Acta chirurgica Iugoslavica
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The employment of a diversity of prosthetic materials and several types of mesh different in construction is opening a new chapter in hernia surgery and tension-free techniques are becoming a "golden standard" for repairing abdominal wall defects, whereas the conventional methods, i.e., the tension techniques are performed on young patients having small direct, indirect, or femoral hernias. ⋯ The employment of PHS, UHS and 3DP devices, which have not yet been widely accepted in our hospitals, has had outstanding results in outpatient surgery. In addition, the type of anaesthesia and the 3D mesh construction prepare the way for a short hospital stay, smooth recovery and a swift return to normal activity.
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To analyze patients suffering from penetrating colon injuries management, clinical outcomes and factors, which predict higher morbidity and complications rate. ⋯ Fecal contamination of the peritoneal cavity and hypotension were determined to be crucial in choice of performing fecal diversion or primary repair. But the same criteria and PATI predict higher rate of postoperative complications and higher morbidity.
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Haemorrhage remains a leading cause of early death in injured and application of concentrated RBC transfusion in the treatment of multiple injuries is the basis and potential component of saving lives. The aim of this study was to analyze the received amount reimbursed blood in patients with severe trauma, depending on the outcome, severity and mechanism of injury. ⋯ Results showed that patients with lethal outcome received a larger amount of blood, there is a statistically significant correlation with ISS and AIS score for extremity injuries, and that larger amount of blood received patients injured in the traffic accidents, as pedestrians and motorcycle riders/bike, and there is no correlation with APACHE II score. Based on the importance of this topic for further research are necessary in this area in order to more accurately define indications and dosage and method of reimbursement of blood in patient with severe trauma.
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Determination of patient's functional status in early postoperative period is a delicate task, because of its general health status. Measures that can be used for that purpose are walk tests and functional status questionnaires. ⋯ 2MWT was sensitive to change postoperatively. Significant correlation of 2MWT postoperatively with DASI preoperatively, age and VAS, as well as prediction capacity of age and DASI, gives us possibility to utilize those parameters in early rehabilitation program in order to achieve maximal functional recovery of patients.
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Careful assessment of the fluid balance is required in the perioperative period since appropriate fluid therapy is essential for successful patient's outcome. Haemodynamic monitoring allows understanding the physiology of the circulation and changes of fluid balance in the perioperative period. This is diagnostic aid and guide for fluid replacement therapy. ⋯ Since the pulmonary artery catheter (PAC) had been introduced into clinical practice it was considered as a golden standard for cardiac output measurements, haemodynamic and fluid balance assessment. Nevertheless, in previous 10 years new minimally invasive and noninvasive simple techniques for haemodynamic monitoring and patient's hydroelectricity status evaluation have been developed. They can replace PAC under different clinical circumstances and some of these techniques