) + 0.2 m thick roller compacted concrete + fibre reinforced plastic (FRP) course, and Crater 2 composed of 2.4 m thick FO + 0.6 m thick GCR + FRP course) were backfilled. Static and dynamic loads were applied using two airplanes. Results show that, laying FRP pavement layers reduced the maximum deflection of Crater 2 by 21%. Crater 1 and concrete pavement were both slightly rigid structures with a strong load transfer ability. The dynamic deflection basin curves of Crater 2 could be fit using a Gaussian function; while the curves of Crater 1 and concrete pavement could be fit using a quartic polynomial. Under static loading, the earth pressures of Crater 2 at −0.6 m, −0.4 m, and −0.2 m sites were 4.3, 9, and 9.6 times of those of Crater 1, respectively. At the −0.2 m site, the earth pressure of Crater 1 was 0.11 MPa, while that of Crater 2 reached 1.06 MPa. The research results can guide the rapid quality inspection and optimization design of emergency repair pavement structure and material.

O25 MORTALITY AFTER EMERGENCY VERSUS ELECTIVE GROIN HERNIA REPAIR: A SYSTEMATIC REVIEW AND META-ANALYSIS

Aim This systematic review and meta-analysis aimed to investigate 30- and 90-day postoperative mortality in patients undergoing emergency or elective groin hernia repair. Material and Methods This review is reported after the PRISMA 2020 guidelines. A protocol (CRD42021244412) was registered to PROSPERO. Three databases (PubMed, EMBASE, and Cochrane CENTRAL) were searched in April 2021. The identified studies were screened for eligibility and included if they reported 30- and/or 90-day mortality following emergency or elective groin hernia repair. Meta-analyses were conducted when possible, and a subgroup analysis on patients undergoing bowel resection was made. Results We included 37 studies with a total of 30,740 patients receiving emergency repair and 457,253 receiving elective repair. Meta-analyses could not be conducted for the two repair settings separately due to heterogeneity. However, the 30-day mortality ranged from 0.0–1.7% following elective repair and 0.0–11.8% following emergency repair. The risk of 30-day mortality following emergency repair was estimated to be 26-fold higher than after elective repair. A subgroup meta-analysis on bowel resection in emergency repair estimated 30-day mortality to be 7.9%. Conclusions Emergency groin hernia remains a challenging and potentially fatal surgical emergency. This review emphasizes the importance of performing hernia repair in an elective setting to prevent a potential acute presentation with acute surgical intervention. Patients presenting with symptoms of emergency groin hernias should receive particular attention to minimize the high risk of mortality and morbidity following emergency repair.

Mesh hernioplasty in emergency repair of traumatic abdominal wall hernia following bull horn injury

Traumatic abdominal wall hernia (TAWH) is uncommon, mostly following motor vehicle accidents, fall from height and bullfighting. Bullhorn injury, common in rural areas, presents as either penetrating injuries to the abdomen or blunt injuries leading to internal organs injury. Rarely the bull horn injury may lead to TAWH. We report a 70-year-old female from a rural area who suffered bull horn injury to the abdomen leading to TAWH without penetrating the horn and was managed in the emergency by an open mesh hernioplasty. We suture closed the 10×5 cm size defect and reinforced it with a polypropylene mesh of 15×15 cm in the emergency setting. The patient recovered well without any complications or recurrence and doing well at 1 year of follow-up. Mesh hernioplasty can be considered a feasible and safe option in the emergency repair of traumatic abdominal hernia following bull horn injury.