International journal of surgery
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Comparative Study
Hemostatic efficacy of a novel, PEG-coated collagen pad in clinically relevant animal models.
Currently available hemostatic pads are effective in treating oozing bleeds, but otherwise ineffective in more severe bleeding. This study investigates the hemostatic efficacy of a new hemostatic pad with advanced sealing properties using protein-reactive polyethylene glycol-coated collagen (PCC, Hemopatch) versus an oxidized regenerated cellulose (ORC, Tabotamp/Surgicel Original) in a leporine arterial bleeding model of vascular reconstruction and a porcine hepatic model of general surgery. ⋯ PCC provided faster hemostasis than ORC in a vascular and hepatic surgical model with impaired coagulation.
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Effects of vitamin E and pyrroloquinoline quinone on peripheral nerve regeneration were studied using a rat sciatic nerve transection model. Ninety male healthy White Wistar rats were divided into three experimental groups (n = 15), randomly: Sham-operation (SHAM), transected control (TC), chitosan conduit (Chit) and three treatment groups (Vit E, PQQ and PQQ + Vit E). In SHAM group after anesthesia, left sciatic nerve was exposed through a gluteal muscle incision and after homeostasis muscle was sutured. ⋯ Morphometric indices of regenerated fibers showed number and diameter of the myelinated fibers in PQQ + Vit E was significantly higher than in other treatment groups. In immunohistochemistry, location of reactions to S-100 in PQQ + Vit E was clearly more positive than in other treatment groups. Response to PQQ + Vit E treatment demonstrates that it influences and improves functional recovery of peripheral nerve regeneration.
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Sometimes even in adequate graft to recipient weight ratio (GRWR) settings and after ruling out all other causes, recipients still show features of the small for size syndrome. The purpose of this study was to evaluate all causative factors responsible for early graft dysfunction fulfilling the definition of the small for size syndrome, regardless of the GRWR status, and with particular emphasis on portal flow (ml/min/100 g). We also tried to establish whether a high portal flow on intraoperative Doppler study immediately after reperfusion can predict graft dysfunction. ⋯ A portal vein flow immediately after reperfusion >190/ml/min/100 g. reliably predicted whether a graft would behave as small for size or not, regardless of the GRWR status. Portal vein flow was the most significant predictor of graft dysfunction.
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Oesophageal resection is notoriously complicated and produces a cohort of patients prone to postoperative complications. Maintaining quality care demands a systematic approach to patient management yet postoperative recovery after oesophagectomy is often needlessly inefficient, heterogeneous and governed by the idiosyncrasies of the operating surgeon. Enhanced recovery after surgery (ERAS) programmes are now well established in colorectal surgery and here we describe the implementation and effectiveness of an ERAS programme for the postoperative management of Ivor Lewis oesophago-gastrectomy (ILOG). ⋯ The introduction of an ERAS programme after ILOG can significantly reduce TLOS without jeopardising patient safety or clinical outcomes. The successful introduction of an ERAS programme requires full motivation and support from all team members including the patient.
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Intestinal obstruction is an abdominal disease associated to mortality, especially if complicated with sepsis. Resuscitation increases survival, although controversies remain concerning to therapeutic strategy. ⋯ Hypertonic saline and pentoxifylline, both alone and in combination, attenuated oxidative stress and the activation of NF-κB, leading to a decrease in the inflammatory response.