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

Phenolic Compounds in Bryophytes

Bazı briyofit türlerinin geçmişte kanamaların durdurulması, morluk ve yaraların iyileştirilmesinde kullanılmış olduğu, ayrıca güçlü antimikrobiyal ve biyolojik etkilerine dair bilimsel çalışmalar mevcuttur. Briyofitler fenolik bileşikler bakımından çok çeşitli içeriğe sahiptir. Fakat bugüne kadar sadece %5’inin kimyasal analizi yapılmıştır. Bu nedenle briyofitlerin fenolik içeriklerinin araştırılması önem kazanmaktadır ve briyofitler ülkemizde doğal olarak yetişen potansiyel bir kaynaktır. Ayrıca fenolik bileşikler doğal antioksidan maddelerdir. Serbest radikallerin meydana getirdiği reaksiyonları durdurarak veya engelleyerek onkolojik, kardiyovasküler ve akciğer hastalıkları gibi pek çok hastalıkların oluşumuna engel olurlar. Briyofitlerin doğal ürünler veya sekonder metabolitlerin yeni bir kaynağı olduğu düşünülmektedir.There are also scientific studies regarding some bryophyte species as having strong antimicrobial and biological effects as well as their usage for cessation of bleeding, healing wounds and bruises. Bryophytes have various contents in terms of phenolic compounds, but only %5 of them have been analyzed up to date. In this respect, the investigation of phenolic components of bryophytes gains importance. Bryophytes are potential sources that naturally grow in our country. As well as that phenolic compounds are natural antioxidant substances. They prevent oncological, cardiovascular and lung diseases by inhibiting or preventing reactions formed by free radicals. Bryophytes are considered as the new sources of natural products or secondary metabolite

Contributions to Bryophyte Flora of Zonguldak Province

With this study, some new bryophyte taxa have been added for the bryophyte flora of Zonguldak. One taxon from Anthoceratophyta (Hornworts), 11 from Marchantiophyta (Liverworts) and 55 from Bryophyta (Mosses), totally 67 taxa are determined as new for the bryophyte flora of Zonguldak province with examination of specimens collected from field trips held on different habitats between 2012-2014. Among them, 14 taxa are newly reported from A2 square according to the Henderson grid system. Considering previous studies, the number of specific and infra specific taxa in the research area are reached up to 282