Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study

Despite current guidelines, intraperitoneal drain placement after elective colorectal surgery remains widespread. Drains were not associated with earlier detection of intraperitoneal collections, but were associated with prolonged hospital stay and increased risk of surgical-site infections.Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien-Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P < 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P < 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk

A holistic framework of corporate website favourability

This paper extends the current knowledge of corporate website favourability (CWF) by developing a comprehensive conceptual model of its influence on corporate image, corporate reputation, loyalty and identification. The paper reviews previous studies on corporate websites from the perspectives of marketing, management, corporate identity and corporate visual identity in order to inform our understanding of the antecedents and consequences of CWF. The propositions and the conceptual framework present an approach by which a corporation can design and manage a favourable corporate website. A number of important contributions are offered: First, the paper adds to the understanding of CWF; second, it discusses the antecedents of CWF by drawing upon the existing literature; third, it is beneficial for practitioners in shaping CWF strategies, and fourth, it offers possible consequences of CWF and provides a framework for future testing

Three-dimensional vascularized self-assembled tumor spheroids

41st FEBS Congress on Molecular and Systems Biology for a Better Life -- SEP 03-08, 2016 -- Kusadasi, TURKEYWOS: 000383616900279FEB

The role of PRP and adipose tissue-derived keratinocytes on burn wound healing in diabetic rats

Introduction: Diabetic burn wounds and ulcers are significant complications of diabetic patients. The aim of this study was to investigate the use of platelet rich-plasma (PRP) and/or keratinocytelike cells (KLCs) in diabetic thermal wound rat model and to evaluate EGF, FGF-2, TGF-β1, COL1a2, MCP-1 and VEGF-α as wound healing markers at the gene expression level. Methods: In this study, we used adipose tissue as the source of mesenchymal stem cells (MSCs) and differentiated MSCs into KLCs. KLCs were characterized and transferred to the burn areas on the dorsum of streptozotocin (STZ)-induced diabetic rats. We prepared PRP from rat blood and evaluated its effect alone or in combination with KLCs. On the 3rd, 7th, 10th and 14th days after the treatment, the wound areas were measured and biopsy samples were excised from the wound areas of the KLCs and/or PRP-treated and the untreated diabetic rats to analyze the gene expression levels of the wound healing markers by qPCR. Results: We observed that, wound contraction started earlier in the PRP and/or KLCs-treated groups in comparison to the control group. However, PRP and KLCs when applied in combination showed additive affect in the wound healing. In all groups treated with KLCs and/or PRP, the gene expression levels of evaluated growth factors and COL1a2 increased, while MCP-1 levels decreased when compared to the untreated diabetic rats. In addition, the most prominent difference in qPCR results belongs to the combined PRP and KLCs-treated group. Conclusion: We demonstrated that applying PRP and KLCs in combination has a greater potential for the treatment of diabetic burn wounds. © 2018 The Author(s)