Damage Control Surgery

Objective: The basis of damage control surgery rests on quick control of life-threatening bleeding, injuries, and septic sources in the appropriate patients before restoring their physiological reserves as a first step followed by ensuring of the physiological reserves and control of acidosis, coagulopathy, and hypothermia prior to complementary surgery

Evaluation of the findings affecting the treatment decision in cases of adhesive intestinal obstruction

To establish a standard approach in patient management by determining the parameters that affect the decision of surgical or conservative treatment in adhesive small bowel obstructions. 94 patients who were admitted to the emergency department with symptoms of ileus and were diagnosed with adhesive intestinal obstruction according to clinical, examination and imaging findings were grouped as patients who were followed up with conservative methods (Group 1) and patients who underwent surgery (Group 2). All patients' laboratory values (hemoglobin, white blood cell (WBC), C- reactive protein (CRP), Blodd urea nitrogen (BUN)/creatinin, sodium, potassium, Lactate dehydrogenase (LDH), lactate and amylase) and imaging findings (air-fluid level in direct abdominal X-ray, increase in small intestine diameter (≥3.95 cm) in computerized tomography), wall thickness increase (>3mm), transition zone, fecal sign, and presence of contrast in the colon) were evaluated, and criteria for early surgery and non-operative follow-up-treatment criteria were determined. 72% (n:68) of the patients were classified as Group 1 and 28% (n:26) as Group 2, and no significant difference was found between the groups according to age and gender. Surgical treatment with increased lactate (r:0.326, p=0.001), diameter increase in the small intestine (r:0.299, p=0.003) and wall thickness increase (r:0.540, p [Med-Science 2023; 12(1.000): 217-23

Ultrasound-guided transversus abdominis block vs wound infiltration in patients undergoing open appendectomies

The aim of this study was to compare USG-guided Transversus Abdominis Plan Block (TAP) and wound infiltration in terms of intraoperative parameters, postoperative complications, VAS scores, analgesic requirement time in the patients undergoing open appendectomy. A total of forty patients, aged 18-65 years, ASA physical status I or II scheduled to undergo open appendectomy, were enrolled in this retrospective study and allocated to two groups. We reviewed the procedures that was experienced in 2014 retrospectively. Patients were allocated into two equal groups: Transversus Abdominis Plan Block (TAP group) (n=20) group and wound infiltration (WD group) (n=20) group. The patients demographic datas such as intraoperative hearth rate (HR), noninvasive blood pressure (NBP), duration of anesthesia, postoperative Visuel Analog Scala (VAS) values, complications (nausea, vomiting, somnolence, wound infection, ichting), duration of analgesic requirement were recorded retrospectively. The data were compared using t-test and chi-square test within the groups, p values < 0.05 were considered significant. Demographic datas such age, sex, weight, lenght and ASA status were similar in both groups. The duration of anesthesia (min) was significantly higher in Group TAP (49 ± 12,2 min) compared with Group WD (32,75 ± 10,06 min) (p=0.001). Intraoperative opioid consumption (mcg) was significantly shorter in Group TAP group. There was statistically significant difference between the two groups as regards the first time of analgesic requirement (Group TAP 24,74 ± 7,77 h, Group WD 3,5 ± 3,52 h). HR values were compared between the groups, it was no significiant difference found expect HR-20, HR-25 and HR-30. it was lower in Group TAP. We didnt find significant difference between groups at all hours for postoperative complications. VAS pain scores were lower in Group at rest and on couching at PACU, postoperative first, second and third hours (p [Med-Science 2018; 7(3.000): 634-8

Pilonidal sinüs apse olgularında erken cerrahi (unroofıng-küretaj) ile elektif cerrahinin (Karydakis flep tekniği) karşılaştırılması]

BACKGROUND: The aim of this study is to compare the effectiveness and success of early (acute) period local surgical intervention (unroofing-curettage) followed by dressing and secondary healing with the surgery performed in elective conditions (pilonidal sinus excision and Karydakis flap) following conventional abscess treatment (drainage-antibiotic therapy) in pilonidal sinus abscess cases. METHODS: The data of the patients treated for pilonidal sinus abscesses in our clinic between January 2012 and March 2013 were analyzed, retrospectively. Those who had early surgery were determined as Group S, and those who had elective surgery following drainage-antibiotic therapy were determined as Group K. Patients in both groups were compared in terms of age, gender, complications, recurrence rate and healing time. Patients were followed for an average of 14 months. RESULTS: Of the 53 patients included in the study, 28 were in Group S and 25 in Group K. The mean age and gender distribution of both groups were similar and a significant difference was not found between the groups in terms of complication development and recurrence. However, there was a statistically significant difference between the groups in terms of treatment duration (p=0.02). CONCLUSION: In treating acute pilonidal abscesses, the Karydakis method, following drainage-antibiotic therapy, is a preferable method due to its shorter treatment duration and higher patient comfort

Comparison Of Early Surgery (Unroofing Curettage) And Elective Surgery (Karydakis Flap Technique) In Pilonidal Sinus Abscess Cases

BACKGROUND: The aim of this study is to compare the effectiveness and success of early (acute) period local surgical intervention (unroofing-curettage) followed by dressing and secondary healing with the surgery performed in elective conditions (pilonidal sinus excision and Karydakis flap) following conventional abscess treatment (drainage-antibiotic therapy) in pilonidal sinus abscess cases. METHODS: The data of the patients treated for pilonidal sinus abscesses in our clinic between January 2012 and March 2013 were analyzed, retrospectively. Those who had early surgery were determined as Group S, and those who had elective surgery following drainage-antibiotic therapy were determined as Group K. Patients in both groups were compared in terms of age, gender, complications, recurrence rate and healing time. Patients were followed for an average of 14 months. RESULTS: Of the 53 patients included in the study, 28 were in Group S and 25 in Group K. The mean age and gender distribution of both groups were similar and a significant difference was not found between the groups in terms of complication development and recurrence. However, there was a statistically significant difference between the groups in terms of treatment duration (p=0.02). CONCLUSION: In treating acute pilonidal abscesses, the Karydakis method, following drainage-antibiotic therapy, is a preferable method due to its shorter treatment duration and higher patient comfort

The Relationship Between Hepatic Activity Index and Serum Tumor Necrosis Factor Alpha Levels in Patients with Chronic Active Hepatitis-B and Chronic Active Hepatitis-C

In the present study, we investigated the relationship between serum TNF-α levels and hepatic activity in liver biopsies of chronic hepatitis B and C patients.The study was performed on 30 chronic hepatitis B patients, 25 chronic hepatitis C patients and 25 healthy controls. Serum samples of patients who underwent biopsy and healthy controls were collected. Control group was seronegative for hepatitis and had normal liver function tests. TNF- α levels measured by ELISA. Knodells hepatic activity index was used in evaluation of liver biopsies. Serum TNF-α levels were determined higher in chronic hepatitis B and C patients than control group. HAI and TNF- α compared in chronic hepatitis B and C patients. Although we detected a relationship between HAI and TNF-α levels in chronic hepatitis B patients, no true correlation was shown in chronic hepatitis C patients. Cytokines have an important role in progression of chronic hepatitis B and C infections. There is a relationship between hepatic activity index and TNF-α level in chronic hepatitis B infection.But There is not relationship between hepatic activity index and chronic hepatitis C infection.only in two patients and both of them where in the middle of their reproductive age while as symptomatic ovarian cysts was a more common finding in unmarried females in 21-28 years of age group. This study concluded that laparoscopy has a diagnostic as well as a therapeutic implication in management of NSAP. [Med-Science 2015; 4(4.000): 2772-81

Factors Affecting Perioperative Patient Satisfaction with Regional Anesthesia: A Patient-Centered Survey Study

Objective: To determine the demographic and clinical characteristics that affect patient satisfaction with regional anesthesia