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Your search keyword '"D. J. Pournaras"' showing total 7 results
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7 results on '"D. J. Pournaras"'

1. Plus Sutures for preventing surgical site infection: a systematic review of clinical outcomes with economic and environmental models

Author

M. Edwards, S. Graziadio, J. Shore, N. D. Schmitz, T. Galvain, W. A. Danker, M. Kocaman, D. J. Pournaras, D. M. Bowley, and K. J. Hardy

Subjects
Triclosan, Antibiotic coating, Sutures, SSI, Surgery, Infection, RD1-811
Abstract

Abstract Background Surgical site infections (SSIs) represent ~ 20% of all hospital-acquired infections in surgical patients and are associated with prolonged hospital stay, admission to intensive care, and mortality. We conducted a systematic review with economic and environmental models to assess whether triclosan-coated sutures (Plus Sutures) provide benefits over non-coated sutures in the reduction of SSI risk. Methods Searches were conducted in fifteen databases. A total of 1,991 records were retrieved. Following deduplication and screening by two independent reviewers, 31 randomized controlled trials in adults and children were included in the review. Similarity of the studies was assessed by narrative review and confirmed by quantitative assessment. A fixed effects meta-analysis of SSI incidence model including all groups of patients estimated a risk ratio of 0.71 (95% confidence interval: 0.64 to 0.79) indicating those in the Plus Sutures group had a 29% reduction in the risk of developing an SSI compared with those in the control group (p

Published
2023
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2. Fascial defect closure versus bridged repair in laparoscopic ventral hernia mesh repair: a systematic review and meta-analysis of randomized controlled trials

Author

V Tyselskyi, D J Pournaras, I Demykhova, Yegor Tryliskyy, A Kebkalo, C S Wong, and V Poylin

Subjects
education.field_of_study, medicine.medical_specialty, business.industry, Population, medicine.disease, law.invention, Surgery, Clinical equipoise, Systematic review, Quality of life, Randomized controlled trial, law, Seroma, Meta-analysis, Medicine, Hernia, business, education
Abstract

Purpose Several studies have examined effectiveness of primary fascial defect closure (FDC) versus bridged repair (no-FDC) during laparoscopic ventral hernia mesh repair (LVHMR). The purpose of this study was to systematically review and meta-analyse randomized controlled trials (RCTs) which compared safety and effectiveness of two techniques. Methods Systematic literature searches (EMBASE, MEDLINE, PubMed, and CINAHL) were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines using predefined terms. RCTs comparing FDC and no-FDC in LVHMR were identified and retrieved. Primary outcomes were risk of recurrence and risk of major complications analyzed as a single composite outcome. Secondary outcomes were risks of seroma formation, clinical or radiologically confirmed eventration, incidence of readmission to hospital, postoperative changes in quality of life (QoL), and postoperative pain. Random effects modeling to summarize statistics were performed. The risk of bias was assessed using Cohrane's Risk of Bias tool 2. Results Three RCTs that enrolled total of 259 patients were included. There was clinical heterogeneity present between studies related to patients' characteristics, hernia characteristics, and operative techniques. There was no difference found in primary outcomes, risks of seroma formation, eventration, and chronic pain. There is conflicting evidence on how both techniques affect postoperative QoL or early postoperative pain. Conclusions Both techniques were detected to have equal safety profile and do not differ in risk of recurrence, seroma formation, risks of clinical or radiological eventration. Giving uncertainty and clinical equipoise, another RCT examining FDC vs no-FDC laparoscopic mesh repair separately for primary and secondary hernias using narrow inclusion criteria for hernia size on well-defined population would be ethical and pragmatic. Prospero registration CRD42021274581.

Published
2021

3. Fascial defect closure versus bridged repair in laparoscopic ventral hernia mesh repair: a systematic review and meta-analysis of randomized controlled trials

Author

Y, Tryliskyy, C S, Wong, I, Demykhova, V, Tyselskyi, A, Kebkalo, V, Poylin, and D J, Pournaras

Subjects
Pain, Postoperative, Seroma, Recurrence, Humans, Laparoscopy, Surgical Mesh, Herniorrhaphy, Hernia, Ventral, Randomized Controlled Trials as Topic
Abstract

Several studies have examined effectiveness of primary fascial defect closure (FDC) versus bridged repair (no-FDC) during laparoscopic ventral hernia mesh repair (LVHMR). The purpose of this study was to systematically review and meta-analyse randomized controlled trials (RCTs) which compared safety and effectiveness of two techniques.Systematic literature searches (EMBASE, MEDLINE, PubMed, and CINAHL) were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines using predefined terms. RCTs comparing FDC and no-FDC in LVHMR were identified and retrieved. Primary outcomes were risk of recurrence and risk of major complications analyzed as a single composite outcome. Secondary outcomes were risks of seroma formation, clinical or radiologically confirmed eventration, incidence of readmission to hospital, postoperative changes in quality of life (QoL), and postoperative pain. Random effects modeling to summarize statistics were performed. The risk of bias was assessed using Cohrane's Risk of Bias tool 2.Three RCTs that enrolled total of 259 patients were included. There was clinical heterogeneity present between studies related to patients' characteristics, hernia characteristics, and operative techniques. There was no difference found in primary outcomes, risks of seroma formation, eventration, and chronic pain. There is conflicting evidence on how both techniques affect postoperative QoL or early postoperative pain.Both techniques were detected to have equal safety profile and do not differ in risk of recurrence, seroma formation, risks of clinical or radiological eventration. Giving uncertainty and clinical equipoise, another RCT examining FDC vs no-FDC laparoscopic mesh repair separately for primary and secondary hernias using narrow inclusion criteria for hernia size on well-defined population would be ethical and pragmatic.CRD42021274581.

Published
2021

4. Staple line integrity test in sleeve gastrectomy

Author

D J Pournaras, E Howie, and D Mahon

Subjects
Sleeve gastrectomy, medicine.medical_specialty, medicine.medical_treatment, Gastric Bypass, Coloring agents, Anastomotic Leak, 030209 endocrinology & metabolism, 03 medical and health sciences, Surgical Staplers, 0302 clinical medicine, Surgical Stapling, medicine, Humans, Coloring Agents, business.industry, General Medicine, Obesity, Morbid, Surgery, Methylene Blue, Staple line, Laparoscopy, 030211 gastroenterology & hepatology, Gastroscopes, business, Technical Section
Published
2017

5. Authors' reply to Carradice

Author

M.-C. Nogaro, D. J. Pournaras, and A. Chaudhuri

Subjects
medicine.medical_specialty, business.industry, General Engineering, Exceptional circumstances, General Medicine, Primary care, medicine.disease, Asymptomatic varicose veins, Surgery, Intervention (counseling), General Earth and Planetary Sciences, Medicine, Medical emergency, business, health care economics and organizations, General Environmental Science
Abstract

Rather than tackling the wider challenge of NHS resources allocation, we focused on practical advice to GPs on managing patients with varicose veins.1 2 Intervention for uncomplicated or asymptomatic varicose veins currently falls into the low priority category that some primary care trusts fund in exceptional circumstances only. Our paper was intended to provide simple …

Published
2012

6. Varicose veins

Author

M-C, Nogaro, D J, Pournaras, C, Prasannan, and A, Chaudhuri

Subjects
Varicose Veins, Compression Bandages, General Engineering, Humans, Minimally Invasive Surgical Procedures, General Earth and Planetary Sciences, Female, General Medicine, Middle Aged, Family Practice, Medical History Taking, Referral and Consultation, General Environmental Science
Published
2012

7. Review of Advances in Anti-obesity Pharmacotherapy: Implications for a Multimodal Treatment Approach with Metabolic Surgery.

Author

C Sudlow A, W le Roux C, and J Pournaras D

Subjects
Combined Modality Therapy, Health Behavior, Humans, Life Style, Weight Loss, Anti-Obesity Agents therapeutic use, Bariatric Surgery, Obesity therapy
Abstract

There is a growing need for treatments for patients who would benefit from further weight loss following bariatric surgery or weight loss maintenance/long-term disease remission. Currently, therapeutic options are limited. Although largely dismissed previously, advances in weight loss pharmacotherapy now offer the possibility of achieving clinically significant weight loss. Historical comparisons drawn between the effects of medications vs surgery are generally inaccurate as novel classes of anti-obesity pharmacotherapy have since been developed and moreover, reflect an outdated approach in comparing medicine with surgery. Herein, we provide an overview of the most recently developed anti-obesity medications which may not only present a potentially innovative approach to medical treatment of obesity but may also inspire renewed enthusiasm for investigating what can be achieved through multimodal care.

Published
2019
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