Surgery Research and Practice最新文献

{"title":"Antiplatelet Resistance in Coronary Artery Bypass Grafting: A Systematic Review.","authors":"Myat Soe Thet, Amir Khosravi, Samson Egbulonu, Aung Ye Oo","doi":"10.1155/2024/1807241","DOIUrl":"10.1155/2024/1807241","url":null,"abstract":"<p><strong>Background: </strong>This systematic review examines the occurrence and implications of resistance to primary antiplatelet agents, aspirin and clopidogrel, often utilised in patients undergoing coronary artery bypass grafting (CABG), alongside the methodologies for assessment of such resistance.</p><p><strong>Methods: </strong>An extensive literature search across various databases such as PubMed, MEDLINE via Ovid, Embase, and Cochrane CENTRAL until May 2024 was conducted to identify studies evaluating antiplatelet resistance in on-pump and off-pump CABG patients. Following quality assessment, only high-quality studies were incorporated into this review.</p><p><strong>Results: </strong>This review included 19 studies with 3,915 patients, four of which were randomised controlled trials and 15 were observational studies. Aspirin resistance incidence ranged from 11.0% to 51.5%, while clopidogrel resistance was 22%. Antiplatelet resistance, assessed through a wide variety of methods, was associated with a 13 times increase in the risk of vein graft occlusion and increased rates of mortality, myocardial infarction, and target vessel revascularisation in the case of clopidogrel resistance. The effect of cardiopulmonary bypass on antiplatelet resistance remains ambiguous.</p><p><strong>Conclusion: </strong>The academic literature lacks a standardised definition for antiplatelet resistance. Assessment methodologies greatly vary, leading to noninterchangeable outcomes. While aspirin resistance has a conflicting overall significant impact on adverse outcomes, clopidogrel resistance correlates with poorer clinical outcomes.</p>","PeriodicalId":30584,"journal":{"name":"Surgery Research and Practice","volume":"2024 ","pages":"1807241"},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11193597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Significance of Scapular Fracture Existence in Blunt Chest Trauma: A Retrospective Cohort Study","authors":"Ashraf F. Hefny, Nirmin A. Mansour, Mohamed Ahmed Hefny, Emad Masuadi, Shadi al Bahri, Ashraf A. Elkamhawy, Khalid S. Saber","doi":"10.1155/2024/3550087","DOIUrl":"https://doi.org/10.1155/2024/3550087","url":null,"abstract":"Background. Scapular fracture is a rare encounter in blunt trauma patients. The scapula is surrounded by strong groups of muscles offering good protection for the bone. Therefore, a high-energy trauma is needed to cause a scapular fracture. We aim to study scapular fractures and their relation to injury severity and mortality in blunt chest trauma (BCT) patients. Methods. We retrospectively collected data from all patients with BCT who were admitted to our hospital from December 2014 through January 2017. The injury details of all BCT patients were retrieved from the trauma registry of the hospital and were supplemented by patients’ electronic files for missing information. Collected data included demography, mechanism of injury, vital signs, Glasgow Coma Score (GCS) on admission, injured body regions, management, Injury Severity Score (ISS), New Injury Severity Score (NISS), length of hospital stay (LOS), and mortality. Results. During the study period, 669 patients had BCT. Scapular fracture was present in 29 (4.3%) of the BCT patients. The scapular fracture was missed by chest X-ray in 35.7% of the patients; however, it was accurately diagnosed by computed tomography (CT) scan of the chest. Neck injury was significantly higher in patients with scapular fracture compared with patients without fracture (p<0.001). ISS and NISS were significantly higher in patients with scapular fractures compared to other patients without fractures (p=0.04 and p=0.003 Mann–Whitney U test, respectively). Two patients with scapular fractures died due to severe associated injuries (the overall mortality was 9.6%). Conclusions. Scapular fracture in BCT patients indicates a high-energy type of trauma. Compared to a chest X-ray, CT scan was more accurate for the diagnosis of scapular fracture. Associated injuries are the main cause of trauma-related mortality rather than the direct effect of the fractured scapula. Particular attention and meticulous evaluation should be paid to head and neck injuries to avoid missing injuries.","PeriodicalId":30584,"journal":{"name":"Surgery Research and Practice","volume":"42 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141121986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Porous Cage Macro-Topography Improves Early Fusion Rates in Anterior Cervical Discectomy and Fusion.","authors":"Gregory M Malham, Dean T Biddau, Jordan P Laggoune, Charlie R Faulks, William R Walsh, Yi Yuen Wang","doi":"10.1155/2024/8452050","DOIUrl":"10.1155/2024/8452050","url":null,"abstract":"<p><strong>Objectives: </strong>Anterior cervical discectomy and fusion (ACDF) aims to improve pain, relieve neural compression, achieve rapid solid bony arthrodesis, and restore cervical alignment. Bony fusion occurs as early as 3 months and up to 24 months after ACDF. The correlations between bony fusion and clinical outcomes after ACDF remain unclear. Macro-topographic and porous features have been introduced to interbody cage technology, aiming to improve the strength of the bone-implant interface to promote early fusion. In this study, we aimed to compare clinical outcomes and CT-evaluated fusion rates in patients undergoing ACDF using one of two different interbody cages: traditional NanoMetalene™ (NM) cages and NM cages with machined porous features (NMRT).</p><p><strong>Methods: </strong>This was a prospective, observational, nonrandomised, cohort study of consecutive patients undergoing ACDF. The NM cage cohort was enrolled first, then the NMRT cohort second. The visual analogue scale, neck disability index, and 12-item Short Form Survey scores were evaluated preoperatively and at 6 weeks, 3 months, and 6 months. The minimum clinical follow-up period was 12 months. Plain radiographs were obtained on postoperative day 2 to assess instrumentation positioning, and computed tomography (CT) was performed at 3 and 6 months postoperatively to assess interbody fusion (Bridwell grade).</p><p><strong>Results: </strong>Eighty-nine (52% male) patients with a mean age of 62 ± 10.5 years were included in this study. Forty-one patients received NM cages, and 48 received NMRT cages. All clinical outcomes improved significantly from baseline to 6 months. By 3 months, the NMRT group had significantly higher CT fusion rates than the NM group (79% vs 56%, <i>p</i>=0.02). By 6 months, there were no significant differences in fusion rates between the NMRT and NM groups (83% vs 78%, <i>p</i>=0.69). The mean Bridwell grade at 6 months was 1.4 ± 0.7 in the NMRT group and 1.8 ± 1.0 in the NM group (<i>p</i>=0.08).</p><p><strong>Conclusions: </strong>With both NM and NMRT cages, serial improvements in postoperative clinical outcomes were associated with fusion progression on CT. NMRT cages demonstrated significantly better fusion at 3 months and a trend toward higher quality of fusion at 6 months compared with NM cages, suggesting earlier cage integration with NMRT. An early 3-month postoperative CT is adequate for fusion assessment in almost 80% of patients undergoing ACDF with an NMRT cage, permitting an earlier return to activity.</p>","PeriodicalId":30584,"journal":{"name":"Surgery Research and Practice","volume":"2024 ","pages":"8452050"},"PeriodicalIF":0.0,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10957252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140207737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Short-Term Weight Loss on Hemostasis and Thrombosis after Bariatric Surgery","authors":"Ahmed Taha, Hasan Eroğlu, İskender Eren Demirbaş, Berkay Demir, Evren Dilektaşli","doi":"10.1155/2023/1729167","DOIUrl":"https://doi.org/10.1155/2023/1729167","url":null,"abstract":"Introduction. Obesity causes thrombophilia and many coagulation problems related to slowing the capillary flow. We aimed to evaluate rapid weight loss outcomes in the early period after bariatric surgery on the coagulation system. Materials and Method. A prospective study enrolled 28 patients with a BMI > 40 kg/m2 who underwent bariatric surgery. Preoperative and postoperative (first and third months) demographic criteria—such as age, gender, weight, height, and alcohol and tobacco use, and biochemical parameters such as PLT, PT, aPTT, INR, bleeding time, coagulation time, fibrinogen, D-dimer, albumin, calcium, ionized calcium, vitamin D, and PTH—were analyzed. Results. We found that both bleeding and thrombotic parameters increase in early-slowing surgery. The first-month platelet levels were significantly different from the preoperative values ( <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M1\"> <mi>p</mi> </math> < 0.001). The prothrombin time in the first ( <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M2\"> <mi>p</mi> </math> < 0.001) and third months ( <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M3\"> <mi>p</mi> </math> < 0.009) was also comparable. The PTT in the first month was higher than in the preoperative period ( <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M4\"> <mi>p</mi> </math> < 0.011). INR in the first month ( <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M5\"> <mi>p</mi> </math> < 0.001) was higher than that in the preoperative period and the third month ( <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M6\"> <mi>p</mi> </math> = 0.007) value was higher than in the first month. In terms of fibrinogen levels, all parameters indicated statistical significance within each other; preoperative to the first month ( <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M7\"> <mi>p</mi> </math> < 0.001), the first month to the third month ( <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M8\"> <mi>p</mi> </math> < 0.016). Third-month D-dimer levels were lower than the first month’s values ( <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M9\"> <mi>p</mi> </math> = 0.032). Conclusion. Thromboembolic events have crucial importance in the converse scenario of haemorrhagic diathesis during the first months of bariatric surgery. Vitamin support and antithrombotic agents may be recommended in the early postoperative period.","PeriodicalId":30584,"journal":{"name":"Surgery Research and Practice","volume":"67 43","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136281860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standardized Protocol for Chest Tube Management for Trauma Patients Significantly Decreases Complications.","authors":"Christopher A Dai,&nbsp;Christopher J Fang,&nbsp;David Schwartz,&nbsp;Jessica Enderson,&nbsp;Ashley McMann,&nbsp;Russel Hyde,&nbsp;Nathan Smith,&nbsp;Jennifer Serfin","doi":"10.1155/2023/2615557","DOIUrl":"https://doi.org/10.1155/2023/2615557","url":null,"abstract":"<p><strong>Background: </strong>As health care shifts to a value-based model with a focus on patient outcomes per dollar spent, it is important to develop and evaluate standardized protocols that ultimately lead to improved patient outcomes and decreased hospital complications. Prior to our chest tube protocol, chest tube management at our Trauma Center was nonuniform and surgeon-specific. The aim of this study was to (1) develop an institutional standardized protocol for chest tube management at our Level II Trauma Center and (2) compare patient outcomes before and after the implementation of our protocol.</p><p><strong>Methods: </strong>An institutional, standardized protocol was initiated at our Level II-Certified Trauma Center teaching hospital in 2014. An IRB-approved, single-institution retrospective chart review was performed between January 2011 and May 2017, in order to capture the 3 years prior and 3 years after protocol implementation. All patients with a diagnosis of hemothorax or pneumothorax (H/PTX) from blunt or penetrating trauma that resulted in a >24 French chest tube placement were included in the study. Patients were excluded if interventional radiology (IR) placed the chest tube, the mechanism was nontraumatic, or the patient expired at index hospitalization. Univariate analyses were performed to evaluate significant differences in patient outcomes before and after the implementation of the protocol.</p><p><strong>Results: </strong>A total of 143 patients were analyzed for this study, with 43 preprotocol patients and 100 postprotocol patients. Hospital length of stay (LOS), persistent H/PTX, and the need for further surgical intervention all improved after the implementation of the standardized protocol (<i>p</i> < 0.04).</p><p><strong>Conclusions: </strong>Our standardized protocol for chest tube management at our Level II Trauma Center significantly improved patient outcomes and can serve as a model for similar institutions.</p>","PeriodicalId":30584,"journal":{"name":"Surgery Research and Practice","volume":"2023 ","pages":"2615557"},"PeriodicalIF":0.0,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10539096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41172911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Efficient Are Isolation Protocols? Outcome of Isolation Protocol in Surgery during COVID-19 Pandemic: A Single Institute Experience.","authors":"Rohan Chandra R Gatty,&nbsp;Alphonsa Mary Job,&nbsp;Dinesh Shet","doi":"10.1155/2023/5774071","DOIUrl":"https://doi.org/10.1155/2023/5774071","url":null,"abstract":"<p><strong>Background: </strong>The timing of screening for SARS-CoV-2 preoperatively by RT-PCR/CBNAAT, isolation protocols in preoperative wards, operation theatres, and postoperative wards are not well established.</p><p><strong>Methods: </strong>Evaluating the effectiveness of maintaining three pathways of two COVID-19 negative pathways (1) immediate testing pathway (2) isolation, or quarantine for five days and testing prior to surgery pathway, and (3) the tested COVID-19-positive pathway, was the aim of the study. The primary objective was to assess the utility and outcome of the two COVID-19 negative pathways adopted before surgery in terms of infectivity (seroconversion; COVID-19 positivity rate before surgery and symptomatic COVID-19 disease after surgery). The secondary objective was to derive a practical protocol for isolation or quarantine for emergency and elective surgery. Enrolled patients were grouped based on the need for surgery; Group-1 emergency basis, Group-2 urgent basis, and Group-3 COVID-19 positive and the three channels were kept separate with separate dedicated healthcare staff for each channel.</p><p><strong>Results: </strong>There were 199 (4.56%) COVID-19-positive patients, of whom 80 (40%) were operated. COVID-19 positivity rate was low in Group 2 (3% vs. Group 1, 11%). There was no seroconversion from negative to positive in our patients during the peri-operative period.</p><p><strong>Conclusion: </strong>COVID-19 positivity rate in Group-2 was significantly less. None of the COVID-19-negative patients turned symptomatic and the probability of seroconversion from COVID-19-negative was less during the peri-operative period. The isolation protocol of non-COVID-19 positive patients with the separate channel is effective.</p>","PeriodicalId":30584,"journal":{"name":"Surgery Research and Practice","volume":"2023 ","pages":"5774071"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10081896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9336673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Blunt Sternal Fractures in a Community-Based Hospital.","authors":"Fathima T Kunhivalappil,&nbsp;Taleb M Almansoori,&nbsp;Muhamed Salim AbdulRahman,&nbsp;Mohamed A Hefny,&nbsp;Nirmin A Mansour,&nbsp;Taoufik Zoubeidi,&nbsp;Moien A B Khan,&nbsp;Ashraf F Hefny","doi":"10.1155/2023/8896989","DOIUrl":"https://doi.org/10.1155/2023/8896989","url":null,"abstract":"<p><strong>Background: </strong>Sternal fractures are not commonly observed in patients with blunt trauma. The routine use of computed tomography (CT) in the evaluation of chest trauma helps identify these fractures. We studied the incidence, injury mechanism, management, and outcome of sternal fractures in patients with blunt trauma treated at our community-based hospital.</p><p><strong>Methods: </strong>We retrospectively reviewed the chest CT scans of all patients with blunt trauma who were presented to our community-based hospital from October 2010 to March 2019. The study variables included age at the time of injury, sex, mechanism of injury, type, and site of fracture, associated injuries, Glasgow Coma Scale, Injury Severity Score, need for intensive care unit admission, hospital stay, and long-term outcome.</p><p><strong>Results: </strong>In total, 5632 patients with blunt trauma presented to our hospital during the study period, and chest CT scan was performed for 2578 patients. Sternal fractures were diagnosed in 63 patients. The primary mechanism of injury was a motor vehicle collision. The most common site of fracture was the body of the sternum (47 patients; 74.6%). Twenty (31.7%) patients had an isolated sternal fracture with no other injuries. Seven (11.1%) patients were discharged directly from the emergency department. Two patients died (overall mortality rate, 3.2%) and two experienced long-term disability.</p><p><strong>Conclusions: </strong>The incidence of sternal fractures in our patient population was similar to that reported by tertiary hospitals. Patients with a sternal fracture and normal cardiac enzyme levels and electrocardiogram may be safely discharged from the emergency department, provided there are no other major injuries.</p>","PeriodicalId":30584,"journal":{"name":"Surgery Research and Practice","volume":"2023 ","pages":"8896989"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10027460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9518608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short Term Outcomes of Open and Minimally Invasive Approaches to Segmental Colectomy for Benign Colovesical Fistula.","authors":"Zhobin Yeganeh,&nbsp;Dustin Hau Huynh,&nbsp;Anthony Paul Kopatsis,&nbsp;Anthony Kopatsis","doi":"10.1155/2022/9242813","DOIUrl":"https://doi.org/10.1155/2022/9242813","url":null,"abstract":"<p><strong>Background: </strong>We speculated that a minimally invasive (MIS) colectomy for colovesical fistula is associated with less morbidity compared to an open colectomy.</p><p><strong>Methods: </strong>Multivariate analysis using logistic regression was used to investigate the outcomes of patients who underwent colectomy for benign colovesical fistula during 2012-2017 by surgical approach using the NSQIP database.</p><p><strong>Results: </strong>We identified 748 patients underwent partial colectomy for benign colovesical fistula during 2012-2017. Surgeons used the MIS approach in 72.7% of operations, with a conversion rate of 13.1%. The MIS approach was associated with lower morbidity (27.4% vs. 43.1%, AOR: 0.46, <i>P</i>=0.02) compared to the open approach. The mean operation duration was longer in MIS operations compared to open (225 min vs. 201 min, <i>P</i> < 0.01). The robotic approach to colectomy showed no significant difference in morbidity (28.4% vs. 27.2%, <i>P</i>=0.77) but a decrease in conversion rate (8.1% vs. 13.8%, <i>P</i> < 0.01) and an increase in operation length (249 min vs. 222 min, mean difference: 27 min, <i>P</i> < 0.01) compared to a laparoscopic approach. There was no significant difference in the anastomotic leak rate between MIS and open approaches (3.7% vs. 5.4%, <i>P</i>=0.14) and between laparoscopic and robotic approaches (2.8% vs. 3.8%, <i>P</i>=0.99).</p><p><strong>Conclusions: </strong>We found a 72.7% utilization rate of MIS approach to colectomy for benign colovesical fistula in the NSQIP hospitals with a 13.6% conversion rate. Patients with MIS approach had significantly lower morbidity compared to open. A robotic approach to partial colectomy has the same morbidity risk with a decreased conversion rate compared to laparoscopic approach.</p>","PeriodicalId":30584,"journal":{"name":"Surgery Research and Practice","volume":"2022 ","pages":"9242813"},"PeriodicalIF":0.0,"publicationDate":"2022-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9712019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35209450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Prophylactic Negative-Pressure Wound Therapy with Delayed Primary Closure for Contaminated Abdominal Wounds.","authors":"Yo Sato,&nbsp;Eiji Sunami,&nbsp;Kenichiro Hirano,&nbsp;Motoko Takahashi,&nbsp;Shin-Ichi Kosugi","doi":"10.1155/2022/6767570","DOIUrl":"https://doi.org/10.1155/2022/6767570","url":null,"abstract":"<p><strong>Background: </strong>Prophylactic negative-pressure wound therapy (NPWT) to prevent surgical site infection (SSI) may be effective for severely contaminated wounds. We investigated the safety and efficacy of NPWT with delayed primary closure (DPC) for preventing SSI.</p><p><strong>Methods: </strong>For patients with contaminated and dirty/infected surgical wounds after an emergency laparotomy, the abdominal fascia was closed with antibacterial absorbent threads and the skin was left open. Negative pressure (-80 mmHg) was applied through the polyurethane foam, which was replaced on postoperative days 3 and 7. DPC was performed when sufficient granulation was observed. The duration and adverse events of NPWT, the development of SSI, and the postoperative hospital stay were retrospectively reviewed.</p><p><strong>Results: </strong>We analyzed the cases of patients with contaminated (<i>n</i> = 15) and dirty/infected wounds (<i>n</i> = 7). The median duration of NPWT was 7 days (range 5-11 days). NPWT was discontinued in one (4.5%) patient due to wound traction pain. SSI developed in seven patients (31.8%), with incisional SSI in one (4.5%) and organ/space SSI in six (27.3%). The median postoperative hospital stay was 17 days (range 7-91 days). There was no significant relationship between postoperative hospital stay and wound classification (<i>P</i>=0.17) or type of SSI (<i>P</i>=0.07).</p><p><strong>Conclusion: </strong>Prophylactic NPWT with DPC was feasible and may be particularly suitable for severely contaminated wounds, with a low incidence of incisional SSI.</p>","PeriodicalId":30584,"journal":{"name":"Surgery Research and Practice","volume":" ","pages":"6767570"},"PeriodicalIF":0.0,"publicationDate":"2022-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9678480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40508483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management Outcome and Factors Associated with Pediatric Surgical Patient Admitted to Arbaminch General Hospital, Southern Ethiopia, 2021: Retrospective Cross-Sectional Study.","authors":"Fikre Moga,&nbsp;Filagot Assefa,&nbsp;Kalkidan Wondwossen,&nbsp;Yeshiwork Berhan","doi":"10.1155/2022/6865874","DOIUrl":"https://doi.org/10.1155/2022/6865874","url":null,"abstract":"<p><strong>Background: </strong>Pediatric surgical situations are often disregarded around the world, particularly in developing countries. The number of children hospitalized for surgical reasons has climbed dramatically. There is extensive research on the management outcome of pediatric surgical admissions in industrialized countries, but developing countries have paid little attention to it. Furthermore, to the best of the authors' knowledge, there has been no research in the study area on the management outcome of pediatric surgical patient admission.</p><p><strong>Objective: </strong>To assess management outcome and factors associated with pediatric surgical patients admitted to Arbaminch General Hospital, Southern Ethiopia, 2021.</p><p><strong>Method: </strong>An institution-based retrospective cross-sectional study design was employed among 265 children with surgical problems. Data were collected from patients' medical records using pretested data collection checklist. Epi Data 4.2 was used to enter data, and data were exported to SPSS version 25 for analysis. Those variables with <i>P</i>-value ≤0.25 in bivariable analysis were entered into multivariable logistic regression analysis, and statistical significance was declared at <i>P</i> < 0.05.</p><p><strong>Result: </strong>A total of 265 surgically admitted children were included in this study. About 26% of study subjects were discharged with unfavorable management outcome. Children admitted due to trauma cause (AOR: 5.753, 95% CI: 2.366-13.987), children with a preexisting medical condition (AOR: 3.240, 95% CI: 1.436-7.310), children with an early complication (AOR: 2.515, 95% CI: 1.130-5.599), presenting to hospital ≥24 hr after the onset (AOR:8.351, 95% CI: 2.089-33.381), hospital stay >7 days (AOR: 10.671, 95% CI: 1.363-83.546), and children treated with surgery (AOR: 2.742, 95% CI: 1.137-6.611) were associated with unfavorable management outcome. <i>Conclusion and recommendations</i>: Twenty-six percent of patients were discharged with unfavorable outcome. Reasons for admission, preexisting medical condition, early complications, duration of hospital presentation, length of hospitalization, and type of management were all linked to the outcome of pediatric surgical admission. To have a good outcome, early identification and treatment of the cause are required, as well as well-equipped surgical care centers.</p>","PeriodicalId":30584,"journal":{"name":"Surgery Research and Practice","volume":" ","pages":"6865874"},"PeriodicalIF":0.0,"publicationDate":"2022-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9436610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40349783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}