Reduction in post-operative pancreatic fistula with polyethylene glycol and recombinant human albumin sealant following stapled distal pancreatectomy

BACKGROUND: Postoperative pancreatic fistula (POPF) remains a significant cause of morbidity in patients undergoing distal pancreatectomy (DP). The use of polyethylene glycol (PEG) and recombinant human albumin sealant gel applied to the transected pancreatic margin in DP may reduce POPF rates and was assessed. METHODS: A retrospective single centre cohort study of patient undergoing DP at an Australian high volume tertiary institution between January 2015 and January 2021. Rates of POPF in patients undergoing stapled pancreatic transection with PEG sealant were compared to other methods. RESULTS: A total of 54 cases were identified for analysis, with 16 undergoing stapled DP combined with staple line application of PEG (PEG group). Most patients in the control group had stapled DP 92% (35 of 38), with 47% (18 of 38) combined with a reinforcing buttress, with or without the use other glue types. Overall, 28 of 54 (52%) developed a POPF, with a significantly lower rate in the PEG group (3 of 16 vs. 25 of 38 in the Control group; p = 0.003). Clinically significant Grade B/C POPF was lower in the PEG group (0 of 16 vs. 9 of 28 in the Control group; p = 0.045), and patients in the PEG group had a shorter median (range) length of hospital stay (6 [4-14] days vs. 10 [6-41] days p = 0.04). CONCLUSION: Stapled DP with the application of PEG and recombinant human albumin sealant to the transection line appears to be associated with a lower rate of clinically significant POPF

Superhydrophobic Coatings and Artificial Neural Networks: Design, Development and Optimization

Recently, considerable attention has been devoted to the development of superhydrophobic surfaces due to their advantageous antifouling and antimicrobial capacity. While significant effort has been devoted to fabricating such surfaces, very few polymeric superhydrophobic surfaces can be considered durable against various externally imposed stresses. Pyrogenic hydrophobic silica nanoparticles were used to confer superhydrophobic properties to the coatings. 450 samples were prepared using a layer-by-layer approach, deposing an epoxy resin or PDMS layer as adhesive on a substrate (PC/ABS), followed by one or more layers of silica nanoparticles, or silica-resin mixed layers. The best coating obtained shows a contact angle of 157° and a tape peeling grade resistance. The applied method involves the spray deposition of a multilayer coating composed of: silica layer/epoxy resin layer/silica layer, followed by partial curing of the coating (15 min, 70 °C); another silica layer is then sprayed on the surface and is cured for 10 min. Given the high number of parameters involved, process optimization is quite tricky. Artificial Neural Networks are the best tool to deal with multivariate analysis problems and for this reason, data from all the prepared samples were collected into a matrix and was used to train a neural network capable of predicting the degree of hydrophobicity of a silica nanoparticles-based coating