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

The role of additives in the manufacture of sheets of unsaturated polyester and postconsumer unsaturated polyester/glass fiber composites: Mechanical and dynamic mechanical properties

The storage of postconsumer glass fiber re-inforced unsaturated polyester composite impacts negatively on the environment because of the long lifetime and the volume/amount ratio of residuals, which are important aspects to be considered. Two types of additives were employed as an attempt to improve the mechanical properties of sheets manufactured with ground postconsumer glass fiber reinforced orthophthalic unsaturated polyester resin composite and virgin orthophthalic unsaturated polyester resin, a silane-coupling agent and an organic dispersant. Flexural and impact tests, and dynamic mechanical analyses, demonstrated that the coupling agent increased the mechanical properties, while the dispersant decreased these properties, compared to material without either additive. (C) 2004 Wiley Periodicals, Inc.9231834183

Glassy state on the undergraduate course in chemistry (physical chemistry).

We consider the relevance of the study of the glassy state properties and the glass transition as important topics of the physical chemistry for undergraduate courses of Chemistry. Two of the most important theoretical approaches for the description of the glassy state, the thermodynamic and the kinetic models, are summarized with emphasis on the physical chemistry aspects. Examples illustrating the glass transition of some materials are also presented.25233033