Langenbeck's archives of surgery
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Langenbecks Arch Surg · Jan 2015
Management of the open abdomen using vacuum-assisted wound closure and mesh-mediated fascial traction.
The open abdomen has become an accepted treatment option of critically ill patients with severe intra-abdominal conditions. Fascial closure is a particular challenge in patients with peritonitis. This study investigates whether fascial closure rates can be increased in peritonitis patients by using an algorithm that combines vacuum-assisted wound closure and mesh-mediated fascial traction. Moreover, fascial closure rates for patients with peritonitis, trauma or abdominal compartment system (ACS) are compared. ⋯ Regardless of the underlying pathology, high fascial closure rates can be achieved using a combination of vacuum-assisted closure and mesh-mediated fascial traction.
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Langenbecks Arch Surg · Jan 2015
Randomized Controlled TrialSubcutaneous application of gentamicin collagen implants as prophylaxis of surgical site infections in laparoscopic colorectal surgery: a randomized, double-blinded, three-arm trial.
Despite a standardized prophylaxis with antibiotics, surgical site infections (SSI) are a characteristic problem in colorectal surgery. Local administration of gentamicin-collagen sponges (GCS) has been shown to decrease the infection rate after contaminated procedures. So far, the effect has not been tested for standardized laparoscopic colorectal resections. ⋯ The local administration of GCS showed no significant benefit regarding wound infection after standardized laparoscopic colorectal resections. However, there was a trend toward reduced SSI in the GCS group. Therefore, a larger trial or meta-analysis is necessary to validate this result.
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Langenbecks Arch Surg · Jan 2015
Complications after laparotomy for trauma: a retrospective analysis in a level I trauma centre.
Laparotomy is a potential life-saving procedure after traumatic abdominal injury. There is limited literature about morbidity and mortality rates after trauma laparotomy. The primary aim of this study is to describe the complications which may occur due to laparotomy for trauma. ⋯ Laparotomy for trauma has a high complication rate resulting in significant morbidity and mortality. Most events occur in the early postoperative period. Further prospective research needs to be conducted in order to identify possibilities to improve care in the future.
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Langenbecks Arch Surg · Jan 2015
Short- and long term effects of epidural analgesia on morbidity and mortality of esophageal cancer surgery.
Perioperative regional anesthesia with consecutive reduction of intra- and postoperative systemic opioid requirements in order to improve oncological result after cancer surgery has only been addressed by a few reports. This hypothesis has never been proved in esophageal cancer with a long-term follow-up of more than 5 years. Therefore, we addressed the impact on short- and long-term outcomes of epidural analgesia for esophagus cancer surgery. ⋯ The results of our study underline the well-known clinical benefits of epidural analgesia for esophagus surgery. However, we found no evidence that the further oncological outcome is determined or significantly influenced by the presence or absence of epidural analgesia.
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A sliding inguinal hernia is defined as a hernia where part of the hernial sac wall is formed by an organ, e.g., the colon or bladder. Thus, repair of a sliding inguinal hernia may have higher risk of complications and recurrence compared with non-sliding inguinal hernia. The aim of this study was to investigate the incidence and reoperation rates following sliding inguinal hernia repair. ⋯ The incidence of sliding inguinal hernia is higher in males than in females, and sliding inguinal hernia is a risk factor for reoperation for recurrence. The Lichtenstein repair could be considered over the laparoscopic approach because of lower reoperation rates.