The British journal of surgery
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Surgical-site infection (SSI) occurs in 1-10 per cent of all patients undergoing surgery; rates can be higher depending on the type of surgery. The aim of this review was to establish whether (or not) surgical hand asepsis, intraoperative skin antisepsis and selected surgical dressings are cost-effective in SSI prevention, and to examine the quality of reporting. ⋯ With few economic studies undertaken in this area, the cost-effectiveness of these strategies is unclear. Incorporating economic evaluations alongside RCTs will help towards evidence-informed decisions.
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Biofilms are ubiquitous, and have been observed in both acute and chronic wounds. Their role in wound healing and infection, however, remains controversial. The aim of this review was to provide an overview of the role and relevance of biofilms to surgical wounds. ⋯ Biofilms in acute surgical and chronic wounds appear to cause a delay in healing and potentially increase the risk of infection. Biofilms can be prevented and once developed can be controlled using wound desloughing and debridement.
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Patterns of recurrence after surgery with postoperative chemoradiotherapy (S-CCRT) or surgery alone in patients with oesophageal squamous cell carcinoma (SCC) may differ. This might influence the nature and timing of subsequent management strategies. ⋯ Oesophagectomy with postoperative chemoradiotherapy was associated with longer survival and lower recurrence rates, especially at a locoregional level, compared with surgery alone.
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Observational Study
ECSPECT prospective multicentre registry for single-port laparoscopic colorectal procedures.
The international multicentre registry ECSPECT (European Consensus of Single Port Expertise in Colorectal Treatment) was established to evaluate the general feasibility and safety of single-port colorectal surgery with regard to preoperative risk assessment. ⋯ The feasibility and safety, conversion and complication profile demonstrated here provides guidance for patient selection.
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The treatment of end-stage lymphoedema of the leg is challenging, especially when conservative treatment fails and there is a large volume difference between the affected and unaffected legs. Circumferential suction-assisted lipectomy (CSAL) has been described as a treatment option for end-stage lymphoedema of the leg. Here, the long-term results of CSAL in end-stage primary and secondary lymphoedema of the leg were analysed. ⋯ CSAL is an effective method for treating both primary and secondary lymphoedema of the leg.