Background: Wound infection remains a common and serious complication after colonic surgery. Although many colonic operations are performed laparoscopically, it remains unclear whether this has any impact on the incidence of wound infection. Subcutaneous tissue oxygenation is an excellent predictor of surgical wound infection. The impact of open and laparoscopic colonic surgery on tissue oxygenation was compared.
Methods: Fifty-two patients undergoing elective open and laparoscopic left-sided colonic resections were evaluated in a prospective observational study. Anaesthesia management was standardized and intraoperative arterial partial pressure of oxygen was kept at 150 mmHg in both groups. Oxygen tension was measured in the subcutaneous tissue of the right upper arm.
Results: At the start of surgery subcutaneous tissue oxygen tension (PsqO(2)) was similar in both groups (mean(s.d.) 65.8(17.2) and 63.7(23.6) mmHg for open and laparoscopic operations respectively; P = 0.714). Tissue oxygen remained stable in the open group, but dropped significantly in the laparoscopic group during the course of surgery (PsqO(2) after operation 53.4(12.9) and 45.5(11.6) mmHg, respectively; P = 0.012).
Conclusion: Laparoscopic colonic surgery significantly decreases PsqO(2), an effect that occurs early in the course of surgery. As tissue oxygen tension is a predictor of wound infection, these results may explain why the risk of wound infection after laparoscopic surgery remains higher than expected.
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http://dx.doi.org/10.1002/bjs.5569 | DOI Listing |
J Med Case Rep
January 2025
Bone and Joint Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Background: Management of the extensive soft tissue injuries remains a significant challenge in orthopedic and plastic reconstructive surgery. Since the thumb is responsible for 40% of the functions of the hand, saving and reconstructing a mangled thumb is essential for the patient's future.
Case Presentation: This case report describes the management of a severe occupational thumb injury in a 25-year-old white Persian male who sustained an occupational injury to his left thumb, resulting in extensive burn, crush injury to the distal and proximal phalanx, and severe soft tissue damage to the first metacarpal, thenar, and palmar areas.
BMJ Open
January 2025
Cardiovascular Sciences, University of Leicester College of Medicine Biological Sciences and Psychology, Leicester, UK.
Objectives: To explore patients' and carers' preferences for postdischarge surgical wound monitoring.
Design: Explanatory mixed methods study with an online survey followed by online interviews.
Setting: The online survey was distributed via the Cardiothoracic Interdisciplinary Research Network and cardiac surgery patient and public involvement groups in London and Leicester, UK.
J Surg Res
January 2025
Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, Cleveland, Ohio. Electronic address:
Introduction: In the United States, while most nonmalignant polyps are effectively treated through endoscopic removal, colectomy remains a treatment option for selected cases of nonmalignant polyps (NMPs) and colon cancer. This study aimed to compare postoperative outcomes for colectomies in these two conditions, hypothesizing similar complication rates.
Methods: We conducted a retrospective review of the American College of Surgeons National Surgical Quality Improvement Program database from 2015 to 2021, including patients who underwent elective colectomies for colon cancer or NMPs.
Biomater Adv
January 2025
Department of Biological Sciences and Engineering, Indian Institute of Technology Gandhinagar, Gujarat, India. Electronic address:
Deep cutaneous wounds, which are difficult to heal and specifically occur on dynamic body surfaces, remain a substantial healthcare challenge in clinical practice because of multiple underlying factors, including excessive reactive oxygen species, potential bacterial infection, and extensive degradation of the extracellular matrix (ECM) which further leads to the progressive deterioration of the wound microenvironment. Any available individual wound therapy, such as antibiotic-loaded cotton gauze, cannot address all these issues. Engineering an advanced multifunctional wound dressing is the current need to promote the overall healing process of such wounds.
View Article and Find Full Text PDFInt J Surg Case Rep
January 2025
Department of Plastic and Breast Surgery, Aarhus University Hospital, Denmark.
Introduction: Necrotising soft tissue infection (NSTI) is an exceptionally dangerous infectious disease targeting soft tissues with high mortality as well as morbidity. The aim of reconstructive surgery after initial debridement is to maintain function as well as to achieve a satisfactory cosmetic result.
Presentation Of Case: A 50-year-old male presented with necrotising soft tissue infection on the thorax and left upper arm following mastectomy for breast cancer.
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