International journal of surgery
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The enhanced recovery program for perioperative care of the surgical patient reduces postoperative metabolic response and organ dysfunction, accelerating functional recovery. The aim of this study was to determine the impact on postoperative recovery and cost-effectiveness of implementing a colorectal enhanced recovery program in an Italian academic centre. ⋯ Implementing a colorectal enhanced recovery program is feasible, efficient for functional recovery and hospital stay reduction, safe, and cost-effective. High patient satisfaction and nursing workload reduction may also be expected, but high protocol adherence is necessary.
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Review Meta Analysis
Platelet rich plasma versus hyaluronic acid in patients with hip osteoarthritis: A meta-analysis of randomized controlled trials.
This study aims to compare the efficacy of intra-articular injection of hyaluronic acid (HA) and platelet-rich plasma (PRP) for treating hip osteoarthritis (OA). ⋯ Intra-articular injection of PRP was associated with a significant reduction of VAS at 2 months. Both of them showed comparable results in terms of functional recovery. Further studies were still necessary.
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Anastomotic leakage, fibrous stricture and gastro-oesophageal reflux are three major complications of gastro-oesophageal anastomosis, particularly in cervical anastomosis. Our aim was to evaluate the safety and efficacy of a novel cervical anastomosis technique (NA) by comparing it to traditional side-to-side anastomosis (SS) and end-to-side anastomosis using a circular stapler (CS) in terms of postoperative leakage, stricture and reflux. ⋯ Jiang's anastomosis technique remarkably reduces the incidence of gastro-oesophageal anastomotic leakage, stricture and reflux, and it is a safe and effective technique for minimally invasive oesophagectomy.
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Review Meta Analysis Comparative Study
Negative pressure wound therapy versus conventional wound dressings in treatment of open fractures: A systematic review and meta-analysis.
Though several systematic reviews concerned have been published, controversy still exists. The current systematic review was designed to clarify the detailed advantages and disadvantages of the negative pressure wound therapy (NPWT) in treatment of open fractures in comparison with the conventional wound dressings. ⋯ NPWT can significantly reduce the risk of infection in treatment of open fractures and accelerate their wound healing process. Some but not much evidence suggests that NPWT may possibly help reduce the severity of the limb injury and therefore provide a chance for the limb to avoid amputation. Use of NPWT in the flap area is probably safe, but should be carried out with caution. The advantage of NPWT over the conventional wound dressings still requires to be confirmed in the other aspects.
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Review Comparative Study
Absorbable versus non-absorbable tacks for mesh fixation in laparoscopic ventral hernia repair: A systematic review and meta-analysis.
To investigate the outcomes of absorbable versus non-absorbable tacks in patients undergoing laparoscopic ventral hernia repair. ⋯ We found no difference in clinical outcomes between absorbable and non-absorbable tacks for mesh fixation in patients undergoing laparoscopic ventral hernia repair. The quality of the available evidence is moderate with a possibility of type 2 error. High quality RCTs with adequate statistical power are required to provide more robust basis for definite conclusions. Considering the similarity of both techniques in terms of clinical outcomes, the cost-effectiveness of each technique would be an important outcome determining which technique should be used; this needs to be considered as an outcome of interest in future studies.