Limberg flap repair for pilonidal sinus disease

WOS: 000188739300015PubMed: 15043295PURPOSE: There are many methods described for the treatment of sacrococcygeal pilonidal sinus disease, and none of them has been accepted as an optimal modality. Plastic procedures have some advantages, such as short duration of hospitalization, quick healing time, low risk of wound infection, and lower recurrence rates. Our choice is Limberg flap repair; we present here our experience with this procedure. METHODS: From August 1998 to July 2000, 147 male patients were treated with Limberg flap repair under regional anesthesia in a soldier's hospital. RESULTS: No major anesthetic complication or wound infection developed. Three patients (2 percent) had a seroma (with negative culture) and six patients (4.1 percent) had partial wound detachment. Patients returned to full activity on the 10th to 25th postoperative day (mean, 18.8). Patients were followed from 1 to 40 (mean; 13.1) months. Seven patients (4.8 percent) had a recurrence. CONCLUSION: The Limberg flap procedure is an easy and effective technique. Patient comfort, quick healing time, early return to full activity, and low complication and recurrence rates are the important advantages of this procedure

A comparison of four intravenous sedation techniques and Bispectral Index monitoring in sinonasal surgery

WOS: 000182279400004PubMed: 12712779This study was performed to investigate the quality of different intravenous sedation techniques, and the correlation between the Bispectral Index (BIS) values and the Observer's Assessment of Alertness/Sedation (OAA/S) scores. Eighty patients undergoing sinonasal surgery were randomly assigned to one of four groups. Group MF received midazolam and fentanyl, group PF received propofol and fentanyl, group MR received midazolam and remifentanil, and group PR received propofol and remifentanil. Heart rate and mean arterial pressuure values were not different among the groups. SpO(2) decreased only after intravenous medication in groups MF and MR (P<0.017). Emesis was less common with propofol. A positive relationship existed between the BIS values and OAA/S scores during the operation in all groups and the strongest correlation was observed in group PR (r=0.565 and P<0.001). In conclusion, these four intravenous sedation techniques did not change mean arterial pressure, heart rate or SpO(2) clinically and produced a similar level of light sedation. The BIS was useful for monitoring of sedation during sinonasal surgery under local anaesthesia with intravenous sedation

The effect of peritoneal wrapping on colonic anastomosis healing in rats with impaired wound healing due to superior mesenteric artery occlusion

45th Congress of the European-Society-for-Surgical-Research -- JUN 09-12, 2010 -- Geneva, SWITZERLANDWOS: 000281136400435…European Soc Surg Re

The effects of anesthetic techniques on acute phase response at delivery (anesthesia and acute phase response)

WOS: 000180795300012PubMed: 12554063Objectives: To investigate the effects of anesthetic techniques and delivery types on stress response during uncomplicated delivery. Design and methods: Forty pregnant women at term were divided into four groups. Group-I, cesarean section with general anesthesia; Group-II, section with spinal anesthesia; Group-III, section with epidural anesthesia; and Group-IV, vaginal delivery with epidural analgesia. C-reactive protein and albumin were measured on hospital admission, immediately after delivery and 24 h later. Results: Albumin and CRP levels decreased significantly in Group-II and Group-III, just after delivery. CRP increased significantly in all groups at the 24(th) hour of delivery. The effect of hemodilution on CRP and Albumin, due to volum loading, during spinal and epidural anesthesia disappeared after 24 h. Conclusion: We found no influence of anesthetic techniques on acute phase response except hemodilution effect. In the view of delivery types, vaginal delivery caused less stress response than section. (C) 2003 The Canadian Society of Clinical Chemists. All rights reserved

The effect of G-CSF in an experimental MRSA graft infection in mice

Eurosurgery 2000 Meeting -- JUN 21-24, 2000 -- ISTANBUL, TURKEYWOS: 000233300500003PubMed: 16249165Wound infection after prosthetic material implantation is a troublesome complication with an incidence of 2% to 10%. The effect of granulocyte colony-stimulating factor (G-CSF) was studied in an experimental methicillin-resistant Staphylococcus aureus (MRSA) graft infection model. Eighty adult mice were used. Under general anesthesia an abdominal incision of 2 cm in length was performed. A subcutaneous cavity of 2 x 2 cm in size was created. Polypropylene mesh pieces of 2 x 1 cm and MRSA solution of 0.1 ml of 10(8) CFU/mL were used. G-CSF was applied systemically or locally in a dosage of 0.02 MU/30 g body weight. There were 8 groups: group I, wound + MRSA; group II, wound + mesh + MRSA; group III, wound + mesh + MRSA + G-CSF (ip, 48 h before operation); group IV, wound + mesh + MRSA + G-CSF (ip, 24 h before operation); group V, wound + mesh + MRSA + G-CSF (locally, into the cavity); group VI, wound + mesh (incubated in G-CSF solution for 4 h) + MRSA; group VII, wound + mesh + MRSA + G-CSF, ip, 24 h from operation; and group VIII (positive control group), wound + mesh + MRSA + Teicoplanin (0.03 mg/30 g body weight, ip, 1/2 h before operation). Three days after, animals were killed and incisions were examined for possible infection or abscess formation and wound failure. Meshes were removed; after vortexing and dilution, samples were incubated with 5% agar media. Results of bacterial incubation were evaluated 24 h and 48 h later. There were symptoms of wound infection and abscess formation in all groups except group VIII. In group VIII, MRSA was isolated in 7 events with a colony count below 10(3). Bacterial counts were above 106 (10(6)-10(8)) in all other groups. Thus, it was observed that wound infection could be created with this model, but G-CSF could not prevent the development of wound infection, whether it was administered systemically or locally. Teicoplanin decreased the number of colony-forming units of MRSA, and prevents wound infection in this MRSA wound infection model

Case report: Intramesocolic malposition of the gallbladder

[No abstract available

THE EFFICACY OF CARBOXYMETHYL CHITOSAN ON PREVENTING POSTSURGICAL ADHESIONS VERSUS PETROLEUM JELLY IN RAT MODEL

WOS: 000344610900039

Gold and gold-palladium coated polypropylene grafts in a S-epidermidis wound infection model

WOS: 000235771200010PubMed: 16139304Background. The use of non-absorbable mesh grafts in both abdominal wall defects and inguinal hernias are impossible in the presence of contamination. This study was conducted for evaluation of the efficiencies of polypropylene mesh grafts coated with gold and palladium-gold. Materials and methods. Ten piece of 1 x 2 cm. of polypropylene mesh grafts were used in each group of naive, gold-coated, and palladium-gold-coated. The grafts were incubated in physiological saline buffered and 0.5 McFarland slime positive Staphylococcus epidermidis for 24 h. At intervals of 6,12,24,48, 72 h grafts were washed with saline and vortexed for 2 min in 2 ml of physiological saline. There were 100 mu l of samples of vortexed material incubated in blood agar and 24 h later, colony numbers were assessed. In the second part of study, the grafts were implanted below the musculoaponeurotic layer at inguinal. region of rats following the same procedure of incubation and washing. On the 8th day, the rats were examined for infection rate and their wound cultures were obtained. Results. The least amount of bacterial growth was detected in the samples obtained from gold-palladium coated grafts; whereas the highest rate of growth was found in samples of naive grafts. The superficial surgical site infection rate was 0% in gold-palladium coated, 30% in gold-coated and 100% in naive polypropylene group. The bacterial growth rate from wound cultures confirmed the superficial surgical site infection rates in all groups. Conclusion. Prosthetic graft infection with S. epidermidis can be prevented by coating the graft with gold-palladium or gold. (c) 2006 Elsevier Inc. All rights reserved