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Research Article
Assessment of a Quick Monofilament Suture in Paediatric Urology - A Prospective, Single Centre, Observational Cohort Study
Petra Baumann*,
Stefan Gfroerer
Issue:
Volume 11, Issue 6, December 2023
Pages:
124-131
Received:
Aug. 16, 2023
Accepted:
Oct. 12, 2023
Published:
Nov. 09, 2023
DOI:
10.11648/j.js.20231106.11
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Abstract: Absorbable sutures of different filament structure and absorption profile are commonly used for the repair of paediatric urological pathologies. Review of the literature shows that there is no consensus about the optimal suture technique and the ideal suture material. The selected type of the suture material (either monofilament or braided and either fast absorbable or long-term absorbable) as well as the suture technique (continuous or interrupted) are mainly based on the surgeon´s preference. The present prospective observational study assessed, for the first time, the clinical performance of a new quick-absorbable monofilament suture (Monosyn® Quick) made from a triblock copolymer in paediatric urology and compares the clinical outcome to the available literature data. A total of 53 children were enrolled. The intraoperative handling of the sutures was judged by the paediatric surgeons using a 5-point Likert scale (1: poor to 5: excellent). The handling parameters were knot security, tensile strength, pliability and tissue drag. The outcomes of the wound healings were rated by the patients/parents and observers (surgeons) using the Patient and Observer Scar Assessment Scale (POSAS) at 3 months ±10 days after surgery. The resulting hospital stay was short with an average of 1.32 ±1.27 days. Neither wound healing complications nor other adverse events occurred until 3 months after surgery. The mean POSAS value was 11.56 ±5.84 for the Patient component and 12.52 ±6.51 for the Observer component, indicating an excellent aesthetic result. All suture handling dimensions were mostly rated with 4 to 5 points revealing a comfortable and safe handling. In conclusion, this is the first study which prospectively evaluates the handling and clinical outcomes of a quick absorbable, monofilament suture in paediatric urological repairs. Results indicate that the investigated suture represents a viable suture for paediatric urological surgeries.
Abstract: Absorbable sutures of different filament structure and absorption profile are commonly used for the repair of paediatric urological pathologies. Review of the literature shows that there is no consensus about the optimal suture technique and the ideal suture material. The selected type of the suture material (either monofilament or braided and eith...
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Case Report
Abdominal Compartment Syndrome During Unilateral Biportal Endoscopic Spinal Surgery: A Case Report
Issue:
Volume 11, Issue 6, December 2023
Pages:
132-135
Received:
Oct. 26, 2023
Accepted:
Nov. 14, 2023
Published:
Nov. 24, 2023
DOI:
10.11648/j.js.20231106.12
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Abstract: Background: Abdominal compartment syndrome (ACS), a serious complication of organ failure, which is caused by acute and persistent increase of intra-abdominal pressure (IAP). Ascites is often ignored as a rare complication of unilateral biportal endoscopic (UBE) surgery. However, intra-abdominal hypertension (IAH) caused by massive ascites can lead to multiple organ dysfunction, which leads to the occurrence of ACS with a very high mortality rate. Case Presentation: In this case, the patient was a 74-year-old man who underwent UBE decompression for severe lumbar disc herniation. During the surgery, the airway pressure and stroke volume variation (SVV) were incerased gradually. when increasing saline pressure. Subsequently, the patient was diagnosed with ACS and treated with emergency diuretics and performing ultrasound-guided abdominal paracentesis to reduce abdominal pressure. After emergency treatment, the patient's IAH symptom was significantly relieved and his airway pressure and hemodynamics was rapidly improved. Conclusion: The possibility of ACS should be considered in the presence of persistently elevated airway pressure during UBE surgery. Without early diagnosis and timely management, ACS would have a high mortality rate. Considering the severity of ACS during surgery, we recommend taking measures to monitor intra-abdominal pressure during UBE surgery.
Abstract: Background: Abdominal compartment syndrome (ACS), a serious complication of organ failure, which is caused by acute and persistent increase of intra-abdominal pressure (IAP). Ascites is often ignored as a rare complication of unilateral biportal endoscopic (UBE) surgery. However, intra-abdominal hypertension (IAH) caused by massive ascites can lead...
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Case Report
Emphysematous Cholecystitis a Rare and Serious Clinical Entity: A Case Report of 6 Patients
Leh Bi Kalou Ismaèl*,
Bamba Inza,
Ekra Amos Serge,
Kouakou Blaise Amos,
Ghassam Mzahem,
Dager Nahed
Issue:
Volume 11, Issue 6, December 2023
Pages:
136-139
Received:
Nov. 05, 2023
Accepted:
Nov. 23, 2023
Published:
Dec. 06, 2023
DOI:
10.11648/j.js.20231106.13
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Abstract: Introduction: Emphysematous cholecystitis or pneumocholecystitis is a condition caused by gas-forming microorganisms that cause ischemia and necrosis of the vesicular wall. It is characterized by the presence of gas in the wall and lumen of the gallbladder. Its incidence is higher in diabetics. It is a rare disease entity responsible for high mortality. However, early diagnosis combined with prompt and appropriate treatment can prevent the progression to septic shock and then death. The objective of this study was to describe the diagnostic and prognostic aspects, in order to enrich the limited literature concerning this pathology. Patients and methods: This was a descriptive retrospective study that ran from January 2019 to December 2021. It concerned patients admitted for emphysematous cholecystitis. Results: We collected 6 records of patients admitted for 6 emphysematous cholecystitis. They accounted for 1.8% of all cholecystectomies (n=278) and 4% of emergency cholecystectomies (n=112). These were 4 men (67%) and 2 women (33%). The mean age was 76.4 years. Patients generally had several histories, including the hypertension-diabetes couple, but 1 patient did not have diabetes. The average consultation time was 3 days. The clinical picture was acute generalized peritonitis in 1 patient and localized irritation to the right hypochondrium in 5 patients with septic shock. The diagnosis in all patients was made by abdominal CT scan. One patient had an ASA IV score, the other 5 patients had a score from ASA to III. In all cases, after intense resuscitation, cholecystectomy was performed, of which four (67%) were performed laparoscopically and 2 (33%) were performed by laparotomy. Bacteriology of bile fluid revealed gram-negative baccilia (E. coli, Citrobacter koseri) and gram-positive cocci (staphylococcus aerus) in 5 cases and 1 case of sterile fluid. The mean length of hospital stay was 5 days (range: 5-18 days). The morbidity was a case of parietal suppuration treated with local dressing. No deaths. Conclusion: Rare pathology. Diagnosis is essentially based on imaging, in this case abdominal CT scans. The prognosis depends on early and appropriate medical-surgical management.
Abstract: Introduction: Emphysematous cholecystitis or pneumocholecystitis is a condition caused by gas-forming microorganisms that cause ischemia and necrosis of the vesicular wall. It is characterized by the presence of gas in the wall and lumen of the gallbladder. Its incidence is higher in diabetics. It is a rare disease entity responsible for high morta...
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